CT and Radiation Safety Legislation
The CRS is supporting AB 510 ( Lowenthal) which amends the prior adopted bill by Senator Padilla regarding recording of CT radiation dose, reporting of certain misadministration of CT exams or radiation therapy, and required accreditation for CT units. The original legislation will take effect on 7/1/12 and AB 510 was amended in January and passed by the Assembly moving now to the Senate. It is our hope that AB 510 will be passed and signed prior to July 2012. The discussions continue on the specifics with the original sponsors and author, the hospital association and CDPH. The CRS is seeking the following changes, some of which are already included in AB 510. The changes include;
- Exempt from dose reporting those CT units which are only used for radiation therapy treatment planning or image guidance for interventional radiology.
- Require that for purposes of accreditation that the facility or unit only have a medical physicist verify the displayed dose for certain procedures, i.e. adult brain, adult abdomen and pediatric brain to ensure that the displayed dose is within 20 % of the displayed dose.
- Clarification that no report of misadministration is necessary if an adjacent organ/body part is irradiated if that was intended by the ordering physician or radiologist.
- Clarification that if the CT unit is able to record the dose, i.e. DLP or CDTI vol, that this information can be recorded in the protocol page as part of the electronic medical record. We want to eliminate any interpretation that would require a radiologist to dictate that dose information into the report.
AB 510 will next be heard in the Senate Health Committee and we will inform you of the outcome and specifics of any changes as they are finalized.
CRS Obtains Correction Medicare Payment for PET Radiopharmaceutical
The CRS was contacted by several members who saw a dramatic reduction in the allowed amount for FDG radiopharmaceutical for PET procedures. The allowed amount as of 1/1/12 was $93.94 when the prior allowable was approximately $271. The CRS contacted Palmetto as the Medicare carrier and was initially told that this new amount was based on Palmetto surveying invoices and distributor charges for FDG. The CRS continued that dialogue and had our CAC representative, Dr. Mark Alson, submit additional comments indicating that this assumption of cost was not reflective of many provider's costs.
After further review Palmetto reported that the previous allowable will be reinstated and that any claims paid at the lower allowable as of 1/1/12 will be reprocessed and paid at the old allowable. They reported that their cost evaluation was not correct.
U.S. Supreme Court Sends Case Back to Court of Appeals
In a 5-4 decision, judges keep patient rights alive
Sacramento, CA- Today, in a majority decision, the United States Supreme Court refused to reverse the Ninth Circuit Court of Appeals decision in Douglas v. Independent Living Center of Southern California ("Independent Living Center"). That court has previously sided with physicians and other providers, agreeing that interested parties should have the ability to sue in order to block cuts to California's Medicaid program, Medi-Cal. The case will now return to the Ninth Circuit Court of Appeals.
The federal Medicaid Act requires that government insured and privately insured patients have equal access to medical care. If the state and federal government continue to cut funding to these programs, physicians will be forced to stop taking new patients, meaning that access to care will be greatly impacted.
"This is a win for physicians and their patients in California," said James T. Hay, M.D., President of the California Medical Association (CMA). "The lower court has previously ruled that interested parties indeed have the right to sue the state and federal government if the federal Medicaid Act is being violated. They will have the opportunity to decide that once again."
The Supreme Court's decision will have huge implications for the more than 10 million patients who are currently enrolled in California's Medicaid program.
"The state cannot continue to propose sweeping cuts to programs for California's poorest and most vulnerable patients," Dr. Hay added. "Our hope is that they get the message loud and clear with the U.S. Supreme Court's decision today."
Through Medi-Cal, physicians, dentists, pharmacists, adult day health care providers, clinics and hospitals provide health care services to low-income seniors, families, children and people with disabilities. By providing these primary and preventive care services, the state ensures these Californians have access to health care, while at the same time saving money by lowering the chances they will be forced to seek more costly health care, such as emergency rooms or hospital admissions.
SAVE THE DATE
California Radiological Society 2012 Annual Meeting
September 7-9, 2012
Grand Hyatt Union Square
San Francisco, CA
