‘‘(E) whether the examinations leading to 
certification by the certification organization 
are accredited by an appropriate accrediting 
body as defined in subsection (d); 
‘‘(F) the ability of the certification organi-
zation to review applications for certification in 
a timely manner; and 
‘‘(G) such other factors as the Secretary 
determines appropriate. 
‘‘(3) EQUIVALENT EDUCATION, TRAINING, AND 
EXPERIENCE.— 
‘‘(A) IN GENERAL.—For purposes of this 
section, the Secretary shall, through regulation, 
provide a method for the recognition of individ-
uals whose training or experience are deter-
mined to be equal to, or in excess of, those of 
a graduate of an accredited educational pro-
gram in that specialty. Such authority shall ex-
pire seven years after the enactment of this sec-
tion. 
‘‘(B) ELIGIBILITY.—The Secretary shall 
not recognize any individual pursuant to the au-
thority of subparagraph (A) unless such indi-
vidual— 
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‘‘(i) was performing or planning the 
technical component of medical imaging 
examinations or radiation therapy treat-
ments prior to enactment of this section; 
and 
‘‘(ii) is ineligible to take the licensure 
or certification examination for that dis-
cipline. 
‘‘(4) PROCESS.— 
‘‘(A) REGULATIONS.—The Secretary shall, 
by July 1, 2012, promulgate regulations for 
designating certification organizations pursuant 
to this paragraph. 
‘‘(B) DESIGNATIONS AND LIST.—The Sec-
retary shall, by January 1, 2013, make deter-
minations regarding all certification organiza-
tions that have applied for designation pursuant 
to the regulations promulgated under subpara-
graph (A), and shall publish a list of all certifi-
cation organizations that have received designa-
tion. 
‘‘(C) PERIODIC REVIEW AND REVISION.— 
The Secretary shall periodically review the list, 
taking into account the factors established 
under paragraph (2). After such review, the 
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Secretary may, by regulation, modify the list of 
certification organizations that have received 
designation. 
‘‘(D) CERTIFICATIONS PRIOR TO REMOVAL 
FROM LIST.—If the Secretary removes a certifi-
cation organization from the list of certification 
organizations designated under subparagraph 
(B), any individual who was certified by the 
certification organization during or before the 
period beginning on the date on which the cer-
tification organization was designated as a cer-
tification organization under subparagraph (B) 
and ending on the date on which the certifi-
cation organization is removed from such list 
shall be considered to have been certified by a 
certification organization designated by the Sec-
retary under subparagraph (B) for the remain-
ing period that such certification is in effect. 
‘‘(d) APPROVED ACCREDITING BODIES.— 
‘‘(1) IN GENERAL.—The Secretary shall publish 
a list of entities that are approved accrediting bodies 
for certification organizations for purposes of sub-
section (c)(2)(E). The Secretary shall publish the 
list no later than 24 months after enactment of this 
section and shall revise the list as appropriate. 
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‘‘(2) REQUIREMENTS
FOR
APPROVAL.—The 
Secretary shall not approve an accrediting body for 
certification organizations unless the Secretary de-
termines that such accrediting body— 
‘‘(A) is a nonprofit organization; 
‘‘(B) is a national or international organi-
zation with accreditation programs for examina-
tions leading to certification by certification or-
ganizations; 
‘‘(C) has established standards for record-
keeping and to minimize the possibility of con-
flicts of interest; and 
‘‘(D) demonstrates compliance with any 
other requirements established by the Sec-
retary. 
‘‘(3) WITHDRAWAL
OF
APPROVAL.—The Sec-
retary may withdraw the approval of an accrediting 
body if the Secretary determines that the body does 
not meet the standards defined in paragraph (2). 
‘‘(e) ALTERNATIVE STANDARDS
FOR RURAL
AND 
UNDERSERVED AREAS.— 
‘‘(1) IN GENERAL.—The Secretary shall deter-
mine whether the standards established under sub-
section (a) must be met in their entirety for medical 
imaging examinations or radiation therapy proce-
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dures that are performed and planned in a geo-
graphic area that is determined by the Medicare Ge-
ographic Classification Review Board to be a ‘rural 
area’ or that is designated as a health professional 
shortage area. If the Secretary determines that al-
ternative standards for such rural areas or health 
professional shortage areas are appropriate to assure 
access to quality medical imaging examinations or 
radiation therapy procedures, the Secretary is au-
thorized to develop such alternative standards. 
