Amendment SSA1-AB790

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1995 - 1996 LEGISLATURE

SENATE SUBSTITUTE AMENDMENT 1, To 1995 ASSEMBLY BILL 790

May 7, 1996 - Offered by Senators Schultz, Petak, Andrea and Breske.

AB790-SSA1,2,5 An Act to repeal 15.407 (1) (b), 448.03 (3) (c), 448.04 (1) (d), 448.05 (3) and 448.10 (2); to renumber 448.01 (1), 448.01 (9g), 448.01 (9m), 448.075 (1) (b) 1., 2. and 3. and subchapter IV of chapter 448 [precedes 448.70]; to renumber and amend 448.01 (7), 448.01 (8), 448.01 (11), 448.03 (4), 448.075 (title), 448.075 (1) (intro.), 448.075 (1) (a), 448.075 (1) (b) (intro.) and 448.075 (2); to amend 15.08 (1m) (b), 15.085 (1m) (b), 15.406 (2) (a) 1., 49.45 (3) (k), 50.09 (6) (b), 50.36 (3), 50.39 (3), 146.37 (1g), 146.81 (1) (em), 180.1901 (1m) (br), 227.54, 252.10 (7), 252.14 (1) (ar) 4m., 448.01 (2g), 448.01 (2r), 448.01 (5), 448.01 (6), 448.01 (12), 448.02 (1), 448.02 (3) (a), 448.02 (4), 448.02 (6), 448.03 (1), 448.03 (2) (intro.), 448.03 (2) (c), 448.03 (2) (d), 448.03 (2) (e), 448.03 (3) (f) 3. a., 448.03 (3) (g) 3. a., 448.03 (5) (a), 448.04 (1) (c), 448.04 (3), 448.05 (1) (d), 448.07 (1) (a), 448.07 (1) (d), 448.07 (2), 448.08 (1m), 448.08 (2), 448.08 (4), 448.09 (1), 448.09 (2), 448.10 (5), 448.11, 448.13 (1), 448.21 (1) (d), 448.40 (1), 448.86 (1), 450.10 (3) (a) 5m., 450.11 (8) (b), 632.895 (1) (b) 5. b. and 655.45 (1); and to create 15.406 (3), 180.1901 (1m) (bk), 448.015 (intro.), 448.02 (8), 448.02 (9), 448.09 (1m), 448.14, subchapter IV of chapter 448 [precedes 448.60] and 450.11 (8) (bm) of the statutes; relating to: disciplinary actions against physicians, requiring a report on disciplinary actions against physicians, the regulation of podiatrists, licensure and continuing education requirements for podiatrists, abolishing the podiatry examining council and creating a podiatrists affiliated credentialing board, granting rule-making authority and providing a penalty.

The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

AB790-SSA1, s. 1 Section 1. 15.08 (1m) (b) of the statutes is amended to read:

AB790-SSA1,2,16 15.08 (1m) (b) The public members of the chiropractic examining board, the dentistry examining board, the hearing and speech examining board, the medical examining board, podiatry examining council, occupational therapy examining council, respiratory care practitioners examining council and council on physician assistants, the board of nursing, the nursing home administrator examining board, the veterinary examining board, the optometry examining board, the pharmacy examining board, the examining board of social workers, marriage and family therapists and professional counselors and the psychology examining board shall not be engaged in any profession or occupation concerned with the delivery of physical or mental health care.

AB790-SSA1, s. 2 Section 2. 15.085 (1m) (b) of the statutes is amended to read:

AB790-SSA1,2,21 15.085 (1m) (b) The public members of the physical therapists affiliated credentialing board and the podiatrists affiliated credentialing board shall not be engaged in any profession or occupation concerned with the delivery of physical or mental health care.

AB790-SSA1, s. 3 Section 3. 15.406 (2) (a) 1. of the statutes is amended to read:

AB790-SSA1,2,23 15.406 (2) (a) 1. Three dietitians who are certified under subch. IV V of ch. 448.

