Advanced Authorization for Imaging Services is a Money Loser

As the congressional super committee considers ways to cut Medicare spending, one issue area the super committee is considering is to require advanced authorization for selected imaging procedures. However, a recent industry study released Tuesday maintains that 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 before ordering selected medical imaging procedures.

“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 increase 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.

The super committee 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.

By Nov. 23, 2011, the super committee will attempt to target $1.5 trillion in “discretionary funding and direct spending” for deficit reduction efforts through 2021. If Congress does not approve the committees’ proposal by Dec. 23, 2011, the government is obligated to make across-the-board spending cuts worth $1.2 trillion.

With little time to spare, the super committee began moving into high gear this past week to try to hammer out a deficit reduction package at a time when American pessimism about the direction of the economy-and the government’s ability to deal with it-is at an all-time low.

ADVOCATE will continue to provide updates as they become available.

Best regards,
Kirk Reinitz, CPA
President & CEO