New Mexico Governor Signs Licensure Law

New Mexico Governor Bill Richardson on April 6, 2009 signed a historic bill that, for the first time in the United States, requires licensure of sonographers/technologists in New Mexico. The bill—Medical Imaging and Radiation Therapy Health and Safety Act—adds sonographers/vascular technologists (and MRI technologists) to the list of medical imaging professionals licensed by the State of New Mexico. Until now, anyone could perform sonograms/vascular exams in New Mexico. Prior to the passage of the New Mexico licensure law, virtually all other health care providers and professionals had tobe licensed.

Thanks to the coordinated efforts of the Sonography Licensure Coalition (SLC), of which SVU is one of seven ultrasound related organizations, the ultrasound profession provided significant feedback on the development of this bill. As a result, national credentials/certifications should provide evidence of meeting the state’s new licensure standards. All sonographers/vascular technologists who are performing these critical medical imaging services in New Mexico will be required to meet national certification standards. However, there would be no additional exam in New Mexico beyond the national certification exams. The bill also requires the state to recognize the continuing medical education completed for national certification renewal.

The most visible impact on New Mexico sonographers/technologists will be a license fee. However, the legislation caps the license fee at $100 per two-year license. In addition, only the New Mexico Legislature can change this cap. The SLC hopes that many employers will pay or provide reimbursement for the license fee (as they often do for other licensed health care professionals). The license fees go toward administering the licensure program including paying for investigations or disciplinary actions when necessary.

When needed, the state agency can conduct investigations of those who fail to meet the standards or who cause harm to their patients. Ad hoc disciplinary committees will be created to review and consider disciplinary actions against sonographers. The legislation ensures that when needed these ad hoc disciplinary committees include sonographers/technologists (with similar knowledge and experience), a physician, and a neutral, public member.

In the past, SVU had opposed specific efforts to create state-by-state licensure and has instead worked for federal credentialing requirements through Medicare regulations and more recently the CARE Bill, which is still pending in the 111th Congress. In part, this strategy has been based on the enormous amount of work required to ensure passage of a licensure bill in each state. But ultimately, even federal requirements may not stop what is now commonly occurring...people with a weekend course (or less) in ultrasound and enough money to buy a machine, are setting up shop ‘taking baby pictures’ or providing ‘medical’ sonograms without the proper education or certification.

SVU, along with other members of the Sonography Licensure Coalition, remains concerned about a state-by-state approach resulting in significant differences in licensure between the states. The legislative process is imperfect and the best of intentions can have negative impact on sonographers. However, the SLC also recognizes that it must work toward addressing the concerns raised by the states about unlicensed health care providers.

The responsibility for administering the NM sonographer/technologist licensure program would rest with the New Mexico Environment Department, which currently manages the radiologic technology licensure program; so the administrative infrastructure is already in place. By ensuring the creation of an advisory council that includes representation by each medical imaging and radiation therapy modality regulated, the bill helps ensure that the Department’s other areas of emphasis do not detract from sonographer/technologist licensure.

With today’s practical realities in state government where severely limited resources and tough economic times dictate policy decisions, a separate licensure board for sonographers/technologists is simply not viable. Radiologic technology licensure programs are in place in most states and adding another imaging modality, such as ultrasound, is much more feasible than creating a new licensure board and licensing system. Another potential downside is that each state’s radiologic technology licensure laws are different and will require careful consideration of how sonography can be incorporated.

Because sonographers/technologists have never had to be licensed before, they may not understand the distinction between state licensure and national certification. National certifications or credentials issued by voluntary organizations such as ARDMS, CCI, and ARRT have little legal weight alone. The certification process and resulting credential are valuable tools in ensuring sonographers/technologists have met minimum education and knowledge requirements, but do not independently regulate anyone’s ability to perform sonography.

The NM licensure bill will help ensure that physicians receive quality sonograms, that their treatment decisions are based on the best available information, and that those paying for sonograms will not have to pay to have the study repeated because the first person who performed it did not how to perform the study properly.

The next step in New Mexico with this new law is the beginning of the development of administrative rules to implement the legislation. New Mexico sonographers/technologists, as well as the SLC, will certainly have an opportunity to review and comment on any administrative rules under consideration by the New Mexico Environment Department. The Medical Imaging and Radiation Therapy Advisory Council will need to be formed as well with representation from the sonography profession.

Once the administrative rules have been implemented, sonographers/technologists in New Mexico will need to apply for licensure and pay the $100 license fee (student sonographers will have to register, but are not required to pay a license fee). At this time, it is not known how long the implementation process will take. The SLC will be working closely with state officials and sonographers/technologists as the licensure bill is implemented and SVU will provide updates to its members as more information becomes available.

The SLC expects other states will consider adoption of sonography/technologist licensure in the next few years and the SLC will be working to ensure the adoption of appropriate legislation.

Status of Oregon State Licensure Legislation

Work continues to move forward with the Oregon medical imaging licensure bill – HB 2245. Last week the Oregon House Health Care Committee gave the Oregon licensure bill a "DO Pass" recommendation. The bill now goes to the joint House/Senate Ways and Means Committee where the Sonography Licensure Coalition, of which SVU is a member, does not anticipate any problems. The bill will then go to a vote. The SLC is optimistic that Oregon may soon become the second state to require sonographer/technologist licensure.