Date of enactment: April 8, 2014
2013 Senate Bill 579   Date of publication*: April 9, 2014
* Section 991.11, Wisconsin Statutes: Effective date of acts. "Every act and every portion of an act enacted by the legislature over the governor's partial veto which does not expressly prescribe the time when it takes effect shall take effect on the day after its date of publication."
2013 WISCONSIN ACT 240
An Act to repeal 448.04 (1) (b) 2., 448.04 (1) (c), 448.065, 448.10 (1), (4) and (5), 448.10 (2m) and 448.10 (3m); to renumber 448.10 (1m); to amend 440.08 (2) (a) (intro.), 448.02 (1), 448.02 (3) (a), 448.02 (3) (b), 448.02 (3) (c), 448.02 (3) (e), 448.02 (3) (h), 448.02 (4) (a), 448.02 (4) (b), 448.02 (5), 448.02 (6), 448.02 (8) (a), 448.02 (8) (b), 448.02 (8) (c), 448.05 (1) (c), 448.05 (1) (d), 448.05 (6) (a), 448.06 (title), 448.06 (1), 448.06 (1), 448.07 (1) (d), 448.08 (1) (a), 448.08 (1) (a) and 462.01 (4); to repeal and recreate 448.05 (2); and to create 448.04 (1) (ac), 448.04 (1) (bg) and (bm), 448.05 (2c), 448.05 (6) (at), 448.063 and 448.10 (1m), (2m) and (3m) of the statutes; relating to: licensure of physicians; providing an exemption from emergency rule procedures; and granting rule-making authority.
The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:
240,1 Section 1. 440.08 (2) (a) (intro.) of the statutes is amended to read:
440.08 (2) (a) (intro.) Except as provided in par. (b) and in ss. 440.51, 442.04, 444.03, 444.11, 447.04 (2) (c) 2., 448.065, 449.17 (1m) (d), and 449.18 (2) (d) and subch. II of ch. 448, the renewal dates for credentials are as follows:
240,2 Section 2. 448.02 (1) of the statutes is amended to read:
448.02 (1) License. The board may grant licenses, including various classes of temporary licenses, to practice medicine and surgery, to practice as an administrative physician, to practice perfusion, to practice as an anesthesiologist assistant, and to practice as a physician assistant.
240,3 Section 3. 448.02 (3) (a) of the statutes is amended to read:
448.02 (3) (a) The board shall investigate allegations of unprofessional conduct and negligence in treatment by persons holding a license, or certificate or limited permit granted by the board. An allegation that a physician has violated s. 253.10 (3), 448.30 or 450.13 (2) or has failed to mail or present a medical certification required under s. 69.18 (2) within 21 days after the pronouncement of death of the person who is the subject of the required certificate or that a physician has failed at least 6 times within a 6-month period to mail or present a medical certificate required under s. 69.18 (2) within 6 days after the pronouncement of death of the person who is the subject of the required certificate is an allegation of unprofessional conduct. Information contained in reports filed with the board under s. 49.45 (2) (a) 12r., 50.36 (3) (b), 609.17 or 632.715, or under 42 CFR 1001.2005, shall be investigated by the board. Information contained in a report filed with the board under s. 655.045 (1), as created by 1985 Wisconsin Act 29, which is not a finding of negligence or in a report filed with the board under s. 50.36 (3) (c) may, within the discretion of the board, be used as the basis of an investigation of a person named in the report. The board may require a person holding a license, or certificate or limited permit to undergo and may consider the results of one or more physical, mental or professional competency examinations if the board believes that the results of any such examinations may be useful to the board in conducting its investigation.
240,4 Section 4. 448.02 (3) (b) of the statutes is amended to read:
448.02 (3) (b) After an investigation, if the board finds that there is probable cause to believe that the person is guilty of unprofessional conduct or negligence in treatment, the board shall hold a hearing on such conduct. The board may use any information obtained by the board or the department under s. 655.17 (7) (b), as created by 1985 Wisconsin Act 29, in an investigation or a disciplinary proceeding, including a public disciplinary proceeding, conducted under this subsection and the board may require a person holding a license, or certificate or limited permit to undergo and may consider the results of one or more physical, mental or professional competency examinations if the board believes that the results of any such examinations may be useful to the board in conducting its hearing. A unanimous finding by a panel established under s. 655.02, 1983 stats., or a finding by a court that a physician has acted negligently in treating a patient is conclusive evidence that the physician is guilty of negligence in treatment. A finding that is not a unanimous finding by a panel established under s. 655.02, 1983 stats., that a physician has acted negligently in treating a patient is presumptive evidence that the physician is guilty of negligence in treatment. A certified copy of the findings of fact, conclusions of law and order of the panel or the order of a court is presumptive evidence that the finding of negligence in treatment was made. The board shall render a decision within 90 days after the date on which the hearing is held or, if subsequent proceedings are conducted under s. 227.46 (2), within 90 days after the date on which those proceedings are completed.
