State Legislative Update: AEDs, EMGs, and EEGs

June 8, 2009

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As state legislatures around the country wrap up their 2009 legislative sessions, the Academy continues to monitor issues relevant to members. While many items of significance were introduced in 2009, many others failed to get past the committee process. Much of this can be attributed to states focusing their efforts on their budget crisis. Below is an update on just some of the legislation the Academy has been following very closely.

Anti-Epileptic Drugs (AED)

New Jersey: Assembly Bill 3029, which prohibits substitution of prescribed epilepsy drugs by pharmacists without prior notification to and written consent of physician and patient, passed through the NJ Assembly Health and Senior Services Committee on June 4. Academy staff sent a letters to members of the committee asking for their support of this legislation. The bill now moves to the Assembly floor.

Connecticut: SB 757, a bill that would have prohibited a pharmacy from substituting and AED without first obtaining patient consent, was able to make it all the way through the Senate committee process. Unfortunately, behind-the-curtain politics prevented this legislation from receiving a vote on the Senate floor before the CT Legislature adjourned.

Electromyography (EMG)

New Jersey: Senate Bill 1305, which would remove a stipulation that states only a licensed physician may perform NCV studies, passed out of the NJ Assembly Health and Senior Services Committee on June 4, after receiving a unanimous vote on the Senate floor on May 21. This legislation now moves to the Assembly floor.

Arizona: Academy staff had been working with numerous groups over concerns about a chiropractor bill that could have potentially changed their scope of practice, which could have permitted them to diagnose EMGs (HB 2160). The bill sponsor requested an opinion from the Arizona Board of Chiropractic Examiners, who in turn said the legislation would "have no bearing on including or removing any portion of that scope." This letter satisfied the concerns of all parties involved.

North Carolina: Legislation in North Carolina that revises the North Carolina Physical Therapy Act includes language that states physical therapy can include "the performance of electrodiagnostic, electrophysiologic, and other specialized tests of neuromuscular function or physical capacities." (HB 1374) Academy staff sent a letter to members of the NC House Committee on Health, asking them to remove language that states "Physical therapy further includes the performance of electrodiagnostic, electrophysiologic, and other specialized tests of neuromuscular function or physical capacities." The bill was scheduled to receive a hearing at the end of May, but was pulled from the agenda at the last minute. However, the North Carolina legislative session isn't scheduled to adjourn until August, which means it is likely this bill will be brought up again.

Electroencephalography (EEG)

California: At the request of Marc R. Nuwer, MD, PhD, FAAN, the Academy sent a letter of concern to a CA State Senator regarding a bill (SB 132) that addresses the qualifications of certified polysomnographic technologists. The concern in this bill revolved around language that defined polysomnography as "the treatment, management, diagnostic testing, control, education, and care of patients with sleep and wake disorders. Polysomnography shall include, but not be limited to, the process of analysis, monitoring, and recording of physiologic data during sleep and wakefulness to assist in the treatment of disorders, syndromes, and dysfunctions that are sleep-related, manifest during sleep, or disrupt normal sleep activities."

It is believed that this definition inadvertently catches the process of electroencephalography (EEG), which, as defined by the guidelines of the American Clinical Neurophysiology Society, is a process that records sleep or wakefulness or both during a routine EEG, seizure monitoring EEG, electrocerebral silence EEG, 24 hour EEG monitoring or sleep deprived EEG.

The Academy requested that language be added to the bill, asking that this legislation should not apply to EEGs, in order to avoid confusion.

For questions or comments regarding this or any other legislation, please contact Tim Miller, Health Policy Analyst, at tmiller@aan.com or at (651) 695-2792.