VIDEO: AMA will ask Congress to change mandate on appropriate use criteria clinical decision support
Alexander Ding, MD, MBA, a radiologist, incoming American Medical Association (AMA) Board of Trustees member, AMA delegate with the California Medical Association, explains the new AMA policy calling on Congress to change the language and implementation of the current Medicare mandate that all advanced medical imaging needs certification that the order includes consulting a clinician decision support (CDS) software. The goal of the legislation, which originated under the PAMA Act in 2014, was to determine if the imaging exams falls under appropriate use criteria set by various medical societies.
The goal is to reduce the use of expensive imaging exams that are not necessary. However, implementation of the rule has been delayed for years because of technical issues and complaints about the policy, which penalizes radiologists, even though the order and the need to use the CDS software comes from referring physicians.
The American Society of Nuclear Cardiology (ASNC) spearheaded an effort to get 44 medical societies to sign on to a letter earlier in 2022 asking Congress to change the requirements in the rule or repeal it. Discussions at the AMA led to the AMA resolution being considered to remove the repeal language. Ding said the medical societies are in control of the appropriate use guidelines, and the AMA policy seeks to change the language of the mandate to make it easier to implement with less administrative burdens.
The Medicare rule is slated to go into effect in January 2023.
Ding is also a clinical assistant professor at the University of Louisville and is physician executive-in-residence in the Office of the Chief Medical Officer at Humana, and chair of the AMA Council on Science and Public Health.
Read more on the push be medical societies reform or repeal the CDS requirement — American Society of Nuclear Cardiology urges Congress to speed prior authorizations, repeal AUC mandate.
How radiology should prepare for AUC clinical decision support reporting requirements
Watch the related VIDEO: Imaging societies ask Congress to repeal appropriate use decision support mandate — interview with Randall Thompson, MD, former ASNC president.
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Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: dfornell@innovatehealthcare.com