2025 October Ebrief of the FRS & FRBMA

Edition: October 2025

Table of Contents

Letter from the Editor | FRS President's Message | FRBMA President's Message
A message from the FRS Physics Committee | RFS Committee Message
Legislative Update | Announcing our New FRS Career Center
Become a PAC Member

FRS Membership
Dues

Please contact the American College of Radiology Membership Services at (800) 347-7748 to pay your 2026 Florida Radiological Society membership dues.

Meet Your 2025 - 2026 FRS Executive Committee


President Andrew Bowman, MD, PhD	President Elect Edem Chen, MD	Treasurer James Banks, MD


Secretary Santo Maimone, MD, FSBI	Past President Juan Batlle, MD, FACR	Radiation Oncology, Chair Jennifer Peterson, MD

Letter from the Editor
		Dear Colleagues, Breast Cancer Awareness Month has arrived again. To our Florida radiologists interpreting breast imaging exams and all our providers in breast health, thank you for your diligence, skill, and compassion to helping your patients. This month allows a unique opportunity to engage with your patients and motivate your teams to do all you can to detect breast cancer and limit its morbidity. We share a special purpose with our families, friends, and colleagues who have been impacted by breast cancer, and October is a time to get the message out to a greater audience to save more lives.
Early detection through imaging remains the cornerstone of improved breast cancer outcomes. With localized breast cancers having a 5-year survival rate of 99%, the value of annual mammography (starting at age 40, or earlier for those at elevated risk) is indisputable. Radiologists are uniquely positioned to identify subtle findings, guide biopsy decisions, and recommend adjunctive imaging when appropriate. Our expertise directly influences staging, treatment planning, and prognosis, making our vigilance and accuracy essential to patient care. If you are engaging in outreach, facing questions at work, or just seeking more information, the Society of Breast Imaging offers many resources that can assist you. Facts and guidelines about screening, hot topics, and position statements can be quickly referenced on the SBI website . This October, please continue to raise awareness for breast cancer and the importance of expanding the impact of breast imaging.
Santo Maimone, MD, FSBI Secretary, FRS

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FRS President's Message
		Hello Everyone! One item of interest for members is the call for nominations for the American College of Radiology. If anyone is interested in a national position, you may apply through the ACR main webpage by November 7.
College Nominating Committee Call for Nominations If you have any questions about requirements or eligibility, please do not hesitate to reach out to any of the members of the FRS executive board. As my local department’s quality chair, I was happy to attend the ACR Quality & Safety + Informatics annual conference held in San Diego this past month. This conference featured several relevant topics to our practice today, with session topics including: Findings that matter Improvement science at scale (from radiologists who are their institution’s chief quality officers) Patient-centered radiology Safety in a workforce shortage Planning for system failures Numerous AI topics in quality and informatics Overall, the conference was well organized with excellent speakers. For those of you with similar interests, I would highly recommend it for next year. Once again, I also wish to remind everyone of our ongoing fundraising campaign for the FRS Foundation. If we reach our goal of $50,000 in donations by Dec 17, Drs. Kurt Mori and Emile Latour will each match these gifts. Thank you to everyone who has donated thus far. You may donate by clicking the link below. Thank you to Drs. Mori and Latour and to everyone who has donated thus far. https://www.flrad.org/frs-foundation/ Thank you for all you do for our patients and our profession.
Andrew Bowman, MD, PhD President, Florida Radiological Society

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FRBMA President's Message

The Government Shutdown and Its Impact on Radiology Practices

For the first time since 2019, congressional gridlock has shut down big parts of the federal government, including many health programs. While many policy conversations happen in Washington, D.C., the ripple effects reach directly into our imaging suites, reading rooms, and patient access points. Three key issues stand out, with the third issue being one of the main cruxes causing issues between the two political parties.

