SB579: Bill Text

LRB-4204/1

MED:jld:jf

2013 - 2014 LEGISLATURE

2013 Senate BILL 579

February 7, 2014 - Introduced by Senator Vukmir, cosponsored by Representative Severson. Referred to Committee on Health and Human Services.

SB579,1,11 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.

Analysis by the Legislative Reference Bureau

Under current law, physicians are licensed under the authority of the Medical Examining Board (MEB), a credentialing board attached to the Department of Safety and Professional Services. A physician's credential to practice is known as a license to practice medicine and surgery. This bill makes various changes regarding the licenses to practice medicine and surgery and related credentials issued by the MEB. Significant changes in the bill are described as follows:

Regular licenses to practice medicine and surgery

Current law

Current law provides that an applicant for any class of license to practice medicine and surgery must supply evidence satisfactory to the MEB that the applicant is a graduate of and possesses a diploma from a medical or osteopathic college approved by the MEB and has completed postgraduate training of 12 months in a facility approved by the MEB. Current law also contains provisions for issuing licenses to practice medicine and surgery to graduates of foreign medical schools that are not approved by the MEB. Such a graduate of a foreign medical school may be admitted to examination for a license to practice medicine and surgery if he or she satisfies certain requirements.

The bill — licensure of accredited medical and osteopathic college graduates

The bill repeals the provisions described above and replaces them with the following requirements that an applicant other than a graduate of a foreign medical college must satisfy in order to be eligible for a regular license to practice medicine and surgery:

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 MEB.

2. That the applicant either: a) 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; or b) be currently enrolled in a postgraduate training program accredited by the Accreditation Council for Graduate Medical Education, the American Osteopathic Association, or a successor organization; has successfully completed and received credit for 12 consecutive months of postgraduate training in that program; and 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 MEB by rule.

The bill — licensure of graduates of foreign medical colleges

The bill repeals the provisions described above and replaces them with the following requirements that an applicant who is a graduate of a foreign medical college must satisfy in order to be eligible for a regular license to practice medicine and surgery:

1. That the applicant be a graduate of and possess a diploma from a foreign medical college credentialed by an agency approved by the MEB.

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 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 or the American Osteopathic Association or a successor organization, the last 12 months of which were completed in a single program.

5. That the applicant satisfies any other requirement established by the MEB by rule for issuing the license.

The bill — exceptions

The bill allows the MEB to promulgate rules specifying circumstances in which the MEB, 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 described above for a regular license to practice medicine and surgery. The MEB may grant such a waiver only in accordance with those rules.

The bill also grandfathers existing holders of a regular license to practice medicine and surgery so that they may retain and continue to renew their licenses notwithstanding the requirements in the bill described above.

Credentials for medical residents

Current law — temporary educational permits

Under current law, the MEB may grant a temporary educational permit to practice medicine and surgery (TEP) to a person who meets the requirements for a license to practice medicine and surgery, other than required examinations. A TEP may be issued for a period not to exceed one year and may be renewed annually for not more than four years. A TEP permits the holder to take postgraduate educational training in a facility approved by the MEB, and the holder of a TEP may, under the direction of a licensed physician, perform services requisite to that training, but must confine training and practice to the facility in which the holder is taking the training.

The bill — resident educational licenses

The bill repeals the provisions for granting a TEP and replaces them with provisions allowing the MEB to grant a resident educational license (REL). An applicant must, under the bill, satisfy the following requirements in order to be granted an REL:

1. Provide proof that he or she 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. Provide written confirmation from the institution sponsoring the postgraduate training program into which he or she has been accepted confirming the appointment to that program.

3. Provide proof that he or she is a graduate of and possesses a diploma from a medical or osteopathic college that is approved by the MEB.

The bill provides that an REL is valid for one year and may be renewed for additional one-year terms while the REL holder is enrolled in his or her postgraduate training program. The bill also provides that an REL remains valid only while the REL holder is actively engaged in the practice of medicine and surgery in his or her postgraduate training program and is lawfully entitled to work in the United States. Finally, the bill provides that the holder of an REL may engage in the practice of medicine and surgery only in connection with his or her duties under his or her postgraduate training program.

The bill grandfathers existing TEP holders so that they may retain and renew their TEPs for up to three years following enactment of the bill.

Licenses for visiting physicians

Current law — temporary licenses for visiting professors

Under current law, an applicant who is a graduate of a foreign medical school and who, because of noteworthy professional attainment, is invited to serve on the academic staff of a medical college in this state as a visiting professor, may be granted a temporary license to practice medicine and surgery (visiting professor license). A visiting professor license remains in force only while the holder is serving full time on the academic staff of a medical college and the license holder's practice is limited to the duties of the academic position.

The bill — restricted licenses to practice as a visiting physician

The bill repeals the provisions for granting a visiting professor license and replaces them with provisions allowing the MEB to grant a restricted license to practice medicine and surgery as a visiting physician (visiting physician license). An applicant must, under the bill, satisfy the following requirements in order to be granted a visiting physician license:

1. Provide proof that he or she is a graduate of and possesses a diploma from a medical or osteopathic college that is approved by the board.

2. Provide proof that he or she teaches medicine, engages in medical research, or practices medicine and surgery outside this state.

3. Provide proof that the applicant is licensed to practice medicine and surgery outside this state.

4. Provide documentation that he or she intends to teach, research, or practice medicine and surgery at a medical education facility, medical research facility, or medical college in this state, which must include a signed letter from the dean or president of the facility or college.

5. Provide proof that he or she satisfies any other requirement established by the MEB by rule for issuing the license.

The bill provides that the holder of a visiting physician license may engage in the practice of medicine and surgery only at the medical education facility, medical research facility, or medical college where he or she is teaching, researching, or practicing, and only in accordance with the terms and restrictions established by the MEB. The bill provides that a visiting physician license is valid for one year and may be renewed at the discretion of the MEB. Finally, the bill provides that a visiting physician license 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.

The bill grandfathers existing visiting professor license holders so that they may retain and renew their visiting professor licenses for up to three years following enactment of the bill.

Administrative physician license

The bill allows the MEB to grant a new type of license known under the bill as an administrative physician license (APL). The MEB may grant an APL to an applicant who satisfies the requirements for a regular license to practice medicine and surgery, other than any requirement established by the MEB relating to the active practice of medicine and surgery.