A Wave Of Payment Policies Is
Sweeping The Nation
THE EVER-CHANGING WORLD OF REIMBURSEMENT
from
the June 2005 issue
The issue of reimbursement policy, one that quite often shares
the spotlight with accreditation, has come into sharper focus
recently as it relates to diagnostic imaging procedures, including
echocardiography. With payments for imaging services increasing
in double-digit percentages each year, insurance carriers are
looking for ways to reduce costly, repeat procedures and ensure
that they are only paying for the most accurate diagnoses possible.
Buzz phrases such as "pay for quality" and "reduction
of inappropriate use" are being used by insurers as they
seek objective, reliable, expert guidelines for providers of
imaging services. Adoption of such guidelines is intended to
ensure that imaging providers are delivering high quality imaging
services to patients while at the same time helping to control
the rapid growth of imaging spending. By no mere coincidence,
the ICAEL itself has subsequently seen a steady increase in
the number of laboratories applying for accreditation, recently
celebrating its most impressive quarter in company history.
Currently,
Medicare reimbursement policy is handled individually by each
state, as determined by the designated Medicare carrier director.
Since the inception of the ICAEL in 1996, an increasing number
of states have enacted policies linking payment for the reimbursement
of echocardiography procedures to the accreditation status of
the laboratory. Recognizing the strength of the ICAEL accreditation
process and the Registered Diagnostic Cardiac Sonographer (RDCS)
and Registered Cardiac Sonographer (RCS) credentials, the Medicare
carriers in Florida, New Jersey, New York, North Carolina and
South Carolina now require either laboratory accreditation,
certification of the individuals performing the examinations,
or a combination of these two indicators of quality.
THE
CURRENT STATE OF REIMBURSEMENT POLICY
The
map above shows the states that have adopted a reimbursement
policy. The ICAEL website provides an excerpt of each state's
policy as it directly relates to the requirement for accreditation
or certification, as well as a link to their website. For this
and all of the latest information regarding state policies,
visit the ICAEL website at www.icael.org/icael/reimbursement/terms.htm.
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