1. Possible (Although Unlikely) Delays in Medicare Payments

The Medicare and Medicaid programs are deemed “mandatory” spending programs instead of “discretionary,” so they are still funded during a federal shutdown. The Department of Health and Human Services is full of discretionary spending programs that will be shut down, including the cancer imaging funding through the National Institute of Health, screening programs administered by the Centers for Disease Control, and graduate medical education programs (e.g., ACGME radiology residency programs) administered through the Health Resources and Services Administration.

Effective October 1, 2025, CMS has instructed all Medicare MACs to put a 10-day hold on all claims processing. Assuming a new budget is approved by October 10th, this hold will be virtually inconsequential to physicians, groups, and hospitals due to the normal 14-day hold that is in force all the time (First Coast Service Options, 2025). But, if Congress does not approve a federal budget by October 10th, CMS will need to issue additional instructions to Medicare MACs that may include further delays in payments.

In January 2019, the federal government experienced a 35-day shutdown. During that time, physicians did not realize any delays in payments because claims processing was considered an essential function of the Medicare program. Administrative and support functions slowed down, such as appeal decision delays, enrollment actions, and customer support.

The Independent Dispute Resolution (IDR) program hosted by CMS and created under the No Surprises Act (NSA), may experience delays in payments. Since this is the first federal shutdown since the NSA was passed in 2022, it is unknown exactly how the shutdown will affect the IDR program. It seems likely that due to the furloughing of about 50% of CMS employees, the IDR determinations, appeals, auditing, and compliance monitoring will be slowed. Thus, already submitted disputes may proceed, but likely will be delayed. New disputes submitted on the portal will likely take longer to be accepted or reviewed. For high-volume out-of-network submissions, the delay in resolution could cause cash flow delays.

If the federal government continues to be shut down past October 10th, it is possible that CMS could delay physician and hospital payments; however, if CMS treats 2025 similarly to 2019, it seems unlikely that we will see any payment delays outside of payments for approved appeals, physician enrollments, or resolved IDR disputes.

2. Telehealth Reimbursements for Medicare Patients

Effective immediately, Medicare (and many Medicare replacement plans) will no longer provide payments for telehealth coverage. The telehealth provisions from the CARES Act during the COVID-19 Public Health Emergency were extended several times and recently expired on September 30th.

Suppose your clinic already has scheduled patients in October for telehealth consultations. Now your clinic must decide whether it wants to continue with the telehealth visits (and likely not be paid), or does it want to try to convince the patients to come into the clinic to be seen in person. Practices that built workflows, infrastructure, and staffing around the more flexible telehealth model will likely face operational disruption and/or financial loss for virtual visits conducted after expiration. When your group saw 10 to 15 pre-procedure consultations per day via telehealth but will now only be able to see 5 to 8 patients per day in person, your IR and neurointerventional procedure schedules will be delayed.

Medicare Advantage plans are not required to follow the same rules as Medicare; however, in my experience, many of the plans do follow Medicare rules, particularly if the rule allows the plan to save money on payments to physicians and hospitals. We previously saw that with many Advantage plans, such as with MIPS bonus payments versus the 2% sequestration cuts. Many of the plans would not mirror the MIPS bonus payments that Medicare paid us, but they would mirror the sequestration cuts that Medicare deducted from our payments.

3. Rising Uninsured Populations in 2026 Without Subsidy Fixes

For many years running, Florida has had the highest number of enrollees in the Marketplace compared to any other state. For 2025, more than 4.7 million Florida residents bought insurance through the Marketplace out of a total of more than 24.3 million in the entire United States (CMS, 2025a). Of the 4.7 million Florida residents buying insurance on the Marketplace, 98% of them are receiving full or partial premium subsidies from the federal government. (CMS, 2025a)

These subsidies lower the cost of their monthly premiums. Previous legislation temporarily expanded the original Affordable Care Act premium subsidies (American Rescue Plan and Inﬂation Reduction Act). Households with incomes between 100% and 150% of the Federal Poverty Level (FPL) were awarded subsidies that allowed their monthly premiums to cost $0 or nearly $0. For a single person to be eligible for the premium subsidy, the person would need to earn between ~$15k and ~$22.6k per year. For a single parent with two children to be eligible for the premium subsidy, the parent would need to earn between ~$26.6k and ~$40k per year. Keep in mind, these are gross incomes before any expenses like rent, utilities, transportation, food, etc.

