Appropriate Use

The start of Appropriate Use Criteria (AUC) may be delayed as it has been added to the Medicare Physician Fee Schedule proposed rule which was published by CMS on 07/21/2017.  The program was to start January 1, 2018, however, the proposed rule mentions delaying this program’s start date to January 1, 2019.  The Protecting Access to Medicare Act (PAMA) of 2014 included a mandate to start using AUC electronically through clinical decision support (CDS) when physician’s ordered outpatient advanced imaging exams for Medicare patients.  However, after the original release, CMS received feedback that the timelines posed did not allow enough time for physicians to be able to adopt a qualified CDS.  This additional year will allow physicians to adopt and possibly begin to report beginning in July 2018.  eClinicalWorks is partnering with National Decision Support Company (NDSC) to develop CDS within the application and is to be released in 2018.

Reference and proposed rule:
https://www.federalregister.gov/documents/2017/07/21/2017-14639/medicare-program-revisions-to-payment-policies-under-the-physician-fee-schedule-and-other-revisions

Reference:
https://www.advisory.com/research/imaging-performance-partnership/the-reading-room/2017/07/imaging-cds