On January 1, Rhode Island became the first state in the U.S. to rely on American College of Radiology accreditation as a criterion for licensing its MRI facilities and physicians.
The law requires all facilities that offer MRI examinations, as well as physicians who interpret the exams, to be accredited by the ACR. Because accreditation will be required as a condition of state licensure, it will affect the facilities' eligibility for reimbursement by health insurers.
Implementation of the law, known as General Assembly Act 9-H5762, coincides with Aetna U.S. Healthcare's requirement that beginning January 1, 2000, its MRI providers must also be accredited by the ACR in order to be eligible for reimbursement.
According to Dr. Glenn Tung, president of the Rhode Island chapter of the ACR, existing MRI facilities and physicians in the Ocean State will have six months in which to apply for accreditation, and 18 months to complete the process. For new facilities, he said the 18-month grace period begins when they open their doors for business.
"If you don't have a license...third-party payors aren’t required to pay you," Tung said. He added that the 18-month period was designed to give the ACR leeway in processing the flood of applications the college is expecting as a result of the legislation and Aetna's new reimbursement policy.
"We looked at this pretty rigorously before we endorsed the process, because we wanted to make sure the ACR was geared up for this," Tung said.
The ACR's MRI accreditation program has been plagued since its inception in 1997 with delays and high failure rates caused by problems ranging from incompatible software to a lack of instructions for calibrating MRI machines to read test images correctly. Although the ACR says these problems have largely been solved, it remains to be seen whether the college is ready to handle the higher volume of applications that will begin to arrive later this month.
Marybeth Farquhar, a consultant who specializes in helping people get through the accreditation process, said the inability of ACR reviewers to read images from different manufacturers’ scanners has caused delays in processing applications.
"People applying for accreditation have a particular type of machine, and they’re sending back the images in a particular medium, such as magnetic tape," Farquhar said. "If the ACR doesn’t have the capability of reading that tape, they’re going to have a problem. That was part of the issue. I think they’ve gotten around some of that by actually going to the site to read the disks."
Farquhar advises facilities seeking accreditation to document their contact with the ACR thoroughly.
"Send everything by certified mail or Federal Express," she said. "Keep the receipts, and make sure you assign one or two people to follow up on a consistent basis. When you call the ACR, keep a log to at least show that you’ve talked to someone, and then you know the ball is in their court, not yours."
Above all, Farquhar said, "Don’t wait until the last minute. Get your stuff in as soon as possible. I think the ACR is going to need every last second."
According to the ACR, stereostatic MRI accreditation must be renewed every three years. The program is designed to evaluate the qualifications of personnel performing MRI exams, as well as equipment performance, the effectiveness of quality control measures, and the quality of the clinical images the facility produces. Information about the program is available online at www.acr.org/f-standards.html, or by e-mailing [email protected].
The new law does not require health insurance to provide reimbursement for MRI services, but merely establishes accreditation as a requirement for reimbursement under individual and group health insurance policies.
Dr. Tung said the law will replace the state's current MRI certification program based on certificates of need, which he said had become "cumbersome and politically charged."
By Eric Barnes
AuntMinnie.com staff writer
January 3, 2000
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