The ISCD Public Policy Map includes detailed information regarding state certification and licensure requirements to perform DXA testing in the United States.
Included in membership benefits, ISCD Members may access the state by state information by clicking on the button below (please be sure you are logged into the ISCD website) to use the interactive map.
The ISCD Public Policy Team supports our mission related to Skeletal Health Assessment. Our focus is primarily at the state level and is meant to ensure access to quality patient testing by a broader recognition of the ISCD certification programs.
THE INFORMATION OUTLINED ON THIS PAGE IS AN OVERVIEW OF STATE LEGISLATIVE AND REGULATORY PROPOSALS INCLUDED IN MULTISTATE REPORTS AS OF DECEMBER 13, 2021.
Congress Passes Bill to Avert Medicare Cuts
A number of payment cuts for physician practices amounting to a combined 9.75% were scheduled to go into effect on January 1, 2022. On December 7, 2021, the U.S. House passed S. 610, Protecting Medicare and American Framers from Sequester Cuts Act, which appears to have averted much of the scheduled 9.75% Medicare payment cuts. The House passed the bill by a vote of 222-212 and will prevent billions of automatic Medicare cuts from taking effect. The Senate followed suit on December 9th, in a 59-35 bipartisan vote. President Biden is expected to sign the bill very soon. We will continue to monitor the legislation to evaluate the effect on DXA reimbursement rates.
The ISCD Continues Work to Increase DXA Payment Rates
As part of the Fracture Prevention Coalition, the ISCD is working to ensure access to DXA testing by increasing the office-based reimbursement rate. We are pleased to report that The Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2021 has again been introduced in both the House and Senate to address this growing problem. The bill would increase DXA in the office setting to approximately $98.
Rep. John B. Larson (CT-01) introduced the HR 3517 with Reps. Linda Sánchez (CA-38), Lori Trahan (MA-03), Michael Burgess M.D. (TX-26), and Jackie Walorski (IN-02) and Sen. Susan Collins (R-ME) introduced S. 1943 with Sen. Cardin (D-MD), Sen. Marshall (R-KS), Sen. Stabenow (D-MI), Sen. Capito (R-WV), Sen. King (I-ME), Sen. Cassidy (R-LA), Sen. Sinema (D-AZ), Sen. Menendez (D-NJ), Sen. Rosen (D-NV).
As you may know, fractures caused by osteoporosis are among the most significant challenges threatening the independence and quality of life for older Americans. We have continued our grassroots advocacy efforts around the country to build support for these critical legislative proposals. We have created a new website at www.fracturepreventioncoalition.org that contains a variety of resources, including infographics with terrific statistics, key state charts and other important information. You can also share your own personal story via a link on the page that could be used in our advocacy efforts.
At present there are 57 cosponsors in the House and 12 in the Senate. We need your help in contacting members of both chambers today to urge their support of HR 3517 and S. 1943.
Please click here to send a message to members of your state delegation urging their co-sponsorship of these critical proposals. For more information, or to share your story, please contact donnafiorentino56@gmail.com.
CMS Issues Correction re: Reimbursement for Trabecular Bone Score
The Centers for Medicare and Medicaid Services have issued a correction regarding the reimbursement for Trabecular Bone Score (77089). Effective January 1, 2022, the national average reimbursement for this code in the office setting will be $41.53 and $82.61 in the hospital setting. See below for detailed description of the family of TBS codes.
THE INFORMATION OUTLINED ON THIS PAGE IS AN OVERVIEW OF STATE LEGISLATIVE AND REGULATORY PROPOSALS INCLUDED IN MULTISTATE REPORTS AS OF OCTOBER 18, 2021.
October has brought several new actions in state activity as states gear up for both state and local elections on November 2, 2021.
Of particular interest is a bill in Pennsylvania that would re-institute and regulate the qualifications of radiologic technologists. ISCD has worked with the Commonwealth in the past, and as drafted, the certification of the ISCD would remain in place, and we would strongly encourage support of this measure. A copy of this bill can be found at:
https://iscd.org/wp-content/uploads/2021/10/PA-HB1440.pdf
As of mid-October, 6 state Legislatures currently remain in active legislative sessions (including Pennsylvania). There are now 5 states are in Special Session, and 8 states are currently accepting proposed (pre-filed) legislation for the 2022 Legislative Session, up one state from three weeks ago. There will be increased activity of pre-filed legislation after the November election and prior to the end of the year.
