House Bill 590 creates the “Patient Safety in Medical Imaging Act” and establishes a new regulatory framework in Chapter 90 for radiologic technologists, radiation therapists, sonographers, and related medical imaging professionals. The bill requires licensure for people performing or offering to perform medical imaging or radiation therapy procedures on humans, subject to specified exemptions for licensed practitioners, certain dental personnel, students in supervised training, federal employees, veterinarians, podiatrists, and some advanced practice nurses performing fluoroscopy. It also creates the North Carolina Medical Imaging and Radiation Therapy Board of Examiners, defines multiple imaging and therapy modalities, and sets out the Board’s authority over licensure standards, education program approval, discipline, fees, reciprocity, and rulemaking.
The bill sets detailed qualification standards for each license type, including age and education requirements, completion of approved educational programs, and current certification from recognized national credentialing organizations. It also adds scope-of-practice limits, such as restricting limited practice radiographers from performing CT, MRI, fluoroscopy, mammography, sonography, radiation therapy, mobile imaging, or contrast studies, and requiring CT certification for diagnostic CT work beginning January 1, 2026. Existing practitioners may be grandfathered into licensure if they register with the Board and meet specified conditions, and the Board must adopt implementing rules by January 1, 2026. Violations are made a Class 1 misdemeanor, and the Board may seek injunctive relief.
The bill’s impact on state law is significant because it adds a new licensing and enforcement regime for a broad segment of the medical imaging and radiation therapy workforce. It would shift oversight from a largely credential-based environment to a state-licensed profession with mandatory licensure, continuing education, disciplinary authority, and formal educational program approval. Employers would also be prohibited from knowingly using unlicensed personnel for covered procedures, and the Board would have authority to set fees and standards for practice, renewal, and reciprocity.
The overall sentiment reflected in the bill’s progress appears strongly favorable, at least procedurally: the bill received a unanimous 108-0 second-reading vote in the House on June 25, 2025, and there is no recorded committee transcript showing opposition or debate in the provided materials. The bill’s title and structure suggest a patient-safety rationale that likely resonated broadly with lawmakers, especially its emphasis on education, competency, and supervision.
The main points of potential contention are likely to involve workforce regulation and transition issues rather than the patient-safety goal itself. The bill imposes new licensure requirements on currently practicing professionals, creates misdemeanor penalties for violations, and gives the new Board substantial authority over scope of practice, education standards, and fees. Possible concerns could include whether the licensure mandate could affect staffing availability, how existing practitioners will be grandfathered in, the breadth of exemptions, and whether the Board’s discretion over remote-area requirements and approved certifications is too expansive.
The bill amends Chapter 90 of the North Carolina General Statutes by creating a new Article 44 governing radiologic technologists, radiation therapists, sonographers, and related imaging professionals. It establishes mandatory state licensure for covered medical imaging and radiation therapy practice, creates a new Board of Examiners, authorizes rulemaking, discipline, fees, and educational program approval, and adds criminal and injunctive enforcement provisions. It also sets transition rules for current practitioners and delayed effective dates for licensure and enforcement provisions.
The available voting history indicates strong support: the bill passed second reading in the House 108-0 on June 25, 2025. No committee transcript is provided, so there is no recorded floor or committee debate to suggest organized opposition in the supplied materials. The bill’s framing around patient safety, education, and competency suggests a generally favorable reception among lawmakers.
Likely areas of contention are the new licensing mandate, the creation of a new regulatory board, and the scope of the Board’s authority over practice standards, fees, and approved credentials. Stakeholders in the imaging workforce may be concerned about transition requirements for current practitioners, the misdemeanor penalty for violations, and whether the new rules could limit staffing flexibility or access in underserved or rural areas. Exemptions for certain professions and the Board’s discretion to adjust requirements in remote areas may also be points of policy debate.