UnitedHealth pushes imaging accreditation deadline to 2009

Aug 21, 2008

Insurance giant UnitedHealth Group of Minneapolis has extended its deadline until the fourth quarter of 2009 for freestanding imaging facilities and physician offices to apply for accreditation to receive reimbursement for their services.

Under UnitedHealth's directive, announced in January 2007, freestanding imaging facilities and physician offices performing CT, CT angiography, MRI, MR angiography, nuclear medicine/cardiology, PET, and echocardiography will need to complete and submit an application and receive accreditation to receive payment for services.

UnitedHealth's original deadline for accreditation was March 1, but earlier this year the insurer pushed that to the third quarter of 2008. Then, in an August 20 notice to imaging services providers, UnitedHealth said it was extending the deadline again "based on feedback from physicians, imaging professionals, and specialty societies, as well as the recently passed federal legislation."

The communiqué adds that UnitedHealth's decision to postpone was based on the "recent implementation of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) [which] requires providers of advanced imaging services to be accredited by Jan. 1, 2012. Effective this date, accreditation will become a mandatory requirement in order to receive payment for the technical component of imaging services. We believe it will be beneficial to our network providers to more closely align our reimbursement adjustment timeline with MIPPA."

The announcement continues: "While the growth in the number of accredited practices is impressive, we have also received feedback that some communities may not have a sufficient number of accredited facilities to meet patient and physician needs."

Accreditation process

Imaging facilities and physician offices still have the option to apply for accreditation, through either the Intersocietal Accreditation Commission (IAC) of Columbia, MD, or the American College of Radiology (ACR) of Reston, VA. Accreditation is a peer-review process through which both technologists and physicians review an application's cases, images, and final reports.

The IAC and ACR met with UnitedHealth last month to discuss the status of the policy and providers' compliance. IAC CEO Sandra Katanick said her organization recognizes UnitedHealth's "dilemma with not having enough of their providers accredited and the potential of losing access [to imaging services] for their customers. We certainly understand where they are coming from, we applaud them for not removing the requirement altogether, and giving people more time to get it accomplished."

While she said that she could not speak for UnitedHealth, Katanick described the insurer as "disappointed," adding that the below-par response to accreditation by imaging providers "was not as they expected ... it was a fine line and hard decision for them to make as to whether or not they would push back the date."

Accreditation fees

Fees for accreditation range from $1,300 for noninvasive vascular imaging with ultrasound to $3,800 for nuclear cardiology with PET imaging. Because the IAC and ACR are nonprofit organizations, money generated from the accreditation applications is used to support the program.

Since UnitedHealth announced its accreditation policy early last year, the application rate for accreditation has tripled at the IAC. "What we have seen along with that increase in application rate is a decrease in the quality of the images and a decrease in the quality of the final reports," Katanick said. "Our decisions [for accreditation] can be to either grant or delay a lab for deficiencies. We have seen that delay rate increase pretty significantly."

While some imaging services providers may perceive the accreditation process as being somewhat onerous, Katanick views it as "a very worthwhile process. I think it allows facilities to evaluate the quality of the work that they do and improve that quality."

By Wayne Forrest
AuntMinnie.com staff writer
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