AB1090: Bill Text

Analysis by the Legislative Reference Bureau

Under current law, with exceptions, a person must be licensed as a podiatrist by the medical examining board (MEB) in the department of regulation and licensing (DORL) in order to practice podiatry or podiatric medicine and surgery or to represent himself or herself to the public as a podiatrist.

This bill creates a 4-member podiatrists affiliated credentialing board (PACB) in DORL consisting of 3 podiatrists and one public member, and transfers to PACB all authority that MEB has under current law relating to the regulation of podiatrists. In addition, the bill does all of the following with respect to the regulation of podiatrists:

1. Under current law, an applicant for a podiatrist license must have graduated from a school of podiatric medicine and surgery approved by MEB with the degree of doctor of podiatric medicine or an equivalent degree. Under this bill, PACB may waive the requirement of graduation from a school of podiatric medicine and surgery approved by PACB if the applicant shows, among other things, that he or she graduated from a podiatry school approved by the licensing jurisdiction of another state. In addition, this bill also requires an applicant to have completed 12 months of postgraduate training in a program approved by PACB.

2. Under this bill, if an applicant passes the podiatry examinations required by PACB for a license, PACB is prohibited from testing the applicant for proficiency in the English language if the sole reason for the testing is that the applicant was educated at a podiatry school outside the United States. There is no comparable prohibition under current law.

3. To qualify for a podiatrist license under current law, a person must meet education, examination and other requirements and must also be found qualified by three-fourths of the members of MEB. For a temporary podiatrist license, current law requires a person to be found qualified by 2 members of MEB. Except as described above in items 1 and 2, this bill retains the education, examination and other requirements that a person must satisfy for PACB to issue a podiatrist license, but does not require PACB to find that a person is qualified.

4. Current law does not require a licensed podiatrist to meet continuing education requirements. This bill requires a podiatrist to complete, every 2 years, 30 hours of continuing education in courses approved by PACB.

5. Under current law, a health care practitioner licensed or certified by MEB, including a podiatrist, must register with MEB every 2 years, pay a license or certificate renewal fee, and display a certificate of registration in his or her office at all times. Registration with MEB is deemed to satisfy any statutory requirement to renew a license or certificate. This bill does not require a podiatrist to register with PACB. Instead, a podiatrist must renew his or her license every 2 years by submitting a renewal form to DORL and paying a renewal fee. In addition, the renewal form must be accompanied by proof that the podiatrist completed the continuing education requirements described above in item 4.

Finally, current law requires the affirmative vote of two-thirds of the membership of an examining board to suspend or revoke a credential that the examining board issued to a person and that entitles the person to practice a trade or profession. This bill requires an affirmative vote of two-thirds of the voting membership of the examining board to suspend or revoke a credential. Currently, MEB and the nursing home administrator examining board each have one nonvoting member. Thus, under the bill, the nonvoting member on these examining boards would not be counted for purposes of determining whether two-thirds of the examining board's members had voted to suspend or revoke a credential.

For further information see the state fiscal estimate, which will be printed as an appendix to this bill.

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

AB1090, s. 1 Section 1. 15.08 (1m) (b) of the statutes is amended to read:

AB1090,3,11 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.

AB1090, s. 2 Section 2. 15.08 (4) (b) of the statutes is amended to read:

AB1090,4,4 15.08 (4) (b) Notwithstanding par. (a), no certificate or license which entitles the person certified or licensed to practice a trade or profession shall be suspended or revoked without the affirmative vote of two-thirds of the voting membership of the examining board.

AB1090, s. 3 Section 3. 15.085 (1m) (b) of the statutes is amended to read:

AB1090,4,9 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.

AB1090, s. 4 Section 4. 15.406 (2) (a) 1. of the statutes is amended to read:

AB1090,4,11 15.406 (2) (a) 1. Three dietitians who are certified under subch. IV V of ch. 448.

