You may have heard about the upcoming Medicare requirement to consult Appropriate Use Criteria (AUC) through approved clinical decision support mechanisms prior to ordering advanced imaging services. You may have even heard that you have to do this for all your Medicare patients to comply with federal regulations. Read how ACEP advocated for and received an exemption for individuals with emergency medical conditions and to download a sample letter to help explain this exemption to your hospital administrators.
The Emergency Exemption for Medicare’s Appropriate Use Criteria (AUC)
Topics: Appropriate Use CriteriaImaging & UltrasoundMedicareMedicare & Medicaid
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One Response to “The Emergency Exemption for Medicare’s Appropriate Use Criteria (AUC)”
February 16, 2020
Joseph ToscanoToward the end of last year, my hospital system informed us of the AU. After seeing this article, I informed them of ACEP’s work regarding the exemption. They have responded to me that they can find no record of that, except this article.
The CMS AUC site (updated 1/10/20) still says that EDs are included: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Appropriate-Use-Criteria-Program
I’m just wondering if there are other authoritative sources to confirm the ED Exemption. We’re still about year off but will likely be starting training, etc, and it’d be nice to know whether the associated time and effort is really going to be needed.