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(123rd General Assembly)(Substitute House Bill Number 585)
AN ACT
To amend sections 4725.09, 4725.26, 4731.143, 4731.20, 4731.22, 4731.222,
4731.224, 4731.281, 4731.29, 4731.294, 4731.31, 4731.34, 4731.341, 4731.35,
4731.36, 4731.51, 4731.52, 4731.53,
4731.55, 4731.56, 4731.57, 4731.571, 4731.572, 4731.60, 4731.66,
4731.85, 4755.40, and 4755.60
and to enact sections 4731.053 and 4731.296 of the Revised Code to specify
that the practice of medicine in this state includes certain activities
performed in person or through the use of any communication, including oral,
written, or electronic communication, to establish requirements for obtaining
a telemedicine certificate, to modify the exceptions to the law governing
physician licensure, to require the adoption
of rules regarding the authority of physicians to delegate the performance of
medical tasks and the authority of optometrists to delegate the performance of
optometric tasks, to authorize physical therapists and athletic trainers
to apply topical prescription drugs, and to
change references in statutes governing the practice of medicine from
"podiatry" to "podiatric medicine and surgery".
Be it enacted by the General Assembly of the State of Ohio:
SECTION 1 . That sections 4725.09, 4725.26, 4731.143, 4731.20, 4731.22,
4731.222, 4731.224, 4731.281, 4731.29, 4731.31, 4731.294, 4731.31, 4731.34,
4731.341, 4731.35,
4731.36, 4731.51, 4731.52, 4731.53, 4731.55, 4731.56,
4731.57, 4731.571, 4731.572, 4731.60, 4731.66, 4731.85, 4755.40, and 4755.60
of the Revised Code be amended and sections 4731.053 and 4731.296 of the
Revised Code be enacted to read as follows:
Sec. 4725.09. (A) The state board of optometry shall
adopt rules as it considers necessary to govern the practice of
optometry and to administer and enforce sections 4725.01 to
4725.34 of the Revised Code. All rules adopted
under sections 4725.01 to 4725.34 of the Revised
Code shall be adopted in accordance with Chapter
119. of the Revised Code. (B) The board, in consultation with the state board of
pharmacy, shall adopt rules specifying oral dosages of drugs or
dangerous drugs that are therapeutic pharmaceutical agents under
division (C)(3) of section 4725.01 of the Revised
Code. (C) The board shall adopt rules that establish standards to be
met and procedures to be followed with respect to the delegation
by an optometrist of the performance of an optometric task to a
person who is not licensed or otherwise specifically authorized by
the Revised Code to perform the task. The rules shall
permit an
optometrist who holds a topical ocular pharmaceutical agents certificate or
therapeutic pharmaceutical agents certificate to
delegate the administration of drugs included in the optometrist's
scope of practice. The rules adopted under this division shall provide for all of the
following: (1) On-site supervision when the delegation occurs in an institution or
other facility that is used primarily for the purpose of providing health
care, unless the board established a specific exception to the on-site
supervision requirement with respect to routine administration of a topical
drug; (2) Evaluation of whether delegation is appropriate according to the
acuity of the patient involved; (3) Training and competency requirements that must be met by the person
administering the drugs; (4) Other standards and procedures the board considers relevant. Sec. 4725.26.
Division (A) of section 4725.02 of the Revised Code
does not apply to
the following: (A) Physicians authorized to practice
medicine and surgery or osteopathic medicine and surgery under
Chapter 4731. of the Revised Code; (B) Persons who sell
optical accessories but do not assume to adapt them
to the eye, and neither practice nor profess to practice optometry; (C) An instructor in a school of optometry that is located in
this state and
approved by the state board of optometry under
section 4725.10 of the Revised Code who holds a valid current license to practice
optometry
from a licensing body in another jurisdiction and
limits the practice of optometry to the
instruction of students
enrolled in the school. (D) A student at a school of optometry located in this
state and approved by the board under section 4725.10 of the
Revised Code while enrolled in an optometry
training program and acting under the direct, personal
supervision and control of an optometrist licensed by the board
or authorized to practice pursuant to division (C) of
this section. (E) An individual who is licensed or otherwise specifically
authorized by the Revised Code to engage in an activity that
is included in the practice of optometry. (F) An individual who is not licensed or otherwise specifically
authorized by the Revised Code to engage in an activity that
is included in the practice of optometry, but is acting pursuant to the rules
for delegation of optometric tasks adopted under section 4725.09 of the Revised Code. Sec. 4731.053. (A) As used in this section,
"physician" means
an individual authorized by this chapter to practice medicine and
surgery, osteopathic medicine and surgery, or podiatric medicine and
surgery. (B) The state medical board shall adopt rules
that establish standards to be met and procedures
to be
followed by a physician with respect to the physician's delegation
of the performance of a
medical task to a person who is not licensed or otherwise specifically
authorized by the Revised Code
to
perform the task.
