April 18, 2019

Imaging-Specific Bills Move Through State Legislatures

State legislative proposals relevant to breast density disclosure, breast tomosynthesis, cancer screening, certificate of need and scope of practice all saw progress in the past week.

Breast Density

In Illinois, SB 1506 cleared the Senate and was referred to the House Rules Committee. The bill would mandate mammography services providers to inform and notify patients if their mammogram demonstrates dense breast tissue. The mammography report would include a summary with language that may include, but not be limited to, the following information:

“Your mammogram shows that your breast tissue is dense. Dense breast tissue is very common and is not abnormal. However, dense breast tissue can make it harder to find cancer on a mammogram and may also be associated with an increased risk of breast cancer. This information about the result of your mammogram is given to you to raise your awareness. Use this information to talk to your doctor about your own risks for breast cancer. At that time, ask your doctor if more screening tests might be useful, based on your risk. A report of your results was sent to your physician."

Breast Tomosynthesis

In Colorado, HB 1301, cleared the House chamber. The bill would mandate coverage for preventive breast cancer screening studies defined as a mammogram for individuals at average risk, a mammogram using a noninvasive imaging modality as recommended by the health provider or a mammogram and medically recommended subsequent noninvasive imaging modality for patients at average risk with incomplete mammogram results or for high-risk patients. It would mandate coverage for annual breast cancer screenings for all individuals who have at least one breast cancer risk factor — prior family history, aged 40 years or older or an increased lifetime risk determined by a risk factor model.

In New Hampshire, SB 58 is scheduled for a public hearing April 23. The bill would require that providers of low-dose mammography screenings be reimbursed at rates accurately reflecting the resource costs specific to each modality, including any increased cost of digital breast tomosynthesis (DBT).\

Cancer Screening

In Illinois, SB 162, cleared the Senate Chamber and was referred to the House Rules Committee. It would expand coverage to diagnostic mammograms when deemed medically necessary and would cover breast ultrasounds for evaluating dense breast tissue.

In Louisiana, HB 347 is scheduled for a hearing at the House Insurance Committee. If enacted, the bill would cover diagnostic imaging at the same level of coverage for mammography exams.

In Maine, LD 1264/SP 384 is scheduled for a hearing at the Joint Committee on Health Coverage, Insurance and Financial Services. It would amend the definition of screening mammography to include DBT screening and would require insurance coverage for the procedure.

In Pennsylvania, Rep. Isabella Fitzgerald introduced HB 1245 which was referred to the House Insurance Committee. If enacted, the bill would cover ultrasound screening, MRIs, or other supplemental screening if a patient shows heterogeneous or dense breast tissue or is at risk for breast cancer due to prior personal or family history, positive genetic testing or other indications as deemed medically necessary by a physician.

Rhode Island’s Rep. Kathleen Fogarty introduced HB 6005. It would mandate coverage for two mammogram screenings per year when recommended by a physician for women who have been treated for breast cancer within the last five years or are at high risk of developing breast cancer due to genetic predisposition or atypical ductal hyperplasia. Additionally, women who have been notified of having dense breast tissue would be covered for breast MRI exams and/or DBT screenings. The bill was referred to the House Health, Education and Welfare Committee.

Certificate of Need

In Alaska, SB 1 would repeal the certificate of need program for health care facilities. The bill passed the Senate Health and Social Services Committee and was referred to the Finance Committee.

Scope of Practice

In Florida, HB 821 cleared the House Health and Human Services Committee and is scheduled for the House floor. The bill would expand the scope of advanced practice registered nurses by allowing them to order diagnostic tests.

In California, AB 890 would expand the scope of practice of nurse practitioners to include ordering and interpreting diagnostic procedures without the supervision of a physician. The bill passed the Committee on Business and Professions and was referred to the Appropriations Committee.

In Oregon, SB 128 would direct the Oregon’s Board of Medical Imaging to issue permits that would allow qualified advanced practice registered nurses (APRNs) to supervise fluoroscopy under a physician or an APRN who holds a permit. If enacted, the bill would allow fluoroscopic X-ray equipment to be operated by a medical imaging licensee who specializes in radiography. The bill is scheduled for a public hearing.