|American College of Radiology, AMA Partner to Fight Nonphysician Scope Creep
By Marty Stempniak | June 22, 2023
The American College of Radiology and the AMA are partnering to help fight nonphysician scope creep.
Both doc groups have banded together to create new advocacy materials that empower patients to ask more questions about their care provider. Those include a card that can be handed to consumers, offering sample questions such as: “Will a physician be reviewing my chart, lab results, X-rays and other tests?”
“Physicians are the only healthcare professionals who complete four years of medical school, three to seven years of supervised postgraduate training, and a comprehensive licensing exam series before they are eligible for an unlimited medical license,” the card states. “However, did you know that not every state requires physicians to be involved in patient care?”
ACR highlighted the partnership in a Wednesday news update, labeling scope of practice as “one of the leading issues that are addressed by state legislatures.” The college said it offers a host of resources on this topic and it also has teamed with legislation tracking service Fiscal Note to stay abreast of the latest developments.
Radiologists also took part in the American Medical Association’s Scope of Practice Summit recently held at AMA’s Annual Meeting in Chicago. South Dakota physicians spoke during the event, highlighting a recent victory. The state radiological society helped to defeat a bill that would have allowed experienced physician assistants to independently take X-rays and perform radiologic procedures.
“We’ve seen a ton of activity so far at the state level this year,” Kimberly Horvath, a senior attorney with the AMA Advocacy Resource Center, said in a recent news update from the association, estimating that there have been “hundreds of bills” introduced in 2023.
To read more, go to Radiology Business.
Lawmakers Want CMS’ Prior Authorization Proposal to Go Further
By Andrew Cass | June 21, 2023
More than 230 U.S. representatives and 61 senators are asking HHS and CMS leaders to bolster a proposed rule aimed at streamlining the prior authorization process, Politico reported June 21.
A letter sent to the leaders was spearheaded by Washington Rep. Suzan DelBene, who was one of the sponsors of a bill in 2022 that attempted to reform the Medicare Advantage prior authorization process. The bill passed the House but died in the Senate over concerns about its projected $16 billion cost, according to the report.
Ms. DelBene told Politico that the rule CMS proposed in December makes “huge strides forward for seniors,” but “we think it needs to go further.”
The lawmakers are asking CMS to add provisions to the proposed rule to align more with the legislation that passed the House last year, according to the report.
The provisions include:Real-time prior authorization for routine matters.A 24-hour deadline for Medicare Advantage plans to answer prior authorization requests for urgently needed care. More detailed transparency metrics. CMS set a December 2025 deadline to finalize the rule, but the agency said it will publish it sooner if possible, according to the report.
To read more, go to Becker’s Payer Issues.
American College of Radiology Tells CMS New Quality Measure Would Pose Too Much Burden
By Marty Stempniak | June 19, 2023
The American College of Radiology is expressing concern that a new proposed quality metric from the Centers for Medicare & Medicaid Services would pose too much burden for hospitals.
CMS first announced the change in April as part of the 2024 Inpatient Prospective Payment System rule. The agency is proposing a new electronic clinical quality measure for inpatients tied to “Excessive Radiation Dose or Inadequate Image Quality for Diagnostic Computed Tomography in Adults.”
The college said it agrees with efforts to increase patient safety in the radiology department.
“However, we strongly recommend that CMS take a considered approach to implementing the Excessive Radiation Dose measure into the [Inpatient Quality Reporting] program, allowing a period for larger-scale testing and experience with the measure before attaching stricter requirements impacting hospitals providing services under the IPPS,” ACR CEO William T. Thorwarth Jr., MD, wrote in comments submitted on June 9.
The agency proposes to adopt the measure into the IQR and the Medicare Promoting Interoperability programs starting with 2025 calendar year reporting period. But ACR is concerned the change would require “considerable organizational efforts” to access and process the data required to calculate a provider’s score. Such complexity would force hospitals to either create software or buy a commercial product to track this information, ACR noted.
