Medicare panel mulls oversight of outpatient imaging services

Evidence of quality problems in physician offices could lead to greater regulation.

By Markian Hawryluk, AMNews staff. April 12, 2004.

Washington -- Rapid growth in Medicare spending for imaging services and concerns about the safety of equipment in doctors' offices soon could lead to tougher federal oversight and regulation.

At its March meeting, the Medicare Payment Advisory Commission considered the prospect of using private-sector strategies to try to rein in Medicare spending for outpatient imaging services, but it was patient safety issues that caught the panel's attention.

Cherrill Farnsworth, CEO and chair of HealthHelp Inc., a radiology benefit management company, said her firm performs site visits to physicians' and other practitioners' offices to inspect imaging equipment and had found many safety problems.

"I don't think Medicare enrollees or any citizens of our country should be exposed to some of the old imaging equipment and high radiation doses that we see," Farnsworth said. "We've seen a lot of equipment that's pretty shocking that's used in physicians' offices."

HealthHelp recently undertook a review of imaging equipment used by chiropractors for a health plan in Utah. It found that 49% of the chiropractors used equipment that did not meet basic safety standards. And even when equipment is in good condition, doctors are not always trained on how to read the images correctly.

"We have discovered that the quality in a non-radiologist's office on equipment and on the professional read is very low," Farnsworth said. Studies have shown that non-radiologists have a 10% to 35% error rate in their imaging examinations. And 60% to 90% of all doctor-based imaging is performed by non-radiologists.