To amend sections 4731.34, 4731.341, and 4731.36 and to enact sections 2307.386, 4731.342, 4731.361, and 4731.362 of the Revised Code to provide, with certain exceptions, that a physician licensed by another state who provides medical services in this state, either in person or through the use of any communication, including oral, written, or electronic communication, must comply with all laws governing the practice of medicine in this state and submit to the jurisdiction of the State Medical Board and the courts of this state.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Sec. 2307.386. AS USED IN THIS SECTION, "MEDICAL CLAIM" HAS THE SAME MEANING AS IN SECTION 2305.11 of the Revised Code.

A RESIDENT OF THIS STATE MAY COMMENCE A CIVIL ACTION BASED ON A MEDICAL CLAIM IN THE APPROPRIATE COURT OF THIS STATE AGAINST A LEGAL PRACTITIONER OF MEDICINE IN ANOTHER STATE WHO IS DESCRIBED IN SECTION 4731.342 of the Revised Code.

Sec. 4731.34. (A) A person shall be regarded as practicing medicine, surgery, or podiatry, within the meaning of this chapter, who uses DOES ANY OF THE FOLLOWING:

(1) USES the words or letters, "Dr.," "Doctor," "Professor," "M.D.," "D.S.C.," "Pod. D.," "M.B. D.O.," "D.P.M.," or any other title in connection with the person's name that in any way represents the person as engaged in the practice of medicine, AND surgery, OSTEOPATHIC MEDICINE AND SURGERY, or podiatry, in any of its branches, or who examines;

(2) ANY OF THE FOLLOWING IN PERSON OR THROUGH THE USE OF ANY COMMUNICATION, INCLUDING ORAL, WRITTEN, OR ELECTRONIC COMMUNICATION:

(a) EXAMINES or diagnoses for compensation of any kind, or prescribes;

(b) PRESCRIBES, advises, recommends, administers, or dispenses for compensation of any kind, direct or indirect, a drug or medicine, appliance, mold or cast, application, operation, or treatment, of whatever nature, for the cure or relief of a wound, fracture or bodily injury, infirmity, or disease, provided that the;

(c) ADVERTISES, SOLICITS, OR REPRESENTS IN ANY WAY TO THE PUBLIC THAT THE PERSON IS PRACTICING MEDICINE AND SURGERY, OSTEOPATHIC MEDICINE AND SURGERY, OR PODIATRY.

(B) THE treatment of human ills through prayer alone by a practitioner of the Christian Science church, in accordance with the tenets and creed of such church, shall not be regarded as the practice of medicine; and, provided further that sanitary and public health laws shall be complied with, no practices shall be used that may be dangerous or detrimental to life or health, and no person shall be denied the benefits of accepted medical and surgical practices.

(C) The use of any such words, letters, or titles in any connection or under any circumstances as to induce the belief that the person who uses them is engaged in the practice of medicine, AND SURGERY, OSTEOPATHIC MEDICINE AND surgery, or podiatry is prima-facie evidence of the intent of such person to represent the person as engaged in the practice of medicine, AND SURGERY, OSTEOPATHIC MEDICINE AND surgery, or podiatry.

Sec. 4731.341. (A) The FOLLOWING ARE HEREBY DECLARED TO BE INIMICAL TO THE PUBLIC WELFARE AND CONSTITUTE A PUBLIC NUISANCE:

(1) THE practice of medicine in all of its branches or the treatment of human ailments without the use of drugs or medicines and without operative surgery by any person not at that time holding a valid and current certificate as provided by Chapter 4723., 4725., or 4731. of the Revised Code is hereby declared to be inimical to the public welfare and to constitute a public nuisance. The;

(2) CONDUCT EXEMPTED UNDER SECTION 4731.36 of the Revised Code WHEN THE INDIVIDUAL IS IN VIOLATION OF DIVISION (B) OF SECTION 4731.22 of the Revised Code.