The rules shall be
adopted in accordance with Chapter 119. of the Revised
Code. (C) To the extent that delegation applies to the administration
of drugs, the rules adopted under this section shall provide for all
of the following: (1) On-site supervision when the delegation
occurs in an institution or other facility that is used primarily
for the purpose of providing health care, unless the board establishes a
specific exception to the on-site supervision requirement with respect to
routine administration of a topical drug, such as the use of a medicated
shampoo; (2) Evaluation of whether delegation is appropriate according to
the acuity of the patient involved; (3) Training and competency requirements that must be met by the
person administering the drugs; (4) Other standards and procedures the board considers relevant. (D) The board shall not adopt rules that do any of the
following: (1) Authorize a physician to transfer the physician's
responsibility for supervising a person who is performing a delegated
medical task to a health professional other than another
physician; (2) Authorize an individual to whom a medical task is delegated
to delegate the performance of that task to another individual; (3) Except as provided in divisions (D)(4) to (8) of this
section, authorize a physician to delegate the administration of anesthesia,
controlled substances, drugs administered intravenously, or any other drug or
category of drug the board considers to be inappropriate for delegation; (4) Prevent an individual from engaging in an activity performed
for a handicapped child as a service needed to meet the educational needs
of the child, as identified in the individualized education program
developed for the child under Chapter 3323. of the Revised
Code; (5) Prevent delegation from occurring pursuant to section
5126.356 of the Revised Code within the programs and
services
offered by a county board of mental retardation and developmental
disabilities; (6) Conflict with any provision of the Revised Code that
specifically authorizes an individual to perform a particular
task; (7) Conflict with any rule adopted pursuant to the Revised
Code that is in effect on the effective date of this section, as long
as the rule remains in effect, specifically authorizing an individual to
perform a particular task; (8) Prohibit a perfusionist from administering drugs intravenously while
practicing as a perfusionist; (9) Authorize a physician assistant, anesthesiologist assistant,
or any other professional regulated by the board to delegate tasks pursuant to
this section. Sec. 4731.143. (A) Each person holding a valid certificate under this
chapter authorizing the certificate holder to practice medicine and surgery,
osteopathic medicine and surgery, or podiatry podiatric medicine and
surgery, who is not covered by medical
malpractice insurance as defined in section 3929.71 of the Revised Code, shall
provide a patient with written notice of the certificate holder's lack of such
insurance coverage prior to providing nonemergency professional services to
the patient. The notice shall be provided alone on its own page. The notice
shall provide space for the patient to acknowledge receipt of the notice, and
shall be in the following form: "N O T I C E: Dr. ............... (here state the full name of the certificate holder) is
not covered by medical malpractice insurance. The undersigned acknowledges the receipt of this notice.
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(Patient's Signature) | |
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(Date)" | |
The certificate holder shall obtain the patient's
signature, acknowledging the patient's receipt of the notice,
prior to providing nonemergency professional services to the
patient. The certificate holder shall maintain the signed notice
in the patient's file. (B) This section does not apply to any officer or employee of the
state, as those terms are defined in section 9.85 of the Revised Code, who is
immune from civil liability under section 9.86 of the Revised Code or is
entitled to indemnification pursuant to section 9.87 of the Revised Code, to
the extent that the person is acting within the scope of the person's
employment or official responsibilities. This section does not apply to a person who complies with division
(B)(2) of section 2305.234 of the Revised Code. Sec. 4731.20. The powers and duties conferred by this
chapter on the state medical board, including all of the
board's officers,
for purposes of regulating the practices of medicine and surgery,
osteopathic medicine and surgery, and podiatry podiatric medicine
and surgery, shall apply in the same
manner, with any modifications the board considers necessary, for purposes of
regulating the practices of limited branches of medicine, including the
power of the board to
take disciplinary actions under section 4731.22 of
the Revised Code. Sec. 4731.22. (A) The state medical board,
by an affirmative vote of not fewer than six of its members,
may revoke or may
refuse to grant a certificate to a person found by the board to
have committed fraud during the administration of the
examination for a certificate to practice or to have
committed fraud, misrepresentation, or deception in applying for
or securing any certificate to practice or certificate of
registration issued by the board. (B) The board, by an affirmative
vote of not fewer than
six members, shall, to the extent permitted by law, limit,
revoke, or suspend an individual's certificate to
practice, refuse to register an individual, refuse
to reinstate a certificate, or reprimand or place on
probation the
holder of a certificate for one or more of the following reasons: (1) Permitting one's name or one's certificate to practice or
certificate of
registration to be used by a person, group, or corporation when
the individual concerned is not actually directing the treatment
given; (2) Failure to maintain
minimal standards applicable to the
selection or administration of drugs, or failure to employ acceptable
scientific methods in the selection of drugs or other modalities
for treatment of disease; (3) Selling, giving away, personally furnishing, prescribing, or
administering drugs for other than legal and legitimate therapeutic purposes
or a plea of guilty to, a judicial finding of guilt of, or a
judicial finding of eligibility for intervention in
lieu of conviction
of, a violation of any federal or state law regulating the possession,
distribution, or use of any drug; (4) Willfully betraying a professional confidence. For purposes of this division, "willfully betraying a professional
confidence" does not include providing any information, documents, or reports
to a child fatality review board under sections 307.621 to 307.629 of the
Revised Code and does not include the making of a report of an
employee's use of a drug of abuse, or a report of a condition of
an employee other than one involving the use of a drug of abuse,
to the employer of the employee as described in division (B) of
section 2305.33 of the Revised Code.
