President’s Message

Summer 2017

Dear Colleagues,

On behalf of the Massachusetts Radiological Society (MRS) Officers and Executive Committee, I would like to update you regarding our activities over the past year, the most pressing issues facing our profession, and our goals as a leadership team for the upcoming year.

It is my privilege to succeed Dr. Deborah Levine as the President of the MRS for the 2017-2018 term. I would like to extend a sincere thank you to Dr. Levine for her leadership, dedication and guidance. I am grateful to have the support of a dedicated and talented team of volunteer leaders drawn from radiology, radiation oncology, and medical physics, supported by the guidance of our national leadership at the American College of Radiology, our legal counsel Mr. Ed Brennan, and our chapter administrator Ms. Ginny DuLong. Our society is in strong financial shape with a positive balance. I would like to thank past Treasurer (now Vice President) Dr. Rodrick Williams and current treasurer Dr. Priscilla Slanetz for their financial stewardship. I would also like to acknowledge the help of Dr. Maryellen Sun who is now President Elect and Dr. Samuel Madoff who is our current Secretary. The members of our Executive Committee and the above officers spend hours of selfless time representing you, our constituency, on a variety of issues.

Our key activities include educating and informing legislators, insurance companies/third party payers, and other imaging stakeholders in the Commonwealth regarding the essential role of imaging in order to secure the support our specialty deserves to take care of our patients. We make every effort to be vigilant and active in legislative and informational efforts.

Below is a summary of the current and future key issues:

Out of Network Surprise Billing

An issue that has received much attention this year including by the Health Policy Commission (HPC), the Special Commission of Provider Price Variation and the legislature has been out of network (OON) surprise billing in which a patient may receive a bill for medical services provided at an in network hospital by an out of network provider such as a radiologist. Good data do not exist as to the extent of OON surprise billing in the Commonwealth. Surrounding states including Connecticut and New York have passed laws regulating this practice including payment caps and balance billing prohibitions. Such billing may become more commonplace in the future with the proliferation of limited/narrow network plans offered by health insurers. Dr. Philip Rogoff, past president of the MRS, provided testimony on behalf of the MRS to the Joint Committee on Financial Services in May 2017 opposing multiple state bills which would have set payments to physicians who are out of a patient’s insurance network to Medicare fee levels, among other flaws. A senate amendment was also added to the state budget to address OON billing which the MRS also opposed based on the rate-setting role of the HPC and a transparency provision which would have unrealistically placed the burden of informing patients if they are out of network on the provider at the time of service. Fortunately, the compromise budget released in July 2017 did not contain this amendment although this issue will surely continue to be active. The MRS has encouraged the HPC to convene a workgroup of stakeholders to find a reasonable solution to this complex problem that would hold the patient harmless. We will continue to monitor this issue closely and other proposals to cap provider fees.

Advanced Practice Nursing Independent Practice

The MA Coalition of Nurse Practitioners has refiled a bill to grant independent practice to Nurse Practitioners, which the MRS has opposed in the past. The MRS continues to be vocal in our concerns regarding nurses practicing without physician oversight. Particularly, we are strongly opposed to language expanding nurse scope of practice to include the interpretation of tests, which could include imaging exams. We continue to strongly advocate that imaging interpretation should remain the purview of radiologists and other appropriately trained physicians. Just recently, Governor Baker sent proposed budget amendments to the legislature that would increase scope of practice for “lower cost providers” including independent practice for nurse practitioners. MRS will provide strong testimony against these provisions and remain vigilant on further developments.

Multiple Procedures Payment Reduction (MPPR)

As you are likely aware, the MPPR imposed by Medicare on the professional component on advanced imaging was reduced from 25% to 5% starting January 1, 2017, largely in part due to the tireless advocacy by the ACR to reverse this ill-informed policy. The MRS continues to work with third party private payors in MA to encourage them to also eliminate and/or reduce their multiple procedure payment reductions such as to bring them in line with these federal changes.

