SB196: Bill Text

2015 - 2016 LEGISLATURE

2015 Senate BILL 196

June 17, 2015 - Introduced by Senators Harsdorf, Cowles, Moulton, Erpenbach, Carpenter, Gudex, Marklein, Bewley, Harris Dodd, Lassa, Olsen, Ringhand, Roth, Shilling, Vinehout and Wanggaard, cosponsored by Representatives VanderMeer, Petryk, Krug, Jacque, Allen, Ballweg, Bernier, Brandtjen, E. Brooks, R. Brooks, Edming, Gannon, Heaton, Horlacher, Hutton, Jagler, Jarchow, Katsma, Kitchens, Knodl, Knudson, Kremer, Kuglitsch, Kulp, T. Larson, Murphy, Mursau, Murtha, Nerison, Novak, A. Ott, J. Ott, Quinn, Ripp, Rohrkaste, Steffen, Swearingen, Tauchen, Thiesfeldt, Tittl, Tranel, Vorpagel, Weatherston, Barnes, Billings, Danou, Doyle, Genrich, Goyke, Kahl, Kolste, Riemer, Subeck and Wachs. Referred to Committee on Health and Human Services.

SB196,1,7 An Act to renumber and amend 440.03 (11m) (c); to amend 20.165 (1) (hg), 440.03 (13) (b) (intro.), 440.03 (13) (d), 440.05 (intro.), 440.08 (2) (c), 440.14 (2), 440.14 (3), 440.15, 448.01 (5), 448.05 (2) (a) (intro.), 448.05 (2) (b) (intro.), 448.07 (1) (a) and 448.07 (2); and to create 14.83, 440.03 (11m) (c) 2., 440.08 (2) (e), 448.015 (1dm), 448.04 (1) (ab), 448.05 (2) (f) and subchapter VIII of chapter 448 [precedes 448.980] of the statutes; relating to: ratification of the Interstate Medical Licensure Compact and making appropriations.

Analysis by the Legislative Reference Bureau

This bill ratifies and enters Wisconsin into the Interstate Medical Licensure Compact (compact), which provides for, as stated in the compact, "a streamlined process that allows physicians to become licensed in multiple states." Provisions in the compact are to be administered by boards that regulate physicians in the states that are parties to the compact (member boards). Significant provisions of the compact include:

1. The creation of an Interstate Medical Licensure Compact Commission (commission), which includes two representatives of each member board. The commission has various powers and duties granted in the compact, including overseeing the administration of the compact, enforcing the compact, adopting bylaws, promulgating binding rules for the compact, employing an executive director and employees, and maintaining records.

2. A process whereby a physician who possesses a license to engage in the practice of medicine issued by a member board and who satisfies other criteria designates a state where the physician is already licensed as his or her state of principal license and applies to the member board in that state for licensure through the compact. After a verification and registration process that includes a background check, the physician may receive an "expedited license" in other states that are parties to the compact. If a physician's license in his or her state of principal license is revoked or suspended, then all expedited licenses issued by other states are revoked or suspended as well until each is reinstated.

3. The ability for member boards to conduct joint investigations of physicians and the ability of member states to issue subpoenas that are enforceable in other states.

4. The creation of a coordinated information system including a database of all physicians who have applied for or received an expedited license. The compact requires, or in other cases allows, for member boards to submit public actions, complaints, or disciplinary information to the commission.

The compact provides that it becomes effective upon being enacted into law by seven states and that it may be amended upon enactment of an amendment by all member states. A state may withdraw from the compact by repealing the statute authorizing the compact, but the compact provides that a withdrawal does not take effect until one year after the effective date of that repeal.

The compact provides that laws of a member state that are not inconsistent with the compact may be enforced, but that all laws of a member state in conflict with the compact are superseded to the extent of the conflict.

In addition to enacting the compact, the bill provides all of the following:

1. Numerous limitations on the sharing of information under the compact about physicians, including limiting disclosures to physicians who have designated or applied to designate this state as their state of principal license or who hold or are applying to hold expedited licenses granted by the Wisconsin Medical Examining Board (MEB). The bill also includes limitations with respect to the enforceability of subpoenas under the compact and investigations of other states' medical practice laws.

