Widely publicized errors from CT scanners and radiation therapy have pushed the U.S. Senate to call for uniform training standards for radiologic technologists and other technicians who handle high-tech medical equipment.

On Thursday, Sen. Mike Enzi (R-Wyo.) and Tom Harkin (D-Iowa) introduced a bill that would require mandatory minimum education and certification standards for radiologic technologists. These standards would have to be met by staff for health centers to qualify for Medicare payments.

DOTmed News has also learned of reports of a broader medical imaging bill in development this summer that would incorporate the Senate legislation.

The bill currently at hand, the Consistency, Accuracy, Responsibility and Excellence in Medical Imaging and Radiation Therapy bill (S. 3737), is nearly identical to a similar "CARE" bill introduced into the House in September, according to the American Society of Radiologic Technologists, which endorses both bills.

"In light of all the reporting that's been done on radiation therapy mis-administration and CT radiation overdoses during brain perfusion scans, ASRT feels the best way to address some of these programs identified by Congress is to enact CARE," ASRT's vice president of government relations and public policy Christine Lung told DOTmed News.

Over the past several months, the New York Times has run profiles documenting radiation therapy, and CT scanning, mishaps.

The bill would govern nearly everyone involved in planning, performing and checking up on advanced imaging scans and radiation treatments. This includes medical physicists, medical dosimetrists, cardiac cath technologists, MR technologists, radiologic techs, radiation therapy assistants, limited scope operators and others.

However, unlike the House bill, it would exempt those doing certain ophthalmologic and vascular access procedures. These two procedures have "limited" medical scope, according to the ASRT.

The aim of the bill is to bring uniformity to patchwork legislation, with each state deciding its own credentialing requirements for RTs.

"States license different aspects and different professions, and there's no consistency across the country to judge an individual's qualifications," Lung said.

For instance, California requires radiographers, nuclear med techs, radiation therapists and limited scope operators to be licensed by the state. But in neighboring Nevada, the only profession required to get a license is a mammographer, Lung said.

The bill's sponsors think tougher, more uniform credentialing will result in safer, cheaper health care, as better trained technologists will capture clearer images and not have to repeat exams.

"Obviously, if you get an image right the first time, it's less stress on the patient, there's less opportunity for error," Sen. Enzi's spokesman Craig Orfield told DOTmed News. "[Enzi] views it as good medicine on both sides - both for patient care and cost containment in health care."

A University of Michigan study from the early 1990s found that after the state passed a certification and education requirement, the technical quality of mammography increased around 30 percent, Lung said.

"With the economics of health care uncertain right now, we know that there are physicians' offices and clinics who are trying to treat patients as economically as possible," observed Lung, "and who may be using non-qualified personnel to [perform] their imaging exams, not understanding that an educated and certified technologist in the long run may command a little bit higher salary but will ultimately save the practice money in the number of examinations that have to be repeated and providing a more curative atmosphere for the patient."

The bill authorizes the Department of Health and Human Services to set standards that have to be met if facilities want to continue receiving Medicare payments, Lung said. ASRT and the Alliance for Quality Medical Imaging and Radiation Therapy, a coalition of 25 health care organizations, have drafted consensus standards they hope to show HHS after the bill is passed, Lung said.

As with the House's version of the bill, those states that already have tough standards would be exempt from the new rules, Orfield said.

It's likely the bill would require technologists from different disciplines to be certified by different boards, such as the American Registry of Radiologic Technologists. The bill would take effect by Jan. 1 2013, Lung said.

And although the bill technically only affects staff working with Medicare patients, ASRT believes the Medicare "trickle down" effect should result in the training standards required by the bill to be widely adopted.

"Knowing that Medicare sets the prevailing standards of health care through payment policy, it will trickle down to non-Medicare-paid procedures," Lung said. "It's just not cost-effective for a hospital to have qualified staff in place to image only Medicare patients and have non-qualified staff to image anybody else."

Sen. Enzi's office said that, at least in spirit, it would apply beyond Medicare-involved centers.

"If you want to look at it strictly from the standpoint of 'I don't have to worry about compliance, because I don't bill any Medicare, and therefore can't be penalized,' that's true," Orfield wrote in an e-mail. "But that really misses the point of the CARE Act."

The similar House CARE bill, still in committee, currently has 117 co-sponsors, Lung said.

Another Bill in the Works?

Over its August recess, Congress may be working on a broader medical imaging bill to "address some of the concerns that were raised in the New York Times articles," Lung said. If that comes to pass, ASRT hopes the CARE bill would be folded within that larger legislation.

The Senate is currently on recess until Sept. 13. Once it returns, Sen. Enzi's office predicts the Senate's CARE bill might go through the upper chambers "pretty easily and pretty quickly."

"We'd hope it could be acted on before the October adjournment, but it is the Senate," Orfield said. "You never know."