February 17, 2023

States Continue to Introduce Legislation Ranging From Surprise Billing to Scope of Practice

The American College of Radiology® (ACR®) and state radiological societies continue their review of state legislative activity that impacts the practice of radiology. Bills of interest include surprise billing, scope of practice, telemedicine and more.

Out-of-Network/Surprise/Balance Billing

New Mexico

House Bill (HB) 370 would extend the sunset date for the reimbursement requirements section in the “Surprise Bill Protection Act” to 2028. This section requires insurance to directly reimburse a nonparticipating provider for care rendered, the greatest of the following amounts:

  • If the provider participates in one or more of the health insurance carrier's commercial networks, the median amount of any commercial in-network reimbursement rates.
  • “The usual, customary, and reasonable rate” for services. This rate is defined as the sixtieth percentile of the allowed reimbursement rate for the healthcare service performed by a provider in the same or similar specialty in the same geographic area.
  • 150% of the rate at which the service would be reimbursed under the Medicare fee schedule.

Scope of Practice


HB 2308 would amend the Radiation Protection Act of 1990, by specifying that individuals seeking accreditation for limited diagnostic radiography shall not apply ionizing radiation to human beings until the individual has passed an Illinois Emergency Management Agency-approved examination and is accredited by the agency. This bill also removes language requiring that persons seeking limited-scope accreditation register with the agency as a "student-in-training."

HB 2306 would allow a physician assistant (PA) who has completed 250 hours of continuing education and 2,000 hours of clinical experience the ability to practice without a written collaborative agreement. This includes ordering, performing and interpreting diagnostic studies and therapeutic procedures.

Senate Bill (SB) 1572 would extend the expiration date for any healthcare license by three months if said license expires during a public health emergency declared by the Governor.

SB 1785 would mandate that a physician may not enter into a collaborative agreement with more than seven physician assistants. This rule would not apply if the physician were in a hospital, hospital affiliate, ambulatory surgical treatment center or within a Health Professional Shortage Area score greater than or equal to twelve.


Senate Study Bill 1142 would repeal the requirement that a physician assistant (PA) practice under the supervision of a licensed physician.

New Mexico

HB 349 would allow an advanced practice registered nurse (APRN), nurse practitioner (NP), certified registered nurse anesthetist (CRNA) and clinical nurse specialist (CNS) to perform beyond their scope of practice of professional registered nursing and to make independent healthcare decisions.

South Carolina

SB 517 would allow advanced practice registered nurses (APRN) to have full independent practice authority.



HB 2337 would create a Kansas telehealth advisory committee. It also defines in-state practitioner and interstate telehealth practitioner and clarifies that telemedicine can be used by an in-state practitioner to refer a patient to a specialty service healthcare provider.


SB 724 would require a health benefit plan to reimburse a preferred or contracted health professional at the same rate for telemedicine services as they would for an in-person visit.

The College has 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. You can also access information and ACR resources about scope of practice.

For more information about state legislative activities, please contact Eugenia Brandt, ACR Senior Government Affairs Director, or Dillon Harp, ACR Senior Government Relations Specialist.