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Edition: October 2021
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Table of Contents
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| Letter from the Editor |
Now that the academic year has started and fall has begun, many of us are planning our 2021-2022 calendars. Many events continue to be disrupted due to coronavirus, and we would like to update you on several of those fronts.
October to April – ACR Parameters/Standards and ACR Annual Meeting – In-person The ACR Annual Meeting will be held April 24th to April 28th, 2022, at the Hilton Washington in Washington, DC. This is currently planned as an in-person meeting. The comment period for Practice Parameters and Technical Standards started in August, and the ACR is actively cycling through the documents on their portal in order to receive member comments. Please Click Here to access the documents and make your comments. Please contribute to these parameters and standards! The more that members draw attention to proofreading errors, issues on content, and omissions, the more that the parameters and standards can be ready for full review by the Council at the Annual Meeting. Many members feel blindsided or rushed at the time of the Annual Meeting with unexpected inclusions or exclusions within these documents, so this is a very good opportunity to review the documents (or have your local subject-matter expert review the document) so that comments can be made now or reserved for discussion at the Annual Meeting. We are currently in the third Field Review Cycle (Oct 4 – Oct 22) for 10 different documents. October – ACR Quality & Safety and Informatics Summit – Virtual-Only The ACR Quality & Safety Conference and the ACR Informatics Summit are being held as virtual events this year, from October 14th to October 16th, 2021 and October 16th to October 17th, 2021, respectively. They are coming up soon, but no travel is needed as they are virtual. Registration links here: https://pages.acr.org/qualityconference2021.html and https://pages.acr.org/informatics-summit-2021-virtual-registration.html. The Quality and Safety Conference focuses on the broad range of endeavors that can improve patient care, from informatics solutions to communication improvements to error analysis and mitigation to workflow and ergonomic initiatives. The Q&S Keynote Lecture is “The Role of Radiology in Population Health Management” by Syed Zaidi, MD. The Informatics Summit is a conference intended for all ACR members, not just the computer-science majors in the crowd. The course is therefore practical in nature — how can radiologists best deploy and integrate informatics solutions into their daily practice and generate concrete gains for their practices and their patients. Keynote lectures are “Welcome to the Radiology Team, AI Bot”, by Dr. Greg Moore (Microsoft/Nuance) and “The Return on Investment of AI” by Dr. Melissa Chen (MD Anderson). In the spirit of full disclosure, I am one of the co-chairs for the Informatics Summit this year, along with Dr. Tessa Cook from the University of Pennsylvania, and so I personally look forward to perhaps seeing you there. November – RSNA – In-person The RSNA Board of Directors met in mid-September and reconfirmed its plans to hold RSNA 2021 in person. The Board “recognized the challenging circumstances that many are in and extends its sincere appreciation for your commitment”. RSNA dates are November 28th to December 2nd, 2021, at McCormick Place in Chicago, IL. For those interested in the health and safety policies, please Click Here. Faculty with travel restrictions or conflicts will be presenting via recorded video, so portions of the program will be virtual. Ongoing – ACR Education Center – Virtual-Only The ACR Education Center in Reston, VA, will remain closed for the remainder of 2021. The ACR anticipates opening the center for in-person education in early 2022. For now the ACR is offering virtual “micro-courses” that allow access to the datasets for the courses paired with recorded lectures by the faculty. Please see the ACR’s education center page for the full list of courses: https://www.acr.org/Lifelong-Learning-and-CME/Education-Center. July – Florida Radiological Society Meeting – In-person The 2022 FRS Annual Meeting will be held in-person July 15th to July 17th, 2022 at the Ritz-Carlton, Amelia Island, near Jacksonville, FL. Please check back later this year at https://www.flrad.org/ for details on registration. We look forward to seeing you there! Thank you!
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Juan Batlle, MD
Secretary, FRS
juancarlos98@gmail.com |
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| Meet Your 2021 – 2022 FRS Executive Committee |
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President
Rajendra Kedar, MD, FACR |
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President Elect
Chintan Desai, MD, FACR
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Treasurer
Laura Vallow, MD |
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Secretary
Juan Batlle, MD |
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| FRS President’s Message |
We can’t let this happen! During the COVID-19 initial wave followed by resurgence, many patients were hesitant to get their diagnostic and screening examinations done especially if symptoms were minor or non-acute, for follow-ups, and screening examinations such as mammography. This can be potentially disastrous as this may lead to delayed diagnosis and unnecessary deaths. We as radiologists can create awareness in this regard by patient and referring provider education, allocating resources, and marketing. During October’s breast cancer awareness month, this is an opportunity to drive this message for promoting mammography and early detection of cancer. On another note, various committees of the FRS have openings that include subspecialty committees, as well as, several others. You can go to the FRS website to see various committees that we have and email Lorraine Roger at: lroger@flrad.org to express your interest. I would love to see newer, younger, and enthusiastic people getting involved in the FRS committees for newer and fresher ideas and to make the FRS more vibrant. Stay safe and stay healthy!
