Breast Density Bill Signed by the Governor

The Governor signed SB 1538 (Simitian) regarding providing notice to women who undergo screening mammography and are determined to have dense breast tissue. The CRS was in support of SB 1538 as it was amended this year.

Women who are determined to have heterogeneously dense or extremely dense breast tissue based upon the BIRADs reporting system would receive the following notice in the MQSA letter sent by the mammography facility;

            "Your mammogram shows that your breast tissue is dense. Dense breast tissue is common and is not abnormal. However, dense breast tissue can make it harder to evaluate the results of your mammogram and may also be associated with an increased risk of breast cancer.

            This information about the results of your mammogram is given to you to raise your awareness and to inform your conversations with your doctor. Together, you can decide which screening options are right for you. A report of your results was sent to your physician."

SB 1538 includes the following:

• Notice would be required to be sent beginning April 1, 2013.
• There is no liability for failure to have sent the notice prior to that date.
• Nothing in the law creates a new standard of care or obligation beyond the duty to provide notice.
• If MQSA later determines a different type of notice or language, it would take precedence.
• The requirement to provide this notice would sunset on 1/1/2019 unless it is reauthorized.

The CRS sponsored SB 1199 (Dutton) regarding the training and scope of practice for RTs to inject contrast material. Existing law allows an RT to inject contrast material into an upper extremity provided they obtain certain training. That training includes performing 10 venipunctures. Last year the RHB sent a letter to all RT schools indicating that those 10 venipunctures must be performed on humans. That is an issue for some schools who might use phantom simulators due to liability concerns or shortage of human volunteers for this purpose.

SB 1199 makes two changes (1) to specify that training including performing 10 venipunctures can be done on a human or phantom simulator, and (2) that the RT could be allowed to administer other substances to insure the patency of the IV cannula according to hospital or imaging facility protocol. The latter provision would clarify that injection of a saline solution to flush the line would be specifically permitted.

An RT who does the required venipunctures on phantom simulators would be required to be personally supervised performing the required ten venipunctures on a human before being allowed to inject contrast material independently. Since it is common practice for this proctoring to occur when an RT has their initial employment at a hospital or imaging center it is a practical solution. An RT who was trained and performing these injections prior to 1/1/13 is grandfathered and not required to have the supervised venipunctures. 

Palmetto-Medicare MAC for California Loses Contract Award

Palmetto lost their MAC contract for California as a result of re-bidding the contract for this region.  On September 20, 2012, CMS made a contract award for the Jurisdiction E A/B MAC contract to Noridian Administrative Services. The Jurisdiction E A/B MAC administers Medicare Part A and Part B claims for covered services in the California, Hawaii, and Nevada, as well as the U.S. territories of American Samoa, Guam, and the Northern Mariana Islands. The current A/B MAC for this geographic area, Palmetto GBA, will continue to administer provider claims for up to six months as CMS oversees the transfer of these Medicare contract responsibilities to Noridian Administrative Services. Click here for more information about the Jurisdiction E award.

There may be an appeal of the decision by Palmetto but nothing has occurred as of yet.