MINNEAPOLIS, 5:10 a.m. CST March 14, 2007 -- An MMA bill was introduced Monday in the Legislature that will place a moratorium on high-technology medical imaging notification programs until December of next year.

The bill in the House is HF2003, sponsored by Rep. Thomas Huntley, DFL-Duluth. The Senate version is SF1752, sponsored by Sen. Sandy Pappas, DFL-St. Paul.

The effect of both versions is to halt health plans’ practice of requiring prior “consultations” with third-party utilization review vendors before physicians can refer patients for MRIs, CT scans, and other high-technology imaging. Medica and HealthPartners have both been requiring these kinds of prior consultations, citing cost-containment reasons.

Physicians have criticized the requirement, saying that the consultations are wasteful of their time, of their clinics’ resources, and of their patients’ patience.

The MMA invited physicians to offer feedback about these consultations, pro and con, and over a hundred physicians complained about the practice as intrusive.

The MMA worked with lawmakers to draft the language of the moratorium bill:

"Health plan companies are prohibited from requiring prior authorization, notification, or consultation, including through existing programs, for diagnostic imaging services, including but not limited to computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), magnetic resonance angiography (MRA), and nuclear cardiology, until December 15, 2008."

The bill further calls for the commissioner of health to establish a 12-member diagnostic imaging services advisory committee that would find out what is causing increased use of imaging services, and make recommendations on how to improve the delivery of those services. The committee would include three physician members appointed by the MMA.

The bill, introduced Monday by Huntley, has not yet been heard.

The bill introduction is the latest action in a series of MMA responses to physician concerns about high-tech utilization review. The MMA has written to the Minnesota commissioner of commerce, alleging that one of the third-party vendors, HealthHelp, was operating in violation of Minnesota state law on utilization review because it is not licensed to perform utilization review in Minnesota

And the MMA wrote to the health plans, urging them to withdraw the programs. 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;
* that data should be used to develop solutions that will address any inappropriate use of high-tech imaging;
* and that health care providers should rapidly move toward implementing evidence based decision support tools at the point of care.