Should Medicare Stop Medical Imaging Before It Starts?

From the Wall Street Journal Health Blog:

Medicare has been trying to clamp down on burgeoning costs from medical imaging. But a new GAO report suggests the agency might have more success if it were to stop unnecessary CT scans, MRIs and the like before they happen in the first place.

To cut imaging costs, Medicare has been cutting certain physician payments, sifting through its data to spot improper claims, and educating medical practitioners about the issue. But the GAO’s suggestions for Medicare include weighing a front-end tactic that’s common in the private health-insurance market: prior authorization. That’s when, for a patient to get coverage, an insurer has to give permission before something takes place. “We believe that post-payment claims review alone is inadequate to manage one of the fastest growing parts of Medicare,” the GAO said.

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