decisionhealth Newsletters, Part B News - 2008 Issue 9 (September)
MedPAC hears options for how to curtail imaging growth
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Article Overview
This article covers a MedPAC session on rising imaging utilization in Medicare and the policy responses being considered by federal officials, researchers, and physician organizations. It discusses broad approaches such as prior authorization, accreditation, and payment policy changes, along with concerns about administrative burden, self-referral, and program integrity. The piece is relevant to healthcare administrators, radiology stakeholders, compliance teams, and anyone tracking Medicare imaging policy.
Why This Topic Matters
Imaging utilization and payment policy can materially affect Medicare spending, provider workflows, and compliance oversight. Understanding the competing approaches discussed in this article helps readers evaluate how federal policy may influence imaging access, documentation, and administrative requirements.
Article Sections
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MedPAC review of imaging overutilization
The article opens with a MedPAC discussion of rising imaging use in Medicare and the policy concerns driving the review. It introduces the key stakeholders and the general problem of overutilization and improper payments.
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Views on prior authorization and accreditation
This section summarizes differing opinions on potential policy tools for controlling imaging growth. It includes discussion of prior authorization, accreditation, and the administrative and operational concerns raised by stakeholders.
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Payment policy and spending trends
The closing portion addresses broader Medicare payment policy issues affecting imaging services. It references spending growth, service migration across settings, and related federal payment initiatives.
What You Will Learn
- The policy concerns behind rapid growth in Medicare imaging services
- How MedPAC and other stakeholders are discussing possible strategies to address overutilization
- Why accreditation, prior authorization, and payment policy changes are being considered
- Which organizations and federal entities are involved in the imaging policy debate
Who Should Read This
- Medical coders
- Compliance professionals
- Radiology administrators
- Practice managers
- Healthcare policy analysts
- Revenue cycle teams
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