Medicare Quality Reporting
The Centers for Medicare and Medicaid Services (CMS) have implemented three clinician-level programs to promote improvements in the quality of care provided to beneficiaries. As the Medicare program continues to evolve into a pay-for-value system, it is important for providers to understand each of these programs and their associated requirements.
Appropriate Use Criteria Program
The Protecting Access to Medicare Act of 2014 includes a provision requiring ordering professionals to consult with appropriate use criteria (AUC) through a clinical decision support mechanism (CDSM) for all Medicare patients receiving advanced imaging (cardiac nuclear, CT, MR). Under the law, only AUC developed by entities meeting the “provider-led entity” (PLE) standards as defined by regulation can be used under the Centers for Medicare and Medicaid Services’ AUC Program. The ACC meets requirements to be a qualified PLE to develop and modify AUC under the Medicare AUC Program for advanced diagnostic imaging. As a result, the national AUC developed by the College will be an accepted standard for cardiologists and others when submitting to Medicare for the review of cardiac imaging. Click here to learn more >>>