furnishing professional

(1) Program established (A) In general The Secretary shall establish a program to promote the use of appropriate use criteria (as defined in subparagraph (B)) for applicable imaging services (as defined in subparagraph (C)) furnished in an applicable setting (as defined in subparagraph (D)) by ordering professionals and furnishing professionals (as defined in subparagraphs (E) and (F), respectively). (B) Appropriate use criteria defined In this subsection, the term “appropriate use criteria” means criteria, only developed or endorsed by national professional medical specialty societies or other provider-led entities, to assist ordering professionals and furnishing professionals in making the most appropriate treatment decision for a specific clinical condition for an individual. To the extent feasible, such criteria shall be evidence-based. (C) Applicable imaging service defined In this subsection, the term “applicable imaging service” means an advanced diagnostic imaging service (as defined in subsection (e)(1)(B)) for which the Secretary determines— (i) one or more applicable appropriate use criteria specified under paragraph (2) apply; (ii) there are one or more qualified clinical decision support mechanisms listed under paragraph (3)(C); and (iii) one or more of such mechanisms is available free of charge. (D) Applicable setting defined In this subsection, the term “applicable setting” means a physician’s office, a hospital outpatient department (including an emergency department), an ambulatory surgical center, and any other provider-led outpatient setting determined appropriate by the Secretary. (E) Ordering professional defined In this subsection, the term “ordering professional” means a physician (as defined in section 1395x(r) of this title ) or a practitioner described in section 1395u(b)(18)(C) of this title who orders an applicable imaging service. (F) Furnishing professional defined In this subsection, the term “furnishing professional” means a physician (as defined in section 1395x(r) of this title ) or a practitioner described in section 1395u(b)(18)(C) of this title who furnishes an applicable imaging service.

Source

42 USC § 1395m(q)(1)


Scoping language

None identified. Default scope is assumed to be the entire title.
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