240,5 Section 5. 448.02 (3) (c) of the statutes is amended to read:
448.02 (3) (c) Subject to par. (cm), after a disciplinary hearing, the board may, when it determines that a panel established under s. 655.02, 1983 stats., has unanimously found or a court has found that a person has been negligent in treating a patient or when it finds a person guilty of unprofessional conduct or negligence in treatment, do one or more of the following: warn or reprimand that person, or limit, suspend or revoke any license, or certificate or limited permit granted by the board to that person. The board may condition the removal of limitations on a license, or certificate or limited permit or the restoration of a suspended or revoked license, or certificate or limited permit upon obtaining minimum results specified by the board on one or more physical, mental or professional competency examinations if the board believes that obtaining the minimum results is related to correcting one or more of the bases upon which the limitation, suspension or revocation was imposed.
240,6 Section 6. 448.02 (3) (e) of the statutes is amended to read:
448.02 (3) (e) A person whose license, or certificate or limited permit is limited under this subchapter shall be permitted to continue practice upon condition that the person will refrain from engaging in unprofessional conduct; that the person will appear before the board or its officers or agents at such times and places as may be designated by the board from time to time; that the person will fully disclose to the board or its officers or agents the nature of the person's practice and conduct; that the person will fully comply with the limits placed on his or her practice and conduct by the board; that the person will obtain additional training, education or supervision required by the board; and that the person will cooperate with the board.
240,7 Section 7. 448.02 (3) (h) of the statutes is amended to read:
448.02 (3) (h) Nothing in this subsection prohibits the board, in its discretion, from investigating and conducting disciplinary proceedings on allegations of unprofessional conduct by persons holding a license, or certificate or limited permit granted by the board when the allegations of unprofessional conduct may also constitute allegations of negligence in treatment.
240,8 Section 8. 448.02 (4) (a) of the statutes is amended to read:
448.02 (4) (a) The board may summarily suspend any license, or certificate, or limited permit granted by the board when the board has in its possession evidence establishing probable cause to believe that the holder of the license, or certificate, or limited permit has violated the provisions of this subchapter and that it is necessary to suspend the license, or certificate , or limited permit immediately to protect the public health, safety, or welfare. The holder of the license, or certificate, or limited permit shall be granted an opportunity to be heard during the determination of probable cause. The board chair and 2 board members designated by the chair or, if the board chair is not available, the board vice-chair and 2 board members designated by the vice-chair, shall exercise the authority granted by this paragraph to suspend summarily a license, or certificate , or limited permit in the manner provided under par. (b).
240,9 Section 9. 448.02 (4) (b) of the statutes is amended to read:
448.02 (4) (b) An order of summary suspension shall be served upon the holder of the license, or certificate, or limited permit in the manner provided in s. 801.11 for service of summons. The order of summary suspension shall be effective upon service or upon actual notice of the summary suspension given to the holder of the license, or certificate, or limited permit or to the attorney of the license, permit, or limited permit certificate holder, whichever is sooner. A notice of hearing commencing a disciplinary proceeding shall be issued no more than 10 days following the issuance of the order of summary suspension. The order of summary suspension remains in effect until the effective date of a final decision and order in the disciplinary proceeding against the holder or until the order of summary suspension is discontinued by the board following a hearing to show cause. The holder of the license, or certificate, or limited permit shall have the right to request a hearing to show cause why the order of summary suspension should not be continued and the order of summary suspension shall notify the holder of the license, or certificate, or limited permit of that right. If a hearing to show cause is requested by the holder of the license, or certificate, or limited permit, the hearing shall be scheduled on a date within 20 days of receipt by the board of the request for the hearing to show cause.
