News | Clinical Decision Support | December 26, 2019

Provides no-fee access to qualified clinical decision support mechanism to help providers ensure PAMA compliance in advance of deadline

Effective Jan. 1, 2020, new regulations under the Centers for Medicare & Medicaid Services (CMS) Protecting Access to Medicare Act (PAMA) will require physicians to consult a CMS-approved clinical decision support mechanism before ordering advanced imaging exams for fee-for-service Medicare patients

December 26, 2019 — Effective Jan. 1, 2020, new regulations under the Centers for Medicare & Medicaid Services (CMS) Protecting Access to Medicare Act (PAMA) will require physicians to consult a CMS-approved clinical decision support mechanism before ordering advanced imaging exams for fee-for-service Medicare patients. To help providers ensure compliance with this regulation, Change Healthcare announced that all providers can now leverage the CareSelect Imaging Open Access clinical decision support mechanism for no fee.

“Referring providers without decision support integrated into their EHR lack the tools needed to ensure compliance with the new layer of PAMA requirements that go into effect in January,” said Michael Mardini, CEO of National Decision Support Company, a Change Healthcare company. “By providing no-fee access to our interactive, web-based, clinical decision support technology, we’re making it easy for providers to reference and consult against the largest collection of evidence-based, physician-authored imaging criteria currently available to achieve compliance.”

Customers using CareSelect Imaging with Epic, Cerner, Meditech, and other leading EHRs can enable their external, referring providers to consult through CareSelect Imaging Open Access to help ensure PAMA compliance and meet the January deadline. These providers can register for access and consult Appropriate Use Criteria (AUC) using Open Access. No software or hardware investment is required. Providers can register for access and help ensure their advanced imaging orders are PAMA-compliant by logging onto the CareSelect Imaging Open Access portal.

When providers place an imaging order, CareSelect Imaging Open Access will analyze and validate the appropriateness of the order against the latest clinical standards to provide an AUC consultation. An “appropriateness rating” is presented for the imaging order, along with a ranking of estimated costs and appropriate alternative imaging choices. Using this appropriateness information, the physician can make an informed decision about the imaging order and ensure completion of a digital consultation as required for PAMA. The results of these consultations should then be sent along with their order requisition forms.

CareSelect Imaging Open Access is fully qualified by CMS as a Clinical Decision Support Mechanism (CDSM). Its AUC content, which ordering physicians consult, is provided by CMS- qualified, provider-led entities including the American College of Radiology, the American College of Cardiology, the Society of Nuclear Medicine and Molecular Imaging, and the National Comprehensive Cancer Network. Access to this comprehensive criteria set helps ensure that clinical guidelines criteria are available for all Priority Clinical Areas outlined by CMS.

CareSelect Imaging Open Access is available to providers immediately. Providers can register at https://openaccess.careselect.org/registration.

National Decision Support Company, a Change Healthcare Company, offers CareSelect Clinical Decision Support and analytics solutions designed to influence clinician ordering to manage utilization and control costs while reducing administrative burden and streamlining the payer and provider data exchange. CareSelect Imaging is installed in over a thousand healthcare provider organizations.

For more information: changehealthcare.com

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