AB790-SSA1, s. 4 Section 4. 15.406 (3) of the statutes is created to read:

AB790-SSA1,3,5 15.406 (3) Podiatrists affiliated credentialing board. There is created in the department of regulation and licensing, attached to the medical examining board, a podiatrists affiliated credentialing board consisting of the following members appointed for 4-year terms:

AB790-SSA1,3,6 (a) Three podiatrists who are licensed under subch. IV of ch. 448.

AB790-SSA1,3,7 (b) One public member.

AB790-SSA1, s. 5 Section 5. 15.407 (1) (b) of the statutes is repealed.

AB790-SSA1, s. 6 Section 6. 49.45 (3) (k) of the statutes is amended to read:

AB790-SSA1,3,13 49.45 (3) (k) If a physician performs a surgical procedure that is within the scope of practice of a podiatrist, as defined in s. 448.01 (7) 448.60 (3), the allowable charge for the procedure may not exceed the charge the department determines is reasonable.

AB790-SSA1, s. 7 Section 7. 50.09 (6) (b) of the statutes is amended to read:

AB790-SSA1,3,22 50.09 (6) (b) Allegations of violations of such rights by persons licensed, certified or registered under chs. 441, 446 to 450, 455 and 456 shall be promptly reported by the facility to the appropriate licensing or , examining or affiliated credentialing board and to the person against whom the allegation has been made. Any employe of the facility and any person licensed, certified or registered under chs. 441, 446 to 450, 455 and 456 may also report such allegations to the board. Such board may make further investigation and take such disciplinary action, within the board's statutory authority, as the case requires.

AB790-SSA1, s. 8 Section 8. 50.36 (3) of the statutes is amended to read:

AB790-SSA1,4,6 50.36 (3) (a) Any person licensed to practice medicine and surgery under subch. II of ch. 448 or podiatry under ss. 448.05 and 448.06 subch. IV of ch. 448 shall be afforded an equal opportunity to obtain hospital staff privileges and may not be denied hospital staff privileges solely for the reason that the person is an osteopathic physician and surgeon or a podiatrist. Each individual hospital shall retain the right to determine whether the applicant's training, experience and demonstrated competence is sufficient to justify the granting of hospital staff privileges or is sufficient to justify the granting of limited hospital staff privileges.

AB790-SSA1,4,14 (b) If, as a result of peer investigation or written notice thereof, a hospital staff member who is licensed by the medical examining board or podiatrists affiliated credentialing board, for any reasons that include the quality of or ability to practice, loses his or her hospital staff privileges, has his or her hospital staff privileges reduced or resigns from the hospital staff, the hospital shall so notify the medical examining board or podiatrists affiliated credentialing board, whichever is applicable, within 30 days after the loss, reduction or resignation takes effect. Temporary suspension due to incomplete records need not be reported.

AB790-SSA1,4,23 (c) If, as a result of peer investigation or written notice thereof, a hospital staff member who is licensed by the medical examining board or podiatrists affiliated credentialing board, for reasons that do not include the quality of or ability to practice, loses his or her hospital staff privileges for 30 days or more, has his or her hospital staff privileges reduced for 30 days or more or resigns from the hospital staff for 30 days or more, the hospital shall so notify the medical examining board or podiatrists affiliated credentialing board, whichever is applicable, within 30 days after the loss, reduction or resignation takes effect. Temporary suspension due to incomplete records need not be reported.

AB790-SSA1, s. 9 Section 9. 50.39 (3) of the statutes, as affected by 1995 Wisconsin Act 77, is amended to read:

AB790-SSA1,5,9 50.39 (3) Facilities governed by ss. 45.365, 48.62, 49.70, 49.72, 50.02, 51.09, 58.06, 252.073, 252.076 and 252.10, secured correctional facilities as defined in s. 938.02 (15m), correctional institutions governed by the department of corrections under s. 301.02 and the offices and clinics of persons licensed to treat the sick under chs. 446, 447 and 448 are exempt from ss. 50.32 to 50.39. Sections 50.32 to 50.39 do not abridge the rights of the medical examining board, physical therapists affiliated credentialing board, podiatrists affiliated credentialing board, dentistry examining board, pharmacy examining board, chiropractic examining board and board of nursing in carrying out their statutory duties and responsibilities.

