I

106TH CONGRESS

2D SESSION H. R. 5274

To amend title XIX of the Social Security Act to provide public access

to quality medical imaging procedures and radiation therapy procedures.

IN THE HOUSE OF REPRESENTATIVES

SEPTEMBER 25, 2000

Mr. LAZIO (for himself, Mr. MCHUGH, Mr. RAHALL, Mr. MCKEON, Mr.

OBERSTAR, and Mr. LIPINSKI) introduced the following bill; which was

referred to the Committee on Commerce

A BILL

To amend title XIX of the Social Security Act to provide

public access to quality medical imaging procedures and

radiation therapy procedures.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Consumer Assurance

5 of Radiologic Excellence Act’’.
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1 SEC. 2. STATE LICENSES REGARDING PRACTITIONERS OF

2 MEDICAL IMAGING AND RADIATION THER3 APY; LIMITATION ON MEDICAID PAYMENTS

4 FOR PROCEDURES.

5 Title XIX of the Social Security Act (42 U.S.C. 1396

6 et seq.) is amended—

7 (1) in section 1903(i) (42 U.S.C. 1396b(i))—

8 (A) in paragraph (20), by striking the pe9 riod at the end and inserting ‘‘; or’’; and

10 (B) by inserting after paragraph (20) the

11 following paragraph:

12 ‘‘(21) with respect to any amount expended on

13 medical imaging procedures or radiation therapy

14 procedures unless the State meets the requirements

15 of section 1930A (relating to State medical radiation

16 licenses).’’; and

17 (2) by inserting after section 1930 the following

18 section:

19 ‘‘STATE MEDICAL RADIATION LICENSES

20 ‘‘SEC. 1930A. (a) STATE LICENSES REGARDING

21 MEDICAL IMAGING AND RADIATION THERAPY.—For pur22 poses of section 1903(i)(21), a State meets the require23 ments of this section if the State demonstrates to the sat24 isfaction of the Secretary that the law of the State has

25 in effect the following policies:
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1 ‘‘(1) Subject to paragraphs (2) and (3), it is

2 unlawful for an individual to administer medical im3 aging procedures or radiation therapy procedures in

4 the State unless the individual has obtained from

5 the State a license, certificate, or other document

6 that authorizes the individual to administer such

7 procedures in the State (referred to in this section

8 as a ‘medical radiation license’).

9 ‘‘(2) Notwithstanding any other provision of

10 this section, the State deems an individual as hold11 ing a medical radiation license if the individual is li12 censed in the State as a doctor of medicine, osteop13 athy, dentistry, podiatry, or chiropractic.

14 ‘‘(3) The State requires an individual who ad15 ministers medical imaging procedures or radiation

16 therapy procedures to obtain a medical radiation li17 cense from the State, unless—

18 ‘‘(A) the individual exclusively performs

19 medical ultrasound or echocardiography; or

20 ‘‘(B) the individual is a student enrolled in

21 an educational institution or program that is

22 accredited pursuant to subsection (b)(2)(B)

23 and, as a student, intentionally administers

24 medical imaging procedures or radiation ther25 apy procedures for medical purposes under the
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1 supervision of an individual who holds a medical

2 radiation license obtained from the State.

3 ‘‘(4) The State considers an individual as ad4 ministering medical imaging procedures or radiation

5 therapy procedures if the individual is a medical or

6 chiropractic radiologic technologist, a radiation ther7 apist, or a nuclear medicine technologist, or is any

8 other individual who intentionally administers any of

9 such procedures to another individual for medical

10 purposes.

11 ‘‘(5) The State does not provide a medical radi12 ation license to an individual unless the individual

13 meets—

14 ‘‘(A) the criteria established under sub15 section (b) by the Secretary; and

16 ‘‘(B) such additional criteria as the State

17 may establish.

