The Access to Medical Imaging Coalition (AMIC) is speaking out against provisions calling for the use of prior authorization for fee-for-service imaging procedures paid for by Medicare that were included in President Obama's proposed 2017 budget.
If the prior authorization provision were applied to medical imaging, it would inappropriately interfere with physician decision-making and harm access to medical imaging technologies, according to AMIC. It would also interfere with implementation of the appropriate use criteria legislative program, which AMIC believes will ensure clinical appropriateness of imaging services delivered to Medicare beneficiaries, AMIC said.
Rather than consulting a cost-driven third party with prior authorization, policymakers should continue to incentivize widespread adoption of appropriate use criteria to promote and improve proper medical imaging utilization, according to the organization.
As part of the Protecting Access to Medicare Act of 2014, Congress mandated that beginning in 2017, physicians ordering advanced imaging services for Medicare beneficiaries must first consult with clinical decision-support software based on appropriate use criteria.
"This [appropriate use criteria] consultation requirement will foster improved imaging ordering practices and ensure that patients receive the right scan at the right time," AMIC said in a statement.
