The fees charged for a high-tech scanning tool for medical diagnoses are being excessively cut by the island’s health regulator, a leading service provider has said.

Ewart Brown, the former premier and owner of Bermuda Healthcare Services, said his two clinics were continuing to feel the impact from reduced reimbursements for both MRI and CT scans.

Dr Brown said the Bermuda Health Council had “chipped away steadily” at regulated fees for the scans over the past three years.

The health council responded last week that it “maintains transparency around these requirements, providing all participating providers at least 60 days — and up to 90 days — of advance notice of any fee changes”.

It said it had been gradually reducing the fees to keep the procedures, which can run into the region of $1,500 per scan, in line with industry standards.

The fee amendments were said to be fair and aimed at “system-wide affordability”.

Dr Brown claimed that the fee reductions had revived a longstanding issue about what could be fairly charged for diagnostic imaging.

He told The Royal Gazette: “At Bermuda Healthcare Services, I have asked the staff to look at the reimbursement for MRI and CAT scans since 2022.

“Just in that three-year period, the Bermuda Health Council has reduced our payment for these scans by up to $60. But at the same time we were cut back, payment for ultrasound studies has been going up, and to me that does not make sense.

“Other services such as surgery and anaesthesia have not suffered this.”

Dr Brown likened it to heavy cuts in payments that came into effect on June 2017.

Those moves were condemned by both Dr Brown and J.J. Soares, of another imaging provider, Hamilton Medical Centre.

At the time, Dr Brown’s Bermuda Healthcare Services reported a cut in fees for services such as a CT head scan with contrast at falling to $383 from $1,441.

In the end, he received a $600,000 payment from the Bermuda Government to cover the losses incurred.

In the latest round, Dr Brown said that the system for reckoning fees that had led to the reduction in imaging fees “could not possibly have led to the increases in ultrasound reimbursement”.

He added: “If this continues to happen, the cost of operating scanners in Bermuda is going up immeasurably.

“They are already going up, even down to the cost of the contrast dye that gets used, which has risen 10 to 15 per cent in the same period.”

The health council said the former premier’s clinics continued to take part in the Standard Health Benefit, which is the mandated minimum level of health insurance coverage required for all residents of Bermuda.

The SHB includes “regulated fees for listed providers and services”, the council said.

A statement added: “In exchange, participating providers benefit from guaranteed 100 per cent reimbursement for patients and commit to regular statistical reporting.”

The council said: “Specifically regarding MRI and CT rates: historically, MRI and CT rates were considered out of scope and aligned closely with the hospital’s cost of doing business, resulting in relatively higher baseline fees.

“Recognising this, the health council established a target of a 10 per cent reduction in these fees over a four-year period to improve affordability and alignment with cost frameworks.”

It added: “Based on previous feedback from providers about abrupt fee adjustments, we have been gradually smoothing out these reductions across multiple periods to ease the transition.”

The council described setting the fees as a balancing act based solely on healthcare affordability.

The statement added: “The recent National Health Accounts show that overall health system costs have risen by about 2 per cent annually since 2018.

“Specifically, total expenditure for diagnostic imaging services under the SHB has increased significantly during this period.”

It said the overall cost of CT scans had soared from $1,428,000 in the 2018 financial year to $3,499,625 in the present financial year, marking a 145.1 per cent increase.

The statement added: “We remain committed to actively receiving and considering feedback, using it to refine the SHB programme sustainably and fairly, as we move towards the goal of achieving universal health coverage.”