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

TrumpCare
News | Business| February 20, 2017
According to Vertess, an international healthcare-focused M + A advisory firm with expertise in diverse healthcare and...
GE Healthcare, GSI Xtream, FDA clearance, spectral CT, Revolution, RSNA 2017, SCCT
Technology | Computed Tomography (CT)| February 15, 2017
February 15, 2017 — GE Healthcare announced U.S.
Cardinal Health survey, hospital staff, supply chain management, quality of care
News | Inventory Management| February 15, 2017
Better hospital supply chain management leads to better quality of care and supports patient safety, according to a new...
heart team, hybird OR, structural heart team

The heart team approach was first used on a large scale in the CoreValve and Sapien TAVR trials and helped lead to excellent outcomes in high-risk patients.

Feature | Hybrid OR| February 15, 2017 | Dave Fornell
In the current era of healthcare reform and the push toward evidence-based medicine to both lower costs and improve p
HeartFlow FFRct Analysis, NICE guidance, U.K., United Kingdom, guidelines, stable chest pain
News | CT Angiography (CTA)| February 14, 2017
The National Institute for Health and Care Excellence (NICE) in the United Kingdom recently issued guidance for use of...
Rep. Tom Price, confirmed, Health and Human Services, HHS, new secretary
News | Business| February 10, 2017 | Jeff Zagoudis
Rep. Tom Price was confirmed by the U.S. Senate as the new secretary of the Department of Health and Human Services (...
GE Healthcare, Rapiscan stress imaging agent, North America, Rapidscan Pharma Solutions Inc.
News | Pharmaceuticals| February 07, 2017
GE Healthcare’s Life Sciences business announced in January that it acquired Rapidscan Pharma Solutions Inc., which has...
Innovaccer, MIPS Platform, reporting and performance optimization, Datashop
Technology | Business| February 07, 2017
Healthcare analytics company Innovaccer Inc. announced the launch of its holistic MIPS Platform designed to enable...
Inventory management, analytics software, cardiology, cath lab
Sponsored Content | Case Study | Inventory Management| February 07, 2017
The supply chain can serve as a critical strategic asset when addressing important initiatives tied to managing costs
Sponsored Content | Webinar | Inventory Management| February 01, 2017
How healthy is your cath lab supply chain?
Overlay Init