As Introduced 1
123rd General Assembly 4
Regular Session H. B. No. 585 5
1999-2000 6
REPRESENTATIVES VESPER-HOLLISTER-O'BRIEN-CLANCY-KRUPINSKI- 8
HARRIS-BARRETT-SMITH-ALLEN-BUEHRER-TERWILLEGER-SYKES 9
_________________________________________________________________ 10
A B I L L
To amend sections 4731.34, 4731.341, and 4731.36 and 11
to enact sections 2307.386, 4731.342, 4731.361, 12
and 4731.362 of the Revised Code to provide, with 13
certain exceptions, that a physician licensed by 14
another state who provides medical services in
this state, either in person or through the use 15
of any communication, including oral, written, or 16
electronic communication, must comply with all
laws governing the practice of medicine in this 17
state and submit to the jurisdiction of the State 18
Medical Board and the courts of this state.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO: 20
Section 1. That sections 4731.34, 4731.341, and 4731.36 be 22
amended and sections 2307.386, 4731.342, 4731.361, and 4731.362 23
of the Revised Code be enacted to read as follows: 25
Sec. 2307.386. AS USED IN THIS SECTION, "MEDICAL CLAIM" 27
HAS THE SAME MEANING AS IN SECTION 2305.11 OF THE REVISED CODE. 28
A RESIDENT OF THIS STATE MAY COMMENCE A CIVIL ACTION BASED 30
ON A MEDICAL CLAIM IN THE APPROPRIATE COURT OF THIS STATE AGAINST 31
A LEGAL PRACTITIONER OF MEDICINE IN ANOTHER STATE WHO IS 32
DESCRIBED IN SECTION 4731.342 OF THE REVISED CODE.
Sec. 4731.34. (A) A person shall be regarded as 41
practicing medicine, surgery, or podiatry, within the meaning of 43
this chapter, who uses DOES ANY OF THE FOLLOWING: 44
(1) USES the words or letters, "Dr.," "Doctor," 46
2
"Professor," "M.D.," "D.S.C.," "Pod. D.," "M.B. D.O.," "D.P.M.," 48
or any other title in connection with the person's name that in 50
any way represents the person as engaged in the practice of 52
medicine, AND surgery, OSTEOPATHIC MEDICINE AND SURGERY, or 53
podiatry, in any of its branches, or who examines; 54
(2) ANY OF THE FOLLOWING IN PERSON OR THROUGH THE USE OF 56
ANY COMMUNICATION, INCLUDING ORAL, WRITTEN, OR ELECTRONIC 57
COMMUNICATION:
(a) EXAMINES or diagnoses for compensation of any kind, or 59
prescribes; 60
(b) PRESCRIBES, advises, recommends, administers, or 62
dispenses for compensation of any kind, direct or indirect, a 63
drug or medicine, appliance, mold or cast, application, 64
operation, or treatment, of whatever nature, for the cure or 65
relief of a wound, fracture or bodily injury, infirmity, or 66
disease, provided that the; 67
(c) ADVERTISES, SOLICITS, OR REPRESENTS IN ANY WAY TO THE 69
PUBLIC THAT THE PERSON IS PRACTICING MEDICINE AND SURGERY, 70
OSTEOPATHIC MEDICINE AND SURGERY, OR PODIATRY. 71
(B) THE treatment of human ills through prayer alone by a 75
practitioner of the Christian Science church, in accordance with 76
the tenets and creed of such church, shall not be regarded as the 77
practice of medicine; and, provided further that sanitary and 78
public health laws shall be complied with, no practices shall be 79
used that may be dangerous or detrimental to life or health, and 80
no person shall be denied the benefits of accepted medical and 82
surgical practices.
