MINNEAPOLIS, Updated 9:26 a.m. CST February 1, 2007 -- The MMA on Jan. 30 called for an end to new requirements that physicians “consult” with a third party vendor before ordering high-tech imaging procedures, such as CT, MRI, and PET scans. The MMA asked Medica to withdraw its program, which has provoked outrage among physicians, and asked the other third-party payers to drop their plans and work with the MMA to understand the issue and address any problems that might exist.

HealthPartners rolled out a program similar to Medica’s today, and Blue Cross, UCare, Metropolitan Health Care, and PreferredOne intend to follow suit later this year. The Department of Human Services plans to go further and roll out a prior authorization procedure in response to a 2005 legislative mandate.

The MMA notified members about the letters in an email message on Jan. 31 and sent out a news release immediately afterwards. Articles were published in the Star Tribune and Business Journal today and Minnesota Public Radio is broadcasting a news feature.

“We know that the use of high-tech imaging is increasing and it’s important to find out why,” said G. Richard Geier, M.D., president of the MMA, was quoted as saying in the MMA news release. “If there are problems, we want to address them. But diagnosis of a problem should come before a solution. This is the wrong response.”

Demanding “consultations” for all imaging procedures is a waste of energy, time, and money, MMA leaders told the health plans. It puts an administrative burden on clinics, increases health care costs and adds to the time patients must wait for an imaging procedure.

“All Minnesota patients deserve the right scan at the right time, based on their medical needs and circumstances,” said Geier in the news release. “There shouldn’t be overuse or underuse of imaging procedures.”

In letters to health plans and DHS the MMA recommended that:

• There be a community-wide effort to collect information that will result in a clear understanding of high-tech imaging use throughout Minnesota.
• Data be used to develop solutions that will address any inappropriate use of high-tech imaging.
• Health care providers rapidly move towards implementing evidence-based decision tools.

“We hope to work in collaboration with the Institute for Clinical Systems Improvement (ICSI) and other major stakeholders, including the health plans and DHS,” said Geier.

Before strongly urging third-party payers to change course, the MMA conducted an extensive review of efforts to address the escalating costs of high-tech imaging in Minnesota and in other states and listened to an outpouring of anger from members.

We’d like to hear your experiences with high tech imaging consultations. How long does the process take? How much of a hassle has it been? How has it affected your ability to help your patients? Please email your experiences to imaging@mnmed.org.

Click here to read the high-tech imaging letters sent to health plans.