Menu

legislation

New York

A New Chapter and Developments in the Legislative Atmosphere

, , ,

The ASET Governmental Advocacy Committee (GAC) continues to monitor legislative and regulatory issues of interest and importance to our members.

[restrict userlevel=”subscriber”]

What follows is an update on recent developments in Ohio and Missouri as it pertains to Occupational Licensing Reform (OLR):

Ohio Senate Bill 255

Ohio Senate Bill 255 was introduced in the Ohio General Assembly in February. The legislation proposes to establish a statewide policy on occupational regulation, to require standing committees of the General Assembly to periodically review occupational licensing boards regarding their sunset, and to require the Legislative Service Commission to perform assessments of occupational licensing bills and state regulation of occupations. This means that the committees will review and assess 20 percent of licensing boards each year for 5 years. Each board will have to present a strong, rigorous case to justify its continued existence.

Additional bill language of importance includes:

The definition of Certification. The bill defines certification as “a voluntary program in which a private organization or the state grants nontransferable recognition to an individual who meets personal qualifications established by the private organization or state law.”

The definition of Registration. The bill defines registration as “a requirement to give notice to the government that may include the individual’s name and address, the individual’s agent for service of process, the location of the activity to be performed, and a description of the service the individual provides. Registration does not include personal qualifications but may require a bond or insurance.”

ASET consulted with lawmakers at the Ohio General Assembly through the Ohio Neurodiagnostic Society: A Chapter of ASET, and learned that it is the legislative intent that private organization certifications are recognized. It is not the legislative intent to create an alternate licensing or certification process at this time. The goal of this bill is to reduce what the General Assembly considers unnecessary occupational licenses and apply the least restrictive approach possible when it comes to regulating occupations.

As a result, the bill provides the following scale of Least Restrictive to Most Restrictive approaches:

  • Market Competition
  • Third-party or consumer-created ratings and reviews
  • Private Certification;
  • Specific private civil cause of action to remedy consumer harm
  • Actions under Chapter 1345. of the Revised Code
  • Regulation of the process of providing the specific goods or services to consumers
  • Inspection
  • Bonding or insurance
  • Registration
  • Government Certification
  • Specialty occupational license for medical reimbursement
  • Occupational license

The legislation was passed by the Senate at the end of June and currently awaits action in the House of Representatives. Lawmakers in both chambers have expressed a willingness to discuss any ongoing concerns with the legislative language and/or process going forward. ASET will continue to monitor the bill through the Ohio Chapter and Licensure Committee and will keep membership advised.

Missouri House Bill 1719

Missouri House Bill 1719, the Professional Employer Organization Act, was introduced during the 2018 General Assembly session. From the outset of the legislative process, the objective of HB 1719 was to modify the state government’s approach to the licensing of occupations and professional employer organizations. ASET worked alongside other organizations that monitor state certification/licensing legislation, including the American Society of Association Executives (ASAE), to bring to light concerns with the bill. Three of the initial concerns centered around these issues:

The definition of “Certification.” The bill defines certification as “a program in which the government grants nontransferable recognition to an individual who meets personal qualifications established by a regulatory entity. Upon approval, the individual may use “certified” as a designated title.”

The definition of “Registration.” The bill defines registration as “a requirement established by the general assembly in which an individual: (a) Submits notification to a state agency; and (b) May use “registered” as a designated title.”

The bill would establish standards for state-controlled licensing programs that are so rigorous and require an extremely high burden of proof of necessity that could potentially result in ending state licensing of the professions, including doctors, lawyers, accountants, architects, etc.

ASET joined with ASAE – The Center for Association Leadership, and other like-minded organizations in engaging in a letter writing campaign to Missouri’s Lieutenant Governor, prior to his ascension to the governorship, expressing opposition to the bill. The position of ASET is that that since neurodiagnostics is not a licensed profession in Missouri, the non-governmental professional credentials offered for neurodiagnostics play an even more important role in protecting patient safety and providing the public, hospitals, risk managers, and insurers with objective and valid measures of knowledge and competence of neurodiagnostic technologists. During the legislative process, ASAE conveyed the belief that this bill contains language that is detrimental to both credentialing programs that are incorporated into state licensure laws (such as medical fields, CPAs, etc.) and voluntary certifications that are not required to practice an occupation in any state but demonstrate an individual’s professional knowledge and competence in a field (such as ASAE’s CAE credential).

