Consistency, Accuracy, Responsibility and Excellence (CARE) in Medical Imaging and Radiation Therapy Bill, HR 2104
Patrick Hoier, BS, RCIS, FSICP
Invasive Cardiovascular Program Director
Southeast Technical Institute, Sioux Falls, South Dakota
As many of our members have probably heard by now, the Consistency, Accuracy, Responsibility and Excellence (CARE) in Medical Imaging and Radiation Therapy Bill, HR 2104, was reintroduced in the House of Representatives on March 13th, 2012. On May 17th, the American Society of Radiologic Technologists (ASRT) held a Capitol Hill Briefing to educate and inform representatives about the importance of quality medical imaging for proper medical care and the toll that exams repeatedly performed due to improper techniques have on the cost of health care in the United States. During this briefing, members of several different medical imaging societies highlighted the importance of HR 2104 on assuring higher quality medical imaging procedures. On June 8th, the CARE bill was introduced and discussed by the House Energy and Commerce Committee’s Subcommittee on Health.
The bill currently being examined and discussed by the subcommittee is a continuation of a legislative process that began approximately ten years ago. The original intent of the legislation was to improve patient care, increase quality of medical imaging, and decrease overall health care costs caused by repeat procedures performed by individuals not trained in medical imaging. The CARE bill is, in actuality, an amendment to a bill that was passed in 1981. The original bill, Consumer-Patient Radiation Health & Safety Act of 1981, required the Secretary of the Department of Health and Human Services (HHS) to create specific certification requirements for individuals who would be providing medical imaging and radiation therapy. Although HHS did provide the regulations required, there was no method of enforcing these requirements. The resulting regulation was considered a “guideline” for states to follow. The lack of enforcement measures resulted in few states implementing the regulations (only 35 states currently have licensure laws for radiographers). The CARE bill seeks to correct this problem by requiring HHS to develop new minimum standards for education and certification of individuals performing medical imaging and tying the implementation of these standards to Medicare reimbursement.
This new bill was developed with the input of 26 separate organizations that represent professionals performing advanced medical imaging. This coalition of professional organizations came together to form the Alliance for Quality Medical Imaging & Radiation Therapy (AQMIRT). The Society of Invasive Cardiovascular Professionals (SICP), Cardiovascular Credentialing International (CCI), and the Joint Review Committee on Education in Cardiovascular Technology (JRC-CVT) are three of the represented organizations. Through many hours of discussion and debate, the Alliance helped craft the current legislation, and has been working on a draft of consensus regarding educational and credentialing standards to help HHS formulate regulations should the bill pass. At this time, the RCIS credential is identified on the draft consensus as a recognized imaging specialty.
As you can see, this legislation has the potential to significantly impact imaging standards for invasive cardiovascular laboratories. Failure to comply with the regulations, should the bill pass, may result in the hospital or clinic being refused Medicare reimbursement for the imaging procedures.
The executive board of the SICP realizes that many of you may have questions and concerns regarding the CARE Bill, its potential implications for invasive imaging procedures, and SICP’s role in supporting the legislation. Because of this, we have provided links to the video of the subcommittee hearing on http://www.sicp.com and the SICP Facebook page. We have also set up a discussion thread on the SICP Facebook page so that you can post your comments and questions regarding this issue. SICP will continue to communicate with our members the status of the CARE Bill throughout the legislative session.
Finally, I would like to encourage all invasive cardiovascular professionals who are not already members of SICP to consider joining. SICP’s mission is to represent our profession and those who work within it. With your help, we can continue to focus on legislative issues like the CARE Bill and continue to strengthen the invasive cardiovascular profession.
Watch the video!
June 8, 2012 - Health
Subcommittee Hearing on
Appropriateness of Standards for Imaging at www.sicp.com.
Direct your comments, questions and discussion to the SICP
SICP’s Signature RCIS Review Course –
The Cleveland Clinic Heart & Vascular Institute
Saturday, October 6, 2012
The Society of Invasive Cardiovascular Professionals is excited to present a one-day Signature RCIS Review Course at The Cleveland Clinic Heart & Vascular Institute. The SICP Signature RCIS Review Course is designed to review information for the Cardiovascular Credentialing International (CCI) RCIS invasive registry exam. This course will help you identify areas in which you need to concentrate your self- study, or will serve as an overview for those who are preparing to take the exam.
Topics: Hemodynamics, calculations, interventional and diagnostic tools, cardiovascular diseases, and 12-lead EKG
Schedule: Saturday, Oct. 6th, 8:00am - 5:00 pm
Registration: Members $99; non-members $150 (SICP Membership is included with the cost of a non-member registration). Online at:
SICP’s Signature RCIS & RCES Review Course - Visalia, CA
November 3-4- 2012
The Society of Invasive Cardiovascular Professionals with the California Central Valley Chapter is excited to present two-day Signature RCIS and RCES Review Courses at Kaweah Delta Medical, Visalia, CA. The SICP Signature RCIS Review Course is designed to review information for the Cardiovascular Credentialing International (CCI) RCIS invasive registry exam. This course will help you identify areas in which you need to concentrate your self-study, or will serve as an overview for those who are preparing to take the exam.
Topics will include, but are not limited to: cardiovascular diseases, hemodynamics, calculations, 12-lead EKG, patient care & assessment, cardiovascular A&P, pharmacology and radiation safety.
