MINNEAPOLIS, March 10, 2008—The Board of Trustees of the Minnesota Medical Association adopted policies at its March 8 meeting on the controversial subject of imaging services.

The policies were the product of long deliberation by the MMA Imaging Task Force set up to make recommendations on issues of imaging utilization, ownership, regulations, and payment policy. The task force was led by Timothy Crimmins, M.D.

Among the task force’s key conclusions was the lack of timely, useful and valid data about the use of imaging services within Minnesota. To address the lack of data, the MMA supports efforts to develop and study community-wide data to:

In all the board adopted sixteen different recommendations in the areas of imaging utilization and cost trends, legal and regulatory controls, quality improvement strategies, and the role of payment policy. While the task force was created to address a resolution from the MMA House of Delegates, the group was also well positioned to consider the controversial imaging utilization techniques that emerged in late 2006when several Minnesota health plans implemented prior authorization/notification procedures for outpatient high-tech imaging services.

Among the other recommendations adopted, the MMA will continue to urge health plans and payers to clearly document and share relevant data regarding claims of inappropriate use of high tech imaging services.

To reduce the inappropriate use of imaging and other services associated with defensive medicine, the MMA will explore possible changes to medical malpractice law to protect physicians who rely on evidence-based clinical guidelines.

The MMA also pledged that it will work to educate Minnesota physicians about self-referral laws and regulations, and the MMA will educate physicians on their responsibility to recognize the potential financial conflict of interest with self-referral for imaging services.

The MMA will support the development of appropriateness guidelines for improving the delivery of evidence-based imaging services, and will urge specialty societies to continue developing guidelines to support evidence-based delivery of imaging services.

The MMA will likewise support the use of decision-support tools to improve the appropriate delivery of high-tech imaging services, but urges review of the long-term return on investment for decision support, as it may vary across physician practices.

The MMA pledged to support the value of valid and transparent imaging accreditation programs and processes, but does not support accreditation as an absolute criterion, given concerns about access to care in certain geographic areas, and the MMA will work with MN Community measurement to develop and publish meaningful quality metrics for imaging services.

The MMA recognizes the role of patient demand/expectations on the utilization of imaging services and supports efforts to incorporate reasonable financial cost-sharing arrangements into insurance benefit design, consistent with the MMA's policy for an essential benefit set.

The MMA stressed that it will continue to oppose the use of utilization review/prior notification as a tool to mitigate high-tech imaging utilization, and it supports a moratorium on its expansion.