
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.
To
read the full report, click on the PDF icon
at left.
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