PRIOR PRINTER'S NOS. 1555, 2642
PRINTER'S NO. 2716
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
1440
Session of
2021
INTRODUCED BY MILLARD, NEILSON, DeLUCA, PICKETT, RADER,
SCHWEYER, JAMES, FRITZ, KAUFER, WHEELAND, BIZZARRO, MENTZER,
GAYDOS, HARKINS, MEHAFFIE AND HELM, MAY 17, 2021
AS AMENDED ON SECOND CONSIDERATION, HOUSE OF REPRESENTATIVES,
FEBRUARY 7, 2022
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, for
respiratory therapists, for perfusionist, for genetic
counselor and for prosthetists, orthotists, pedorthists and
orthotic fitters; providing for medical imaging
professionals, radiation therapists and radiologist
assistants; further providing for licenses and certificates
and general qualification; 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
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have the meanings given to them in this section unless the
context clearly indicates otherwise:
* * *
"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 purposes.
* * *
"Fluoroscopy." A medical procedure that makes a real-time
video of the movements inside a part of the body by passing x-
rays through the body over a period of time.
* * *
"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
radiation, including high-frequency sound waves, magnetic
fields, microwaves, radiofrequency signals or visible, infrared
or ultraviolet light.
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* * *
"Licensed practitioner." An individual who is a licensed
physician, dentist, chiropractor or podiatrist in this
Commonwealth .
"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 professional." An individual, other than a
licensed practitioner , who has undergone appropriate training
and testing by a certification organization to be licensed under
section 13.7 in the modality in which the individual practices,
including any of the following:
(1) Diagnostic medical sonography.
(2) Advanced medical sonography.
(3) Limited x-ray machine operations.
(4) Magnetic resonance imaging.
(5) Nuclear medicine technology.
(6) Radiography.
* * *
"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
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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 licensed
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 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
licensed physician, who has undergone appropriate
training and testing by a certification organization to
become a radiologist assistant.
* * *
"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.
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* * *
Section 2. Sections 13.1(a)(3), 13.3(f)(2), 13.4(e)(2) and
13.5(a)(1) of the act are amended to read:
Section 13.1. Respiratory therapists.
(a) Qualifications.--An individual shall be eligible to
apply for licensure as a respiratory therapist if that
individual satisfies all of the following:
* * *
(3) Has proved to the satisfaction of the board that the
individual is of good moral character and is not unfit or
unable to practice as a respiratory therapist by reason of
physical or mental impairment. In assessing the moral
character of an applicant with a criminal conviction, the
board shall conduct an individualized assessment in
accordance with 63 Pa.C.S. ยง 3113 (relating to consideration
of criminal convictions).
* * *
Section 13.3. Perfusionist.
* * *
(f) Qualifications.--An applicant shall be licensed to
practice perfusion under this act if the applicant meets all of
the following qualifications and has otherwise complied with the
provisions of this act:
* * *
(2) The person is of good moral character. In assessing
the moral character of an applicant with a criminal
conviction, the board shall conduct an individualized
assessment in accordance with 63 Pa.C.S. ยง 3113 (relating to
consideration of criminal convictions).
* * *
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Section 13.4. Genetic counselor.
* * *
(e) Qualifications.--An applicant shall be licensed to
practice genetic counseling under this act if the applicant
meets all of the following qualifications and has otherwise
complied with the provisions of this act:
* * *
(2) The person is of good moral character. In assessing
the moral character of an applicant with a criminal
conviction, the board shall conduct an individualized
assessment in accordance with 63 Pa.C.S. ยง 3113 (relating to
consideration of criminal convictions).
* * *
Section 13.5. Prosthetists, orthotists, pedorthists and
orthotic fitters.
(a) Licensure qualifications.--To qualify for licensure to
practice prosthetics, orthotics, pedorthics or orthotic fitting,
an applicant shall:
(1) Be of good moral character. In assessing the moral
character of an applicant with a criminal conviction, the
board shall conduct an individualized assessment in
accordance with 63 Pa.C.S. ยง 3113 (relating to consideration
of criminal convictions).
* * *
Section 3. The act is amended by adding a section to read:
Section 13.7. Medical imaging professionals, radiation
therapists and radiologist assistants.
(a) License required.--Beginning two years after the
effective date of this section, it shall be unlawful for an
individual who is not licensed under this section to perform or
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offer to perform medical imaging or radiation therapy procedures
on humans for diagnostic, interventional or therapeutic purposes
or practice as a medical imaging professional, radiation
therapist or radiologist assistant.
(b) Medical imaging professional license.--The board shall
issue a license as a medical imaging professional to an
applicant who meets all of the following requirements:
(1) Is at least 18 years of age.
(2) Submits an application and the required fee as
established by the board by regulation.
