January 11, 2024

Scope of Practice and Telemedicine Bills Highlight Start of State Legislative Sessions

The early 2024 state legislative cycle sees states across the country introducing legislation ranging from scope of practice to telemedicine.

Scope of Practice


House Bill (HB) 1059 would remove the requirement that an advanced practice registered nurse (APRN) have a practice agreement with a collaborating physician. This bill would also remove the provision that requires an APRN to operate under a collaborative practice agreement or the privileges granted by a hospital governing board.


HB 2217 would remove the requirement for geographic proximity in collaborative practice arrangements between physicians and registered professional nurses (RNs).


Legislative Bill 823 would enjoin the state of Nebraska into the physician assistance (PA) licensure compact. This compact allows PAs who meet its eligibility requirements to practice in other compact states.

New Hampshire

Senate Bill (SB) 486 would enjoin the state of New Hampshire into the PA licensure compact. This compact allows PAs who meet its eligibility requirements to practice in other compact states.

HB 1427 would allow an individual, who has not completed at least two years of postgraduate training approved by the Accreditation Council on Graduate Medical Education, but has completed steps 1 and 2 of the United States Medical Licensing Examination, to practice as a “deputy physician.” A deputy physician would be considered a PA for purposes of regulations of the Centers for Medicare and Medicaid Services (CMS) and would be allowed to enter collaborative practice arrangements with a physician.

New York

Assembly Bill (AB) 8247 would allow licensed NPs and licensed PAs to directly supervise the intravascular administration of contrast media by a radiographer.

AB 7753 would allow the New York Department of Health to issue limited-scope radiographer licenses to individuals who have received relevant education and passed a requisite exam. This limited-scope license would allow the holder to practice radiography at urgent care centers under the direct supervision of a licensed practitioner. Limited-scope radiographers would not be allowed to inject intravenous contrast media.

AB 4860 would enjoin the state of New York into the interstate medical licensure compact and the nurse licensure compact. The interstate medical licensure compact allows physicians who meet the compact’s eligibility requirements to practice medicine in other compact states.

SB 2126 would allow a PA to use fluoroscopy for guidance of diagnostic and therapeutic procedures if the PA completed an educational program consisting of 40 hours of didactic and 40 hours of clinical training and has completed a competency exam.


HB 324 would enjoin the state of Virginia into the PA licensure compact. This compact allows PAs who meet its eligibility requirements to practice in other compact states.


Rhode Island

HB 1410 would repeal the boards' registration of medical technicians and medical imaging and radiation therapy.

Out-of-Network / Surprise / Balance Billing Bills

New York

AB 8507 would direct the New York (NY) State Department of Civil Service to collect and analyze health care claims data from the Empire Plan (NY health insurance plan exclusively for NY public employees and employers) and publish a New York state health benefit plan hospital pricing report annually. Such a report would include, but not be limited to, a comparative analysis of actual hospital in-network allowed amounts and out-of-network allowed amounts for each hospital facility.

SB 5753 and AB2663 would require notification to insured persons that an out-of-network physician may be used in their procedure, test or surgery, and such physician's services shall not be covered by their insurance policy. However, such services must be covered if the insured person does not receive notification before such services or procedure.



SB 851 would make the following changes regarding telemedicine in the state of Missouri:

  • All physicians in Missouri that utilize telemedicine would be required to ensure that a properly established physician-patient relationship exists with the person who receives the telemedicine services. This could be accomplished by an in-person encounter, consultation with another physician or a telemedicine encounter, if the standard of care does not require an in-person encounter.
  • Before a physician could prescribe any drug, controlled substance or other treatment through telemedicine, said physician would have to establish a valid physician-patient relationship.

The American College of Radiology® (ACR®) 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.

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