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

Society of Interventional Radiology Backs Reallocations Bill for Graduate Medical Education
News | Interventional Radiology| May 24, 2017
Fourteen members of the Society of Interventional Radiology (SIR) took to Capitol Hill recently to express the society’...
DAIC reaches 1 million pageviews using SEO and social media
Feature | May 23, 2017
May 23, 2017 — Diagnostic and Interventional Cardiology (DAIC) won the 2017 Azbee National Bronze Award and the Regio
Memorial Hospital of Gulfport used a McKesson cardiovascular information system (CVIS) to improve workflow efficiency

Memorial Hospital has increased efficiency using a single cardiovascular information management database. 

Sponsored Content | Case Study | Cardiac PACS| May 23, 2017
Located along Mississippi’s Gulf Coast, Memorial Hospital at Gulfport is a nonprofit, 445-bed facility originally est
News | May 23, 2017
To ensure you continue to receive information most critical to your job, please participate in a survey that will tak
HRS released a consensus statement on MRI for patients with cardiac implantable electronic devices
Feature | May 15, 2017
May 15, 2017 — The Heart Rhythm Society (HRS) released a first-of-its-kind consensus statement in the United States o
Cindy Grines, MD, is the chair of cardiology at the Hofstra Northwell School of Medicine.
News | Business| May 05, 2017
May 5, 2017 — Northwell Health recently announced that Cindy Grines, M.D., one of the nation’s pre-eminent cardiologi
House Passes American Health Care Act, Obamacare repeal
News | Business| May 04, 2017 | Jeff Zagoudis
The U.S. House of Representatives on Thursday narrowly approved the American Health Care Act, the legislation designed...
Sponsored Content | Videos | Business| May 03, 2017
Kim A.
CMS to require AUC documentation clinical decision support for medical imaging

No. 4 on this month's list is an article about what will be required as of Jan. 1, 2018 to be reimbursed  by CMS for cardiac CT, MRI or nuclear imaging. Medicare will require documentation that appropriate use criteria (AUC) clinical decision support (CDS) was used to verify the more expensive tests are appropriate over less expensive testing options. 

Feature | May 02, 2017 | Dave Fornell
May 2, 2017 — Here is the list of the top 20 most popular pieces of content on the Diagnostic and Interventional Card
RFID inventory management system in use scanning in cath lab supplies using a Cardinal Health system

RFID tagged cath lab inventory being scanned in for use in a procedure at Nebraska Medicine's Bellevue Hospital. Automated systems like this can help eliminate or reduce the need for manual counts and enable more easily accessible analytics for better business management.

Feature | Inventory Management| April 28, 2017 | Dave Fornell
Tracking cardiovascular device inventory in cath labs, electrophysiology (EP) labs and operating rooms (ORs) can be a
Overlay Init