WSHA Industry Partner details developments in appropriate use criteria

May 10, 2017

PARA logoThe Protecting Access to Medicare Act (PAMA) authorized Medicare to promote the use of “appropriate use criteria” (AUC) before ordering advanced diagnostic tests — such as advanced imaging as well as the use of clinical decision support mechanisms in eight clinical areas — for Medicare patients. WSHA Industry partner PARA Healthcare Financial Services has written a paper detailing developments regarding this topic.

Over time, this may lead to greater consistency and uniformity of the medical necessity requirements and mechanisms used by health plans. (Andrew Busz)

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