Bill > HR5737

This bill, known as the Radiology Outpatient Ordering Transmission Act (ROOT Act), modifies the data collection requirements for appropriate use criteria for medical imaging services under Medicare. Starting January 1, 2026, the bill requires clinical decision support mechanisms to provide the Secretary of Health and Human Services with detailed information about imaging service orders, including specifics about the order and ordering professional. The bill introduces a new compliance tracking system where professionals will be designated as "low compliant" if they do not consistently consult qualified clinical decision support mechanisms when ordering applicable imaging services. The Secretary will calculate compliance rates annually, excluding certain types of imaging services like mammograms, lung cancer screenings, and colonoscopies, as well as services ordered by small or rural practices. By January 1, 2031, and every five years thereafter, the Secretary must conduct a study and report to Congress about compliance rates, the impact on imaging service utilization, and potential improvement mechanisms such as prior authorization or payment adjustments for low-compliant ordering professionals. The bill also requires that when specifying appropriate use criteria, the Secretary should substantially follow existing regulatory approaches, ensuring consistency with current medical guidelines.

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https://www.congress.gov/bill/119th-congress/house-bill/5737/all-info