Imaging Legislation in the Election Cycle

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No matter where you fall on the political spectrum, odds are you’re not thrilled with how you’re represented on Capitol Hill. In RADPAC’s Congressional and political update at the RBMA conference this week, further evidence was presented for your ongoing disillusionment.

First a bit of context for the uninitiated: RADPAC is the political action committee of the ACR and the fourth-largest health care PAC on the Hill. Through education, lobbying and targeted donations, RADPAC attempts to advance the interests of imaging in DC, and in years past has had enormous success waylaying further reimbursement cuts, increases to the imaging equipment utilization rate, and more. Ted Burnes, the PAC’s director, estimates that in 2011 the organization leveraged just over a million dollars in contributions to members of Congress into 130 million dollars in prevented cuts.

But this isn’t 2011, it’s 2013, and Burnes observes that the 2014 election cycle is already underway. What does this mean for imaging? “Everything [Congress does] is a messaging agenda,” Burnes said in the session. “It’s not about legislation right now.”

As an example, he pointed to the recent vote to repeal the Affordable Care Act. Impossible though it may seem, this was the 37th vote to repeal from a House of Representatives that knows it is hamstrung by the Senate and executive branches. The vote was a symbolic opportunity for freshman representatives to demonstrate their opposition to the health care reform package, lest they be accused, next year, of tacit support. But the rest of us could be forgiven for feeling that it, like the votes that preceded it, was a giant waste of everyone’s time.

The ACR’s legislative asks in 2013 include repealing the MPPR, implementing clinical appropriateness guidelines for management of imaging utilization, and a handful of smaller bills (one involving Medicare reimbursement for the work of radiologist assistants) for which there is little hope in this tumultuous year of messaging, not legislating.

Perhaps most disheartening? Self-referral just doesn’t seem to be on Congress’ agenda at the moment. HHS Secretary Kathleen Sebelius publicly admitted to being unaware of the problem, and a recent CBO score estimated the financial impact of legislation limiting self-referral at 1.8 billion dollars over ten years. As Burnes said, “1.8 billion is just not enough to sway members of Congress.” Evidently, in an election cycle it takes splashier savings to catch a lawmaker’s eye.