State Publishes Guidance on SB 1237 (Padilla) CT and Radiation Safety

The California Bureau of Radiologic Health has published a Frequently Asked Question document on the new provisions established re SB 1237 (Padilla). That bill established specific requirements for recording of CT dose on  

CT equipment with that capability, reporting of misadministration of CT exposure or radiation oncology.   It is worth reviewing to get some practical answers to question s and guidance on dose calculation and reporting.

Here is the link  

The requirements for dose recording and accreditation of CT units have delayed operative dates to July 1, 2012. The reporting of excessive exposure or misadministration of CT or radiation oncology did not have a specific effective

date and has been interpreted to take effect on 1/1/11 even though the author did clarify via a Letter to the Journal

prior to passage that his intent was that this provision would also have a delayed operative date. SB 38 (Padilla) introduced in December would establish an effective date of 7/1/12, is an urgency bill, and will be heard in  

Committee this week. The CRS is supporting this bill and also working with the author to make changes to the provisions in enacted SB 1237 to safeguard patient safety and cerate a workable reporting system.

State Budget Impact on Radiology Reimbursement Under Medi-Cal

The state budget adopted last year for the current fiscal year ending June 30, 2011 called for a reduction in radiology reimbursement under Medi-Cal to no more then 80% of the average Medicare allowable for the same procedure.  

The CRS has established a legal fund to file a legal challenge to this reduction. Though the budget states that the change would take effect on 10/1/10 no one has seen evidence of take backs on prior paid claims. We did hear form one member today that they saw evidence of recoupments on some claims.

In the meantime the Legislature has passed a series of bills to enact cuts in an effort to balance the 2011-12 budget. Though the total budget solution has yet to come to a fruition the Governor's suggestion of a combination of cuts and tax extensions has only been accomplished by enacting reductions in some programs including Medi-Cal. The program was targeted for $1.7 Billion in reductions which included;

·         A 10 % provider rate cut for all Medi-Cal providers

·         Co-pays of $5 for physician or clinic visits, $50 co-pay for use of ER, $100 per day for

    hospital in-patient stays  ( $200 max)

·         A cap on physician visits of 7 per year, provision for waiver in certain situations.

All of these changes require approval via a State Plan Amendment that is submitted and reviewed by CMS. It's also likely that they will be court challenges to the rate cuts and perhaps other service reductions. There is a pending appeal with the US Supreme Court on the 10% provider rate cut that was enjoined in 2009. We will keep you updated on the status of these changes.