Feature | March 06, 2014

ACR: President’s Budget Would Curtail Imaging and Radiation Oncology Self-Referral

Prior authorization provision would burden providers, restrict access

American College of Radiology ACR CT Systems Imaging

March 6, 2014 — The American College of Radiology applauded steps to reign in medical imaging and radiation oncology self-referral included in President Obama’s Fiscal Year 2015 budget. However, prior authorization for imaging services, also included the FY 2015 budget, is unnecessary and will ultimately raise costs, interfere in the doctor-patient relationship and restrict ready access to imaging care.

Government Accountability Office (GAO) reports have examined self-referral of medical imaging and radiation oncology services and found significant and inappropriate increases in referrals when physicians are allowed to self-refer. This drains Medicare of hundreds of millions of dollars each year.

“Imaging use and associated costs are down significantly since 2006. Only self-referred imaging grew significantly since the middle of last decade. It is past time for government to address self-referral,” said Paul H. Ellenbogen, M.D., FACR, chair of the American College of Radiology Board of Chancellors.

Radiology benefits managers and prior authorization programs take medical decisions out of doctors’ hands, may delay or deny lifesaving imaging and often result in longer waiting times for patients to receive care. A 2011 Moran Co. report found prior imaging authorization would produce no meaningful cost savings, could cost insurers and the government more than it saves and imposes administrative burdens on already strapped physician practices.

“The Sustainable Growth Rate Repeal and Medicare Provider Payment Modernization Act of 2014 would require ordering providers to consult physician-developed appropriateness criteria when prescribing advanced medical imaging studies for Medicare patients,” Ellenbogen said. “This is a far more effective and efficient policy than blanket prior authorization. Electronic ordering systems, based on these criteria, are compatible with hospital electronic health records systems and are shown to reduce duplicate and unnecessary scanning and associated costs without taking decisions out of doctors’ hands or affecting access to care. This approach enjoys bicameral, bipartisan support. We will continue to work with Congress to advance this policy.”

For more information: www.acr.org

Related Content

Vascular Solutions, Teleflex
Feature | December 07, 2016
December 7, 2016 — Teleflex Inc. and Vascular Solutions Inc.
Cardioband, valtech, Edwards Lifesciences, transcatheter mitral repair, transcatheter tricuspid valve repair, transcatheter annuloplasty

An illustration of how the transcatheter Cardioband System can used as a non-surgical form on annuloplasty repair. 

News | Heart Valve Technology| December 02, 2016
December 2, 2016 — Edwards Lifesciences Corp.
coronary CT angiography, CCTA, alcohol consumption, CAD, coronary artery disease, RSNA 2016
News | CT Angiography (CTA)| November 29, 2016
Researchers using coronary computed tomography angiography (CCTA) found no association between light to moderate...
Philips, DoseWise Portal 2.2, RSNA 2016, radiation dose management
Technology | Radiation Dose Management| November 21, 2016
November 21, 2016 — Philips introduced DoseWise Portal 2.2, a next-generation...
Sponsored Content | Videos | CT Angiography (CTA)| November 18, 2016
A discussion with Simon Dixon, M.D., MBChB, on the use of fractional flow reserve-computed tomography (FFR-CT) to eva
Siemens Healthineers, Somatom Drive CT, computed tomography, first U.S. install, Stead Family Children's Hospital
News | Computed Tomography (CT)| November 11, 2016
Siemens Healthineers announced that University of Iowa Stead Family Children’s Hospital in Iowa City is the first...
Siemens, Healthineers, public listing, healthcare business
News | Business| November 11, 2016
Siemens announced it intends to further develop its healthcare business, Siemens Healthineers, and give it even greater...
Sponsored Content | Videos | Structural Heart| November 09, 2016
Brijeshwar Maini, M.D., and Brian Bethea, M.D., from Tenet Florida’s structural heart program, explain the importance
cybersecurity, healthcare industry, SecurityScorecard report, social engineering, cyberattacks
News | Information Technology| October 31, 2016
SecurityScorecard, a security rating and continuous risk monitoring platform, released its 2016 Healthcare Industry...
GE Healthcare, Revolution CT, Whisper Drive, RSNA 2016, cardiac imaging
News | CT Angiography (CTA)| October 31, 2016
At the 2016 annual meeting of the Radiological Society of North America (RSNA 2016), GE Healthcare will introduce the...
Overlay Init