All 50 states continue to promulgate regulations that may be of concern or interest to the ISCD.
In various U.S. state legislatures, we have now screened 167 proposals- 42% of those pieces of legislation concern qualifications for radiologic technologists; 26% address radiologic equipment standards, and 32% focus on osteoporosis or general bone health issues.
Within state agencies, we have now screened 71 proposed regulations, of which about 47 regulations are/were relevant to the ISCD mission.
We will update this report again in November after the mid-term elections. At that time, there will be a significant increase in pre-filed activity by legislatures around the country. Throughout the year, many more proposed bills and regulations will be introduced that affect the field of bone densitometry; we will keep you informed as we continue to monitor and work on these important legislative and regulatory proposals.
THE INFORMATION OUTLINED ON THIS PAGE IS AN OVERVIEW OF STATE LEGISLATIVE AND REGULATORY PROPOSALS INCLUDED IN MULTISTATE REPORTS AS OF SEPTEMBER 24, 2021.
As of September 24, 2021, 7 state Legislatures currently remain in active legislative sessions. Three states are in Special Session, largely tacking issues related to the pandemic; 8 states are currently accepting proposed ( pre-filed) legislation for the 2022 legislative Session.
All 50 states continue to promulgate regulations that may be of concern or interest to the ISCD.
The state of Maryland has determined that there is no need for a technologist who is performing bone density to be either licensed or certified; ISCD has made repeated attempts to address this issue with the state, citing the danger to patients if a person has no qualifications to perform these tests. This type of “exemption” form certification represents the worst type of outcome for patients and quality of care. We have updated our map to reflect this determination.
In the Legislature, we have now screened 144 proposals- 72 concern qualifications for radiologic technologists; 26 address radiologic equipment standards, and 56 focus on osteoporosis or bone health issues.
Within state agencies, we have screened 62 proposed regulations, of which about 38 regulations are/were relevant to the ISCD mission.
We will update this report again in Mid-October. At that time, there will be increased activity by legislature. Throughout the year, many more proposed bills and regulations will be introduced that affect the field of bone densitometry; we will keep you informed as we continue to monitor and work on these important legislative and regulatory proposals.
THE INFORMATION OUTLINED ON THIS PAGE IS AN OVERVIEW OF STATE LEGISLATIVE AND REGULATORY PROPOSALS INCLUDED IN MULTISTATE REPORTS as of JULY 29, 2021.
As of July 29, 2021, 38 state legislatures adjourned their 2021 Legislative Sessions. Nine states and jurisdictions – California, Wisconsin, Michigan, Ohio, North Carolina, Massachusetts, New Jersey, Pennsylvania, and Washington, DC are still in active legislative sessions. One state, Texas, is in Special Session.
The Tennessee legislature passed a bill that allowed the Board of Medical Imaging to continue to regulate radiologic technologists. On July 25, the Board of Medical Imaging posted regulations governing licensure for radiologic technologists and this includes regulations for bone densitometry limited licensure. The hearing on these regulations is scheduled for October 12, 2021 and the ISCD will submit testimony, specifically asking for the ISCD program to be recognized by the Board.
Many public meetings are still being held by remote means or by hybrid in person and remote meetings due to continued COVID-19 outbreaks. Each month we will update this report to make sure our members have the most up to date information. Throughout the year, many more proposed bills and regulations will be introduced that affect the field of bone densitometry; we will keep you informed as we continue to monitor and work on these important legislative and regulatory proposals.
ISCD, Fracture Prevention Coalition Advocate for Increased DXA Reimbursement to Protect Bone Health
Rep. John B. Larson (CT-01) has again introduced HR 3517 the Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2021 with Reps. Linda Sánchez (CA-38), Lori Trahan (MA-03), Michael Burgess M.D. (TX-26), and Jackie Walorski (IN-02). In the US Senate, Sen. Susan Collins (R-ME) has again introduced S. 1943 with Sen. Cardin (D-MD), Sen. Marshall (R-KS), Sen. Stabenow (D-MI), Sen. Capito (R-WV), Sen. King (I-ME), Sen. Cassidy (R-LA), Sen. Sinema (D-AZ), Sen. Menendez (D-NJ), Sen. Rosen (D-NV) to improve access to osteoporosis screening.
