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Home > Medical Professionals > Health Policy and Government Relations > Physician Payment > Final Rule On Deficit Reduction Act Release November 1, 2006

Final Rule On Deficit Reduction Act Released November 1, 2006

SVS submitted comments on October 10, 2006 to the Centers for Medicare and Medicaid Services (CMS) on the proposed rule on the Deficit Reduction Act (DRA) of 2005. The comments were on three issues:
 
1. Opposition to proposed adjustments for payments for imaging services;
2. Support for the proposed addition of ultrasound screening for abdominal aortic aneurysms (AAA);
3. Opposition to the Medicare Physician Payment Rate for 2007.

Along with letters from 18 members of Congress, including five who are physicians, (see letter) and letters from numerous SVS members, SVS requested that non-invasive vascular diagnostic studies be exempt from DRA cuts. Arguments included the following: physiologic vascular studies do not include imaging; Doppler velocity measurement is the most important aspect of duplex exams; and imaging in arterial duplex scans constitutes the minority of vascular study data.  In the final rule, five vascular lab codes were excluded from the DRA provisions (93875, 93922, 93923, 93924, 93965) because CMS agreed these physiologic codes do not include imaging. This is significant because there were very few codes excluded from DRA cuts in the final rule. However, the duplex codes remain under the DRA and payments will decrease substantially.

SVS will continue to support a legislative solution to exempt additional non-invasive vascular studies from DRA cuts. Recently, SVS helped create and signed onto a proposal supported by the Access to Medical Imaging Coalition, which would exclude all ultrasound services from DRA cuts and provide a one year delay for cuts to all imaging services. There could be action on this proposal during the “lame duck” session of Congress following the November elections.

A positive development was the finalization of the AAA screening benefit for at-risk Medicare beneficiaries, which will be available on January 1, 2007. Male ever-smokers and men and women with a family history of AAA are eligible to receive the one-time screening if they participate in the Welcome to Medicare physical exam. CMS highlighted the AAA screening benefit as part of its press release on the final rule. SVS is in the process of educating primary care physician and non-physician organizations about the availability of this benefit and asking them to publicize its availability to their members.

Finally, the rule requires CMS to implement a 5% decrease in payment for all physician-related services for 2007 using the Sustainable Growth Rate formula. SVS and many other health care associations continue to work with Congress, requesting that it block the SGR pay cut and enact an increase in the Medicare payment rate during the lame duck session later this year. A negative update went into effect in 2002, but for the last four years, Congress has intervened by suspending the requirements of the formula and enacting either an increase or a freeze.