# 119-s-1692: Radiology Outpatient Ordering Transmission (ROOT) Act

119-s-1692, Radiology Outpatient Ordering Transmission (ROOT) Act, is a 119th Congress bill sponsored by Sen. Blackburn, Marsha [R-TN] (R-TN); status introduced; PRIA reads it as touching household money (as of 2026-08-27).

- Canonical: https://policyrisk.com/legislation/119-s-1692
- As of: 2026-08-27
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-s-1692
- Congress: 119
- Title: Radiology Outpatient Ordering Transmission (ROOT) Act
- Status: introduced
- Introduced: 2025-05-08
- Sponsor: Sen. Blackburn, Marsha [R-TN] (R-TN)
- Cosponsors: 4
- Policy area: Health
- Touches household money: yes
- Last recorded action: 2026-08-27

## Summary

**Strengthens Medicare's tracking of imaging orders by shifting reporting duties to qualified clinical decision support mechanisms (QCDSMs) and creating a data-driven compliance program.** It would require QCDSMs to submit standardized data to the Secretary starting January 1, 2026 and introduce a 'low compliant' designation based on a compliant-rate metric. - Ordering professionals and Medicare patients: Could be labeled 'low compliant' if their compliant-rate falls below a Secretary-set threshold. That designation could lead HHS to consider actions that affect imaging use, such as prior authorization or payment changes, after study and reporting. - Qualified clinical decision support mechanisms (QCDSMs) and claims: QCDSMs would take on new obligations to maintain and report specific data elements to the Secretary in the form and on the schedule HHS specifies beginning January 1, 2026. When imaging is paid under an applicable system, claims must include the ordering professional's national provider identifier. - Small/rural practices, trials, screening services, and oversight: The bill creates explicit exemptions for clinical trials, certain preventive screenings, and small or rural practices (defined as 15 or fewer ordering professionals or located in a rural health professional shortage area). It would also require a congress-facing study due January 1, 2031 and every 5 years that examines compliance, utilization effects, and potential remedies, and it directs HHS to follow specialty society endorsement approaches when specifying AUC and QCDSMs.

## Cosponsors (4)

- Sen. Cortez Masto, Catherine [D-NV] (D-NV), 2025-05-08T00:00:00.000Z
- Sen. Risch, James E. [R-ID] (R-ID), 2025-07-08T00:00:00.000Z
- Sen. Scott, Rick [R-FL] (R-FL), 2025-07-21T00:00:00.000Z
- Sen. Rosen, Jacky [D-NV] (D-NV), 2025-07-21T00:00:00.000Z

## Provisions PRIA read

- Put ordering clinician NPI on claims: cost, low. If enacted, this would require providers to put the ordering clinician's NPI on the Medicare claim for certain outpatient imaging starting January 1, 2026. The rule applies when the ordering clinician is different from the person who furnished the scan and the service is paid under an applicable pa…
- New rules for imaging decision systems: mixed, medium. If enacted, this would make clinical decision support systems keep and send detailed data to HHS starting January 1, 2026. The Secretary would use that data to compute each ordering clinician's compliance rate and each year label clinicians as “low compliant” if their rate is below a cutoff the Sec…

## Related bills

- 119-s-4744: Take Care of America’s Veterans Act
- 119-s-545: Combating Illicit Xylazine Act
- 119-s-1404: Combating Organized Retail Crime Act
- 119-s-1032: Major Richard Star Act
- 119-sres-913: A resolution relating to the death of the Honorable Nancy Kassebaum, former United States Senator for the State of Kansas.
- 119-sres-897: A resolution honoring the life, service, and legacy of the Honorable Jon Llewellyn Kyl, former Senator for the State of Arizona.

## Sources
- [119-s-1692 on Congress.gov](https://www.congress.gov/bill/119th-congress/senate-bill/1692)

## Related
- [119-s-4744: Take Care of America’s Veterans Act](https://policyrisk.com/legislation/119-s-4744)
- [119-s-545: Combating Illicit Xylazine Act](https://policyrisk.com/legislation/119-s-545)
- [119-s-1404: Combating Organized Retail Crime Act](https://policyrisk.com/legislation/119-s-1404)
- [119-s-1032: Major Richard Star Act](https://policyrisk.com/legislation/119-s-1032)
- [119-sres-913: A resolution relating to the death of the Honorable Nancy Kassebaum, former Uni…](https://policyrisk.com/legislation/119-sres-913)
- [119-sres-897: A resolution honoring the life, service, and legacy of the Honorable Jon Llewel…](https://policyrisk.com/legislation/119-sres-897)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-s-1692 (as of 2026-08-27).