Policies and regulations shaping radiology in 2025

Providers are winning most disputes. However, he emphasized ongoing issues with compliance, particularly insurers failing to meet payment deadlines after losing disputes.

House Resolution 9572, a bipartisan bill introduced by Rep. Greg Murphy, MD, R-N.C., aims to financially penalize insurance companies that fail to pay physicians within the mandated 30 days of an IDR determination.

Medicare reimbursements continue to decline

Radiology practices continue to grapple with cuts to the Medicare Physician Fee Schedule, with reductions of 3%–4% expected in 2025 when figuring in inflation. This is compounded by rising costs for staffing and practice operations, creating access-to-care concerns for Medicare beneficiaries.

"The elephant in the room is the continuing decline in the Medicare Physician Fee Schedule. I do think in 2025 they're going to take a meaningful look...and figure out how to at least accommodate it for the Medicare Economic Index factor."

Expanding insurance coverage for early and advanced breast imaging

Policies like the Find It Early Act, H.R. 3086, propose expanding insurance coverage for early detection screenings and requiring insurance carriers to cover supplemental breast imaging. By treating these as preventative rather than diagnostic services, the legislation aims to eliminate cost barriers and improve access to life-saving procedures, he said.

Telehealth and remote imaging regulations

With the rise of telehealth and remote imaging, evolving rules on licensure, data privacy and reimbursement are key areas of focus. Radiology practices must stay abreast of these changes to ensure compliance and maintain quality patient care, Isenberg said.

He added there also are numerous new state-level regulations targeting healthcare debt and private equity ownership.

Predictions of how the Trump administration will impact healthcare reform

Isenberg acknowledged the unpredictability of healthcare policies under a new Trump administration in 2025. However, he expressed cautious optimism about potential reforms targeting regulatory burdens, such as the Merit-based Incentive Payment System. “It would be great to see meaningful adjustments that reduce unnecessary burdens on physicians,” he said.

While many have concerns about the Trump administration and its appointees upending the healthcare system, he said this also might be an opportunity to make meaningful reform in Medicare that have not occurred, despite years of advocacy efforts by hundreds of healthcare lobbying groups. 

"If anyone told you that they knew what was going to happen, then they'd be lying because it's a whole new ballgame," Isenberg said. "Even the lobbyists that are in the beltway are out of the loop on a lot of the stuff that's going on. We continue to find the same problems and do the same thing over and over and over again. So, I do have a little optimism that [the new administration] might just go in there and see what they can fix...So, I'm cautiously optimistic, but aware that no one really knows with certainty what's going to transpire."