Save the Date!

CRS Annual Meeting and Leadership Summit

September 16-18, 2011

Grand Hyatt, San Francisco, Union Square

This year's CRS Meeting has been expanded to be a Leadership Summit that will include group leaders and practice managers from the Western States. Hear radiology's leading visionaries discuss their predictions for radiology amidst health care reform and technological disruptors. Learn how to leverage these changes to improve your practice and patient care. Gain practical tips on such subjects as Meaningful Use funding, cloud imaging, ACO's, and leadership development, reimbursement, practice efficiency, and much more. Full program will be available on the CRS website very soon under the events tab! For questions or additional information, contact Christine Feenstra at cfeenstra@amgroup.us or 916/446-2028.

Breast Density Bill Moves to Assembly

SB 173 (Simitian) has passed the Senate and now will be heard in the Assembly. The bill would require that any woman who obtains screening mammography and is determined to have dense breast tissue by the radiologist, a 3 or 4 density under the ACR BIRADS reporting system, would  receive notification from the radiologist that she has dense breast tissue. The notice which would likely be included in the MQSA patient letter would indicate that breast density;

1) Could hide small abnormalities;

2) Patient might benefit from supplementary screening tests depending on individual risk factors, and;

3) A similar report has been sent to your physician and you should contact your physician with questions.

CRS has continued to oppose this bill along with OB-GYNs and the CMA with concerns over increased utilization of breast ultrasound and the inherent additional follow-up costs for biopsies. Though California law does require health insurers and plans to cover all medically indicated breast cancer screening tests, there is no clear consensus that breast ultrasound is appropriate where the only factor is dense breast tissue. SB 173 originally required that any subsequent procedures such as breast ultrasound or MRI would be required to be covered by the patient's insurance or HMO. That requirement, however was deleted from bill language prior to the first hearing on the bill.

SB 173 is modeled after a law passed in Connecticut in 2009. Connecticut law however, includes both patient notification of dense breast tissue and mandatory health insurance coverage for any additional screening or diagnostic procedures.

CMS Guidance Could Help Radiologists Comply with 'Meaningful Use'

June 10, 2011 - The Centers for Medicare and Medicaid Services (CMS) recently published new guidance which could enhance the ability of radiologists to comply with requirements of the EHR Incentive Program, or "meaningful use." 

A newly posted FAQ from CMS indicates that in cases where the eligible professional (EP) and the patient do not have an actual physical or telemedicine encounter, but the EP renders a minimal consultative service for the patient (the example CMS gives is a cardiologist reading an EKG), the EP may choose whether or not to include the patient in the denominator as "seen by the EP," provided the EP's choice is consistent. Previously, the verbiage "seen by" implied that any professional service rendered by the EP (aside from those coded to inpatient and ER settings) should be included in an EP's relevant MU measure calculations.

"The implication of this FAQ is that, for MU measures that include the 'seen by' verbiage, a diagnostic radiologist could conceivably choose to limit his/her 'seen' patients to physical visits and leave out teleradiology and similar services," said Keith J. Dreyer, DO, PhD, co-chair of ACR's IT and Informatics Committee. "There is a good amount of flexibility in the current language of this new FAQ. The key is CMS wants each EP to have a consistent policy on what services do and do not count as 'seeing' patients."

Another new FAQ from CMS indicates that when a patient is seen by the EP's clinical staff and not by the EP themselves, the EP can elect to include or not include those patients in their denominator as long as the decision applies universally to all patients and the EP is consistent across MU measures. Previously, the implication was that patient data would be included in the MU measure calculations if any professional services were rendered by the EP, regardless of whether or not the EP physically saw the patient. The latest FAQ implies, however, that EPs can now choose to not include patients "seen by" staff and not his/herself.

Please visit the ACR Meaningful Use Resource Center for more information about the Medicare EHR Incentive Program.

This notice was provided by the American College of Radiology and we are passing this along for your convenience. It highlights an issue that will be one of the major topics at the CRS Annual Meeting and Leadership Summit in San Francisco on September 16-18, 2011. Dr. Dreyer will be one of the featured speakers. A meeting brochure will be sent in the very near future to all members.