2. A requirement that the Wisconsin MEB report annually to the Joint Committee on Finance about investigations of physicians under the compact.

3. That payment of this state's assessments under the commission is from licensure fees paid by physicians who have applied for licensure through the compact.

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:

SB196,1 Section 1. 14.83 of the statutes is created to read:

SB196,3,6 14.83 Interstate medical licensure compact. There is created an interstate medical licensure compact commission as specified in s. 448.980. The members of the commission representing this state under s. 448.980 (11) (d) shall be members of the medical examining board and shall be appointed by the chairperson of the medical examining board. The commission has the powers and duties granted and imposed under s. 448.980.

SB196,2 Section 2. 20.165 (1) (hg) of the statutes is amended to read:

SB196,3,20 20.165 (1) (hg) General program operations; medical examining board; interstate medical licensure compact; prescription drug monitoring program. Biennially, the amounts in the schedule for the licensing, rule-making, and regulatory functions of the medical examining board and the affiliated credentialing boards attached to the medical examining board, except for preparing, administering, and grading examinations; for any costs associated with the interstate medical licensure compact under s. 448.980, including payment of assessments under s. 448.980 (13) (a); and for the pharmacy examining board's operation of the prescription drug monitoring program under s. 450.19. Ninety percent of all moneys received for issuing and renewing credentials under ch. 448 shall be credited to this appropriation. All moneys received from the interstate medical licensure compact commission under s. 448.980 shall be credited to this appropriation.

SB196,3 Section 3. 440.03 (11m) (c) of the statutes is renumbered 440.03 (11m) (c) (intro.) and amended to read:

SB196,3,25 440.03 (11m) (c) (intro.) The department of safety and professional services may not disclose a social security number obtained under par. (a) to any person except for the following:

SB196,4,1 1. The coordinated licensure information system under s. 441.50 (7); the.

SB196,4,3 3. The department of children and families for purposes of administering s. 49.22; and, for.

SB196,4,7 4. For a social security number obtained under par. (a) 1., the department of revenue for the purpose of requesting certifications under s. 73.0301 and administering state taxes and the department of workforce development for the purpose of requesting certifications under s. 108.227.

SB196,4 Section 4. 440.03 (11m) (c) 2. of the statutes is created to read:

SB196,4,11 440.03 (11m) (c) 2. The coordinated licensure information system under s. 448.980 (8), if such disclosure is required under the interstate medical licensure compact under s. 448.980.

SB196,5 Section 5. 440.03 (13) (b) (intro.) of the statutes is amended to read:

SB196,4,18 440.03 (13) (b) (intro.) The department may investigate whether an applicant for or holder of any of the following credentials has been charged with or convicted of a crime only pursuant to rules promulgated by the department under this paragraph, including rules that establish the criteria that the department will use to determine whether an investigation under this paragraph is necessary, except as provided in par. (c) and s. 448.980 (5) (b) 3.:

SB196,6 Section 6. 440.03 (13) (d) of the statutes is amended to read:

SB196,4,24 440.03 (13) (d) The department shall charge an applicant any fees, costs, or other expenses incurred in conducting any investigation under this subsection or s. 440.26. The department shall charge an applicant seeking licensure through the interstate medical licensure compact under s. 448.980, directly or indirectly, for any expenses incurred in conducting any investigation under s. 448.980 (5) (b) 3.

SB196,7 Section 7. 440.05 (intro.) of the statutes is amended to read:

SB196,5,3 440.05 Standard fees. (intro.) The following standard fees apply to all initial credentials, except as provided in ss. 440.51, 444.03, 444.11, 446.02 (2) (c), 447.04 (2) (c) 2., 448.07 (2), 449.17 (1m) (d), and 449.18 (2) (d):

SB196,8 Section 8. 440.08 (2) (c) of the statutes is amended to read:

SB196,5,7 440.08 (2) (c) Except as provided in par. (e) and sub. (3), renewal applications shall include the applicable renewal fee as determined by the department under s. 440.03 (9) (a) or as specified in par. (b).

