March 11, 2021

States Consider Radiation Therapy, Out-of-Network Billing and Scope

Florida and New Jersey address breast cancer screening legislation. Missouri’s House and Senate consider a bill creating a Radiologic Imaging and Radiation Therapy Advisory Committee. Michigan holds a hearing on a proposed rule that would implement out-of-network billing provisions. Colorado, Florida and Wyoming discuss legislation impacting supervision requirements for physician assistants (PAs) and advanced practice registered nurses (APRNs).

Breast Cancer Screening

In Florida, HB 743 had its first reading on the House floor. It would mandate carriers to cover diagnostic mammograms, breast MRIs and breast ultrasounds. A similar bill, SB 1038 was introduced in the Senate.

In New Jersey, NJ A 5414 was introduced and referred to the Assembly Health Committee. For a woman of color, the bill would require carriers to cover an ultrasound evaluation, MRI, 3-D mammography or other additional testing of an entire breast or breasts concurrently ordered with a mammogram examination by a healthcare provider.

Out-of-Network Billing

Michigan’s Department of Insurance will hold a hearing on a proposed rule on out-of-network billing. The proposed rule would implement out-of- network provisions that would, among other things, establish procedures for the Department of Insurance and Financial Services to review and resolve requests for calculation determinations, establish procedures for processing requests for binding arbitration, and establish standards for approving arbitrators in the independent dispute resolution process.

In Oklahoma, HB 2323 passed the House chamber. The bill would prohibit carriers from removing a provider from a network solely because the provider informs an enrollee of the full range of physicians and providers available to the enrollee, including out-of-network providers.

In Utah, HB 54 passed the House and Senate chambers. It would require carriers to cover emergency healthcare services at the in-network rate.
Radiation Therapy Licensure

In Missouri, SB 624 had its first reading in the Senate. The bill would create a Radiologic Imaging and Radiation Therapy Advisory Committee which would guide, advise and make recommendations to the state’s commerce and insurance department. The department, based on recommendations from the Committee would, among other things:

  • Establish scopes of practice for limited X-ray machine operators, nuclear medicine technologists, nuclear medicine advanced associates, radiation therapists, radiographers and radiologist assistants;
  • Promulgate rules for issuance of licenses;
  • Establish minimum requirements for the issuance of licenses and recognition of licenses issued by other states; and
  • Establish minimum requirements for continuing education, including radiation safety.

A similar bill, HB 1426, had its second reading in the House.

Scope of Practice

In Colorado, HB 21-1184 was introduced and assigned to the Health and Insurance Committee. The measure seeks to change the practice agreement between a physician assistant and physician to a collaborative agreement. Physician supervision would only be required for a PA with fewer than 5,760 hours of practice experience or who is beginning practice in a new specialty. The bill would also require carriers to consider PAs to be primary care providers when the PA is practicing in a medical specialty in which a physician is required to be a primary care provider.

In Florida, HB 1299 had its first reading in the House. The bill seeks to define an “autonomous physician assistant" as a PA who would practice primary care without physician supervision after 4,000 clinical practice hours.

Also in Florida, SB 424 was introduced in the Senate. The measure seeks to permit autonomous practice for APRNs to perform protocol procedures including ordering and administering regional, spinal, and general anesthesia; inhalation agents and techniques; and intravenous agents and techniques.

In Wyoming, SF 33 passed the Senate. The bill seeks to change the practice agreement between a PA and physician from a supervising to a collaborating agreement.

To stay abreast of state legislative developments relevant to radiology, view our policy map.