As some states hit the halfway point of their legislative cycles, lawmakers in others are busy introducing legislation that ranges in topics from scope of practice to prior authorization.
Scope of Practice
Georgia
would mandate that a delegating physician may not supervise more than eight advanced practice registered nurses (APRN) or physician assistants (PA).
Illinois
& would allow a PA to practice without a collaborative agreement with a physician once they complete 250 hours of continuing education or 2,000 hours of clinical experience.
Minnesota
would allow an APRN to practice without a collaborative agreement after completing 2,080 practice hours.
New York
would allow the intravenous administration of contrast media by a radiographer when such a procedure is done under the direct supervision of a licensed physician, licensed nurse practitioner or licensed PA.
Oklahoma
would enjoin Oklahoma into the PA licensure compact. This compact allows PAs who meet its eligibility requirements to practice in other compact states.
Network Adequacy
Illinois
and would mandate that the minimum ratio for each provider type shall be no less than any such ratio established for qualified health plans in federally facilitated exchanges by federal law or by the federal Centers for Medicare and Medicaid Services (CMS). This bill would also require that the maximum travel time and distance standards, and appointment wait time standards shall be no greater than any such standards established for qualified health plans in exchanges by federal law or by CMS.
Out-of-Network/Surprise/Balance Billing Bills
Maryland
would require out-of-network healthcare facilities to:
- Obtain a signed consent form from the consumer before providing healthcare services.
- Send a notice informing the consumer that the healthcare facility is out of network and that the consumer will likely incur higher out-of-pocket cost.
- Provide the consumer with a written estimate of the cost of receiving such healthcare services at the out-of-network facility.
Prior Authorization
Iowa
would require a utilization review organization to respond to a request for prior authorization from a healthcare provider within 48 hours after receipt for urgent requests or within 10 calendar days for non-urgent requests. This bill would also require that on or before Jan. 15, all health carriers in the state to implement a pilot program that exempts a subset of participating providers from prior authorization.
Mississippi
would make the following changes regarding prior authorization:
- A health insurance issuer shall make any current prior authorization requirements and restrictions readily accessible and conspicuously posted on its website to enrollees and healthcare providers.
- The clinical review criteria must be nationally recognized and generally accepted standards.
- A health insurance issuer must ensure that all adverse determinations are made by a physician when the request is by a physician or a representative of a physician.
Illinois
states that an individual or group policy of accident and health insurance or a managed care plan must not require authorization or referral by the plan, issuer, or any person, including a primary care provider, for any covered individual who seeks coverage for certain obstetrical or gynecological care.
The 黑料网® (黑料网®) 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 黑料网 policy map. You can also access information and 黑料网 resources about scope of practice.
For more information about state legislative activities, contact Eugenia Brandt, 黑料网 Senior Government Affairs Director, or Dillon Harp, 黑料网 Senior Government Relations Specialist.