(C) The use of any such words, letters, or titles in any 85
connection or under any circumstances as to induce the belief
that the person who uses them is engaged in the practice of 86
medicine, AND SURGERY, OSTEOPATHIC MEDICINE AND surgery, or 87
podiatry is prima-facie evidence of the intent of such person to 88
represent the person as engaged in the practice of medicine, AND 89
SURGERY, OSTEOPATHIC MEDICINE AND surgery, or podiatry. 90
3
Sec. 4731.341. (A) The FOLLOWING ARE HEREBY DECLARED TO 100
BE INIMICAL TO THE PUBLIC WELFARE AND CONSTITUTE A PUBLIC 101
NUISANCE:
(1) THE practice of medicine in all of its branches or the 105
treatment of human ailments without the use of drugs or medicines 107
and without operative surgery by any person not at that time 108
holding a valid and current certificate as provided by Chapter 110
4723., 4725., or 4731. of the Revised Code is hereby declared to 111
be inimical to the public welfare and to constitute a public 112
nuisance. The;
(2) CONDUCT EXEMPTED UNDER SECTION 4731.36 OF THE REVISED 114
CODE WHEN THE INDIVIDUAL IS IN VIOLATION OF DIVISION (B) OF 115
SECTION 4731.22 OF THE REVISED CODE.
(B) THE attorney general, the prosecuting attorney of any 118
county in which the offense was committed or the offender 119
resides, the state medical board, or any other person having 120
knowledge of a person engaged WHO either directly or by 121
complicity IS in the practice of medicine without having first 123
obtained a certificate to do so pursuant to such chapters 124
VIOLATION OF DIVISION (A) OF THIS SECTION, may on or after 125
January 1, 1969, in accord with provisions of the Revised Code 126
governing injunctions, maintain an action in the name of the 127
state to enjoin any person from engaging either directly or by 128
complicity in the unlawful practice of medicine in all of its 130
branches, or the treatment of human ailments without the use of 131
drugs or medicines and without operative surgery, ACTIVITY by 132
applying for an injunction in any THE FRANKLIN COUNTY court of 134
competent jurisdiction COMMON PLEAS. 135
Prior to application for such injunction, the secretary of 137
the state medical board shall notify the person allegedly engaged 138
either directly or by complicity in the unlawful practice of 139
medicine or any of its branches ACTIVITY by registered mail that 141
the secretary has received information indicating that this 142
person is so engaged. Said person shall answer the secretary 143
4
within thirty days showing that the person is either properly 145
licensed for the stated activity or that the person is not in 146
violation of Chapter 4723. or 4731. of the Revised Code. If the 148
answer is not forthcoming within thirty days after notice by the 149
secretary, the secretary shall request that the attorney general, 150
the prosecuting attorney of the county in which the offense was 151
committed or the offender resides, or the state medical board 152
proceed as authorized in this section. 153
Upon the filing of a verified petition in court, the court 155
shall conduct a hearing on the petition and shall give the same 156
preference to this proceeding as is given all proceedings under 157
Chapter 119. of the Revised Code, irrespective of the position of 160
the proceeding on the calendar of the court.
Such injunction proceedings shall be in addition to, and 162
not in lieu of, all penalties and other remedies provided in 163
Chapters 4723. and 4731. of the Revised Code. 164
Sec. 4731.342. AS USED IN THIS SECTION, "MEDICAL CLAIM" 166
HAS THE SAME MEANING AS IN SECTION 2305.11 OF THE REVISED CODE. 167
A LEGAL PRACTITIONER OF MEDICINE IN ANOTHER STATE WHO IS 169
PRACTICING MEDICINE IN THIS STATE EITHER IN PERSON OR THROUGH THE 170
USE OF ANY COMMUNICATION, INCLUDING ORAL, WRITTEN, OR ELECTRONIC 171
COMMUNICATION, PURSUANT TO A VALID CERTIFICATE ISSUED UNDER THIS 172
CHAPTER OR ONE OF THE EXCEPTIONS DESCRIBED IN SECTION 4731.36 OF 173
THE REVISED CODE CONSENTS TO THE JURISDICTION OF THE STATE
MEDICAL BOARD AND THE COURTS OF THIS STATE IN ANY ACTION OR 174
PROCEEDING, INCLUDING A CIVIL ACTION BASED ON A MEDICAL CLAIM, 175
ARISING OUT OF EXAMINATION, DIAGNOSIS, OR TREATMENT PROVIDED TO A 176
PATIENT IN THIS STATE.