240,10 Section 10. 448.02 (5) of the statutes is amended to read:
448.02 (5) Voluntary surrender. The holder of any license, or certificate or limited permit granted by the board may voluntarily surrender the license, or certificate or limited permit to the secretary of the board, but the secretary may refuse to accept the surrender if the board has received allegations of unprofessional conduct against the holder of the license, or certificate or limited permit. The board may negotiate stipulations in consideration for accepting the surrender of licenses.
240,11 Section 11. 448.02 (6) of the statutes is amended to read:
448.02 (6) Restoration of license, or certificate or limited permit. The board may restore any license, or certificate or limited permit which that has been voluntarily surrendered or revoked under any of the provisions of this subchapter, on such terms and conditions as it may deem appropriate.
240,12 Section 12. 448.02 (8) (a) of the statutes is amended to read:
448.02 (8) (a) After an investigation by the board under sub. (3) (a) or by the department under s. 440.03 (3m) or (5), the board may issue a private and confidential administrative warning to a holder of a license, or certificate or limited permit if the board determines that there is evidence of misconduct by him or her. The board may issue an administrative warning under this paragraph only if the board determines that no further action is warranted because the matter involves a first occurrence of minor misconduct and the issuance of an administrative warning adequately protects the public by putting the holder of the license, or certificate or limited permit on notice that any subsequent misconduct may result in disciplinary action. The board shall review the determination if the holder of the license, or certificate or limited permit makes a personal appearance before the board. Following the review, the board may affirm, rescind or modify the administrative warning. A holder of a license, or certificate or limited permit may seek judicial review under ch. 227 of an affirmation or modification of an administrative warning by the board.
240,13 Section 13. 448.02 (8) (b) of the statutes is amended to read:
448.02 (8) (b) An administrative warning issued under par. (a) does not constitute an adjudication of guilt or the imposition of discipline and may not be used as evidence that the holder of a license, or certificate or limited permit is guilty of misconduct.
240,14 Section 14. 448.02 (8) (c) of the statutes is amended to read:
448.02 (8) (c) Notwithstanding par. (b), if the board receives a subsequent allegation of misconduct about a holder of a license, or certificate or limited permit to whom the board issued an administrative warning under par. (a), the board may reopen the matter that resulted in the issuance of the administrative warning or use the administrative warning in any subsequent disciplinary hearing under sub. (3) (b) as evidence that he or she had actual knowledge that the misconduct that was the basis for the administrative warning was contrary to law.
240,15 Section 15. 448.04 (1) (ac) of the statutes is created to read:
448.04 (1) (ac) Administrative physician license. The board may grant an administrative physician license to an applicant who satisfies the requirements under s. 448.05 (2c). The board shall issue a license under this paragraph subject to the same terms as a license issued under par. (a), except that, notwithstanding any other provision of law that permits a physician to engage in any act that constitutes the practice of medicine and surgery, the holder of a license issued under this paragraph may not engage in the practice of medicine and surgery except as otherwise authorized under s. 448.03 (2) and may not practice as provided in s. 448.035.
240,16 Section 16. 448.04 (1) (b) 2. of the statutes is repealed.
240,17 Section 17. 448.04 (1) (bg) and (bm) of the statutes are created to read:
448.04 (1) (bg) Restricted license to practice medicine and surgery as a visiting physician. 1. The board may grant a restricted license to practice medicine and surgery as a visiting physician to an applicant who satisfies the requirements under s. 448.05 (2) (e).
2. The holder of a license issued under this paragraph may engage in the practice of medicine and surgery only at the medical education facility, medical research facility, or medical college where the license holder is teaching, researching, or practicing, and only in accordance with the terms and restrictions established by the board.
3. Subject to subd. 4., a license issued under this paragraph is valid for one year and may be renewed at the discretion of the board.
4. A license issued under this paragraph remains valid only while the license holder is actively engaged in teaching, researching, or practicing medicine and surgery and is lawfully entitled to work in the United States.
(bm) Resident educational license to practice medicine and surgery. 1. The board may grant a resident educational license to practice medicine and surgery to an applicant who satisfies the requirements under s. 448.05 (2) (d).
2. Subject to subd. 3., a license issued under this paragraph is valid for one year and may be renewed for additional one-year terms while the license holder is enrolled in the postgraduate training program under s. 448.05 (2) (d) 1.
