Radiologists to Lawmakers: We Told You So
They warned the state that private radiology practices would close their doors if the state adopted lower Medicaid reimbursement rates and it happened.
Radiologists told the Public Health Committee on Wednesday that the reduction in rates has caused one of two private practices in Hartford to close and one in Meriden to stop accepting new Medicaid patients. That means low-income Medicaid patients will only have access to chest X-rays and mammograms through a hospital.
“Six dollars for a chest X-ray! Are you kidding?” Rep. Brian Becker, D-West Hartford, asked the committee. “It costs a medical office more than six dollars just to send out a bill for a chest X-ray.”
The Public Health Committee was hearing about a bill that would require the Department of Public Health to study the impact of the new radiology rates to determine if access has been impacted.
“Reducing access to health care specialties for low-income patients is a serious concern,” Becker said.
Ideally, Becker would be fighting to restore the funding, but with the state’s budget woes it’s unlikely the General Assembly will be able to restore the 42.5 percent rate cut for radiology services approved last year.
In the meantime, Becker said he wants to quantify the problem so lawmakers aren’t just dealing with anecdotal stories about the impact of the reduction.
But Department of Public Health Commissioner Raul Pino said his department doesn’t have the resources to conduct the study. Pino testified that the Department of Social Services expects to have information about the reduction in radiology by April.
Dr. Robert Russo, the immediate past president of the Connecticut State Medical Society, warned lawmakers back in June that this would happen.
The budget signed into law last summer annualized a cut in radiology rates for Medicaid patients by $4.45 million. It restored a previous $500,000 cut to radiology rates for ultrasounds in high-risk pregnancies, but other radiology services will be reimbursed at 57.5 percent of the 2007 Medicare fee schedule.
Russo, who is retired, said there’s no question that radiologists are “cost shifting” in order to serve Medicaid patients.
The reimbursement rate for mammograms is $20 and $6 for a chest X-ray.
“I am worried about those patients in the inner cities,” Russo said.
Jacqueline Roberts, from the Nubian Sisters Cancer Support Group, told the committee that she’s a two-time cancer survivor so this issue is personal.
“The radiology and imaging cost cuts the state made is being felt in the community,” Roberts said. “This is hitting our cities hard.”
She called the cut “pennywise and pound foolish” because patients will be sent to hospitals for these services where they will cost more.
“These are life saving tests, so let’s get the data we need to figure out how we can fix the problem,” Roberts urged.
Thomas Farquhar, a doctor practicing radiology in Hartford, agreed that having the data would be useful, but it’s not hard to see that the reduction in rates has already impacted access to these services.
“We are very worried decreased reimbursement will ultimately limit Medicaid patient access to these vital services,” he said.
Recently, the Susan G. Komen Foundation announced that Connecticut has the highest incidence of breast cancer in the country.
“Is now really the time to hamper access to screening exams like mammography?” Farquhar asked.
Farquhar said practices are hopeful these cuts can be restored and are waiting to make a decision on whether to close their doors.