Last week representatives from five medical specialties, including Radiology, met with the Meaningful Use Workgroup of the Office of the National Coordinator for Health Information Technology to push for changes to the draft stage 2 criteria for the U.S. government's meaningful use stimulus program before final versions are submitted in June. Though more than 90 percent of all radiologists are considered eligible for some of the program's $20 billion in health information technology (HIT) incentives, stage 1 criteria were largely geared towards primary care physicians, mostly ignoring specialists.
Though Radiologists, along with other specialists, are exempt from certain criteria, the traditional PACS and RIS systems they use are unlikely to be certified under current meaningful use guidelines, requiring them to purchase extra electronic health record systems that they do not need and will not use in order to qualify. Radiologist representatives argued that they pioneered the adoption of electronic record keeping decades ago, and that most Radiologists were "meaningfully using" these technologies on a daily basis. Technology that already exists and works successfully, representatives argued, should be incorporated into the stage 2 meaningful use criteria recommendations.
Radiologists Push For Specialty-Centric Meaningful Use Guidelines
Concerns regarding the safety of medical imaging and its link to an increased cancer risk have intensified significantly in the past two years. High-profile stories of radiation overexposure received wide coverage in the media and have already led to the passage of landmark legislation in California regulating medical imaging that uses ionizing radiation. As a result of the mounting unease, it comes as no surprise that this week the American College of Radiology (ACR) announced
that it has launched a CT dose index registry that allows imaging facilities to track and compare radiation dose from imaging exams.
ACR launches CT Dose Index Registry
A state probe into Blue Cross Blue Shield of Delaware (BCBSD) has found that the insurer violated state law when it signed a contract with Tennessee-based radiology benefits management company MedSolutions that incentivized the latter to deny requests for advanced cardiac imaging exams. At the same time, an independent federal investigation has found MedSolutions to be inappropriately denying anywhere from 10-15% of such requests.
After 13 months of investigation, the state probe, carried out by Delaware's Department of Insurance, found that a 2009 contract between BCBSD and MedSolutions broke state law when it obligated MedSolutions to return 10% of its fee if it did not save the insurer 20% in payments for cardiac imaging services. This 'guaranteed savings' provision was stripped from Blue Cross Blue Shield's contract with MedSolutions last summer, while the state prepared its report.
State and Federal Investigations Find BCBSD Inappropriately Denying Advanced Cardiac Imaging Exams