The American College of Radiology (ACR) reports that several states are considering breast, colon and lung cancer screening measures. West Virginia’s Senate passed a bill prohibiting prior authorization for imaging procedures. Maryland, Arizona and South Dakota deliberated over bills expanding the scope of practice for clinical nurse specialists and physician assistants (PAs).
Breast Cancer Screening
In Kansas, House Bill (HB) 2562 was referred to the Committee on Insurance and Pensions. If enacted, the bill would require carriers to cover diagnostic and supplemental breast screening examinations at least as favorably as coverage for screening mammography.
In Rhode Island, HB 7020 will be considered by the House Health and Human Services Committee. If enacted, the bill would require carriers to cover digital breast tomosynthesis screenings.
The Rhode Island Radiological Society supports the bill.
Colon Cancer Screening
In Mississippi, HB 812 was referred to the House Insurance Committee. If enacted, carriers would be required to cover all colorectal cancer examinations and laboratory tests specified in current American Cancer Society (ACS) guidelines for colorectal cancer screening of asymptomatic individuals. Coverage would be for enrollees 45 years of age or older, or under 45 years of age and at high risk for colorectal cancer according to current ACS guidelines.
Also in Mississippi, HB 932 and its companion bill Senate Bill (SB) 2666 were referred to their respective insurance committees. The bills would mandate carriers cover colorectal cancer screenings and laboratory tests for enrollees who meet any of the following criteria:
- Who are 45 years of age or older.
- Who are at high risk for colorectal cancer.
- Who are experiencing bleeding from the rectum or blood in the stool, or a change in bowel habits that lasts more than five days.
Carriers would also cover colorectal cancer examinations, preventative services and laboratory tests assigned a grade of "A" or "B" by the United States Preventative Services Task Force (USPSTF) for average-risk individuals, including the services that may be assigned a grade "A" or "B" in the future.
In Washington, HB 1939 was considered by the Health Care and Wellness Committee. If enacted, carriers offering a health plan issued on or after Jan. 1, 2023, would be prohibited from imposing enrollee cost sharing on colonoscopies performed as a result of a positive result on a non-colonoscopy preventive colorectal cancer screening test assigned either a grade “A “or “B” by the USPSTF.
The Washington Radiological Society is monitoring the bill.
Lung Cancer Screening
In Hawaii, HB 2391 was referred to the Committees on Health, Human Services, and Homelessness and Finance. Its companion bill (SB 3367) was referred to the Committees on Health and Ways and Means. If enacted, the bills would establish an early lung cancer screening task force to research steps and resources needed to implement. The chairperson of the task force would invite at least one representative from an organization representing healthcare providers with relevant expertise on lung cancer screening.
The Hawaii Radiological Society supports the measure.
Prior Authorization
In West Virginia, SB 40 passed the Senate and was referred to the House Health and Human Resources Committee. If enacted, health plans or policies issued or renewed on or after July 1, 2023, would be prohibited from requiring prior authorization for physician-prescribed tests to stage cancer, including computerized tomography scans, magnetic resonance imaging scans and positron emission tomography scans.
The West Virginia Radiological Society supports the measure.
Scope of Practice
In Arizona, the Senate is considering SB 1367 . Bill sponsors seek to change the practice agreement between a physician assistant (PA) and physician to a collaborative agreement.
In Maryland, HB 276 was considered by the Health and Government Operations Committee. Its companion bill (SB 513) will be considered by the Senate Education, Health, and Environmental Affairs Committee. The bill sponsors seek to permit clinical nurse specialists to order, perform and interpret diagnostic tests.
The Maryland Radiological Society is monitoring the bill.
In South Dakota, SB 134 was referred to the Health and Human Services Committee. Bill sponsors seek to change the practice agreement between a PA and physician to a collaborative agreement.
The South Dakota Radiological Society opposes the bill.
For more information: www.acr.org
April 22, 2024 
