AB257: Bill Text

AB257,121 Section 121. 441.11 (2) of the statutes is renumbered 441.09 (5m) and amended to read:

AB257,58,8 441.09 (5m) Licensure exemption. The provisions of s. 448.04 (1) (g) 448.03 (1) (d) do not apply to a an advanced practice registered nurse licensed under this section who possesses a certified registered nurse anesthetist specialty designation under sub. (1) (b) 1. or to a person who engages in the practice of a nurse anesthetist while performing official duties for the armed services or federal health services of the United States.

AB257,122 Section 122. 441.11 (3) of the statutes is repealed.

AB257,123 Section 123. 441.15 of the statutes is repealed.

AB257,124 Section 124. 441.16 of the statutes is repealed.

AB257,125 Section 125. 441.18 (2) (a) (intro.) of the statutes is amended to read:

AB257,58,15 441.18 (2) (a) (intro.) An advanced practice registered nurse certified to who may issue prescription orders under s. 441.16 441.09 (2) may do any of the following:

AB257,126 Section 126. 441.18 (2) (b) of the statutes is amended to read:

AB257,58,23 441.18 (2) (b) An advanced practice registered nurse who prescribes or delivers an opioid antagonist under par. (a) 1. shall ensure that the person to whom the opioid antagonist is prescribed has or has the capacity to provide the knowledge and training necessary to safely administer the opioid antagonist to an individual undergoing an opioid-related overdose and that the person demonstrates the capacity to ensure that any individual to whom the person further delivers the opioid antagonist has or receives that knowledge and training.

AB257,127 Section 127. 441.18 (3) of the statutes is amended to read:

AB257,59,7 441.18 (3) An advanced practice registered nurse who, acting in good faith, prescribes or delivers an opioid antagonist in accordance with sub. (2), or who, acting in good faith, otherwise lawfully prescribes or dispenses an opioid antagonist, shall be immune from criminal or civil liability and may not be subject to professional discipline under s. 441.07 for any outcomes resulting from prescribing, delivering, or dispensing the opioid antagonist.

AB257,128 Section 128. 441.19 of the statutes is repealed.

AB257,129 Section 129. 448.03 (2) (a) of the statutes is amended to read:

AB257,59,18 448.03 (2) (a) Any person lawfully practicing within the scope of a license, permit, registration, certificate, or certification granted to practice midwifery under subch. XIII of ch. 440, to practice professional or, practical, or advanced practice registered nursing or nurse-midwifery under ch. 441, to practice chiropractic under ch. 446, to practice dentistry, dental therapy, or dental hygiene or as an expanded function dental auxiliary under ch. 447, to practice optometry under ch. 449, to practice as a physician assistant under subch. IX, to practice acupuncture under ch. 451 or under any other statutory provision, to practice naturopathic medicine under ch. 466, or as otherwise provided by statute.

AB257,130 Section 130. 448.035 (1) (a) of the statutes is repealed.

AB257,131 Section 131. 448.035 (2) to (4) of the statutes are amended to read:

AB257,60,9 448.035 (2) Notwithstanding the requirements of s. 448.30, a physician or certified advanced practice nurse prescriber may provide expedited partner therapy if the patient is diagnosed as infected with a chlamydial infection, gonorrhea, or trichomoniasis and the patient has had sexual contact with a sexual partner during which the chlamydial infection, gonorrhea, or trichomoniasis may have been transmitted to or from the sexual partner. The physician or certified advanced practice nurse prescriber shall attempt to obtain the name of the patient’s sexual partner. A prescription order for an antimicrobial drug prepared under this subsection shall include the name and address of the patient’s sexual partner, if known. If the physician or certified advanced practice nurse prescriber is unable to obtain the name of the patient’s sexual partner, the prescription order shall include, in ordinary bold-faced capital letters, the words, “expedited partner therapy” or the letters “EPT.”

AB257,60,13 (3) The physician or certified advanced practice nurse prescriber shall provide the patient with a copy of the information sheet prepared by the department of health services under s. 46.03 (44) and shall request that the patient give the information sheet to the person with whom the patient had sexual contact.

AB257,60,18 (4) (a) Except as provided in par. (b), a physician or certified advanced practice nurse prescriber is immune from civil liability for injury to or the death of a person who takes any antimicrobial drug if the antimicrobial drug is prescribed, dispensed, or furnished under this section and if expedited partner therapy is provided as specified under this section.

AB257,60,22 (b) The immunity under par. (a) does not extend to the donation, distribution, furnishing, or dispensing of an antimicrobial drug by a physician or certified advanced practice nurse prescriber whose act or omission involves reckless, wanton, or intentional misconduct.

