Washington, D.C. – Today, Congressmen Tom Emmer (MN-06) sent a letter to the Secretary of the Department of Health and Human Services (HHS) and Administrator of the Center for Medicare and Medicaid Services (CMS) expressing concerns about the delay of the appropriate use criteria (AUC) program implementation.

The AUC program would streamline the diagnostic imaging process for Medicare patients by directing providers to use additional support mechanisms before ordering imaging tests, like CT, PET, and MRI scans. This would prevent patients from undergoing duplicative or unnecessary imaging procedures.

“Imaging services can be an invaluable diagnostic tool for patients suffering from everything from a fractured bone to cancer,” said Emmer.

“Without evidence-based guidance, providers are at risk of wasting precious time, money and resources on improper testing. The Biden Administration must stop dragging their feet and finally implement the AUC program,” Emmer concluded.

Minnesota is a global leader in medical technology. The industry employs more than 26,500 workers and generates an additional 41,500 jobs in Minnesota alone.

Background:

The AUC program was authorized as part of the Protecting Access to Medicare Act, more than eight years ago. In July, CMS announced that they were no longer committed to their previous implementation deadline of January 1, 2023 or the year following the cessation of the current COVID public health emergency. A new timeline for implementation has yet to be announced.

At least 10-15% of orders submitted for advanced imaging do not adhere to evidence-based guidance, costing Medicare hundreds of millions of dollars annually. Implementing the AUC program will improve the efficiency and efficacy of care available to Medicare patients. 

You can read the letter in full here.

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