The Washington State Radiological Society advances radiology and radiologists to promote the highest standards of quality, safety and public health.
How many of you are pleased with the current state of advanced imaging authorization?
To address inadequacies in this process, in 2014, the Washington State Legislature passed ESSB 6511, an act relating to prior authorization of health care services. This bill directs the Insurance Commissioner to develop recommendations designed to improve how prior authorizations of healthcare services are administered. The Insurance Commissioner is now considering rulemaking to regulate issuer’s prior authorization processes, with the intent to streamline the prior authorization process, making it easier for consumers to get prior authorization for covered services. As interested stakeholders, the WSRS has contributed comments on this rule-making process on your behalf.
Because advanced imaging is so crucial and essential to modern healthcare delivery, a delay in diagnosis and subsequent treatment due to delays in authorization can literally mean the difference between life and death. If or until there is a complete shift away from fee for service healthcare to accountable care, risk-based, payment models that will essentially eliminate the need for prior authorization, IT tools can now integrate radiologists more tightly into the care delivery process streamlining the benefit review process. Such tools support closer collaboration between the radiologist, the referring physician and the patient. Ordering of advanced imaging can be guided in real-time by the latest in medical and clinical effectiveness research, the patient’s radiation dose history, and the patient’s prior health and imaging records. That is why we communicated to the OIC how crucial it is to streamline the prior authorization process by having advanced electronic data interfaces to allow for immediate auto-authorization, at the point of care.
As members, I hope you will plan to attend our State Chapter annual meeting this fall to learn more about issues like this, among the many issues related to our practices. Please mark your calendars; Saturday Nov. 5, 2016 at the W Hotel in downtown Seattle. This should prove to be our biggest and best meeting yet. The meeting is dedicated to our colleague Doug Green, who passed away so unexpectedly this past winter. I am delighted to share with you that Dr. Geraldine McGinty, the new Vice-Chair of the ACR Board of Chancellors, will be one of our special guests!
Wishing you all a great summer,
Eric J. Stern MD