Nursing home providers in 11 states and Washington, D.C., may have to send more residents to the hospital to undergo X-rays, if a change from a Medicare Administrative Contractor goes into effect this spring.

That is because Medicare Administrative Contractor Novitas Solutions Inc. may reduce transportation rates for portable X-ray suppliers starting April 1. It initially was going to update the rates in late 2019 but postponed this change as it awaits additional survey responses on transportation cost information from radiology providers, the company said in a December disclosure. 

“What Novitas is trying to do is make the rate uniform in all 11 states,” explained Cynthia Morton, executive vice president for the National Association for the Support of Long-Term Care. “They ratcheted the rate so low that the impact would be that some suppliers, in fact a lot, would have to make their service area smaller.”

A reduction in the transportation rates could mean that portable X-ray suppliers might limit or eliminate altogether their hours of operation for nursing homes, which then might be forced to send residents to the hospital for X-rays, she said.

 The rate reductions that were set to take effect at the end of 2019 ranged from 15% in Mississippi to 56% in Colorado, Morton said. The other states whose rates are in question are: Arkansas, Delaware, Louisiana, Maryland, New Jersey, New Mexico, Oklahoma, Pennsylvania and Texas. Novitas also covers the Washington, D.C., metro area.

McKnight’s efforts to reach Novitas for comment were unsuccessful.  

NASL will provide Novitas data with hopes that it will re-evaluate the rate change.