As of January 1, 2020, new regulations under the Centers for Medicare & Medicaid Services (CMS) Protecting Access to Medicare Act (PAMA) will require physicians to consult a CMS-approved clinical decision support mechanism before ordering advanced imaging exams for fee-for-service Medicare patients.
The CareSelect Imaging Open Access clinical decision
To help providers ensure compliance with this regulation, Change Healthcare announced that all providers can now leverage the CareSelect Imaging Open Access clinical decision support mechanism for no fee.
“Now providers have a stand-alone web portal that will deliver a decision support consultation based on the same logic as the CareSelect Imaging suite. Then they can leverage that information however they need to,” said Nicholas Geyer, product marketing manager of imaging at CareSelect.
When providers place an imaging order, CareSelect Imaging Open Access will analyze and validate the appropriateness of the order against the latest clinical standards to provide an Appropriate Use Criteria (AUC) consultation. An “appropriateness rating” is presented for the imaging order, along with a ranking of estimated costs and appropriate alternative imaging choices.
Using this appropriateness information, the physician can make an informed decision about the imaging order and ensure completion of a digital consultation as required for PAMA. The results of these consultations should then be sent along with their order requisition forms.
CareSelect Imaging Open Access is fully qualified by CMS as a Clinical Decision Support Mechanism (CDSM). Its AUC content, which ordering physicians consult, is provided by CMS- qualified, provider-led entities including the American College of Radiology, the American College of Cardiology, the Society of Nuclear Medicine and Molecular Imaging, and the National Comprehensive Cancer Network.
Access to this comprehensive criteria set helps ensure that clinical guidelines criteria are available for all Priority Clinical Areas outlined by CMS.
Customers using CareSelect Imaging with Epic, Cerner, Meditech, and other leading EHRs can enable their external, referring providers to consult through CareSelect Imaging Open Access to help ensure PAMA compliance and meet the January deadline. Providers can register for access and help ensure their advanced imaging orders are PAMA-compliant by logging onto the CareSelect Imaging Open Access portal.
Change Healthcare creates a pathway to PAMA compliance with no-fee access to CareSelect™ clinical decision support. Appl Radiol.