December 17, 2013 — The American College of Radiology (ACR) commends the House Committee on Ways and Means and the United States Senate Committee on Finance for passing bicameral, bipartisan legislation to replace the flawed sustainable growth rate (SGR) physician payment formula. The SGR Repeal and Medicare Beneficiary Access Act of 2013 includes ACR-supported provisions that would require ordering providers to consult physician-developed appropriateness criteria when referring Medicare patients for advanced diagnostic imaging exams.
The imaging-specific provisions in the legislation would require the Secretary of the Department of Health and Human Services (HHS) to specify appropriateness criteria from among those developed/endorsed by national professional medical specialty societies such as the ACR. ACR Appropriateness Criteria are evidence-based, have been in existence for 20 years and are created and updated by multispecialty panels of physicians. Clinical decision support systems (CDS), based on such appropriateness criteria, in use in Minnesota and at Massachusetts General Hospital, have been shown to cut down on duplicate and unnecessary scanning and associated costs.
“The ACR strongly supports the imaging provisions in this legislation. This approach will help medicine transition from volume-based to quality-based care without affecting access or interfering in the doctor-patient relationship. The legislation represents a landmark step by Congress and a validation of a cornerstone of the College’s Imaging 3.0 initiative that increases quality of care and preserves health care resources,” said Paul Ellenbogen, M.D., FACR, chair, ACR Board of Chancellors.
The bill awaits consideration by the full House of Representatives and Senate in early 2014. The SGR Repeal and Medicare Beneficiary Access Act of 2013 can be viewed here.
For more information: www.acr.org