State Legislative Roundup: Lawmakers Consider Surprise Billing Legislation

While states continue to introduce bills about scope of practice, the American College of Radiology® (ACR®) also sees more bills related to surprise billing and telemedicine.

Surprise/Balance Billing

In New Hampshire, Senate Bill (SB) 173 would prohibit surprise medical bills and balance billing. Insurers would be required to cover emergency services provided by nonparticipating providers in the same manner as if the services were provided by a participating provider; the insurer would be required to pay the nonparticipating provider the out-of-network rate, less any cost-sharing for the services provided.

Scope of Practice

Iowa
Senate Study Bill 1046 would permit the referral of a patient by a physical therapist for diagnostic imaging, including plain radiographs and magnetic resonance imaging, provided the results of the imaging are evaluated by a healthcare provider that is qualified and permitted to interpret the results.

The Iowa Radiological Society is opposed to this bill.

Arizona

House Bill (HB) 2043 would eliminate the supervision agreement requirement for a physician assistant (PA) that has at least 6,000 hours of clinical practice. Instead, the PA would be required to collaborate with, consult or refer to the appropriate healthcare professional as indicated by the patient’s condition.

Connecticut

HB 6145 would create incentives for Advanced Practice Registered Nurses (APRNs) with an existing private practice to mentor APRNs who seek to establish their own private practice.

HB 6149 aims to eliminate barriers for APRNs and PAs to practice in Connecticut. If enacted, the bill would:

• Allow an APRN, during the first three years after being issued a license, to practice in collaboration with an APRN who has had a license for three years or more and has practiced as an APRN for more than 2,000 hours.
• Establish reciprocity for an APRN licensed in another state for three or more years, practiced for more than 2,000 hours, and is relocating to Connecticut to practice independently without collaborating with a physician or another APRN.
• Allow an APRN and PA to sign any healthcare form that ensures fulfillment of a patient order or referral, or recognition of a patient's health status or care that is within their scope of practice.

Hawaii

HB 666 would enjoin the state of Hawaii into the Interstate Medical Licensure Compact. This compact allows physicians who meet the compact’s eligibility requirements to practice medicine in other compact states.

Mississippi

SB 2796 would allow an APRN that has completed 6,240 practice hours to be exempt from the requirement of entering and maintaining a collaborative/consultative relationship with a licensed physician.

New Hampshire

SB 83 would allow an 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 can’t be construed to expand the scope of practice of an APRN or a certified nurse midwife.

New Mexico

SB 67 would enjoin New Mexico into the Interstate Medical Licensure Compact. This compact allows physicians who meet its eligibility requirements to practice medicine in other compact states.

New York

SB 2126 would allow a PA to engage in the use of fluoroscopy for guidance of diagnostic and therapeutic procedures, provided that the PA has successfully completed an educational program consisting of at least 40 hours of didactic and 40 hours of clinical training with successful completion of a competency exam.

SB 2216 would enjoin New York into the Interstate Medical Licensure Compact. This compact allows physicians who meet its eligibility requirements to practice medicine in other compact states

SB 2124 would allow PAs to serve as primary care practitioners for purposes of Medicaid managed care.

Virginia

HB 2073 would enjoin Virginia into the Interstate Medical Licensure Compact. This compact allows physicians who meet its eligibility requirements to practice medicine in other compact states.

The Virginia Radiological Society is monitoring this bill.

Telemedicine/Teleradiology and Licensure

Virginia

SB 1119 would allow patients who have an established relationship with a practitioner, that is a member of a health maintenance organization or multispecialty group, to receive services from another practitioner who is a member of the same multispecialty group via telemedicine without undergoing another in-person exam for another three years.

Washington

SB 5481 would make changes to telemedicine services in Washington, including:

• A Washington healthcare practitioner may provide telemedicine services to a patient located in the state if the services are consistent with the practitioner's scope of practice.
• An out-of-state healthcare practitioner may provide telemedicine services to a patient located in Washington if the provider holds a current license or certification to provide healthcare in the state or is otherwise authorized to provide healthcare there, including through a multistate compact.
• Location of care would be defined as the patient's location at the time the telemedicine service was provided.

The 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, please contact Eugenia Brandt, ACR Senior Government Affairs Director, or Dillon Harp, ACR Senior Government Relations Specialist.