ASNC speaks to policymakers about prior authorization, Medicare cuts and more

He noted that several congressional offices ASNC visited are already co-sponsors of the legislation, signaling momentum for the bill.

ASNC opposes ROOT Act

While supporting prior authorization reform, ASNC is opposing the proposed Radiology Outpatient Ordering Transmission (ROOT) Act, legislation supported by some radiology organizations as a mechanism to automate appropriate use criteria (AUC) documentation and potentially reduce prior authorization burdens.

Bourque said ASNC’s concerns center on increased administrative complexity and the limited flexibility of CMS-approved software systems.

“The concern is that it’s an administrative burden,” he said. “The cardiology AUC may not be represented, and we really feel in the cardiology space that cardiology-developed AUC tools may be a better fit.”

ASNC has long supported AUC and helped develop some of the earliest cardiology AUC frameworks. Bourque said those tools have already improved imaging appropriateness and generated substantial cost savings without adding excessive workflow burdens.

Medicare payment cuts remain a central concern

Another major topic during the Capitol Hill meetings involved Medicare physician reimbursement and concerns over continued payment reductions. ASNC joined other physician organizations in advocating support for the Efficiency Adjustment Delay Act, which would halt a proposed 2.5% efficiency adjustment tied to the 2026 Medicare physician fee schedule.

“There has been a very stagnant increase in physician reimbursement for procedures and care provided,” Bourque said. “At some point there needs to be comprehensive reform and a more logical solution overall.”

He also highlighted support for the Provider Reimbursement Stability Act, which would modernize Medicare’s longstanding budget neutrality threshold. The current $20 million trigger was established in the late 1980s and has not kept pace with inflation or healthcare costs.

According to Bourque, ongoing reimbursement pressure threatens provider sustainability and ultimately limits patient access to care, particularly in underserved regions.

“If providers find that services are not financially viable, then they don’t provide those services,” he said. “We see areas of the country where there can be deserts of care.”

The issue has become increasingly urgent for physician groups, which argue Medicare physician reimbursement has effectively declined by more than 30% over the past two decades when adjusted for inflation, even as hospital reimbursement has continued to rise.

Concerns over healthcare price transparency legislation

ASNC also voiced opposition to the Patients Deserve Price Tags Act, though the group does support the broader principle of healthcare price transparency. Bourque said the proposed legislation would place a significant compliance burden on imaging centers by requiring them to maintain and provide highly detailed pricing information across hundreds of insurance plans and benefit structures.

“We are all for better price transparency, but this act would require imaging centers to provide information for all the different health plans and payment structures, and there’s an enormous administrative burden to that,” he said.

Instead, ASNC believes insurers and health plans should bear most of the responsibility for providing accurate patient cost estimates.

Workforce shortages raises concerns of H1B visas

Healthcare workforce shortages also emerged as a major advocacy issue, particularly in cardiology imaging and rural healthcare systems.

Bourque said ASNC supports the H1B Visa for Physicians and Healthcare Workforce Act, which would exempt healthcare workers from a new $100,000 visa petition fee that many organizations say is making recruitment financially infeasible.

ASNC’s concerns extend beyond physicians to include nuclear technologists, sonographers, nurses, physician assistants and nurse practitioners.

“We are very concerned about physician and healthcare worker shortages. A lot of very well-trained providers who want to stay and contribute to the U.S. healthcare system unfortunately are not able to because of this financial requirement,” Bourque said.

The impact has already been felt within the University of Virginia health system, where he said recruitment efforts for satellite hospitals fell through because of the new visa costs.