PRINTER'S NO. 1555
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
1440
Session of
2021
INTRODUCED BY MILLARD, NEILSON, DeLUCA, PICKETT, RADER,
SCHWEYER, JAMES, FRITZ, KAUFER, WHEELAND AND BIZZARRO,
MAY 17, 2021
REFERRED TO COMMITTEE ON PROFESSIONAL LICENSURE, MAY 17, 2021
AN ACT
Amending the act of December 20, 1985 (P.L.457, No.112),
entitled "An act relating to the right to practice medicine
and surgery and the right to practice medically related acts;
reestablishing the State Board of Medical Education and
Licensure as the State Board of Medicine and providing for
its composition, powers and duties; providing for the
issuance of licenses and certificates and the suspension and
revocation of licenses and certificates; provided penalties;
and making repeals," further providing for definitions and
for State Board of Medicine; providing for medical imaging
professionals, radiation therapists, radiologist assistants
and related fields; repealing provisions relating to
radiologic procedures and education and training required;
and making related and inconsistent repeals.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Section 2 of the act of December 20, 1985
(P.L.457, No.112), known as the Medical Practice Act of 1985, is
amended by adding definitions to read:
Section 2. Definitions.
The following words and phrases when used in this act shall
have the meanings given to them in this section unless the
context clearly indicates otherwise:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
* * *
"Accredited program." A program in medical imaging or
radiation therapy that is accredited by an accrediting agency
recognized and approved by the United States Department of
Education.
* * *
"Certification organization." A national organization that
specializes in the certification and registration of medical
imaging or radiation therapy technical personnel and is
accredited by the National Commission for Certifying Agencies,
the American National Standards Institute or another
accreditation organization recognized by the board.
* * *
"Computed tomography." The process of producing sectional or
three-dimensional images using external ionizing radiation for
diagnostic or therapeutic purposes.
* * *
"Diagnostic medical sonography." The use of high-frequency
sound waves with specialized equipment to direct the sound waves
into an area of the human body to generate a diagnostic image
for diagnostic or therapeutic purposes.
* * *
"Fluoroscopy." The exposure of a patient to x-rays in a
fluoroscopy mode, including positioning the patient and
fluoroscopy equipment and the selection of exposure factors.
* * *
"Ionizing radiation." Radiation that consists of alpha
particles, beta particles, gamma rays, x-rays, neutrons, high-
speed electrons, high-speed protons or other particles capable
of producing ions. The term does not include non-ionizing
20210HB1440PN1555 - 2 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
radiation, including high-frequency sound waves, magnetic
fields, microwaves, radiofrequency signals or visible, infrared
or ultraviolet light.
* * *
"Licensed practitioner." An individual who is licensed to
practice medicine, dentistry, podiatry or osteopathy in this
Commonwealth.
"Limited x-ray machine operator." An individual who is
licensed to perform only x-ray procedures that do not involve
the administration or utilization of contrast media on selected
specific parts of the human anatomy under the supervision of a
licensed practitioner.
"Magnetic resonance imaging." The creation or acquisition of
images generated by using radiofrequency signals within a
magnetic field for diagnostic or therapeutic purposes.
* * *
"Medical imaging." A modality used to produce images of the
internal structures of the human body for diagnostic,
interventional or therapeutic purposes through the use of
electromagnetic waves, sound waves, radio waves, magnetic
fields, ionizing radiation or radioactive materials.
"Medical imaging, radiation therapy or radiologist assistant
license." A license to use radioactive substances or equipment
emitting high-frequency sound waves, ionizing radiation,
magnetic fields or radiofrequency signals for medical imaging or
radiation therapy procedures on humans for diagnostic or
therapeutic purposes in this Commonwealth in accordance with
section 13.7.
"Medical imaging professional." An individual, other than a
physician, an osteopathic physician or a podiatrist, who has
20210HB1440PN1555 - 3 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
undergone appropriate training and testing by a certification
organization to become a medical imaging licensee in the
modality in which the individual's practices, including any of
the following:
(1) Diagnostic medical sonography.
(2) Advanced medical sonography.
(3) Fluoroscopy.
(4) Limited x-ray machine operations.
(5) Magnetic resonance imaging.
(6) Nuclear medicine technology.
(7) Radiography.
* * *
"Mobile imaging." An arrangement in which medical imaging
services are transported to various sites. The term does not
include movement within a hospital or movement to a site where
the equipment will be located permanently.
