MISSISSIPPI LEGISLATURE

2005 Regular Session

To: Public Health and Welfare; Appropriations

By: Senator(s) Nunnelee (By Request)

Senate Bill 2733

AN ACT ENTITLED "MEDICAL IMAGING AND RADIATION THERAPY QUALITY ASSURANCE ACT"; TO PROVIDE FOR THE REGULATION AND LICENSING OF PERSONS WHO ADMINISTER MEDICAL RADIATION IMAGING AND RADIATION THERAPY PROCEDURES; TO PROVIDE FOR A PROCESS FOR RADIOLOGIST ASSISTANTS AND FUSION TECHNOLOGISTS TO PRACTICE; TO ESTABLISH AND EMPOWER A MEDICAL IMAGING AND RADIATION THERAPY BOARD OF EXAMINERS; TO PROVIDE THAT INDIVIDUALS OPERATING A MEDICAL RADIATION TECHNOLOGY MACHINE SHALL BE REGISTERED WITH THE AMERICAN REGISTRY OF RADIOLOGIC TECHNOLOGISTS OR THE NUCLEAR MEDICINE TECHNOLOGY CERTIFICATION BOARD; TO PROVIDE DEFINITIONS AND CERTAIN EXEMPTIONS FROM THIS REQUIREMENT; TO AUTHORIZE THE STATE BOARD OF HEALTH TO ENFORCE THE PROVISIONS OF THIS ACT; TO REPEAL SECTIONS 41-58-1, 41-58-3 AND 41-58-5, MISSISSIPPI CODE OF 1972, WHICH PROVIDE FOR THE REGISTRATION OF MEDICAL RADIATION TECHNOLOGISTS, NUCLEAR MEDICINE TECHNOLOGISTS OR RADIATION THERAPISTS, AND CREATE A MEDICAL RADIATION ADVISORY COUNCIL TO THE STATE BOARD OF HEALTH; AND FOR RELATED PURPOSES.

     BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

     SECTION 1.  This act may be cited as the "Mississippi Medical Imaging and Radiation Therapy Quality Assurance Act of 2005."

     SECTION 2.  As used in this act:

          (a)  "Board" means the Mississippi Board of Medical Imaging and Radiation Therapy, established under this act.

          (b)  "Fusion technology" means medical imaging equipment combining two or more imaging modalities, such as x-rays, computed tomography, magnetic resonance, positron measurements of radioactivity to produce a medical image of the metabolic function of cells and relevant human anatomy.

          (c)  "Fusion technologist" means a person other than a licensed practitioner who is licensed as a radiographer, radiation therapist or nuclear medicine technologist and who is qualified by additional education, training or experience to use fusion technology and who is granted a license by the board.

              (1)  The applicant is licensed as a radiographer, radiation therapist or nuclear medicine technologist by the board; and

              (2)  The applicant has completed a course of study in fusion technology that meets the content specified in the current Positron Emission Tomography (PET)-Computed Tomography (CT) Curriculum published by the American Society of Radiologic Technologists and the Society of Nuclear Medicine Technologist Section.

          (d)  "Licensed Practitioner" means a person licensed or otherwise authorized by law to practice medicine, dentistry, chiropractic, osteopathy or podiatry.

          (e)  "Ionizing radiation" means x-rays and gamma rays, alpha and beta particles, high speed electrons, neutrons and other nuclear particles.

          (f)  "X-radiation" means penetrating electromagnetic radiation with wavelengths shorter than ten (10) nanometers produced by bombarding a metallic target with fast electrons in a high vacuum.

          (g)  "Medical radiation imaging" means the science and art of applying ionizing radiation to human beings for diagnostic and therapeutic purposes.  The four (4) specialized disciplines of medical radiation technology are medical radiologic technology, nuclear medicine technology, radiation therapy and radiologist assistant.

          (h)  "Radiologic technologist" means an individual, other than a licensed practitioner, who applies x-radiation or ionizing to any part of the human body for diagnostic purposes as stated in the scope of practices adopted by the American Society of Radiologic Technologists as a:

              (1)  Diagnostic radiologic technologist, who is a person who actually handles x-ray equipment in the process of applying radiation on a human being for diagnostic purposes at the direction of a licensed practitioner.

              (2)  Nuclear medicine technologist, who is a person who prepares radiopharmaceuticals and administers them to human beings for diagnostic and therapeutic purposes and who performs in vivo and in vitro detection and measurement of radioactivity for medical purposes at the direction of a licensed practitioner.

              (3)  Radiation therapist, who is a person who applies x-radiation and the ionizing radiation emitted from particle accelerators, cobalt sixty (60) units and sealed sources of radioactive material to human beings for therapeutic purposes while under the supervision of a licensed practitioner who is licensed to possess and use radioactive material.

