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The Medicare Payment Advisory Commission has voted to crack down on clinicians who overuse diagnostic and imaging tests by making them gain prior approval for Medicare patients.

Commissioners said that prior authorization would only be required for clinicians who ordered significantly more advanced imaging tests than other physicians in the same peer group or specialty. The congressional advisory panel voted 15-1 during meetings last week on the issue. According to MedPAC data from March, the volume of all imaging grew 2% per Medicare fee-for-service beneficiaries between 2008 and 2009, while the volume for other advanced imaging increased 0.1% during the same period, the Bureau of National Affairs reported.

Additionally, the MedPAC panel also offered changes for quality improvement organization programs. It recommended redesigning the QIO program to give providers more help and flexibility getting technical assistance, and focusing resources on low-performing providers.