N.H. Code Admin. R. Plc 1311.10 – Determination of Monetary Penalties

(a) Monetary penalties for violations as specified in Plc 1311.03 shall not exceed the following amounts, and in no event shall exceed $2,500 per violation:
1. (1) When no violation of any type has occurred during a period of licensure within the 5 years prior to the executive director’s notice to the respondent, the fine assessed shall not exceed the greater of $100 per day or $1,000 per violation;
2. (2) When a violation other than a violation of the same type has occurred during a period of licensure within the 5 years prior to the executive director’s notice to the respondent, the fine assessed shall not exceed the greater of $200 per day or $1,500 per violation;
3. (3) When a single violation of the same type has occurred during a period of licensure within the 5 years prior to the executive director’s notice to the respondent, the fine assessed shall not exceed the greater of $250 per day or $2,000 per violation; and
4. (4) When more than one violation of the same type has occurred during a period of licensure within the 5 years preceding the executive director’s notice to the respondent, the fine assessed shall not exceed the greater of $300 per day or $2,500.
(b) If a respondent has committed more than one violation of the same requirement or standard, a separate fine shall be assessed for each occurrence, but the total amount of the fine and the respondent’s promptness and cooperativeness in ceasing the prohibited conduct in question shall be considered in assessing the fines.
(c) A course of continuous conduct shall be treated as a single violation for purposes of (a), above.
Source. (See Revision Note at chapter heading for Plc 1300) #13701, eff 8-1-23
Appendix A: State Statutes Implemented
Rule
State Statute(s) Implemented
Plc 1300 (see below for more specific
and additional statutes)
RSA 328-J
Plc 1303
RSA 328-J:3
Plc 1304
RSA 328-J:11
Plc 1305
RSA 328-J:7-a; RSA 328-J:10; RSA 328-J:13
Plc 1306
RSA 328-J:13, II
Plc 1307
RSA 328-J:12
Plc 1308
RSA 328-J:17; RSA 328-J:15
Plc 1309
RSA 328-J:15
Plc 1310
RSA 328-J:7, IV
Plc 1311
RSA 328-J:19; RSA 328-J:20
Appendix B: Incorporated Documents
Rule(s)
Incorporated Reference
Obtain at:
Plc 1307.03(a)
Plc 1307.11
“Magnetic Resonance Practice Standards”, found in “The ASRT Practice Standards for Medical Imaging and Radiation Therapy”
dated June 26, 2022
American Society of Radiologic Technologists; go to https://www.asrt.org/main/standards-regulations/practice-standards/practice-standards; click on “Read The ASRT Practice Standards for Medical Imaging and Radiation Therapy”, then scroll down to “Magnetic Resonance
Practice Standards”
Plc 1307.04(a)
“Nuclear Medicine Practice Standards”, found in “The ASRT Practice Standards for Medical Imaging and Radiation Therapy”
dated June 26, 2022
American Society of Radiologic Technologists; go to https://www.asrt.org/main/standards-regulations/practice-standards/practice-standards; click on “Read The ASRT Practice Standards for Medical Imaging and Radiation Therapy”, then scroll down to “Nuclear Medicine Practice Standards”
Plc 1307.04(b)
“Nuclear Medicine Technologist Scope of Practice and Performance Standards”, 2^nd Edition, approved
June 9, 2022
Society of Nuclear Medicine & Molecular Imaging; go to http://www.snmmi.org/ClinicalPractice/content.aspx?
