Policy & Regulations

This channel includes news coverage of healthcare policy and regulations set by Congress, the states, Centers for Disease Control and Prevention (CDC), the Department of Health and Human Services (HHS), U.S. Food and Drug Administration (FDA), and medical associations and societies. 

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12-Month SGR Fix in House Requires Referrers to Consult Appropriateness Criteria

While a long-term solution to the sustainable growth-rate (SGR) problem has slid to the backburner, a bipartisan 12-month SGR fix has emerged in the U.S. House of Representatives that would preserve physician compensation levels—and require referring physicians to consult appropriateness criteria when ordering advanced medical imaging procedures for Medicare patients.

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SB 1215 Would Eliminate In-office Exception for Advanced Imaging in California

A bill introduced in the California Senate has been amended to remove the in-office exception (IOE) for advanced imaging and radiation oncology from the state’s self-referral regulations. Additionally, SB 1215 would prohibit physicians in the state of California from self-referring for anatomic pathology and physical therapy services.

Obama FY2015 Budget Takes Aim at Self-referral, Calls for Pre-Auth

In a good-news–bad-news scenario for the radiology community, President Obama’s $3.9 trillion 2015 fiscal year budget would limit the self-referral rampant in advanced imaging and radiation oncology, but implement prior authorization for advanced imaging.

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The Transition to ICD-10: What it Means to You

APS

On October 1, 2014, healthcare practices will be required to use a revised version of the International Classification of Diseases code: ICD-10.

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Doshi Diagnostics to Settle Qui Tam Case for $15.5 Million

Diagnostic Imaging Group, an outpatient imaging chain with 36 locations in New York and Florida, will pay $15.5 million to settle charges that its centers falsely billed federal and state health-care programs for tests either not performed or not necessary, and for paying kickbacks to physicians.

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Radiologist’s Bid for U.S. Senate Embroiled in Facebook Flap

A radiologist’s social-media indiscretions may have cost him his candidacy for the U.S. Senate and could land him in hot water with his state’s medical board. 

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CMS to Mount End-to-end ICD-10 Testing for Some Providers

Caving to provider concern, CMS announced yesterday that it would implement end-to-end ICD-10 testing this summer for “a small sample group” of providers.

ACR Asks CMS for Reimbursement Cut Dampening

In a comment letter on the final 2014 Medicare fee schedule for physicians, the ACR pointed out once more the cumulative effect on imaging reimbursement of various recent legislative and policy changes and urged CMS to adopt a “dampening” policy to limit the total amount a specific procedural code could be reduced in a given year.

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Around the web

Cardiovascular Business
FDA-cleared software increases throughput for flurpiridaz back-to-back rest-stress imaging

The new F-18 flurpiridaz radiotracer is expected to help drive cardiac PET growth, but it requires waiting between rest and stress scans. Software from MultiFunctional Imaging can help care teams combat that problem.

Health Imaging
MRI projectile incident likely to result in a 'seven-figure sum' repair bill for hospital

News of an incident is a stark reminder that healthcare workers and patients aren’t the only ones who need to be aware around MRI suites.

Health Imaging
American College of Radiology announces significant expansion of Lung Cancer Screening Registry

The ACR hopes these changes, including the addition of diagnostic performance feedback, will help reduce the number of patients with incidental nodules lost to follow-up each year.