Overuse of Medical Scans Is Under Fire As Billings for CT-Scans, MRIs Soar, Medicare Panel To Recommend More Scrutiny | WSJ | 1.13.05
The government is likely to join a growing number of private health plans that are attempting to rein in the use of diagnostic scans.
This week, a Medicare advisory panel is expected to make several recommendations to Congress on the best way to curb the sharply escalating costs of MRIs and other scans.
The recommendations will be voted on by the panel today or tomorrow and aren’t final. But one that is being considered would let Medicare edit claims to possibly reduce payment for tests that scan two body parts at once but have often been billed as two separate procedures. Another would require doctors and imaging centers to meet certain quality criteria in order to bill Medicare for services.
The idea is to join efforts already begun by private insurers to curb the costs of advanced imaging, which are fast approaching $100 billion a year. …
Questions patients should ask to help ensure they are getting an appropriate and high-quality scan.
- Ask why you are being referred to a particular center.
- Does your doctor have a financial interest in that particular facility?
- Ask about the radiologist’s specialty — e.g., orthopedics, pediatrics, or neuro-radiology. His or her specialty should be relevant to your condition.
- Ask about the age of the scanner and how recently the software was upgraded. Both should be less than a few years old.
- Ask about the strength of the scanning equipment. Closed machines should be at least 1 Tesla (a measure of scan strength).
- For open machines, half a Tesla is the norm but may be inadequate. In some cases, scans that produce low-quality images may be meaningless and require a repeat scan. Patients typically pay at least part of that added cost.
The lyrics to Rawhide come to mind… For the patient, excellent questions to be asked!