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Edition: May 2021 |
Table of Contents |
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Letter from the Editor |
The economic impact of COVID-19 on health care continues to reveal itself through reductions in inpatient volumes and in higher practice costs. As the pandemic stretches on, practice viability remains under threat. During this challenging time, practices have been facing an April expiration of the moratorium on the Medicare sequester that would cut Medicare physician pay by 2%. The sequester, which has been in place since 2013, was paused in Congress in the Coronavirus Aid, Relief and Economic Security (CARES) Act and again in the Consolidated Appropriations Act of 2021. The most recent pause was set to expire on March 31, 2021. The House, fortunately, voted favorably on the legislation, and on April 14th President Biden signed HR 1868 into law. This extends the current moratorium halting the 2% cuts in Medicare payments due to sequestration until the end of 2021. CMS directed Medicare Administrative Contractor to release any previously held claims with dates of service on or after April 1, and reprocess any claims paid with the reduction applied. More information is available on the CMS website. Click HereThe AMA released a report documenting changes in Medicare fee-for-service spending for the first half of 2020 with a focus on Medicare physician fee schedule (MPFS) services. Click HereKey findings from the report include MPFS spending dropped sharply in March and April 2020 as much as 57%. This recovered somewhat, however, the spending at the end of June 2020 was still 12% less than expected. Cumulative spending for the first six months of 2020 was 19 percent below the expected amount for that period, a $9.4 billion loss in revenue. The loss in overall physician spending in the U.S. could be much greater than this figure as it covers only Medicare, and even then, excludes the roughly 40 percent of enrollees in Medicare Advantage. The cumulative reduction in MPFS spending from Jan-June 2020 decreased 22 % for Diagnostic Radiology and was down 8% for Radiation Oncology. This may signal a lagged drop in radiation oncology payments secondary to decreased cancer screening. It is unclear how much of the associated drop in utilization of MPFS services have been delayed or foregone entirely. The consequences this disruption in care may have for Medicare patients’ health in the future have yet to be seen.
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Laura Vallow, M.D. Secretary, FRS Vallow.Laura@mayo.edu |
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Meet Your 2020 – 2021 FRS Executive Committee |
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President Douglas Hornsby, MD |
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President-Elect Rajendra Kedar, MD, FACR |
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Treasurer Chintan Desai, MD |
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Secretary Laura Vallow, MD |
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FRS President’s Message |
ATTENTION: Calling on all Counselors and Alternate Counselors for the pending ACR meetingAt the Florida and Southern Caucus, Resolutions 16 and 17 supported strengthening the wording of the ACR position against extending the scope of practice by Radiology Assistants to be permitted to interpret imaging. Recent correspondence among members of the Florida Radiological Society describes that many years ago physician extenders (including Physician’s Assistants, Nurse Practitioners, and RPAs) were extending their guidelines and venturing into radiology. In 2002, in a meeting in Washington DC, representatives from the ACR met with the ARRT and ASRT to establish guidelines for Radiology Assistants, (RAs). The intent was to be involved in the process rather than being presented with state legislatures passing regulations in order to allow Radiology Assistants to perform, interpret, and bill for imaging services. The outcome of the meeting was that the ACR would be involved in establishing guidelines and that the ASRT and ARRT would not interpret examinations, much less bill for separate interpretations. Resolutions 16 and 17 support strengthen this position and were unanimously supported at the Florida Caucus, and later the same day, at the Southern Caucus of the ACR in order to avoid interpretations by Radiologist Assistants. There is some opposition to this by some outside Florida and the Southern Caucuses in Universities to extend the ability for Radiology Assistants to interpret images. Eventually, this would probably evolve not only into independent interpretations, but billing and independent practice by Radiology Assistants to perform radiology studies, interpret images, and bill for their “interpretations.” Opponents to the resolutions suggest the threat of the additional radiology physician extenders, including Physician’s Assistants and Nurse Practitioners, would go to the radiology suite (to perform, interpret the examinations, and bill for the examinations). This inevitably compromises patient care and fully trained Radiologists. The argument is specious. It is like the insurance salesman backing up the hearse into the driveway to sell insurance. Please support Resolutions 16 and 17 in Reference Committee ll and in the General Session. The cliché, be at the table or be devoured is an appropriate analogy. We need all votes on these and other issues.
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Doug Hornsby, MD President, FRS doughornsby@msn.com |
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Past President Patricia Mergo, MD, FACR |
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Legal Counsel Michael M. Raskin, M.D., J.D., FACR |
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FRBMA President’s Message |
It’s time to Plan
The Florida Radiological Society and Florida Radiology Business Management Association Joint Annual Meeting will be in July 16 -18 at the Ritz Carlton in Orlando Florida. This will be a full program offering all the educational and networking opportunities of previous meetings.This includes the annual golf tournament which starts at 7:00 AM on Friday and the Gold Medal Reception which starts at 5:45 PM on Saturday. Here is a brief overview of what else’s is scheduled:
The FRBMA program will start of Friday at 1:00 PM and run till 5:00 PM. Although this is mostly attended by FRBMA members, FRS members are also welcome. Allison Dudley will start this off with an always informative legislative update. Her talk for this meeting will focus on the surprise billing legislation in Florida.