(3) Is of good moral character. In assessing the moral
character of an applicant with a criminal conviction, the
board shall conduct an individualized assessment in
accordance with 63 Pa.C.S. ยง 3113 (relating to consideration
of criminal convictions).
(4) Has a high school diploma or its equivalent.
(5) Satisfactorily completes a course of study in
diagnostic medical sonography, magnetic resonance imaging,
nuclear medicine technology or radiography or an equivalent
course of study determined by the board.
(6) Passes an applicable modality or specialization
examination administered by a certification organization
approved by the board.
(c) Medical imaging professional scope of practice.--A
medical imaging professional shall only perform the functions of
the modality in which the medical imaging professional has
received education and training, and certification by a
certification organization. The functions under this subsection
shall include any of the following:
(1) Diagnostic medical sonography.
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(2) Magnetic resonance imaging.
(3) Nuclear medicine technology.
(4) Radiography.
(d) Radiation therapist license.--The board shall issue a
license as a radiation therapist to an applicant who meets all
of the following requirements:
(1) Is at least 18 years of age.
(2) Submits an application and the required fee as
established by the board by regulation.
(3) Is of good moral character. In assessing the moral
character of an applicant with a criminal conviction, the
board shall conduct an individualized assessment in
accordance with 63 Pa.C.S. ยง 3113.
(4) Has a high school diploma or its equivalent.
(5) Satisfactorily completes a course of study in
radiation therapy or an equivalent course of study determined
by the board.
(6) Passes an applicable radiation therapy examination
administered by a certification organization approved by the
board.
(e) Radiation therapist scope of practice.--A radiation
therapist may use ionizing radiation to deliver radiation
therapy treatments, perform treatment simulation using medical
imaging modalities , plan treatment procedures and dosimetric
calculations as prescribed by a radiation oncologist AND EXECUTE
TREATMENT PLAN PROCEDURES AND DOSIMETRIC CALCULATIONS AS
PRESCRIBED BY A RADIATION ONCOLOGIST .
(f) Radiologist assistant license.--The board shall issue a
license as a radiology assistant to an applicant who meets all
of the following requirements:
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(1) Is at least 18 years of age.
(2) Submits an application and the required fee as
established by the board by regulation.
(3) Is of good moral character. In assessing the moral
character of an applicant with a criminal conviction, the
board shall conduct an individualized assessment in
accordance with 63 Pa.C.S. ยง 3113.
(4) Has a high school diploma or its equivalent.
(5) Satisfactorily completes a course of study in
radiologist assistant or an equivalent course of study
determined by the board.
(6) Passes an applicable radiologist assistant
examination administered by a certification organization
approved by the board.
(7) Holds a current license, certification or
registration as a radiographer and radiologist assistant
issued by a certification organization approved by the board.
(g) Radiologist assistant scope of practice.--
(1) A radiologist assistant may perform advanced
diagnostic imaging procedures under the direction SUPERVISION
of a supervising radiologist. The procedures under this
subsection shall include, but are not limited to, any of the
following:
(i) Enteral and parenteral procedures.
(ii) Injection of diagnostic agents and physician-
prescribed medications.
(iii) Diagnostic and therapeutic aspirations and
localizations.
(iv) Radiologist directed invasive procedures.
(v) Fluoroscopy procedures.
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(2) A radiologist assistant may not interpret imaging,
render diagnoses or prescribe medication or therapies.
(3) (2) A radiologist assistant and the supervising
radiologist shall establish clinical protocols in accordance
with this paragraph. The clinical protocols shall identify
and be signed by the radiologist assistant and supervising
radiologist. The clinical protocols shall describe the manner
and frequency in which the radiologist assistant regularly
communicates with the supervising radiologist. The clinical
protocols shall include procedures performed by the
radiologist assistant, the level of supervision provided by
the supervising radiologist and the location of the practice
designated by the supervising radiologist. THE SUPERVISING
RADIOLOGIST SHALL SUBMIT THE INITIAL CLINICAL PROTOCOLS TO
THE BOARD FOR REVIEW. Upon updating the clinical protocols,
the supervising radiologist shall submit updated clinical
protocols to the board for review. Nothing in this paragraph
shall be construed to require the clinical protocols to be
approved by the board.
(h) Current practitioners.--The board shall issue a license
under this section to an individual practicing as a medical
imaging professional, radiation therapist or radiologist
assistant on the effective date of this section if the
individual meets all of the following requirements within two
years of the effective date of this section:
(1) Is at least 18 years of age.
(2) Submits an application and the required fee as
established by the board by regulation.
(3) Is of good moral character. In assessing the moral
character of an individual with a criminal conviction, the
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board shall conduct an individualized assessment in
accordance with 63 Pa.C.S. ยง 3113.