The open enrollment period for the Marketplace opens on November 1st. Unless Congress acts quickly, residents searching for insurance on the Marketplace in November will be given quotes for insurance with premiums that have no subsidies. Enrollees will be expected to pay 100% of the premium. According to the 2025 OEP State-level public use file from the Centers for Medicare & Medicaid Services, the average premium before subsidies for a Florida enrollee was $641 per month (~$7700 per year). Nobody who is earning between 100% and 150% of the FPL will be able to afford $7700 per year for health insurance premiums, in addition to the patient cost sharing for coinsurance and copays.

Undoubtedly, that will sharply increase the number of uninsured patients presenting for imaging studies, raising uncompensated care burdens on hospitals and radiology groups alike. For outpatient imaging centers already operating under thin margins, this represents a real financial risk.

Below are the eighteen insurance plans offered in Florida on the Marketplace. Most of these 2025 insured patients will likely become uninsured come January 2026 if Congress does not enact an extension of the premium tax subsidies. The debate between the two political parties on whether Congress should extend these premium tax subsidies is one of the main sticking points that has held up the passing of the 2026 federal budget (Shamim, 2025).

Note. From "Individual PPACA Market Monthly Premiums for Plan Year 2026" by Florida Office of Insurance Regulation, 2025, Life and Health Product Review. https://floir.com/docs-sf/life-health-libraries/federal-health-insurance/2026-plan-year/aca-2026-web-tables-individual.pdf

While many headlines around Washington politics may feel far removed from our day-to-day work, this year’s shutdown brings issues that strike at the heart of radiology operations: cash flow stability, the viability of telehealth consultants, and the risk of growing numbers of uninsured patients. As physician leaders, we must stay informed, prepare our practices for potential disruptions, and continue to advocate for policies that protect patient access and the financial health of our imaging services.

References:

Centers for Medicare & Medicaid Services. (2025a). 2025 OEP State-level public use file (ZIP) [Data set]. U.S. Department of Health & Human Services. https://www.cms.gov/data-research/statistics-trends-reports/marketplace-products/2025-marketplace-open-enrollment-period-public-use-files

Centers for Medicare & Medicaid Services. (2025b). Health Insurance Exchanges 2025 Open Enrollment Report. U.S. Department of Health & Human Services. https://www.cms.gov/files/document/health-insurance-exchanges-2025-open-enrollment-report.pdf

First Coast Service Options, Inc. (2025, October 1). Update on Medicare operations: Telehealth, claims processing, and Medicare Administrative Contractors status during the shutdown. FCSO Medicare. https://medicare.fcso.com/learning-center/update-medicare-operations-telehealth-claims-processing-and-medicare-administrative

Florida Office of Insurance Regulation. (2025, August 14). ACA 2026 web tables: Individual market [PDF]. https://floir.com/docs-sf/life-health-libraries/federal-health-insurance/2026-plan-year/aca-2026-web-tables-individual.pdf

Shamim, S. (2025, September 30). Why is the US government shutting down? What will it mean? Al Jazeera. https://www.aljazeera.com/news/2025/9/30/why-is-the-us-government-on-the-brink-of-a-shutdown-what-will-it-mean

Janene W. Markuske, MBA, FRBMA
President, FRBMA

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A message from the FRS Physics Committee:

An article was recently published in the Annals of Internal Medicine that suggested “Exposure to preconception CT imaging may be associated with higher risks for spontaneous pregnancy loss and congenital anomalies…”.

