SICP Legislative Update: CARE Bill

The SICP (Society of Invasive Cardiovascular Professionals) Representative to the Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging (CARE Bill) Alliance attended the recent meeting concerning this bill in Washington, D.C. The SICP is a member of the Alliance for Quality Medical Imaging and Radiation Therapy, and continues to strongly support the intent of the bill, which is to ensure that there are minimum federal standards for the education and credentialing of persons who perform healthcare imaging. This includes those persons working in the cath lab. The CARE Bill is a contingent bill, meaning that if states or facilities do not comply, they will not receive federal reimbursement for Medicare or Medicaid patients who have imaging procedures done in their facilities. To recap the progress of this bill over the last few months, the SICP was pleased that it was unanimously passed in the Senate's last Congressional session. However, the 109th Congress adjourned before the CARE Bill could be voted on in the House time simply ran out. At the time of this writing, the House version (HR 583) is still in play, and the Senate version will be re-introduced. It is expected over the next several weeks that Senator Ted Kennedy's (D-MA) office will issue a Dear Colleague letter to reintroduce the bill to the Senate. The Bill remains unchanged from its previous version, with exception to the acronym CARE, which originally stood for Consumer Assurance of Radiologic Excellence. It was changed to Consistency, Assurance, Responsibility, and Excellence to better represent the various imaging modalities and professionals who will be included in the bill. At the Alliance meeting, the proposed regulations that will amend Title 42 of the Public Health Service were reviewed, discussed, and revised. Although not yet finalized, the proposed regulations have been well thought-out, scrutinized, and favorably represent the various imaging modalities and professionals represented in the bill. I am quite encouraged by what this will mean for cath lab professionals who have earned the RCIS (Registered Cardiovascular Invasive Specialist) credential administered by CCI (Cardiovascular Credentialing International). The RCIS credential will meet the proposed minimum standards to administer imaging under the direction of a licensed operator. The SICP and CCI have worked very hard to ensure that the RCIS credential is appropriately defined and included in the bill. This includes both those persons who have graduated from a formal program in CV (cardiovascular) technology accredited by the JRC-CVT (Joint Review Committee on Education of Cardiovascular Technology), and those who received their training OJT (on the job). Particular emphasis has been directed towards the OJT to make sure that they are included in the bill. Thus, we have taken great measures to make sure there is a generous grandfather clause in the bill to allow ample time for both graduates of accredited programs and OJTs to obtain their RCIS credential and meet minimum credentialing standards. Testing and obtaining the RCIS credential is the only way cardiovascular technologists can demonstrate that they meet a minimum standard of knowledge. Quite frankly, our patients deserve only the best quality care. Our patients should have confidence that the persons performing their imaging procedures are knowledgeable and meet a threshold of education and credentials for the care they are providing. This is the intent of the CARE Bill. Both the SICP and the Alliance stand firm in our conviction to not legislate anyone out of a job. However, the grandfather clause must sunset at some point. Once the bill is passed and goes into effect, OJTs and graduates of CV technology programs will have four years to obtain their RCIS credential. Otherwise, these persons could be faced with not being able to work because only facilities that meet minimum federal standards would receive Medicare reimbursement. The SICP has received comments and concerns that the proposed regulations will not look the same as they are being drafted by the Alliance once they are submitted to HHS (Health and Human Services). This is likely true and we expect that the language will change somewhat. However, the Alliance is comprised of the technical experts in the medical imaging profession in the United States we represent the healthcare imaging industry. Everyone who is a stakeholder is represented, and to our knowledge, there are not any technical groups that are in opposition to the bill. It is for these reasons that we believe that HHS will turn to the Alliance for guidance in development of the rules surrounding the educational and credentialing standards for healthcare imaging professionals. This is a very important time in healthcare. We will continue to face increasing staffing shortages with less entrants into all of our professions (RN, RT, and CVT) due to other occupations that pay as well and are less demanding on personal lives meaning no call, weekends or nights. We are also seeing new devices and therapeutics on the horizon that are, and will continue to bring, more and more patients to the cath labs who want minimally invasive and safer procedures. If this is not enough, in a few short years, we will face the beginning of some 77 million baby boomers who are not only becoming eligible for Medicare, but reaching the age when heart disease begins to rear its ugly head. These factors will force us to do things much differently in the future than we do today. One thing is for certain whatever is thrust upon us in the future, we must be united in ensuring that the quality care we provide our patients should be the best there is. The quality should be better tomorrow than it is today. This is just one way to leave our profession in a better condition than when we came into it, and better serve our patients. Besides, if I ever need cardiovascular imaging services, I do not want any doubts as to the knowledge and skills of the providers who will take care of me. The SICP will keep continue to keep you updated as the CARE Bill moves forward through the legislative process. For comment, please contact Todd Chitwood, President-Elect, SICP and SICP Representative to the Alliance for Quality Medical Imaging and Radiation Therapy at PresidentElect@SICP.com.

NULL