SB196,9 Section 9. 440.08 (2) (e) of the statutes is created to read:

SB196,5,10 440.08 (2) (e) A renewal of a compact license, as defined in s. 448.015 (1dm), shall be governed by s. 448.980 (7) and is subject to s. 448.07 (2).

SB196,10 Section 10. 440.14 (2) of the statutes is amended to read:

SB196,5,21 440.14 (2) If a form that the department or a credentialing board requires an individual to complete in order to apply for a credential or credential renewal or to obtain a product or service from the department or the credentialing board requires the individual to provide any of the individual's personal identifiers, the form shall include a place for the individual to declare that the individual's personal identifiers obtained by the department or the credentialing board from the information on the form may not be disclosed on any list that the department or the credentialing board furnishes to another person. This subsection does not apply with respect to an application filed with the medical examining board pursuant to the interstate medical licensure compact under s. 448.980 (5).

SB196,11 Section 11. 440.14 (3) of the statutes is amended to read:

SB196,6,8 440.14 (3) If the department or a credentialing board requires an individual to provide, by telephone or other electronic means, any of the individual's personal identifiers in order to apply for a credential or credential renewal or to obtain a product or service from the department or a credentialing board, the department or the credentialing board shall ask the individual at the time that the individual provides the information if the individual wants to declare that the individual's personal identifiers obtained by telephone or other electronic means may not be disclosed on any list that the department or the credentialing board furnishes to another person. This subsection does not apply with respect to an application filed with the medical examining board pursuant to the interstate medical licensure compact under s. 448.980 (5).

SB196,12 Section 12. 440.15 of the statutes is amended to read:

SB196,6,14 440.15 No fingerprinting. Except as provided under s. ss. 440.03 (13) (c) and 448.980 (5) (b) 3., the department or a credentialing board may not require that an applicant for a credential or a credential holder be fingerprinted or submit fingerprints in connection with the department's or the credentialing board's credentialing.

SB196,13 Section 13. 448.01 (5) of the statutes is amended to read:

SB196,6,19 448.01 (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. This subsection does not apply in s. 448.980.

SB196,14 Section 14. 448.015 (1dm) of the statutes is created to read:

SB196,6,22 448.015 (1dm) "Compact license" means an expedited license granted by the board pursuant to the interstate medical licensure compact under s. 448.980.

SB196,15 Section 15. 448.04 (1) (ab) of the statutes is created to read:

SB196,6,25 448.04 (1) (ab) Compact license. The board may grant a compact license pursuant to the interstate medical licensure compact under s. 448.980.

SB196,16 Section 16. 448.05 (2) (a) (intro.) of the statutes, as affected by 2013 Wisconsin Act 240, is amended to read:

SB196,7,5 448.05 (2) (a) (intro.) Except as provided in pars. (b) to (e) (f), an applicant for any class of license to practice medicine and surgery must supply evidence satisfactory to the board of all of the following:

SB196,17 Section 17. 448.05 (2) (b) (intro.) of the statutes, as affected by 2013 Wisconsin Act 240, is amended to read:

SB196,7,10 448.05 (2) (b) (intro.) Except as provided in pars. (c) to (e) (f), 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:

SB196,18 Section 18. 448.05 (2) (f) of the statutes is created to read:

SB196,7,13 448.05 (2) (f) The board shall grant a compact license as provided under s. 448.980.

SB196,19 Section 19. 448.07 (1) (a) of the statutes is amended to read:

SB196,8,2 448.07 (1) (a) Every person licensed or certified under this subchapter shall register on or before November 1 of each odd-numbered year following issuance of the license or certificate with the board. Registration shall be completed in such manner as the board shall designate and upon forms the board shall provide, except that registration with respect to a compact license shall be governed by the renewal provisions in s. 448.980 (7). The secretary of the board, on or before October 1 of each odd-numbered year, shall mail or cause to be mailed to every person required to register a registration form. The board shall furnish to each person registered under this section a certificate of registration, and the person shall display the registration certificate conspicuously in the office at all times. No person may exercise the rights or privileges conferred by any license or certificate granted by the board unless currently registered as required under this subsection.

