CMS Officials Delay Diagnostic Imaging Test Mandate That Had Been Set for January 2017 | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

CMS Officials Delay Diagnostic Imaging Test Mandate That Had Been Set for January 2017

November 12, 2015
by Mark Hagland
| Reprints
According to a Nov. 11 media report, CMS has postponed its January 1, 2017 deadline for physicians to use CDS software when ordering diagnostic imaging tests

According to a report published online on Nov. 11 by the online publication, the Centers for Medicare and Medicaid Services (CMS) has postponed its January 1, 2017 deadline for physicians to use clinical decision support (CDS) software, based on appropriate-use criteria (AUC), when ordering diagnostic imaging tests.

The report, by AuntMinnie staff writer Erik L. Ridley, stated that, “In an announcement included in the final rule of the Medicare Physician Fee Schedule (MPFS) on October 30, CMS indicated that it now doesn't expect to have approved CDS "mechanisms" until approximately the summer of 2017. The agency said it was not yet in a position to predict the exact timing of a new deadline for when practitioners are expected to begin utilizing clinical decision support.”

Signed into law in April 2014 by President Obama, the Protecting Access to Medicare Act (PAMA) included a mandate that physicians utilize appropriate use criteria via clinical decision support for ordering advanced imaging studies such as diagnostic MRI, CT, and nuclear medicine (including PET). X-ray, fluoroscopy, and ultrasound exams were excluded. The appropriate use criteria requirements also only apply to outpatient settings such as physician offices, hospital outpatient departments, ambulatory surgical centers, and any provider-led outpatient setting.

PAMA had an aggressive timeline. After a series of planned milestones laid out for CMS to approve qualified appropriateness use criteria as well as clinical decision-support mechanisms, all ordering professionals in the Medicare program were mandated, by January 1, 2017, to consult with a qualified CDS mechanism when ordering an advanced imaging study.

PAMA also has reporting requirements for radiologists. By January 1, 2020, outlier professionals -- those who have low adherence to AUC criteria when ordering imaging studies -- will be required to obtain prior authorization.

But the aggressive approach at CMS may not have been realistic. The agency agreed with several commenters that the January 1, 2017, deadline wasn't feasible, and instead CMS chose to delay the implementation date.

Healthcare Informatics will update readers on this story as new developments emerge.



Get the latest information on Health IT and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.

Learn More



Survey: Infrastructure, Interoperability Key Barriers to Global HIT Development

A new survey report from Black Book Research on global healthcare IT adoption and records systems connectivity finds nations in various phases of regional electronic health record (EHR) adoption. The survey results also reveal rapidly advancing opportunities for U.S.-based and local technology vendors.

Penn Medicine Opens Up Telehealth Hub

Philadelphia-based Penn Medicine has opened its Center for Connected Care to centralize the health system’s telemedicine activities.

Roche to Pay $1.9B for Flatiron Health

Switzerland-based pharmaceutical company Roche has agreed to pay $1.9 billion to buy New York-based Flatiron Health Inc., which has both an oncology EHR and data analytics platform.

Financial Exec Survey: Interoperability Key Obstacle to Value-Based Payment Models

Momentum continues to grow for value-based care as nearly three-quarters of healthcare executives report their organizations have achieved positive financial results from value-based payment programs, to date, according to a new study from the Healthcare Financial Management Association (HFMA).

Cerner, Children's National to Help UAE Pediatric Center with Health IT

Al Jalila Children's Specialty Hospital, the only pediatric hospital in the United Arab Emirates, has entered into an agreement with Washington, D.C.-based Children's National Health System to form a health IT strategic partnership.

Telemedicine Association Names New CEO

The American Telemedicine Association (ATA) has named Ann Mond Johnson its new CEO, replacing Jon Linkous who stepped down suddenly last August after 24 years as the organization’s CEO.