ASNC Advocates for AUC Program Delay

ASNC members met with elected representatives and aides from more than 50 congressional offices and with advisors to Secretary of the Department of Health and Human Services Tom Price, MD. From left, Nishant Shah, MD, James Arrighi, MD, MASNC, Senator Jack Reed (D-RI), Ron Blankstein, MD, FASNC, and Brian Abbott, MD, MASNC. 

Anticipating that the Centers for Medicare and Medicaid Services (CMS) will proceed with implementation in 2018 of the Medicare appropriate use criteria (AUC) program for advanced diagnostic imaging, American Society of Nuclear Cardiology (ASNC) leaders traveled to Capitol Hill on March 16 to ask lawmakers to delay the program and revisit the value and necessity of a stand-alone AUC program.

Protecting Access to Medicare Act of 2014 (PAMA) established the program, which requires clinicians to consult AUC using a CMS-approved clinical decision support mechanism (CDSM) when ordering advanced imaging tests. After two years of data collection, CMS will subject clinicians whose ordering patterns represent outliers to prior authorization.

ASNC members visited more than 50 congressional offices, including with several members of the House GOP Doctor's Caucus. ASNC also met with top advisors to Department of Health and Human Services Secretary Tom Price, MD.

While ASNC is a proponent of AUC as a tool to ensure that patients get the right diagnostic test first, ASNC has also been a vocal critic of a law that has proven complex to implement, even by CMS's own admission.

ASNC successfully led an advocacy effort in 2015 to avoid the program's statutory effective date of 2017, but is now asking Congress to intervene and halt implementation. ASNC argues the goals and intent of the AUC program can be adequately captured in the Merit-based Incentive Payment Program and in alternative payment models, which make the cost and regulatory burden of a new stand-alone program on any clinician who orders or furnishes an advanced diagnostic imaging test unnecessary. 

ASNC is assembling state and national medical societies and other provider groups that share the position that the AUC program should be delayed and rethought. In the weeks ahead, ASNC will be calling on its members to lend their voices to ASNC's efforts to delay the AUC program.