Heading to the Hill
Over 450 radiologists, fellows, and residents participated in the annual lobbying effort during ACR 2018.
At ACR 2018, radiologists once again headed to Capitol Hill to meet their senators and representatives to advocate for their patients.
This year, the College’s lobbying efforts focused on two key issues: recruiting support for legislation that would require Medicare to cover CT colonography (CTC) without any form of patient cost-sharing, as well as legislation recognizing radiologist assistants (RA) as Medicare non-physician providers. This year’s Capitol Hill Day also gave participants an opportunity to thank federal representatives who voted to increase Fiscal Year 2018 funding for the National Institutes of Health by $3 billion.
Lawmakers and staff responded well to the visits, which enabled radiologists and radiologists-in-training to recruit many new cosponsors for H.R. 1298, the CT Colonography Screening for Colorectal Cancer Act, and H.R. 1904/S. 769, the Medicare Access to Radiologic Care Act (MARCA).
If enacted, H.R. 1298 will require Medicare to cover CTC screening for colon cancer. Medicare now only covers CTC in the case of an incomplete optical colonoscopy. Per the provisions of the Patient Protection and Affordable Care Act (PPACA), private insurers are required to cover CTC without cost-sharing due to the fact that colon cancer screening services, in general, received a Grade of “A” from the U.S. Preventive Services Task Force (USPSTF). However, Medicare is not bound by the same mandatory coverage requirements within PPACA and relies on a national coverage determination process to add services without cost-sharing. The ACR has long supported Medicare coverage for CTC and is committed to ensuring beneficiaries have equal access to this effective, non invasive screening test.
The MARCA legislation seeks to amend the Medicare statute to recognize RAs as non-physician Medicare providers and to align Medicare supervision requirements with state law. RAs always practice under the onsite supervision of a radiologist and are also explicitly prevented from interpreting images. If adopted, this legislation will allow radiologists to devote more time to reviewing and interpreting complex medical images while preserving quality care. This legislation currently has the full support of all stakeholders in the medical imaging community, including the ACR, the American Society of Radiologic Technologists, the Society of Radiology Physician Extenders, and the American Registry of Radiologic Technologists.
This year, evidence-based advocacy was once again in full force both on Capitol Hill and on social media. The Radiology Advocacy Network (RAN) hosted its third annual “Virtual Hill Day,” where radiologists unable to travel to Washington, D.C., for in-person meetings emailed their federal senators and representatives in support of key legislation. The radiologists (known as #radvocates on Twitter) also took to social media to document their experiences during Capitol Hill Day. Additionally, ACR members used certain hashtags, such as #ACRHillDay2018 and #radvocacy, which were included in 129 tweets on Hill Day alone and racked up 23,429 impressions. The significance of impressions like these suggests our message can reach beyond those who tweeted that day and into the radiology community and beyond. We can make our political advocacy and grassroots efforts known in other healthcare arenas virtually.
Finally, many members of Congress who have been champions of our profession will not be running for re-election. These include Reps. Lynn Jenkins (R-Kan.), Michelle Grisham (D-N.M.), Diane Black (R-Tenn.), Marsha Blackburn (R-Tenn.), Kristi Noem (R-S.D.), Charlie Dent (R-Pa.), Evan Jenkins (R-W.Va.), Ryan Costello (R-Pa.), Ted Poe (R-Texas), and Sens. Orrin Hatch (R-Utah) and Thad Cochran (R-Miss.). Hill Day participants extended their gratitude to these lawmakers and their staff for their support of the radiology community throughout the years.
The crucial takeaway from ACR Hill Day 2018 is that in an uncertain healthcare climate, radiologists are intensifying their involvement to advocate on behalf of their patients and profession. The ACR acknowledges this commitment and is working to further expand and support advocacy efforts through the RAN and the Commission on Government Relations. Collectively, these efforts will help move the College’s legislative agenda forward and undoubtedly translate to the continued success of our field.
By Amy K. Patel, MD, breast radiologist in Kansas City, Mo.