ItemNumber=5532, then click on Scope of Practice & Performance Standards 2022
Plc 1307.05
“Radiation Therapy Practice Standards”, part of “The ASRT Practice Standards for Medical Imaging and Radiation Therapy”
dated June 26, 2022
American Society of Radiologic Technologists; go to https://www.asrt.org/main/standards-regulations/practice-standards/practice-standards; click on “Read The ASRT Practice Standards for Medical Imaging and Radiation Therapy”, then scroll down to “Radiation Therapy Practice Standards”
Plc 1307.06
ASRT’s “Radiography Practice Standards”, part of “The ASRT Practice Standards for Medical Imaging and Radiation Therapy”
dated June 26, 2022
American Society of Radiologic Technologists; go to https://www.asrt.org/main/standards-regulations/practice-standards/practice-standards click on “Read The ASRT
Practice Standards for Medical Imaging and Radiation Therapy”, then scroll down to “Radiography Practice Standards”
Plc 1307.07(a)
“Radiologist Assistant Practice Standards”, part of “The ASRT Practice Standards for Medical Imaging and Radiation Therapy”
dated June 26, 2022
American Society of Radiologic Technologists; go to https://www.asrt.org/main/standards-regulations/practice-standards/practice-standards click on “Read The ASRT
Practice Standards for Medical Imaging and Radiation Therapy”, then scroll down to “Radiologist Assistant
Practice Standards”
Plc 1307.08(a)
Plc 1307.08(c)
“Scope of Practice and Clinical Standards for the Diagnostic
Medical Sonographer” dated
04-13-15
Society of Diagnostic Medical Sonography
Available at http://www.sdms.org/about/who-we-
are/scope-of-practice
Plc 1307.08(b)
“Sonography Practice Standards”,
part of “The ASRT Practice
Standards for Medical Imaging
and Radiation Therapy” dated
June 26, 2022
American Society of Radiologic Technologists; go to https://www.asrt.org/main/standards-regulations/practice-standards/practice-standards click on “Read The ASRT
Practice Standards for Medical Imaging and Radiation Therapy”, then scroll down to “Sonography Practice
Standards”
Plc 1307.09(a)
“Scope of Practice for the
Registered Cardiovascular Electrophysiology Specialist
(RCES)”, 2017
Alliance of Cardiovascular Professionals
https://www.acp-online.org/advocacy/scopes-of-practice/
Plc 1307.10(a)
“Scope of Practice for the
Registered Cardiovascular
Invasive Specialist (RCIS)”,
2018
https://www.acp-online.org/advocacy/scopes-of-practice/
Plc 1310.02(a),
(b)
1. (1) , (d), (e)(1),
  (f), & (g)(2)
  “ARRT Standards of Ethics,”
  effective September 1, 2021
  American Registry of Radiologic Technologists; go to https://www.arrt.org/docs/default-source/Governing-Documents/arrt-standards-of-ethics.pdf?sfvrsn=12
  Plc 1310.02(b)(2)
  “ARMRIT Code of Ethics”
2. (undated) American Registry of Magnetic Resonance Imaging Technologists; go to https://www.armrit.org/index.php, then scroll to the bottom of the page and click on “Code of
  Ethics” or see Appendix D
  Plc 1310.02(c)
  “Nuclear Medicine Technologist Scope of Practice and Performance Standards,” 2nd Ed., 06-09-22,
  lines 98-137
  Society of Nuclear Medicine and Molecular Imaging Technologist Section; found at http://www.snmmi.org/IssuesAdvocacy/content.aspx?
  ItemNumber=6416&navItemNumber=592
  Plc 1310.02(e)(2)
  & (g)(3)
  CCI “Policy 10A, Code of Ethics”
  last revised 1/16
  Cardiovascular Credentialing International; go to
  https://cci-online.org/why-cci/bylaws-policies/ then scroll
  down to Policy – Ethics-Disciplinary Policy and
  Committee.pdf
  Plc 1310.02(g)(1)
  “Code of Ethics for the Profession
  of Diagnostic Medical Sonography”,
  re-approved by SDMS Board of Directors, effective 02/08/2017
  Society of Diagnostic Medical Sonography; http://www.sdms.org/about/who-we-are/code-of-ethics
  Appendix C: O*NET Online Tasks for ARMRIT-Certified Licensed Magnetic Resonance Technologists
  Tasks
  · Operate magnetic resonance imaging (MRI) scanners.
  · Select appropriate imaging techniques or coils to produce required images.
  · Intravenously inject contrast dyes, such as gadolinium contrast, in accordance with scope of practice.
  · Position patients on cradle, attaching immobilization devices, if needed, to ensure appropriate placement for imaging.
  · Conduct screening interviews of patients to identify contraindications, such as ferrous objects, pregnancy, prosthetic heart valves, cardiac pacemakers, or tattoos.
  · Explain magnetic resonance imaging (MRI) procedures to patients, patient representatives, or family members.
  · Provide headphones or earplugs to patients to improve comfort and reduce unpleasant noise.
  · Take brief medical histories from patients.