AB257,132 Section 132. 448.56 (1) and (1m) (b) of the statutes are amended to read:

AB257,61,16 448.56 (1) Written referral. Except as provided in this subsection and s. 448.52, a person may practice physical therapy only upon the written referral of a physician, naturopathic doctor, physician assistant, chiropractor, dentist, podiatrist, or advanced practice registered nurse prescriber certified under s. 441.16 (2). Written referral is not required if a physical therapist provides services in schools to children with disabilities, as defined in s. 115.76 (5), pursuant to rules promulgated by the department of public instruction; provides services as part of a home health care agency; provides services to a patient in a nursing home pursuant to the patient’s plan of care; provides services related to athletic activities, conditioning, or injury prevention; or provides services to an individual for a previously diagnosed medical condition after informing the individual’s physician, naturopathic doctor, physician assistant, chiropractor, dentist, podiatrist, or advanced practice registered nurse prescriber certified under s. 441.16 (2) who made the diagnosis. The examining board may promulgate rules establishing additional services that are excepted from the written referral requirements of this subsection.

AB257,61,22 (1m) (b) The examining board shall promulgate rules establishing the requirements that a physical therapist must satisfy if a physician, naturopathic doctor, physician assistant, chiropractor, dentist, podiatrist, or advanced practice registered nurse prescriber makes a written referral under sub. (1). The purpose of the rules shall be to ensure continuity of care between the physical therapist and the health care practitioner.

AB257,133 Section 133. 448.62 (2m) of the statutes is amended to read:

AB257,62,4 448.62 (2m) An advanced practice registered nurse who is certified to issue prescription orders under s. 441.16 and who is providing nonsurgical patient services as directed, supervised, and inspected by a podiatrist who has the power to direct, decide, and oversee the implementation of the patient services rendered.

AB257,134 Section 134. 448.67 (2) of the statutes is amended to read:

AB257,62,15 448.67 (2) Separate billing required. Except as provided in sub. (4), a licensee who renders any podiatric service or assistance, or gives any podiatric advice or any similar advice or assistance, to any patient, podiatrist, physician, physician assistant, advanced practice registered nurse prescriber certified under s. 441.16 (2), partnership, or corporation, or to any other institution or organization, including a hospital, for which a charge is made to a patient, shall, except as authorized by Title 18 or Title 19 of the federal Social Security Act, render an individual statement or account of the charge directly to the patient, distinct and separate from any statement or account by any other podiatrist, physician, physician assistant, advanced practice registered nurse prescriber, or other person.

AB257,135 Section 135. 448.956 (1m) of the statutes is amended to read:

AB257,62,23 448.956 (1m) Subject to sub. (1) (a), a licensee may provide athletic training to an individual without a referral, except that a licensee may not provide athletic training as described under s. 448.95 (5) (d) or (e) in an outpatient rehabilitation setting unless the licensee has obtained a written referral for the individual from a practitioner licensed or certified under subch. II, III, IV, V, or VII of this chapter; under ch. 446; or under s. 441.16 (2) 441.09 or from a practitioner who holds a compact privilege under subch. XI or XII of ch. 448.

AB257,136 Section 136. 450.01 (1m) of the statutes is repealed.

AB257,137 Section 137. 450.01 (16) (h) 2. of the statutes is amended to read:

AB257,63,6 450.01 (16) (h) 2. The patient’s advanced practice registered nurse prescriber, if the advanced practice registered nurse prescriber has entered into a written agreement to collaborate with a physician may issue prescription orders under s. 441.09 (2).

AB257,138 Section 138. 450.01 (16) (hr) 2. of the statutes is amended to read:

AB257,63,9 450.01 (16) (hr) 2. An advanced practice registered nurse prescriber who may issue prescription orders under s. 441.09 (2).

AB257,139 Section 139. 450.03 (1) (e) of the statutes is amended to read:

AB257,63,19 450.03 (1) (e) Any person lawfully practicing within the scope of a license, permit, registration, certificate, or certification granted to practice as a pharmacy technician under s. 450.068, to provide home medical oxygen under s. 450.076, to practice professional or, practical, or advanced practice registered nursing or nurse- midwifery under ch. 441, to practice dentistry, dental therapy, or dental hygiene or as an expanded function dental auxiliary under ch. 447, to practice medicine and surgery under ch. 448, to practice optometry under ch. 449, to practice naturopathic medicine under ch. 466, or to practice veterinary medicine under ch. 89, or as otherwise provided by statute.

AB257,140 Section 140. 450.11 (1g) (b) of the statutes is amended to read:

AB257,64,10 450.11 (1g) (b) A pharmacist may, upon the prescription order of a practitioner providing expedited partner therapy, as specified in s. 441.092, 448.035, or 448.9725, that complies with the requirements of sub. (1), dispense an antimicrobial drug as a course of therapy for treatment of chlamydial infections, gonorrhea, or trichomoniasis to the practitioner’s patient or a person with whom the patient has had sexual contact for use by the person with whom the patient has had sexual contact. The pharmacist shall provide a consultation in accordance with rules promulgated by the board for the dispensing of a prescription to the person to whom the antimicrobial drug is dispensed. A pharmacist providing a consultation under this paragraph shall ask whether the person for whom the antimicrobial drug has been prescribed is allergic to the antimicrobial drug and advise that the person for whom the antimicrobial drug has been prescribed must discontinue use of the antimicrobial drug if the person is allergic to or develops signs of an allergic reaction to the antimicrobial drug.

