Despite strong efforts by ISCD and our sister societies in the Fracture Prevention Coalition, a provision to increase Medicare payments for DXA was not included in the fiscal cliff legislation. The bill, The American Taxpayer Relief Act of 2012, HR 8 was adopted by Congress on January 1, 2013. The bill included a number of other provisions affecting Medicare payments to physicians that have caused some confusion. Below is a summary of how the various Medicare provisions were resolved in the act and the bottom line for DXA:
1. The new law blocks the 27% Medicare physician payment cut due Medicare Sustainable Growth Rate (SGR) formula, freezing Medicare payments at the 2012 level through calendar year 2013.
2. The automatic "sequestration" cuts that would have also have reduced Medicare physician payments by another 2% are postponed for two months until 3/1/12013.
3. The bill authorizes cuts to reimbursement for advanced imagining services such as MRI and CT. These cuts do NOT apply to DXA, which is not considered an advanced imaging service.
As a practical matter, the new payment rate for DXA in the office setting dropped on 1/1/2013 from a national average of $56 to $50.
The Fracture Prevention Coalition is discussing potential legislative opportunities to secure a payment fix for DXA in the new year. The 2% sequestration cuts to Medicare that are now scheduled to take place on 3/1/2013, will be part of the next round of negotiations between Congress and the President on deficit reduction and increasing the national debt ceiling. These negotiations which will take place in mid February, will be our next opportunity to address the DXA cuts.
ISCD will continue to keep you posted about any new developments regarding DXA reimbursement. If you have questions, please contact ISCD Legislative Counsel, Donna Fiorentino at 860-402-2159 or email@example.com.