January 12, 2023

State Legislatures Begin 2023 Considering Cancer Screening and Scope of Practice Bills

State legislatures across the nation are convening for their 2023 legislative sessions, and lawmakers are in the process of introducing bills. The American College of Radiology® (ACR®) tracks and provides advocacy efforts related to hundreds of bills introduced in the state legislatures of interest to radiologists and their patients throughout each legislative session. This week, the College highlights recently introduced cancer screening mandate and scope of practice legislation.

Cancer Screening


House Bill 198 would create a “Wisewoman and Wiseman” program to reduce the incidences of certain chronic diseases among Mississippians through education, prevention, and early screening and detection. The program, only to be implemented in counties located wholly or partially west of Interstate 55, would be a joint contract between the Mississippi Department of Health and public/private clinics and agencies. The Mississippi Department of Health would apply for grants from the Centers for Disease Control and Prevention and other public or private entities to fund the program. If implemented, this program would do the following:

  • Provide education about healthy behaviors and how to reduce the risk factors for heart disease, breast cancer, cervical cancer, colorectal cancer, prostate cancer and other chronic diseases.
  • Provide screening and testing to detect those chronic diseases early when they can be effectively treated, managed or controlled.
  • Direct more resources toward populations in greatest need.


House Bill 575 would require insurance policies covering Missouri residents (except those preempted by federal law) to cover:

  • A baseline mammogram for women ages 35–39.
  • A mammogram every year for women ages 40 and beyond.
  • A mammogram every year for any woman deemed by a treating physician to have an above-average risk for breast cancer in accordance with ACR guidelines for breast cancer screening.
  • Any additional or supplemental imaging, such as breast magnetic resonance imaging or ultrasound, deemed medically necessary by a treating physician for proper breast cancer screening or evaluation in accordance with applicable ACR guidelines.

The Missouri Radiological Society is in support of this bill.


Legislative Bill 145 would require insurance policies to include coverage for screening mammography for women:

  • Ages 35–40 (one baseline mammogram each year).
  • Under the age of 40 that have a family history of breast cancer (one mammogram at the age and in the intervals considered medically necessary by the patient's healthcare provider).
  • Ages 40 and beyond (one mammogram per year).

The Nebraska Radiological Society supports this legislation.

Scope of Practice


House Bill 108 would enjoin Kentucky into the Advanced Practice Registered Nurse (APRN) Compact. This compact allows APRNs to hold one multistate license with the privilege to practice in other compact states. This bill has been assigned to the House Committee on Committees.

The Kentucky Radiological Society is monitoring this legislation.


House Bill 407 would enjoin the state of Missouri into the Interstate Medical Licensure Compact. This compact allows physicians who meet the compact’s eligibility requirements to practice medicine in other compact states.

House Bill 69 would replace the existing collaborative practice arrangements (CPA) with nurses with the following:

  • CPAs may delegate to a registered professional nurse the authority to administer, dispense or prescribe drugs, and provide treatment if the registered professional nurse is an APRN.
  • The collaborating physician shall review every 14 days a minimum of 20% of the charts in which the APRN prescribes controlled substances.
  • A collaborating physician shall not enter a collaborative practice arrangement with more than six full-time APRNS, full-time licensed physician assistants, full-time equivalent assistant physicians or any combination thereof.
  • No CPA will supersede current hospital licensing regulations governing hospital medication orders under protocols or standing orders for the purpose of delivering inpatient or emergency care within a hospital.
  • A physician may not be forced to act as a collaborating physician against their will.

If you have any questions on these bills or any other piece of state legislation, please contact Eugenia Brandt, ACR Senior Government Affairs Director, or Dillon Harp, ACR Senior Government Relations Specialist.