[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1214 Introduced in House (IH)]







108th CONGRESS
  1st Session
                                H. R. 1214

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

                             March 11, 2003

  Mrs. Wilson of New Mexico introduced the following bill; which was 
            referred to the Committee on Energy and 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.

    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 ``Consumer Assurance of Radiologic 
Excellence Act''.

SEC. 2. STATE LICENSES REGARDING PRACTITIONERS OF MEDICAL IMAGING AND 
              RADIATION THERAPY; LIMITATION ON MEDICAID PAYMENTS FOR 
              PROCEDURES.

    Title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) is 
amended--
            (1) in section 1903(i) (42 U.S.C. 1396b(i))--
                    (A) in paragraph (20), by striking the period at 
                the end and inserting ``; or''; and
                    (B) by inserting after paragraph (20) the following 
                paragraph:
            ``(21) with respect to any amount expended on medical 
        imaging procedures or radiation therapy procedures unless the 
        State meets the requirements of section 1930A (relating to 
        State medical radiation licenses).''; and
            (2) by inserting after section 1930 the following section:

                   ``state medical radiation licenses

    ``Sec. 1930A. (a) State Licenses Regarding Medical Imaging and 
Radiation Therapy.--For purposes of section 1903(i)(21), a State meets 
the requirements of this section if the State demonstrates to the 
satisfaction of the Secretary that the law of the State has in effect 
the following policies:
            ``(1) Subject to paragraphs (2) and (3), it is unlawful for 
        an individual in the State to intentionally administer or plan 
        medical imaging procedures or radiation therapy procedures to 
        or for a patient for medical or chiropractic purposes unless 
        the individual has obtained from the State a license, 
        certificate, or other document that authorizes the individual 
        to administer such procedures in the State (referred to in this 
        section as a `medical radiation license').
            ``(2) Notwithstanding any other provision of this section, 
        the State deems an individual as holding a medical radiation 
        license if the individual is licensed in the State as a doctor 
        of medicine, osteopathy, dentistry, podiatry, or chiropractic.
            ``(3) The State requires an individual who administers or 
        plans medical imaging procedures or radiation therapy 
        procedures to obtain a medical radiation license from the 
        State, unless--
                    ``(A) the individual exclusively performs medical 
                ultrasound or echocardiography; or
                    ``(B) the individual is a student enrolled in an 
                educational institution or program that is accredited 
                pursuant to subsection (b)(2)(B) and, as a student, 
                intentionally administers medical imaging procedures or 
                radiation therapy procedures for medical or 
                chiropractic purposes under the supervision of an 
                individual who holds a medical radiation license 
                obtained from the State.
            ``(4) The State does not provide a medical radiation 
        license to an individual unless the individual meets--
                    ``(A) the criteria established under subsection (b) 
                by the Secretary; and
                    ``(B) such additional criteria as the State may 
                establish.
    ``(b) Issuance by Secretary of Minimum Licensing Criteria.--
            ``(1) In general.--Not later than 18 months after the date 
        of the enactment of the Consumer Assurance of Radiologic 
        Excellence Act, the Secretary shall by regulation issue 
        criteria that, for purposes of subsection (a)(4)(A), establish 
        the minimum standards for an individual to obtain a medical 
        radiation license from a State. In carrying out the preceding 
        sentence, the Secretary shall--
                    ``(A) establish such standards as the Secretary 
                determines to be appropriate for ensuring the quality 
                performance of medical imaging procedures and radiation 
therapy procedures; and
                    ``(B) ensure that the standards are at least as 
                protective of the public health as standards issued 
                under the Consumer-Patient Radiation Health and Safety 
                Act of 1981.
            ``(2) Certain standards.--The Secretary shall ensure that 
        standards under paragraph (1) are in accordance with the 
        following:
                    ``(A) The standards shall specify the educational 
                requirements for an individual to obtain a medical 
                radiation license, including, if applicable, 
                requirements regarding practical experience.
                    ``(B) The standards shall provide that an 
                educational requirement under subparagraph (A) is that 
                the education involved be provided by an educational 
                institution or program that is accredited by a 
                nonprofit private entity recognized by the Secretary 
                for purposes of this subsection.
                    ``(C) The standards shall specify the criteria that 
                an entity is required to meet in order to be recognized 
                by the Secretary as an accrediting entity under 
                subparagraph (B). Such criteria shall provide that an 
                entity will not be so recognized unless the entity 
                establishes accrediting criteria satisfactory to the 
                Secretary with respect to the quality of educational 
                institutions and programs in the areas of 
                administrative policies and procedures, curricula, 
                recordkeeping, faculty, administrative support, and 
                such other areas as the Secretary determines to be 
                appropriate.
            ``(3) Consultation.--In developing standards under 
        paragraph (1), the Secretary shall consult with organizations 
        that are nationally recognized for their expertise in education 
        and credentialing in medical imaging procedures and radiation 
        therapy procedures.
    ``(c) Definitions.--For purposes of this section:
            ``(1) The term `administer', with respect to medical 
        imaging procedures or radiation therapy procedures, means--
                    ``(A) the act of directly exposing a patient to 
                radiation via ionizing or RF radiation for purposes of 
                medical imaging or for purposes of radiation therapy; 
                and
                    ``(B) the act of positioning a patient to receive 
                such an exposure.
            ``(2) The term `medical imaging procedure' means any 
        procedure or article, excluding medical ultrasound procedures 
        or articles, intended for use in the diagnosis of disease or 
        other medical or chiropractic conditions in humans, including 
        diagnostic X-rays, nuclear medicine, and magnetic resonance 
        procedures.
            ``(3) The term `medical radiation license' has the meaning 
        indicated for such term in subsection (a)(1).
            ``(4) The term `plan', with respect to medical imaging 
        procedures or radiation therapy procedures, means the act of 
        preparing for the administering of such a procedure to a 
        patient by evaluating patient-specific or site-specific 
        information, based on computer analysis or direct measurement 
        of dose, in order to customize the procedure for the patient 
        and verifying appropriate dose administrations.
            ``(5) The term `radiation therapy procedure' means any 
        radiation procedure or article intended for the cure, 
        mitigation, or prevention of diseases or disorders in 
        humans.''.

SEC. 3. APPLICABILITY.

    With respect to the condition described in paragraph (21) of 
section 1903(i) of the Social Security Act (as inserted by section 2 of 
this Act):
            (1) Except as provided in paragraph (2), such condition 
        applies to the States on and after the first day of the first 
        calendar quarter that begins after the date on which the 
        Secretary of Health and Human Services promulgates the final 
        rule under section 1930A(b)(1) of the Social Security Act (as 
        added by section 2 of this Act).
            (2) If the Secretary determines that meeting such condition 
        requires State legislation (other than legislation 
        appropriating funds), the condition applies to the State 
        involved on and after the first day of the first calendar 
        quarter that begins after the close of the relevant session of 
        the State legislature. For purposes of the preceding sentence:
                    (A) The relevant session is the first regular 
                session of the State legislature that begins after the 
                date on which such final rule is promulgated by the 
                Secretary, subject to subparagraph (B).
                    (B) If the State has a two-year legislative 
                session, each year of the session is deemed to be a 
                separate regular session of the State legislature for 
                purposes of subparagraph (A).
                                 <all>