Radiology benefits managers; decision to deny physician's order for diagnostic radiology test. (HB398)

Introduced By

Del. Patrick Hope (D-Arlington)


Passed Committee
Passed House
Passed Senate
Signed by Governor
Became Law


Radiology benefits managers.  Requires that any decision by a radiology benefits manager to deny a treating physician's order or recommendation for a diagnostic radiology test be made by a physician. An authorization to perform a diagnostic radiology test given by a health carrier or by a radiology benefits manager shall be conclusive to satisfy any requirement of medical necessity in a health benefit plan or a health carrier's plan, policy, or schedule of benefits. A managed care health insurance utilization review entity's utilization review plan is required to include a provision designed to ensure that adverse determinations by a radiology benefits manager are made by a licensed physician. Any person who countermands the treatment order or recommendation of a treating physician for a diagnostic radiology test by any means or manner that is intended to influence the patient to refuse a recommended diagnostic radiology test or to elect to receive a different service than the diagnostic radiology test ordered or recommended by the treating physician shall be deemed to be practicing medicine. Read the Bill »


Bill Has Failed


01/10/2012Prefiled and ordered printed; offered 01/11/12 12100674D
01/10/2012Referred to Committee on Health, Welfare and Institutions
01/13/2012Impact statement from DPB (HB398)
01/16/2012Assigned HWI sub: #3
01/26/2012Subcommittee recommends continuing to 2013
01/31/2012Continued to 2013 in Health, Welfare and Institutions