Rend Lake College Director of Radiologic Technology Kim Robert (CENTER) stops lobbying on Capitol Hill long enough for a photo with some colleagues; Valerie Bryne (LEFT)with Hines Veterans Hospital in Chicago, and Catherine Kukec with LaGrange Memorial Hospital in Chicago. Robert joined fellow members of the American Society of Radiologic Technologists (ASRT) in Washington D.C. this Spring to build support for the CARE Bill. CLICK HERE for a larger photo.
WASHINGTON – Rend Lake College’s Kim Robert cares about patient care.
The director of radiologic technology at RLC joined colleagues from across the country this Spring by marching on Capitol Hill in support of the CARE Bill – a piece of legislation with roots back to 1981 that calls for federal standards in the field.
The Consistency, Accuracy, Responsibility and Excellence (CARE) in Medical Imaging and Radiation Therapy bill – as it is known now – calls for the establishment of minimum standards for personnel who produce the images doctors use to make life-saving decisions. American Society of Radiologic Technologists (ASRT) members like Robert have been building support for the bill in Washington for more than a decade.
Based on information distributed by ASRT to its members, U.S. Rep. John Shimkus (R-Illinois-19) cosponsored the bill when it was re-introduced in 2001 by Heather Wilson, a republican representative from New Mexico. Shimkus was among more than 50 cosponsors from the House of Representatives.
CARE’s history goes back to the Consumer-Patient Radiation Health and Safety Act of 1981. When it was passed, minimum standards regarding state licensure of personnel who perform radiologic procedures were established by the federal government. According to ASRT, the Act provided a model licensure bill for states to follow, but adoption of these standards was made discretionary for each state, and there are no sanctions for noncompliance.
“Right now, eight states and Washington D.C., do not have guidelines, so anyone can take an x-ray,” Robert said. “This bill is important to overall patient care.”
According to the bill, eight states – Alabama, Alaska, Georgia, Idaho, Missouri, North
Carolina, Oklahoma and South Dakota – and the District of Columbia allow people with little or no training to perform x-rays, MRI scans, CT scans and other diagnostic imaging examinations. It further states that inadequately educated personnel are allowed to deliver radiation therapy designed to treat cancer in 18 states and that they are allowed to perform nuclear medicine procedures in 24 states.
The bill died in the House at the conclusion of the 107th session of Congress in 2002, was introduced again by Wilson in 2003 and died again when Congress adjourned in 2004, according to ASRT’s information. It made progress in 2003 by being introduced in the Senate for the first time, with a new name – the RadCARE bill – and gaining the support of 17 Senate cosponsors.
According to ASRT, the organization’s CEO, Lynn May, gave testimony to a House subcommittee on health in 2006. May noted that “if the CARE bill could reduce the number of images that must be repeated due to improper positioning or technique by just one percent, Medicare would save more than $90 million a year,” ASRT information states.
The Senate passed its RadCARE bill in late 2006 and forwarded it to the House. Calls and e-mails from radiologic technologists from around the country flooded the lines and inboxes of legislators in Washington, ASRT states. The House adjourned later that month without taking any action on the bill.
The bill was introduced with a new name in the House in 2007. It was still called the CARE bill, but the word “radiologic” was replaced with “responsibility” in order to include other modes of imaging, according to ASRT.
Legislation has since been passed which contains significant requirements for medical imaging facilities providing CT, MR, nuclear medicine and PET examinations – the top 20 percent regarding cost – for Medicare patients, ASRT states. The legislation labelled these examinations “advanced imaging modalities,” and did not include x-ray, fluoroscopy and ultrasound; which make up 70 percent of medical imaging provided to Medicare patients, ASRT information states. Therefore, ASRT remains committed to enactment of the CARE bill, which takes into account these types of imaging.
According to ASRT, only 38 states fully or partially license, regulate or register radiographers; 33 states license radiation therapists; and 27 states license nuclear medicine technologists. Robert said Illinois is considered the gold standard since being regulated in 1985.
In September, Rep. John Barrow (D-Ga.) introduced H.R. 3652 – a version of the bill which closely parallels previous versions of the CARE bill and would hold a facility or practitioner to personnel standards if they want to be reimbursed for medical imaging and radiation therapy procedures through Medicare. H.R. 3652 currently has 57 cosponsors and has been assigned to House subcommittees on Energy and Commerce, and Ways and Means.
Robert said she will continue to do her part to stay educated, pass that education on to students at RLC and encourage legislators about the CARE bill.