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Thirty-two states enacted breast density reporting legislation in the last eight years, but no such bills have been passed on a federal level. Could that soon change?

Temperatures are dropping and my front yard is covered in leaves, which means it’s almost time for another eventful RSNA annual meeting in Chicago. I’ve spent some with this year’s schedule and wanted to share five can’t-miss sessions.

Women should not stop undergoing regular mammography based on their age alone, according to a new analysis published by the American Journal of Roentgenology. The authors of the article explored both the benefits and the risks of screening mammography for women ages 75 years and older.

Physicians aren’t the only ones who might benefit from using lead shields to guard against radiation exposure during cardiac catheterization, a new study suggests.

The chair of the American College of Radiology (ACR) Board of Chancellors, James A. Brink, MD, spoke to the U.S. House Committee on Science, Space and Technology Subcommittee on Energy today in Washington, D.C. The subcommittee was there to discuss the United States Department of Energy’s funding of low-dose radiation research, and Brink told its members that such research was needed to improve patient care.


Recent Headlines

Lessons Learned From a Pioneer ACO

On July 16, 2013, CMS announced the results¹ of its accountable-care organization (ACO) program, the Pioneer ACO Model. The program was designed to test the impact of higher levels of shared savings and risk on ACO success, and it attracted 32 participants from around the country. After the first year of participation, seven Pioneer ACOs that did not produce shared savings announced their intention to transition to the lower-risk (and lower-reward) Medicare Shared Savings Program, while two dropped out of the ACO model entirely.

Physicians Are Leery of Exchange Participation

Some observers have commented on the narrow networks associated with many insurance products being offered by the state and federal insurance exchanges mandated by the Patient Protection and Affordable Care Act (PPACA). A new survey¹ of members of the Medical Group Management Association (MGMA) suggests why insurers may be having trouble attracting broader physician panels. The MGMA received more than 1,000 responses from practices representing more than 47,500 physicians.

A Yawning Void

As Ezequiel Silva III, MD, makes perfectly clear in his guest editorial in this issue, the entire continuum of radiology delivery services is inches away from getting slammed—again. The root of radiology’s latest problem is in a 2007 report¹ (based on data of an even earlier vintage) from RTI International, LLC, that recommends separate cost centers for MRI and CT.

The In-office Ancillary-services Exception: Time to Ground the Skyrocket?

Some battles are destined to be fought over and over again. The fight to eliminate the IOASE is one such skirmish; it refuses to go away, after more than a decade of debate.

Washington 2013: Imaging at the Grindhouse

Imaging has been through a long legislative and regulatory grind since the first big blow was struck with the DRA, and there is little to indicate that much will change on that front in 2013, according to Ted Burnes, MPA, director of RADPAC, the political-action committee of the ACR®. With Maurine Dennis, MPH, MBA, a consultant for the RBMA, Burnes copresented “Radiology Economics and RADPAC Update” on May 22, 2013, at the RBMA Radiology Summit in Colorado Springs, Colorado.

The MAC–CMS Disconnect

As we previously reported,¹ last fall, CMS published its supposedly final guidance² on place-of-service requirements for the professional and technical components of diagnostic tests. Transmittal 2563 (later replaced by Transmittals 2613 and 2679) revised the instructions contained in chapter 13 of the CMS manual system for Medicare claims processing. The most recent transmittal became effective on April 1, 2013. On April 25, CMS issued a frequently asked question (FAQ)3 set to respond to additional concerns about the place-of-service instructions. Among other clarifications in the FAQ list, CMS reported that it will be developing a national enrollment policy for telehealth and telemedicine services.

Anatomy of a Pay Cut My initial reaction was to flinch and move on, like a punch-drunk fighter, when I heard about the 90% assumed equipment-utilization rate in the omnibus bill intended to avert the fiscal cliff. Instead, I bear witness to the latest in a series of cuts to the technical and professional components of radiology reimbursement.
Navigating the Regulatory Landscape: The 8 Top Legal Issues of 2012 Idle hands are said to be the devil’s workshop; in 2012, government regulators proved the same to be true of hands that are busy, as evidenced by the new and modified rules that they churned out to address perceived problems in the delivery of radiology services. Many of these rules—brought forth by DHHS agencies—were unhelpful to radiology practices striving to keep their heads above water. In fairness, though, one or two rules were of the opposite character.
Putting Lung-cancer Screening Through the Actuarial Wringer

An article by Milliman actuaries¹ in the April 2012 issue of Health Affairs details an interesting accounting exercise that is likely to cause private insurers to take notice. Using a method employed to evaluate new insurance features, the researchers created an actuarial model designed to estimate the cost (and cost benefit) of lung-cancer