The ARRT and ASRT are committed to the success of the radiologist assistant
a radiologic technologist, so the supervision of all Medicare and Medicaid procedures is set to the highest level; that of personal supervision. In other words, the radiologist must be present in the room during the performance of the examination or the insurance companies will not reimburse the expenses incurred. So if the radiologist must be present at all times, then why would they hire an RA to do the procedure? This is the question many radiologists' practices and unemployed RAs are struggling with, and is the main barrier to our full utilisation and growth in the field. It is also the reason why many RAs are working below their capabilities. However, some private insurance companies do not have such stringent guidelines as Medicare and Medicaid, therefore RAs can perform procedures on these patients, with the radiologist safe in the knowledge that reimbursement will be obtained.
Working towards federal legislation to recognise the RA The radiology community is proposing federal legislation, which will solve this problem. Under this proposed legislation, HR 1148, Medicare Access to Radiology Care Act (MARCA), radiologist assistants would perform the procedure with 'direct supervision' and the radiologist would receive 85% reimbursement5
. This
percentage is similar to a nurse practitioner or physician assistant payment schedule. Direct supervision means the radiologist is in the building and readily available. The ARRT and ASRT are committed to the success of the radiologist assistant and have hired a lobbying firm to help achieve this legislative fix. Grassroots efforts have been going strong and the representatives in Washington DC have been hearing from radiologists, RAs, managers, technologists, and patients throughout the country. It is anticipated that this legislation will be passed soon. Once the legislation passes it will then be up to the 50 individual states to govern how RAs practice. More than half (29 states) already have legislation in place recognising the RA profession, further supporting the need. Without legislation RAs will continue to struggle to find appropriate employment after qualifying, and
university programs are in danger of closing. The lack of recognition makes some radiologists reluctant to hire RAs, not doubting their ability, but doubting the legalities and billing of the profession. Another negativity is that some radiologists see RA students as free labour during their training, but are unwilling to pay them a salary when they qualify, if they cannot do all procedures on all patients. Nevertheless, radiologic technologists are excited about this new advanced clinical pathway and many want to access university courses to become RAs. However, as with many career-advancing opportunities involving formal study,
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