I 
111TH CONGRESS 
1ST SESSION H. R. 3652 
To amend the Public Health Service Act and title XVIII of the Social 
Security Act to make the provision of technical services for medical 
imaging examinations and radiation therapy treatments safer, more accu-
rate, and less costly. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 25, 2009 
Mr. BARROW introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committee on 
Ways and Means, for a period to be subsequently determined by the 
Speaker, in each case for consideration of such provisions as fall within 
the jurisdiction of the committee concerned 
A BILL 
To amend the Public Health Service Act and title XVIII 
of the Social Security Act to make the provision of 
technical services for medical imaging examinations and 
radiation therapy treatments safer, more accurate, and 
less costly. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Consistency, Accuracy, 
Responsibility, and Excellence in Medical Imaging and 
Radiation Therapy Act of 2009’’. 
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SEC. 2. PURPOSE. 
The purpose of this Act is to improve the quality and 
value of health care by increasing the safety and accuracy 
of medical imaging examinations and radiation therapy 
procedures, thereby reducing duplication of services and 
decreasing costs. 
SEC. 3. QUALITY OF MEDICAL IMAGING AND RADIATION 
THERAPY. 
Part F of title III of the Public Health Service Act 
(42 U.S.C. 262 et seq.) is amended by adding at the end 
the following: 
‘‘Subpart 4—Medical Imaging and Radiation Therapy 
‘‘SEC. 355. QUALITY OF MEDICAL IMAGING AND RADIATION 
THERAPY. 
‘‘(a) QUALIFIED PERSONNEL.— 
‘‘(1) IN GENERAL.—Effective January 1, 2013, 
personnel who perform or plan the technical compo-
nent of either medical imaging examinations or radi-
ation therapy procedures for medical purposes must 
be qualified under this section to perform or plan 
such services. 
‘‘(2) QUALIFICATION.—Individuals qualified to 
perform or plan the technical component of medical 
imaging examinations or radiation therapy proce-
dures must— 
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‘‘(A) possess current certification in each 
medical imaging or radiation therapy modality 
and service provided from a certification organi-
zation designated by the Secretary pursuant to 
subsection (c); or 
‘‘(B) possess current State licensure, or 
certification, where— 
‘‘(i) such services and modalities are 
within the scope of practice as defined by 
the State for such profession; and 
‘‘(ii) the requirements for licensure, 
certification, or registration meet or exceed 
the standards established by the Secretary 
pursuant to this section. 
‘‘(3) STATE
LICENSURE, CERTIFICATION, OR 
REGISTRATION.— 
‘‘(A) Nothing in this section diminishes the 
authority of a State to define requirements for 
licensure, certification, or registration, the re-
quirements for practice, or the scope of practice 
of personnel. 
‘‘(B) The Secretary shall not take any ac-
tion under this section that would require licen-
sure by a State of those who perform or plan 
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the technical component of medical imaging ex-
aminations or radiation therapy procedures. 
‘‘(4) EXEMPTIONS.—The qualification stand-
ards described in this subsection shall not apply to 
physicians (as defined in section 1861(r) of the So-
cial Security Act (42 U.S.C. 1395x(r))) or to nurse 
practitioners and physician assistants (each as de-
fined in section 1861(aa)(5) of the Social Security 
Act (42 U.S.C. 1395x(aa)(5))). 
‘‘(b) ESTABLISHMENT OF STANDARDS.— 
‘‘(1) IN GENERAL.—For the purposes of deter-
mining compliance with subsection (a), the Sec-
retary, in consultation with recognized experts in the 
technical provision of medical imaging or radiation 
therapy services, shall establish minimum standards 
for personnel who perform, plan, evaluate, or verify 
patient dose for medical imaging examinations or ra-
diation therapy procedures. Such standards shall not 
apply to the equipment used. 
‘‘(2) EXPERTS.—For the purposes of this sub-
section, the Secretary shall select expert advisers to 
reflect a broad and balanced input from all sectors 
of the health care community that are involved in 
the provision of such services to avoid undue influ-
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ence from any single sector of practice on the con-
tent of such standards. 
‘‘(3) MINIMUM STANDARDS.—Minimum stand-
ards may vary in form for each of the covered dis-
ciplines, reflecting the unique or specialized nature 
of the technical services provided, and shall rep-
resent expert consensus from those practicing in 
each of the covered disciplines as to what constitutes 
excellence in practice and be appropriate to the par-
ticular scope of care involved. 
‘‘(4) ALLOWANCE
FOR
ADDITIONAL
STAND-
ARDS.—Nothing in this subsection shall be con-
strued to prohibit a State or certification organiza-
tion from requiring compliance with higher stand-
ards than the minimum standards specified by the 
Secretary pursuant to this subsection. 
‘‘(5) TIMELINE.—The Secretary shall promul-
gate regulations for the purposes of carrying out this 
subsection no later than 18 months after the date on 
which this section is enacted. 
‘‘(c) DESIGNATION
OF CERTIFICATION ORGANIZA-
TIONS.— 
‘‘(1) IN GENERAL.—The Secretary shall estab-
lish a program for designating certification organiza-
tions that the Secretary determines have established 
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appropriate procedures and programs for certifying 
personnel as qualified to furnish medical imaging or 
radiation therapy services. 
‘‘(2) FACTORS.—When designating certification 
organizations, and when reviewing or modifying the 
list of designated organizations for the purposes of 
paragraph (4)(B), the Secretary shall consider— 
‘‘(A) whether the certification organization 
has established certification requirements for 
individuals that are consistent with or exceed 
the minimum standards established in sub-
section (b); 
‘‘(B) whether the certification organization 
has established a process for the timely integra-
tion of new medical imaging or radiation ther-
apy services into the organization’s certification 
program; 
‘‘(C) whether the certification organization 
has established education and continuing edu-
cation requirements for individuals certified by 
the organization; 
‘‘(D) whether the organization has estab-
lished reasonable fees to be charged to those 
applying for certification; 
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