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

News | Computed Tomography (CT)
March 29, 2022 – Cardiac computed tomography (CCT) is an accurate, noninvasive diagnostic test for obstructive coronary ...
Home March 29, 2022
Home
News | Computed Tomography (CT)
March 11, 2022 – Is cardiac computed tomography (CT) as reliable as catheterization in patients with suspected coronary ...
Home March 11, 2022
Home
News | Computed Tomography (CT)

January 31, 2022 — Lee Health’s Gulf Coast Medical Center in Fort Myers, Fla., recently became the first U.S. healthcare ...

Home January 31, 2022
Home
News | Computed Tomography (CT)

October 20, 2021 — HeartFlow Inc. announced the commencement of the REVEALPLAQUE (A pRospEctiVe, multicEnter study to ...

Home October 20, 2021
Home
News | Computed Tomography (CT)

October 14, 2021 — Cardiac computed tomography angiography (CTA) derived left atrium emptying fraction (LAEF) improves ...

Home October 14, 2021
Home
Feature | Computed Tomography (CT)

October 6, 2021 — Data presented during the late-breaking science session at the European Society of Cardiology (ESC) ...

Home October 06, 2021
Home
Feature | Computed Tomography (CT) | By Dave Fornell, DAIC Editor

The U.S. Food and Drug Administration (FDA) Sept. 30 cleared the world's first photon-counting computed tomography (CT) ...

Home October 04, 2021
Home
News | Computed Tomography (CT)

July 16, 2021 — Canon Medical Systems USA is joining forces with Cleerly in a strategic partnership to support simple ...

Home July 16, 2021
Home
News | Computed Tomography (CT)

July 14, 2021 — Performing the first cardiac scan on their new photon-counting detector computed tomography (CT) scanner ...

Home July 14, 2021
Home
Feature | Computed Tomography (CT)

May 27, 2021 — Philips Healthcare released a workhorse computed tomography (CT) system, the Spectral CT 7500, which has ...

Home May 27, 2021
Home
Subscribe Now