To All Members,
New York State Department of Health requires that all patients having a screening mammogram study have a prescription requesting such exam. This requirement comes from regulation that requires a prescription for ordering the application of radiation from radiation equipment to a patient:
16.19 Limitations on application of radiation to humans.9
(a) Diagnostic x-ray equipment. No person other than a professional practitioner, as defined in section 16.2(a)(85) of this part; a physician’s assistant working under the authority of a physician in accordance with Article 37 of the Public Health Law; or, a certified nurse practitioner working in accordance with Article 139 of the Education Law, within a practice agreement with a physician, or under the authority of a Medical Director or Medical Board in an Article 28 facility, shall direct or order the application of radiation from radiation equipment, as defined in section 16.2(a)(97) of this Part to a human being… Such direction or order to apply, or application of, radiation shall be in the course of the practitioner’s professional practice and shall comply with the applicable provisions of Part 89 of this Title and article 35 of the Public Health Law of the State of New York.
This includes self-referral patients and self-requesting patients. New York State regulations supersede MQSA regulations which do not require a prescription. Self-referred patients are those who come for mammography but have no health care provider, who decline a health care provider, or for whom the provider declines responsibility. Self-requesting patients are those who come for mammography, but are able to name a health care provider (or accept a health care provider offered by the facility) who accepts responsibility for that patient’s clinical breast care. If the health care provider declines to accept the mammography report from the facility, then those patients should be treated as self-referred.
Facilities that want to perform screening mammography on self referred patients need to apply to the Department of Health and comply with the regulations listed under section 16.22 of Part 16 of the Public Health Law, using the following link: http://www.nyhealth.gov/environmental/radiological/radon/radioactive_material_licensing/docs/part16.pdf
Facilities performing screening mammography on self referral patients still require a prescription, which must be written by a qualified person as defined in section 16.19 above. Radiologists may write the prescription for these patients. Any further questions may be addressed to me at the e-mail address below.
Sincerely,
George Autz, MD
Chair, Mammography Committee
New York State Radiological Society
gaport@optonline.net