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 UPDATE ON STATE AND FEDERAL LEGISLATIVE AND REGULATORY AFFAIRS AS OF December 12, 2022.
At the Federal level:
DXA Doesn’t Make the Cut in End of Year Package
With your help, ISCD and the Fracture Prevention Coalition have continued to build support for HR 3517 the Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2021 introduced by Rep. John Larson (CT-01) with Reps. Linda Sánchez (CA-38), Lori Trahan (MA-03), Michael Burgess M.D. (TX-26), and Jackie Walorski (IN-02) and S. 1943 introduced by Sen. Susan Collins (R-ME) 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), and Sen. Rosen (D-NV) to improve access to osteoporosis screening.
In early December, lobbyists for the Fracture Prevention Coalition provided an update on our progress. Our lead bill sponsors had been working to include a DXA provision in the end of year package being developed by House and Senate leadership. Our sponsors had been cautiously optimistic and believed we were closer than ever to getting a provision included that would have increased DXA reimbursement for a two-year period.
We were disappointed to learn that the Congressional Budget Office (CBO) had “scored” the DXA bill at a cost of over a billion dollars. (A bill’s score is the CBO’s estimate of the cost of a bill over a ten-year period). The latest score far exceeded previous CBO estimates. Our bill sponsors pushed back on the bill score but were unable to get CBO to revise the billion-dollar price tag, thus sealing the bill’s fate at this late time in deliberations. The CBO had been unwilling to offset the increased cost of reimbursement and medication by the reduction costs associated with hip fractures.
We appreciate the support of our bill sponsors and will continue to work with the Fracture Prevention Coalition to address the DXA reimbursement problem. Thank you for your help throughout this year as we have tried to move the DXA bill forward.
At the State Level:
With state and federal elections behind us, many state legislatures have returned to work, while others have begun the process of entertaining pre-filed legislation. A majority of legislatures allow for the pre-filing of legislation which allows bills to be drafted and introduced before the beginning of the regular legislative session.
At this time, states that are in active session include: California, Illinois, Michigan, Ohio, New Jersey and the District of Columbia. None of these states or the District have bills pending that would affect ISCD certification.
States that are entertaining pre-filed legislation include: Washington, Oregon, Montana, Nevada, Utah, Wyoming, Colorado, North Dakota, Kansas, Oklahoma, Texas, Iowa, Missouri, Arkansas, Mississippi, Indiana, Kentucky, Tennessee, Georgia, Florida, South Carolina, Virginia, Maryland, New York, New Hampshire and Rhode Island. The ISCD public policy staff will review these pre-filed proposals once they become available when legislative sessions reconvene. At this time, there are 172 bills pre-filed within 38 states.
Regulations are proposed by states all year long and are not subject to the statutory restrictions of state legislatures. We continue to monitor those proposals bi- weekly and reach out to those state agencies when regulations impact the ISCD.
As legislatures reconvene in January, we will inform our membership regarding relevant legislation.
THE INFORMATION OUTLINED ON THIS PAGE IS AN UPDATE ON STATE AND FEDERAL LEGISLATIVE AND REGULATORY AFFAIRS AS OF October 7, 2022.
At the Federal level:
ISCD Continues to Spearhead Osteoporosis Campaign. Alarming New Study Underscores Need for DXA Bills
The Fracture Prevention Coalition, together with ISCD, has continued to build support for both HR 3517 and S. 1943 the Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Acts of 2021. These bills were introduced to improve access to osteoporosis screening by stabilizing reimbursement rates.
Through our advocacy efforts and grassroots outreach, several new co-sponsors have signed on, now HR 3517 has 73 co-sponsors and S. 1943 has 16 co-sponsors. We need to keep the momentum going over the coming weeks. We urge you to help demonstrate the community support for these proposals by sending a quick email to members of the House and Senate by clicking here.
Fractures caused by osteoporosis are among the most significant challenges threatening the independence and quality of life for older Americans, making these bills more important than ever. In fact, the New York times just reported that hip fractures are expected to nearly double by 2050 based on research reported out of Hong Kong. It’s a concerning change. DXA was highlighted in the article as an important tool in the fight to protect bone health.
Important information on Osteoporosis and both proposals can be found on the Fracture Prevention Coalition website at www.fracturepreventioncoalition.org. We’re happy to report that a new group has also joined the coalition #HealthyWomen. Information on the group and their efforts can also be found on the site.
As Donna Fiorentino, ISCD’s Legislative Counsel continues to share information on the importance of DXA testing in meetings with members of the US House and Senate, sharing stories from individual providers and patients is critical. If you have a story to share, please contact Donna at dfiorentino@iscd.org so that we can use that information in our Congressional discussion.
