On November 2, the Academy sent comments to Humana opposing their new Imaging and Interpretation Criteria for Diagnostic Imaging Authorizations. The new criteria states that Humana will not reimburse otolaryngologists for either the technical or professional component of imaging studies including CT, MRI, and ultrasound. The Academy stated that, as otolaryngologists who perform these imaging studies own or lease the equipment (e.g. MINI CAT in office-CT scanner), and provide the nonprofessional interpreting elements required to provide a radiologic image/tracing, they should be appropriately reimbursed for providing these valuable services. Additionally, the AAO-HNS asked Humana to revisit and amend these criteria as otolaryngologists are trained and board-certified in the interpretation of imaging studies performed on their patients. The comment letter also conveyed the rigorous training otolaryngologists receive to comply with the Intersocietal Accreditation Commission’s standards and requirements and those set out in the Medicare Improvements for Patients and Providers Act. Finally, the Academy noted that “point of service” imaging in an otolaryngologists office offers patients a necessary, convenient service, that saves time and, in most circumstances, is less expensive than hospital-based and other imaging centers.
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