Bill mandates CDS use by docs receiving Medicare, Medicaid reimbursement

Tools

U.S. Reps. Erik Paulsen (R-Minn.) and Jim Matheson (D-Utah) have introduced a bill in to Congress that would mandate the use of clinical decision support software by physicians receiving Medicare and Medicaid reimbursement.

H.R. 3705--dubbed the "Excellence in Diagnostic Imaging Utilization Act"--would establish appropriateness criteria for advanced imaging scans such as MRI and CT, and also would require physicians to use clinical decision support tools to follow that criteria.

"There is nothing more frustrating that when a patient is told they need a particular test by their trusted physician only to be told by their insurance provider that they can't get it," Paulsen said in an announcement. "By following Minnesota's lead and utilizing tools like clinical decision support, we can share best practices, improve clinical outcomes, reduce costs from unnecessary testing, and improve patient safety. This important bill takes cutting edge steps to help ensure patients get the right test at the right time."

In October, the House Ways and Means Committee and the Senate Finance Committee released a draft version of a policy to replace the sustainable growth rate (SGR) formula that includes language requiring that ordering physicians consult appropriateness criteria for advanced imaging services for Medicare and Medicaid patients.

But, according to RADPAC, the political action committee of the American College of Radiology, with that legislation there is no guarantee clinical decision support language would be included in the final version of the bill, or whether the bill would even be voted on by the end of the year.

"A standalone bill is another way to increase visibility regarding the CDS issue," RADPAC Director Ted Burnes told ImagingBiz. "It's also a way to broaden general support on the Hill."

To learn more:
- read up on the bill (.pdf)
- check out the announcement from Paulsen
- read the article in ImagingBiz

Related Articles:
SGR draft proposal includes imaging language
CDS alerts about dose, cost impact imaging test orders
Rely on governance, tools to keep clinical decision support up to date
With CDS, familiarity with the system breeds greater acceptance