Information on the decline in testing, as well as state and national statistics on hip fractures and fracture related deaths are part of the details shared with each member of Congress and really helps to illustrate the problems facing our providers and patients.
Finally, we’re sad to report that one of our lead champions in the House died unexpectedly this summer in a tragic accident. Rep. Walorksi was a champion for our cause and her efforts, leadership and commitment to improving the lives of her constituents will be greatly missed.
At the State Level:
States Gear Up for Election Day – Legislative and Regulatory Activity Remains Higher than Usual
Legislation
The anticipation of the elections on November 8th have triggered an unusual amount of state activity. Legislators are filing proposals and holding “off session” hearings as they campaign for re-election.
Four states are in active session- Michigan, New Jersey, Ohio and Pennsylvania. These four states are not currently entertaining any immediate proposals that would impact the ISCD or its members, although proposals for the 2023 session are expected in these typically active legislatures.
An unprecedented eight states have already pre-filed legislation for the 2023 session- Florida, Kentucky, Montana, Nevada, New Hampshire, North Dakota, Oregon, and Virginia. There are approximately 30 pieces of pre-filed legislation (and increasing) that we are reviewing that could impact the ISCD. As these pre-filed bills emerge, Anita Schepker is researching and tracking those proposals and notifying ISCD members in those states should there be issues of concern that jeopardize best practices and patient quality.
The state of Oklahoma is currently in Special Session – largely looking at budgetary issues; this state remains without certification requirements and we continue to work with that state to push for certification to ensure quality health outcomes.
Missouri, while not in special session, has been a very active state. Legislators who are running for re-election plan to re-introduce legislation that will recognize the ISCD certification program in 2023 and we are again working with both state Representatives and state Senators to pass a strong certification law.
Regulations
There have been, to date, 133 regulatory proposals that we have reviewed for ISCD members. Current activity this month includes the states of Kansas, where they are looking to modify and increase continuing education credits and whom may offer those credits. The state of Arizona, is proposing changes to the radiologic technology licensing requirements; and while we have ISCD recognition in Arizona, we monitor the activity of the hearings in order to ensure that there is no erosion of quality standards.
2023 Legislative Activity
We anticipate a very busy year in the states in 2023. It is typical that after an election, especially a midterm election, that Governors and Legislators propose a flurry of bills reflecting campaign promises. Similarly, there will be pressure on state agencies to enact regulations to clarify or amend laws that are or will be enacted.
Look for our election update in November! In the meantime, we will continue to keep the ISCD members apprised of critical activities.
THE INFORMATION OUTLINED ON THIS PAGE IS AN UPDATE ON STATE AND FEDERAL LEGISLATIVE AND REGULATORY AFFAIRS AS OF August 9, 2022.
At the Federal Level:
Medicare Proposes Payment Cuts for 2023
On July 7, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, effective on or after January 1, 2023.
The rule, CMS 1770-P, proposes a $1.53 decrease to the conversion factor for the Physician Fee Schedule for 2023 from $34.61 in 2022 to $33.08 in 2023. Part of the cut is related to the expiration of the 3 percent increase in Physician Fee Schedule reimbursements in 2022 that were required under the Protecting Medicare and American Farmers from Sequester Cuts Act. Under that law, Congress had temporarily increased physician reimbursements by 3 percent to mitigate the effect of pandemic related expenses.
The chart below includes the proposed reimbursement rates for 2023 osteoporosis related codes. The ISCD will submit comments to CMS objecting to these additional payment cuts. Our comments will be posted on the ISCD website when they are filed in September.
Six New Co-Sponsors have signed onto HR 3517 since June
This summer, The ISCD, as part of the Fracture Prevention Coalition, has continued to build support for HR 3517 and S. 1943 the Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Acts of 2021. These bills have been introduced to improve access to osteoporosis screening by increasing the reimbursement for DXA in the office setting from the current $38.07 to $98.
We’re pleased to report that several new co-sponsors were recently added. HR 3517 has 70 co-sponsors and S. 1943 has 16 co-sponsors. Important information on both proposals can be found on the coalition website at www.fracturepreventioncoalition.org.
Fractures caused by osteoporosis are among the most significant challenges threatening the independence and quality of life for older Americans, making passage of these bills more important than ever.
Donna Fiorentino continues to share information on the importance of DXA testing, meeting with Congressional staff to discuss the effects of the reimbursement cuts on access to DXA. Information on the declines in testing and treatment among Medicare women, as well as state and national statistics on hip fractures and fracture related deaths are part of the details shared with each member of Congress.