18 ‘‘(b) ISSUANCE BY SECRETARY OF MINIMUM LICENS19 ING CRITERIA.—

20 ‘‘(1) IN GENERAL.—Not later than 18 months

21 after the date of the enactment of the Consumer As22 surance of Radiologic Excellence Act, the Secretary

23 shall by regulation issue criteria that, for purposes

24 of subsection (a)(5)(A), establish the minimum

25 standards for an individual to obtain a medical radi-
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1 ation license from a State. In carrying out the pre2 ceding sentence, the Secretary shall—

3 ‘‘(A) establish such standards as the Sec4 retary determines to be appropriate for ensur5 ing the quality performance of medical imaging

6 procedures and radiation therapy procedures;

7 and

8 ‘‘(B) ensure that the standards are at least

9 as protective of the public health as standards

10 issued under the Consumer-Patient Radiation

11 Health and Safety Act of 1981.

12 ‘‘(2) CERTAIN STANDARDS.—The Secretary

13 shall ensure that standards under paragraph (1) are

14 in accordance with the following:

15 ‘‘(A) The standards shall specify the edu16 cational requirements for an individual to ob17 tain a medical radiation license, including, if

18 applicable, requirements regarding practical ex19 perience.

20 ‘‘(B) The standards shall provide that an

21 educational requirement under subparagraph

22 (A) is that the education involved be provided

23 by an educational institution or program that is

24 accredited by a nonprofit private entity recog-
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1 nized by the Secretary for purposes of this sub2 section.

3 ‘‘(C) The standards shall specify the cri4 teria that an entity is required to meet in order

5 to be recognized by the Secretary as an accred6 iting entity under subparagraph (B). Such cri7 teria shall provide that an entity will not be so

8 recognized unless the entity establishes accred9 iting criteria satisfactory to the Secretary with

10 respect to the quality of educational institutions

11 and programs in the areas of administrative

12 policies and procedures, curricula, record13 keeping, faculty, administrative support, and

14 such other areas as the Secretary determines to

15 be appropriate.

16 ‘‘(3) CONSULTATION.—In developing standards

17 under paragraph (1), the Secretary shall consult

18 with organizations that are nationally recognized for

19 their expertise in education and credentialing in

20 radiologic technology.

21 ‘‘(c) DEFINITIONS.—For purposes of this section:

22 ‘‘(1) The term ‘medical imaging procedure’

23 means any procedure or article, excluding medical

24 ultrasound procedures or articles, intended for use

25 in the diagnosis of disease or other medical, chiro-
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1 practic, or dental conditions in humans, including di2 agnostic X-rays, nuclear medicine and magnetic res3 onance procedures.

4 ‘‘(2) The term ‘medical radiation license’ has

5 the meaning indicated for such term in subsection

6 (a)(1).

7 ‘‘(3) The term ‘radiation therapy procedure’

8 means any radiation procedure or article intended

9 for the cure, mitigation, or prevention of diseases or

10 disorders in humans.’’.

11 SEC. 3. APPLICABILITY.

12 With respect to the condition described in paragraph

13 (21) of section 1903(i) of the Social Security Act (as in14 serted by section 2 of this Act):

15 (1) Except as provided in paragraph (2), such

16 condition applies to the States on and after the first

17 day of the first calendar quarter that begins after

18 the date on which the Secretary of Health and

19 Human Services promulgates the final rule under

20 section 1930A(b)(1) of the Social Security Act (as

21 added by section 2 of this Act).

22 (2) If the Secretary determines that meeting

23 such condition requires State legislation (other than

24 legislation appropriating funds), the condition ap25 plies to the State involved on and after the first day
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1 of the first calendar quarter that begins after the

2 close of the relevant session of the State legislature.

3 For purposes of the preceding sentence:

4 (A) The relevant session is the first reg5 ular session of the State legislature that begins

6 after the date on which such final rule is pro7 mulgated by the Secretary, subject to subpara8 graph (B).

9 (B) If the State has a two-year legislative

10 session, each year of the session is deemed to

11 be a separate regular session of the State legis12 lature for purposes of subparagraph (A).

Æ