* * *
"Nuclear medicine technology." Medical imaging that utilizes
sealed and unsealed radioactive materials for diagnostic,
treatment and research purposes. The term includes any of the
following:
(1) The procurement, preparation and administration of
radiopharmaceuticals, adjunctive and imaging medications.
(2) The combination of nuclear medicine instrumentation
with computed tomography, magnetic resonance imaging or other
modalities to produce a three-dimensional image with or
without adjunctive and imaging medications to enhance the
evaluation of physiological processes at a molecular level.
* * *
"Radiation therapist." An individual, other than a physician
20210HB1440PN1555 - 4 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
or an osteopathic physician, who has undergone appropriate
training and testing by a certification organization to become a
radiation therapist.
"Radiation therapy." The use of ionizing radiation for
treating disease.
"Radiography." The process of obtaining an image using
external ionizing radiation for diagnostic or therapeutic
purposes.
"Radiologist." A physician who is licensed in this
Commonwealth and is board-eligible for certification as a
radiologist or is certified by the American Board of Radiology,
the American Osteopathic Board of Radiology, the Royal College
of Radiology or the Royal College of Physicians and Surgeons of
Canada as a radiologist.
"Radiologist assistant." An individual, other than a
physician or an osteopathic physician, who meets all of the
following criteria:
(1) The individual has undergone appropriate training
and testing by a certification organization to become a
radiologist assistant.
(2) The individual works under the supervision of a
radiologist.
(3) The individual does not interpret imaging, render
diagnoses or prescribe medications or therapies.
* * *
"Specialization." A medical specialty area or type of
equipment used within a medical imaging or radiation therapy
modality, which has a corresponding certification from a
certification organization recognized by the board.
* * *
20210HB1440PN1555 - 5 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Section 2. Section 3(a) and (b) of the act are amended to
read:
Section 3. State Board of Medicine.
(a) Establishment.--The State Board of Medicine shall
consist of the commissioner or his designee, the Secretary of
Health or his designee, two members appointed by the Governor
who shall be persons representing the public at large and seven
members appointed by the Governor, six of whom shall be medical
doctors with unrestricted licenses to practice medicine and
surgery in this Commonwealth for five years immediately
preceding their appointment and one who shall be a nurse
midwife, physician assistant, certified registered nurse
practitioner, respiratory therapist, licensed athletic trainer
[or], perfusionist or a medical imaging professional, radiation
therapist or radiologist assistant licensed or certified under
the laws of this Commonwealth. All professional and public
members of the board shall be appointed by the Governor, with
the advice and consent of a majority of the members elected to
the Senate.
(b) Terms of office.--The term of each professional and
public member of the board shall be four years or until his or
her successor has been appointed and qualified, but not longer
than six months beyond the four-year period. In the event that
any of said members shall die or resign or otherwise become
disqualified during his or her term, a successor shall be
appointed in the same way and with the same qualifications and
shall hold office for the unexpired term. No member shall be
eligible for appointment to serve more than two consecutive
terms. The Governor shall assure that nurse midwives, physician
assistants, certified registered nurse practitioners,
20210HB1440PN1555 - 6 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
perfusionists [and], respiratory therapists and medical imaging
professionals, radiation therapists or radiologist assistants
are appointed to four-year terms on a rotating basis so that, of
every [four] five appointments to a four-year term, one is a
nurse midwife, one is a physician assistant, one is a certified
registered nurse practitioner [and], one is a respiratory
therapist and one is a medical imaging professional, radiation
therapist or radiologist assistant.
* * *
Section 3. The act is amended by adding a section to read:
Section 13.7. Medical imaging professionals, radiation
therapists, radiologist assistants and related
fields.
(a) Functions.--A medical imaging professional, radiation
therapist or radiologist assistant shall perform the functions
of the modality in which the medical imaging professional,
radiation therapist or radiologist assistant is licensed and any
related specializations. The functions under this subsection
shall include any of the following:
(1) Diagnostic medical sonography.
(2) Magnetic resonance imaging.
(3) Nuclear technology medicine.
(4) Radiation therapy.
(5) Radiography.
(6) Radiologist assistant.
