Analysis Shows Insurers Undermine No Surprises Act IDR Process
Insurers use unrealistically low initial payments, flawed Qualifying Payment Amounts, and impractical contracting terms to push physicians to the IDR process.
Read moreAUC Implementation is a Step Toward Medicare Payment Stability
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:
“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.
Analysis Shows Insurers Undermine No Surprises Act IDR Process
Insurers use unrealistically low initial payments, flawed Qualifying Payment Amounts, and impractical contracting terms to push physicians to the IDR process.
Read moreLandmark Ullrich Gift to Strengthen Radiology Access and Outcomes
The transformative donation will advance ACR initiatives supporting radiology advocacy, research and patient care for years to come.
Read more
ACR Challenges Health Affairs Study Claims on NSA Dispute Costs
Evidence from court rulings, arbitration outcomes and insurer network cuts challenges the study's conclusions on NSA dispute costs.
Read more