Advocating for the Profession

Over 500 radiologists, fellows, and residents participated in the annual lobbying effort during ACR 2019.

August Images 4 web7.jpgAshley Evens, MD, Kimberly M. Beavers, MD, Andrew Cibulas, MD, Rajendra P. Kedar, MD, FACR, and Michael Damiano, MD, participate in Hill Day.

Capitol Hill Day is an annual reminder that legislative advocacy is alive and well in radiology, ensuring protection of our patients and profession in the future. This year’s Hill Day had one of the highest levels of engagement and participation in history. Over 500 radiologists visited over 275 congressional offices to discuss four key legislation issues affecting radiology and patient care.

Surprise Billing

Mitigating unexpected medical bills is a critical issue in today’s healthcare economy and presents challenges for many patients. The so-called surprise medical bills refer to unforeseen charges received after care is provided, typically in a multidisciplinary setting where multiple physicians are involved. Although the patient may be in an in-network facility or initially see an in-network physician, consultants and other billable services may not be covered, unbeknownst to the patient. The goal of discussing this matter was to encourage legislators to protect patients by providing more detailed information on in- and out-of-network services and hold insurance companies accountable.

The Protecting Access to Lifesaving Screens Act (PALS) was initially introduced by Rep. Debbie Wasserman Schultz (D-Fla.) to protect patient insurance coverage for screening mammograms between the ages of 40 to 49. In both 2009 and 2016, the U.S. Preventative Services Task Force (USPSTF) gave screening mammograms for women ages 40 to 49 a grade of “C.” As a result, insurance companies would no longer be required to cover these services.

The PALS Act placed a moratorium on the USPSTF breast cancer screening guideline change. However, this moratorium is set to expire on Dec. 31, 2020. The ACR, the Society of Breast Imaging, and the American Society of Breast Surgeons advocate for annual screening mammography in average risk women beginning at age 40. As cost could serve as a significant barrier to the diagnosis of early breast cancer, we encouraged legislators to extend the PALS Act to ensure coverage of
lifesaving screening mammograms.

The Medicare Access to Radiology Care Act (MARCA) addresses the importance of radiologist assistants (RAs) in today’s modern radiology practice. RAs are master’s degree-equivalent healthcare professionals who, under the supervision of a radiologist, perform minor procedures. With their assistance, radiologists are able to care for significantly more patients in a timely fashion. The MARCA bill aims to allow radiologists to submit claims to Medicare for RA services to
financially support this valuable radiology service.

The Resident Education Deferred Interest Act (REDI) addresses the increasingly prevalent issue of student loan debt. The average medical student debt in 2017 was $195,000. During medical school and residency training, students accrue interest on their loans, even when qualifying for deferment or forbearance. In practical terms, this means a radiology resident who has $300,000 in student loan debt after the completion of medical school will pay approximately $75,000 in accrued interest during their residency.

This financial hardship could discourage students from pursuing a career in medicine, which poses a significant threat to the future workforce when combined with the projected shortage of 121,300 physicians by 2030.1 The REDI Act halts the accrual of student loan interest during training. This would not affect the repayment of the principal of the loan and would provide significant relief for young physicians. With this eased financial burden, there is more incentive for bright minds to
enter medicine in the future without the fear of insurmountable debt.

The crucial takeaway from ACR Hill Day 2019 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 Kimberly M. Beavers, MD, a breast imaging fellow at Memorial Sloan Kettering Cancer Center

ENDNOTE
1. Davis D, Dill M. Projected shortage of physicians
through 2030. Association of American Medical
Colleges April 11, 2018.

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