Most ACR Survey Respondents Oppose MARCA Passage, But Not NPRP Use

November 5, 2021 — Most respondents (60%) to an American College of Radiology (ACR) member survey on Non-Physician Radiology Providers (NPRPs) do not support Medicare Access to Radiology Care Act (MARCA) passage. Yet only 43% of the survey population, which represents 16% of ACR membership, oppose NPRP use in their practice.

MARCA would provide payment to the supervising radiologist for registered radiologist assistant (RRA) services performed in a facility setting. The bill does not allow for independent RRA practice and direct RRA payment.

Sixty-two percent of respondents say whether to employ NPRPs, such as advanced practice registered nurses, physician assistants or RRAs, is a practice-level decision.

Survey results also show:

• 57% of respondents say their practice uses NPRPs — with 40% agreeing that NPRPs serve an important role in radiology practice.
• 55% of respondents say NPRPs are a threat to the quality of patient care, but two-thirds expect NPRP use to remain consistent or increase. 

The survey is one component of NPRP data gathering by the ACR:

• The ACR may hold listening sessions and focus groups with the Residents and Fellows, Young and Early Career Professional sections, and others to better understand concerns identified in the survey.
• At the April 2022 ACR Council meeting, Board of Chancellors Chair, Howard B. Fleishon, MD, will present the BOC report on Resolution 10b from the 2020 annual meeting.
• The deadline to submit any resolution to the ACR Council is Jan. 24, 2022.

The ACR remains neutral on MARCA, which currently has little congressional support:

• No congressional committees have held hearings related to MARCA.
• The Senate and House MARCA bills have only eight cosponsors combined/total.
• The ACR has not met with members of Congress regarding MARCA.
• RADPAC, the ACR Association political action committee, has not attended nor held MARCA-specific fundraisers, nor contributed in any way related to MARCA. 

The ACR remains focused on legislative and regulatory priorities that will soon impact radiology — including: 

• Urging Congress to ensure stability in the Medicare Physician Fee Schedule (and avert further cuts) — by retaining the 3.75% conversion factor adjustment through 2022.
• Working with the Centers for Medicare and Medicaid Services (CMS) and Congress to mitigate payment impact of budget neutrality application to the clinical labor wage update proposed in the Medicare Physician Fee Schedule rule.
• Working with the administration to ensure Surprise Billing Act implementation reflects Congress’ intent by removing patients from provider/insurer disputes and founding an equitable dispute resolution process.
• Opposing legislative efforts at the state level to unwisely expand NPRP scope of practice (SOP), thus endangering the level of care provided to patients.
• Imaging supervision and interpretation by highly trained radiologists are vital to accurate diagnosis and treatment of disease, injury and illness. The ACR has long fought SOP expansion by NPRPs and started a grant program to assist chapters with SOP concerns. ACR encourages members to take part in this advocacy.

MARCA updates are continually available on the ACR website.