  · Inspect images for quality, using magnetic resonance scanner equipment and laser camera.
  · Create backup copies of images by transferring images from disk to storage media or workstation.
  · Troubleshoot technical issues related to magnetic resonance imaging (MRI) scanner or peripheral equipment, such as monitors or coils.
  · Write reports or notes to summarize testing procedures or outcomes for physicians or other medical professionals.
  · Test magnetic resonance imaging (MRI) equipment to ensure proper functioning and performance in accordance with specifications.
  · Calibrate magnetic resonance imaging (MRI) console or peripheral hardware.
  · Instruct medical staff or students in magnetic resonance imaging (MRI) procedures or equipment operation.
  · Attach physiological monitoring leads to patient's finger, chest, waist, or other body parts.
  · Conduct inventories to maintain stock of clinical supplies.
  · Operate optical systems to capture dynamic magnetic resonance imaging (MRI) images, such as functional brain imaging, real-time organ motion tracking, or musculoskeletal anatomy and trajectory visualization.
  · Request sedatives or other medication from physicians for patients with anxiety or claustrophobia.
  · Connect physiological leads to physiological acquisition control (PAC) units.
  · Schedule appointments for research subjects or clinical patients.
  · Develop or otherwise produce film records of magnetic resonance images.
  · Place and secure small, portable magnetic resonance imaging (MRI) scanners on body part to be imaged, such as arm, leg, or head.
  Appendix D: ARMRIT Code of Ethics and Mission Statement
  Magnetic Resonance Imaging Technologists, as Certified Technologists of an allied health care profession, must endeavor to always practice their specialty with the highest ethical standards in mind. The American Registry of Magnetic Resonance Imaging Technologists’ Board of Directors adopted and enacted the following Guidelines:
  1) The MRI technologist shall provide quality service and patient care with empathy, respect and concern for the rights, privacy and safety of the patient.
  2) The MRI technologist shall always be aware of the precautions necessary and available to anyone in the MRI environment in order to safeguard the patient and others.
  3) The MRI technologist shall respect the confidentiality and never divulge patient information to anyone not directly related to the care of the patient as allowed by law.
  4) The MRI technologist shall adhere and comply with statutes, laws, regulations or specifications that govern the medical imaging modality of magnetic resonance imaging technology under federal, state and local law.
  5) The MRI technologist shall perform their assigned duties responsibly, accurately and competently, and professionally.
  6) The MRI technologist shall always endeavor to enhance and improve their knowledge of the specialty and skills annually through formal and informal continuing education.
  7) The MRI technologist shall not violate any laws.
  8) The MRI technologist shall promote community awareness of the importance of quality health care and participate in related activities, whenever possible.
  ARMRIT Mission Statement
  The mission of the American Registry of Magnetic Resonance Imaging Technologists (ARMRIT) is to recognize individuals qualified as specialists in the use of Magnetic Resonance Imaging (MRI) Technology which employs non-ionizing radiation to promote high standards of patient care and safety in the diagnostic medical imaging modality of MRI Technology including interventional MRI, cardiovascular MRI, functional MRI, and MRI breast imaging. The Registry is open to all qualified technologists in all imaging fields provided a formal education has been completed through bonafide established schools dedicated to MRI technologists.
  Appendix E: Referenced Statutory Provisions
  328-J:19 Penalties. –
  I. The executive director may deny, suspend, revoke, or refuse to renew a license or impose probationary conditions on a license if the licensee or applicant for licensure has engaged in any of the following conduct:
3. (a) Obtaining a license by means of fraud, misrepresentation, or concealment of material facts.
4. (b) Engaging in unprofessional conduct pursuant to rules adopted by the executive director.
5. (c) Having been convicted of or pleaded guilty or nolo contendere to a crime involving moral turpitude or any crime which indicates that the licensee or applicant is unfit or incompetent to administer medical imaging or radiation therapy procedures or that the licensee or applicant has deceived or defrauded the public.
6. (d) Engaging in any act or practice in violation of any of the provisions of this chapter or any rule adopted by the executive director or aiding, abetting, or assisting any person in such a violation.
7. (e) Committing an act or acts of malpractice, gross negligence, or incompetence in administering medical imaging or radiation therapy procedures.
8. (f) Practicing as a person licensed to administer medical imaging or radiation therapy procedures without a current license.
