Advanced imaging accreditation looms, and that's good
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"Medical imaging has seen great financial growth over the past two decades. It makes sense that CMS tries to constrain some of this growth," Green said.
"There has clearly been some abuse of the system in the past, which continues," he said. "Having internists performing echocardiograms and carotid duplex studies in their offices is just one example of the outmigration of low expense—for the doctor—imaging techniques being performed today."
The Medicare Payment Advisory Commission in 2005 found that imaging services grew twice as fast as other physician services. The finding helped to inform the Medicare Improvement for Patients and Providers Act of 2008, which mandates the accreditation.
Providers of CT, MRI, PET and nuclear medicine must be accredited by Jan. 1, 2012, to be reimbursed under the Medicare Physician Fee Schedule for the technical component of an imaging exam.
"My hope is that accreditation for the technical component and board certification for the professional component be required for all outpatient imaging studies. As much as possible, the 'rules' for cardiologists, radiologists and others should be similar," Green said.
"Unfortunately," he concluded, "radiologists can frequently take the higher ground, as generally their imaging cases are not self-referred, whereas clinicians who perform imaging testing in their offices are self-referred."
The mandate from CMS will affect more than 7,000 healthcare organizations. It is recommended that facilities begin the application process as soon as possible and submit the paperwork prior to July 2011 to allow ample time to achieve accreditation by Jan. 1, 2012.
They three approved accrediting bodies are the Joint Commission, the Intersocietal Accreditation Commission and the American College of Radiology.