              (4)  Radiologist Assistant, who is a health care provider, and must be a Radiologic technologist registered through the American Registry of Radiologic Technologists (A.R.R.T.), certified by the board of medical examiners, and credentialed by the A.R.R.T. as a radiologist assistant to provide radiology services under the supervision of a radiologist.

                   (i)  The board of medical examiners shall define the roles, duties and responsibilities of a radiologist assistant and the educational qualifications necessary to practice as a radiologist assistant.  Such rules shall be consistent with guidelines adopted by the American College of Radiology, the American Society of Radiologic Technologists and the American Registry of Radiologic Technologists.

                   (ii)  A radiologist assistant may not interpret images, make diagnoses or prescribe medications or therapies.

              (5)  On or after the effective date of this act, a radiology practitioner assistant shall only be known as a radiologist assistant.

              (6)  On or after July 1, 2007, any person seeking to become a radiologist assistant in Mississippi must have satisfactorily completed an advanced academic program encompassing a nationally recognized radiologist assistant curriculum that includes a radiologist directed clinical preceptorship, all culminating in a baccalaureate degree, master's degree or post-baccalaureate certificate.

          (i)  "License" means a certificate issued by the board authorizing the licensee to use radioactive materials, medical imaging or radiation therapy equipment on humans for diagnostic or therapeutic purposes in accordance with the provisions of this act.

          (j)  "Persons who administer medical imaging or radiation therapy procedures" means any person, other than a licensed practitioner, who intentionally administers medical imaging or radiation therapy procedures to other persons for medical purposes and uses radiographers. radiologic technologists, radiation therapists, radiologist assistants and nuclear medicine technologists, licensed under this act.

          (k)  "Radiation therapy" means any radiation procedure or article intended for the cure, mitigation or prevention of diseases in humans.

          (l)  "Radiologic physicist" means a person who is certified by the American Board of Radiology, in radiological physics or one of the subspecialties of radiological physics or is eligible for such certification.

          (m)  "Radiographer" means a person, other than a licensed practitioner, who applies radiation to humans for diagnostic purposes.

          (n)  "Radiologist" means a physician certified by the American Board of Radiology or the American Osteopathic Board of Radiology, the British Royal College of Radiology or the Canadian College of Physicians and Surgeons.

     SECTION 3.  (1)  Only the following licensed individuals shall be authorized to operate a medical radiation technology machine for medical use:

          (a)  American Registry of Radiologic Technologists (ARRT) Registered Medical Radiologic Technologists, Nuclear Medicine Technologists or Radiation Therapists, Nuclear Medicine Technology Certification Board of Nuclear Medicine Technologists, or

          (b)  Individuals who are not AART Registered Technologists, who have been working for two or more years in medical radiation therapy.

     The names and training of all personnel currently operating a medical radiation technology machines shall be kept on file at the facility.  Information on former operators shall be retained for a period of two (2) years beyond the last date they were authorized to operate a medical radiation technology machine at that facility.

     All personnel currently operating a medical radiation technology machine shall be required to submit evidence of twelve (12) hours of continuing education approved by the American Registry of Radiologic Technologists (A.R.R.T.) or Nuclear Medicine Technology Certification Board (NMTCB) on an annual basis.

     (2)  A license is not required for:

          (a)  A student enrolled in and participating in an approved course of study for medical radiologic technology, nuclear medicine technology or radiation therapy, when a part of his clinical course of study applies ionizing radiation to a human being while under the supervision of a licensed practitioner;

          (b)  Laboratory personnel who use radiopharmaceuticals for in vitro studies, or;

          (c)  A dental hygienist or a dental assistant possessing a radiology permit issued by the Board of Dental Examiners applying ionizing radiation under the specific direction of a licensed dentist.

          (d)  Any licensed or registered health professional may be exempted where a listed procedure is covered within their respective scope of practice.

     SECTION 4.  (1)  A Mississippi Medical Imaging and Radiation Therapy Board of Examiners is hereby established.  The board shall consist of eleven (11) members appointed by the Governor within the advice and consent of the Senate, two from each Congressional District presently constituted and three (3) from the state-at-large.  They shall be residents of the state.  Among the board members shall be five (5) persons who administer medical imaging and radiation therapy procedures, two (2) radiologists, two (2) other licensed practitioners, one (1) radiologic physicist, and one (1) public member.  The terms of office shall be three (3) years, except that of the members first appointed.  Three (3) shall be appointed for a term of one (1) year, four (4) for a term of two (2) years, and four (4) for a term of three (3) years.  Vacancies shall be filled for an unexpired term only in the manner provided by original appointment.  Persons who administer medical imaging and radiation therapy procedures appointed to the board for terms beginning thirty-six (36) months following issuance of a license in any category by the board shall hold a valid license in any category issued by the board.

