New Rules for Radiology Orders: Exemptions for Screenings and Rural Doctors.
This Act modifies Medicare rules for ordering advanced imaging services (like MRIs or CT scans) by increasing data collection on whether doctors use clinical decision support tools. Crucially, it exempts common screenings (like mammograms) and orders from small or rural practices from these administrative requirements, potentially speeding up patient access to these specific services. Doctors who consistently fail to follow the consultation rules will be monitored as "low compliant" and may face future requirements for prior authorization.
Key points
Administrative requirements for consulting clinical decision support systems before ordering imaging are removed for common screenings like mammography and lung cancer screening.
Small medical practices (15 or fewer professionals) and practices in rural, underserved areas are exempted from the new ordering documentation rules.
Physicians who frequently fail to consult the required systems will be designated "low compliant," potentially leading to future prior authorization requirements for their patients' non-exempt imaging services.
Introduced
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