Distinction of Echo from Advanced Diagnostic Imaging

We were very troubled to see that the original Sustainable Growth Rate (SGR) repeal bill released by the Finance and Way and Means Committees contained a provision that would have been very harmful to all physicians ordering and performing echocardiograms, in both hospitals and private practices. The provision lumped cardiac ultrasound in with “advanced diagnostic imaging,” thereby placing echo in the path of additional payment restrictions and requiring prior authorization for some ordering physicians. The concerns were that the required echocardiography Appropriate Use Criteria (AUC) are not broad enough in scope at this time, that infrastructure to implemented these AUC requirements has not been established, and that authorization increases already strained staffing costs.

The committees of jurisdiction acted very quickly on this proposed legislation. Working with a very tight deadline, ASE’s lobbyist was able to have cardiac ultrasound removed from the proposed bill. ASE lobbied legislators, worked with committee staffs, and mobilized our grassroots to ensure that the final committee language did not contain this mandate. There are currently three SGR bills before Congress pertaining to the SGR repeal, and none includes the echocardiography AUC provision.

The Playing Field is Not Level

Last summer, ASE engaged a lobbyist to deliver our message on Capitol Hill. At that time, MedPAC (an advisory group that provides recommendations to Congress on Medicare legislation) recommended that Medicare payment for hospital outpatient services be limited to the amounts paid to physicians’ offices. Hospital outpatient echocardiography was among the primary targets, and our lobbyist has repeatedly met with key legislators to dissuade Congress from implementing these draconian (up to 60%) cuts. This January, MedPAC voted formally to endorse leveling the playing field between physicians’ offices and hospital outpatient departments for 66 APCs, including echo. We urge you to get involved by contacting your legislators. It is absolutely clear that hospitals nationwide will be severely hurt if echo payments are “levelled” to match the unjustified physician office cuts of >50% imposed by Centers for Medicare & Medicaid Services (CMS) over the past four years. ASE’s able Advocacy team is working hard on this “leveling” issue, and occasionally email “blasts” from ASE will solicit a quick contact with your legislators.