House members urge CMS to stave off ‘disruptive’ cuts that would harm heart PET

A bipartisan group of U.S. House members are urging the federal government to pull back on proposed cuts that could severely hamper heart treatment using PET.

The 43 elected officials join a collection of several industry trade groups who are opposing cuts as high as 80% to reimbursement for such imaging services. CMS spelled out those changes as part of its 2020 Medicare Physician Fee Schedule released earlier this year.

Under the proposed rule, Medicare fee-for-service reimbursement for PET multiple perfusion services would drop by about 72%, House members note in their Sept. 27 letter to CMS Administrator Seema Verma.

“We are concerned these reductions will drive cardiac PET services out of physician offices where the majority of cardiac PET is provided and into hospitals, which could limit patient access to this important imaging modality, particularly in rural and underserved areas, and beneficiary and health system costs,” they wrote.

“Physician practices depend on payment predictability and stability,” they added later in the letter. “Immediate reductions of this scale could be disruptive. We urge you to delay these cuts and work with stakeholders to improve the accuracy of equipment inputs when calculating PET reimbursement, thereby mitigating cuts of the proposed magnitude.”

The group of U.S. Congress members—led by Ron Kind (D-WI), Mike Kelly (R-PA), and Ronald Estes (R-KS)—join a host of industry trade groups in their opposition. Others fighting the fee schedule include the American College of Cardiology, American College of Nuclear Medicine, American Society of Nuclear Cardiology, Cardiology Advocacy Alliance and Society of Nuclear Medicine and Molecular Imaging. The latter thanked its members for reaching out to Congress about proposed cuts last week.

The 2020 Medicare Physician Fee Schedule is available on the CMS website. The public comment period for the rule ended on Friday, Sept. 27.