Senate bill ties physicians’ pay to appropriateness criteria

(DIAGNOSTIC IMAGING) -- A proposal that could allow higher payments for physicians who refer patients in accordance with appropriateness criteria has been added to a healthcare reform bill now before the Senate Finance Committee. The America's Healthy Future Act of 2009 would create the CMS Innovation Center, a new Medicare program charged with evaluating and implementing physician payment methods that keep quality patient care up and costs down. The bill builds upon a four-decade old law that gives the Secretary of Health and Human Services authority to test new reimbursement approaches. The bill would allocate $10 billion over 10 years to fund the center. Among the methods suggested to the Senate panel, the innovation center would be required to scale down payments to physicians who do not consult appropriateness criteria before ordering advanced diagnostic imaging services for their patients, said Cynthia R. Moran, assistant executive director for government relations and economic policy at the American College of Radiology.

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