We will continue to demonstrate local grassroots support for HR 3517 and S. 1943 and urge ISCD members to participate in our advocacy efforts by sending a quick email to their Congressional delegation by clicking here.
Stories about how the DXA cuts have affected you and your patients is also critical to our efforts. Please contact Donna Fiorentino at donnafiorentino56@gmail.com with your story that will help us reinforce the need to pass the DXA bill today. We can set up a zoom call with members of your Congressional delegation to underscore the need for the bill.
At the State Level:
The summer months tend to be relatively quiet, with the majority of state legislatures adjourned for the year. The ISCD public policy team will continue to monitor any proposed laws or regulations in those states that are still in session or have been called into special session.
THE INFORMATION OUTLINED ON THIS PAGE IS AN UPDATE ON STATE AND FEDERAL LEGISLATIVE AND REGULATORY AFFAIRS AS OF June 10, 2022.
At the Federal Level:
ISCD, Fracture Prevention Coalition Highlight National Osteoporosis Month. New Co-Sponsors Added to DXA Bills.
At the federal level, the ISCD, as part of the Fracture Prevention Coalition, continues to work on building support for HR 3517 the Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2021 introduced by Rep. John Larson (CT-01) with Reps. Linda Sánchez (CA-38), Lori Trahan (MA-03), Michael Burgess M.D. (TX-26), and Jackie Walorski (IN-02) and S. 1943 introduced by Sen. Susan Collins (R-ME) 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), and Sen. Rosen (D-NV). As you know, these bills have been introduced to improve access to osteoporosis screening by increasing the Medicare reimbursement for DXA testing from the current $39 to $98.
A concerted effort to add co-sponsors to the DXA bills has been under way and National Osteoporosis Month created new momentum. The Coalition shared information relating to osteoporosis with members of Congress, highlighting the cost of the disease on both the health care system and the quality of life of patients. We’re pleased to report that several new co-sponsors were added. Currently, HR 3517 has 67 co-sponsors and S. 1943 has 16 co-sponsors. More are expected soon. Important information on the proposals can be found on the coalition website at www.fracturepreventioncoalition.org.
ISCD Legislative Counsel, Donna Fiorentino, continues to share our story, meeting with members of the US House and Senate on the DXA bills, discussing the decline in testing while sharing both state and national statistics on hip fractures and fracture related deaths.
We will continue to demonstrate local grassroots support for HR 3517 and S. 1943 and urge ISCD members to participate in our advocacy efforts by sending a quick email to their Congressional delegation by clicking here. If you have a story to share or if your member of Congress or Senators have not co-sponsored the legislation, please contact Donna for more details on how you can help us with your Congressional delegation at donnafiorentino56@gmail.com.
At the State Level:
Many state legislatures are winding down their activities for the year. However, at least nine states are still in session. The ISCD continues to monitor and work in those states to make sure that our certification programs are recognized. While legislative sessions have concluded in many states, state agencies will continue to enact regulations that may affect our members. We will monitor these regulations as they are proposed in the upcoming months.
Since January, the ISCD legislative team has reviewed 181 different proposals across 36 states that have a potential impact on our members. Of the 181 proposals, 157 are legislative and 24 were proposed regulations. We expect the number of regulations to increase during this next quarter.
As mask mandates have abated in many states, state officials began in-person meetings and hearings this year, but most have also adopted a hybrid approach by continuing virtual options for constituents.
Of particular interest in the past months was a bill proposed in Missouri, HB 2166, that would regulate radiologic technologists for the first time in that state. The ISCD has worked over the past year to ensure that our CBDT certification program was specifically mentioned and therefore recognized in the new bill. Unfortunately, the proposed legislation was not adopted before the Missouri General Assembly adjourned in May. We expect that this bill will be introduced again in January of 2023 when the legislature reconvenes.
The ISCD reviews each legislative or regulatory proposal in depth. We provide a legal analysis of legislative proposals, contact the sponsors, prepare and submit testimony, and reach out to our members to enlist their help in our grassroots efforts. In the case of proposed regulations, the ISCD contacts the state regulatory agency, have conversations with staff, and prepare comments and written testimony for our members.
We will continue to update our members on key state activities that impact the ISCD. We thank those members who we reach out to for their expertise and support in their individual states and look forward to more successful outcomes.
THE INFORMATION OUTLINED ON THIS PAGE IS AN UPDATE ON STATE AND FEDERAL LEGISLATIVE AND REGULATORY AFFAIRS AS OF April 14, 2022.
