AMIC calls on MedPAC to back appropriate use criteria

The Access to Medical Imaging Coalition (AMIC) is requesting that the Medicare Payment Advisory Commission (MedPAC) fully endorse the implementation of appropriate use criteria (AUC) for advanced imaging studies.

In its letter, AMIC said it believes that full and expedient implementation of the statutory AUC requirements for ordering imaging services -- currently scheduled to take effect on January 1, 2018 -- will help limit low-value care. It also urged MedPAC to make this recommendation to U.S. Department of Health and Human Services Secretary Dr. Tom Price and to Congress.

"By providing physicians with clinical decision-support tools that tap into evolving scientific and clinical evidence, Medicare will be able to ensure that beneficiaries are receiving the most appropriate scan for their clinical circumstances and therefore eliminating inappropriate or unnecessary care," AMIC said in a statement. "AUC can reassure patients, providers, and payors that the test ordered was based on the best available evidence, weighing the risk of harm and potential benefit to the patient."

AMIC wrote to MedPAC in response to the commission's March report and April session, in which MedPAC indicated that imaging may still be overused. In its correspondence, AMIC also encouraged MedPAC to reconsider recent imaging trends, such as the commission's own March 2017 "Report to the Congress." The report showed that beginning in 2009, imaging was the only service category that experienced a consistent decrease in volume of services per beneficiary, according to the coalition.

In addition, AMIC pointed to an April 2017 article in Health Affairs demonstrating that the trend in imaging growth has ended and that the volume of imaging services has stabilized.

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