(b) License required.--On or after January 1, 2024, an
individual who is not licensed under this section may not
perform or offer to perform medical imaging or radiation therapy
procedures on humans for diagnostic, interventional or
therapeutic purposes. A person, practice or business entity may
20210HB1440PN1555 - 7 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
not knowingly employ an individual who does not hold a license
under this section or is not exempt from the license
requirements under this section to perform medical imaging or
radiation therapy procedures on humans for diagnostic or
therapeutic purposes.
(c) License standards.--The board shall issue a license to
an individual who meets the standards established for
certification by a certification organization. The board shall
issue a license for two years and may renew the license upon the
completion of the license renewal requirements, including
continuing education requirements approved by the board.
(d) License requirements.--
(1) An individual seeking to obtain a license for a
medical imaging or radiation therapy modality shall comply
with all of the following requirements:
(i) The individual shall at least be 18 years of age
at the time of application.
(ii) The individual shall have a high school diploma
or pass an approved equivalency test.
(iii) The individual shall satisfactorily complete a
course of study in diagnostic medical sonography,
magnetic resonance imaging, nuclear medicine technology,
radiation therapy or radiography or an equivalent course
of study determined by the board.
(iv) The individual shall pass an applicable
modality or specialization examination administered by a
certification organization. If an individual holds a
current certification and registration in a medical
imaging or radiation therapy modality on the effective
date of this section, the board shall deem that the
20210HB1440PN1555 - 8 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
individual has met the requirements under this
subparagraph.
(v) The individual shall pay applicable license
fees.
(2) In addition to the requirements for a medical
imaging or radiation therapist license under paragraph (1),
an individual seeking to obtain a license as a radiologist
assistant shall comply with all of the following
requirements:
(i) The individual shall hold a current license as a
radiographer and be currently certified and registered as
a radiographer by the American Registry of Radiologic
Technologists.
(ii) The individual shall hold a current
certification and registration as a radiologist assistant
by the American Registry of Radiologic Technologists or
as a radiology practitioner assistant by the
Certification Board of Radiology Practitioner Assistants.
(iii) The individual shall submit clinical protocols
signed by the supervising radiologist to the board
specifying procedures that are performed by the
individual, the levels of radiologist supervision and the
location of practice designated by the supervising
radiologist. The individual shall submit updated
protocols under this subparagraph biennially to the board
and consistent with license renewal.
(e) Scope of practice and limitations.--
(1) A radiologist assistant scope of practice shall be
consistent with the Radiologist Assistant Practice Standards
published by the American Society of Radiologic Technologists
20210HB1440PN1555 - 9 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
published on the effective date of this section. An
individual licensed as a radiologist assistant may not
interpret images, make diagnoses or prescribe medications or
therapies.
(2) The board shall establish by regulation the scope of
practice, education, certification, continuing education and
licensure standards for an individual performing, under the
supervision of a physician, a medical imaging modality and
any related specializations, including any of the following:
(i) Diagnostic medical sonography.
(ii) Advanced medical sonography.
(iii) Fluoroscopy.
(iv) Limited x-ray machine operations.
(v) Magnetic resonance imaging.
(vi) Nuclear medicine technology.
(vii) Radiography.
(viii) Radiologist assistant.
(3) The board shall establish by regulation the scope of
practice, education, continuing education and licensure
standards for an individual performing radiation therapist
duties under the supervision of a physician.
(4) In establishing the scope of practice, education,
continuing education and licensure standards under paragraph
(3), the board may review and adopt the current standards of
the certification organization of each medical imaging and
radiation therapy modality.
(5) An individual licensed as a fluoroscopy operator
shall only perform fluoroscopy within the scope of the
license issued to the individual and may not perform computed
tomography, diagnostic medical sonography, magnetic resonance
20210HB1440PN1555 - 10 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
imaging, mammography, mobile imaging, nuclear medicine
technology, radiography or radiation therapy procedures.
(6) An individual licensed as a limited x-ray machine
operator shall perform tasks or procedures only within the
scope of the specific permit issued to the individual by the
board for a particular area of the human anatomy and may not
perform procedures involving the administration and
utilization of contrast media or perform computed tomography,
diagnostic medical sonography, fluoroscopy, magnetic
resonance imaging, mammography, mobile imaging, nuclear
medicine technology or radiation therapy.
