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

Siemens Healthineers Announces First U.S. Install of Somatom go.Top CT
News | Computed Tomography (CT) | September 17, 2018
September 17, 2018 — The Ohio State University Wexner Medical Center in Columbus recently became the first healthcare
Key Patient Preparations for a CT Scan
News | Computed Tomography (CT) | September 05, 2018
The Center for Diagnostic Imaging (CDI) in Miami recently released a list of important preparations patients should...
Videos | Computed Tomography (CT) | July 25, 2018
A discussion with Patricia Dickson, LRT(CT), director of imaging and outpatient services, Capital Cardiology Associat
Videos | Computed Tomography (CT) | July 23, 2018
Ed Nicol, M.D., FSCCT, MBA, head of cardiac CT, Royal Brompton Hospital, London, and chair of the Society of Cardiova
Videos | Computed Tomography (CT) | July 17, 2018
An interview with Patrick Serruys, M.D., Ph.D., Imperial College London, principal investigator of the SYNTAX III Tri
Zebra Medical Vision Announces FDA 510(k) Clearance of Coronary Calcium Algorithm
Technology | Computed Tomography (CT) | July 12, 2018
Zebra Medical Vision has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) for its Coronary...
IAC Awards First CT Accreditation for a Mobile Stroke Unit
News | Computed Tomography (CT) | July 09, 2018
The Intersocietal Accreditation Commission (IAC) recently recognized the University of Tennessee Health Science Center...
FFR-CT may soon replace invasive angiography for coronary lesion assessment. #EuroPCR 

Anexample of a clinical case of CT-FFR, which can derive the FFR numbers for their entire coronary tree using a noninvasive CT scan.

Feature | Computed Tomography (CT) | May 29, 2018
May 29, 2018 — Results from the innovative SYNTAX III Revolution Trial [1] underline the effectiveness of evolving no
James Min Named Editor-in-Chief of Journal of Cardiovascular Computed Tomography
News | Computed Tomography (CT) | May 01, 2018
James K. Min, M.D., FSCCT, has been selected for a five-year term as the new editor-in-chief of the Journal of...
FDA Clears Siemens' Somatom go.All, go.Top CT Scanners
Technology | Computed Tomography (CT) | April 18, 2018
April 18, 2018 — The U.S.
Overlay Init