Sec. 4731.36. (A) AS USED IN THIS SECTION, "CONSULTATION" 186
MEANS THE ACT OF PROVIDING ADVICE OR INFORMATION REGARDING 188
EXAMINATION, DIAGNOSIS, OR TREATMENT OF A PATIENT TO AN
INDIVIDUAL IN THIS STATE WHO HOLDS A VALID CERTIFICATE ISSUED 189
UNDER THIS CHAPTER AND HAS PRIMARY RESPONSIBILITY OVER THE 190
EXAMINATION, DIAGNOSIS, OR TREATMENT. 191
5
(B) Sections 4731.01 to 4731.47 of the Revised Code shall 195
not prohibit service in case of emergency, or domestic 196
administration of family remedies. Such sections
SECTIONS 4731.01 TO 4731.47 OF THE REVISED CODE shall not 199
apply to a ANY OF THE FOLLOWING:
(1) A commissioned medical officer of the United States 201
army, navy, or marine hospital service ARMED FORCES, AS DEFINED 202
IN SECTION 5903.11 OF THE REVISED CODE, OR AN EMPLOYEE OF THE 203
VETERANS ADMINISTRATION OF THE UNITED STATES OR THE UNITED STATES 204
PUBLIC HEALTH SERVICE in the discharge of his THE OFFICER'S OR 205
EMPLOYEE'S professional duties, or to a regularly qualified; 206
(2) A dentist AUTHORIZED UNDER CHAPTER 4715. OF THE 208
REVISED CODE TO PRACTICE DENTISTRY when engaged exclusively in 210
the practice of dentistry, or when administering anaesthetics, or 211
to a ANESTHETICS IN THE PRACTICE OF DENTISTRY; 212
(3) A physician or surgeon residing in another state or 215
territory who is a legal practitioner of medicine or surgery 216
therein, when in UNDER THE FOLLOWING CIRCUMSTANCES: 217
(a) WHEN PROVIDING EPISODIC consultation with a regular 220
practitioner of this state; nor shall such sections apply to a. 222
AS USED IN DIVISION (B)(3)(a) OF THIS SECTION, "EPISODIC 224
CONSULTATION" MEANS CONSULTATION THAT OCCURS ON AN IRREGULAR OR 225
INFREQUENT BASIS. 226
(b) WHEN PROVIDING CONSULTATION IF THE CONSULTATION IS 228
PROVIDED WITHOUT REMUNERATION; 229
(c) WHEN PROVIDING CONSULTATION AS PART OF THE CURRICULUM 231
OF A MEDICAL SCHOOL OR OSTEOPATHIC MEDICAL SCHOOL OF THIS STATE 232
OR A PROGRAM DESCRIBED IN DIVISION (A)(2) OF SECTION 4731.291 OF 233
THE REVISED CODE.
