State legislators nationwide are busy introducing healthcare-related legislation, with scope of practice being one of the most widely discussed topics.
Scope of Practice
Arkansas
House Bill (HB) 1134 would enjoin Arkansas into the Advanced Practice Registered Nurse (APRN) Compact. This compact allows APRNs who meet eligibility requirements to practice in other compact states .
Massachusetts
Senate Docket 1880 would allow physical therapists (PTs) to administer and interpret diagnostic imaging.
Mississippi
HB 813 would permit a certified registered nurse practitioner (CRNP) to practice independently under the following conditions:
- Current and active CRNP license from the state of Mississippi.
- At least 10,000 hours of documented clinical practice; no more than 25% of clinical hours completed via telehealth.
North Dakota
Senate Bill (SB) 2273 would allow PTs to order diagnostic imaging.
Oklahoma
SB 442 would change the definition of “interventional pain management” in Oklahoma from “the practice of medicine” to the “delivery of health care services.” This bill would also allow certified registered nurse anesthetists (CRNA) certified in nonsurgical pain management to perform fluoroscopy.
South Carolina
HB 3580 would permit APRNs to practice independently if they have completed 2,000 clinical hours and possess malpractice insurance.
SB 44/HB 3579 would permit a physician assistant (PA) to practice only under an attestation statement if they possess more than 2,000 hours of postgraduate clinical practice experience and 1,000 hours of practice experience gained after transitioning to a new medical specialty of practice. This bill would also expand the South Carolina Board of Medical Examiners from 13 to 15 members and require that two are PAs.
Texas
HB 1942 would allow a health maintenance organization (HMO) to contract directly with APRNs to provide healthcare services on the HMO’s behalf, regardless of whether the supervising physician provides healthcare services for the HMO.
Washington
HB 1430 would require health carriers to reimburse APRNs, PAs and physicians at the same rate for providing the same healthcare services.
SB 5299 would permit a physician to provide general supervision when a radiological technologist (RT) is performing intravenous contrast procedures. General supervision in Washington is defined as “supervision of a procedure that is furnished under the overall direction and control of a licensed physician, but where the physician is not required to be physically present during the performance of the procedure.” This bill also states that if general supervision is performed remotely, the process must comply with all federal and state laws and regulations and local, institutional, site, and facility policies, guidelines, and rules related to telemedicine and the supervising physician must be within 15 minutes to respond.
Private Equity
Connecticut
SB 567 would expand the authority of the attorney general and commissioner of Health Strategy to regulate private equity ownership of certain healthcare facilities and restrict self-dealing property transactions.
Surprise Billing
South Carolina
H 3302 would make the following changes regarding surprise billing:
- No health insurer may impose coinsurance, copayment, deductible, or other out-of-pocket expense for emergency services, including laboratory tests and services, rendered by an out-of-network healthcare provider that is greater than the total expense that would be imposed if such emergency services were rendered by an in-network healthcare provider.
- If an insured receives emergency services, including laboratory tests and services, from an out-of-network healthcare provider, such healthcare provider may bill the insurer directly and the insurer must reimburse the healthcare provider.
- An insurer may not require prior authorization for the rendering of emergency services, including laboratory tests and services.
- Surprise billing for emergency services would be classified as an unfair trade practice.
For more information about these bills, contact Dillon Harp, American College of Radiology® (ACR®) Senior State Government Relations Specialist. ACR is committed to supporting its chapters in their state-level advocacy efforts. The College also has resources available for members through its State Issues homepage and can assist with sending legislative calls-to-action and mobilizing grassroots. ACR has also partnered with Fiscal Note, a legislation and regulation tracking service, to provide continuous, comprehensive updates on radiology and healthcare-related legislation. To stay current on state legislative developments relevant to radiology, view the ACR policy map or receive state-specific reports from Fiscal Note. For state-level calls to action or to sign up to receive Fiscal Note reports, chapter leaders should contact Eugenia Brandt, ACR Senior Government Relations Director and Melody Ballesteros, ACR Assistant Director Government Relations.
