On April 1, 2025, California took a significant step toward improving access to diagnostic care with the passage of Assembly Bill 460 (AB 460) through committee action. The bill, which garnered unanimous support with a 15-0 vote in the Committee on Appropriations, redefines supervision requirements for radiologic technologists administering contrast materials, aligning California law with federal standards and addressing long-standing barriers to timely patient care.
Background and Need for AB 460
Under existing California law, specifically the Radiologic Technology Act (California Health and Safety Code, Section 106985), radiologic technologists are required to perform venipuncture for contrast administration under the direct, on-site supervision of a licensed physician or surgeon. This meant the supervising physician had to be physically present and available within the facility to intervene if needed. While intended to ensure patient safety, this requirement created significant delays in care, particularly in rural and community hospitals where on-site radiologists are often unavailable.
Assemblymember Phillip Chen, the bill’s author, highlighted these challenges during the committee hearing: “Current law requires on-site supervision for radiologic technologists who are administering contrast materials, which has created significant delays and barriers in access to care.” These delays have been particularly acute in urgent or emergency cases, where the absence of an on-site radiologist could postpone critical imaging procedures.
Ryan Spencer, representing the California Radiological Society (CRS), the bill’s sponsor, emphasized the practical implications: “In many rural and community hospitals, having an on-site radiologist at all times simply isn’t possible. This results in patients experiencing delays in care… not because of lack of equipment or trained technologists, but because of an outdated supervision rule.”
What AB 460 Changes
AB 460 amends the Radiologic Technology Act to redefine “direct supervision” for radiologic technologists performing venipuncture. The new definition allows a licensed physician to supervise remotely via real-time audio and video communication, provided they have immediate access to the patient’s electronic medical records and the ability to intervene through standing orders or protocols. This aligns California with the federal Centers for Medicare & Medicaid Services (CMS) policy, which has permitted virtual direct supervision since 2020 and is extended through 2025.
The bill also includes a critical safety provision, added through recent amendments, requiring facilities to have qualified personnel physically present on-site during contrast administration. These personnel must be capable of responding immediately to any adverse reactions, ensuring patient safety is not compromised by the radiologist’s remote presence.
Spencer underscored this balance: “AB 460 maintains and strengthens patient safety… there will be somebody on-site physically to be able to respond to the adverse reaction.”
Addressing Committee Concerns
During the committee hearing, legislators raised important questions about the implementation of remote supervision. Assemblymember Pilar Schiavo sought clarification on how remote supervision would work in practice: “Can the person who is remote… see what’s happening, or are they on the phone? How can they monitor or engage with what’s happening on the ground remotely?”
Chen and Spencer explained that the bill mandates both audio and video components, ensuring the radiologist can visually monitor the procedure and communicate in real-time. Spencer noted, “The reason why a radiologist needs to be on-site is to answer any questions… They can just access them through video teleconference… and be able to answer those questions.” This allows radiologists to provide guidance on contrast type, precautions, or procedural adjustments without being physically present.
Schiavo also inquired about geographic limitations for the supervising radiologist, to which Spencer clarified, “They would still be a licensed physician in the State of California… but there’s nothing in the bill that says the person has to be a certain radius from the clinic.” This ensures that only California-licensed physicians can supervise, maintaining regulatory oversight while offering flexibility in location.
Assemblymember Darshana Patel raised concerns about data security, asking, “When it’s done via telehealth, is there a requirement or any sort of assurance that these will be secure lines… as it is health data?” Spencer confirmed that while the bill does not specify security protocols, telehealth networks used for such purposes must adhere to established standards for data privacy and security, ensuring secure communication channels beyond casual tools like FaceTime.
Alignment with Federal and State Practices
AB 460 brings California in line with federal CMS policy, which has allowed virtual direct supervision since 2020, a policy proven “safe and effective” through 2025. More than a dozen states, including Texas, Florida, New Jersey, and Alabama, have already adopted similar approaches, recognizing that radiologists can effectively supervise remotely while trained technologists perform procedures under strict protocols.
Impact and Support
The bill is expected to reduce unnecessary delays, relieve strain on the radiology workforce, and improve access to care, particularly in underserved areas. Chen cited examples of telemedicine bridging gaps from Catalina Island to Palmdale, illustrating its potential to connect patients with specialists across distances.
The California Radiological Society and the California Medical Association, represented by George Soares, voiced strong support. Soares affirmed, “George Soares with the California Medical Association in support,” reflecting broad medical community backing. No opposition was recorded during the hearing, and the bill passed with a unanimous 15-0 vote, with legislators like Heath Flora, Maggie Krell, and Joaquin Arambula voting in favor.
Financial and Statutory Notes
The bill addresses financial implications by noting that the California Constitution requires the state to reimburse local agencies and school districts for certain mandated costs. However, AB 460 specifies that “no reimbursement is required by this act for a specified reason,” likely due to its alignment with federal standards already in practice.
Looking Ahead
Having passed the Committee on Appropriations on April 1, 2025, AB 460 now moves to the broader legislative process. Its focus on modernizing supervision without compromising safety positions it as a practical solution to California’s healthcare access challenges, particularly for rural patients. As Assemblymember Patel, a mother of athletes familiar with radiology needs, noted, “I can see the need for this.” With strong legislative support and clear patient benefits, AB 460 is poised to enhance the efficiency and equity of radiologic care across the state.
.svg)
.png)