Radiologists may be asked about this study by patients or referring providers. Being familiar with AAPM’s position helps ensure accurate, evidence-based communication and reinforces confidence in the safety and appropriateness of CT when clinically justified.

The AAPM issued a response to this article listing multiple shortcomings of the research, including:

Elevated risks were observed even after head CT, where ovarian dose is essentially zero—making radiation an unlikely explanation.
Women who underwent CT had significantly higher rates of comorbidities such as obesity, diabetes, thyroid disorders, and smoking, all of which are established risk factors for adverse pregnancy outcomes.
The study lacked individual dosimetry, excluded other imaging exposures, and did not account for major reductions in CT dose over the 30-year enrollment period.
The AAPM concluded that the findings are better explained by comorbidities, not radiation, and emphasized that decades of research, including NCRP Report 174, show no convincing evidence of heritable mutations in humans from ionizing radiation.

Source: Exposure to Computed Tomography Before Pregnancy and Risk for Pregnancy Loss and Congenital Anomalies: A Population-Based Cohort Study. Simard et al. Annals of Internal Medicine. September 9, 2025. https://doi.org/10.7326/ANNALS-24-03479

James Kofler, PhD
Chair, FRS Physics Committee

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RFS Committee Message

Welcome to the first RFS Committee message in the FRS Quarterly Ebrief!

We’ll use this space to keep Florida residents and fellows updated on key opportunities, resources, and news at both the state and national level. Think of it as your friendly neighborhood bulletin board—minus the thumbtacks and ads for guitar lessons.

AAR Annual Meeting – Atlanta
This year’s meeting comes with a couple of great scholarship opportunities (and who doesn’t love an all expense covered trip to Atlanta?):

AAR-ACR Research Scholar Program: For residents and fellows interested in scientific, health services, and health policy research. Includes a health policy curriculum, scholar presentations, and mentorship. Applicants must submit an abstract as first author. Each department receives a $1,000 travel stipend.
https://aarad.memberclicks.net/research-scholar-program
Clinical Educator Track (CET): Launching in 2026 for PGY-2 residents. A two-year program with mentorship, annual meeting programming, and an education project. Ten awards will be given, with a $1,000 stipend per department.
https://aarad.memberclicks.net/clinical-education-track

Deadline: Applications for both programs are due October 17, 2025.

ACR RFS Nominations
The ACR RFS is seeking nominations for its Executive Committee and subcommittees. Executive Committee candidates must attend the ACR Annual Meeting in Washington, DC. The FRS will sponsor one resident per Florida program to attend.

Until next time,

Niki Nour DO, MPH
RFS Executive Committee Vice President

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Legislative Update
	Session starts in January this year and ends in March. The first round of committee weeks start the week of October 5th. Legislation is starting to be filed but there is not much to report yet except for a couple of bills and one that I know none of us like and it is important to all.
The med mal bill, that was vetoed four months ago, has been refiled. The Speaker has announced the House will revisit the issue. As you recall this would repeal a 35-year-old legal provision preventing some families from suing for the wrongful death of a loved one and collecting pain and suffering. The bill as filed has no caps on damages. The immunization issue has been a hot topic to date. I anticipate mammo related legislation being filed like what was filed last year. Details have yet to be finalized. The House and Senate have chosen their next Speaker and Senate President for the 2026 Session. Rep Sam Garrison will be our next Speaker and Senator Jim Boyd will be our next Senate President. They will be having their designation ceremonies in October. There are solid Republican majorities in both chambers. This upcoming election cycles the Governor and cabinet members are up for re-election. Governor DeSantis is termed out, and Congressman Byron Donald's is the front runner in the race. The CFO is Blaise Ingoglia who was appointed to fill the position when Jimmy Patronis resigned to run for Matt Gaetz’s Congressional seat. CFO Ingoglia has announced his intention to run for the seat. When the President appointed Senator Marco Rubio to be Secretary of State that opened the US Senate seat for the Governor to make an appointment. The Governor appointed Attorney General Ashley Moody to the US Senate. He then appointed James Uthmeier, his Chief of Staff, to be Attorney General. AG Uthmeier intends to run for the seat. As I write this, the special election for former Senator Blaise Ingoglia’s seat is being held. I predict Dr. Ralph Massulo will win the Primary to go onto the General election. Updates on the race in the next Ebrief.
Best, Alison Dudley Lobbyist, FRS AlisonDudley@dudleyandassociates.com

