Creating Accountability in Image Quality Analysis. Part 2: Medical Imaging Accreditation

Abstract

The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) requires all non-hospital providers of advance diagnostic imaging (ADI) submitting technical reimbursement claims to Medicare to undergo a formal accreditation in order to qualify for continued Medicare reimbursement (http://www.govtrack.us/congress/bills/110/hr6331/text). ADI includes MRI, CT, and nuclear medicine imaging and does not include X-ray, ultrasound, and fluoroscopy. Mammography is covered separately by the Mammography Quality Standards Act (http://www.fda.gov/CDRH/MAMMOGRAPHY). The quality standards which must be demonstrated by medical imaging providers in this accreditation process include the following (http://www.cms.gov/outreach-and-education/medicare-learning-network-MLN/MLNI): Qualifications of medical personnel who are not physicians Qualifications and responsibilities of medical directors and supervisory physicians Procedures to ensure equipment being used meets performance specifications Procedures to ensure the safety of both medical imaging beneficiaries and personnel Establishment and maintenance of a quality assurance and quality control program to ensure reliability, clarity, and accuracy of image technical quality The accreditation process is triennial and averages US$3,500 per imaging modality being evaluated. In the event that an applicant is determined to be noncompliant with the established standards, a corrective action plan is required, with the possibility of a site visit. After the accreditation process has been successfully completed, the provider is required to notify the accreditation organization of any change in service (e.g., equipment change).