Senators introduce bipartisan bill to revive shelved imaging appropriate-use criteria program
Bipartisan members of the U.S. Senate on May 9 introduced legislation to revive the shelved imaging appropriate-use criteria program.
The initiative was established in 2014 through the Protecting Access to Medicare Act, requiring referrers to consult a decision-support system before ordering advanced imaging in a bid to curb waste. However, the program was plagued by postponements and other challenges, and the Centers for Medicare & Medicaid Services opted to table AUC in 2023.
Sens. Marsha Blackburn, R-Tenn., and Catherine Cortez Masto, D-Nev., are now attempting to bring the program back. Their Radiology Outpatient Ordering Transmission (ROOT) Act would remove a key barrier to implementing appropriate-use criteria in imaging, which would save American taxpayers upward of $700 million annually.
“When the right imaging is used at the right time, it can lead to better health outcomes and reduce costs for patients and the healthcare system,” Cortez Masto said in a statement shared Friday. “This commonsense, bipartisan legislation supports evidence-based care and reduces unnecessary scans, saving Medicare billions of dollars while ensuring safer, more personalized care.”
Full implementation of AUC was supposed to have happened by Jan. 1, 2017, those involved noted. The ROOT Act would get the effort back on track by removing requirements for real-time claims reporting, the “primary barrier” to implementation. CMS would, instead, conduct retrospective audits based on this data to “ensure compliance and inform provider education.” An additional carveout further “reduces administrative burden,” the senators add, exempting those participating in clinical trials or in small rural practices.
Advocates estimate the ROOT Act could reduce federal spending by about $2.2 billion between 2025 and 2034. They also highlighted $1.6 billion in savings for Medicare beneficiaries from reduced cost-sharing over the same period.
The legislation is endorsed by the Tennessee Radiological Society, American Society of Emergency Radiology, and the American College of Radiology. ACR last week held its 2025 Capitol Hill Day, at which it urged Congress to pass a legislative fix to revive AUC.
“The quality-based AUC ordering approach is good for patients, providers, and taxpayers,” ACR CEO Dana Smetherman, MD, MPH, MBA, said in the same statement from the two senators. “The ACR urges health systems, hospitals and practices to build on their [clinical decision support] investment, and for Congress and CMS to continue to work with medical associations, providers groups and other stakeholders to implement the federal AUC program.”
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.