AB790-SSA1, s. 10 Section 10. 146.37 (1g) of the statutes is amended to read:

AB790-SSA1,5,25 146.37 (1g) Except as provided in s. 153.85, no person acting in good faith who participates in the review or evaluation of the services of health care providers or facilities or the charges for such services conducted in connection with any program organized and operated to help improve the quality of health care, to avoid improper utilization of the services of health care providers or facilities or to determine the reasonable charges for such services, or who participates in the obtaining of health care information under ch. 153, is liable for any civil damages as a result of any act or omission by such person in the course of such review or evaluation. Acts and omissions to which this subsection applies include, but are not limited to, acts or omissions by peer review committees or hospital governing bodies in censuring, reprimanding, limiting or revoking hospital staff privileges or notifying the medical examining board or podiatrists affiliated credentialing board under s. 50.36 or taking any other disciplinary action against a health care provider or facility and acts or omissions by a medical director, as defined in s. 146.50 (1) (j), in reviewing the performance of emergency medical technicians or ambulance service providers.

AB790-SSA1, s. 11 Section 11. 146.81 (1) (em) of the statutes, as created by 1993 Wisconsin Act 443, is amended to read:

AB790-SSA1,6,4 146.81 (1) (em) A dietitian certified under subch. IV V of ch. 448. This paragraph does not apply after June 30, 1999.

AB790-SSA1, s. 12 Section 12. 180.1901 (1m) (bk) of the statutes is created to read:

AB790-SSA1,6,7 180.1901 (1m) (bk) Podiatrists affiliated credentialing board under subch. IV of ch. 448.

AB790-SSA1, s. 13 Section 13. 180.1901 (1m) (br) of the statutes, as created by 1995 Wisconsin Act 167, is amended to read:

AB790-SSA1,6,11 180.1901 (1m) (br) Dietitians affiliated credentialing board under subch. IV V of ch. 448. This paragraph does not apply after June 30, 1999.

AB790-SSA1, s. 14 Section 14. 227.54 of the statutes is amended to read:

AB790-SSA1,6,16 227.54 Stay of proceedings. The institution of the proceeding for review shall not stay enforcement of the agency decision. The reviewing court may order a stay upon such terms as it deems proper, except as otherwise provided in ss. 196.43, 448.02 (8) and 551.62.

AB790-SSA1, s. 15 Section 15. 252.10 (7) of the statutes, as affected by 1993 Wisconsin Act 443, is amended to read:

AB790-SSA1,7,2 252.10 (7) Drugs necessary for the treatment of mycobacterium tuberculosis shall be purchased by the department from the appropriation under s. 20.435 (1) (e) and dispensed to patients through the public health dispensaries or through health care providers, as defined in s. 146.81 (1), other than social workers, marriage and family therapists or professional counselors certified under ch. 457, speech-language pathologists or audiologists licensed under subch. II of ch. 459, speech and language pathologists licensed by the department of education or, on or after July 1, 1995, and no later than June 30, 1999, dietitians certified under subch. IV V of ch. 448.

AB790-SSA1, s. 16 Section 16. 252.14 (1) (ar) 4m. of the statutes, as created by 1993 Wisconsin Act 443, is amended to read:

AB790-SSA1,7,6 252.14 (1) (ar) 4m. A dietitian certified under subch. IV V of ch. 448. This subdivision does not apply after June 30, 1999.

AB790-SSA1, s. 17 Section 17. 448.01 (1) of the statutes is renumbered 448.015 (1).

AB790-SSA1, s. 18 Section 18. 448.01 (2g) of the statutes is amended to read:

AB790-SSA1,7,11 448.01 (2g) "Occupational therapist" means an individual who meets the requirements under s. 448.05 (5m) (a) and is certified by the medical examining board to practice occupational therapy.

