462.04 Prescription or order required. A person who holds a license or limited X-ray machine operator permit under this chapter may not use diagnostic X-ray equipment on humans for diagnostic purposes unless authorized to do so by prescription or order of a physician licensed under s. 448.04 (1) (a), a naturopathic doctor licensed under s. 466.04 (1), a dentist licensed under s. 447.04 (1), a podiatrist licensed under s. 448.63, a chiropractor licensed under s. 446.02, an advanced practice registered nurse certified licensed under s. 441.16 (2) 441.09, a physician assistant licensed under s. 448.974, or, subject to s. 448.56 (7) (a), a physical therapist who is licensed under s. 448.53 or who holds a compact privilege under subch. XI of ch. 448.
SB145,135
Section
135. 655.001 (1) of the statutes is renumbered 655.001 (1r).
SB145,136
Section
136. 655.001 (1g) of the statutes is created to read:
655.001 (1g) “Advanced practice registered nurse” means an individual who is licensed under s. 441.09, who has qualified to practice independently in his or her recognized role under s. 441.09 (3m) (b), and who practices advanced practice registered nursing, as defined under s. 441.001 (1c), outside of a collaborative relationship with a physician or dentist, as described under s. 441.09 (3m) (a) 1., or other employment relationship.
SB145,137
Section 137
. 655.001 (7t) of the statutes is amended to read:
655.001 (7t) “Health care practitioner" means a health care professional, as defined in s. 180.1901 (1m), who is an employee of a health care provider described in s. 655.002 (1) (d), (e), (em), or (f) and who has the authority to provide health care services that are not in collaboration with a physician under s. 441.15 (2) (b) or under the direction and supervision of a physician or nurse anesthetist advanced practice registered nurse.
SB145,138
Section
138. 655.001 (9) of the statutes is repealed.
SB145,139
Section
139. 655.002 (1) (a) of the statutes is amended to read:
655.002 (1) (a) A physician or a nurse anesthetist an advanced practice registered nurse for whom this state is a principal place of practice and who practices his or her profession in this state more than 240 hours in a fiscal year.
SB145,140
Section
140. 655.002 (1) (b) of the statutes is amended to read:
655.002 (1) (b) A physician or a nurse anesthetist an advanced practice registered nurse for whom Michigan is a principal place of practice, if all of the following apply:
1. The physician or nurse anesthetist advanced practice registered nurse is a resident of this state.
2. The physician or nurse anesthetist advanced practice registered nurse practices his or her profession in this state or in Michigan or a combination of both more than 240 hours in a fiscal year.
3. The physician or nurse anesthetist advanced practice registered nurse performs more procedures in a Michigan hospital than in any other hospital. In this subdivision, “Michigan hospital" means a hospital located in Michigan that is an affiliate of a corporation organized under the laws of this state that maintains its principal office and a hospital in this state.
SB145,141
Section
141. 655.002 (1) (c) of the statutes is amended to read:
655.002 (1) (c) A physician or nurse anesthetist an advanced practice registered nurse who is exempt under s. 655.003 (1) or (3), but who practices his or her profession outside the scope of the exemption and who fulfills the requirements under par. (a) in relation to that practice outside the scope of the exemption. For a physician or a nurse anesthetist an advanced practice registered nurse who is subject to this chapter under this paragraph, this chapter applies only to claims arising out of practice that is outside the scope of the exemption under s. 655.003 (1) or (3).
SB145,142
Section
142. 655.002 (1) (d) of the statutes is amended to read:
655.002 (1) (d) A partnership comprised of physicians or nurse anesthetists advanced practice registered nurses and organized and operated in this state for the primary purpose of providing the medical services of physicians or nurse anesthetists advanced practice registered nurses.
SB145,143
Section
143. 655.002 (1) (e) of the statutes is amended to read:
655.002 (1) (e) A corporation organized and operated in this state for the primary purpose of providing the medical services of physicians or nurse anesthetists
advanced practice registered nurses.
