,i #aacth ,,congress #ast ,session ,h4 ,r4 #aadf ,,in ,,the ,,house ,,of ,,representatives ,march #ac1 #bjac ,mr4 ,whitfield 7for himself1 ,mr4 ,barrow of ,georgia1 and ,ms4 ,schwartz7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committee on ,ways and ,means1 for a period to be subsequently determined by the ,speaker1 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 safer1 more accurate1 and less costly4 #a4 ,short title ,this ,act may be cited as the ,consistency1 ,accuracy1 ,responsibility1 and ,excellence in ,medical ,imaging and ,radiation ,therapy ,act of #bjac4 #b4 ,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 procedures1 thereby reducing duplication of services and decreasing costs4 #c4 ,quality of medical imaging and radiation therapy ,part ,f of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bfb et seq47 is amended by adding at the end the following3 #d ,medical imaging and radiation therapy #cee4 ,quality of medical imaging and radiation therapy 7a7 ,qualified personnel 7#a7 ,in general ,effective #db months after the date of enactment of this section1 personnel who furnish the technical component of either medical imaging examinations or radiation therapy procedures for medical purposes 7except exempt individuals as described in paragraph 7#d77 shall be fully qualified under this section to furnish such services4 7#b7 ,qualifications ,individuals qualified to furnish the technical component of medical imaging examinations or radiation therapy procedures shall-- 7,a7 possess current certification in the medical imaging or radiation therapy modality or service they furnish from a certification organization designated under subsection 7b72 or 7,b7 possess current ,state licensure or certification1 where-- 7i7 such services and modalities are within the scope of practice as defined by the ,state for such profession2 and 7ii7 the requirements for licensure1 certification1 or registration meet or exceed the standards established by the certification organization designated under subsection 7b74 7#c7 ,state licensure1 certification1 or registration 7,a7 ,in general ,nothing in this section shall be construed to diminish the authority of a ,state to define requirements for licensure1 certification1 or registration1 the requirements for practice1 or the scope of practice of personnel4 7,b7 ,limitation ,the ,secretary shall not take any action under this section that would require licensure by a ,state of personnel who furnish the technical component of medical imaging examinations or radiation therapy procedures4 7#d7 ,exemptions 7,a7 ,in general ,the qualification standards described in this subsection and the payment provisions in section #ahdh7;b77#d77;,e7 of the ,social ,security ,act shall not apply to physicians 7as defined in section #ahfa7r7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7r777 or to nurse practitioners and physician assistants 7each as defined in section #ahfa7;aa77#e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7aa77#e7774 ,such practitioners shall not be included under the terms personnel or qualified personnel for purposes of this section4 7,b7 ,individuals currently enrolled ,individuals currently enrolled in a nuclear medicine1 radiation therapy1 or medical physicist training or certification program as of the date the ,secretary publishes the list of approved certification organizations shall have #f months from the date of completion of the training program to become fully qualified as required under subsection 7a74 7b7 ,designation of certification organizations 7#a7 ,in general ,the ,secretary shall establish a program for designating medical imaging or radiation therapy certification organizations that the ,secretary determines have established appropriate procedures and programs for certifying personnel as qualified to furnish medical imaging or radiation therapy services4 ,in establishing such program1 the ,secretary shall consult with professional organizations and recognized experts in the technical component of medical imaging and radiation therapy services4 7#b7 ,factors 7,a7 ,in general ,when designating certification organizations under this subsection1 and when reviewing or modifying the list of designated organizations for the purposes of paragraph 7#d77;,b71 the ,secretary-- 7i7 shall consider-- 7,i7 whether the certification organization has established a process for the timely integration of new medical imaging or radiation therapy services into the organization's certification program2 7,,ii7 whether the certification organization has established education and continuing education requirements for individuals certified by the organization2 7,,iii7 whether the certification organization is a nonprofit organization2 7,,iv7 whether the certification organization requires completion of a certification examination as a prerequisite for certification2 and 7,v7 whether the certification organization has been accredited by an accrediting body 7as defined in subparagraph 7,b77 that is approved by the ,secretary2 and 7ii7 may consider-- 7,i7 whether the certification organization has established reasonable fees to be charged to those applying for certification2 and 7,,ii7 the ability of the certification organization to review applications for certification in a timely manner4 7,b7 ,accrediting body ,for purposes of this section1 the term accrediting body means an organization that-- 7i7 is a nonprofit organization2 7ii7 is a national or international organization with accreditation programs for examinations leading to certification by certification organizations2 and 7iii7 has established standards for recordkeeping and to minimize the possibility of conflicts of interest4 7#c7 ,equivalent education1 training1 and experience 7,a7 ,in general ,for purposes of this section1 the ,secretary shall1 through regulation1 provide a process for individuals whose training or experience are determined to be equal to1 or in excess of1 those of a graduate of an accredited educational program in that specialty to demonstrate their experience meets the educational