In response to the continued growth of fraud, abuse, and the number of unqualified providers performing EDX studies, the AANEM Board voted to move forward with an ambitious plan of working to establish mandatory standards for EDX medicine nationwide based upon AANEM’s EDX Laboratory Accreditation Program. This effort is to ensure patients receive only quality EDX care from qualified providers. Several patient advocacy groups, such as the ALS Association and Muscular Dystrophy Association (MDA), are supportive and are closely involved in the efforts. Currently, the advocacy efforts are focused on working with Congress and the Centers for Medicare and Medicaid Services (CMS) to mandate such standards for Medicare providers.
Some members have asked -
Why did AANEM choose to use the EDX Laboratory Accreditation Program versus requiring ABEM certification (or other board certification) to perform EDX testing? Isn’t requiring both redundant?
While it is certainly true that ABEM certification demonstrates that the physician is competent and trained to perform EDX studies, unfortunately, most private payers, and certainly government payers, are not willing to limit medical treatments/procedures to those with specific board certifications due to concerns of encroaching upon scope of practice issues. It is seen as a restraint of trade issue.
Using board certification to define what types of testing can be performed is complicated by the fact that physicians with different board certification often perform testing that could be seen as part of another group’s certification. For example, AANEM members would not want ultrasound to be limited to board certified radiologists. Spine injections are another example of testing performed by physicians of different board certifications.
AANEM is not aware of any instances that Board certification is used by any government entities or private payers to restrict the ability to perform a procedure in any area of medicine. “We understand our members’ frustrations about participating in both certification and laboratory accreditation. However, it is clear that using certification to determine who can perform medical procedures has never been used in the past and it is extremely unlikely that it will ever be used in the future,” stated Shirlyn Adkins, JD, AANEM Executive Director.
The laboratory accreditation program, unlike board certifications, looks beyond physician training and qualifications. EDX laboratory accreditation also ensures that NCS technologists are adequately trained and supervised, certifies that only proper EDX equipment is used, confirms that appropriate safety protocols are in place, and reviews several other aspects of the delivery of EDX medicine. The laboratory accreditation program requires that individuals performing EDX studies undergo sufficient training (which is generally only included in neurology fellowships or PMR residencies), but does NOT require specific board certifications.
Our discussions with representatives from other specialty societies who faced similar quality issues, including radiology (with mammography) and sleep medicine, revealed they successfully used laboratory accreditation to raise the level of patient care when working with the government and private payers. This is the set of standards AANEM is working to mandate through CMS.
Regardless of whether or not a mandate is enacted, you should get your EDX lab accredited because it:
Demonstrates clinical excellence in EDX medicine
Proves a laboratory’s commitment to providing the highest quality health care and a safe environment for patients
Provides patients, referral sources, and payers with a credible measure to differentiate the laboratory’s quality of care.
Some accredited EDX laboratories have successfully used their accreditation status to negotiate higher reimbursement from private payers. And at least one worker’s compensation carrier has decided to only use accredited EDX laboratories (see the August AANEM News print newsletter to read more).
Isn’t lab accreditation only a view of the lab at one point in time and therefore certification is better?
Both laboratory accreditation and certification check for something at a point in time making one not better than the other for measuring quality. Certification measures knowledge at a point in time, accreditation measures more items including ability to perform the test, lab standards and procedures, and more. Both require a review process – laboratories must be reaccredited every 5 years and physicians must pass the maintenance examination every 10 years.
For more information on the EDX Accreditation Program, click here
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