Slow implementation bogs down Medicare-mandated imaging accreditation

Pro-radiology forces are claiming mandated Medicare accreditation as a victory. They will have to wait until January 2012, however, to see the actual implementation of federal law passed in July to mandate accreditation for high-tech medical imaging covered by outpatient Medicare.

The Medicare Improvement for Patients and Providers Act limits its precedent-setting accreditation requirement to the technical component of MRI, CT, nuclear medicine, and PET scanning, according to Josh Cooper, senior director of government relations at the American College of Radiology. Diagnostic ultrasound and x-ray were excluded.

"The language placing that at the (HHS) secretary's discretion was targeted at new, innovative technologies rather than reaching back and going after x-ray and ultrasound," he said in an interview.

By linking accreditation to the technical component of Medicare reimbursement, Congress set aside consideration of the professional qualification of physicians who prescribe high-tech imaging. Instead, accreditation will revolve around machine performance, quality assurance, quality control, and the qualifications of the supervising physician and technologists, Cooper said.

The ACR and the Intersocietal Accreditation Commission have both announced that they plan to apply to become accrediting agencies for the program. By law, the deadline to apply for that role is Jan. 1, 2010.

Thousands of outpatient imaging services will be subject to the accreditation mandate. Passage of the accreditation requirement marks a turning point in recognizing the importance of national quality standards for medical imaging, according to IAC officials.

"With all the talk about growing imaging utilization and the need for cost control, we have always maintained that the first step is to make sure that facilities provide quality imaging," said Sandra L. Katanick, chief executive officer of the IAC, in an interview.

The nonprofit IAC supports accreditation for facilities that perform noninvasive vascular testing, echocardiography, nuclear cardiology, general nuclear medicine and/or PET, MRI, and CT scanning.

The ACR's accreditation program covers eight categories of medical imaging. It has been a national accrediting body for a mandatory federal mammography accreditation program through the FDA since the program's inception in 1994. It announced earlier this month that it had been selected as the accrediting organization for U.S. Department of Veterans Affairs radiation oncology facilities.

The ACR hopes accreditation will lead to cost savings and reduced utilization of outpatient imaging services covered by Medicare, Cooper said.

"Hopefully, the folks who are not serious about imaging will either get out of the business or choose not to get in, so we can avoid poor quality and duplicative services," Cooper said.

For more information from the Diagnostic Imaging archives:

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