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ACR Hails ROOT Act Inclusion in House Medicare Reform Bill

AUC Implementation is a Step Toward Medicare Payment Stability

July 15, 2026

The American College of Radiology® (ACR®) today praised the inclusion of the Radiology Outpatient Ordering Transmission (ROOT) Act in the Patients First Act, bipartisan legislation introduced in the U.S. House to update Medicare healthcare provider payments.

The ROOT Act would modernize implementation of Medicare’s imaging Appropriate Use Criteria (AUC) program and is projected to save approximately $2 billion for Medicare and $1.5 billion for beneficiaries over 10 years.

“Inclusion of the ROOT Act offers a practical path forward that can help improve access and ensure patients receive the most appropriate imaging exams while reducing unnecessary, low-value scans and associated costs,” said ACR CEO Dana H. Smetherman, MD, MPH, MBA, FACR.

Providers would use AUC-based clinical decision support tools to consult multi-specialty-developed, evidence-based guidelines at the point of care. Physicians would maintain their clinical judgment and only need to document that they consulted the guidelines.

Other provisions in the Patients First Act that may affect radiology include:

  • Create an annual Medicare payment update tied to the Medical Economic Index, minus 1%, helping better account for inflation. ACR and other medical groups have long asked for such a step.
  • Establish the POINTS program, which creates a physician and clinician-led task force at CMS to develop quality metrics that are streamlined and reduce administrative burden.
  • Adjust Medicare budget-neutrality policies in the Medicare Physician Fee Schedule to help reduce significant payment fluctuations and support long-term payment reform.

“ACR has long advocated for Medicare payment policies that support patient access to high-quality imaging care while promoting value, efficiency and physician-led decision-making. The College will continue working with Congress to advance reforms that strengthen the Medicare program for patients and physicians alike,” said Smetherman.

The Patients First Act was introduced by Reps. John Joyce, M.D. (PA-13), Greg Murphy, M.D. (NC-03), and Kim Schrier, M.D. (WA-08), respective chairs of the GOP and Democratic Doctors Caucuses.

To speak with an ACR spokesperson, contact ACR Public Affairs.

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