     Members of the board shall be compensated in a matter set by law.  They shall be reimbursed for reasonable and necessary expenses incurred in the performance of their official duties.

     The State Board of Health shall designate an officer or employee to act as a secretary to the board who shall not be a member of the board.  The State Board of Health shall furnish staff, logistics, budget and other support to the board as appropriate.

     No public member shall have any association or relationship with a licensed practitioner, person who administers medical imaging and radiation therapy procedures that would prevent or in any way hinder the public member in representing the interest of the public.

     (3)  The board, for administrative purposes, shall meet at least every three months at times and places of its choosing.  The first meeting of the board shall be for organization only, in which they set forth their responsibilities and rules and regulations.  A majority of the voting members of the board shall constitute a quorum.  No action may be taken by the board except by affirmative vote of the majority of those present and voting.  The board has responsibility for setting and implementing policies for licensing individuals, accrediting programs, imposing discipline and hearing appeals.

     SECTION 5.  (1)  The board shall issue a license to any applicant who shall pay a nonrefundable fee established by the rule of the board and submit satisfactory evidence, verified by oath or affirmation, that the applicant.

          (a)  At the time of the application is at least eighteen (18) years of age; and

          (b)  Each applicant for a license as a radiographer, radiation therapist, radiologist assistant or nuclear medicine technologist shall have satisfactorily completed a course of study in radiography, radiation therapy, radiology assistant, or nuclear medicine, respectively, or an equivalent to be determined by the board.

          (c)  The board may charge a registration fee of not more than Twenty-five Dollars ($25.00) annually to each person to whom it issues a registration under the provisions of this chapter.

     (2)  In addition to the requirements of subsection (a), any person seeking to obtain a license in a specific area of medical imaging and radiation therapy must comply with the following requirement.

          (a)  The curriculum for each course of study shall be no less stringent than the standards approved by the Joint Review Committee on Education in Radiologic Technology, Joint Review Committee on Nuclear Medicine Technology or other appropriate accreditation agency approved by the board, provided the standards are not in conflict with board policy.

     (3)  The board shall establish criteria and standards within the state for educational programs in medical imaging and radiation therapy, and approve these programs upon finding that the criteria and standards have been met.

     (4)  For a period not to exceed two (2) years from the effective date of this act, the board shall admit to examination for licensure a person who has been employed, for a minimum of three (3) of the immediately preceding past five years, as a radiographer, radiation therapist or nuclear medicine technologist.  The person shall submit proof of having successfully completed twelve (12) continuing education courses as a (continuing) requirement for renewal as prescribed by regulation.

     SECTION 6.  (1)  An approved program of medical imaging and radiation therapy may be offered by a medical facility, educational institution or other public or private agency or institution.  The program shall be affiliated with one or more hospitals that, in the opinion of the board and the appropriate accreditation agency, shall provide the requisite clinical education.

     (2)  By regulation the board shall:

          (a)  Adopt procedures for an educational program to follow in making application for accreditation.

          (b)  Provide a process for review of such accreditation by an existing accreditation agency and approval by a recognized national voluntary accrediting organization.

     SECTION 7.  (1)  Each applicant for licensure shall be required to pass a national license examination administered by the American Registry of Raiologic Technologists, Nuclear Medicine Technologist Certification Board or other recognized national voluntary credentialing bodies, issued on the basis of an examination satisfactory to the board, provided that the standards of that body are at least an stringent as those established by the board.

     (2)  An applicant who fails to pass the examination may reapply to the examination provided the applicant complies with the regulations established by the board.

     (3)  The board may accept, in lieu of its own examination, a current certificate, registration or license as a person who administers medical imaging and radiation therapy procedures issued by another state, provided that the standards in the other states are at least as stringent as those established by the board.

     SECTION 8.  The board may issue a license to each applicant who successfully passed the examinations under subsection (a) of Section 7 of this act and has paid the prescribed fees.

     The board may, at its discretion, issue a temporary license to any person whose licensure or relicensure may be pending and when issuance may be justified by special circumstances.  A temporary license shall be issued only if the board finds that it will not violate the purpose of this act or endanger the public health and safety.  A temporary license shall expire ninety (90) days after the date of the next examination if the applicant is required to take the same, or, if the applicant does not take the examination, then on the date of the examination.  In all cases, a temporary license shall expire when the determination is made either to issue or deny the applicant a regular license and in no event shall a temporary license be issued for a period longer than one hundred eighty (180) days.

