On Jan. 1, 2020, a new Medicare policy is scheduled to go into effect that will eventually require doctors to use a computer algorithm to vet imaging tests to determine “appropriateness.” If the tests, such as CT scans and M.R.I.s, do not meet certain “appropriate-use criteria,” Medicare may not reimburse the cost. Intended to reduce unnecessary imaging, the policy may penalize doctors who don’t comply by requiring them to get “prior authorization” before ordering imaging tests in the future — in other words, to follow another regulation.

Predictably, many doctors want the policy reversed or at least delayed so that they can come up with an alternative. They say that there is little evidence that the regulation will achieve its intended aim. They have concerns about how the computer algorithm will interact with existing electronic medical records. More generally, they complain of burdensome regulations, created largely without physician input, that doctors already must follow. The new policy, they say, is another intrusion on physicians’ decision-making authority — an authority gained over many years of difficult training.

…continue reading ‘Physician, Regulate Yourself’

Thumb image via article -Shapecharge/E+, via Getty Images Plus

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