As Introduced

136th General Assembly

Regular Session H. B. No. 479

2025-2026

To amend sections 4773.10, 4774.08, and 4774.10 and to enact sections 4723.37, 4773.062, and 4774.101 of the Revised Code regarding physician supervision of contrast administration for imaging.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section 1. That sections 4773.10, 4774.08, and 4774.10 be amended and sections 4723.37, 4773.062, and 4774.101 of the Revised Code be enacted to read as follows:

Sec. 4723.37. (A) A registered nurse or licensed practical nurse may administer contrast only under the direct or general supervision of a physician.

For purposes of this section, both of the following apply to a physician's supervision:

(1) Direct supervision does not require the supervising physician to observe the administration of contrast, but does require the supervising physician to be present at the location where contrast is administered.

(2) General supervision does not require the supervising physician to observe the administration of contrast or to be present at the location where contrast is administered, but does require the supervising physician to be readily available for purposes of consulting with and directing the nurse while administering contrast.

(B) If a physician provides general supervision of a nurse under this section, then a health care provider that the physician and institution's clinical leadership has determined meets the following qualifications shall be present at the location where the nurse administers contrast, in order to assist the nurse in the event of a reaction to contrast material or other adverse event resulting from contrast administration:

(1) The provider received training and meets competency guidelines set by the institution for recognizing, evaluating, diagnosing, and differentiating reactions to contrast material or other adverse events resulting from contrast administration.

(2) The provider is able to recognize when medical intervention is required for an immediate, hypersensitive reaction to contrast material or for a physiological adverse event resulting from contrast administration.

(3) The provider is able to consult with the supervising physician within an appropriate time frame.

(C) When engaging in or supervising contrast administration or when assisting with a reaction to contrast material or other adverse event resulting from contrast administration, the registered nurse, licensed practical nurse, physician, and qualified health care provider shall do so in a manner that is consistent with a definitive set of treatment guidelines approved by the clinical leadership of the institution at which the registered nurse, licensed practical nurse, physician, and qualified health care provider practice.

Sec. 4773.062. (A) A radiographer, radiation therapy technologist, or nuclear medicine technologist may administer contrast only under the direct or general supervision of a physician.

For purposes of this section, both of the following apply to a physician's supervision:

(B) If a physician provides general supervision of a radiographer, radiation therapy technologist, or nuclear medicine technologist under this section, then a health care provider that the physician and institution's clinical leadership has determined meets the following qualifications shall be present at the location where the radiographer or technologist administers contrast, in order to assist the radiographer or technologist in the event of a reaction to contrast material or other adverse event resulting from contrast administration:

(1) The provider received training and meets competency guidelines set by the institution for recognizing, evaluating, diagnosing, and differentiating reactions to contrast material and other adverse events resulting from contrast administration.

(3) The provider is legally authorized to administer prescription drugs and other interventions, either independently or in accordance with a physician's standing order or institutional protocol, to treat a reaction or event described in division (B)(2) of this section.

(4) The provider is able to consult with the supervising physician within an appropriate time frame.

(5) The provider is certified in basic life support by an organization acceptable to the institution.

(6) The provider understands when to call for assistance and how to activate emergency response systems.

(C) When engaging in or supervising contrast administration or when assisting with a reaction to contrast material or other adverse event resulting from contrast administration, the radiographer, radiation therapy technologist, nuclear medicine technologist, physician, and qualified health care provider shall do so in a manner that is consistent with a definitive set of treatment guidelines approved by the clinical leadership of the institution at which the radiographer, technologist, physician, and qualified health care provider practice.

Sec. 4773.10. As used in this section, "clinical leadership" includes an institution's medical director and director of radiology.

~~When~~ Except as provided in section 4773.062 of the Revised Code, when engaging in an activity pursuant to a license issued under this chapter to practice as a radiographer or nuclear medicine technologist, the radiographer or nuclear medicine technologist shall do so in a manner that is consistent with a definitive set of treatment guidelines approved by the clinical leadership of the institution at which the radiographer or technologist practices.

Sec. 4774.08. (A) A radiologist assistant shall practice only under the supervision of a radiologist acting in accordance with ~~section~~ sections 4774.10 and 4774.101 of the Revised Code. Under this supervision and subject to division (B) of this section, a radiologist assistant may do all of the following:

(1) Perform fluoroscopic procedures;

(2) Assess and evaluate the physiologic and psychological responsiveness of patients undergoing radiologic procedures;

(3) Evaluate image quality, make initial image observations, and communicate observations to the supervising radiologist;

(4) Administer contrast media, radio-isotopes, and other drugs prescribed by the supervising radiologist that are directly related to the radiologic procedures being performed;

(5) Perform any other radiologic procedures specified by the state medical board in rules adopted under section 4774.11 of the Revised Code.

