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ADVOCACY GOAL
To change the patient referral law and eliminate the exclusions that allow only radiologists to perform CT and MR in office.
BACKGROUND – CHAPTER ACTIONS 2007-2008
In December 2005, the chapter leadership created an ambitious plan to change the patient referral law. The Council backed the proposal and most chapter activities became centered on the plan. The ACC Board of Governors Steering Committee reviewed the plan and allocated some funds in order for the chapter to start the process without waiting for the membership fundraising piece to begin.
The plan was successfully implemented in four areas: Education of the Membership, Secure Funding, Hire a Lobbyist and Creation of a Coalition. Over $10,000 was raised from the membership through a series of e-mail and letters educating about the law and its implication for patients and physicians. In August 2007 an RFP process was complete and Gil Genn came aboard as our lobbyist. From day one Gill brought a passion and drive to the organization. His effort and contributions to our strategy is a keystone to our success.
Our legislative activities of September 2007 through March 2008 are impressive for an organization that had no voice in Annapolis in any previous years. The MDACC: hosted our first Annapolis Day bringing members together to visit 18 key legislators in one day, hosted Healthy Heart Day giving free EKGs, screening and consultations to 30 lawmakers, hosted a dinner for health committee representatives, hired a lobbyist, had 8 member visits to legislators offices in key districts and combined personal contributions at fundraisers to lawmakers targeted districts.
Most importantly we were able to get a bill introduced in the house and senate committees to overturn the law. An MDACC panel testified for the bill. Members Roger Leonard, Sam Goldberg, Sri Panmanabhan, Vinny Shaw and Marc Mugmon were key to our testimony. The power point presentations helped to put real meaning into the words and what patients experience everyday.
There are also successes that are not apparent - we have added early career FACCs to our advocacy committee. We have heard from members who have never participated in the chapter or the ACC words of encouragement and financial support. We have members who took the initiative to ask other practices for support of the chapter.
STATUS – LEGISLATIVE SESSION 2008
While we did not actually get a bill passed this year to alter the law on imaging and patient access, but we had many other victories along the way. We made several positive differences from last year's efforts. To that end, because so much progress had been made, Delegate Kullen withdraw the bill rather than risk any untoward result and request a "summer study." She formally sent a letter to Pete Hammen, the Chair requesting a summer study and that it be overseen by impartial third parties such as the Milbank Foundation or the Robert Woods Johnson Foundation. A letter was also sent by Senator Dyson to EHEA Chair Joan Carter Conway. We have been informed orally by both the Chairs and confirmed by Committee Counsel that a letter will be formally sent from the Chairs to these entities requesting help to facilitate the discussion during the interim and before the next legislative session.
BACKGROUND – GENERAL
In 1993, the State of Maryland passed the Maryland Health Occupations Article known as the Self-Referral Law. The law prohibits referral within an office for CT and MR, except for a waiver granted exclusively to radiologists. Further, the law excludes any non-radiologist practice from hiring a radiologist to read scans or become a partner in an effort to circumvent the law. At the outset, not many physicians were concerned about this law as it did little to affect the day-to-day rhythm of their practice or their ability to provide quality care. In 2004 at the request of two members of the House of Delegates, the state’s Attorney General issued an opinion that fully upheld the law: "In our opinion, State law bars a physician in an orthopedic group practice from referring patients for tests on an MRI machine or CT scanner owned by that practice…The same analysis holds true for any other non-radiology medical practice."
Beginning in the spring of 2005, the Maryland Board of Physicians took action against neurosurgery and orthopedic practitioners to "Cease and Desist" self-referral for such exams. The Maryland Patient Care and Access Coalition (see below) challenged this action and won in the Circuit Court for Baltimore City. Subsequently, the Board of Physicians withdrew the two newsletter publications of action. The Board is in the process of issuing a Declaratory Ruling to clarify their intent prior to the end of 2006.
In 2004, the American College of Radiology (ACR) announced their nation-wide advocacy goal was to emulate the Maryland law in the other 49 states in order to protect the profession of radiology. Since 2004, American College of Cardiology (ACC) and the ACC state chapter network have defeated measures in almost every state.
POSTING ARCHIVE
2007
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