(4) Holds a current license, certification or
registration as a medical imaging professional, radiation
therapist or radiologist assistant issued by a certification
organization approved by the board.
(i) Use of title.--Only an individual who holds an active
license under this section may do any of the following:
(1) Hold oneself out as a licensed medical imaging
professional, radiation therapist or radiologist assistant.
(2) Use a title indicating the specific modality for
which the individual is licensed under this section.
(3) Use any words, symbols or abbreviations indicating
the specific modality for which the individual is licensed
under this section.
(j) Exemptions.--The licensure requirements under this
section shall not apply to any of the following:
(1) An individual licensed in this Commonwealth whose
scope of practice includes performing medical imaging or
radiation therapy procedures.
(2) Auxiliary personnel under the supervision of a
licensed 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 .
(3) Auxiliary personnel under the supervision of a
licensed dentist who is authorized to perform x-rays under
section 11.4 of the act of May 1, 1933 (P.L.216, No.76),
known as The Dental Law .
(4) Auxiliary personnel under the supervision of a
doctor of podiatric medicine who is permitted to perform x-
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rays under section 21.2 of the act of March 2, 1956 (1955
P.L.1206, No.375), known as the Podiatry Practice Act .
(5) 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 an 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.
(6) A resident physician or GRADUATE MEDICAL TRAINEE
PHYSICIAN OR A 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.
(7) A student enrolled in a medical imaging educational
program recognized by the board who is employed by a medical
facility affiliated with the 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
the supervision of an individual holding a license under this
section in the supervised modality.
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(8) An individual employed by the Federal Government to
provide medical imaging or radiation therapy services while
in the discharge of the individual's official duties.
(9) An individual performing medical imaging or
radiation therapy procedures on nonhuman subjects or
cadavers.
(k) Authorizations and restrictions.--
(1) 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 an individual
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 section and the regulations promulgated by the
board and in a modality for which the licensee has
received education and training.
(2) A licensee under this section may not make a
diagnostic interpretation of an image, make a diagnosis or
prescribe a medication or therapy.
(l) License renewal.--A license under this section shall be
subject to biennial renewal. For license renewal, a licensee
shall submit all of the following to the board:
(1) An application and the required fee as established
by the board by regulation.
(2) Proof of continuing education as determined by the
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board by regulation.
(3) Proof of holding a current certification and
registration issued by a certification organization approved
by the board.
(m) Professional liability.--
(1) A licensee under this section practicing in this
Commonwealth shall maintain a level of professional liability
insurance coverage in the minimum amount of $1,000,000 per
occurrence or claims made. Failure to maintain insurance
coverage as required shall subject the licensee to
disciplinary proceedings. The board shall accept from the
licensee as satisfactory evidence of insurance coverage any
of the following:
(i) Self-insurance.
(ii) Personally purchased liability insurance.
(iii) Professional liability insurance coverage
provided by the licensee's employer or similar insurance
coverage acceptable to the board.
(2) An applicant for a license under this section shall
provide proof that the applicant has obtained professional
liability insurance in accordance with paragraph (1). It is
sufficient if the applicant files with the application a copy
of a letter from the applicant's professional liability
insurance carrier indicating that the applicant will be
covered against professional liability in the required
amounts effective upon the issuance of the applicant's
license to practice in this Commonwealth under this section.
Upon issuance of the license, the licensee has 30 days to
submit to the board the certificate of insurance or a copy of
the policy declaration page.
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Section 4. Section 22(b) introductory paragraph of the act
is amended to read:
Section 22. Licenses and certificates; general qualification.
* * *
(b) Qualifications.--The board shall not issue a license or
certificate to an applicant unless the applicant establishes
with evidence, verified by an affidavit or affirmation of the
applicant, that the applicant is of legal age, is of good moral
character and is not addicted to the intemperate use of alcohol
or the habitual use of narcotics or other habit-forming drugs
and that the applicant has completed the educational
requirements prescribed by the board and otherwise satisfies the
qualifications for the license or certificate contained in or
authorized by this act. In assessing the moral character of an
applicant with a criminal conviction, the board shall conduct an
individualized assessment in accordance with 63 Pa.C.S. ยง 3113
(relating to consideration of criminal convictions). The board
shall not issue a license or certificate to an applicant who has
been convicted of a felony under the act of April 14, 1972
(P.L.233, No.64), known as The Controlled Substance, Drug,
Device and Cosmetic Act, or of an offense under the laws of
another jurisdiction which, if committed in this Commonwealth,
would be a felony under The Controlled Substance, Drug, Device
and Cosmetic Act, unless:
* * *
Section 5. 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
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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
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
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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 6. 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
(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 7. The State Board of Medicine shall promulgate
final regulations necessary to implement the addition of section
13.7 of the act within 180 days of the effective date of this
section.
Section 8. This act shall take effect in 60 days.
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