Medical Imaging Modernization Act of 2015

Summary: Medical Imaging Modernization Act of 2015 This bill amends title XVIII (Medicare) of the Social Security Act to make a special rule reducing by 20% the payment under the physician fee schedule and the hospital outpatient prospective payment system for the technical component of imaging services that are x-rays taken using film. Imaging services that are x-rays taken using computed radiography technology shall have the technical component payment: (1) for services furnished from 2018 through 2022 reduced by 7%; and (2) for services furnished during 2023 or a subsequent year reduced by 10%. Reduced expenditures attributable to incentives to transition to digital radiography under the physician fee schedule are exempt from budget-neutrality calculation. The Department of Health and Human Services may not apply a multiple procedure payment reduction to the professional component of imaging services furnished before it publishes, as part of the Medicare Physician Fee Schedule Proposed Rule for a year, a empirical analysis of the Resource-Based Relative Value Scale (commonly known as the &quot;RBRVS&quot;) Data Manager information used to determine what, if any, efficiencies exist within the professional component of imaging services when two or more studies are performed on the same patient on the same day. These payment reductions under the hospital outpatient prospective payment system for the transition from traditional x-ray imaging to digital radiography shall apply without regard to budget neutrality.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medical Imaging Modernization Act of 
2015''.

SEC. 2. MEDICARE PAYMENT INCENTIVE FOR THE TRANSITION FROM TRADITIONAL 
              X-RAY IMAGING TO DIGITAL RADIOGRAPHY AND OTHER MEDICARE 
              IMAGING PAYMENT PROVISION.

