Radiology interest groups urge Congress to delay implementation of imaging appropriate-use criteria

Several imaging industry lobbying groups are continuing to press national lawmakers to provide relief for radiology practices hit hard by the COVID-19 pandemic.

This latest request came in the form of a letter addressed to leaders of the House and Senate, signed by the Radiology Business Management Association, American College of Radiology, and others. They’re asking lawmakers to consider six legislative remedies to help the field, which would include granting radiologists and others hazard pay, waiving budget neutrality requirements, and suspending prior authorization during the pandemic.

The nine organizations are also requesting that lawmakers delay implementation of imaging appropriate-use criteria to help simplify things as providers sort through an overwhelming accumulation of exams in the coming months.

“As the backlog of routine imaging procedures amasses during the suspension of elective procedures, it will be a daunting return for providers to manage the influx of overdue scans and treatment,” the groups wrote May 8. “The Centers for Medicare and Medicaid Services has been working over the past few years to implement the Protecting Access to Medicare Act of 2014, which mandates consultation of AUC prior to referring Medicare beneficiaries for advanced diagnostic imaging services. However, there have been significant delays in implementing the program which we believe can be addressed with several technical changes to the PAMA law.”

They’re asking Congress to work in tandem with the industry to incorporate these “no-cost perfecting changes” into the next COVID relief bill. However, if such modifications cannot be implemented by the end of 2020, the groups are asking the feds to extend the current educational testing period through 2021.

PAMA mandates that referring providers consult appropriate-use criteria before sending Medicare beneficiaries for advanced diagnostic imaging services. In an April 29 news post, the American College of Radiology noted that the changes they’re suggesting would “finally allow CMS to implement this critical utilization program without having to revert to the disruptions and delays of prior authorization programs.”

You can read the entire letter in full here. Others signing the request include the Society of Nuclear Medicine & Molecular Imaging, the American Society of Radiologic Technologists, the Association for Medical Imaging Management, and the Medical Imaging & Technology Alliance. MITA also highlighted the request in a news announcement posted on Monday.

“As this letter makes clear, the coronavirus pandemic and surge of COVID-19 cases have forced many radiology practices and departments to make difficult decisions about reducing operations, taking pay cuts and furloughing staff,” Bayer’s Dennis Durmis, chair of the MITA Board of Directors, said in a statement. “With recent data showing a dramatic decline in cancer screenings, especially where medical imaging is used, we can also reasonably expect that many cancers are going undetected. This will have an enormous human and financial cost, both during and after we emerge from the other side of this pandemic.”