ACR lists key Congressional advocacy efforts in 2026
The American College of Radiology is intensifying its Congressional advocacy in 2026, focusing on legislation aimed at expanding access to cancer screening, reducing administrative burden, and modernizing imaging utilization through technology and artificial intelligence.
ACR Chief Executive Officer Dana Smetherman, MD, said recent progress on lung screening legislation is a major priority for the organization. “There is a new bill for access to lung cancer screening for Medicaid patients. That's a piece of legislation that we are very excited about,” Smetherman said.
Breast cancer screening also remains another key focus. The Find It Early Act, which would expand coverage for supplemental screening for women at high risk, has been reintroduced in Congress after failing to advance in prior sessions.
“And then also on the screening front with breast cancer screening, the Find It Early Act, which has been introduced in the past, but has not been successful, has now been reintroduced I think back in October. We are definitely excited about that and advocating for that as well,” she said. “So, get out there and advocate for women to be able to have the supplemental screening if they're high risk and have that paid without any out of pocket expense.”
Beyond screening, ACR also is advocating for passage of the Radiology Outpatient Ordering Transmission (ROOT) Act, which would modify implementation of the Protecting Access to Medicare Act (PAMA) of 2014. Smetherman noted that the legislation is gaining momentum. “Initially we had sponsors in the House of Representatives. Now we have some sponsors in the Senate,” she said.
According to Smetherman, the ROOT Act would streamline clinical decision support requirements under PAMA, reduce burden on ordering clinicians, and enable greater use of emerging technologies. “And so that is allowing a path for much smoother implementation of the PAMA legislation from 2014, decreasing the burden on the ordering physicians and nonphysician providers, trying to incorporate new technology like AI to guide an ordering physician into the right imaging study,” she said.
She emphasized that unnecessary imaging creates significant downstream consequences for patients and the healthcare system.
“The burden of doing those additional imaging studies is really significant. It is a burden for patients who may have to take time off of work to get an imaging study they don't need or pay out of pocket for one they don't need that doesn't add value to their care. It burdens just sort of the whole healthcare system. It makes access an even bigger issue,” Smetherman said.
Workforce shortages in radiology are another factor driving ACR’s advocacy. “As we look at the workforce shortage of radiologists and radiologic technologists, I often say that we don't have enough people to take care of the imaging studies that patients need, much less imaging studies that really are unnecessary and don't add value to their care,” she said.
With imaging volumes continuing to rise faster than the radiology workforce can keep up, ACR sees policy reform as essential to preserving access. “The volumes have continued to go up, but the number of radiologists to do the work have only gone up a little bit. Finding a way to do everything that we can to make sure that we are creating as much capacity as possible is really important for the ACR,” Smetherman said.
She also pointed to prior authorization as a universal pain point that could be eased through legislative and technological changes. This includes auditing cases retrospectively and the use of AI to guide clinicians weighing whether imaging is appropriate.
“Prior authorization is a pain point universally for ordering doctors, for radiologists, for insurance companies, for patients,” she said.
Looking ahead, Smetherman described a vision in which AI tools seamlessly support clinical decision-making at the point of care. “Wouldn't it be wonderful if we could basically just have the physician seeing the patient in the clinic and they have an ambient listening tool that basically acts as their scribe? They can be paying attention to the patient better. And the AI tees up for them what would be the appropriate imaging,” she said.
She added that the ROOT Act also would provide practices with better oversight of imaging utilization.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]