News | July 13, 2008

AMIC Criticizes GAO Report Recommending Authorization for Medical Imaging

July 14, 2008 – The Access to Medical Imaging Coalition (AMIC) said in a statement today, "A report from the Government Accountability Office (GAO) that recommends Medicare adopt prior authorization criteria to address appropriate utilization of medical imaging services was constructed on an incomplete analysis and should not be used by policymakers to make coverage decisions."

“The GAO’s recommendation that CMS rely on a Radiology Benefit Manager (RBM) model of prior authorization will create inefficiencies in the healthcare system resulting in seniors being denied access to life-saving diagnostic and therapeutic imaging services,” said Tim Trysla, executive director of AMIC.

According the consortium of patient advocates, physicians, providers and medical manufacturers, the GAO’s recommendation was built on an inadequate analysis of RBMs. The report did not offer any analysis of how prior authorization requirements and other physician limitations impact healthcare savings. Nor did the report include comment from the medical professional societies, or physicians, on their experience with RBMs or prior authorization.

“Proper utilization of imaging is an important issue,” Trysla said. “But instead of adopting cost limitations that will create red tape and increase inefficiencies, policymakers should work with professional medical societies to adopt appropriateness criteria.”

In conjunction with cardiology and radiology professional societies, the U.S. Department of Health and Human Services (HHS) should adopt criteria for assessing the appropriate utilization of imaging services, the Access to Medical Imaging Coalition (AMIC) said today.

Trysla says AMIC applauds the House and Senate for passing H.R. 6331, The Medicare Improvement for Patients and Providers Act of 2008, which includes measures to improve the appropriateness and quality of imaging services. The bill requires that advanced imaging providers be accredited by nationally recognized accrediting bodies in order to receive Medicare payment. It would also launch a demonstration program to make sure that advanced imaging is not overused as a diagnostic tool.

“Development of appropriateness criteria – not prior authorization - is an essential step toward ensuring that beneficiaries have access to imaging that best suits their medical conditions,” said Trylsa. “As imaging becomes increasingly integral to best practices in healthcare diagnosis and treatment, it is imperative that physicians and payers agree on which imaging services are appropriate, so that beneficiaries get the right scan at the right time.”

The pilot program will test a proposed set of appropriateness criteria, created by HHS through consultation with relevant medical societies such as the American College of Radiology (ACR) and American College of Cardiology (ACC), at a broad spectrum of representative sites across the country. The main requirement for selection would be the capability to submit diagnostic and service-related data in electronic format for monitoring purposes.

For more information: www.imagingaccess.org

Related Content

Houston Methodist Hospital Enters Multi-Year Technology and Research Agreement With Siemens Healthineers
News | Cardiac Imaging| August 17, 2017
Houston Methodist Hospital and Siemens Healthineers have entered into a multi-year agreement to bring cutting-edge...
CDN to Integrate Advanced Cardiac Imaging Tools From DiA Imaging Analysis
Technology | August 10, 2017
August 10, 2017 — CDN recently announced a new partnership agreement with DiA Imaging Analysis Ltd., makers of next-g
Four Blue Cross Blue Shield Companies Issue Positive Medical Policies on HeartFlow FFRct Analysis
News | FFR Catheters| August 09, 2017
HeartFlow Inc. announced that four Blue Cross Blue Shield companies have each issued a positive medical policy for the...
Left Atrial Pressure Monitor from Vectorious Medical Technologies Offers New Hope for Heart Failure Patients

On of the top stories in July was the introduction of a left atrial pressure monitor from Vectorious Medical Technologies to prevent heart failure patient hospitalizations or readmissions. Read the article"Left Atrial Pressure Monitor Offers New Hope for Heart Failure Patients."

Feature | August 01, 2017 | Dave Fornell
Aug.
Philips released a new version of its iFR system that displays FFR readings as an overlay on live angiographic, angiogram images.

Philips released a new version of its iFR system that displays hemodynamic pressure drop points in an overlay on live angiographic images, matching up the iFR readings with corresponding lesions. The system is supposed to speed diagnostic decision making and help guide percutaneous revascularization procedures. 

Feature | FFR Catheters| July 31, 2017 | Dave Fornell
The gold standard for assessing the hemodynamic significance or coronary lesions to determine if they should be revas
New PET-CT Scan Improves Detection in Rare Cardiac Condition
News | PET-CT| July 25, 2017
Using a new imaging technique that can diagnose cardiac sarcoidosis much more accurately than traditional tests,...
Sponsored Content | Videos | CT Angiography (CTA)| July 21, 2017
DAIC and ITN Editor Dave Fornell discusses some of the most innovative new computed tomography (CT) technology and tr
Cardiac CT scan showing plaque and calcification in the coronary arteries, from a Toshiba CT scanner
News | Business| July 19, 2017
July 19, 2017 — The Society of Cardiovascular Computed Tomography (SCCT) created a reimbursement fee chart for cardia
Sponsored Content | Videos | Cardiovascular Surgery| July 19, 2017
This video educational session, provided in partnership with the American Society of Echocardiography (ASE), is title
Overlay Init