House unanimously passes Engell bill to protect access to essential diagnostic imaging, especially in rural communities
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House unanimously passes Engell bill to protect access to essential diagnostic imaging, especially in rural communities
The Washington State House of Representatives has unanimously approved legislation from Rep. Andrew Engell, R-Colville, to allow advanced registered nurse practitioners (ARNPs) and physicians assistants (PAs) to supervise radiologic procedures, ensuring patients can continue to receive timely diagnostic care across Washington, particularly in rural areas.
House Bill 2113 updates state law governing how diagnostic radiologic technologists, therapeutic radiologic technologists, and MRI technologists perform certain procedures involving intravenous contrast. The measure allows these procedures to be supervised either in person by a physician, advanced practice registered nurse, or physician assistant, or through real-time audio and video technology when a physician provides virtual direct supervision.
“For decades, hospitals have safely used ARNPs and PAs in addition to Physicians to deliver these services, but a technical interpretation in state law a few months ago suddenly put that access at risk,” said Engell, the bill’s prime sponsor. “This legislation restores clarity, aligns state policy with longstanding practice, and makes sure patients continue to have access to diagnostic tests necessary to treat a stroke, appendicitis, and many other illnesses. Without this bill, many hospitals will be required to hire more doctors that they may not be able to find or afford, and ARNPs and PAs will lose career opportunities they have safely practiced for many years.”
Under the recent interpretation of current law, only physicians can provide the level of supervision required for these procedures, even though federal Centers for Medicare and Medicaid Services regulations have long allowed broader supervision. Health care providers warned that without clarification, the change could disrupt emergency departments and delay care, especially in smaller or underserved communities that rely heavily on physician assistants and advanced practice nurses.
Engell’s legislation maintains patient safety requirements by ensuring appropriately trained clinical staff and emergency response resources are present when contrast agents are administered.
Testimony before the House Health Care and Wellness Committee emphasized that the measure protects long-standing care models and prevents unnecessary barriers to treatment. Hospital representatives and provider organizations explained that advanced practice clinicians have supervised these procedures safely for years and are essential to maintaining services in rural hospitals. Supporters also noted the legislation aligns Washington with permanent federal rules that took effect Jan. 1, 2026, and helps address workforce shortages in radiology.
“This is about making sure our laws reflect how medicine is actually practiced today,” said Engell. “When someone walks into an emergency department in a rural community, they deserve prompt answers and the same standard of care they would receive anywhere else.”
No opposition testimony was presented. Stakeholders, including radiology professionals, described the bill as a collaborative effort to modernize outdated supervision requirements while preserving safeguards for patient care.
House Bill 2113 passed the House on a 97-0 vote and now moves to the Senate for further consideration.