(B) A radiologist assistant shall not do any of the following:

(1) Interpret radiologic images;

(2) Make diagnoses;

(3) Prescribe therapies;

(4) Administer or participate in the administration of general anesthesia, deep sedation, moderate sedation, or minimal sedation.

Sec. 4774.10. (A) To be eligible to supervise a radiologist assistant, a physician shall be actively and directly engaged in the clinical practice of medicine and surgery as a radiologist or actively and directly engaged in the clinical practice of osteopathic medicine and surgery as a radiologist.

(B) In providing supervision of a radiologist assistant, a supervising radiologist is subject to all of the following:

(1) Except as provided in divisions (B)(2) and (3) of this section and section 4774.101 of the Revised Code, the supervising radiologist shall provide on-site supervision of the radiologist assistant. The supervision shall be provided by being physically present in the same location as the radiologist assistant. The provision of on-site supervision does not necessarily require that the supervising radiologist be in the same room as the radiologist assistant. On-site supervision shall be provided when the radiologist assistant performs a radiologic procedure on a patient who is under minimal sedation.

(2) When the radiologist assistant performs a radiologic procedure on a patient who is under general anesthesia, deep sedation, or moderate sedation, the supervising radiologist shall provide direct supervision. The supervision shall be provided by being physically present in the same room as the radiologist assistant, with the radiologist assistant in the actual sight of the supervising radiologist when the radiologist assistant is performing the radiologic procedure.

(3) In the case of any radiologic procedure that a radiologist assistant is authorized to perform pursuant to division (A)(5) of section 4774.08 of the Revised Code, the supervising radiologist shall provide the level of supervision specified by the state medical board in the rules adopted under section 4774.11 of the Revised Code authorizing the performance of the procedure.

(C) The supervising radiologist of a radiologist assistant assumes legal liability for the services provided by the radiologist assistant.

Sec. 4774.101. (A) When a radiologist assistant administers contrast media as described in division (A)(4) of section 4774.08 of the Revised Code, a supervising radiologist shall provide on-site or remote supervision.

For purposes of this section, both of the following apply to a radiologist's supervision:

(1) On-site supervision does not require the supervising radiologist to be in the same room as the radiologist assistant during the administration of contrast media, but does require the supervising radiologist to be physically present at the same location where contrast media is administered.

(2) Remote supervision does not require the supervising radiologist to be physically present in the same room or location as the radiologist assistant during the administration of contrast media, but does require the supervising radiologist to be readily available for purposes of consulting with and directing the radiologist assistant while administering contrast media.

(B) If a supervising radiologist provides remote supervision of a radiologist assistant, then a health care provider that the radiologist and institution's clinical leadership has determined meets the following qualifications shall be present at the same location where the radiologist assistant administers contrast media, in order to assist the radiologist assistant in the event of a reaction to contrast media or other adverse event resulting from contrast media administration:

(1) The provider received training and meets competency guidelines set by the institution for recognizing, evaluating, diagnosing, and differentiating reactions to contrast media and other adverse events resulting from contrast media administration.

(2) The provider is able to recognize when medical intervention is required for an immediate, hypersensitive reaction to contrast media or for a physiological adverse event resulting from contrast media administration.

(3) The provider is legally authorized to administer prescription drugs and other interventions, either independently or in accordance with a radiologist's standing order or institutional protocol, to treat a reaction or event described in division (B)(2) of this section.

(4) The provider is able to consult with the supervising radiologist within an appropriate time frame.

(5) The provider is certified in basic life support by an organization acceptable to the institution.

(6) The provider understands when to call for assistance and how to activate emergency response systems.

(C) When engaging in or supervising contrast media administration or when assisting with a reaction to contrast media or other adverse event resulting from contrast media administration, the radiologist assistant, supervising radiologist, and qualified health care provider shall do so in a manner that is consistent with a definitive set of treatment guidelines approved by the clinical leadership of the institution at which the assistant, radiologist, and qualified health care provider practice.

Section 2. That existing sections 4773.10, 4774.08, and 4774.10 of the Revised Code are hereby repealed.