Select your question from the list below.
1. What is the new Medicare accreditation requirement?
2. Is accreditation required for all imaging services?
3. Is accreditation for echocardiography required?
4. Who are the accrediting bodies?
5. Which accreditation body does the ACC recommend for its members?
6. What if my facility is already accredited through IAC or ACR?
7. My practice was recently purchased by a hospital, do we need to be accredited?
8. My practice has multiple locations performing advanced imaging. Must they all be accredited?
9. I am planning to open an advanced imaging facility after January 1, 2012. Is there a grace period for accreditation?
10. I understand there are Medicare enrollment forms that must be completed in order to receive payment. What are they and where can I find them? 11. What criteria will be reviewed by accrediting bodies?
12. How long does the accreditation process take?
1. What is the new Medicare accreditation requirement?
The “Medicare Improvements for Patients and Providers Act of 2008” (MIPPA) requires that as of Jan. 1, 2012, all non-hospital suppliers furnishing the technical component (TC) of advanced imaging services must be accredited by a designated accreditation organization for purposes of reimbursement. At this time, the MIPPA requirements only apply to freestanding imaging centers.
2. Is accreditation required for all imaging services?
The law requires accreditation for advanced diagnostic imaging services, defined as:
- Magnetic Resonance Imaging
- Computed Tomography
- Nuclear Medicine
- PET
3. Is accreditation for echocardiography required?
No, MIPPA excludes x-ray, fluoroscopy, and ultrasound, including echocardiography. However, to improve health care quality, the ACC strongly supports participation in physician certification and/or laboratory accreditation programs developed by physicians and appropriate to the field of practice. To learn more, review ACC’s Statement on Accreditation/Certification.
4. Who are the accrediting bodies?
In January 2010, Medicare announced the three approved accreditation organizations:
5. Which accreditation body does the ACC recommend for its members?
The ACC encourages its members to review each body’s accreditation standards to ensure their laboratory meets its requirements. The IAC, of which ACC is a sponsoring organization, provides facility accreditation programs for noninvasive vascular, echocardiography, nuclear cardiology/nuclear medicine/PET, magnetic resonance, computed tomography and carotid stenting. The Joint Commission (formerly known as JCAHO) is primarily known for its role accrediting hospitals and the ACR as a professional organization representing radiologists.
6. What if my facility is already accredited through IAC or ACR?
Facilities that are accredited prior to the new law’s deadline will meet the requirement if the accreditation is through an accrediting organization designated by the Secretary of Health and Human Services. IAC and ACR are designated as accrediting bodies. Please note the expiration date of accreditation – if it is prior to Jan. 1, 2012, it will have to be renewed.
7. My practice was recently purchased by a hospital, do we need to be accredited?
MIPPA applies specifically to payments made under the Medicare Physician Fee Schedule (PFS). If your practice bills for the TC under the PFS, then the answer is yes. If your practice bills under the Hospital Outpatient Prospective Payment System (HOPPS), then the answer is no. Many practices that become employed by hospitals bill the TC with HOPPS. ACC recommends checking with your hospital’s leadership to determine under which system your practice is billing.
8. My practice has multiple locations performing advanced imaging. Must they all be accredited?
For practices with multiple locations, each location must be separately accredited. ACC recommends notifying and seeking the advice of your accrediting body if your practice has more than one location.
9. I am planning to open an advanced imaging facility after January 1, 2012. Is there a grace period for accreditation?
Currently, there is not a grace period in place for new facilities. In order to receive payment for services under the PFS, the lab must be accredited. Your ACC is working with IAC to try to create a process that allows new labs to see Medicare patients while undergoing accreditation.
10. I understand there are Medicare enrollment forms that must be completed in order to receive payment. What are they and where can I find them?
CMS originally proposed that accredited labs would have to complete new enrollment paperwork but rescinded that onerous requirement based on discussions with the accrediting bodies, ACC, and others. No new CMS documentation will be required.
11. What criteria will be reviewed by accrediting bodies?
The accreditation organizations will evaluate facilities based on specific criteria such as:
- Standards for qualifications of medical personnel who are not physicians and who furnish the TC of advanced diagnostic imaging services;
- Standards for qualifications and responsibilities of medical directors and supervising physicians, including standards that recognize the specific considerations for the evaluation of medical directors and supervising physicians;
- Procedures to ensure that equipment used in furnishing the TC of advanced diagnostic imaging services meets performance specifications;
- Standards that require the supplier have procedures in place to ensure the safety of persons who furnish the TC of advanced diagnostic imaging services and individuals to whom such services are furnished;
- Standards that require the establishment and maintenance of a quality assurance and quality control program by the supplier that is adequate and appropriate to ensure the reliability, clarity, and accuracy of the technical quality of diagnostic images produced by such supplier.
12. How long does the accreditation process take?
CMS is encouraging all providers of advanced diagnostic imaging services to begin the accreditation process as soon as possible in order to meet the January 1, 2012 deadline. The agency estimates the accreditation process may take as long as nine months from start to finish. Providers should have begun receiving a series of letters in July 2010 from their Medicare contractors with more details about the process.
To learn more, view the ACC’s position on imaging accreditation.