Many state legislatures have convened and are beginning to consider legislation of interest to radiologists, including cancer screening and scope of practice.
Cancer Screening
In Minnesota, was referred to the Senate Committee on Health and Human Services. If enacted, the bill would mandate health plans provide coverage for the additional diagnostic services or testing with no cost sharing (including copay, deductible or coinsurance) if a healthcare provider determines an enrollee requires additional diagnostic services or testing after a mammogram.
In Nebraska, would require insurance policies to cover one annual stool-based preventive screening as approved by the United States Preventive Services Task Force for non-symptomatic persons 45 years of age and older (with no cost to the patient).
In New York, would require a health insurance policy to cover at no cost the following for persons that are at high risk of developing ovarian cancer:
• An annual FDA-approved test.
• A transvaginal ultrasound.
• A pelvic exam.
In Virginia, would require health insurers to provide coverage for examinations and laboratory tests related to colorectal cancer screening in accordance with the American Cancer Society guidelines for average-risk individuals. This bill would prohibit such coverage from being subject to any deductible, coinsurance or any other cost-sharing requirements, and would provide that an initial screening test is not complete until a follow-up colonoscopy is performed.
In West Virginia, would require an insurance policy to provide reimbursement for laboratory expenses or X-rays for the following services:
• One baseline mammogram examination for women who are at least 30 but less than 40 years of age.
• One mammogram examination every year for women ages 40 and over.
• A mammogram examination(s) for women 40 years of age and who have a family history of breast cancer or other breast cancer risk factors (these examinations will take place when deemed medically necessary by the woman’s healthcare provider).
Scope of Practice
In Connecticut, two bills were introduced related to scope of practice requirements. would eliminate mandatory physician oversight of a physician assistant. would allow for reciprocal licensing for certain out-of-state healthcare providers, including physicians, radiographers, radiologic technologists, radiologist assistants, nuclear medicine technologists and nurses.
In Indiana, would require an advanced practice registered nurse (APRN) who is under a collaborative agreement with a licensed practitioner to display:
• Name.
• Type of license.
• Primary board certification (if any).
• Specialty (if any).
• Collaborative practitioner's primary practice address.
Other bills introduced in the Indiana General Assembly relating to scope of practice include , and . HB 1330 and SB 213 would remove the requirements that an APRN have a practice agreement with a collaborating physician. The bills would also remove a provision requiring an APRN to operate under a collaborative practice agreement or the privileges granted by a hospital governing board.
SB 190 would make changes to a collaborative agreement between a physician and a physician assistant, including:
• Inclusion of limitations.
• Establishment of the method of collaboration between the physician and physician assistant.
• Annual signature made available to the medical licensing board of Indiana.
The legislation also would eliminate current requirements, including a prohibition against a physician collaborating with more than four physician assistants at the same time and physician submission of collaborative agreements to the medical licensing board.
In Missouri, would repeal the requirement that an APRN operate under a collaborative practice arrangement with a licensed physician. This bill would also allow APRNs to use telemedicine to provide treatment to patients without geographic restrictions.
In Montana, would remove the requirement that a physician assistant be supervised by a licensed physician.
In North Dakota, would require the following truth in advertising activities:
• Any advertisement for healthcare services, which names a healthcare practitioner, must identify the type of license held and not contain deceptive or misleading information.
• Any healthcare practitioner providing healthcare services shall post conspicuously and communicate affirmatively the practitioner's specific licensure.
• Any healthcare practitioner shall wear a photo identification name tag during all patient encounters which must include a recent photograph of the practitioner, the practitioner's name and the type of license.
In Oregon, would change the term physician assistant to physician associate. A physician associate would still have to practice under a collaborative agreement with a physician.
In Virginia, would require physician assistants to practice as part of a patient care team. This bill would also forbid a patient care team physician to collaborate or consult with more than six physician assistants on a patient care team at any one time. would enter Virginia into the Interstate Medical Licensure Compact. This compact allows physicians who meet certain requirements to practice medicine across state lines with other compact states.
In Washington, would require health insurance plans to reimburse advanced registered nurse practitioners and physician assistants at the same rates as a physician when the same service is provided.
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