(7) A licensee under this section may use radioactive
substances or equipment emitting ionizing radiation, high-
frequency sound waves or magnetic resonance and perform
medical imaging and radiation therapy procedures on humans
for diagnostic or therapeutic purposes only:
(i) with a valid prescription of a person authorized
by the Commonwealth to prescribe medical imaging and
radiation therapy procedures;
(ii) under the supervision of a licensed
practitioner; and
(iii) within the scope of the license as specified
under this chapter and under regulations adopted by the
board and in a modality for which the licensee is
licensed.
(8) A licensee under this section may not make a
diagnostic interpretation of an image, make a diagnosis or
prescribe a medication or therapy.
(f) Current certification.--An individual currently
registered and certified by a certification organization on the
20210HB1440PN1555 - 11 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
effective date of this section shall immediately qualify for a
license under this section.
(g) Use of title.--An individual may not indicate or
otherwise imply that an individual is certified or licensed to
perform medical imaging or radiation therapy procedures in a
medical imaging modality unless the individual is currently
licensed in the medical imaging modality to perform medical
imaging or radiation therapy procedures.
(h) Fluoroscopy and computed tomography.--
(1) An applicant for a fluoroscopy operator license
shall be a physician assistant licensed in this Commonwealth
who meets all of the following requirements:
(i) The applicant shall complete 40 hours of
didactic education in radiation safety, radiation
protection, equipment operation, image acquisition and
patient positioning.
(ii) The applicant shall complete 40 hours of
clinical education supervised by a radiologist or
radiographer.
(iii) The applicant shall successfully complete the
fluoroscopy examination of a certification organization.
(2) An individual who is licensed as a fluoroscopy
operator in this Commonwealth shall only perform fluoroscopy
within the scope of the individual's license and may not
perform computed tomography, diagnostic medical sonography,
magnetic resonance imaging, mammography, mobile imaging,
nuclear medicine technology, radiography or radiation
therapy.
(3) On and after October 1, 2025, a licensee under this
section who performs computed tomography for diagnostic
20210HB1440PN1555 - 12 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
purposes shall receive a certification in computed tomography
by the American Registry of Radiologic Technologists, Nuclear
Medicine Technologist Certification Board or other
certification organization.
(i) Limitation or expansion of practice.--Nothing in this
section relating to medical imaging or radiation therapy shall
be construed to limit or expand the practice of a licensed
practitioner.
(j) Exemptions.--This section shall not apply to any of the
following:
(1) A licensed practitioner performing medical imaging
or radiation therapy procedures.
(2) A dental hygienist currently licensed in this
Commonwealth.
(3) A dental assistant currently licensed in this
Commonwealth
(4) A resident physician or student enrolled in and
attending a school or college of medicine, chiropractic,
podiatry, medical imaging or radiation therapy who performs
authorized medical imaging or radiation therapy procedures on
humans while under the supervision of a licensed practitioner
or the supervision of an individual holding a license under
this section in the supervised modality. In accordance with
the regulations established by the board under this section,
a student enrolled in a medical imaging educational program
recognized by the board may be employed by a medical facility
affiliated with the educational program to perform authorized
medical imaging procedures for which the student has a
demonstrated competency if the medical imaging procedures are
performed under the supervision of a licensed practitioner or
20210HB1440PN1555 - 13 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
the supervision of an individual holding a license under this
section in the supervised modality.
(5) A licensed chiropractor or an individual under the
supervision of a chiropractor who is permitted to perform x-
rays under the act of December 16, 1986 (P.L.1646, No.188),
known as the Chiropractic Practice Act.
(6) An individual who is employed by the Federal
Government to perform medical imaging or radiation therapy
procedures associated with the employment.
(7) An individual performing sonography procedures
within the individual's scope of practice that is used to
assess information about a patient's immediate condition, is
limited to a focused imaging target and does not generate a
recorded diagnostic medical image, including assessment of
any of the following:
(i) Fetal presentation or heartbeat.
(ii) Fluid in a body cavity.
(iii) Foreign body position or location.
(iv) Fetal monitoring during active labor.
(v) An anatomical landmark or blood vessel for
vascular access or administration of anesthesia.
(8) An individual performing medical imaging or
radiation therapy procedures on nonhuman subjects or
cadavers.
(k) License renewal and maintenance.--
(1) A license under this section shall be subject to
biennial renewal. If at the time of application for renewal,
the applicant for license renewal has verified, by oath or
affirmation, that the applicant is not in violation of this
section, has complied with board's regulations under this
20210HB1440PN1555 - 14 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
section and has paid the license renewal fee, the board shall
renew the applicant's license under this section.
