Perhaps the only thing more exciting than the coronation of King Charles III on May 6 was celebrating the ACR’s 100th anniversary in Washington, D.C. I look forward to this conference every year because I get to reunite with my colleagues and friends from all over the nation and appreciate our amazing specialty and the patients who have brought us all together.
This year also signifies the first time in three years, since the beginning of the COVID-19 pandemic, that we were able to return to ACR Hill Day. More than 475 “radvocates” joined this annual trek to Capitol Hill on May 10, participating in over 275 meetings in congressional offices. This gave us a chance to discuss the ACR’s legislative positions and provide lawmakers and their teams with a firsthand look at how these issues impact patient safety and the delivery of care. ACR members left their mark on Capitol Hill by contributing their perspectives on several key topics that have been standing priorities.
First on the Hill Day agenda was a topic most physicians are well aware of: mitigating Medicare payment cuts. We spent time educating congressional offices on the dire state of physician reimbursement — specifically, the lack of positive updates to the Medicare Physician Fee Schedule (MPFS) despite inflation and rising costs of operating a medical practice. We suggested adding a Medicare Economic Index based on inflationary updates to the MPFS. We explained how this reform could provide long-term financial stability to Medicare providers, ensuring that patients get the high-quality care they deserve.
While specific policy agendas won’t change overnight, participating in ACR Hill Day was an incredible and enlightening experience.
We also asked legislators to ensure that the No Surprises Act is implemented as Congress has intended. The ACR strongly supports the plan, which was meant to enforce insurer transparency and accountability and created a process — the independent dispute resolution (IDR) — to keep patients from getting caught in the middle of billing disputes between commercial health insurers and physicians or hospitals.
However, as it currently stands, this process gives insurance companies an unfair advantage by making the qualified payment amount, which is computed by insurance companies, the primary factor in determining billing dispute resolutions. The process ultimately hinders access to care by discouraging meaningful contract negotiations and reducing physician and hospital networks. Several offices we met with acknowledged the need for a solution and were aware of this issue, as many lawsuits have already been filed against the federal government challenging the process.
Finally, we discussed the delay in implementing the Protecting Access to Medicare Act of 2014, which included a program that required the use of ACR Appropriateness Criteria® (AC) by providers ordering advanced medical imaging. The program was set to be fully implemented by CMS in January 2017. It has since been delayed indefinitely, however, due to the difficulty in processing the claims in the existing plan.
We have urged lawmakers to amend the language so that it is more in favor of an annual audit and review by CMS, rather than the need for CMS to process claims in “real time.” This would alleviate the issue without undermining the program. Many members we spoke with agreed that the implementation of the AC requirement would ensure patients receive the correct imaging study at the right time without unnecessary workups and radiation, a practice that would cut healthcare costs.
While specific policy agendas won’t change overnight, participating in ACR Hill Day was an incredible and enlightening experience. I was inspired watching the advocacy efforts of my colleagues and seeing how receptive and grateful all the congressional staff members were during our meetings. I left feeling confident that together, we can make a difference.
To see more photos from ACR 2023, view the full magazine online.