(4) A PHYSICIAN OR SURGEON IN ANOTHER STATE OR TERRITORY 235
WHO IS A LEGAL PRACTITIONER OF MEDICINE OR SURGERY THEREIN AND 236
PROVIDED SERVICES TO A PATIENT IN THAT STATE OR TERRITORY, WHEN 237
PROVIDING, NOT LATER THAN ONE YEAR AFTER THE LAST DATE SERVICES 238
WERE PROVIDED IN ANOTHER STATE OR TERRITORY, FOLLOW-UP SERVICES 239
6
IN PERSON OR THROUGH THE USE OF ANY COMMUNICATION, INCLUDING 240
ORAL, WRITTEN, OR ELECTRONIC COMMUNICATION, IN THIS STATE TO THE 241
PATIENT FOR THE SAME CONDITION; 242
(5) A physician or surgeon residing on the border of a 245
neighboring CONTIGUOUS state and authorized under the laws 246
thereof to practice medicine and surgery therein, whose practice 247
extends within the limits of this state; provided equal rights 248
and privileges are accorded by such neighboring state to the 250
physicians and surgeons residing on the border of this state 251
contiguous to such neighboring state. Such practitioner shall 252
not EITHER IN PERSON OR THROUGH THE USE OF ANY COMMUNICATION, 253
INCLUDING ORAL, WRITTEN, OR ELECTRONIC COMMUNICATION, open an 254
office or appoint a place to see patients or receive calls within 256
the limits of this state.
(B)(6) A BOARD, COMMITTEE, OR CORPORATION ENGAGED IN THE 258
CONDUCT DESCRIBED IN DIVISION (A) OF SECTION 2305.25 OF THE 260
REVISED CODE WHEN ACTING WITHIN THE SCOPE OF THE FUNCTIONS OF THE 261
BOARD, COMMITTEE, OR CORPORATION;
(7) THE CONDUCT OF AN INTERNAL REVIEW SYSTEM DESCRIBED IN 263
SECTION 1751.83 OF THE REVISED CODE; 264
(8) THE CONDUCT OF AN INDEPENDENT REVIEW ORGANIZATION 266
DESCRIBED IN SECTIONS 1751.84, 1751.85, 3923.67, 3923.68, 267
3923.76, AND 3923.77 OF THE REVISED CODE. 268
(C) Sections 4731.51 to 4731.61 of the Revised Code do not 270
apply to any graduate of a podiatric school or college while 271
performing those acts that may be prescribed by or incidental to 272
participation in an accredited podiatric internship, residency, 273
or fellowship program situated in this state approved by the 274
state medical board. 275
(D) ANY PERSON MAY REQUEST IN WRITING A DETERMINATION FROM 277
THE STATE MEDICAL BOARD OF WHETHER THE PERSON IS OR HAS ENGAGED 278
IN AN ACT THAT CONSTITUTES AN ACT DESCRIBED IN DIVISION (B) OF 279
THIS SECTION. ON RECEIPT OF A REQUEST UNDER THIS DIVISION, THE 280
BOARD SHALL MAKE A DETERMINATION AND PROVIDE WRITTEN NOTICE OF IT 281
7
TO THE REQUESTING PERSON.
Sec. 4731.361. (A) A PHYSICIAN OR SURGEON IN ANOTHER 284
STATE OR TERRITORY WHO IS A LEGAL PRACTITIONER OF MEDICINE AND 285
SURGERY THEREIN, PRACTICES MEDICINE IN THIS STATE BY PROVIDING 286
MEDICAL SERVICES TO PATIENTS IN PERSON OR THROUGH THE USE OF ANY 287
COMMUNICATION, INCLUDING ORAL, WRITTEN, OR ELECTRONIC 288
COMMUNICATION, AND IS NOT EXEMPTED BY SECTION 4731.36 OF THE 289