‘‘(2) STATE DISCRETION.—The chief executive 
officer of a State may submit to the Secretary a 
statement declaring that an alternative standard de-
veloped under paragraph (1) is inappropriate for ap-
plication to such State, and such alternative stand-
ard shall not apply in such submitting State. The 
chief executive officer of a State may rescind a 
statement described in this paragraph following the 
provision of appropriate notice to the Secretary. 
‘‘(f) RULE
OF
CONSTRUCTION.—Notwithstanding 
any other provision of this section, individuals who provide 
medical imaging examinations relating to mammograms 
shall continue to meet the regulations applicable under the 
Mammography Quality Standards Act of 1992, as amend-
ed. 
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‘‘(g) DEFINITIONS.—As used in this section— 
‘‘(1) MEDICAL
IMAGING.—The term ‘medical 
imaging’ means any examination or procedure used 
to visualize tissues, organs, or physiologic processes 
in humans for the purpose of detecting, diagnosing, 
treating or impacting the progression of disease or 
illness. For purposes of this section, such term does 
not include routine dental diagnostic procedures or 
advanced imaging procedures as defined in section 
1834(e)(1)(B) of the Social Security Act. 
‘‘(2) PERFORM.—The term ‘perform’, with re-
spect to medical imaging or radiation therapy, 
means— 
‘‘(A) the act of directly exposing a patient 
to radiation including ionizing or radio fre-
quency radiation, to ultrasound, or to a mag-
netic field for purposes of medical imaging or 
for purposes of radiation therapy; and 
‘‘(B) the act of positioning a patient to re-
ceive such an exposure. 
‘‘(3) PLAN.—The term ‘plan’, with respect to 
medical imaging or radiation therapy, means the act 
of preparing for the performance of such a proce-
dure to a patient by evaluating site-specific informa-
tion, based on measurement and verification of radi-
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ation dose distribution, computer analysis, or direct 
measurement of dose, in order to customize the pro-
cedure for the patient. 
‘‘(4) RADIATION
THERAPY.—The term ‘radi-
ation therapy’ means any procedure or article in-
tended for use in the cure, mitigation, treatment, or 
prevention of disease in humans that achieves its in-
tended purpose through the emission of ionizing or 
non-ionizing radiation.’’. 
SEC. 4. PAYMENT AND STANDARDS FOR MEDICAL IMAGING 
AND RADIATION THERAPY. 
Section 1848(b)(4) of the Social Security Act (42 
U.S.C. 1395w–4(b)(4)) is amended— 
(1) in subparagraph (A), by striking the ‘‘imag-
ing’’ and inserting ‘‘medical imaging and radiation 
therapy’’ and; 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(C) PAYMENT
FOR
MEDICAL
IMAGING 
AND RADIATION THERAPY SERVICES.—With re-
spect to expenses incurred for the planning and 
performing of the technical component of med-
ical imaging examinations or radiation therapy 
procedures furnished on or after January 1, 
2013, payment shall be made under this section 
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only if the examination or procedure is planned 
or performed by an individual who meets the 
requirements established by the Secretary under 
section 355 of the Public Health Service Act.’’. 
SEC. 5. REPORT ON THE EFFECTS OF THIS ACT. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Director of the Agen-
cy for Healthcare Research and Quality, shall submit to 
the Committee on Health, Education, Labor, and Pen-
sions of the Senate, the Committee on Finance of the Sen-
ate, and the Committee on Energy and Commerce of the 
House of Representatives, a report on the effects of this 
Act no later than 5 years after the date of the enactment 
of this Act. 
(b) REQUIREMENTS.—Such report shall include the 
types and numbers of individuals qualified to perform or 
plan the technical component of medical imaging or radi-
ation therapy services for whom standards have been de-
veloped, the impact of such standards on diagnostic accu-
racy and patient safety, and the availability and cost of 
services. Entities reimbursed for technical services 
through programs operating under the authority of the 
Secretary of Health and Human Services shall be required 
to contribute data to such report. 
Æ 
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