01 Jan Preparing for the 2022 CMS Mandate for Clinical Decision Support

Continuing through 2021, radiology, orthopedic, and cardiology practices, freestanding imaging centers, and outpatient hospital facilities are weighing their readiness and implementing the systems necessary for compliance with the CMS Medicare rules governing the Appropriate Use Criteria (AUC) Program. This is part of the “Protecting Access to Medicare Act” (PAMA) passed by Congress in 2014 and is designed to improve diagnostic accuracy and quality of care while reducing unnecessary testing for Medicare patients.

The Appropriate Use Criteria (AUC) program is focused on supporting referring providers when ordering advanced diagnostic and interventional testing procedures to include MRI, CT, Nuclear Medicine, and PET. It’s mandated that when ordering these advanced imaging services, the referring provider or their designee will be required to consult a Clinical Decision Support Mechanism (CDSM), an interactive, electronic portal where they can access AUC that will greatly enhance the clinical decision experience.

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