3. A license issued under this paragraph remains valid only while the license holder is actively engaged in the practice of medicine and surgery in the postgraduate training program under s. 448.05 (2) (d) 1. and is lawfully entitled to work in the United States.
4. The holder of a license issued under this paragraph may engage in the practice of medicine and surgery only in connection with his or her duties under the postgraduate training program under s. 448.05 (2) (d) 1.
240,18 Section 18. 448.04 (1) (c) of the statutes is repealed.
240,19 Section 19. 448.05 (1) (c) of the statutes is amended to read:
448.05 (1) (c) Achieve a passing grade in the any examinations required in this section.
240,20 Section 20. 448.05 (1) (d) of the statutes is amended to read:
448.05 (1) (d) Be found qualified by three-fourths of the members of the board, except that an applicant for a temporary license or certificate under s. 448.04 (1) (b) 1. and 3., (e), and (g), or (i) or a resident educational license under s. 448.04 (1) (bm) must be found qualified by 2 members of the board.
240,21 Section 21. 448.05 (2) of the statutes is repealed and recreated to read:
448.05 (2) License to practice medicine and surgery. (a) Except as provided in pars. (b) to (e), an applicant for any class of license to practice medicine and surgery must supply evidence satisfactory to the board of all of the following:
1. That the applicant is a graduate of and possesses a diploma from a medical or osteopathic college that is accredited by the Liaison Committee on Medical Education, the American Osteopathic Association, or a successor organization and that is approved by the board.
2. That the applicant satisfies one of the following:
a. The applicant has successfully completed and received credit for 24 months of postgraduate training in one or more programs accredited by the Accreditation Council for Graduate Medical Education, the American Osteopathic Association, or a successor organization.
b. The applicant is currently enrolled in a postgraduate training program accredited by the Accreditation Council for Graduate Medical Education, the American Osteopathic Association, or a successor organization; the applicant has successfully completed and received credit for 12 consecutive months of postgraduate training in that program; and the applicant has received an unrestricted endorsement from the postgraduate training program director that includes confirmation that the applicant is expected to continue in the program and complete at least 24 months of postgraduate training.
3. That the applicant satisfies any other requirement established by the board by rule for issuing the license.
(b) Except as provided in pars. (c) to (e), an applicant for a license to practice medicine and surgery who is a graduate of a foreign medical college must supply evidence satisfactory to the board of all of the following:
1.   That the applicant is a graduate of and possesses a diploma from a foreign medical college credentialed by an agency approved by the board.
2.   That the applicant has obtained certification by the Educational Council for Foreign Medical Graduates or a successor organization.
3.   That the applicant has passed all steps of the United States Medical Licensing Examination administered by the National Board of Medical Examiners and the Federation of State Medical Boards, or their successor organizations.
4. That the applicant satisfies one of the following:
a. The applicant has successfully completed and received credit for 24 months of postgraduate training in one or more programs accredited by the Accreditation Council for Graduate Medical Education, the American Osteopathic Association, or a successor organization.
b. The applicant is currently enrolled in a postgraduate training program accredited by the Accreditation Council for Graduate Medical Education, the American Osteopathic Association, or a successor organization; the applicant has successfully completed and received credit for 12 consecutive months of postgraduate training in that program; and the applicant has received an unrestricted endorsement from the postgraduate training program director that includes confirmation that the applicant is expected to continue in the program and complete at least 24 months of postgraduate training.
5. That the applicant satisfies any other requirement established by the board by rule for issuing the license.
(c) The board may promulgate rules specifying circumstances in which the board, in cases of hardship or in cases in which the applicant possesses a medical license issued by another jurisdiction, may grant a waiver from any requirement under par. (a) or (b). The board may grant such a waiver only in accordance with those rules.
(d) An applicant for a resident educational license under s. 448.04 (1) (bm) shall provide the board with all of the following:
1. Proof that the applicant has been accepted into a postgraduate training program accredited by the Accreditation Council for Graduate Medical Education, the American Osteopathic Association, or a successor organization.
2. Written confirmation from the institution sponsoring the postgraduate training program into which the applicant has been accepted confirming that the applicant has been or will be appointed to a position in the program.
3. Proof that the applicant is a graduate of and possesses a diploma from a medical or osteopathic college that is approved by the board.
(e) An applicant for a restricted license to practice medicine and surgery as a visiting physician under s. 448.04 (1) (bg) shall provide the board with all of the following:
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