Consistency, Accuracy, Responsibility, and Excellence in Medical Imaging and Radiation Therapy Act of 2013 - Amends the Public Health Service Act to require personnel (excluding physicians, nurse practitioners, and physician assistants) who furnish the technical component of medical imaging examinations or radiation therapy procedures for medical purposes (except certain exempt individuals and suppliers) to possess current: (1) certification in the medical imaging or radiation therapy modality and service they furnish from a certification organization designated under this Act; and (2) state licensure or certification, if required by the state, where such services and modalities are within the profession's scope of practice as defined by the state.
Gives individuals enrolled in specified training or certification programs when the list of approved certification organizations is published an additional six months after completion of a training program to become fully qualified under this Act.
Directs the Secretary of Health and Human Services (HHS) to: (1) establish a program for designating certification organizations after consideration of specified criteria; (2) provide a process for individuals whose training or experience is determined to be equal to, or in excess of, that of a graduate of an accredited educational program in that specialty to demonstrate that their experience meets the educational standards for qualified personnel in their imaging modality or radiation therapy procedures; and (3) publish a list of designated certification organizations. Authorizes the Secretary to waive standards under this Act or to develop alternative standards for rural or health professional shortage areas as appropriate.
Amends title XVIII (Medicare) of the Social Security Act to allow Medicare payment for medical imaging and radiation therapy services only if the examination or procedure is furnished by an individual who meets this Act's requirements.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 642 Introduced in Senate (IS)]
113th CONGRESS
1st Session
S. 642
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.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
March 21, 2013
Mr. Enzi introduced the following bill; which was read twice and
referred to the Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
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 Representatives 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 2013''.
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 42 months after the date of
enactment of this section, personnel who furnish the technical
component of medical imaging examinations or radiation therapy
procedures for medical purposes (except exempt individuals and
suppliers as described in paragraph (4)) shall be fully
qualified under this section to furnish such services.
``(2) Qualifications.--Individuals qualified to furnish the
technical component of medical imaging examinations or
radiation therapy procedures shall--
``(A) possess current certification in the medical
imaging or radiation therapy modality or service they
furnish from a certification organization designated
under subsection (b); and
``(B) if a State requires the possession of
licensure, certification, or registration, possess
current State licensure or certifications where such
services and modalities are within the scope of
practice as defined by the State for such profession.
``(3) State licensure, certification, or registration.--
``(A) In general.--Nothing in this section shall be
construed to diminish the authority of a State to
define requirements for licensure, certification, or
registration, the requirements for practice, or the
scope of practice of personnel.
``(B) 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 procedures.
``(4) Exemptions.--
``(A) In general.--The qualification standards
described in this subsection and the limitation on
payment in section 1848(b)(4)(E) of the Social Security
Act (42 U.S.C. 1395w-4(b)(4)(E)) shall not apply to any
of the following:
``(i) Items and services furnished by a
physician (as defined in section 1861(r) of
such Act (42 U.S.C. 1395x(r))), a nurse
practitioner or a physician assistant (each as
defined in section 1861(aa)(5) of such Act (42
U.S.C. 1395x(aa)(5))). Such physicians and
practitioners shall not be included under the
terms `personnel' or `qualified personnel' for
purposes of this section.
``(ii) Advanced diagnostic imaging services
(as defined in paragraph (1)(B) of section
1834(e) of such Act) furnished by a supplier
(as defined in paragraph (1)(C) of such Act)
for which the accreditation requirement under
such section is applicable.
``(B) Individuals currently enrolled.--Individuals
enrolled in a nuclear medicine, radiation therapy, or
medical physicist training or certification program as
of the date the Secretary publishes the list of
approved certification organizations shall have 6
months from the date of completion of the training
program to become fully qualified as required under
paragraph (1).
``(b) Designation of Certification Organizations.--
``(1) 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 services. In establishing such program, the Secretary
shall consult with professional organizations and recognized
experts in the technical component of medical imaging and
radiation therapy services.
