Advocacy News: Medical Societies Seek Change in AMA Policy on AUC Mandate

At the American Medical Association's June 10-15 House of Delegates (AMA HOD) meeting, ASNC will lead a coalition of medical societies advocating for a change in the AMA's policy on Medicare's Appropriate Use Criteria (AUC) Mandate for advanced diagnostic imaging. 
To change AMA policy, the HOD will need to consider a resolution co-led by ASNC and supported by more than 20 national and state medical societies. 

If the AMA's delegates vote to adopt Resolution 211, then the request for Congress to repeal or modify the AUC Mandate would become official AMA policy, lending important visibility and resources to the robust advocacy effort that ASNC has led and 40+ other societies have supported. 

ASNC's Delegates to the AMA HOD are, from left, Stephen Bloom, MD, FASNC, and Nishant Shah, MD, FASNC.

"A positive vote from the AMA's House of Delegates on Resolution 211 would make the problems with the AUC Program a House of Medicine issue," says Nishant Shah, MD, FASNC, who is one of ASNC's two delegates to the AMA HOD. “The coalition of societies opposing the AUC Mandate includes physician groups from a range of specialties across the House of Medicine. It is a testament to how complex and burdensome the mandate will be and how important it is that the program be repealed or modified before the penalty phase is implemented, which could be as soon as 2023.”

The AUC Mandate was passed into law as part of the Protecting Access to Medicare Act (PAMA) of 2014. The program is currently in a testing and operations period and slated for full implementation on January 1, 2023 (or the January 1 following the end of the COVID-19 public health emergency). This means that, as early as 2023, all ordering clinicians will need to consult a Centers for Medicare & Medicaid (CMS)-qualified clinical decision support mechanism when ordering an advanced imaging test. If this consult does not occur or is not documented, then the test-rendering clinicians will not be paid by Medicare. With the possibility that the penalty phase could begin in just seven months, congressional action on the AUC mandate is urgently needed.

ASNC has been consistent in its support of the appropriate use criteria and its view that the AUC Mandate must be revisited and either repealed or substantially modified on the basis that the mandate – 
  • Diverts clinician resources away from quality improvement activities;
  • Limits provider flexibility for consulting the appropriate use criteria;
  • Adds administrative burden; and
  • Is a costly and disproportionate response to imaging utilization.

What Happens Next? 

ASNC's advocacy on the AUC mandate will continue on multiple paths: 
  • As reported last weekASNC and a coalition of 40+ organizations are continuing to push CMS to work with the physician community to deliver a report to Congress comprehensively detailing the challenges associated with AUC Mandate implementation. We will keep you informed on CMS's actions. 
When the AMA HOD convenes in Chicago, ASNC Delegates Nishant Shah, MD, FASNC, and Stephen Bloom, MD, FASNC, and CEO Kathy Flood will be there, representing you. We will keep you updated on the action around Resolution 211.

What Can You Do? 

Resolution 211 has the support of many organizations with representation in the AMA HOD. These organizations need to hear the physician community's concerns about the AUC Mandate. Please tweet your support for #Resolution211.