AMIC takes aim at prior authorization provisions in 2017 federal budget

Prior authorization provisions in President Obama’s proposed 2017 federal budget would hinder the decision making of doctors and limit access to imaging for patients, according to a statement released today by The Access to Medical Imaging Coalition (AMIC).

“Not only is prior authorization ineffective and administratively burdensome for imaging services, but it would also interfere with the implementation of the Appropriate Use Criteria (AUC) legislative program, which will in and of itself ensure the clinical appropriateness of imaging services delivered to Medicare beneficiaries,” said AMIC executive director Tim Trysla. “Instead of consulting a cost-driven third party, AMIC encourages policymakers to continue to incentivize widespread adoption of the AUC to promote and improve proper use of medical imaging.”

The President’s $4.1 trillion proposed budget, which includes federal funding for healthcare initiatives including Medicaid expansion, mental health infrastructure, substance abuse treatment and more, is considered unlikely to be approved by the GOP-controlled Congress, though some its healthcare-related proposals have seen bipartisan support.

But the AMIC claims the budget’s Medicare Fee-for-Service prior authorization provisions are cause for concern and need to be scrapped altogether.

“When prior authorization schemes are applied to imaging, patients encounter roadblocks to early and proper diagnosis,” Trysla said. “Congress has already developed an effective policy to make certain that advanced imaging orders are informed and supported by sound evidence-based (AUC) guidelines.”