``(2) Factors.--
``(A) In general.--When designating certification
organizations under this subsection, and when reviewing
or modifying the list of designated organizations for
the purposes of paragraph (4)(B), the Secretary--
``(i) shall consider--
``(I) 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 program;
``(II) whether the certification
organization has established education
and continuing education requirements
for individuals certified by the
organization;
``(III) whether the certification
organization is a nonprofit
organization;
``(IV) whether the certification
organization requires completion of a
certification examination as a
prerequisite for certification; and
``(V) whether the certification
organization has been accredited by an
accrediting body (as defined in
subparagraph (B)) that is approved by
the Secretary; and
``(ii) may consider--
``(I) whether the certification
organization has established reasonable
fees to be charged to those applying
for certification; and
``(II) the ability of the
certification organization to review
applications for certification in a
timely manner.
``(B) Accrediting body.--For purposes of this
section, the term `accrediting body' means an
organization that--
``(i) is a nonprofit organization;
``(ii) is a national or international
organization with accreditation programs for
examinations leading to certification by
certification organizations; and
``(iii) has established standards for
recordkeeping and to minimize the possibility
of conflicts of interest.
``(3) Equivalent education, training, and experience.--
``(A) In general.--For purposes of this section,
the Secretary shall, through regulation, provide a
process for individuals whose training or experience
are determined to be equal to, or in excess of, 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 procedures.
Such process may include documentation of items such
as--
``(i) years and type of experience;
``(ii) a list of settings where experience
was obtained; and
``(iii) verification of experience by
supervising physicians or clinically qualified
hospital personnel.
``(B) 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
(A) unless such individual was furnishing the technical
component of medical imaging examinations or radiation
therapy treatments prior to the date of enactment of
this section.
``(4) Process.--
``(A) Regulations.--Not later than 12 months after
the date of enactment of this section, the Secretary
shall promulgate regulations for designating
certification organizations pursuant to this
subsection.
``(B) Designations and list.--Not later than 18
months after the date of enactment of this section, the
Secretary shall make determinations regarding all
certification organizations that have applied for
designation pursuant to the regulations promulgated
under subparagraph (A), and shall publish a list of all
certification organizations that have received a
designation.
``(C) Periodic review and revision.--The Secretary
shall periodically review the list under subparagraph
(B), taking into account the factors under paragraph
(2). After such review, the Secretary may, by
regulation, modify the list of certification
organizations that have received such designation.
``(D) Withdrawal of approval.--The Secretary may
withdraw the approval of a certification organization
listed under subparagraph (B) if the Secretary
determines that the body no longer meets the
requirements of subsection (b).
``(E) Certifications prior to removal from list.--
If the Secretary removes a certification 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
certification organization was designated as a
certification organization under such subparagraph, and
ending 12 months from the date on which the
certification organization is removed from such list,
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 effect.
``(c) 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 (a)
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' (as such term is defined for
purposes of section 1886(d)(2)(D) of the Social Security Act) or that
is designated as a health professional shortage area (as defined in
section 332 of this Act). Upon receipt of such statement, if the
Secretary deems it appropriate, the Secretary may waive the standards
described in subsection (a) or develop alternative standards for such
rural areas or health professional shortage areas.
``(d) 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.
``(e) Definition.--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 or ophthalmologic diagnostic
procedures or ultrasound guidance of vascular access
procedures.
``(2) Radiation therapy.--The term `radiation therapy'
means any procedure or article intended for use in the cure,
mitigation, treatment, or prevention of disease in humans that
achieves its intended purpose through the emission of ionizing
or non-ionizing radiation.''.
SEC. 4. 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 by adding at the end the following new
subparagraph:
``(E) 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 (as defined in subsection (e) of
section 355 of the Public Health Service Act) on or
after 42 months after the date of enactment of the
Consistency, Accuracy, Responsibility, and Excellence
in Medical Imaging and Radiation Therapy Act of 2013,
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 355 (other than an individual
described in subsection (a)(4)(A) of such section).''.
SEC. 5. REPORT ON THE EFFECTS OF THIS ACT.
(a) In General.--Not later than 5 years after the date of enactment
of this Act, the Secretary of Health and Human Services, shall submit
to the Committee on Health, Education, Labor, and Pensions of the
Senate, the Committee on Finance of the Senate, and the Committee on
Energy and Commerce of the House of Representatives, a report on the
effects of this Act.
(b) Requirements.--The report under subsection (a) 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 developed, the impact of such standards on
diagnostic accuracy 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.
<all>
Introduced in Senate
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
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