SB196,20 Section 20. 448.07 (2) of the statutes is amended to read:

SB196,8,13 448.07 (2) Fees. The Except as otherwise provided in s. 448.980, the fees for examination and licenses granted under this subchapter are specified in s. 440.05, and the renewal fee for such licenses is determined by the department under s. 440.03 (9) (a). Compact licenses shall be subject to additional fees and assessments, as established by the department, the board, or the interstate medical licensure compact commission, to cover any costs incurred by the department or the board for this state's participation in the interstate medical licensure compact under s. 448.980 and costs incurred by the interstate medical licensure compact commission for its administration of the renewal process for the interstate medical licensure compact under s. 448.980.

SB196,21 Section 21. Subchapter VIII of chapter 448 [precedes 448.980] of the statutes is created to read:

SB196,8,16 Chapter 448

SB196,8,17 Subchapter VIII

SB196,8,18 interstate medical licensure

SB196,8,19 compact

SB196,8,21 448.980 Interstate medical licensure compact. The following compact is hereby ratified and entered into:

SB196,9,11 (1) Section 1 — Purpose. In order to strengthen access to health care, and in recognition of the advances in the delivery of health care, the member states of the interstate medical licensure compact have allied in common purpose to develop a comprehensive process that complements the existing licensing and regulatory authority of state medical boards, provides a streamlined process that allows physicians to become licensed in multiple states, thereby enhancing the portability of a medical license and ensuring the safety of patients. The compact creates another pathway for licensure and does not otherwise change a state's existing medical practice act. The compact also adopts the prevailing standard for licensure and affirms that the practice of medicine occurs where the patient is located at the time of the physician-patient encounter, and therefore, requires the physician to be under the jurisdiction of the state medical board where the patient is located. State medical boards that participate in the compact retain the jurisdiction to impose an adverse action against a license to practice medicine in that state issued to a physician through the procedures in the compact.

SB196,9,12 (2) Section 2 — Definitions. In this compact:

SB196,9,15 (a) "Bylaws" means those bylaws established by the interstate commission pursuant to sub. (11) for its governance, or for directing and controlling its actions and conduct.

SB196,9,17 (b) "Commissioner" means the voting representative appointed by each member board pursuant to sub. (11).

SB196,9,22 (c) "Conviction" means a finding by a court that an individual is guilty of a criminal offense through adjudication, or entry of a plea of guilt or no contest to the charge by the offender. Evidence of an entry of a conviction of a criminal offense by the court shall be considered final for purposes of disciplinary action by a member board.

SB196,9,25 (d) "Expedited license" means a full and unrestricted medical license granted by a member state to an eligible physician through the process set forth in the compact.

SB196,10,2 (e) "Interstate commission" means the interstate commission created pursuant to sub. (11).

SB196,10,4 (f) "License" means authorization by a state for a physician to engage in the practice of medicine, which would be unlawful without the authorization.

SB196,10,6 (g) "Medical practice act" means laws and regulations governing the practice of allopathic and osteopathic medicine within a member state.

SB196,10,9 (h) "Member board" means a state agency in a member state that acts in the sovereign interests of the state by protecting the public through licensure, regulation, and education of physicians as directed by the state government.

SB196,10,10 (i) "Member state" means a state that has enacted the compact.

SB196,10,13 (j) "Practice of medicine" means the clinical prevention, diagnosis, or treatment of human disease, injury, or condition requiring a physician to obtain and maintain a license in compliance with the medical practice act of a member state.

SB196,10,14 (k) "Physician" means any person who:

SB196,10,18 1. Is a graduate of a medical school accredited by the Liaison Committee on Medical Education, the Commission on Osteopathic College Accreditation, or a medical school listed in the International Medical Education Directory or its equivalent;

SB196,10,22 2. Passed each component of the United States Medical Licensing Examination (USMLE) or the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) within 3 attempts, or any of its predecessor examinations accepted by a state medical board as an equivalent examination for licensure purposes;

SB196,10,25 3. Successfully completed graduate medical education approved by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association;