(2) A licensee under this section shall maintain current
certification and registration by a certification
organization throughout the licensure period and shall not be
required to duplicate the continuing education hours
submitted to the certification organization. The board may
require a licensee under this section to submit evidence of
current certification and registration by a certification
organization, which shall be deemed equivalent to the
continuing education requirements established by the board.
(3) As a condition of license renewal under this
section, an individual licensed as fluoroscopy operator or
limited x-ray machine operator shall complete continuing
education requirements established by the board.
(l) Advisory committees.--
(1) The board shall establish an ad hoc advisory
committee consisting of medical imaging professionals,
radiation therapists and radiologist assistants to assist the
board in promulgating the initial regulations for licensee
qualifications, standards and scope of practice for each
modality and specialization under this paragraph.
(2) The advisory committee under paragraph (1) shall
consist, at a minimum, of the following members:
(i) A radiologist licensed in this Commonwealth.
(ii) A radiographer.
(iii) A diagnostic medical sonographer.
(iv) A nuclear medicine technologist.
(v) A magnetic resonance imaging technologist.
(vi) A radiation therapist.
20210HB1440PN1555 - 15 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
(vii) A radiologist assistant.
(viii) A licensee in one of the modalities under
this section who is also a full-time educator in an
accredited program in medical imaging or radiation
therapy.
(3) The chairperson of the board shall preside over
meetings of the advisory committee under paragraph (1). The
chairperson shall appoint members of the advisory committee
under paragraph (1), schedule meetings and provide notice to
advisory committee members. Members of the advisory committee
under paragraph (1) shall be appointed from nominations
submitted by associations or organizations in this
Commonwealth representing medical imaging professionals,
radiation therapists and radiologist assistants.
Section 4. Section 45 of the act is repealed:
[Section 45. Radiologic procedures; education and training
required.
(a) Supervision.--On and after January 1, 1988, no auxiliary
personnel shall perform radiologic procedures on the premises of
a medical doctor unless such person is under the direct
supervision of a medical doctor and unless such person has
passed an examination approved by the board and administered in
accordance with section 812.1 of the act of April 9, 1929
(P.L.177, No.175), known as The Administrative Code of 1929,
provided that no such auxiliary personnel shall perform
radiologic procedures for therapeutic purposes unless the
medical doctor under whose direct supervision such auxiliary
personnel is acting is on the premises at the time the
radiologic procedures are performed.
(b) Exclusion.--The board shall have the authority, after
20210HB1440PN1555 - 16 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
notice and hearing, to prohibit an auxiliary personnel from
performing radiologic procedures if the continued performance of
radiologic procedures by the auxiliary personnel is determined
by the board to pose a threat to the health, safety or welfare
of the public.
(c) Penalty.--It shall be unlawful under this act to
knowingly permit radiologic procedures to be performed in
violation of this section or in violation of the regulations
promulgated or orders issued in accordance with this section.
(d) Education and testing.--No auxiliary personnel who has
or obtains a license, certificate or registration issued by, or
on behalf of, a board within the Bureau of Professional and
Occupational Affairs or a comparable board of another state, or
who has obtained certification as the result of satisfactory
completion of a test and an educational course accredited by an
accrediting body recognized by the board, shall be required to
undergo any additional education or testing pursuant to this
section if radiologic procedures were included in the education
or the examination which he or she was required to complete
successfully in order to be eligible for such license,
certificate, registration or certification.
(e) Definition.--As used in this section, the term
"radiologic procedures" means the use of ionizing radiation for
diagnostic or therapeutic purposes.]
Section 5. Repeals are as follows:
(1) The General Assembly declares the repeals under
paragraph (2) are necessary to effectuate the addition of
section 13.7 of the act.
(2) The following are repealed:
(i) Section 16.4 of the act of October 5, 1978
20210HB1440PN1555 - 17 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
(P.L.1109, No.261), known as the Osteopathic Medical
Practice Act, is repealed.
(ii) Section 21.2 of the act of March 2, 1956 (1955
P.L.1206, No.375), known as the Podiatry Practice Act,
repealed insofar as it is inconsistent with the addition
of section 13.7 of the act.
Section 6. This act shall take effect immediately.
20210HB1440PN1555 - 18 -
1
2
3
4
5
6
7