The legislation was signed into law June 1, just prior to Governor Eric Greitens’ resignation. The bill’s signing was not unexpected as it was wrapped into an omnibus package that required passage prior to the Legislature ending its session. ASET and ASAE had expressed concerns with HB1500 as well – a bill which also provided for establishing guidelines for the future regulation of occupations and professions in the State of Missouri. This bill passed the legislature at the same time as HB1719.

Since the passage of those bills, ASET has had multiple discussions with staff from the office of the Chair of the Professional Registration Committee in the Missouri Senate, seeking clarification on language and legislative intent.  The staff indicated that the legislative intent is that those definitions apply to occupations that are currently regulated by the state and have a state certification or registration process already in place. The intent was not that it apply to currently unregulated, private organization credentialed occupations. ASET will monitor the Missouri Department of Professional Registration to help ensure that when the rules are written that they not stray from the legislative intent of the bill. Should a legislative fix become necessary in the next session, ASET will work with other stakeholder organizations to help ensure that an appropriate correction is enacted.

At the same time, ASET is continuing its outreach to legislative sponsors, interested parties, and other stakeholders to discuss any concerns that arise and seek clarification where questions remain. By exercising diligence and opening lines of communication with lawmakers, ASET is better able to be proactive in achieving its public policy goals.

Occupational Licensing Reform (OLR)

In monitoring legislation of interest to the industry, a national trend in public policy has become apparent. Occupational Licensure Reform (OLR) now is a major topic of interest, not only at the state level, but at the federal level in Congress and the Administration (current and previous). This trend is illustrated by the increasing number of states that are introducing “sunset” legislation in an attempt to scale back regulation, occupational licensing processes and boards.

Federal efforts to incentivize OLR in state legislatures include US Department of Labor (DOL) grants for organizations to work with groups of states to design and implement approaches that enhance the portability of licenses across state lines and reduce what is perceived as overly burdensome licensing restrictions in general. Additionally, Congress recently passed the Strengthening Career and Technical Education Act. It allows for the use of federal education funds to identify and examine licenses or certifications that are seen as posing “an unwarranted barrier to the workforce.” States could use this funding to create mechanisms to study existing licensing requirements and identify which should be curtailed or eliminated.

Occupational licensing has grown rapidly since the 1950s – 5% of employees where licensed then, whereas 25% of workers are licensed now. Most of that growth is attributed to new licensure of previously unregulated occupations. As a result of the dramatic increase in licensure in recent decades, much research has been conducted by various entities on what the effects are on workers, occupational quality and the economy. The research shows that OLR is a much-talked-about, much-analyzed issue that has bipartisan support. In response,  ASET Licensure Committees and the GAC are working on messaging and talking points to make a clear, robust case to lawmakers that licensure of Neurodiagnostic Technologists is a necessary step in improving patient safety.

Legislative Sessions

The following four states, Washington, D.C., and Congress are currently in session:

  • Michigan
  • New Jersey
  • Ohio
  • Pennsylvania

ASET Welcomes A New Chapter

ASET is pleased to introduce its newest chapter for the state of New York. Officially chartered in August, the officers and Directors of this new chapter are:

President
Justin Silverstein – Neuro Protective Solutions, LLC: DHSc, CNIM, R. EP T., R. NCS T., CNCT.

Vice President
Christopher Moses -NYU Winthrop Hospital: R. EEG T.

Secretary
Maria Marquez -NYU Winthrop Hospital Center for Cancer Care: Executive Administrative Assistant.

Treasurer
Alimo Noreiga – NY Presbyterian Brooklyn Methodist Hospital: RPSGT, R. EEG T., R. EP T.

Directors
Scott Blodgett – Nihon Kohden Corporation, Vice President of Sales/East: MBA, R. EEG T., FASET.

Demetrius Simmons – NYU Winthrop Hospital: Lead R. EEG T./EP T.

Richard Steer – Lenox Hill Hospital, Norwell Health: EEG Coordinator.

We welcome the ASET-New York Chapter and look forward to a productive, collaborative partnership!

This article was written by Jennifer Montgomery, Governmental & Grassroots Advocacy Manager at ASET.

legislative

Important Legislative Updates Impacting Neurodiagnostic Professionals

, ,

By Jennifer Montgomery, Governmental & Grassroots Advocacy Manager

The ASET Governmental Advocacy Committee continues to monitor legislative and regulatory issues of interest and importance to our members. There were recent developments with legislation on the ASET GAC watch list in Illinois, Louisiana and Missouri.

