American College of Radiology ‘strongly urges’ CMS to delay provider Medicare audits

The American College of Radiology is “strongly” urging the feds to delay audits of providers’ Medicare claims that are set to resume on Aug. 3, according to a statement released Wednesday.

The Centers for Medicare and Medicaid Services first suspended most of such fee-for-service reviews back in March because of the COVID-19 pandemic. However, federal officials recently indicated plans to resume the site checks early next month.

ACR pushed back on those plans this week, asking CMS to hold off until at least 90 days after the public health emergency declaration expires. The college also wants the feds to seek input from radiologists and other providers before resumption, given COVID’s “resurgence in many parts of the country.”

“Restarting provider audits now will increase the administrative burden on personnel and practices at a time when sites are rightly focused on protecting patient safety, ensuring access to lifesaving radiology services, and restoring nonurgent, but necessary care delayed during the COVID-19 pandemic,” ACR said July 22.

The college further noted that all radiology practices continue to face disruptions from equipment shortages, calls to help hospitals with front-line care, and an industrywide shift toward teleradiology. And some imaging practices are just now starting to reopen or are operating with reduced staffing following orders to delay elective care.

“This is not the time to resume provider audits,” the college ended its brief statement. “The ACR looks forward to working with CMS to address this issue.”

CMS performs various such audits, often through private contractors, to gauge whether radiologists and hospitals have been overpaid for services. The current public health emergency is set to expire on July 25, but ACR and others have pushed federal officials to extend it. Health and Human Services was expected to issue such an extension earlier this month, but has yet to officially do so as of Wednesday afternoon.

Marty Stempniak

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. 

Around the web

The patient, who was being cared for in the ICU, was not accompanied or monitored by nursing staff during his exam, despite being sedated.

The nuclear imaging isotope shortage of molybdenum-99 may be over now that the sidelined reactor is restarting. ASNC's president says PET and new SPECT technologies helped cardiac imaging labs better weather the storm.

CMS has more than doubled the CCTA payment rate from $175 to $357.13. The move, expected to have a significant impact on the utilization of cardiac CT, received immediate praise from imaging specialists.