Linda Wilgus, MBA, CPA, has spent more hours than she can count over the past 20 years reading physician fee schedules, state and federal laws, and other legal and regulatory documents impacting the business of radiology.  On April 5 in San Diego, Wilgus was recognized for her work as a member and chair of the RBMA Federal Affairs Committee by its president Thomas Dickerson, EdD, when he awarded her with the association’s Global Achievement Award. 

“I am a long-time member of the RBMA,” says Wilgus, the executive director and CFO of Strategic Radiology member practice Northwest Radiology Network. “It has been an invaluable part of my education in radiology, and I am deeply honored to have received the award.” 

Wilgus joined the RBMA as soon as she learned it existed. Having spent a year as controller of an HCA hospital adding real-world health-care accounting experience to her resume, the newly minted CPA had planned to return to the public accounting firm that hired her out of college.  When a friend took the CEO position at Northwest Radiology, Wilgus went along as the CFO and never looked back. That was 20 years ago, and she now serves as Northwest’s executive director with president and CEO W. Kent Hansen, MD, PhD.

When asked about her proudest moments in RBMA advocacy efforts, she replies: “I hope my most gratifying advocacy effort is yet to come.” Wilgus and RBMA executive director Bob Still recently testified in front of CMS—with Ezequiel Silva III, MD, FACR, telephonically representing the ACR—on behalf of all of radiology groups to reverse the day of service policy for the professional component. In 2009, CMS mandated that radiology groups bill Medicare on the date of the interpretation not the date that the patient was scanned, creating additional administrative costs, quality issues, and confusion among patients who are seeing bills for dates they don’t associate with their scans. 

“Most exams are interpreted on the same day, but some are not, and this is causing radiology groups to spend an enormous amount of money to reprogram their billing systems,” Wilgus says. “Both the ACR and the RBMA have been trying since 2009 to get this reversed, and we feel that after this last meeting, we are closer than ever.”

Advocacy successes

Among her advocacy successes she includes participation on two ACR–RBMA workgroups, both headed by Dr. Silva. For one, she and SR Advocacy Committee chair Alan Zuckerman, MD helped to gather data from SR practices that illustrated the negative impact on access to breast cancer screening that a proposed 50% cut to mammography reimbursement would have rendered. They presented the data to CMS and the cuts never came. “We hope that our meeting with CMS influenced that,” she says. 

The other workgroup addressed the practice expense RVU discrepancy for the value associated digital imaging that accurately reflected the transition from analog to digital x-ray four years ago. “MedPAC revalued the technical component RVUs by stripping out the value associated with plain film and replacing it with what they thought was the value associated with digital imaging,” she says, recalling that the costs were vastly undervalued. 

Again, by working with the ACR, the RBMA gathered data that reflected to true cost, including PACS, telecommunications, hardware, and infrastructure associated with digital imaging. “Although we didn’t get 100% of what we proposed the RVU work component should be, we at least increased what they were originally proposing,” she recalls.

Wilgus took the helm of the Federal Affairs committee last year from Liz Quam, whom she calls a mentor.  “She taught me a lot,” Wilgus says. “She has huge experience and tremendous shoes to fill.” She also counts Dr. Silva as a mentor.

On a personal note

Her interest in health policy grew naturally out of a career and life path with many touchpoints in health care. “I’ve seen a lot of different aspects of health care policy and delivery and how they affect different stakeholders,” she notes.

One day, she would like to run for political office. “I have strong beliefs on how we should deliver health in the country, and someday I hope to be in a position where I can have more input,” she shares. “I don’t have all of the answers, but I think there is enough money in the system that we can solve the problem."