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MARCA Bill Introduced in U.S. House of Representatives

Mar 29, 2019

Rep. Mike Doyle introduced H.R. 1970, the Medicare Access to Radiology Care Act, on March 28, 2019. The legislation would allow radiologists to submit claims to Medicare for non-imaging services performed by radiologist assistants in hospital and office settings, as well as imaging services in hospitals. Reps. Pete Olson, Ron Kind, Greg Gianforte, John Sarbanes, and Terri Sewell serve as co-sponsors of the bipartisan bill

Medicare recently revised its rules to allow radiologist assistants to perform services under “direct supervision.” This means a radiologist does not need to be present in the room where the exam is taking place; however the radiologist must be in the facility and immediately available to render assistance. However, the radiology practices that employ them are unable to submit claims to Medicare for services performed by RAs in hospitals and office settings, where they normally work.

If enacted, MARCA would offer Medicare recognition of radiologist assistants and radiologist practitioner assistants as midlevel providers of health care services working under the supervision of a radiologist. The American Society of Radiologic Technologists supports the bill, along with more than 100 national state and local organizations and companies, including the American Registry of Radiologic Technologists, American College of Radiology and the Society for Radiology Physician Extenders

An RA is an advanced-level radiographer who performs procedures under the direct supervision of a radiologist. RAs must complete a rigorous academic program encompassing a nationally recognized curriculum, a radiologist-directed clinical preceptorship and a certification examination. RAs advanced education and training enable them to perform assessments and procedures, but they cannot interpret images or prescribe medications or therapies. RAs allow radiologists to focus on interpretations, thus enhancing patient safety and outcomes.

The MARCA bill is another positive step toward RA recognition at the federal level. In November 2018, the Centers for Medicaid and Medicare Services revised the Physician Fee Schedule to allow RAs and RPAs to practice under “direct supervision” levels. The change followed significant advocacy efforts targeting CMS by ASRT and other radiology stakeholders.

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