MITA member companies have introduced innovative
medical imaging technologies to the market,
including low-dose computed tomography (CT), high-intensity focused ultrasound (HIFU), novel imaging
agents, and advanced artificial intelligence (AI) algorithms.
These technologies play an essential role in our nation’s
health care infrastructure and the care pathways of
screening, staging, evaluating, managing, and effectively
treating patients with cancer, heart disease, neurological
degeneration, COVID-19, and numerous other medical
conditions.
Medical imaging saves lives, but only if patients have
adequate access to these technologies. Policymakers can help by ensuring appropriate and adequate
reimbursement policies.
DEVELOP MARKET PATHWAYS THAT INCENTIVIZE INNOVATION
Too often, innovative devices are authorized by the FDA but aren’t covered by Medicare until additional
evidentiary requirements have been met. This creates a
“Catch-22” scenario in which, without adequate coverage
or reimbursement, access to an FDA approved diagnostic
or therapy is limited to only those who can afford to pay
out-of-pocket. This results in a reduced ability to collect
the very evidence needed to support reimbursement.
MITA supports policies intended to reduce or eliminate
the lag time between FDA authorization of a device or
drug and the subsequent provision of Medicare coverage
- giving seniors faster access to life-saving technologies
and cutting-edge diagnostics.
SUPPORT PROVIDERS OF IMAGING SERVICES
In 2023, Medicare called for significant cuts to provider
payment in the Medicare Physician Fee Schedule (MPFS)
Final Rule. While Congress took action to address
reductions in the MPFS at the end of last year by reducing
the payment cut to -2.5% in 2023 and delaying the implementation of the -4% PAYGO sequestration cut, long-term solutions are needed to stabilize physician and provider payment.
While this Congressional action was needed, temporary provider relief fails to take into account the serious financial pressures of rising inflation, escalating supply costs, and a dwindling workforce faced by physician- owned practices and hospital-based clinics and imaging facilities. Coupled with annual payment cuts, these factors threaten access to medical imaging technologies that empower healthcare providers to make better-informed medical decisions that lead to overall cost savings and improved patient health outcomes.
Ultimately, Congress and the Centers for Medicare & Medicaid Services (CMS) must address the ongoing, systemic dysfunction in Medicare payment policy by addressing the annual negative conversion factor rate adjustment, budget neutrality requirements, and clinical labor pricing changes. These, and other changes, are necessary to stop annual Medicare cuts and protect patients’ ability to access the care they need.