AB1090, s. 5 Section 5. 15.406 (3) of the statutes is created to read:

AB1090,4,16 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:

AB1090,4,17 (a) Three podiatrists who are licensed under subch. IV of ch. 448.

AB1090,4,18 (b) One public member.

AB1090, s. 6 Section 6. 15.407 (1) (b) of the statutes is repealed.

AB1090, s. 7 Section 7. 49.45 (3) (k) of the statutes is amended to read:

AB1090,4,24 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.

AB1090, s. 8 Section 8. 50.09 (6) (b) of the statutes is amended to read:

AB1090,5,8 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.

AB1090, s. 9 Section 9. 50.36 (3) of the statutes is amended to read:

AB1090,5,17 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.

AB1090,5,25 (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.

AB1090,6,9 (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.

AB1090, s. 10 Section 10. 50.39 (3) of the statutes, as affected by 1995 Wisconsin Act 77, is amended to read:

AB1090,6,20 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.

AB1090, s. 11 Section 11. 146.37 (1g) of the statutes is amended to read:

AB1090,7,11 146.37 (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.

AB1090, s. 12 Section 12. 146.81 (1) (em) of the statutes, as created by 1993 Wisconsin Act 443, is amended to read:

AB1090,7,15 146.81 (1) (em) A dietitian certified under subch. IV V of ch. 448. This paragraph does not apply after June 30, 1999.

AB1090, s. 13 Section 13. 180.1901 (1m) (bk) of the statutes is created to read:

AB1090,7,18 180.1901 (1m) (bk) Podiatrists affiliated credentialing board under subch. IV of ch. 448.

AB1090, s. 14 Section 14. 180.1901 (1m) (br) of the statutes, as created by 1995 Wisconsin Act .... (Assembly Bill 325), is amended to read:

AB1090,7,22 180.1901 (1m) (br) Dietitians affiliated credentialing board under subch. IV V of ch. 448. This paragraph does not apply after June 30, 1999.

AB1090, s. 15 Section 15. 252.10 (7) of the statutes, as affected by 1993 Wisconsin Act 443, is amended to read:

AB1090,8,9 252.10 (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.

AB1090, s. 16 Section 16. 252.14 (1) (ar) 4m. of the statutes, as created by 1993 Wisconsin Act 443, is amended to read:

AB1090,8,13 252.14 (1) (ar) 4m. A dietitian certified under subch. IV V of ch. 448. This subdivision does not apply after June 30, 1999.

AB1090, s. 17 Section 17. 448.01 (1) of the statutes is renumbered 448.015 (1).

AB1090, s. 18 Section 18. 448.01 (2g) of the statutes is amended to read:

AB1090,8,18 448.01 (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.

AB1090, s. 19 Section 19. 448.01 (2r) of the statutes is amended to read:

AB1090,8,23 448.01 (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.

AB1090, s. 20 Section 20. 448.01 (5) of the statutes is amended to read:

AB1090,9,4 448.01 (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.

AB1090, s. 21 Section 21. 448.01 (6) of the statutes is amended to read:

AB1090,9,8 448.01 (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.

AB1090, s. 22 Section 22. 448.01 (7) of the statutes is renumbered 448.60 (3) and amended to read:

AB1090,9,14 448.60 (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.

AB1090, s. 23 Section 23. 448.01 (8) of the statutes is renumbered 448.60 (4) and amended to read:

AB1090,9,25 448.60 (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.

AB1090, s. 24 Section 24. 448.01 (9g) of the statutes is renumbered 448.015 (2).

AB1090, s. 25 Section 25. 448.01 (9m) of the statutes is renumbered 448.015 (3).

AB1090, s. 26 Section 26. 448.01 (11) of the statutes is renumbered 448.015 (4) and amended to read:

AB1090,10,8 448.015 (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.

AB1090, s. 27 Section 27. 448.01 (12) of the statutes is amended to read:

AB1090,10,14 448.01 (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.