AB790-SSA1, s. 19 Section 19. 448.01 (2r) of the statutes is amended to read:

AB790-SSA1,7,16 448.01 (2r) "Occupational therapy assistant" means an individual who meets the requirements under s. 448.05 (5m) (b) and is certified by the medical examining board to assist in the practice of occupational therapy under the supervision of an occupational therapist.

AB790-SSA1, s. 20 Section 20. 448.01 (5) of the statutes is amended to read:

AB790-SSA1,7,21 448.01 (5) "Physician" means an individual possessing the degree of doctor of medicine or doctor of osteopathy or an equivalent degree as determined by the medical examining board, and holding a license granted by the medical examining board.

AB790-SSA1, s. 21 Section 21. 448.01 (6) of the statutes is amended to read:

AB790-SSA1,7,25 448.01 (6) "Physician assistant" means an individual certified by the medical examining board to perform patient services under the supervision and direction of a licensed physician.

AB790-SSA1, s. 22 Section 22. 448.01 (7) of the statutes is renumbered 448.60 (3) and amended to read:

AB790-SSA1,8,6 448.60 (3) "Podiatrist" means an individual possessing the degree of doctor of podiatric medicine or doctor of surgical chiropody or equivalent degree as determined by the affiliated credentialing board, and holding a license to practice podiatry or podiatric medicine and surgery granted by the affiliated credentialing board.

AB790-SSA1, s. 23 Section 23. 448.01 (8) of the statutes is renumbered 448.60 (4) and amended to read:

AB790-SSA1,8,17 448.60 (4) "Podiatry" or "podiatric medicine and surgery" means that branch or system of treating the sick which is limited to the diagnosis, or mechanical, medical or surgical treatment or treatment by use of drugs, of the feet, but does not include amputations other than digits of the foot or the use of a general anesthetic unless administered by or under the direction of a person licensed to practice medicine and surgery under subch. II. Diagnosis or treatment shall include no portion of the body above the feet except that diagnosis and treatment shall include the tendons and muscles of the lower leg insofar as they shall be involved in conditions of the feet.

AB790-SSA1, s. 24 Section 24. 448.01 (9g) of the statutes is renumbered 448.015 (2).

AB790-SSA1, s. 25 Section 25. 448.01 (9m) of the statutes is renumbered 448.015 (3).

AB790-SSA1, s. 26 Section 26. 448.01 (11) of the statutes is renumbered 448.015 (4) and amended to read:

AB790-SSA1,8,25 448.015 (4) "Unprofessional conduct" means those acts or attempted acts of commission or omission defined as unprofessional conduct by the board under the authority delegated to the board by s. 15.08 (5) (b) and any act by a physician or podiatrist in violation of ch. 161 or 450.

AB790-SSA1, s. 27 Section 27. 448.01 (12) of the statutes is amended to read:

AB790-SSA1,9,6 448.01 (12) "Warn" means to privately apprise the holder of a license or certificate of the unprofessional nature of the holder's conduct and admonish the holder that continued or repeated conduct of such nature may give the medical examining board or an attached affiliated credentialing board cause to reprimand the holder or to limit, suspend or revoke such license or certificate.

AB790-SSA1, s. 28 Section 28. 448.015 (intro.) of the statutes is created to read:

AB790-SSA1,9,8 448.015 Definitions. (intro.) In this subchapter:

AB790-SSA1, s. 29 Section 29. 448.02 (1) of the statutes is amended to read:

AB790-SSA1,9,12 448.02 (1) License. The board may grant licenses, including various classes of temporary licenses, to practice medicine and surgery and to practice podiatric medicine and surgery.

AB790-SSA1, s. 30 Section 30. 448.02 (3) (a) of the statutes, as affected by 1995 Wisconsin Act 309, is amended to read:

AB790-SSA1,9,25 448.02 (3) (a) The board shall investigate allegations of unprofessional conduct and negligence in treatment by persons holding a license, 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 1001.109 (e) and 42 CFR 1001.124 (a) (3) and (b) 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 the persons a person named in the reports report. The board may require a person holding a license, 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.