Massachusetts Audit Cites ‘Unneeded’ Imaging

The Massachusetts state auditor reported this week that the state’s Medicaid program, MassHealth, “may be losing millions of dollars due to unnecessary advanced imaging services such as MRIs.”

The audit report cited two main reasons for the “unnecessary” expenditures: a lack of state laws or regulations against self-referrals, and a reimbursement rate that’s higher than the federal Medicare reimbursement rate. You can find the report here and a news release about it here.

A July article in CommonWealth magazine (which covers “politics, ideas & civic life in Massachusetts”) described the state as “a medical imaging mecca.” It reported that Massachusetts has 42 MRI machines for every million residents, compared with the national average of 26, which itself is higher than that of any other country. According to the magazine, Massachusetts (population 6.5 million) has more MRI units than Australia and Canada (total population 55 million) combined.

The article also states:

Medical experts say the explosion in medical imaging facilities is fueling a dramatic increase in scans, many of them unnecessary and, in fact, harmful.

In the next few years, whatever the resolution of this particular issue, we can be sure that advanced imaging will be a major target for health care cost-cutters—and not just in Massachusetts.

To close the week, a couple of updates:

• The FDA is warning of mammography problems at another Florida clinic, this time at Medisound, Inc., in Kissimmee (near Orlando). Because of “poor quality mammograms with possibly unreliable results,” the agency recommends that anyone who received a Medisound mammogram anytime from June 10, 2008, through July 12, 2010, should have her mammogram reevaluated and possibly repeated. (We recently mentioned a similar FDA announcement about another Florida clinic.)
• To address medical isotope needs (which we also recently discussed), two Belgian groups and a French group announced on Thursday a partnership to manufacture and distribute molybdenum-99 when a new French reactor goes online in 2015. The National Institute for Radioelements (IRE) of Belgium, one of the partners, says it produces about one third of the world’s molybdenum-99 supply. “There are currently five reactors in the world [producing molybdenum-99], and most of them are 40 years old,” Gregory Delecaut of IRE told DOTmed News. “In the near future, they will be closed, and there will be a problem in the supply chain.”

Related seminar: The Business of Radiology