State Scope of Practice Bills Are a Major Topic in 2026

State legislatures are wasting no time in 2026, with ACR® already monitoring a growing number of scope of practice bills nationwide. This week, we’re featuring those measures alongside notable employment practice and prior authorization legislation.

Scope of Practice

Arizona

House Bill (HB) 2190 would enjoin Arizona into the Physician Assistant (PA) licensure compact. This compact allows PAs who meet their eligibility requirements to practice in other compact states.

Illinois

HB 4369 would enjoin Illinois into the Nurse Licensure Compact (NLC). This compact allows Registered Nurses (RN) and Licensed Practical Nurses (LPN) who meet their eligibility requirements to practice in other compact states.

Indiana

HB 1129 / Senate Bill (SB) 60 would remove the requirement for advanced practice registered nurses (APRNs) to maintain a practice agreement with a physician.

Missouri

HB 2556  specifies that certain medical titles or specialty designations are reserved for the use of licensed physicians. These include specialty designations such as “radiologist,” along with professional titles including “Physician,” “Doctor of Medicine,” “MD,” and “Osteopath.

SB 1492 would enjoin Missouri into the PA licensure compact.

Mississippi

HB 40 would allow APRNs with 3,600 hours of practice to practice without a collaborative agreement with a physician.

New Mexico

HB 45 would enjoin New Mexico into the PA licensure compact.

New York

Assembly Bill (A) 5130 would allow PAs who have completed 3,600 hours to practice without the supervision of a physician.

A 6362 / S 5657 would enjoin New York into the interstate medical licensure compact. This allows physicians who meet the compact’s eligibility requirements to practice medicine in other compact states.

S 352 would permit PAs to perform fluoroscopy upon completion of 40 hours of didactic education, 40 hours of supervised clinical training, and successful passage of a competency exam.

Employment Practices

Wisconsin

Assembly Bill (AB) 675 would make the following changes regarding covenants (non-compete):

• Would prohibit a non-compete clause between a medical practitioner and their employer if the covenant includes a restriction that prohibits working as a medical practitioner for more than twenty-four consecutive months after the first day of the medical practitioner’s employment.
• Would prohibit a non-compete clause if the medical practitioner’s employment is terminated for any reason by the medical practitioner’s employer.

Prior Authorization

New York

A 3991 would require health care service plans and specialized health care service plans that employ AI for utilization review to adhere to several standards, including fair application, transparency, and regular performance evaluations of the AI systems.

For more information about these bills, contact Dillon Harp, ACR^® Senior State Government Relations Specialist.

ACR is committed to supporting its chapters in their state-level advocacy efforts. The College also has resources available for members through the State Issues homepage and can assist with delivery of legislative calls-to-action and grassroots mobilization.

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 or receive state-specific reports from Fiscal Note.

For state-level calls to action or to sign up to receive Fiscal Note reports, chapter leaders should contact Eugenia Brandt, ACR Senior Government Relations Director, or Melody Ballesteros, ACR Assistant Director Government Relations.