AB257,141 Section 141. 450.11 (1i) (a) 1. of the statutes is amended to read:

AB257,64,23 450.11 (1i) (a) 1. A pharmacist may, upon and in accordance with the prescription order of an advanced practice registered nurse prescriber under s. 441.18 (2) (a) 1., of a physician under s. 448.037 (2) (a) 1., or of a physician assistant under s. 448.9727 (2) (a) 1. that complies with the requirements of sub. (1), deliver an opioid antagonist to a person specified in the prescription order and may, upon and in accordance with the standing order of an advanced practice registered nurse prescriber under s. 441.18 (2) (a) 2., of a physician under s. 448.037 (2) (a) 2., or of a physician assistant under s. 448.9727 (2) (a) 2. that complies with the requirements of sub. (1), deliver an opioid antagonist to an individual in accordance with the order. The pharmacist shall provide a consultation in accordance with rules promulgated by the board for the delivery of a prescription to the person to whom the opioid antagonist is delivered.

AB257,142 Section 142. 450.11 (1i) (b) 2. b. of the statutes is amended to read:

AB257,65,4 450.11 (1i) (b) 2. b. An advanced practice registered nurse prescriber may only deliver or dispense an opioid antagonist in accordance with s. 441.18 (2) or in accordance with his or her other legal authority to dispense prescription drugs.

AB257,143 Section 143. 450.11 (7) (b) of the statutes is amended to read:

AB257,65,9 450.11 (7) (b) Information communicated to a physician, physician assistant, or advanced practice registered nurse prescriber in an effort to procure unlawfully a prescription drug or the administration of a prescription drug is not a privileged communication.

AB257,144 Section 144. 450.11 (8) (e) of the statutes is amended to read:

AB257,65,12 450.11 (8) (e) The board of nursing, insofar as this section applies to advanced practice nurse prescribers registered nurses.

AB257,145 Section 145. 450.13 (5) (b) of the statutes is amended to read:

AB257,65,17 450.13 (5) (b) The patient’s advanced practice registered nurse prescriber, if the advanced practice registered nurse prescriber has entered into a written agreement to collaborate with a physician may issue prescription orders under s. 441.09 (2).

AB257,146 Section 146. 450.135 (7) (b) of the statutes is amended to read:

AB257,65,22 450.135 (7) (b) The patient’s advanced practice registered nurse prescriber, if the advanced practice registered nurse prescriber has entered into a written agreement to collaborate with a physician may issue prescription orders under s. 441.09 (2).

AB257,147 Section 147. 462.04 of the statutes is amended to read:

AB257,66,12 462.04 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 who is licensed under s. 447.04 (1) or who holds a compact privilege under subch. II of ch. 447, a dental therapist licensed under s. 447.04 (1m), 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 who is licensed under s. 448.974 or who holds a compact privilege under subch. XIII of ch. 448, 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.

AB257,148 Section 148. 655.001 (1) of the statutes is renumbered 655.001 (1r).

AB257,149 Section 149. 655.001 (1g) of the statutes is created to read:

AB257,66,20 655.001 (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.

AB257,150 Section 150. 655.001 (7t) of the statutes is amended to read:

AB257,67,3 655.001 (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.

AB257,151 Section 151. 655.001 (9) of the statutes is repealed.

AB257,152 Section 152. 655.002 (1) (a) of the statutes is amended to read:

AB257,67,8 655.002 (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.

AB257,153 Section 153. 655.002 (1) (b) of the statutes is amended to read:

AB257,67,12 655.002 (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:

AB257,67,14 1. The physician or nurse anesthetist advanced practice registered nurse is a resident of this state.

AB257,67,17 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.

AB257,67,22 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.

AB257,154 Section 154. 655.002 (1) (c) of the statutes is amended to read:

AB257,68,8 655.002 (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).

AB257,155 Section 155. 655.002 (1) (d) of the statutes is amended to read:

AB257,68,13 655.002 (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.

AB257,156 Section 156. 655.002 (1) (e) of the statutes is amended to read:

AB257,68,17 655.002 (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.

AB257,157 Section 157. 655.002 (1) (em) of the statutes is amended to read:

AB257,68,22 655.002 (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.

AB257,158 Section 158. 655.002 (2) (a) of the statutes is amended to read:

AB257,69,4 655.002 (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.

AB257,159 Section 159. 655.002 (2) (b) of the statutes is amended to read:

AB257,69,12 655.002 (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).

AB257,160 Section 160. 655.003 (1) of the statutes is amended to read:

AB257,69,17 655.003 (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.

AB257,161 Section 161. 655.003 (3) of the statutes is amended to read:

AB257,70,2 655.003 (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).

AB257,162 Section 162. 655.005 (2) (a) of the statutes is amended to read:

AB257,70,8 655.005 (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.

AB257,163 Section 163. 655.005 (2) (b) of the statutes is amended to read:

AB257,70,18 655.005 (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.

AB257,164 Section 164. 655.23 (5m) of the statutes is amended to read:

AB257,70,23 655.23 (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).

AB257,165 Section 165. 655.27 (3) (a) 4. of the statutes is amended to read:

AB257,71,5 655.27 (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.