New York Times September 11, 2019
Sandeep Jauhar

If doctors won’t help fix the problems of health care, they shouldn’t be outraged when outsiders try to do it for them.

On Jan. 1, 2020, a new Medicare policy is scheduled to go into effect that will eventually require doctors to use a computer algorithm to vet imaging tests to determine “appropriateness.” If the tests, such as CT scans and M.R.I.s, do not meet certain “appropriate-use criteria,” Medicare may not reimburse the cost. Intended to reduce unnecessary imaging, the policy may penalize doctors who don’t comply by requiring them to get “prior authorization” before ordering imaging tests in the future — in other words, to follow another regulation.

Predictably, many doctors want the policy reversed or at...

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Topics: CMS, Govt Agencies, Health System / Hospital, Insurance, Medicare, Payment Models, Physician, Provider, RCM (Revenue Cycle Mgmt)
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