June 08, 2023

2023 State Scope of Practice Legislation in Review

Scope of practice (SOP) expansion by non-physicians continued to dominate state legislative sessions this year. Following is a review of several bills and their outcomes. The American College of Radiology® (ACR®) has tracked 96 SOP bills in 2023.

New Hampshire

Senate Bill (SB) 83 allows an Advanced Practice Registered Nurse (APRN) or certified midwife acting within the scope of their practice to certify a document in the place of a physician. The bill states that this provision cannot be construed to expand the scope of practice of an APRN or a certified nurse midwife.

This bill was signed into law by Gov. Chris Sununu.

Puerto Rico

Senate Project 1134 would have allowed any general practitioner to be granted certification as a medical specialist if they worked for at least 10 uninterrupted years full-time in an emergency room and presented evidence of said practice to the satisfaction of the Puerto Rico Board of Medical Licensure and Discipline. The ACR and the Radiological Society of Puerto Rico (SOCRAD) sent a joint letter to members of the Puerto Rico General Assembly opposing Senate Project 1134.

This bill has been removed from consideration by its sponsor, Senate President José Luis Dalmau-Santiago.


SB 28 would enjoin Ohio into the Physician Assistant (PA) Licensure Compact. This compact allows PAs who meet its eligibility requirements to practice in other compact states.

This bill was referred to the Senate Health Committee.


SB 584 would have allowed a physical therapist (PT) to treat a patient for 30 consecutive days without obtaining a referral from a referring practitioner.

The bill failed.

SB 1700 would have allowed APRNS to practice independently of physician supervision, including the ability to order, perform and interpret diagnostic tests.

The bill failed.

West Virginia

SB 698 would have changed the title physician assistant to physician associate. It would have also changed the relationship between a physician and a PA from supervisory to collaborative.

The bill failed.

The ACR is 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 or if you need any guidance on legislation in your state, contact Eugenia Brandt, ACR Senior Government Affairs Director, or Dillon Harp, ACR Senior State Government Relations Specialist.