MedPAC Recommends A New Direction For Medicare
With A Focus On Diagnostic Imaging [continued]


from the July 2005 issue

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Related to the recommendation suggesting the development of standards for physicians who interpret imaging studies (3C), MedPAC directs that CMS should develop standards for physicians who bill for interpreting imaging studies (the professional component) to ensure that they are qualified to do so. While acknowledging the fact that the implementation of these recommendations would represent a new direction for Medicare, the MedPAC report comments, "this policy should improve diagnostic accuracy and treatment. It should also help control the growth of imaging spending by restricting payment for interpretation to only qualified physicians."

As part of recommendations 3C and 3D, a statement synonymous with facility accreditation was made: "The Secretary [of Health and Human Services] should select private organizations to administer the standards." The report discussed the differences amongst the many medical specialties utilizing specific imaging modalities, stating, "Because physician specialty organizations often have a different criteria for determining when a physician is qualified to provide a service, CMS should consult with physician specialty groups and private accreditation organizations when developing standards for Medicare payment. The Intersocietal Accreditation Commission (IAC) has demonstrated that it is possible for different specialties to agree on common standards. The IAC uses a process in which representatives of several specialty groups jointly develop facility and physician standards for three types of imaging services: echocardiography, nuclear medicine, and vascular ultrasound."

Accreditation allows facilities to demonstrate quality to insurance carriers, including efficiency of operations by following established policies and procedures; demonstration of a commitment to quality and continued education; and adherence to nationally standardized protocols and metrics for quality assurance.


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MedPAC not only advises Congress on payments to private health plans participating in Medicare, by also analyzes access to care, quality of care, and other issues affecting the overall program as well as the nation's healthcare system in general.

 
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