In 2012, the ACR partnered with National Decision Support Company as the licensing agent for the ACR Appropriateness Criteria® via ACR Select®. The ACR Rapid Response Committee (RRC) was then formed to respond to customer inquiries for clarifications of clinical decision support content and to expedite consensus expert recommendations when the strength of evidence may be insufficient to develop an ACR Appropriateness Criteria® topic [ 1 Rybicki F.J. Scholarship in the AC process and updates on gaps and harmonization. J Am Coll Radiol. 2017; 14: S381-S382 Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar , 2 Rybicki F.J. The role of the ACR Appropriateness Criteria in the medical literature. J Am Coll Radiol. 2018; 15: S1 Abstract Full Text Full Text PDF PubMed Google Scholar ]. In 2016, the ACR was designated as a qualified provider-led entity (qPLE) by CMS [ 3 Centers for Medicare & Medicaid Services Provider-led entities. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Appropriate-Use-Criteria-Program/PLEDate accessed: July 11, 2022 Google Scholar ], recognizing the ACR Appropriateness Criteria® fulfilled requirements of the Protecting Access to Medicare Act for appropriate use criteria in advanced diagnostic imaging. Concurrently, the ACR Appropriateness Criteria® expanded to address over 2,900 clinical decision support scenarios [ 4 American College of Radiology About the ACR Appropriateness Criteria. https://www.acr.org/Clinical-Resources/ACR-Appropriateness-Criteria/About-the-ACR-ACDate accessed: July 11, 2022 Google Scholar ], the RRC developed over 850 scenarios, and the clinical decision support product and customer support also expanded, including acquisition by Change Healthcare in 2018. In 2019, the RRC shifted focus from responding to customer inquiries to auditing legacy RRC content, eliminating scenarios supplanted by ACR Appropriateness Criteria®, and identifying areas for process improvement [ 5 Lockhart M.L. Bykowski J. Rybicki F.J. Introduction to the JACR Appropriateness Criteria. J Am Coll Radiol. 2019; 16: S315 Abstract Full Text Full Text PDF Scopus (1) Google Scholar ].