AB1090, s. 28 Section 28. 448.015 (intro.) of the statutes is created to read:

AB1090,10,16 448.015 Definitions. (intro.) In this subchapter:

AB1090, s. 29 Section 29. 448.02 (1) of the statutes is amended to read:

AB1090,10,20 448.02 (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.

AB1090, s. 30 Section 30. 448.02 (3) (a) of the statutes is amended to read:

AB1090,11,16 448.02 (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. 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.

AB1090, s. 31 Section 31. 448.02 (4) of the statutes is amended to read:

AB1090,12,10 448.02 (4) Suspension pending hearing. The board may summarily suspend any license, certificate or limited permit granted by the board for a period not to exceed 30 days pending hearing, when the board has in its possession evidence establishing probable cause to believe that the holder of the license, certificate or limited permit has violated the provisions of this chapter subchapter and that it is necessary to suspend the license, certificate or limited permit immediately to protect the public health, safety or welfare. The holder of the license, certificate or limited permit shall be granted an opportunity to be heard during the determination of probable cause. The board may designate any of its officers to exercise the authority granted by this subsection to suspend summarily a license, certificate or limited permit, but such suspension shall be for a period of time not to exceed 72 hours. If a license, certificate or limited permit has been summarily suspended by the board or any of its officers, the board may, while the hearing is in progress, extend the initial 30-day period of suspension for an additional 30 days. If the holder of the license, certificate or limited permit has caused a delay in the hearing process, the board may subsequently suspend the license, certificate or limited permit from the time the hearing is commenced until a final decision is issued or may delegate such authority to the hearing examiner.

AB1090, s. 32 Section 32. 448.02 (6) of the statutes is amended to read:

AB1090,12,15 448.02 (6) Restoration of license, certificate or limited permit. The board may restore any license, certificate or limited permit which has been voluntarily surrendered or revoked under any of the provisions of this chapter subchapter, on such terms and conditions as it may deem appropriate.

AB1090, s. 33 Section 33. 448.03 (1) of the statutes is amended to read:

AB1090,12,19 448.03 (1) License required to practice. No person may practice medicine and surgery, or podiatry, or attempt to do so or make a representation as authorized to do so, without a license granted by the board.

AB1090, s. 34 Section 34. 448.03 (2) (intro.) of the statutes is amended to read:

AB1090,12,23 448.03 (2) Exceptions. (intro.) Nothing in this chapter subchapter shall be construed either to prohibit, or to require, a license or certificate under this chapter subchapter for any of the following:

AB1090, s. 35 Section 35. 448.03 (2) (c) of the statutes is amended to read:

AB1090,13,4 448.03 (2) (c) The activities of a medical student, podiatry student, respiratory care student or physician assistant student required for such student's education and training; , or the activities of a medical school graduate required for training as required in s. 448.05 (2).

AB1090, s. 36 Section 36. 448.03 (2) (d) of the statutes is amended to read:

AB1090,13,9 448.03 (2) (d) Actual consultation or demonstration by licensed physicians or podiatrists or certified respiratory care practitioners of other states or countries with licensed physicians or podiatrists or certified respiratory care practitioners of this state.

AB1090, s. 37 Section 37. 448.03 (2) (e) of the statutes is amended to read:

AB1090,13,13 448.03 (2) (e) Any person providing patient services as directed, supervised and inspected by a physician or podiatrist who has the power to direct, decide and oversee the implementation of the patient services rendered.

AB1090, s. 38 Section 38. 448.03 (3) (c) of the statutes is repealed.

AB1090, s. 39 Section 39. 448.03 (3) (f) 3. a. of the statutes is amended to read:

AB1090,13,19 448.03 (3) (f) 3. a. The person is licensed or certified as an occupational therapist under the law of another state which has licensure or certification requirements that are determined by the board to be at least as stringent as the requirements of this chapter subchapter.