Over the past year there have been several incidents in California hospitals where patients received excessive radiation exposure during CT procedures. SB 1237 (Padilla) is new legislation sponsored by the Consumer Attorneys of California which attempts to reduce the possibility that such errors might occur. As introduced SB 1237 would require that on all imaging procedures involving ionizing radiation the provider would be required to indicate or note the specific radiation dose on the patient's film.

 

The CRS has met with the author and sponsor to indicate concerns with the bill as drafted since much imaging is now digitized, hence there is no film and that in many cases the specific radiation dose is a range that varies based upon the physical aspects of the patient and other factors. Recently there have also been several hearings and pronouncements by the FDA on possible new requirements for manufacturers of imaging equipment that utilizes ionizing radiation that could require more information be available to the operator to indicate specific patient dose.

 

The bill will be heard this week in Senate Health Committee and major amendments are likely to be made. The bill will be limited to CT units only. The CRS has also advocated the inclusion of a delayed mandate for accreditation of CT units in both hospital and freestanding settings that would parallel the Medicare requirement beginning in 2012. We will keep you informed of the progress of this legislation.

 

 

We have informed you of three bills introduced last year that would allow either district or general acute care hospitals to employ physicians. The three bills SB 726 (Ashburn), AB 646 (Swanson) and AB 648 (Chesbro) had all passed their house of origin and were pending in the other House.

 

Recently AB 646 which was initially defeated in the Senate Business and Professions, but granted reconsideration, was amended to change the process by which a district hospital would be allowed to employ a physician. Originally it would have simply eliminated the prohibition on district hospitals being allowed to employ a physician. The amendments would now allow a district hospital in e medically underserved area to employ up to 5 physicians, but only after conducting a public hearing resulting in finding that they are unable to recruit such physicians, and the submission by the administrator of the district hospital of documentation of such finding to the Medical Board of California. The bill has not yet been heard in this form. All of these bills continue to generate greater support from members of both parties where district and other types of hospitals argue an inability to attract certain types of physicians. The CRS continues to oppose these bills and support the retention of the current prohibition. We can support limited exceptions and an earlier version of the Ashburn bill that allowed a limited number of physicians of certain specialties to be employed in specified types of district hospitals after specific findings.

 

All of these bills will be viable during the remainder of this year's legislative session.

 

 

 

Earlier this month the Division of Workers Compensation (DWC) published for initial comment some major revisions to the physician fee schedule that would greatly reduce radiology payments. The DWC was given authority several years ago to revise the current fee schedule that has its own RVS units distinct from the RBRVS. The proposal would do the following;

 

 

The CRS submitted extensive comments in opposition to these changes and specifically to the equipment utilization percentage. Click here for a PDF of the comments. It is expected that these suggested changes or some variation thereof will be submitted for formal public comment in the next 60 days. many believe that DWC will try to push through revisions this year. we will provide further information so that individual members may also want to submit comments. The proposal has drawn opposition from many specialties.