“Regardless of in-house or commercial solutions, hospital staff who are likely already juggling multiple technological priorities, software upgrades, transitions or installations will be tasked with implementing the proposed measure,” Thorwarth wrote.
ACR cited other concerns with the measure, including the methodology to calculate it, validity and possible unintended consequences. Leaders are asking CMS to work with the imaging community to devise an approach that addresses the proposal’s shortfalls.
“Although the ACR has outlined various concerns with the proposed measure, we are aligned with its goal,” the comments concluded. “We seek to work in partnership with this stakeholder community and CMS to identify and implement measures addressing radiation dose and safety that are methodologically and scientifically sound, provide meaningful feedback and improvement opportunities, have transparent data collection and calculation methods, and are as least burdensome as possible.”
To read more, go to Radiology Business.
AMA Opposes Non-Compete Agreements for Hospital-Employed Physicians
By Victoria Bailey | June 19, 2023
The American Medical Association’s (AMA) House of Delegates has voted to oppose non-compete agreements for physicians employed by hospitals or staffing companies.
Non-compete agreements prohibit employees from working for a competitive employer or starting a competing business during their current employment or for a specific duration after their job has ended.
There has been some debate on non-compete agreements among AMA’s members. Physician practice owners may favor using reasonable non-competes, while employed physicians may support banning the agreements.
The House of Delegates opposed non-compete contracts for certain physicians, including those employed by for-profit or nonprofit hospitals, hospital systems, or staffing company employers.
“Allowing physicians to work for multiple hospitals can enhance the availability of specialist coverage in a community, improving patient access to care and reducing health care disparities,” Ilse Levin, DO, MPH&TM, DM, AMA Board of Trustees member, said in the press release.
According to AMA, non-compete agreements have impacted up to 45 percent of primary care physicians, especially as more physicians are working directly for hospitals or practices that are partially owned by a hospital over private practices.
Additionally, non-compete agreements can limit career opportunities and advancements for recently graduated trainees entering the workforce. These contracts can also limit trainees’ ability to provide care in underserved areas, AMA said.
While the Accreditation Council for Graduate Medical Education (ACGME) prohibits restrictive contracts as a contingency for residents or fellows in GME training programs, some non-ACGME fellowship programs require trainees to sign non-compete agreements.
Some states, including California, North Dakota, and Oklahoma, have already banned non-compete contracts.
Other states have banned the agreements specifically for physicians, including New Hampshire, Delaware, Massachusetts, and Rhode Island.
In January 2023, the Federal Trade Commission proposed a ban on non-compete agreements, estimating that it would increase wages by almost $300 billion per year and expand career opportunities for 30 million people.
However, the ban would not cover nonprofit hospitals, which account for 57 percent of all hospitals.
To read more, go to Revcycle Intelligence.
Continued Declines in Screening Mammogram Volumes Could have ‘Worrisome Implications,’ Experts Warn
By Hannah Murphy | June 15, 2023
More than three years after the height of COVID, the volume of screening mammograms still has not returned to pre-pandemic levels, according to new data out of Brigham and Women’s Hospital.
A group of experts from the hospital recently analyzed screening trends there in the years leading up to and following the onset of COVID. They observed a persistent decrease of five screening mammograms per month beginning in June of 2021. In contrast, between October 2016 and March 2020, the group noted a steady increase of 65 screenings per month.
As with most COVID-related impacts, some patients were more affected than others. The decline was seen in every age category below 70 and across all insurance types, but the downward trend was most notable in women who have at least one risk factor of severe COVID, the group explained.
“Mammography screening volume decline[s] especially affected those with risk factors for severe COVID-19, as we saw significantly different trends between the two subgroups,” study corresponding author Allyson L. Chesebro, from the Department of Radiology at Brigham and Women’s, and colleagues noted. “This may be because the fear of contracting COVID-19 outweighs the fear of a breast cancer diagnosis.”
The group’s findings also highlighted a shift in screening locations, with outpatient clinic screenings increasing from 35.8% prior to COVID to just under 45% in the years following.
The study abstract is available in Clinical Imaging.
To read more, go to Health Imaging.