SB145,144
Section
144. 655.002 (1) (em) of the statutes is amended to read:
655.002 (1) (em) Any organization or enterprise not specified under par. (d) or (e) that is organized and operated in this state for the primary purpose of providing the medical services of physicians or nurse anesthetists advanced practice registered nurses.
SB145,145
Section
145. 655.002 (2) (a) of the statutes is amended to read:
655.002 (2) (a) A physician or nurse anesthetist advanced practice registered nurse for whom this state is a principal place of practice but who practices his or her profession fewer than 241 hours in a fiscal year, for a fiscal year, or a portion of a fiscal year, during which he or she practices his or her profession.
SB145,146
Section
146. 655.002 (2) (b) of the statutes is amended to read:
655.002 (2) (b) Except as provided in sub. (1) (b), a physician or nurse anesthetist advanced practice registered nurse for whom this state is not a principal place of practice, for a fiscal year, or a portion of a fiscal year, during which he or she practices his or her profession in this state. For a health care provider who elects to be subject to this chapter under this paragraph, this chapter applies only to claims arising out of practice that is in this state and that is outside the scope of an exemption under s. 655.003 (1) or (3).
SB145,147
Section
147. 655.003 (1) of the statutes is amended to read:
655.003 (1) A physician or a nurse anesthetist an advanced practice registered nurse who is a state, county or municipal employee, or federal employee or contractor covered under the federal tort claims act, as amended, and who is acting within the scope of his or her employment or contractual duties.
SB145,148
Section
148. 655.003 (3) of the statutes is amended to read:
655.003 (3) Except for a physician or nurse anesthetist advanced practice registered nurse who meets the criteria under s. 146.89 (5) (a), a physician or a nurse anesthetist an advanced practice registered nurse who provides professional services under the conditions described in s. 146.89, with respect to those professional services provided by the physician or nurse anesthetist advanced practice registered nurse for which he or she is covered by s. 165.25 and considered an agent of the department, as provided in s. 165.25 (6) (b).
SB145,149
Section 149
. 655.005 (2) (a) of the statutes is amended to read:
655.005 (2) (a) An employee of a health care provider if the employee is a physician or a nurse anesthetist an advanced practice registered nurse or is a health care practitioner who is providing health care services that are not in collaboration with a physician under s. 441.15 (2) (b) or under the direction and supervision of a physician or nurse anesthetist advanced practice registered nurse.
SB145,150
Section
150. 655.005 (2) (b) of the statutes is amended to read:
655.005 (2) (b) A service corporation organized under s. 180.1903 by health care professionals, as defined under s. 180.1901 (1m), if the board of governors determines that it is not the primary purpose of the service corporation to provide the medical services of physicians or nurse anesthetists advanced practice registered nurses. The board of governors may not determine under this paragraph that it is not the primary purpose of a service corporation to provide the medical services of physicians or nurse anesthetists advanced practice registered nurses unless more than 50 percent of the shareholders of the service corporation are neither physicians nor nurse anesthetists advanced practice registered nurses.
SB145,151
Section
151. 655.23 (5m) of the statutes is amended to read:
655.23 (5m) The limits set forth in sub. (4) shall apply to any joint liability of a physician or nurse anesthetist advanced practice registered nurse and his or her corporation, partnership, or other organization or enterprise under s. 655.002 (1) (d), (e), or (em).
SB145,152
Section
152. 655.27 (3) (a) 4. of the statutes is amended to read:
655.27 (3) (a) 4. For a health care provider described in s. 655.002 (1) (d), (e), (em), or (f), risk factors and past and prospective loss and expense experience attributable to employees of that health care provider other than employees licensed as a physician or nurse anesthetist advanced practice registered nurse.
SB145,153
Section
153. 655.27 (3) (b) 2m. of the statutes is amended to read:
655.27 (3) (b) 2m. In addition to the fees and payment classifications described under subds. 1. and 2., the commissioner, after approval by the board of governors, may establish a separate payment classification for physicians satisfying s. 655.002 (1) (b) and a separate fee for nurse anesthetists advanced practice registered nurses satisfying s. 655.002 (1) (b) which take into account the loss experience of health care providers for whom Michigan is a principal place of practice.
