The Medicare Improvements for Patients and Providers Act of 2008 mandated an appropriate use of imaging services demonstration project, and the Centers for Medicare & Medicaid Services (CMS) announced last week that it will now begin soliciting proposals for participation in the Medicare Imaging Demonstration (MID).

The two-year project will test whether the use of decision support systems (DSS) can reduce unnecessary radiation exposure and utilization by promoting appropriate ordering of advanced imaging services by physicians in the Medicare fee-for-service population, as well as improve overall quality of patient care, according to CMS.

Eleven advanced imaging procedures--SPECT MPI, MRI lumbar spine, CT lumbar spine, MRI brain, CT brain, CT sinus, CT thorax, CT abdomen, CT pelvis, MRI knee and MRI shoulder--have been chosen for inclusion in the demonstration based on high expenditures and utilization within the Medicare fee-for-service population. In addition, the law requires that the appropriateness criteria used in the demonstration be based on those developed or endorsed by medical specialty societies, stated CMS.

All current Medicare coverage and payment policies will remain unaffected under the demonstration.

CMS is seeking proposals that include a various mix of physician practice sizes and types, medical specialties, and geographic areas, and will appoint "conveners" to reach out to interested candidates. The conveners will be tasked with deploying a DSS that incorporates medical specialty society guidelines for selected procedures, collecting and transmitting data and distributing payments to practices for reporting data.

Applications for physicians interested in participating in the demonstration as conveners or in collaboration with other organizations to perform the responsibilities specified in the demonstration are due to CMS by Sept. 21. Application instructions and additional information can be found at: http://www.cms.gov/DemoProjectsEvalRpts/MD/itemdetail.asp?itemID=CMS1222075