Breast Tomosynthesis Reimbursement

Officers of the MRS and members of the Breast Imaging Committee have met in person to advocate and lobby MA third party payors to reimburse for tomosynthesis. The increased cost and time of tomosynthesis, which is undertaken to provide improved patient care, needs to be supported financially. Our efforts are intended to secure such essential support.

Insurance Coverage for Tomosynthesis and Breast MRI

The MRS helped file legislation this year as sponsored by Senator Lovely to require state insurers to cover both screening and diagnostic tomosynthesis. The same bill would also require insurance coverage for additional imaging such as ultrasound or breast MRI in patients with dense breast tissue or who have additional breast cancer risk factors. All coverage would not be subject to patient cost sharing such as co-pays or deductibles. The MRS has joined with breast cancer patient advocates to encourage legislators to advance this life-saving legislation.

ACR 2017

The MRS sponsored a large delegation of councilors/alternate councilors and trainees at the ACR’s annual meeting in Washington DC in May 2017. Highlights from the meeting included receiving an ACR Chapter Recognition Award for Membership; a testament to the strength of

our chapter under the recent leadership of Dr. Deborah Levine. Other highlights included the induction of 17 fellows from MA to become FACR, a great honor for the state and one of the largest fellowship classes in recent years. We also visited the offices of 11 legislators during our annual Capitol Hill Day including the offices of both of our Senators and all nine of our House Representatives. Pictures of our award and Capitol Hill Visit can be viewed at our website: http://massrad.org.

Radiology Leadership Institute (RLI)

The RLI is in its sixth year of existence, and was created by the ACR as a resource to facilitate leadership training across the full spectrum of radiology trainees and practitioners. Massachusetts continues to play a prominent role in the activities of the RLI not only as RLI leaders and educators but also as students and participants. The RLI leadership summit will be held this September at Babson College from September 7-10, 2017. All MRS members including residents and fellows are eligible to receive a discount for the RLI Summit, by registering at: http://www.radiologyleaders.org/meetings-and-courses/live-meetings/2017-rli-summit. Residents and fellows should use code MRSMIT25 to receive a 25% discount and MRS members should use MRSRLI750 to save $750 during check out. In addition, MRS members, through a supporting arrangement with the RLI, are also granted access to one RLI webinar for each of the next three years at no charge. If you would like to view the potential webinar options and make your selection, please use the following hyperlink: https://radiologyleaders.wufoo.com/forms/m3pv2u300iznyt.

For the second year in a row, the MRS in conjunction with the RLI is sponsoring an exciting one day course prior to the RLI Summit which is tailored for earlier levels of radiology leadership, particularly trainees and younger radiologists. This event was very well attended last year and received excellent reviews. The “2nd Annual Massachusetts Radiological Society Leadership Symposium” organized by Dr. Kausal Mehta and Dr. Lauren Ferrera will be at held at the Massachusetts Medical Society in Waltham, MA on Wednesday, September 6th. Up to 7.5 hours AMA PRA Category 1 CME credits will be available for this event. Please see the enclosed flyer for further details including how to register.

MRS Annual Meeting

Please mark your calendars for the MRS Annual Meeting which will be held on Wednesday, March 7, 2018 at the headquarters of the Massachusetts Medical Society in Waltham MA. Our guest speaker will be Dr. Ezequiel “Zeke” Silva, III who is the Chair of the ACR Commission on Economics, a practicing Interventional Radiologist and a recognized expert in payment policy and quality initiatives.

 Conclusion

In summary, these are times of rapid change in both radiology and healthcare. While there are many challenges, there are certainly many opportunities as well. The MRS remains committed to monitoring developments at the local and state level and advocating on behalf of our patients and our profession. Our executive committee is honored to serve you, our dedicated members, whose continued membership and support make it possible for us to pursue the missions of our society.

I wish you the best for the remaining summer and upcoming year.

Sincerely,

Bruce G. Stewart, MD
President