It is important to recognize that the Federal government, in its quest to build a healthcare system that provides appropriate levels of healthcare for the various populations, has created this complex system that is often difficult to follow. Multiple agencies and committees have been appointed to ‘ensure’ that the goals for this healthcare system are met. Those individuals who work in the financial areas of a healthcare facility must have current knowledge regarding charges, qualifications for payment, ongoing access to newly approved legislation, and requirements of providers.

Each time something is added or deleted, steps are taken confirming all who need to know are informed. Not doing so can be very costly to the facility, the providers, and the patient. A review of this history is relevant today and will hopefully demonstrate an understanding of how difficult it has been in the past and the current difficulties encountered developing healthcare programs that meet the many needs and expectations of all involved.

Objectives

After studying the information presented, the reader should be able to:

• Describe the purpose of MedPAC and why it is important to the quality of health care
• Explain what MIPPA is and how it works
• Understand how MACRA impacts care quality, cost, and clinical practice improvements to connect performance to payment
• Describe the safety standards for staff and patients in radiology
• Identify the CMS requirements for accreditation of advanced diagnostic imaging suppliers
• Explain the purpose of appropriate use criteria for diagnostic catheterization