9. (g) Engaging in conduct that could result in harm or injury to the public.
10. (h) Having a license issued under this chapter revoked or suspended or other disciplinary action taken, whether in this state or another jurisdiction.
11. (i) Being unfit or incompetent to administer medical imaging or radiation therapy services by reason of deliberate or negligent acts or omissions, regardless of whether actual injury to a patient is established.
  II. The executive director, upon making an affirmative finding under paragraph I, may take disciplinary action in any one or more of the following ways:
12. (a) By written reprimand.
13. (b) By suspension, refusal to renew, limitation or restriction of a license, or probation for a period of time determined to be reasonable by the executive director.
14. (c) By revocation of a license.
15. (d) By requiring the person to participate in a program of continuing education in the area or areas in which the person has been found deficient.
16. (e) By requiring the person to practice under the direct supervision of a medical imaging professional or radiation therapist for a period of time specified by the executive director.
17. (f) By assessing civil penalties, after notification and due process, in amounts established by the executive director which shall not exceed $2,500 per offense or, in the case of continuing offenses, $250 for each day the violation continues, whichever is greater.
  III. The denial, refusal to renew, suspension, revocation, or imposition of probationary conditions upon a license may be ordered by the executive director after a hearing held in accordance with RSA 328-J:18 and rules adopted by the executive director. An application may be made to the executive director for reinstatement of a revoked license if the revocation has been in effect for at least 2 years after the date of the executive director’s order revoking the license.
  Source. 2016, 54:2, eff. July 1, 2016. 2022, 104:6, eff. July 26, 2022.
  328-J:25 Exemptions. – Nothing in this chapter shall be construed to prevent or affect:
  I. A licensed practitioner performing medical imaging or radiation therapy procedures within his or her scope of practice, education, training, and competence.
  II. A registered dental hygienist licensed under the laws of the state of New Hampshire performing dental imaging procedures within his or her scope of practice, education, training, and competence and under the supervision of a dentist licensed under the laws of the state of New Hampshire.
  III. A dental assistant licensed or holding a certificate under the laws of the state of New Hampshire performing dental imaging procedures within his or her scope of practice, education, training, and competence and under the supervision of a dentist licensed under the laws of the state of New Hampshire.
  IV. A resident physician or a student enrolled in and attending a school or college of medicine, dentistry, osteopathy, chiropractic, podiatry, limited x-ray machine operator, medical imaging, or radiation therapy who performs medical imaging or radiation therapy procedures on humans while under the supervision of a licensed practitioner or a person holding a license under this chapter in the supervised modality.
  V. A person administering medical imaging or radiation procedures who is employed by the United States government when performing duties associated with that employment.
  VI. A person licensed under the laws of the state of New Hampshire performing a sonography procedure within his or her scope of practice, education, training, and competence, that is used to assess specific and limited information about a patient's immediate medical condition, is limited to a focused imaging target and does not generate a recorded diagnostic medical image. A focused imaging target includes, but is not limited to:
18. (a) Assessment of fetal presentation or heartbeat;
19. (b) Assessment of fluid in a body cavity;
20. (c) Assessment of foreign body position or location;
21. (d) Fetal monitoring during active labor; or
22. (e) Identification of an anatomical landmark or blood vessel for vascular access or administration of anesthesia.
  VII. A person performing medical procedures or therapy on non-human subjects or cadavers.
  VIII. A person licensed under the laws of the state of New Hampshire performing a medical procedure using ultrasound for a non-imaging purpose that is within his or her scope of practice, education, training, and competence.
  IX. A person licensed to perform a medical imaging or radiation therapy modality, who is performing clinical procedures under the supervision of a licensed practitioner or a person holding a license under this chapter in the supervised modality, in preparation for certification in an additional medical imaging or radiation therapy modality. To receive this exemption, the person shall register with the executive director and meet the requirements as specified in this chapter and under the rules adopted by the board. The executive director may grant this exemption for a period not to exceed 3 years and the exemption may be renewed by the executive director.
  Source. 2016, 54:2, eff. July 1, 2016. 2017, 217:1, eff. Sept. 8, 2017. 2022, 104:8, eff. July 26, 2022.
  Appendix F: Plc 307.04 as effective May 1, 2023