West Virginia’s governor signs legislation into law that modifies the collaboration requirements of physician assistants (PAs). Breast cancer screening provisions advance in Louisiana and Texas. Rhode Island considers a bill modifying out-of-network provisions.
Scope of Practice
West Virginia Gov. Jim Justice signed scope-of-practice Senate Bill (SB) 714 into law. The bill modifies the collaboration agreement between PAs and physicians by removing the personal presence of the collaborating physician requirement if both parties are/can be easily in contact with one another by telecommunication.
In Louisiana, House Bill (HB) 495 was introduced and referred to the Committee on Health and Welfare. The bill seeks to permit full practice authority for advanced practice registered nurses (APRNs), including repealing their collaborative practice agreement requirements. It seeks to allow APRNs to plan and initiate a therapeutic regimen that would include diagnostic services.
The Louisiana Radiological Society is actively opposing this proposed measure.
In North Carolina, SB 249 was referred to the Committee on Rules and Operations. The measure would permit APRNs to order, perform, supervise and interpret diagnostic studies. Its companion bill in the House, HB 277, was referred to the Committees on Health; Rules, Calendar, and Operations; and Finance.
The North Carolina Radiological Society is actively monitoring this proposed measure.
In Oregon, HB 3036 will have its second reading in the House. The bill seeks to change the practice agreement between a physician assistant and physician from a supervising to a collaborating agreement.
Breast Cancer Screening
In Iowa, House File (HF) 874 was introduced and referred to the Commerce Committee. The bill would mandate carriers cover diagnostic breast cancer examinations and prohibit them from requiring cost sharing greater than the cost-sharing amount for a screening mammogram. Diagnostic breast cancer examination is defined in the bill as “an examination of an abnormality, deemed medically necessary by a covered person’s health care professional, for the detection of breast cancer,” and may be conducted using a diagnostic mammogram, breast magnetic resonance imaging (MRI), or breast ultrasound.
In Louisiana, SB 119 passed the Senate. It would expand coverage for:
- An annual MRI starting at age 25 and annual mammography starting at age 30 for women with a hereditary susceptibility from pathogenic mutation carrier status or prior chest wall radiation.
- An annual mammogram (digital breast tomosynthesis [DBT] preferred modality) and access to supplemental imaging (MRI preferred modality) starting at age 35 upon recommendation by the physician if the woman has a predicted lifetime risk greater than 20% by any model, a strong family history, or is at a higher risk for a diagnosis of breast cancer at an earlier age based on ethnicity or race.
- Consideration given to supplemental imaging for women with increased breast density, if recommended by her physician.
- Annual mammography (DBT preferred modality) for any woman who is 40 or older.
In Texas, SB 1065 passed the Business and Commerce Committee. The bill would mandate carriers that cover screening mammograms also cover diagnostic imaging using a diagnostic mammogram, breast MRI or breast ultrasound. Diagnostic imaging would be used to evaluate:
- A subjective or objective abnormality detected by a physician or patient in a breast.
- An individual with a personal history of breast cancer or dense breast tissue.
Out-of-Network Billing
In Rhode Island, SB 304 will be heard before the Health and Human Services Committee. The bill would prohibit carriers from imposing cost sharing to enrollees greater than the in-network rate for emergency out-of-network services. In the event of a payment dispute between an out-of-network provider and the carrier, the bill would establish an IDR process using the American Arbitration Association as the alternative dispute resolution entity. However, if the American Arbitration Association ceases to exist, ceases to be qualified, or becomes unable to perform arbitrations in connection with this section, the office of the health insurance commissioner would specify a similarly qualified organization. In the final award, the arbitrator would determine which party is responsible for paying all administrative fees, arbitrator compensation and expenses.
To stay abreast of state legislative developments relevant to radiology, view our policy map.