News | July 26, 2010

Medicare Tests Medical Imaging Decision Support Systems

July 26, 2010 – The Centers for Medicare and Medicaid Services (CMS) announced it is soliciting proposals for participation in the Medicare Imaging Demonstration (MID). The MID was authorized by section 135(b) of the Medicare Improvements for Patients and Providers Act of 2008 and will test whether the use of decision support systems (DSSs) can improve quality of care and reduce unnecessary radiation exposure and utilization by promoting appropriate ordering of advanced imaging services.

The two-year demonstration will assess the impact that DSSs used by physician practices have on the appropriateness and utilization of advanced medical imaging services ordered for the Medicare fee-for-service population. A DSS provides immediate feedback based on current medical specialty guidelines to the physician on the appropriateness of the test ordered for the patient. In addition, the demonstration will focus on magnetic resonance imaging, computed tomography, and nuclear medicine advanced imaging diagnostic services.

All current Medicare coverage and payment policies are unaffected under this demonstration. Prior authorization processes, which can be used to deny coverage for tests, are not part of the demonstration.
CMS will use “conveners” to reach eligible physicians interested in participating in the demonstration. Conveners will be responsible for recruiting physician practices, deploying a DSS that incorporates medical specialty society guidelines for the selected procedures, ensuring the DSS remains current with those guidelines, collecting and transmitting data, and distributing payments to practices for reporting data. Conveners and physician practices will be paid for reporting complete data necessary to determine the appropriateness of the test.

A wide variety of interested parties may be eligible to apply as conveners or in collaboration with other organizations to perform the responsibilities specified in the demonstration. Examples of conveners include, but are not limited to, physician groups, integrated health care delivery systems, independent practice associations, radiology benefit managers, health plans, information technology vendors, medical specialty societies, and collaborations among the above parties.

CMS is particularly interested in proposals from conveners that involve a diverse mix of physician practice sizes and types, medical specialties, and geographic areas. It will consider the characteristics of the physician practices and the ability of the convener to perform the functions identified in the solicitation when selecting demonstration areas. Award is contingent on the acceptance of CMS demonstration terms and conditions prior to the start of the demonstration.

Eleven advanced imaging procedures — SPECT (single positron emission computed tomography, myocardial perfusion imaging (MPI), magnetic resonance imaging (MRI) lumbar spine, CT (computed tomography) lumbar spine, MRI brain, CT brain, CT sinus, CT thorax, CT abdomen, CT pelvis, MRI knee, and MRI shoulder —will be included in the demonstration. The 11 tests were selected based on high expenditures and utilization in the Medicare fee-for-service population and the availability of relevant medical specialty appropriateness guidelines. The law requires that the appropriateness criteria used in the demonstration be based on those developed or endorsed by medical specialty societies. CMS worked with medical specialty societies and other stakeholders, including the AQA Alliance, to solicit their input and information on available appropriateness criteria.

Applications are due to CMS by Sept. 21, 2010.

For more information: www.cms.gov/DemoProjectsEvalRpts/MD/itemdetail.asp?itemID=CMS1222075

Related Content

Sponsored Content | Videos | Business | July 28, 2017
Angelic McDonald, MSRS, CRA, FAHRA, regional director of imaging, Baylor Scott & White Health and the president-e
CareSelect Declared Fully Qualified Clinical Decision Support Mechanism by CMS
News | Clinical Decision Support | July 18, 2017
National Decision Support Company announced the full qualification of its CareSelect Platform as a Qualified Clinical...
CMS Proposes Delaying Clinical Decision Support Documentation to 2019
News | Clinical Decision Support | July 14, 2017 | Jeff Zagoudis, Associate Editor
In a series of proposed rule changes to the Medicare Physician Fee Schedule (MPFS) released July 13, the Centers for...
News | Artificial Intelligence | July 07, 2017
July 7, 2017 — Zebra Medical Vision and Telerad Tech, the technology arm of Teleradiology Solutions (TRS), announced
ACR Launches Updated LI-RADS for Liver Imaging
News | Clinical Decision Support | July 06, 2017
July 6, 2017 — Radiologists can improve their consistency of interpreting and reporting...
Sponsored Content | Videos | Clinical Decision Support | June 29, 2017
Rami Doukky, M.D., system chair, Division of Cardiology, professor of medicine, Cook County Health and Hospitals Syst
Fujitsu Develops AI-Based Technology to Retrieve Similar Disease Cases in CT Inspections

Newly developed technology to retrieve similar cases. Image courtesy of Fujitsu.

News | Artificial Intelligence | June 26, 2017
Fujitsu Laboratories Ltd. announced development of a technology to retrieve similar disease cases from a computed...
Siemens Healthineers and Fraunhofer MEVIS Announce Research Alliance on Clinical Decision Support
News | Clinical Decision Support | May 31, 2017
Siemens Healthineers and the Fraunhofer Institute for Medical Image Computing MEVIS announced the formation of a new...
ACR Highlights Initial Results of R-SCAN Program at 2017 Annual Meeting
News | Clinical Decision Support | May 22, 2017
The American College of Radiology (ACR) announced a series of sessions at the 2017 Annual Meeting that will highlight...
Partners HealthCare and GE Healthcare Launch 10-Year Collaboration on Artificial Intelligence
News | Artificial Intelligence | May 17, 2017
Partners HealthCare and GE Healthcare announced a 10-year collaboration to rapidly develop, validate and strategically...
Overlay Init