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Very Respectfully,
Raj Kedar, MD, FACR
President, Florida Radiological Society
Professor of Radiology, University of South Florida – Morsani College of Medicine
Director- Body Imaging Education and Fellowship
Chief -Dept of Radiology, Tampa General Hospital |
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Past President
Douglas Hornsby, MD
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Legal Counsel
Michael M. Raskin, M.D., J.D., FACR |
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| FRBMA President’s Message |
Registered Radiology Assistants (RRA) and Medicare Access to Radiology Care Act of 2021 (MARCA)
Registered Radiology Assistants are extenders in a radiology practice and can provide value to a radiology department in several areas. RRAs can work with patients which can include obtaining consent, answering patients’ questions and preparing them and the exam room for their study. In addition, they may also perform certain procedures under the supervision of the radiologist.
Supervision requirements vary depending on the procedure; but typically, the supervision requirements are either direct (mostly) or personal supervision (less common). And finally, they can perform a quality function by reviewing images, adjusting protocols to optimizing the imaging and provide their observations to the radiologists. RRAs do not interpret studies or dictate final reports. They are not classified as providers and any billable procedures performed by the RRA would have to be billed under the supervising radiologists.
The RRA program graduated their first class in 2005. There are several programs that offer either bachelor or master degrees in this field. As of 2019, there was an estimated 700 RRAs employed in hospital radiology departments or within radiology groups. By comparison, there are about 125,000 Physician Assistants (PA) and about 290,000 Nurse Practitioners (NP). PAs and NPs have little or no radiology specific training but some radiology groups will hire PAs or NPs rather than RRAs. The difference between RRAs and NPs or PAs is that PAs and NPs are providers and can therefore bill for the procedures they perform. In our group we have an RRA and a PA and they perform a similar role. For us there was a much longer learning curve for the PA due to her lack of radiology specific training. Although after the learning curve we found that both the PA and RRA perform similar functions for our group and offer similar benefits in terms of efficiency to the radiologists.
The drawback to the RRA is that the radiologist must be actively involved in any study if the radiologist intends, wants to be compensated. Because PAs and NPs are providers, they can bill any study that falls within their scope of practice and for most procedures, radiologists are only required to provide general supervision. Although RRAs may be operating within their scope of practice, under appropriate radiologist supervision level and in accordance with the RRAs delineation of duties as defined by ARRT and adopted into Florida Law, radiology practices still cannot bill for the study unless they were actively engaged in the procedure. And in no case, whether in a hospital setting or an imaging center, can the radiology group bill Medicare for a study performed by an RRA.
To summarize, RRAs are much better acclimated to working in a radiology environment although the limitations on billing reduces their overall value to a radiology group. NPs and PAs take much longer to train and are also more costly; but, overall may be the better value for a radiology group. That’s why MARCA is interesting proposed legislation.
Medicare Access to Radiology Act of 2021 was introduced in June 2021 whereby an RRA could “perform” a procedure under the supervision of a radiologist in any setting and the radiologist would be paid. MARCA defines setting as a hospital, ambulatory surgical center or such other providers of services. The goal of the legislation is to free up radiologists’ time; so, that they can perform the more complex cases that the RRAs cannot perform. There is significant competition for NPs and PAs and because they have had very little radiology training, they often will not consider working for a radiologist.
I am in favor of this legislation. The original design of the RRA program was to create a unique resource for radiology groups. Unfortunately, the billing mechanism is so flawed that practices look to other options rather than hire an RAA. MARCA fixes the billing issues and this should lead to increased demand and supply of RRAs. If the legislation is not enacted, RRAs, as a profession, might fail. That would be an unfortunate outcome because, structured properly, RRAs can be a great value to radiology groups. |
John Detelich, CPA, MBA, CEO
President, FRBMA
jdetelich@radassociates.com |
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| Legislative Update |
October 11-15th and then another week of committees October 18-22nd.
Bills are being filed and hitting the public system. There is still a bit of time to go before the issues develop. So far, the health care committees have been focused on hospitals and health care innovation.
The Governor announced his new Surgeon General, Dr. Joseph Ladapo, who has been generating a lot of headlines regarding his stance on the coronavirus. He will need to be confirmed by the Senate which is anticipated will take place over objections from the Democrats.
It was interesting being live in the Capitol for this first set of committee meetings. It was fairly quiet on the foot traffic front. The House sent out guidelines for the upcoming session and clearly are trying to discourage the large groups from attending the Capitol. For those who have not attended every day during session there will be large groups visiting. Some examples would be Realtors Day, Dade Days, Broward Day’s, and one of the favorite days for past residents, Space Day, where they got to meet astronauts who had traveled into space. It will be interesting to see how folks limit their presence.
Small groups such as our residents visiting the Capitol program should still be fine to visit as long as nothing changes dramatically as relates to Covid.
Please everyone, stay safe and well. |
Thanks, and stay well.
Alison Dudley, FRS Lobbyist
AlisonDudley@dudleyandassociates.com |
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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: Dr. Mergo
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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