November 1, 2018

 

The American College of Radiology has released its annual report on state-level issues around the radiology profession.
Avoiding federal gridlock, many state legislatures are finding their own solutions to questions facing health care delivery in the country as a whole.
The American College of Radiology (ACR) tracked nearly 600 radiology-related bills proposed by state legislatures in the fiscal year ending June 30, 2018. Issues addressed by state legislatures included system reform, physician payment reform, health insurance mergers, private payer reimbursement policy initiatives and out-of-network billing.

Key Trending Issues for State Legislatures

Breast health
In 2018, governors of Florida, Tennessee, Illinois and Wisconsin signed breast density-related notification bills into law. In Utah, an optional notification statute was changed to mandated notification. Additional bills were filed in Georgia, New Mexico and West Virginia.

Women with dense breasts may at greater risk of cancer, so notifications following mammograms are considered very important. Since 2005, a total of 35 states have adopted mandatory disclosure or breast density notification. In Maine, radiologists have agreed to provide information without a legislative mandate.

Support for mandatory private insurance coverage of digital breast tomosynthesis (DBT) increased with the growing weight of evidence demonstrating DBT’s ability to detect breast cancer in patients with dense breast tissues. Twenty states now mandate that kind of coverage.

Scope of Practice
A number of bills sought to expand the scope of practice for non-physician providers: those health care professionals who are not MDs or DOs. Several proposals are broadly written to allow non-physician providers to independently order, supervise and interpret diagnostic studies.

Certificate of Need
Several states considered legislation that proposed modifications to their existing Certificate of Need (CON) regulation of medical business practices. Existing statutes covering CON regulations were put in place to control the growth of hospital infrastructure and medical device acquisition, to lessen proliferation of specialty care centers and to limit inappropriate medical imaging utilization, according to the report.

Network Adequacy and Out-of-network Payments
Bills related to out-of-network provider billing, network adequacy, transparency, notification and disclosure, or accuracy of provider directories were considered by more than 25 states and signed into law in Arizona, Colorado, Louisiana, Missouri, New Jersey, Oregon and Tennessee.
New research shows that patients are burdened with an increasingly larger share of their health care costs through higher premiums and cost sharing, while their insurance networks are becoming more narrow and restrictive. One study sponsored by Physicians for Fair Coverage, concluded that patients are paying more, doctors are being paid the same and insurance companies are making record profits.

Radiologic Technologist Licensure and Radiologist Assistant Recognition
A registered radiologist assistant (RRA) is an advanced-level radiologic technologist (RT) who works under the direct supervision of a radiologist to enhance patient care. Selected chapters of American Society of Radiologic Technologists (ASRT) are working with state radiological societies and the ACR on the radiologist assistant (RA) issue. Thirty-one states license or recognize the RAs through legislation or regulation. Bills related to RT licensure were considered in six others.
Note: The ACR offers its state chapter leaders comprehensive automated reports on legislative bills relating to health care and medical imaging policy. Please let ACR staff know if you would like to opt-in to receive optional legislative notifications for your state.