U.S. Senators Marsha Blackburn and Catherine Cortez Masto have introduced the Radiology Outpatient Ordering Transmission (ROOT) Act, a bipartisan effort aimed at updating Medicare’s imaging oversight process. The legislation seeks to eliminate a reporting requirement that has hindered the full implementation of Medicare’s Appropriate Use Criteria (AUC) program, which is designed to ensure that only necessary advanced imaging services are ordered for patients.
According to the Centers for Medicare & Medicaid Services (CMS), the complete implementation of AUC could save American taxpayers $700 million annually. Senator Blackburn stated, “For years, a flawed reporting mandate has kept a commonsense Medicare cost-saving program from being fully implemented.” She emphasized that the ROOT Act would remove this obstacle by requiring providers to attest to reviewing AUC at the point of care rather than through real-time claims reporting.
Senator Cortez Masto added, “When the right imaging is used at the right time, it can lead to better health outcomes and reduce costs for patients and the health care system.” She noted that this bipartisan legislation supports evidence-based care and aims to save Medicare billions while ensuring safer patient care.
The Protecting Access to Medicare Act (PAMA) originally established the AUC program with goals of guiding clinicians in selecting appropriate diagnostic imaging services and reducing unnecessary costs. However, CMS has faced challenges in integrating AUC with existing systems since its intended full launch on January 1, 2017.
The ROOT Act proposes retrospective audits by CMS based on provider attestations and offers exemptions for those involved in clinical trials or small rural practices. It projects significant savings: $2.2 billion in federal spending reductions from Fiscal Year 2025 through Fiscal Year 2034 and $1.6 billion in savings for Medicare beneficiaries over this period due to reduced cost-sharing.
Endorsements for this legislation come from organizations such as the Tennessee Radiological Society, American College of Radiology, and American Society of Emergency Radiology. Wesley A. Angel, MD from Tennessee Radiological Society highlighted how “the real-time AUC program provides enhanced diagnostic accuracy,” while Alan Matsumoto from American College of Radiology remarked on its potential cost-saving benefits without compromising decision-making or delaying care.
Dana Smetherman from America College of Radiology urged collaboration among health systems, hospitals, practices, Congress, CMS, medical associations, provider groups, and other stakeholders for effective implementation of the federal AUC program.