    (a) Physician Fee Schedule.--
            (1) Payment incentive for transition.--
                    (A) In general.--Section 1848(b) of the Social 
                Security Act (42 U.S.C. 1395w-4(b)) is amended by 
                adding at the end the following new paragraph:
            ``(9) Special rule to incentivize transition from 
        traditional x-ray imaging to digital radiography.--
                    ``(A) Limitation on payment for film x-ray imaging 
                services.--In the case of imaging services that are X-
                rays taken using film and that are furnished during 
                2017 or a subsequent year, the payment amount for the 
                technical component (including the technical component 
                portion of a global fee) of such services that would 
                otherwise be determined under this section (without 
                application of this paragraph and before application of 
                any other adjustment under this section) for such year 
                shall be reduced by 20 percent.
                    ``(B) Phased-in limitation on payment for computed 
                radiography imaging services.--In the case of imaging 
                services that are X-rays taken using computed 
                radiography technology--
                            ``(i) in the case of such services 
                        furnished during 2018, 2019, 2020, 2021, or 
                        2022 the payment amount for the technical 
                        component (including the technical component 
                        portion of a global fee) of such services that 
                        would otherwise be determined under this 
                        section (without application of this paragraph 
                        and before application of any other adjustment 
                        under this section) for such year shall be 
                        reduced by 7 percent; and
                            ``(ii) in the case of such services 
                        furnished during 2023 or a subsequent year, the 
                        payment amount for the technical component 
                        (including the technical component portion of a 
                        global fee) of such services that would 
                        otherwise be determined under this section 
                        (without application of this paragraph and 
                        before application of any other adjustment 
                        under this section) for such year shall be 
                        reduced by 10 percent.
                    ``(C) Computed radiography technology defined.--For 
                purposes of this paragraph, the term `computed 
                radiography technology' means cassette-based imaging 
                which utilizes an imaging plate to create the image 
                involved.
                    ``(D) Implementation.--In order to implement this 
                paragraph, the Secretary shall adopt appropriate 
                mechanisms which may include use of modifiers.''.
                    (B) Exemption from budget neutrality.--Section 
                1848(c)(2)(B)(v) of the Social Security Act (42 U.S.C. 
                1395w-4(c)(2)(B)(v)) is amended, by adding at the end 
                the following new subclause:
                                    ``(X) Reduced expenditures 
                                attributable to incentives to 
                                transition to digital radiography.--
                                Effective for fee schedules established 
                                beginning with 2017, reduced 
                                expenditures attributable to 
                                subparagraph (A) of subsection (b)(9) 
                                and effective for fee schedules 
                                established beginning with 2018, 
                                reduced expenditures attributable to 
                                subparagraph (B) of such subsection.''.
            (2) Elimination of application of multiple procedure 
        payment reduction.--Section 1848(b)(4) of the Social Security 
        Act (42 U.S.C. 1395w-4(b)(4)) is amended by adding at the end 
        the following new subparagraph:
                    ``(E) Elimination of application of multiple 
                procedure payment reduction.--
                            ``(i) In general.--Not later than January 
                        1, 2016, the Secretary shall not apply a 
                        multiple procedure payment reduction policy to 
                        the professional component of imaging services 
                        furnished in any subsequent year that is prior 
                        to a year in which the Secretary conducts and 
                        publishes, as part of the Medicare Physician 
                        Fee Schedule Proposed Rule for a year, the 
                        empirical analysis described in clause (ii).
                            ``(ii) Empirical analysis described.--The 
                        empirical analysis described in this clause is 
                        an analysis of the Resource-Based Relative 
                        Value Scale (commonly known as the `RBRVS') 
                        Data Manager information that is used to 
                        determine what, if any, efficiencies exist 
                        within the professional component of imaging 
                        services when two or more studies are performed 
                        on the same patient on the same day. Such 
                        empirical analysis shall include--
                                    ``(I) work sheets and other 
                                information detailing which physician 
                                work activities performed given the 
                                typical vignettes were assigned 
                                reduction percentages of 0, 25, 50, 75 
                                and 100 percent;
                                    ``(II) a discussion of the clinical 
                                aspects that informed the assignment of 
                                the reduction percentages described in 
                                subclause (I);
                                    ``(III) an explanation of how the 
                                percentage reductions for pre-, intra 
                                and post-service work were determined 
                                and calculated; and
                                    ``(IV) a demonstration that the 
                                Centers for Medicare & Medicaid 
                                Services has consulted with practicing 
                                radiologists to gain knowledge of how 
                                radiologists interpret studies of 
                                multiple body parts on the same 
                                individual on the same day.''.
    (b) Payment Incentive for Transition Under Hospital Outpatient 
Prospective Payment System.--Section 1833(t)(16) of the Social Security 
Act (42 U.S.C. 1395(t)(16)) is amended by adding at the end the 
following new subparagraph:
                    ``(F) Payment incentive for the transition from 
                traditional x-ray imaging to digital radiography.--
                Notwithstanding the previous provisions of this 
                subsection:
                            ``(i) Limitation on payment for film x-ray 
                        imaging services.--In the case of imaging 
                        services that are X-rays taken using film and 
                        that are furnished during 2017 or a subsequent 
                        year, the payment amount for the technical 
                        component (including the technical component 
                        portion of a global fee) of such services that 
                        would otherwise be determined under this 
                        section (without application of this paragraph 
                        and before application of any other adjustment 
                        under this subsection) for such year shall be 
                        reduced by 20 percent.
                            ``(ii) Phased-in limitation on payment for 
                        computed radiography imaging services.--In the 
                        case of imaging services that are X-rays taken 
                        using computed radiography technology (as 
                        defined in section 1848(b)(9)(C))--
                                    ``(I) in the case of such services 
                                furnished during 2018, 2019, 2020, 
                                2021, or 2022 the payment amount for 
                                the technical component (including the 
                                technical component portion of a global 
                                fee) of such services that would 
                                otherwise be determined under this 
                                section (without application of this 
                                paragraph and before application of any 
                                other adjustment under this subsection) 
                                for such year shall be reduced by 7 
                                percent; and
                                    ``(II) in the case of such services 
                                furnished during 2023 or a subsequent 
                                year, the payment amount for the 
                                technical component (including the 
                                technical component portion of a global 
                                fee) of such services that would 
                                otherwise be determined under this 
                                section (without application of this 
                                paragraph and before application of any 
                                other adjustment under this subsection) 
                                for such year shall be reduced by 10 
                                percent.
                            ``(iii) Application without regard to 
                        budget neutrality.--The reductions made under 
                        this paragraph--
                                    ``(I) shall not be considered an 
                                adjustment under paragraph (2)(E); and
                                    ``(II) shall not be implemented in 
                                a budget neutral manner.''.