CBO: Medicare should reject prior authorization

The U.S. Congressional Budget Office's (CBO) scoring of President Obama's fiscal 2014 budget shows that use of prior authorization for imaging within the Medicare program would produce no savings, according to a report released on May 17.

The Access to Medical Imaging Coalition (AMIC) praised the CBO's scoring, and highlighted what it believes are the disadvantages of prior authorization.

"The CBO has confirmed that implementation of a prior authorization program will not only produce zero cost savings, it will insert an artificial barrier between physicians and their patients," said Tim Trysla, AMIC's executive director. "Seniors rely on medical imaging for early detection and to guide their treatment on the road to survivorship."

Research shows that relying on prior authorization programs, such as the use of for-profit radiology benefits managers (RBMs), for advanced imaging increases costs and red tape and burdens physicians, the Medical Imaging and Technology Alliance (MITA) said in a statement.

"Although medical imaging technologies have proven time and again to save lives and lower long-term healthcare costs, access to this technology continues to be threatened by the reintroduction of harmful proposals, such as prior authorization, and indiscriminate cuts to Medicare reimbursement," said Gail Rodriguez, MITA's executive director. "MITA urges Congress to adopt policies such as appropriateness criteria that encourage appropriate use of imaging."

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