A Look At Imaging By State
Congress and payers aren’t the only ones taking a look at growth in medical imaging. Across the country, legislation aimed at regulating who can perform imaging and where is making its way through state legislatures.
California: A bill (A.B. 2805) to amend the state’s self-referral statute to ban part-time leasing arrangements for MR, CT and PET imaging procedures, is currently making its way through the California Legislature. The bill has passed the California Assembly and is currently before the Senate. The bill passed by the Assembly does include language recommended by the ACC’s California Chapter (CA-ACC) that would not harm leasing arrangements that CA-ACC members currently have in place. The ACC and the CA-ACC continue to monitor the bill.
Idaho: The Idaho Medical Association (IMA) – with help from ACC members –overwhelmingly defeated a self-referral resolution offered by the American College of Radiology-Idaho Chapter in October 2005. This past March, the IMA and ACC Idaho members again stymied efforts, this time by the Idaho Hospital Association, to introduce legislation implementing a two-year imaging moratorium. The battle is not over, however. Further imaging legislative efforts are anticipated when the legislature reconvenes in 2007.
Maryland: The Maryland Self-Referral Law, which passed in 1993, contains an in-office ancillary exception, but limits MR, CT, and radiation therapy procedures to radiologists in the office setting. Following on the heels of an Attorney General opinion upholding the law in 2004, the Board of Physicians has issued cease and desist orders to physicians in violation of the statute. The ACC and others continue to work with Maryland lawmakers to amend the law.
Massachusetts: A measure imposing imaging self-referral limitations on MR and PET has been introduced before the state House and Senate in several forms since 2004. The measure, strongly opposed by the ACC and others in the physician community, was most recently attached to the 2007 Senate budget bill only to be amended to mandate a study of magnetic resonance imaging and ambulatory surgical centers and the impact on the health care delivery system. A conference committee is currently working to iron out the differences between the House and Senate versions of the state budget bill and will decide the fate of the amendment.
Rhode Island: State lawmakers passed legislation in 2005 expanding the accreditation process to permit a “nationally recognized accreditation body” to approve MR facilities in addition to the American College of Radiology (ACR). Currently, ICAMRL is seeking recognition under this law. Meanwhile, two bills before the House and Senate (H.B. 7617 and S.B. 2358) would extend the accreditation law to cover CT. The ACC and the Rhode Island chapter are working closely with the Rhode Island Medical Society to craft amendments to protect cardiology interests.
Texas: Texas was the battleground state in 2005 for the ACR’s campaign to limit self-referral. Five measures, ranging from rural self referral bills to sweeping restrictions on in-office imaging, were introduced. Thanks to the efforts of the Texas ACC Chapter and the Texas Medical Association, all five measures were defeated. Excellent lobbying by the Texas ACC Chapter and the Texas Medical Association played a major role in the outcome. Texas is again expected to be a crucial battleground when the legislature reconvenes in 2007.
Washington: A bill that would have permitted only radiologists to perform in-office MR, CT and PET was referred to summer study in 2005. Since then, the issue has continued to be subject of interest to lawmakers. In an effort to educate state legislators on the benefits of in-office imaging, the ACC, the Washington ACC Chapter and the Washington State Medical Association sponsored “Olympia Day” on January 17, 2006 and brought cardiologists from throughout the state to the capitol. Targeted efforts by radiology to revive the 2005 bill are expected in 2007.
