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  • 02.11.16

    AMIC Says Prior Authorization Provision in Administration Budget Threatens Physician Patient Relationship to Medical Imaging

    Expanded Physician-Authored Appropriate Use Criteria, Not Prior Authorization, Drives Proper Imaging Use

    Washington, D.C. – The Access to Medical Imaging Coalition (AMIC) today expressed concern that if the Medicare Fee-for-Service prior authorization provisions in President Obama’s proposed 2017 budget were applied to medical imaging it would inappropriately interfere with physician decision making and harm patient access to medical imaging technologies.

    “When prior authorization schemes are applied to imaging, patients encounter roadblocks to early and proper diagnosis,” said Tim Trysla, executive director of AMIC.  “Congress has already developed an effective policy to make certain that advanced imaging orders are informed and supported by sound evidence-based Appropriate Use Criteria (AUC) guidelines. It is important for policymakers to note that not only is prior authorization ineffective and administratively burdensome for imaging services, but it would also interfere with the implementation of the AUC legislative program, which will in and of itself ensure the clinical appropriateness of imaging services delivered to Medicare beneficiaries.  Instead of consulting a cost-driven third party, AMIC encourages policymakers to continue to incentivize widespread adoption of the AUC to promote and improve proper use of medical imaging.”

    As a part of the Protecting Access to Medicare Act of 2014, Congress required that, beginning in 2017, physicians that order advanced imaging services for Medicare beneficiaries must first consult with evidence-based AUC that are developed or endorsed by medical specialty societies. This AUC consultation requirement will foster improved imaging ordering practices and ensure that patients receive the right scan at the right time.

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    The Access to Medical Imaging Coalition represents physicians, medical providers, and patient organizations throughout the U.S. It also includes health technology firms that manufacture imaging equipment and supplies and that employ tens of thousands of workers. Thus, AMIC represents those who develop medical imaging technologies, those who apply it, and those who benefit from it.

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