Learning Objectives: 1) Describe the American College of Radiology (ACR) involvement in influencing reimbursement through the AMA Relative Value Update Committee (RUC) and Practice Expense Advisory Committee (PEAC). 2) Describe the Medicare Carrier Advisory Committee (CAC) process, and how the ACR CAC Network works to ensure proper Local Medical Review Policies for payment. 3) Review the work of the ACR Managed Care Committee efforts with managed care organizations. 4) Describe the new Hospital Outpatient Prospective Payment System and how radiologists can help their hospitals.