Illinois HB 3126

As previously reported in the 2018 Illinois General Assembly session Senate Bill 3126 was introduced and proposed to create the Registered Neurodiagnostic Technologist Title Protection Act. The bill authorized the Department of Financial and Professional Regulation to register neurodiagnostic technologists. This legislation prohibited Individuals from holding themselves out as a registered neurodiagnostic technologist without being registered by the Department. This bill created title protection and not licensure by the Department. The bill did not require healthcare providers to utilize registered neurodiagnostic technologists when providing neurodiagnostic-related services to patients. The legislation required technologists registered under the act to pay recurring fees and be subject to possible sanctions for incompetent or unprofessional practice, while allowing others who have not earned any of the established neurodiagnostic credentials to continue to perform neurodiagnostic testing. It provided that only those credentialed by ABRET in R. EEG T., R. EP T., CNIM, CLTM, and/or CAP would be eligible to be placed on the state list of registered neurodiagnostic technologists.

ASET proposed amendments to the bill which would have added nerve conduction study credentialing bodies, and allow credentialed nerve conduction study technologists and on-the-job trained technologists the ability to register with the state. The proposed amendments were agreed to by ABRET and the Senate sponsor of the legislation. The deadline for passage of Senate bills over to the House was April 27, 2018, but the sponsor was granted an extension of May 30, 2018 for amendments to the bill to be considered. The bill was neither amended to include the ASET proposed amendments, nor was it amended as first proposed by ABRET’s lobbyist to exempt NCS from the legislation. The Department of Financial and Professional Regulation was opposed to the bill. No further action was taken on the legislation prior to the May 31 adjournment of the General Assembly and the bill failed.

Louisiana  HB 748

Louisiana House Bill 748 created the Occupational Licensing Review Act. The bill included language that prohibited certificants from referring to themselves as “certified” unless their certification is used in conjunction with licensure in that state. The legislation provided that when the state finds it necessary to regulate an occupation or profession, the state is required to use the least restrictive regulation to protect consumers from present, significant, and empirically substantiated harms threatening public health and safety. It required the Governor’s office to recommend that the legislature propose legislation that may do any of the following:

  • Repeal occupational regulations.
  • Convert the occupational regulations to less restrictive regulations.
  • Instruct the relevant licensing board or agency to promulgate revised regulations reflecting the legislature’s decision to use a less restrictive regulation.

ASET joined a coalition of interested parties and lobbied to amend the bill to address the concerns we had with the legislation. An adopted amendment to HB 748 provides for the following:

  • Elimination of the prohibition on holders of certifications identifying themselves as “certified” in their titles.
  • Elimination of the rebuttable presumption against licensure laws requiring certification as a condition of licensure.
  • Keeping the sunset review schedule and process, but included protection of consumer welfare and public health and safety as factors the governor’s office must consider.
  • Elimination of the requirement for empirical evidence present, systemic harms; instead, in considering licensure requirements, the governor’s office can consider present or potential harms or threat of significant harms.
  • Requires the governor’s office to submit any sunset review recommendations with report on the rationale for the recommendation for changing a licensure statute, and the factors and evidence considered; the report must also identify each category of evidence as supporting the recommendation, weighing against the recommendation, or as neutral.

The amended bill was passed by the state legislature on May 18, and was signed by Governor Edwards on May 30. It takes effect on August 1, 2018.

Missouri House Bill 1719

Missouri House Bill 1719, the Professional Employer Organization Act, was introduced during the 2018 General Assembly session. From the outset of the legislative process, the objective of HB 1719 was to modify the state government’s approach to the licensing of occupations and professional employer organizations. On its face, the bill did not give any indication that it would redefine “certification” as an exclusively governmental function, blocking the role of private organizations in certifying an individual’s professional qualifications. But as the process moved forward it became apparent that the legislation would be concerning to organizations such as ASET that monitor state certification/licensing legislation. The concerns included the following:

  • The bill would take under state control the hundreds of non-governmental professional credentialing programs using the term “certification.”
  • The bill would limit the right to use the title “registered” to those professionals whom state law requires to register with the state. It precludes professionals who hold private credentials using the term “registered” from truthfully advertising their earned credentials.
  • The bill would establish standards for state-controlled licensing programs that are so rigorous and unrealistic that they could effectively result in ending state licensing of the professions, including doctors, lawyers, accountants, architects, etc.