SB145,154
Section
154. 655.275 (2) of the statutes is amended to read:
655.275 (2) Appointment. The board of governors shall appoint the members of the council. Section 15.09, except s. 15.09 (4) and (8), does not apply to the council. The board of governors shall designate the chairperson, who shall be a physician, the vice chairperson, and the secretary of the council and the terms to be served by council members. The council shall consist of 5 or 7 persons, not more than 3 of whom are physicians who are licensed and in good standing to practice medicine in this state and one of whom is a nurse anesthetist
an advanced practice registered nurse who is licensed and in good standing to practice nursing in this state. The chairperson or another peer review council member designated by the chairperson shall serve as an ex officio nonvoting member of the medical examining board and may attend meetings of the medical examining board, as appropriate.
SB145,155
Section
155. 655.275 (5) (b) 2. of the statutes is amended to read:
655.275 (5) (b) 2. If a claim was paid for damages arising out of the rendering of care by a nurse anesthetist an advanced practice registered nurse, with at least one nurse anesthetist advanced practice registered nurse.
SB145,156
Section 156
. 961.01 (19) (a) of the statutes is amended to read:
961.01 (19) (a) A physician, advanced practice
registered nurse, dentist, veterinarian, podiatrist, optometrist, scientific investigator or, subject to s. 448.975 (1) (b), a physician assistant, or other person licensed, registered, certified or otherwise permitted to distribute, dispense, conduct research with respect to, administer or use in teaching or chemical analysis a controlled substance in the course of professional practice or research in this state.
SB145,157
Section 157
. 961.395 of the statutes is amended to read:
961.395 Limitation on advanced practice registered nurses. (1) An advanced practice registered nurse who is certified may issue prescription orders under s. 441.16 441.09 (2) may prescribe controlled substances only as permitted by the rules promulgated under s. 441.16 (3) 441.09 (6) (a) 4.
(2) An advanced practice registered nurse certified under s. 441.16 who may issue prescription orders under s. 441.09 (2) shall include with each prescription order the advanced practice nurse prescriber certification license number issued to him or her by the board of nursing.
(3) An advanced practice registered nurse certified under s. 441.16 who may issue prescription orders under s. 441.09 (2) may dispense a controlled substance only by prescribing or administering the controlled substance or as otherwise permitted by the rules promulgated under s. 441.16 (3) 441.09 (6) (a) 4.
SB145,158
Section 158
.
Nonstatutory provisions.
(1) Using the procedure under s. 227.24, the board of nursing may promulgate rules under ch. 441 that are necessary to implement the changes in this act. Notwithstanding s. 227.24 (1) (a) and (3), the board is not required to provide evidence that promulgating a rule under this subsection as an emergency rule is necessary for the preservation of the public peace, health, safety, or welfare and is not required to provide a finding of emergency for a rule promulgated under this subsection. A rule under this subsection may take effect no later than the date specified in Section 159 (intro.) of this act. Notwithstanding s. 227.24 (1) (c) and (2), a rule promulgated under this subsection is effective for 2 years after its promulgation, or until permanent rules take effect, whichever is sooner, and the effective period of a rule promulgated under this subsection may not be further extended under s. 227.24 (2).
(2) (a) In this subsection, the definitions under s. 441.001 apply.
(b) Notwithstanding s. 441.09 (3), an individual who, on January 1, 2024, is licensed as a registered nurse in this state and is practicing in a recognized role may continue to practice advanced practice registered nursing and the corresponding recognized role in which he or she is practicing and may continue to use the titles corresponding to the recognized roles in which he or she is practicing during the period before which the board takes final action on the person's application under s. 441.09. This paragraph does not apply after the first day of the 13th month beginning after the effective date of this paragraph.
SB145,159
Section 159
.
Effective dates. This act takes effect on the first day of the 13th month beginning after publication, except as follows:
(1) Section 158 (1
) of this act takes effect on the day after publication.