At the Federal Level:
ISCD Continues Work on DXA Testing Bills, Planning Underway for Osteoporosis Month
At the federal level, ISCD, as part of the Fracture Prevention Coalition, has been working to build support for HR 3517 the Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2021 introduced by Rep. John Larson (CT-01) with Reps. Linda Sánchez (CA-38), Lori Trahan (MA-03), Michael Burgess M.D. (TX-26), and Jackie Walorski (IN-02) and S. 1943 introduced by Sen. Susan Collins (R-ME) 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), and Sen. Rosen (D-NV). As you know, these bills have been introduced to improve access to osteoporosis screening. Fractures caused by osteoporosis are among the most significant challenges threatening the independence and quality of life for older Americans.
As of today, HR 3517 has 58 co-sponsors and S. 1943 has 16 co-sponsors. Important information on the proposals can be found on the coalition website at www.fracturepreventioncoalition.org.
In the past few weeks, Donna Fiorentino met with several members of the US House and Senate on both bills to discuss the decline in testing and the statistics on hip fractures and fracture related deaths.
We must continue to demonstrate local grassroots support for HR 3517 and S. 1943 and urge ISCD members to participate in our advocacy efforts by sending a quick email to their Congressional delegation by clicking here.
In anticipation of National Osteoporosis Month in May, ISCD together with other members of the Fracture Prevention Coalition will be sharing personal stories and other important information via social media to increase awareness about Osteoporosis and to build support for HR 3517 and S. 1943. It will be very easy to participate in these efforts, so please contact Donna Fiorentino at dfiorentino@iscd.org if you are interested in participating in this important effort. All month long, facts, statistics, personal videos, op-eds and other posts will help to amplify the message on DXA.
At the State Level:
Several states have entertained proposals concerning bone health. As of today, there are 178 proposals pending that are legislative and of those about 75% have a direct impact on the qualifications and certifications that could affect the ISCD. Additionally, there have been 45 regulatory proposals where issues have arisen that could have an impact on the ISCD’s programs.
We have weighed in on certification issues in Missouri, Oklahoma, Tennessee, Minnesota, Kentucky, Alabama, Illinois and New Hampshire.
As mentioned in previous updates, we are hopeful that states like Missouri and Oklahoma which do not have any standards for licensure will finally pass laws that both regulates radiologic technicians and also recognizes the ISCD certification program. As these bills continue to progress, we will keep the members informed.
We want to thank our members whom we contact regularly for their input on particular state issues. We have achieved success in these states because our members have been so willing to help us in our pursuits.
As you are aware, the ISCD receives and reviews updates on state legislative and regulatory activity twice a week. We will continue to update the membership; however be assured that when an issue arises that needs immediate attention, we will be reaching out to key members to help us with any legislation or regulation that could positively or negatively affect the Society.
THE INFORMATION OUTLINED ON THIS PAGE IS AN UPDATE ON STATE AND FEDERAL LEGISLATIVE AND REGULATORY AFFAIRS AS OF FEBRUARY 17, 2022.
At the Federal Level: ISCD Continues Work on Access to DXA Testing
As part of the Fracture Prevention Coalition, ISCD has been working to build support for HR 3517 the Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2021 introduced by Rep. John Larson (CT-01) with Reps. Linda Sánchez (CA-38), Lori Trahan (MA-03), Michael Burgess M.D. (TX-26), and Jackie Walorski (IN-02) and S. 1943 introduced by Sen. Susan Collins (R-ME) 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), and Sen. Rosen (D-NV). The bills have been proposed to improve access to osteoporosis screening because fractures caused by osteoporosis are among the most significant challenges threatening the independence and quality of life for older Americans. As of today, HR 3517 has 58 co-sponsors and S. 1943 has 14 co-sponsors. Important information on the proposals can be found on the coalition website at www.fracturepreventioncoalition.org.
Just this week, Donna Fiorentino met with key members of the US House and Senate on both bills to discuss the decline in testing and the statistics on added hip fractures and fracture related deaths.
We must continue to demonstrate local grassroots support for HR 3517 and S. 1943 and urge ISCD members to participate in our advocacy efforts by sending a quick email to their Congressional delegation by clicking here.
At the State Level:
State Legislatures have started their 2022 Legislative Sessions or carry-over sessions in 32 states. The states have been quite active and in less than one month we are already tracking about 15 new proposals that have been introduced concerning bone health.
Our focus this month has been on the Missouri legislature, which we hope will finally pass a law that regulates radiologic technicians, and which acknowledges the ISCD certification. As the bill moves forward, we will be reaching out to members to contact their state Senators and Representatives to pass the bill.
The ISCD receives and reviews updates on state legislative and regulatory activity twice a week. We will continue to update the membership with this type of monthly update; however, if some issue arises that needs immediate attention, we will be reaching out to key members to help us in any efforts that positively or negatively affect the Society.
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.
