In the ever-evolving world of healthcare legislation, navigating the complexities of policy changes requires a strategic approach. Chris Nugent, MBA, CRA, RT(R)(CT) walked us through his team’s recent success with the limited X-ray law in Maryland on July 11, in the Advocacy In Action webinar (still available to view on-demand for free). He offers a practical application of effective legislative strategies. The process can be broken down into nine steps:

1. Rally the Troops

The first step in the playbook is assembling a dedicated coalition. Recognizing the need for limited X-ray capabilities in Maryland, the team reached out to UCA. UCA connected them with key leaders from various organizations, including hospital systems, Urgent Care entities, and professional associations. This diverse coalition, which included CMOs, CEOs, radiologists, and government affairs representatives, played a crucial role in advocating for the legislation.

2. Form the Coalition

With the initial coalition in place, it was discovered that Concentra had already introduced a preliminary bill. The team collaborated with Concentra and expanded their coalition to include organizations like the Maryland Hospital Association, University of Maryland Medical System, MedStar Health, LifeBridge, and PM. This broad coalition brought together a wide range of expertise and perspectives, enhancing their advocacy efforts.

3. Strengthen the Legislation

The next step involved refining the bill. Radiology professionals provided input on scope of practice, training, examination requirements, and supervision standards. Regular meetings and collaborative discussions ensured that the bill was well-rounded and addressed the needs of various stakeholders. This collective input strengthened the bill and prepared it for legislative review.

4. Anticipate and Address Opposition

Anticipating opposition is a key component of the playbook. The team expected resistance from rad techs, program directors, and radiologist societies. Their concerns typically revolve around patient safety, job displacement, and educational requirements. By leveraging data and well-founded rebuttals from other states, the team prepared strong counterarguments to address these issues effectively.

5. Engage with Sponsors

Securing dedicated sponsors is crucial for advancing legislation. Concentra and MHA had already obtained sponsors: Delegate Tom Hutchison and Senator Katharine Klausmeier. These sponsors played a vital role in guiding the bill through the legislative process, facilitating amendments, and addressing opposition concerns.

6. Navigate Opposition Challenges

Unexpected opposition from RadNet, a for-profit radiology company, presented additional challenges. Through several meetings, the team identified RadNet’s concerns and made amendments to the bill, including increased educational and training requirements. Despite accommodating many of their demands, the team maintained a balanced approach to ensure the bill’s feasibility.

7. Conduct Legislative Hearings

Legislative hearings are a critical stage in the process. During the Senate Finance Committee hearings, radiology leaders and executives testified in support of the bill. The opposition, including RadNet and rad tech representatives, voiced their concerns. However, through continued discussions and amendments, the team was able to address these issues and secure a favorable outcome.

8. Achieve Legislative Approval

The bill passed unanimously in both the Senate and House committees. The coalition’s strategic approach, flexibility in negotiations, and strong support from influential organizations like the American Registry of Radiologic Technologists (ARRT) were instrumental in this success. Legislative approval marked a significant milestone for limited X-ray capabilities in Maryland.

9. Understand the Timeframe

Legislative success can vary based on several factors, including the political environment and state-specific complexities. In Maryland, the goal was achieved in a matter of months, while in New York, the process has taken over a year. Understanding these variables helps set realistic expectations and tailor advocacy efforts accordingly.

The Maryland Limited Scope X-ray law case study exemplifies the effectiveness of a structured legislative playbook. By rallying a diverse coalition, strengthening the legislation, anticipating opposition, engaging with dedicated sponsors, and navigating the legislative process with flexibility, the team achieved a significant policy win. This approach not only underscores the importance of strategic planning but also highlights the value of persistence and collaboration in achieving legislative goals.