March 28, 2024

State Legislatures Are Not Slowing Down — Continue to Pay Attention to Legislative Activity

As many state legislatures head into their final weeks or months of session, healthcare-related bills continue to be introduced, debated and considered. Don’t be caught off guard — be attuned to what is happening at your state legislature.

Certificate of Need

Certificate of Need laws are state regulatory mechanisms for approving major capital expenditures and projects for certain healthcare facilities.


Senate Bill (SB) 440 would modify the existing certificate of need laws in Connecticut to include the following:

  • Any investment in a healthcare facility by a private equity company in which the private equity company acquires a controlling interest, either directly or indirectly, in a healthcare facility.
  • Any transaction in which a private equity company acquires a controlling interest, either directly or indirectly, in a large group practice of 10 or more full-time equivalent physicians.
  • Any transaction involving a private equity company in which a healthcare facility’s assets would be increased or reduced.

Network Adequacy


SB 2641 would direct the Illinois Department of Insurance to determine whether the network plan at each in-network hospital and facility has a sufficient number of hospital-based medical specialists.

Out-of-Network / Surprise / Balance Billing


SB 1762 would require insurers to notify beneficiaries that nonparticipating providers may bill members for any amount up to the billed charge after the plan has paid its portion of the bill, except for specified services, including items or services provided to a Medicare beneficiary, insured or enrollee. This bill also states that healthcare providers cannot charge or collect from a Medicare beneficiary, insured or enrollee any amount over the Medicare-approved amount for any Medicare-covered item or service provided.

Rhode Island

SB 173 would enact, at the state level, the same requirements and prohibitions that exist under the federal No Surprises Act (NSA) regarding payments to, and billing by, out-of-network providers of emergency medical services and out-of-network providers of any healthcare service rendered at an in-network facility.

Radiology Assistants


Assembly Bill 3097 would make the following changes regarding radiology assistants (RAs) in the state:

  • Create a new committee under the Medical Board of California, called the Radiologist Assistant Committee, which would be responsible for the licensure and regulation of RAs.
  • Establish that RAs are an extension of a radiologist and work under the supervision of a radiologist as part of a radiologist-led team.
  • Requires that supervision by the supervising radiologist or the radiologist designee shall be continuous and the supervising radiologist or the radiologist designee shall be physically present in the RA’s practice site.
  • A radiologist who supervises an RA providing medical care in response to an emergency is not required to meet the supervision requirements.

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, or if you’d like to have access to Fiscal Note, contact Eugenia Brandt, ACR Senior Government Affairs Director, or Dillon Harp, ACR Senior Government Relations Specialist.