standards for qualified personnel in their imaging modality or radiation therapy procedures4 ,such process may include documentation of items such as-- 7i7 years and type of experience2 7ii7 a list of settings where experience was obtained2 and 7iii7 verification of experience by supervising physicians or clinically qualified hospital personnel4 7,b7 ,eligibility ,the ,secretary shall not recognize any individual as having met the educational standards applicable under this paragraph based on experience pursuant to the authority of subparagraph 7,a7 unless such individual was furnishing the technical component of medical imaging examinations or radiation therapy treatments prior to the date of enactment of this section4 7#d7 ,process 7,a7 ,regulations ,not later than #ab months after the date of enactment of this section1 the ,secretary shall promulgate regulations for designating certification organizations pursuant to this subsection4 7,b7 ,designations and list ,not later than #ah months after the date of enactment of this section1 the ,secretary shall make determinations regarding all certification organizations that have applied for designation pursuant to the regulations promulgated under subparagraph 7,a71 and shall publish a list of all certification organizations that have received a designation4 7,c7 ,periodic review and revision ,the ,secretary shall periodically review the list under subparagraph 7,b71 taking into account the factors established under paragraph 7#b74 ,after such review1 the ,secretary may1 by regulation1 modify the list of certification organizations that have received such designation4 7,d7 ,withdrawal of approval ,the ,secretary may withdraw the approval of a certification organization listed under subparagraph 7,b7 if the ,secretary determines that the body no longer meets the requirements of this subsection4 7,e7 ,certifications prior to removal from list ,if the ,secretary removes a certification organization from the list of certification organizations designated under subparagraph 7,b71 any individual who was certified by the certification organization during or before the period beginning on the date on which the certification organization was designated as a certification organization under such subparagraph1 and ending #ab months from the date on which the certification organization is removed from such list1 shall be considered to have been certified by a certification organization designated by the ,secretary under such subparagraph for the remaining period that such certification is in effect4 7c7 ,alternative standards for rural and underserved areas ,the chief executive officer of a ,state may submit to the ,secretary a statement declaring that the requirements described in subsection 7a7 are inappropriate for application for medical imaging examinations or radiation therapy procedures that are furnished in a geographic area that is determined to be a rural area 7as such term is defined for purposes of section #ahhf7;d77#b77;,d7 of the ,social ,security ,act7 or that is designated as a health professional shortage area 7as defined in section #ccb of this ,act74 ,upon receipt of such statement1 if the ,secretary deems it appropriate1 the ,secretary may waive the standards described in subsection 7a7 or develop alternative standards for such rural areas or health professional shortage areas4 7d7 ,rule of construction ,notwithstanding any other provision of this section1 individuals who provide medical imaging examinations relating to mammograms shall continue to meet the regulations applicable under the ,mammography ,quality ,standards ,act of #aiib4 7e7 ,definition ,as used in this section3 7#a7 ,medical imaging ,the term medical imaging means any examination or procedure used to visualize tissues1 organs1 or physiologic processes in humans for the purpose of detecting1 diagnosing1 treating1 or impacting the progression of disease or illness4 ,for purposes of this section1 such term does not include routine dental or ophthalmologic diagnostic procedures or ultrasound guidance of vascular access procedures4 7#b7 ,radiation therapy ,the term radiation therapy means any procedure or article intended for use in the cure1 mitigation1 treatment1 or prevention of disease in humans that achieves its intended purpose through the emission of ionizing or non-ionizing radiation4 4 #d4 ,standards for medical imaging and radiation therapy ,section #ahdh7;b77#d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#d7;b77#d77 is amended by adding at the end the following new subparagraph3 7,e7 ,standards for medical imaging and radiation therapy ,with respect to expenses incurred in the furnishing of the technical component of medical imaging examinations or radiation therapy procedures for medical purposes 7as defined in subsection 7e7 of section #cee of the ,public ,health ,service ,act7 on or after #db months after date of enactment of the ,consistency1 ,accuracy1 ,responsibility1 and ,excellence in ,medical ,imaging and ,radiation ,therapy ,act of #bjac1 payment shall be made under this section only if the examination or procedure is furnished by an individual who meets the standards established by the ,secretary under such section #cee 7other than an individual described in subsection 7a77#d77;,b77i7 of such section74 4 #e4 ,report on the effects of this act 7a7 ,in general ,not later than #e years after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services1 shall submit to the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate1 the ,committee on ,finance of the ,senate1 and the ,committee on ,energy and ,commerce of the ,house of ,representatives1 a report on the effects of this ,act4 7b7 ,requirements ,the report under subsection 7a7 shall include the types and numbers of individuals qualified to furnish the technical component of medical imaging or radiation therapy services for whom standards have been developed1 the impact of such standards on diagnostic accuracy and patient safety1 and the availability and cost of services4 ,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 report4