(B) THE attorney general, the prosecuting attorney of any county in which the offense was committed or the offender resides, the state medical board, or any other person having knowledge of a person engaged WHO either directly or by complicity IS in the practice of medicine without having first obtained a certificate to do so pursuant to such chapters VIOLATION OF DIVISION (A) OF THIS SECTION, may on or after January 1, 1969, in accord with provisions of the Revised Code governing injunctions, maintain an action in the name of the state to enjoin any person from engaging either directly or by complicity in the unlawful practice of medicine in all of its branches, or the treatment of human ailments without the use of drugs or medicines and without operative surgery, ACTIVITY by applying for an injunction in any THE FRANKLIN COUNTY court of competent jurisdiction COMMON PLEAS.

Prior to application for such injunction, the secretary of the state medical board shall notify the person allegedly engaged either directly or by complicity in the unlawful practice of medicine or any of its branches ACTIVITY by registered mail that the secretary has received information indicating that this person is so engaged. Said person shall answer the secretary within thirty days showing that the person is either properly licensed for the stated activity or that the person is not in violation of Chapter 4723. or 4731. of the Revised Code. If the answer is not forthcoming within thirty days after notice by the secretary, the secretary shall request that the attorney general, the prosecuting attorney of the county in which the offense was committed or the offender resides, or the state medical board proceed as authorized in this section.

Upon the filing of a verified petition in court, the court shall conduct a hearing on the petition and shall give the same preference to this proceeding as is given all proceedings under Chapter 119. of the Revised Code, irrespective of the position of the proceeding on the calendar of the court.

Such injunction proceedings shall be in addition to, and not in lieu of, all penalties and other remedies provided in Chapters 4723. and 4731. of the Revised Code.

Sec. 4731.342. AS USED IN THIS SECTION, "MEDICAL CLAIM" HAS THE SAME MEANING AS IN SECTION 2305.11 of the Revised Code.

A LEGAL PRACTITIONER OF MEDICINE IN ANOTHER STATE WHO IS PRACTICING MEDICINE IN THIS STATE EITHER IN PERSON OR THROUGH THE USE OF ANY COMMUNICATION, INCLUDING ORAL, WRITTEN, OR ELECTRONIC COMMUNICATION, PURSUANT TO A VALID CERTIFICATE ISSUED UNDER THIS CHAPTER OR ONE OF THE EXCEPTIONS DESCRIBED IN SECTION 4731.36 of the Revised Code CONSENTS TO THE JURISDICTION OF THE STATE MEDICAL BOARD AND THE COURTS OF THIS STATE IN ANY ACTION OR PROCEEDING, INCLUDING A CIVIL ACTION BASED ON A MEDICAL CLAIM, ARISING OUT OF EXAMINATION, DIAGNOSIS, OR TREATMENT PROVIDED TO A PATIENT IN THIS STATE.

Sec. 4731.36. (A) AS USED IN THIS SECTION, "CONSULTATION" MEANS THE ACT OF PROVIDING ADVICE OR INFORMATION REGARDING EXAMINATION, DIAGNOSIS, OR TREATMENT OF A PATIENT TO AN INDIVIDUAL IN THIS STATE WHO HOLDS A VALID CERTIFICATE ISSUED UNDER THIS CHAPTER AND HAS PRIMARY RESPONSIBILITY OVER THE EXAMINATION, DIAGNOSIS, OR TREATMENT.

(B) Sections 4731.01 to 4731.47 of the Revised Code shall not prohibit service in case of emergency, or domestic administration of family remedies. Such sections

SECTIONS 4731.01 TO 4731.47 of the Revised Code shall not apply to a ANY OF THE FOLLOWING:

(1) A commissioned medical officer of the United States army, navy, or marine hospital service ARMED FORCES, AS DEFINED IN SECTION 5903.11 of the Revised Code, OR AN EMPLOYEE OF THE VETERANS ADMINISTRATION OF THE UNITED STATES OR THE UNITED STATES PUBLIC HEALTH SERVICE in the discharge of his THE OFFICER'S OR EMPLOYEE'S professional duties, or to a regularly qualified;

(2) A dentist AUTHORIZED UNDER CHAPTER 4715. of the Revised Code TO PRACTICE DENTISTRY when engaged exclusively in the practice of dentistry, or when administering anaesthetics, or to a ANESTHETICS IN THE PRACTICE OF DENTISTRY;

(3) A physician or surgeon residing in another state or territory who is a legal practitioner of medicine or surgery therein, when in UNDER THE FOLLOWING CIRCUMSTANCES:

(a) WHEN PROVIDING EPISODIC consultation with a regular practitioner of this state; nor shall such sections apply to a. AS USED IN DIVISION (B)(3)(a) OF THIS SECTION, "EPISODIC CONSULTATION" MEANS CONSULTATION THAT OCCURS ON AN IRREGULAR OR INFREQUENT BASIS.