HR 3517 and S 1943 will help to improve Medicare beneficiary access to osteoporosis screening by setting a floor rate of $98 for reimbursement of DXA tests to ensure access to this critical test.
As part of our efforts to educate members of Congress and gather grassroots support for HR 2517 and S. 1943, a new website has been developed to provide important information on osteoporosis and DXA. Please visit www.fracturepreventioncoalition.org for information on the bills, helpful statistics, infographics and more.
In the coming weeks, we’ll continue our efforts to build support for these critical bills. So far, we have 29 co-sponsors in the House and 9 co-sponsors in the Senate. We hope you will continue to support these efforts by sending a quick email to members of the US House and Senate in support of HR 3517 and S. 1943. Click here to send your message today.
THE INFORMATION OUTLINED ON THIS PAGE IS AN OVERVIEW OF STATE LEGISLATIVE AND REGULATORY PROPOSALS INCLUDED IN MULTISTATE REPORTS as of JUNE 11, 2021.
The ISCD Public Policy Team supports our mission related to Skeletal Health Assessment. Our focus is primarily at the state level and is meant to ensure access to quality patient testing by a broader recognition of the ISCD certification programs.
As of June 11, 2021, 39 state legislatures adjourned their 2021 Legislative Sessions. However, 11 states remain actively in session and three states (with an expected two additional states) have declared Special Sessions. Of the remaining active states, many state legislatures are in first half of their legislative sessions and we expect to see many more proposals between now and December 31, 2021.
Additionally, all 50 states continue to promulgate regulations that may be of concern or interest to the ISCD.
COVID-19 brought many challenges to the operations of individual state governments and we expect to see a continuation of modified legislative sessions with Zoom and hybrid meetings through at least Labor Day. All states managed to conduct their legislative business and 6 months into the year we have now seen an unprecedented 137 new laws proposed in 33 states and 51 new proposed regulations covering 24 states that are of interest to the ISCD. We review all proposals and intervene by filing testimony and activating our members as necessary.
Of the 137 proposed laws, 68 concern qualifications for radiologic technologists; 25 (1 address radiologic equipment standards, and 44 focus on osteoporosis or bone health issues. Of the 51 proposed regulations, about 32 regulations are/were relevant to the ISCD mission.
As we have mentioned in the past, eleven states do not regulate or require certification of radiologic technologists, including those performing bone density testing. This year, three of those states —Alabama, Georgia, and Missouri— considered new laws that would regulate radiologic technologists for the first time. In Georgia and Missouri, ISCD certification was explicitly recognized in the proposed legislation. While the language in the proposed bills in Alabama was broad enough to potentially allow recognition of ISCD-certified technologists, we worked with ISCD members in that state to request that the bill be amended so that there is no question that ISCD-certified technologists are specifically recognized.
While the bills did not pass in any of these states, the sponsors have indicated that they will come back to propose regulation again in 2022.
Tennessee has extended their Board of Medical Imaging through June 30, 2025 to continue their work. The bill was signed by the Governor and gives us the opportunity to have the Board recognize ISCD certification.
Each month we will update this report. Throughout the year, many more proposed bills and regulations will be introduced that affect the field of bone densitometry; we will keep you informed as we continue to monitor and work on these important legislative and regulatory proposals.
Many of the states abruptly concluded their 2020 Legislative Sessions due to the COVID-19 pandemic. However, over time, state legislatures were able to modify the way in which they conducted their business, including employing the use of technology such as Zoom for committee meetings and hearings and adjusting in-person session days to meet COVID-19 safety protocols. As a result, four months into 2021, we have already seen 56 new laws proposed in 22 states and 32 new proposed regulations covering 18 states that are of interest to the ISCD. We review all proposals and intervene by filing testimony and activating our members as necessary.
Of the 56 proposed laws, 28 (or 50%) concern qualifications for radiologic technologists; 11 (18%) address radiologic equipment standards and 17 (32%) focus on osteoporosis or bone health issues. Of the 32 proposed regulations, approximately 62% or about 20 regulations are relevant to the ISCD mission.
Eleven states do not regulate or require certification of radiologic technologists, including those performing bone density testing. This year, three of those states (Alabama, Georgia, and Missouri) are considering new laws that would regulate radiologic technologists for the first time. In Georgia and Missouri, ISCD certification is explicitly recognized in the proposed legislation. While the language in the proposed bills in Alabama is broad enough to potentially allow recognition of ISCD-certified technologists, we are working with ISCD members in Alabama to request that the bill be amended so that there is no question that ISCD-certified technologists are specifically recognized.
