Medical Imaging Advocates Fight Proposals Requiring Advance Authorization

As the congressional super committee considers ways to cut Medicare spending, one issue that has been raised is to cut back on imaging services that some experts say are overused by physicians. But an industry study released Tuesday maintains that one tactic that has been suggested — the use of prior authorization for imaging services – doesn’t save money.

The report, financed by the Access to Medical Imaging Coalition, also suggests that it may cost more to run such programs than is often recovered. Prior authorization requires physicians and other practioners to get permission first before performing a service such as medical imaging.

“A prior authorization program would end up costing the government more than it saves and would simply delay patient care and impose administrative burdens and increased costs on physician practices,” coalition executive director Tim Trysla said in a statement.  The group says its members include physicians, providers, patient organizations and health technology companies.

Congress has tried before to cut imaging costs, slicing reimbursement rates to doctors and adding new rules for doctors who refer patients to imaging machines that they own.

The debt panel is expected to look at variety of ways to reduce federal spending. President Barack Obama’s debt reduction plan released last month includes a provision that would require prior authorization from Medicare for advanced imaging services, beginning in 2013.  In June the Medicare Payment Advisory Commission (MedPAC) recommended that some physicians who order a lot of MRIs, CT scans, nuclear medicine studies and other imaging tests to get pre-approval from Medicare.