ASET joined with ASAE – The Center for Association Leadership, and other like-minded organizations in engaging in a letter writing campaign to Missouri’s Lieutenant Governor, prior to his ascension to the governorship, expressing opposition to the bill. The position of ASET is that that since neurodiagnostics is not a licensed profession in Missouri, the non-governmental professional credentials offered for neurodiagnostics play an even more important role in protecting patient safety and providing the public, hospitals, risk managers, and insurers with objective and valid measures of knowledge and competence of neurodiagnostic technologists. During the legislative process, ASAE conveyed the belief that this bill contains language that is detrimental to both credentialing programs that are incorporated into state licensure laws (such as medical fields, CPAs, etc.) and voluntary certifications that are not required to practice an occupation in any state but demonstrate an individual’s professional knowledge and competence in a field (such as ASAE’s CAE credential).

The legislation was signed into law June 1, just prior to Governor Eric Greitens’ resignation. The bill’s signing was not unexpected as it was wrapped into an omnibus package that required passage prior to the Legislature ending its session. ASET and ASAE had expressed concerns with HB1500 as well – a bill which also provided for establishing guidelines for the future regulation of occupations and professions in the State of Missouri. This bill passed the legislature at the same time as HB1719.

ASAE has had productive discussions with staff from the office of the Chair of the Professional Registration Committee in the Missouri Senate, and is seeking a legislative fix. Additionally, ASET will continue to work with ASAE and a coalition of other like-minded organizations concerned about these issues around the country.

Legislative Sessions

The following states, Washington, D.C., and Congress are currently in session.

California North Carolina
Delaware Ohio
Massachusetts Pennsylvania
Michigan Rhode Island
New Hampshire Washington, D.C.
New Jersey Wiscsonsin – Special Session
GAC_featureimage_resized

Latest from the Government Advocacy Committee

, ,

 Legislative Update:  

The 2018 state legislative sessions have begun meeting. There are forty-four states, Congress, and the District of Columbia that are currently in session. The Governmental Advocacy Committee (GAC) monitors legislation and regulations to protect your interest. The GAC has identified legislation and regulations in Illinois, Indiana, Iowa and Virginia that impact neurodiagnostic technologists. Information may be found on the Neurodiagnostic Legislative & Regulatory Center website.  

Code Revisions to Long Term EEG Monitoring  

As reported previously, the American Medical Association CPT® Editorial Panel is considering changes to the family of long term monitoring codes (95950, 95951, 95953, and 95956). It is hoped that the coding changes will better reflect current monitoring and EEG testing methods.  If the changes do not accurately capture current clinical practice, including the role of the technologist, the physician and variations in the technology, patient access to long term monitoring and reimbursement could be negatively impacted. 

ASET has been working with ADVI, a health care consulting company based in Washington, D.C., which has formed a coalition to advocate for a coding framework that captures current technology and the variety of extended EEG testing being utilized. The long term monitoring CPT codes were scheduled to be debated during the American Medical Association CPT® Editorial Panel Meeting, in February. The coalition came to an agreement on the proposal and was prepared to discuss at the meeting. Just prior to the meeting the CPT® Editorial Panel reviewers made substantial changes to the technical codes and negated the work that had been done by the coalition. The proposed new coding was unexpected and represented a significant shift in the composition of the proposed CPT® codes on which the coalition had reached agreement. Action on the proposal was postponed and will be taken up at the May CPT® Editorial Panel Meeting, which will be held in San Antonio. The earliest changes to the codes will be adopted and implemented is 2020. 

Licensure Update:  

The ASET Governmental Advocacy Committee (GAC) has produced a public service announcement in support of licensure. The animated video provides information that illustrates the importance of having licensed professionals conducting neurodiagnostic procedures. Take a moment to watch the video and share the link with your colleagues and friends. Working together we can help protect our scope of practice and the patients we serve. 

Share Your Story 

ASET is currently working on pursuing professional licensure at the state level. To assist the licensure committees working on this effort we have been collecting stories that will demonstrate to our elected officials that properly educated and trained neurodiagnostic technologists provide the best patient care for their constituents. Recently we received a story that highlights the importance of having highly trained and competent neurodiagnostic professionals providing care to patients. A registered Neurodiagnostic technologist shared this story with us:  

“I feel that having properly educated and trained Neurodiagnostic technologists performing neurodiagnostic studies will ensure proper care and safety of the patients that we encounter. Using personnel not trained in Neurodiagnostics is ill advised, places patients in jeopardy, and diminishes the reputation of trained and educated technologists. The only way to make sure that patients receive the care they deserve is to enact legislation that requires properly educated and trained professionals are the only healthcare providers that are allowed to perform neurodiagnostic procedures.” 

We need your help collecting stories to share with legislators as we lobby for enactment of the legislation. If you have a story to share please submit it by clicking here.  

 

Team Person

X
Close