Pat Kroken of Kroken Consulting, is giving a lecture titled “Managing the Fog” which she tells me will take a fresh look at the challenges of running a radiology practice—and reviews and what it’s like when you can’t see far ahead in the fog that represents our current business environment.
Jeff Younger will be talking about radiology group consolidation in the Florida market, both local and National perspective. I have the pleasure of regular updates on this topic from Mr. Younger through our monthly Preferred Radiology Board meetings. Jeff knows this topic well and the trends he points out are always insightful.
Susan Takacs is the COO at Physician Regional Health System and will be discussing what hospitals are looking for in terms of value in the relationship with radiology groups. Ms. Takacs has held several high-level operational roles in hospitals and health systems in Florida, Georgia, Massachusetts and Missouri. I think Ms. Takacs will give us an objective perspective that we do not normally hear.
The Friday FRBMA session will wrap up with an ACR update from Rebecca Spangler. Ms. Spangler is the Director of Congressional Affairs at the ACR. Her issues portfolio includes a variety of areas that help radiologist’s better serve their patients, including but not limited to, coverage of preventative screening tests, appropriate use criteria, and physician reimbursement issues. Ms. Spangler also commented in her e-mail to me that she “likes Pina-coladas and getting caught in the rain, too”, which I think is exceptional.
The Saturday program is a general Session that will be attended by FRS and FRBMA members. I really enjoy the Saturday program because it’s an opportunity to share a learning experience with radiologists. It’s also a good networking opportunity where practice administrators and physicians within the member practices can talk shop and compare notes about issues that we all share. There are several legacy lectures with excellent speakers. This year, the program includes a concentrated focus on the COVID-19 pandemic looking at changing paradigms, strategic issues, and lessons learned. There will be three separate lectures given by Dr. Frank Lexa, Dr. Kent R. Thielen, and Dr. Laurence Muroff. There will valuable takeaways from these lectures.
Dr. Stephen Miles will be discussing how our groups meet the needs of a private sector CEO. I think this lecture pairs well with Susan Takacs lecture on Friday that looks at the same thing but from the hospital perspective.
The final lecture is an interactive debate on artificial intelligence in radiology.The discussion will be moderated by Richard L. Morin, Professor of Medical Physics at Mayo Clinic.There will also be two speakers sharing their knowledge and insight, Dr. Eliot L Siegel, Professor and Vice Chair of Imaging Informatics at the University of Maryland School of Medicine in Baltimore, and Dr. Bradley Ericson, Medical Director for AI at Mayo Clinic. Both of these speakers and the moderator bring advanced expertise to this topic. This will be a great opportunity to learn where things stand and where they might be going in AI. This will be an exciting and informative topic.
There may be a temptation to sleep in on Sunday; but you don’t want to miss the Charles D. Williams Legacy lecture which starts at 8:00 AM Sunday with a lecture on the interface of radiology and the law. The speaker, Dr. Michael M. Raskin, is both an M.D and J.D. and, among other things, has written articles on the intersection between the law and medicine for a radiologist. In preparation for my article, I read few articles by Dr. Raskin, including “Don’t Shoot the Messenger” and “Survival Strategy for Radiologists.” I feel his ideas on risk avoidance and identifying non-obvious risk areas, as in his observations that he made in “The Lax Radiologist” show that Dr. Raskin will provide a valuable perspective to this topic.
Finally, if you are actively recruiting radiologists consider getting a booth at the job fair, this will be held after the conclusion of the meeting on Sunday and run from 11:15 AM -2:00 PM
This will be a terrific program. In addition to being excited about this program, I am especially looking forward to a return to normal. I’m already signed up; but, if you haven’t yet, it’s time to plan.
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John Detelich, CPA, MBA, CEO President, FRBMA jdetelich@radassociates.com |
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Legislative Update |
On Friday, April 30th the Legislature adjourned session at 2:40 pm ending one of the strangest sessions ever as it was almost entirely virtual. The Legislature passed a record $101.5 billion budget and $44.5 billion went to health care spending. $1.86 billion of the health care funding came from federal coronavirus relief money.
A total of 3,140 Bills and proposed Committee Bills were filed and 275 Bills passed both chambers. The Governor has final say on what becomes law. The Covid Liability Bill which provides protection for health care providers passed earlier in session and was signed into law.