(b) WHEN PROVIDING CONSULTATION IF THE CONSULTATION IS PROVIDED WITHOUT REMUNERATION;

(c) WHEN PROVIDING CONSULTATION AS PART OF THE CURRICULUM OF A MEDICAL SCHOOL OR OSTEOPATHIC MEDICAL SCHOOL OF THIS STATE OR A PROGRAM DESCRIBED IN DIVISION (A)(2) OF SECTION 4731.291 of the Revised Code.

(4) A PHYSICIAN OR SURGEON IN ANOTHER STATE OR TERRITORY WHO IS A LEGAL PRACTITIONER OF MEDICINE OR SURGERY THEREIN AND PROVIDED SERVICES TO A PATIENT IN THAT STATE OR TERRITORY, WHEN PROVIDING, NOT LATER THAN ONE YEAR AFTER THE LAST DATE SERVICES WERE PROVIDED IN ANOTHER STATE OR TERRITORY, FOLLOW-UP SERVICES IN PERSON OR THROUGH THE USE OF ANY COMMUNICATION, INCLUDING ORAL, WRITTEN, OR ELECTRONIC COMMUNICATION, IN THIS STATE TO THE PATIENT FOR THE SAME CONDITION;

(5) A physician or surgeon residing on the border of a neighboring CONTIGUOUS state and authorized under the laws thereof to practice medicine and surgery therein, whose practice extends within the limits of this state; provided equal rights and privileges are accorded by such neighboring state to the physicians and surgeons residing on the border of this state contiguous to such neighboring state. Such practitioner shall not EITHER IN PERSON OR THROUGH THE USE OF ANY COMMUNICATION, INCLUDING ORAL, WRITTEN, OR ELECTRONIC COMMUNICATION, open an office or appoint a place to see patients or receive calls within the limits of this state.

(B)(6) A BOARD, COMMITTEE, OR CORPORATION ENGAGED IN THE CONDUCT DESCRIBED IN DIVISION (A) OF SECTION 2305.25 of the Revised Code WHEN ACTING WITHIN THE SCOPE OF THE FUNCTIONS OF THE BOARD, COMMITTEE, OR CORPORATION;

(7) THE CONDUCT OF AN INTERNAL REVIEW SYSTEM DESCRIBED IN SECTION 1751.83 OF THE REVISED CODE;

(8) THE CONDUCT OF AN INDEPENDENT REVIEW ORGANIZATION DESCRIBED IN SECTIONS 1751.84, 1751.85, 3923.67, 3923.68, 3923.76, AND 3923.77 OF THE REVISED CODE.

(C) Sections 4731.51 to 4731.61 of the Revised Code do not apply to any graduate of a podiatric school or college while performing those acts that may be prescribed by or incidental to participation in an accredited podiatric internship, residency, or fellowship program situated in this state approved by the state medical board.

(D) ANY PERSON MAY REQUEST IN WRITING A DETERMINATION FROM THE STATE MEDICAL BOARD OF WHETHER THE PERSON IS OR HAS ENGAGED IN AN ACT THAT CONSTITUTES AN ACT DESCRIBED IN DIVISION (B) OF THIS SECTION. ON RECEIPT OF A REQUEST UNDER THIS DIVISION, THE BOARD SHALL MAKE A DETERMINATION AND PROVIDE WRITTEN NOTICE OF IT TO THE REQUESTING PERSON.