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The FRS Educational Foundation just launched a fundraising campaign to match the generous donations of Dr. Kurt Mori and Dr. Emile Latour.

HELP US
SHAPE THE
FUTURE

FRS EDUCATIONAL FOUNDATION
Shaping the future for Diagnostic Radiologists,
Interventional Radiologists, Radiation
Oncologists, and Medical Physicists

FRS Educational Foundation
Triple your Impact
Fundraising Campaign

An extraordinary opportunity
for the future of our foundation

Dr. Kurt Mori and Dr. Emile Latour have
EACH pledged $50,000 in matching
donations to the FRS Foundation.

That means that every $1 you contribute
becomes $3 for the FRS Foundation!

How to Contribute: https://www.flrad.org/frs-education-foundation/
QCD checks from IRAs can be sent directly to (include FRS Educational Foundation, Inc. in memo): FRS Educational Foundation, Inc. 5620 West Sligh Ave. Tampa, FL 33634
For pre-retirement donations, you may also donate by check with no transaction fees.

Contribute today for this
special limited time fundraising opportunity!

A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLIN TOLL-FREE (800-435-7352) WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE. #CH35637


Announcing our New FRS Career Center
The Florida Radiological Society is proud to announce its new and improved FRS Career Center - the premier resource to connect career opportunities with highly qualified radiology talent. The Career Center is designed to provide you with a better overall experience through a modern design and an intuitive interface. You will be able to access the Career Center through any device of your choice- smartphone, tablet, or desktop. To access FRS Career Center, visit: Careers.flrad.org The FRS Career Center will allow you to: Manage Your Career: Search and apply to the best radiology jobs at organizations that value your credentials! Upload your anonymous resume so employers can contact you, but you maintain control of your information and choose to whom you release your information. Receive an alert every time a job becomes available that matches your personal profile, skills, interests, and preferred location(s). Access career resources and job searching tips and tools. Recruit for Open Positions: Post your jobs, or your organization’s jobs, where the most qualified radiology professionals will find and apply to them. Promote your jobs directly to Florida Radiological Society job seekers via our exclusive Job Flash email. Search the resume database and contact qualified candidates proactively. Expose your job postings to a larger audience through our NEW diversity, veterans and social networks. Take a look & log on today at Careers.flrad.org We hope this new career center will make a significant difference for our members as they navigate their career paths. Thank you for your ongoing support.
Sincerely, Executive Director Florida Radiological Society

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Become A PAC Member Today
Attention FRBMA Members! Please support the cause. We encourage you to be PAC members and supporters; you do not have to belong to the FRS. Donations can be made online through our PAC website www.FLRADPAC.org. Thank you for your donation. It is critical that we support both our Florida PAC and RADPAC in order to bolster our voice in Tallahassee and Washington, respectively. Please join FRS lobbyist Alison Dudley in her special appeal for all Florida radiologists to become Florida PAC members. If you would like to help FRS defend radiology against untoward legislation and introduce bills that have a positive impact on our practices, we need your financial support to re-elect our friends in the state House and Senate. The FRS can also show you simplified ways on how to sign up your radiology group. Contact Lorraine Roger at lroger@flrad.org or Alison Dudley at alisondudley@dudleyandassociates.com for more information.

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The E-Brief is an exclusive member benefit of Florida Radiological Society, delivering monthly member, chapter and industry news. Please do not reply to this automatic e-mail. For comments or questions about the E-Brief, please contact lroger@flrad.org.