Oklahoma’s governor signs a bill modifying out-of-network provisions into law. Arizona’s legislature passes a bill modifying compensation terms for healthcare providers utilizing telehealth services. Texas advances breast cancer screening legislation.
Out-of-Network Billing
Oklahoma Gov. Kevin Stitt signed House Bill (HB) 2323 into law. The law will prohibit carriers from removing a provider from a network solely because the provider informs an enrollee of the full range of physicians and providers available to the enrollee, including out-of-network providers.
Telehealth
In Arizona, HB 2454 passed both legislative chambers and awaits action by Gov. Doug Ducey. The bill would mandate corporations reimburse healthcare providers at the same level of payment for equivalent services as identified by the healthcare common procedure coding system, whether provided through telehealth using an audio-visual format or in-person care, unless the telehealth platform is sponsored or provided by the corporation. A corporation may not require a healthcare provider to use a telehealth platform that is sponsored or provided by the corporation as a condition of network participation.
Breast Cancer Screening
In New Jersey, Senate Bill (SB) 3661 was introduced in the Senate and referred to the Health, Human Services and Senior Citizens Committee. The bill would mandate carriers cover an ultrasound evaluation, a magnetic resonance imaging (MRI) scan, a 3-D mammogram, or other additional breast testing concurrently ordered with a mammography by a healthcare provider.
In North Carolina, HB 703 was introduced in the House. The bill would mandate carriers that cover screening mammograms to also cover diagnostic examinations, including low-dose mammography, breast MRI or breast ultrasound.
In Texas, SB 1065 passed the full Senate. The bill would mandate carriers that cover screening mammograms also cover diagnostic imaging using a diagnostic mammogram, breast MRI or breast ultrasound. Diagnostic imaging would be used to evaluate:
- A subjective or objective abnormality in a breast detected by a physician or patient.
- An individual with a personal history of breast cancer or dense breast tissue.
Scope of Practice
In Louisiana, HB 495 will be discussed on the House floor. Bill sponsors seek to permit full practice authority for advanced practice registered nurses (APRNs), including a repeal of their collaborative practice agreement requirements. It seeks to allow APRNs to plan and initiate a therapeutic regimen that would include diagnostic services.
The Louisiana Radiological Society is actively opposing this proposed measure.
For more information, please contact Tina Getachew or Eugenia Brandt.
To stay current on state legislative developments relevant to radiology, view our policy map.