The SICP Signature RCES Review Course is designed to offer the allied health professional a review of information for the Cardiac Credentialing International (CCI) RCES registry exam. The objective of the course is to offer a comprehensive review of content assessed on the RCES registry. This review may enlighten areas of need as well as serve as a refresher for other areas.
Topics will include, but are not limited to: cardiovascular diseases, hemodynamics, calculations, 12-lead EKG, e-grams, diagnostic electrophysiology, ablation physics I & II, and pacemaker/ICD implant & evaluation.
The two courses will run concurrently. Please indicate which course you plan to attend when registering.
Saturday, November 3,
8:00 am - 5:00 pm
Sunday, November 4,
8:00 am - 4:00 pm
Members $199; Non-members $250 (SICP Membership is included with the cost of a non-member registration); Students $70 - online registration for students is not available. You must include a copy of your student ID or letter from instructor to qualify for student rate.
Online at: http://www.sicp.com/events/rcis-rces-review-course-visalia-ca
Just a reminder…
HealtheCareers is a generous partner to SICP, contributing a small amount to SICP for each member that registers, again for each member that uploads a resume, and again for each member that applies for a job. It’s an easy way for you to help SICP as well as help yourself!
Register today! www.healthecareers.com/sicp
Legislation and Advocacy Awareness
SICP is committed to advancing the profession. One way to do that continually is to monitor what is happening around the country. We cannot do this alone. We need your participation to be effective! Please remember to share your input and your experiences. SICP membership is a valuable way to communicate with others in the profession.
Just a reminder…
Effective July 1, 2013, Cardiovascular Credentialing International (CCI) will officially remove the RCIS1 Qualification (also referred to as the On-the-Job Training qualification) that allows applicants who ONLY have two (2) years (full-time or full-time equivalent) working in Invasive Cardiovascular Technology, at the time of application, to qualify for CCI’s Invasive Registry examination.
WHAT DO YOU THINK?
Send your answer or new question to email@example.com.
I recently took and passed my registered cardiovascular invasive specialist (RCIS) exam here in San Antonio, Texas. I tested under the RCIS1 the “on the job training,” which Cardiovascular Credentialing International (CCI) will no longer be testing as of July 2013. Now that I have my RCIS credentials, my employer is asking that I get a limited radiology license from the state. I submitted my application for a limited radiology license to the Texas Department of Health in Austin and they will not process my application because I did not go to a radiology course or a two-year cardiovascular technologist (CVT) program. I have been in the cath lab for over 16 years and now that I have my credentials, I am being told I have to go get my radiology license or go to a CVT program?? Really? I am just so frustrated at this point. I am not alone. A lot of my friends that have been in the cath lab for over 30 years that were “on the job trained” and now have their credentials under the RCIS1 are being denied the limited radiology license in the state of Texas. These are some of the best RCIS trained professionals in the cath lab. I don’t know where else to turn, to but to ask you if you have any suggestions. I am willing to take this on for the rest of the older RCIS professionals that have been trained “on the job.” We truly love what we do, and we are dedicated to our work and our patients. Thank you for listening to our concerns.
— Anonymous by request, email firstname.lastname@example.org
SICP California Central Valley Chapter (CCVC)
Leslie Pollard, BA, RN, Secretary of SICP CCVC
The CCVC’s latest educational meeting was held on June 7, at Fugazzis Restaurant in Visalia, CA. It was a wonderful success, with approximately 40 people attending. The speaker, Jeffrey A. Southard, MD, presented “Optical Coherence Tomography and Fractional Flow Reserve (FFR).” Dr. Southard was very energetic and enthusiastic about his work with FFR and spoke about what FFR is, indications for its use, advantages and disadvantages, procedures and equipment, and common drugs used. We also had a nice attendance of cardiologists, surgeons, and anesthesiologists who have been very supportive in our endeavor to start a local chapter of SICP.
SICP Fellow Spotlight
Belinda W. Schuder, RCIS, FSICP
Belinda Schuder began her career in the cath lab in the late 1980’s. After obtaining a BS in biology and working in the clinical lab for a number of years, she became interested in the cardiac cath lab/electrophysiology (CCL/EP), and was fortunate to train at the world-renowned cath lab, Mid America Heart Institute in Kansas City, Missouri. At the time, the program was under the direction of the late Dr. Geoff Hartzler, and Belinda would not have traded this experience for anything. During her 20-plus years in the CCL/EP lab, she has had the opportunity to work in some other well-respected labs, including her valuable experience at Duke University Medical Center in the CCL/EP and hybrid OR.
At present, Belinda works for the Gwinnett Medical Center in Lawrenceville, Georgia, where a percutaneous coronary intervention (PCI) and open-heart program started not long ago. Within a year of the program opening, the Gwinnett Medical Center cath lab had performed well over 1000 PCIs. Belinda considers herself very fortunate to be working with some of the best cardiologist and thoracic surgeons the country has to offer, as well as a well-seasoned staff.
Her passion at present is to make the registered cardiovascular invasive specialist (RCIS) a license requirement in the state of Georgia. She recently met with the Georgia Medical Composite Board and received 100 percent support for this goal. She hopes to take it to the legislature next year.
Belinda has seen the CCL/EP change dramatically over the years, and notes, “We have come a long way in the battle against heart disease.”