ACR calls out ‘overly biased’ argument made by CMS in IPPS proposed rule

The American College of Radiology (ACR) has submitted written comments to CMS about the Inpatient Prospective Payment System (IPPS) proposed rule for Calendar Year 2019. The eight-page document is signed by William T. Thorwarth Jr., MD, the ACR’s CEO.

One of the ACR’s comments regards text in the CMS proposal that connects a need for improved hospital pricing transparency with patients who receive “surprise bills.”

The ACR “applauds the overarching effort … to improve patient accessibility and usability of charge information hospitals are required to post on the Internet under Section 2718(e) of the Public Health Service Act,” according to the written comments. However, the ACR believes these specific issues related to surprise bills have more to do with private insurance providers than Medicare.

“Any discussion of ‘surprise bills’ is largely inapplicable to Medicare and outside the scope of the IPPS rulemaking process,” Thorwarth wrote. Such discussions about surprise bills, he added, as “overly biased against physicians and mischaracterizes the role of the insurer.”

In the written comments, the ACR also encouraged CMS to “protect the free flow of clinical information exchanged between users of hospital EHR systems and external medical imaging providers” and wrote at length about evidence that separate cost-to-charge ratios for CT and MR cost centers “are incorrect and are causing payments for hospital patients in need of CT and MR services to be too low.”

The full written comments can be read on the ACR’s website.

Michael Walter
Michael Walter, Managing Editor

Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.

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