     (3)  Holders of a license under this act shall display the official license document or a verified copy in each place of regular employment.

     (4)  The board shall review a license for a period of two (2) years upon payment of renewal fee set by the board.  Continuing education requirements may also be set by regulation.

     (5)  A licensee holding a license under this act whose license has lapsed and who has ceased activities as such for more than five (5) years, may apply for relicensure upon payment of a fee set by the board.  Continuing education requirements may also be set by regulation.

     (6)  A licensee holding a license under this act shall notify the board in writing within thirty (30) days of any name or address change.

     SECTION 9.  (1)  A license of a licensee or holding a license under this act may be suspended or revoked, or the individual may be censured, reprimanded or otherwise sanctioned by the board in accordance with the provisions and procedures of this act if, after due process, it is found that the individual:

          (a)  Is guilty of fraud or deceit in the procurement or holding of the license;

          (b)  Has been convicted of a felony in a court of competent jurisdiction, either within or outside of this state, unless the conviction has been reversed and the holder of the license discharged or acquitted; or if the holder has been pardoned with full restoration of civil rights in which case the license shall be restored;

          (c)  Is or has been afflicted with any medical problem, disability or addiction which, in the opinion of the board, would impair professional competence;

          (d)  Has aided and abetted a person who is not a licensee holding a license under this act or otherwise authorized by Section 3, subsection (c), of this act to perform the duties of a license holder;

          (e)  Has undertaken or engaged in any practice beyond the scope of duties permitted a license holder under this act.

          (f)  Has impersonated a licensee or former licensee or is performing duties of a person who administers medical imaging or radiation therapy procedures under an assumed name;

          (g)  Has been found guilty of violations of a code of ethics that the board may establish by regulation;

          (h)  Has performed medical imaging or radiation therapy procedures without supervision of a licensed practitioner;

          (i)  Has interpreted a diagnostic image for a physician, a patient, the patient's family or the public;

          (j)  Is, or has been, found guilty of incompetence or negligence in his performance as a license or permit holder;

     (2)  Proceedings against the holder of a license or permit under this act shall be instituted by filing a written charge or charges with the board.  A person, corporation, association, public officer or the board may bring the charge or charges.  The chairman of the board shall appoint a committee of three (3) members of the board to examine the charge or charges and prepare a written recommendation to the board stating whether the charge or charges should be dismissed or brought against a license or permit holder under this act.  If a majority of the board, voting by secret ballot, chooses to dismiss the charge or charges, no further action shall be taken.  If a majority of the board, voting by secret ballot, determines that the charges contain sufficient merit, the chairman shall set a time and place for a hearing.  A copy of the charge or charges and any investigational reports compiled by the board, together with the notice of the time and place of the hearing, shall be served on the person charged either in person or by registered mail at least thirty (30) days before the date set for hearing.  The accused shall have the right to appear at the hearing, with counsel, to answer the charge or charges, cross-examine witnesses, and produce evidence and witnesses in his defense.  The board shall have the power to issue subpoenas for the appearance of witnesses and take testimony under oath.  The hearing shall be open to the public.  Upon the conclusion of the hearing, the board shall meet in executive session to render a judgment on guilt or innocence of the accused to the charge or charges.  If a majority of the board, voting by secret ballot, determines that the accused is innocent of the charge or charges, all parties to the hearing shall be notified by registered mail and no further action shall be taken.  If the majority of the board, voting by secret ballot, determines the accused guilty of the charge or charges, all parties to the hearing shall be notified by registered mail.  By a majority vote through secret ballot, the board shall then issue an order suspending or revoking the license of the accused, or otherwise impose disciplinary action it considers appropriate.

     (3)  The board shall implement subsection (2), by regulation.

     (4)  Appeals to the board's order imposing disciplinary action shall be made in writing to the board within thirty (30) days of its ruling.  This subsection shall be implemented through regulation.

     (5)  When the license of any person has been revoked, reapplication to the board may be made no sooner than two (2) years after the date of the board's order revoking the license.

     (6)  No person shall knowingly employ as a radiographer, radiation therapist, nuclear medicine technologist or any person to perform medical imaging or radiation therapy procedures who does not hold a license under this act.

     (7)  Any person who violates any provisions of this act, or any rule or order made pursuant to this act, shall be subject to a fine of the sanctions of Section 9, subsection (2), or other appropriate punishment.

     SECTION 10.  Sections 41-58-1, 41-58-3 and 41-58-5, Mississippi Code of 1972, which provide for the registration of medical radiation technologists, nuclear medicine technologists or radiation therapists, and create a Medical Radiation Advisory Council to the State Board of Health, are hereby repealed.

     SECTION 11.  This act shall take effect and be in force from and after July 1, 2005.