President Barack Obama's proposed 2010 budget includes a line item recommending the use of radiology benefits management firms to preauthorize imaging studies paid for by Medicare. The budget forecasts that preauthorization would save Medicare $70 million over 5 years and $260 million over 10 years. But the proposed use of RBMs to reduce Medicare spending on imaging has triggered strong controversy, notes Sg2 analyst Matthew Krutky, PhD.