Sec. 4731.361. (A) A PHYSICIAN OR SURGEON IN ANOTHER STATE OR TERRITORY WHO IS A LEGAL PRACTITIONER OF MEDICINE AND SURGERY THEREIN, PRACTICES MEDICINE IN THIS STATE BY PROVIDING MEDICAL SERVICES TO PATIENTS IN PERSON OR THROUGH THE USE OF ANY COMMUNICATION, INCLUDING ORAL, WRITTEN, OR ELECTRONIC COMMUNICATION, AND IS NOT EXEMPTED BY SECTION 4731.36 of the Revised Code FROM SECTIONS 4731.01 TO 4731.47 of the Revised Code SHALL COMPLY WITH BOTH OF THE FOLLOWING:

(1) ALL LAWS AND RULES OF THIS STATE GOVERNING THE PRACTICE OF MEDICINE, INCLUDING SECTION 4731.22 OF THE REVISED CODE, AND THE PRESERVATION OF CONFIDENTIALITY OF A PATIENT'S MEDICAL RECORDS;

(2) ALL REPORTING REQUIREMENTS ESTABLISHED IN SECTION 4731.224 OF THE REVISED CODE.

(B) THE STATE MEDICAL BOARD MAY ADOPT RULES TO CARRY OUT THE PURPOSE OF THIS SECTION. THE RULES MAY INCLUDE STANDARDS FOR ALL OF THE FOLLOWING:

(1) THE PRACTICE OF MEDICINE IN PERSON OR THROUGH THE USE OF ANY COMMUNICATION, INCLUDING ORAL, WRITTEN, OR ELECTRONIC COMMUNICATION;

(2) THE APPROPRIATE DELEGATION TO INDIVIDUALS PROVIDING HEALTH CARE SERVICES;

(3) ELECTRONIC RECORDKEEPING, INCLUDING MEASURES TO PREVENT TAMPERING WITH ELECTRONIC RECORDS AND TO PRESERVE AND MAINTAIN THE CONFIDENTIALITY AND AUTHENTICITY OF THE RECORDS.

Sec. 4731.362. (A) AN INDIVIDUAL HOLDING A VALID CERTIFICATE TO PRACTICE ISSUED UNDER THIS CHAPTER WHO CONSULTS WITH A PHYSICIAN OR SURGEON IN ANOTHER STATE OR TERRITORY ACTING UNDER ONE OF THE EXCEPTIONS DESCRIBED IN DIVISION (A)(3) OF SECTION 4731.36 of the Revised Code SHALL, PRIOR TO PROVIDING MEDICAL CARE TO A PATIENT IN THIS STATE, OBTAIN CONSENT FOR THE CONSULTATION FROM THE PATIENT OR THE PATIENT'S LEGAL REPRESENTATIVE. A REQUEST FOR CONSENT SHALL BE COMMUNICATED TO THE PATIENT OR THE PATIENT'S LEGAL REPRESENTATIVE ORALLY AND IN A WRITTEN DOCUMENT AND DISCLOSE ALL OF THE FOLLOWING:

(1) THE RIGHT OF THE PATIENT OR PATIENT'S LEGAL REPRESENTATIVE TO REFUSE OR WITHDRAW CONSENT AT ANY TIME;

(2) A DESCRIPTION OF THE RISKS, BENEFITS, AND POTENTIAL CONSEQUENCES OF RECEIVING MEDICAL CARE EITHER IN PERSON OR THROUGH THE USE OF ANY COMMUNICATION, INCLUDING ORAL, WRITTEN, OR ELECTRONIC COMMUNICATION, THROUGH CONSULTATION WITH A PHYSICIAN OR SURGEON IN ANOTHER STATE;

(3) THE EXISTENCE OF A PHYSICIAN-PATIENT RELATIONSHIP BETWEEN THE CONSULTING PHYSICIAN OR SURGEON AND PATIENT, INCLUDING THE RIGHT OF CONFIDENTIALITY OF PATIENT INFORMATION;

(4) THE RIGHT OF THE PATIENT OR THE PATIENT'S LEGAL REPRESENTATIVE TO OBTAIN THE PATIENT'S MEDICAL RECORDS FROM THE CONSULTING PHYSICIAN OR SURGEON.

(B) THE PATIENT OR THE PATIENT'S LEGAL REPRESENTATIVE SHALL SIGN A COPY OF THE DOCUMENT DESCRIBED IN DIVISION (A) OF THIS SECTION. THE CERTIFICATE HOLDER SHALL RETAIN THE SIGNED COPY IN THE PATIENT'S MEDICAL RECORD.

(C) REFUSAL OR WITHDRAWAL OF CONSENT SHALL NOT AFFECT A PATIENT'S RIGHT TO RECEIVE MEDICAL CARE.