The Consistency, Accuracy, Responsibility and Excellence in Medical Imaging and Radiation Therapy bill (CARE bill) has been introduced into the U.S. House of Representatives. This bill, H.R. 583, introduced by Rep. Mike Doyle, D-Pa., was previously known as the Consumer Assurance of Radiologic Excellence bill. The lead Republican cosponsor on the bill is Rep. Chip Pickering, from Mississippi, who has been a long-time supporter of the legislation and helped advance the bill in the 109th Congress to its furthest point to date. Other cosponsors of the bill are Reps. Marsha Blackburn, R-Tenn.; Lois Capps, D-Calif.; John J. Duncan, Jr., R-Tenn.; Mike Rogers, R-Mich.; and Heather Wilson, R-N.M.

The CARE bill would require people performing the technical components of medical imaging and radiation therapy to meet federal education and credentialing standards in order to participate in federal health programs such as Medicare, Medicaid, and other programs administered by the Department of Health and Human Services. Medical imaging examinations and procedures, as well as radiation therapy treatments for patients covered under these programs, would need to be performed by personnel meeting the federal standards in order to be eligible for reimbursement.

The CARE bill would help reduce the risk of medical errors associated with misdiagnosis or the misadministration of radiation. More specifically, this legislation would:

● Ensure that quality information is presented for diagnosis and that quality radiation therapy treatments are delivered, leading to accurate diagnosis, treatment, and care. Poor quality images can lead to misdiagnosis, additional testing, delays in treatment, and needless anxiety for the patient.

● Reduce health care costs by lowering the number of medical imaging examinations that must be repeated due to improper positioning or poor technique. Repeated imaging examinations cost the United States health care system millions of dollars annually in needless medical bills.

● Improve the safety of medical imaging and radiation therapy procedures. Administered properly, radiation is an invaluable tool in the diagnosis, treatment, and management of disease. But most radiologic procedures also carry a potential health risk, and radiation can be harmful if not administered properly.

This legislation is backed by the Alliance for Quality Medical Imaging and Radiation Therapy, a coalition of organizations that represents more than 300,000 health care professionals. The Alliance is led by the American Society of Radiologic Technologists (ASRT), and the American Association of Medical Assistants (AAMA) is a charter member. The CARE bill also has support from a number of patient groups and other health care organizations, including the American Cancer Society, the American Heart Association’s Council on Cardiovascular Radiology, the Cancer Research Foundation of America, and the American College of Radiology.

The CARE bill is important to medical assisting because the laws of some states permit physicians to delegate radiography of select anatomical sites (e.g., chest and thorax, cranium, extremities) to medical assistants. It is the position of the AAMA that only those medical assistants with adequate education and testing should be permitted to expose patients to ionizing radiation.

“A primary government affairs objective of the AAMA,” according to President Rebecca Walker, CMA, CPC, “is to protect the health and safety of patients. The CARE bill and its regulations would further this objective by mandating education and credentialing for limited scope radiographers, many of whom are medical assistants.”

Twice in 2007, I joined representatives from other Alliance members to meet with the staff of United States Senators and Representatives in Washington, D.C. to advocate for the passage of the CARE bill. “We’re very pleased that the bill was introduced so early in the session,” said Christine Lung, ASRT director of government relations. “The CARE bill came very close to passing last year, and this is the earliest it has ever been introduced into a session. We want to keep the momentum going. This is the fifth time the bill has been introduced into Congress and each time, we get closer.”

The CARE bill was unanimously passed by the Senate in December 2006. Last-minute efforts to get the bill through Congress, however, were not successful. “It was all about time. We simply ran out of it,” said Ms. Lung. “However, with the passing of the bill by the Senate and a new Democratic leadership following the November 2006 elections, we feel we are in a very strong position to get the bill passed this year.”

The CARE bill would amend the Consumer-Patient Radiation Health and Safety Act of 1981, which gave the states recommendations for licensing radiologic personnel. (I helped write this legislation while director of the legal department of the American Dental Assistants Association.) Because compliance with the 1981 Act is voluntary, only 36 states have enacted licensure laws or have regulated radiologic technologists, and many of those laws or regulations do not match the standards recommended by the federal government. As a result, thousands of individuals with limited education and no certification are performing imaging and radiation therapy procedures on patients every day.

Current information about the progress of the CARE bill, and information about contacting federal legislators, will be available periodically on the AAMA website ( and the American Society of Radiologic Technologists website (

Questions? Contact Donald A. Balasa, JD, MBA, at or 800/228-2262.