In Alabama, two bills (SB 64 and HB 176), filed earlier this year, would regulate radiologic technologists in the state of Alabama for the first time. The ISCD has submitted testimony requesting an amendment to the proposed bill that would recognize the ISCD’s National Commission for Certifying Agencies (NCCA) approved technologist certification program for individuals performing bone density testing. The language in the bills would accept the certification from the ISCD or the American Registry of Radiologic Technologists (ARRT) for persons applying for a limited x-ray machine operator license in bone densitometry.
As mentioned, we are working with the bill sponsor and ISCD members to ensure that bone density testing is an appropriate area of certification and that ISCD certification is recognized under the new law.
In Georgia, the bill (HB 811) creates a Medical Imaging Regulatory Board. Section 43-24B-5 of the proposal says:
We will work with our Georgia ISCD members and the Georgia Legislature to encourage passage of this bill.
In Missouri, bills (HB1426 and SB624) have been introduced to establish the certification of technologists. As does Georgia, the Missouri-proposed language specifically recognizes ISCD certification as follows:
Tennessee has extended their Board of Medical Imaging through the year 2025 to continue their work. The bill was signed by the Governor and gives us the opportunity to have the Board recognize ISCD certification.
Throughout the year, many more proposed bills and regulations will be introduced that affect the field of bone densitometry; we will keep you informed as we continue to monitor and work on these important legislative and regulatory proposals.
To date, 189 laws have been proposed in 40 states and 55 regulations were proposed in 23 states that are of interest to the ISCD. We review all proposals and intervene by filing testimony and activating our members as necessary.
Despite the onset of the COVID-19 pandemic, states quickly acclimated to on-line hearings and meetings and continued to do their work:
Of the 189 proposed laws, 88 (or 46%) concerned qualifications for radiologic technologists; 36 (19%) bills addressed radiologic equipment standards and 69 (36%) bills focused on osteoporosis or bone health issues. Of the 55 proposed regulations, about 50% or 27 were relevant to the ISCD.
There are currently 11 states that do not regulate or require certification of radiologic technologists. Three states (Michigan, Georgia and Kentucky) are considering new laws that would regulate radiologic technologists for the first time. In some cases, ISCD certification is explicitly recognized in the new law; in others the proposed language is broad enough to allow a regulatory Board to recognize ISCD certification once the law has passed. We highlight some of the most important proposals below.
In Michigan, HB 6105, filed last week, would require limited scope certification for technologists by the ARRT. We will work with the bill sponsor and ISCD members to insure that bone density testing is an appropriate area of certification and that ISCD certification is recognized under the new law.
In Georgia, (HB1222) creates a Medical Imaging Regulatory Board. The law, if passed gives that Board the authority to recognize various accreditation bodies and states that a “Certification organization” means a national organization that specializes in the certification and registration of medical imaging or radiation therapy personnel and is accredited by the National Commission for Certifying Agencies, the American National 28 Standards Institute, or another accreditation organization recognized by the board. Clearly, the proposed text in Georgia would allow for the recognition of ISCD technologist certificaiton
In Kentucky, there has been a lot of activity, both on the regulatory and legislative front. There continues to be opportunity for us to have the ISCD specifically mentioned in the law or regulation.
A bill passed in West Virginia (HB 4252) that requires that each state board to enact its own regulations. Because the law in West Virginia already recognizes the ISCD, we will have to keep an eye out for any regulatory change that may nullify the ISCD as the standard for bone density.
Oklahoma, Kansas, Minnesota, and Missouri introduced bills for the certification of technologists. In these states, the proposed language specifically recognized ISCD certification; unfortunatey, these bills were not adopted. We expect similar legislation to be proposed in upcoming legislative sessions.
Tennessee has agreed to extend its Medical Imaging Board through 2022 and it is critical that this Board be made permanent.
Pennsylvania has recognized ISCD certification for many years. However, legislation has been proposed this year that would reorganize the Medical Imaging and Radiation Safety Board. We will watch any such reorganization closely to make sure that ISCD certification remains an acceptable credential. While this bill did not pass, there is an indication that it will be back next year.
We will continue to monitor all legislative and regulatory proposals and intervene where appropriate.
