12 2 STA T . 2 537PUBLIC LA W 11 0– 275 —J UL Y 15 , 200 8(i ii )Anyotherm o d e l th a t the S e c retary determine s to b e u se f uline v aluatin g theuseofa p propriateness criteria for advanced diagnostic imaging services . ( F ) POINT O FSERV I C E M O D E L DESCRI B ED. — A model described in this subparagraph is a model that— (i) uses an electronic or paper inta k e form that— ( I ) contains a certification by the physician furnishing the imaging service that the data on the intake form w as confirmed with the M edicare beneficiary before the service was furnished
(II) contains standardi z ed data elements for diagnosis , service ordered, service furnished, and such other information determined by the Sec - retary, in consultation with medical specialty soci- eties and other stakeholders, to be germane to evaluating the effectiveness of the use of appro- priateness criteria selected under subparagraph ( D ); and (III) is accessible to physicians participating in the demonstration pro j ect under this subsection in a format that allows for the electronic submis- sion of such form; and (ii) provides for feedback reports in accordance with paragraph ( 3 )( B ). ( G ) POINT OF ORDER MODEL DESCRIBED.—A model described in this subparagraph is a model that— (i) uses a computerized order-entry system that re q uires the transmittal of relevant supporting information at the time of referral for advanced diag- nostic imaging services and provides automated deci- sion-support feedback to the referring physician regarding the appropriateness of furnishing such imaging services; and (ii) provides for feedback reports in accordance with paragraph (3)(B). ( H ) L IMIT A TION.—In no case may the Secretary use prior authorization— (i) as a model for collecting data regarding physi- cian compliance with appropriateness criteria selected under subparagraph (D) under the demonstration project under this subsection; or (ii) under any model used for collecting such data under the demonstration project. (I) R E QU IRED CONTRACTS AND P ERFORMANCE STAND- ARDS FOR CERTAIN ENTITIES.— (i) IN G ENERAL.— T he Secretary shall enter into contracts with entities to carry out the model described in subparagraph (G). (ii) PERFORMANCE STANDARDS.—The Secretary shall establish and enforce performance standards for such entities under the contracts entered into under clause (i), including performance standards with respect to— (I) the satisfaction of Medicare beneficiaries who are furnished advanced diagnostic imaging services by a physician participating in the dem- onstration project; Certif i ca ti on.
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