REVISED CODE FROM SECTIONS 4731.01 TO 4731.47 OF THE REVISED CODE
SHALL COMPLY WITH BOTH OF THE FOLLOWING: 290
(1) ALL LAWS AND RULES OF THIS STATE GOVERNING THE 292
PRACTICE OF MEDICINE, INCLUDING SECTION 4731.22 OF THE REVISED 294
CODE, AND THE PRESERVATION OF CONFIDENTIALITY OF A PATIENT'S 295
MEDICAL RECORDS;
(2) ALL REPORTING REQUIREMENTS ESTABLISHED IN SECTION 297
4731.224 OF THE REVISED CODE. 298
(B) THE STATE MEDICAL BOARD MAY ADOPT RULES TO CARRY OUT 300
THE PURPOSE OF THIS SECTION. THE RULES MAY INCLUDE STANDARDS FOR 301
ALL OF THE FOLLOWING: 302
(1) THE PRACTICE OF MEDICINE IN PERSON OR THROUGH THE USE 304
OF ANY COMMUNICATION, INCLUDING ORAL, WRITTEN, OR ELECTRONIC 305
COMMUNICATION; 306
(2) THE APPROPRIATE DELEGATION TO INDIVIDUALS PROVIDING 308
HEALTH CARE SERVICES; 309
(3) ELECTRONIC RECORDKEEPING, INCLUDING MEASURES TO 311
PREVENT TAMPERING WITH ELECTRONIC RECORDS AND TO PRESERVE AND 312
MAINTAIN THE CONFIDENTIALITY AND AUTHENTICITY OF THE RECORDS. 314
Sec. 4731.362. (A) AN INDIVIDUAL HOLDING A VALID 316
CERTIFICATE TO PRACTICE ISSUED UNDER THIS CHAPTER WHO CONSULTS 317
WITH A PHYSICIAN OR SURGEON IN ANOTHER STATE OR TERRITORY ACTING 318
UNDER ONE OF THE EXCEPTIONS DESCRIBED IN DIVISION (A)(3) OF 319
SECTION 4731.36 OF THE REVISED CODE SHALL, PRIOR TO PROVIDING
MEDICAL CARE TO A PATIENT IN THIS STATE, OBTAIN CONSENT FOR THE 320
CONSULTATION FROM THE PATIENT OR THE PATIENT'S LEGAL 321
REPRESENTATIVE. A REQUEST FOR CONSENT SHALL BE COMMUNICATED TO 322
8
THE PATIENT OR THE PATIENT'S LEGAL REPRESENTATIVE ORALLY AND IN A 323
WRITTEN DOCUMENT AND DISCLOSE ALL OF THE FOLLOWING:
(1) THE RIGHT OF THE PATIENT OR PATIENT'S LEGAL 325
REPRESENTATIVE TO REFUSE OR WITHDRAW CONSENT AT ANY TIME; 327
(2) A DESCRIPTION OF THE RISKS, BENEFITS, AND POTENTIAL 329
CONSEQUENCES OF RECEIVING MEDICAL CARE EITHER IN PERSON OR 330
THROUGH THE USE OF ANY COMMUNICATION, INCLUDING ORAL, WRITTEN, OR 331
ELECTRONIC COMMUNICATION, THROUGH CONSULTATION WITH A PHYSICIAN 332
OR SURGEON IN ANOTHER STATE;
(3) THE EXISTENCE OF A PHYSICIAN-PATIENT RELATIONSHIP 334
BETWEEN THE CONSULTING PHYSICIAN OR SURGEON AND PATIENT, 335
INCLUDING THE RIGHT OF CONFIDENTIALITY OF PATIENT INFORMATION; 336
(4) THE RIGHT OF THE PATIENT OR THE PATIENT'S LEGAL 338
REPRESENTATIVE TO OBTAIN THE PATIENT'S MEDICAL RECORDS FROM THE 339
CONSULTING PHYSICIAN OR SURGEON.
(B) THE PATIENT OR THE PATIENT'S LEGAL REPRESENTATIVE 341
SHALL SIGN A COPY OF THE DOCUMENT DESCRIBED IN DIVISION (A) OF 342
THIS SECTION. THE CERTIFICATE HOLDER SHALL RETAIN THE SIGNED 343
COPY IN THE PATIENT'S MEDICAL RECORD. 344
(C) REFUSAL OR WITHDRAWAL OF CONSENT SHALL NOT AFFECT A 346
PATIENT'S RIGHT TO RECEIVE MEDICAL CARE. 347
Section 2. That existing sections 4731.34, 4731.341, and 349
4731.36 of the Revised Code are hereby repealed. 350