May 29, 2019

States Finalize Imaging, Surprise Billing and Scope Legislation

As many state legislative sessions come to an end, several bills have passed both chambers and others have been signed into law. The following proposed bills and finalized laws address cancer screening, surprise billing and scope of practice.

Cancer Screening

In Louisiana, HB 347 cleared the House chamber and is scheduled for a hearing before the Senate Finance Committee. The bill would mandate coverage for diagnostic imaging at the same level of coverage provided for screening mammograms.

In Texas, HB 170 cleared both chambers and is awaiting the governor’s signature. The bill would mandate health plans that cover mammography screenings also cover diagnostic mammograms.

Out-Of-Network

In Alabama, HB 11 passed both chambers and was delivered to the governor. The bill would require hospitals to seek reimbursement directly from the patient’s health insurer, except for copayments and deductibles.

In Texas, SB 1264 was delivered to the governor. It would ban balance billing by out-of-network providers and strike out language on enrollees being a party to existing mediation provisions. The bill would allow mediation between providers and insurers for disputes regarding emergency care, out-of-network laboratory services, or diagnostic imaging services. Although the bill does not stipulate particular benchmarking for reimbursement, it does state the insurer would pay the provider at the usual and customary rate.

Washington’s Gov. Jay Inslee signed HB 1065 into law. The bill would require coverage billed at in-network rates for emergency services that screen and stabilize enrollees and would prohibit prior authorization. It would prohibit balance billing directed to enrollees for elective services, including radiology, at in-network hospitals. The law goes into effect July 28, 2019.

Scope of Practice

In Ohio, HB 224 is scheduled for a hearing before the House Health Committee. It would allow certified registered nurse anesthetists to order and evaluate diagnostic tests.

Oregon’s Gov. Kate Brown signed SB 128 into law, which has gone into effect. The law directs the Oregon’s Board of Medical Imaging to issue permits that allow qualified advanced practice registered nurses (APRNs) to supervise fluoroscopy under a physician’s supervision. The bill also allows a medical imaging licensee who specializes in radiography to operate fluoroscopic X-ray equipment.