The Physician Assistants Bill passed and it changed the ratio of PA’s that can be supervised from 1-4 to 1-10. The Nurse Scope Expansion Bill that would have allowed nurses to practice independently did not get a hearing in either house. The Optometry Bill did not pass, which would have allowed optometrists to perform surgery. The Department of Health Bill Package passed and contains language that allows for telehealth to be used to prescribe controlled substances. The PIP Reform Bill passed changing Florida from a no-fault state to an at-fault state and contains $5,000 for med pay opt-out. It is not an ideal bill and there is a lot of concern it will raise rates. It will be interesting to see if this bill survives the veto pen. The Pelvic Exam Clean-Up Bill passed and addressed a majority of the issues last year’s bill had unintentionally caused. In the Emergency Services Bill that passed the state is to stockpile PPE and distribute to physicians and health care workers in the event of an emergency.
The campaign phone calls have already begun. It is a reapportionment year; so, that means everyone runs in a new or modified district. Session starts in January next year which means that it will be a very busy summer.
Ironically, the leaders of the Senate and House have just announced the Capitol will be fully open for the upcoming Special Session set for May 17th on gaming.
Here is hoping the new variants don’t wreak havoc in Florida as virtual sessions make the process more of a challenge.
Thanks to all for their help and support. |
Thanks, and stay well, Alison Dudley, FRS Lobbyist AlisonDudley@dudleyandassociates.com |
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Martin Northup Resident Leadership Award |
H. Martin Northup Resident Leadership Award – A scholarship opportunity for Florida Diagnostic Radiology, Radiation Oncology, and Medical Physicist 2nd year Residents or graduate students.
Martin Northup was very committed to radiology resident education and advancement. To eternally honor and remember him, the board of the FRS Foundation has established a special award bearing his name, the “H Martin Northup Resident Leadership Award.” Each year, this award will be given to a 2nd year Florida radiology resident who will be the 3rd year at the time of the fellowship to support the cost of accommodations for attending the FRS annual summer meeting. The resident will have an officer mentor and will attend all functions including the board meeting. The goal is to develop future leaders in Radiology and develop promising residents to assume greater roles in the society, such as President of the Resident and Fellow’s Section. The award recipient will be chosen for the 2021 Annual Meeting in Orlando, Florida, July 16-18, 2021 by the Scholarships and Grants committee based on a competitive application process.
Please click here to download an application. Return your completed application to lroger@edusymp.com by May 15, 2021 in order to be considered for this award. |
Thank you, Jeffrey Stone, M.D., FACR President, FRS Educational Foundation |
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2021 Annual Meeting of the FRS & FRBMA |
Please join the Florida Radiological Society and the Florida Radiology Business Management Association for the 2021 Annual Meeting at The Ritz-Carlton Orlando, Grande Lakes, July 16-18, 2021. The meeting will focus on “Excelling in an Everchanging Paradigm” and will feature lectures by faculty who are leaders in the practice of radiology. We look forward to seeing you in Orlando, Florida. |
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Job Posting Opportunities |
Florida Radiological Society is pleased to introduce the opportunity for interested parties to advertise for potential jobs in our monthly FRS Ebrief bulletin.
Advertisement pricing is as follows:
Ebrief Job Posting pricing: 3 months ($100 monthly) 6 months ($90 monthly) 12 months ($80 monthly)
Please contact Lorraine Roger, our Society Administrator for further information on how to advertise in our monthly publication. Phone: (813) 806-1070 Fax: (813) 806-1071 Email: lroger@flrad.org
We feel that this will provide a valuable service to both our members and our Florida community of Radiology.
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Thank you for your interest! Patricia Mergo, MD, FACR |
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Become a PAC Member Today |
Attention FRBMA Members! Please support the cause. We encourage you to be PAC members and supporters; you do not have to belong to the FRS. Donations can be made online through our PAC website www.FLRADPAC.org. Thank you for your donation.
It is critical that we support both our Florida PAC and RADPAC in order to bolster our voice in Tallahassee and Washington, respectively. Please join FRS lobbyist Alison Dudley in her special appeal for all Florida radiologists to become Florida PAC members. If you would like to help FRS defend radiology against untoward legislation and introduce bills that have a positive impact on our practices, we need your financial support to re-elect our friends in the state House and Senate. The FRS can also show you simplified ways on how to sign up your radiology group. Contact Lorraine Roger at lroger@flrad.org or contact Alison Dudley at alisondudley@dudleyandassociates.com for more information. |
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Telephone (813) 806-1070 • Fax (813) 806-1071 5620 W. Sligh Avenue • Tampa, Florida 33634 |
The E-Brief is an exclusive member benefit of Florida Radiological Society, delivering monthly member, chapter and industry news. Please do not reply to this automatic e-mail. For comments or questions about the E-Brief, please contact lroger@flrad.org. |
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