April 09, 2021

North Dakota Scope of Practice Bill Signed into Law

North Dakota governor signed a bill into law that modifies scope of practice for physical therapists. Delaware and Texas lawmakers introduced legislation to modify scope of practice for advanced practice registered nurses (APRNs) and physician assistants (PAs). In Louisiana, a senate bill that would expand breast cancer screening coverage was referred to the Committee on Insurance. In North Carolina, senators introduced a bill that would modify out-of-network billing requirements.

Scope of Practice

North Dakota Gov. Doug Burgum signed Senate Bill (SB) 2122 into law. The law will permit physical therapists to order musculoskeletal imaging consisting of plain film radiographs, provided the physical therapist holds a clinical doctorate degree in physical therapy or has completed a board-approved formal medical imaging training program. The imaging must be interpreted by a licensed physician trained in radiology interpretation.

In Delaware, House Bill (HB) 141 was introduced and assigned to the Policy Analysis and Government Accountability Committee. The bill seeks to remove physician supervision of APRNs and would permit the Board of Nursing to grant full practice authority upon the issuance of an APRN license. The bill also seeks to permit APRNs to plan and initiate a therapeutic regimen that includes ordering diagnostic and supportive services.

In Texas, HB 4352 was introduced and referred to the Public Health Committee. The bill seeks to change the practice agreement between a physician assistant and physician from a supervising to a collaborating agreement. PAs also would be permitted to interpret diagnostic studies and therapeutic procedures.
The Texas Radiological Society is actively opposing this proposed bill.

Breast Cancer Screening

In Louisiana, SB 119 was referred to the Committee on Insurance. It would expand coverage for:

  • An annual MRI starting at age 25 and annual mammography starting at age 30 for women with a hereditary susceptibility from pathogenic mutation carrier status or prior chest wall radiation.
  • An annual mammogram and access to supplemental imaging starting at age 35 upon recommendation by her physician if the woman has a predicted lifetime risk greater than 20% by any model, a strong family history or is at a higher risk for a diagnosis of breast cancer at an earlier age based on ethnicity or race.
  • An annual mammogram for women with increased breast density with consideration given to supplemental imaging if recommended by her physician.

Out-of-Network Billing

In North Carolina, SB 415 was referred to the Committee on Rules and Operations. The bill would require carriers to reimburse out-of-network providers at a benchmark amount which would be calculated at least annually and be the lesser of the following:

  • 100% of the current Medicare payment rate for the same or similar service;
  • The healthcare provider's actual charges; or
  • The median contracted rate in the insurer's healthcare provider network for the same or similar services.

To stay up to date on state legislative developments relevant to radiology, view our policy map.