February 02, 2021

End of Year Legislation, 2020: Context, Implications, and You

The 2020 legislative session culminated in the passage of the Consolidated Appropriations Act, 2021. This omnibus spending bill included many provisions that directly impact radiologists, our practices, and the patients we serve. Through the tireless advocacy efforts of the government relations (GR) team acting through the ACR Association (ACRA - the organization that directs advocacy activities and to which you pay your membership dues), and the many radiologists across the country who reached out to their representatives through the Radiology Advocacy Network calls to action (CTAs), many “pro-radiology” considerations were included in the final act. A summary of these provisions is available  on the ACR’s Advocacy News.

All things considered, these advocacy efforts were for the most part successful. However, all of our legislative asks were not included in the final act. For instance, because of Medicare reimbursement valuation changes, radiologists stood to receive an overall 10% cut in reimbursement for 2021 to pay for reimbursement increases for physicians that use E/M codes. You may recall, these changes were approved through a regulatory process by people not directly accountable to citizens. ACRA  led a multi-society effort to influence the legislative process to include a provision that would wave budget neutrality, allowing the reimbursement increases for some providers without decreasing reimbursement for others. You can read more on this here. The result: a payment cut averaging 4% amid a pandemic with further phase-in adjustments later.

What is the response from this outcome? Should we take our frustration with these cuts, throw up our hands, and give up the fight? The short answer is no.

Through my time with the ACR as a Rutherford Lavanty Fellow in GR, I saw firsthand how effective advocacy influences our representatives. Through round tables, luncheons and other venues, the GR team can educate our legislators (most of whom are not in healthcare) on the nuances of our practice and, the impact of their legislative decisions on our practice – and on the patients we serve.

When you respond to a CTA, your voice — not just as a radiologist or radiation oncologist, but as a constituent and potential voter — is heard. The more robust the response rate, the more likely it is to get the attention of the legislative aides and legislators. This provides an opportunity for us to educate them on the issues important to us and help them understand the potential impact on their future campaigns should these priorities not be addressed for their constituents — as well as counter any opposing lobbying efforts.

Are you upset with some of the 2020 legislative outcomes? I am, but I know ACRA is the is the strongest influencer on behalf of radiologists in Washington, and collectively we need to empower our advocates. ACRA member support is an essential component to our three-pronged approach to advocacy: RADPAC®, lobbying and grassroots engagement. Like 2020, the 2021 legislative session portends many looming challenges that face the radiologist community. Now is not the time to be complacent. Now is not the time to give in. Now is the time to strengthen our voice and our stand in Washington, and get engaged with the ACR RAN CTAs. This investment has a direct impact on you, your practice, and your patients. Give ACRA a chance to be a stronger voice — so it, and we, can rise above the noise in Washington. For more information on RADPAC activities, please visit www.radpac.org.

Daniel A. Ortiz, MD, is a partnership track associate radiologist with Summit Radiology Services, P.C., in Northwestern GA, the ACR YPS RADPAC liaison, and a member of the RADPAC Board.