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Provider Led Entities

Provider-led entity (PLE) means a national professional medical specialty society or other organization that is comprised primarily of providers or practitioners who, either within the organization or outside of the organization, predominantly provide direct patient care. Once a PLE is qualified the AUC that are developed or endorsed by the entity would be considered to be specified applicable AUC.

To be qualified by CMS, a PLE must adhere to the evidence-based processes described in 42 CFR 414.94(c)(1) when developing or modifying AUC. PLEs must apply to CMS to become qualified. The application must include a statement as to how the entity meets the definition of a PLE and document adherence to each of the qualification requirements. Applications sent to the CMS Imaging AUC resource box must be received by January 1, and qualified PLEs will be posted to our web site by the following summer at which time all AUC developed or endorsed by that PLE will be considered to be specified AUC. All qualified PLEs must re-apply every 5 years and their applications must be received by January 1 during the 5th year of their approval. A list of qualified provider-led entities can be found below:

Qualified Provider Led Entities (PLEs) as of June 2018

American College of Cardiology Foundation

American College of Radiology

Banner University Medical Group-Tucson University of Arizona

CDI Quality Institute

Cedars-Sinai Health System

High Value Practice Academic Alliance*

Intermountain Healthcare

Massachusetts General Hospital, Department of Radiology

Medical Guidelines Institute

Memorial Sloan Kettering Cancer Center

National Comprehensive Cancer Network

Sage Evidence-based Medicine & Practice Institute

Society for Nuclear Medicine and Molecular Imaging

University of California Medical Campuses

University of Pennsylvania Health System*

University of Texas MD Anderson Cancer Center*

University of Utah Health

University of Washington School of Medicine

Virginia Mason Medical Center

Weill Cornell Medicine Physicians Organization

* Indicates newly qualified PLEs as of June 30, 2018

Information Collections Under 42 CFR 414.94
OMB Control Number: 0938-1288
Expiration Date: 6/30/2019