Nothing in this division
affects the immunity from
civil liability conferred by that section upon a physician who
makes either type of report in accordance with division (B) of
that section. As used in this division, "employee," "employer,"
and "physician" have the same meanings as in section 2305.33 of
the Revised Code. (5) Making a false, fraudulent,
deceptive, or misleading statement
in the solicitation of or advertising
for patients; in relation
to the practice of medicine and surgery, osteopathic medicine
and surgery, podiatry podiatric medicine and surgery, or a
limited branch of medicine;
or in securing or attempting to secure any certificate
to practice or certificate of registration issued by the board. As used in this division, "false, fraudulent, deceptive, or
misleading statement" means a statement that includes a
misrepresentation of fact, is likely to mislead or deceive
because of a failure to disclose material facts, is intended or
is likely to create false or unjustified expectations of
favorable results, or includes representations or implications
that in reasonable probability will cause an ordinarily prudent
person to misunderstand or be deceived. (6) A departure from, or the failure to conform to,
minimal standards of care of similar practitioners under the same
or similar circumstances, whether or not actual injury to a
patient is established; (7) Representing, with the purpose of obtaining
compensation or other advantage as personal gain or for
any other
person, that an incurable disease or injury, or other incurable
condition, can be permanently cured; (8) The obtaining of, or attempting to obtain, money or
anything of value by fraudulent misrepresentations in the course
of practice; (9) A plea of guilty to, a judicial finding of guilt
of, or a judicial finding of eligibility for
intervention in lieu of
conviction for, a felony; (10) Commission of an act that constitutes a felony in
this state, regardless of the jurisdiction in which the act was
committed; (11) A plea of guilty to, a judicial finding of guilt
of, or a judicial finding of eligibility for
intervention in lieu of
conviction for, a misdemeanor committed in the course of practice; (12) Commission of an act in the course of practice that constitutes a
misdemeanor
in this state, regardless of the jurisdiction in which the act was
committed; (13) A plea of guilty to, a judicial finding of guilt
of, or a judicial finding of eligibility for
intervention in lieu of
conviction for, a misdemeanor involving moral turpitude; (14) Commission of an act involving moral turpitude that constitutes a
misdemeanor
in this state, regardless of the jurisdiction in which the act was
committed; (15) Violation of the conditions of limitation placed by
the board upon a certificate to practice; (16) Failure to pay license renewal fees specified in this
chapter; (17) Except as authorized in section 4731.31 of the Revised Code,
engaging in the division of fees
for referral of patients, or the
receiving of a thing of value in return for a specific referral of a patient
to utilize a particular service or business; (18) Subject to section 4731.226 of the Revised Code, violation of
any provision of a code of ethics
of the American medical association, the American osteopathic
association, the American podiatric medical association, or any
other national professional organizations that
the board specifies by
rule. The state medical board shall
obtain and keep on file current copies of the codes of ethics of
the various national professional organizations. The
individual whose certificate is being suspended or
revoked
shall not be found to have violated any provision of a code of
ethics of an organization not appropriate to the
individual's profession. For purposes of this division, a "provision of a code
of ethics of a national professional organization" does not
include any provision that would preclude the making of a
report by a physician of an employee's use of a drug of abuse, or
of a condition of an employee other than one involving the use of
a drug of abuse, to the employer of the employee as described in
division (B) of section 2305.33 of the Revised Code. Nothing
in this division affects the
immunity from civil liability conferred by that section upon a
physician who makes either type of report in accordance with
division (B) of that section. As used in this division,
"employee," "employer," and "physician" have the same meanings as
in section 2305.33 of the Revised Code. (19) Inability to practice according to acceptable and
prevailing standards of care by reason of mental illness or
physical illness, including, but not limited to, physical
deterioration that adversely affects cognitive, motor, or
perceptive skills. In enforcing this division, the board, upon a
showing of a possible violation, may compel any individual
authorized to practice by this chapter or
who has
submitted an application
pursuant to this chapter
to submit to a mental examination, physical
examination, including an HIV test, or both a mental
and a physical
examination. The expense of the
examination is the responsibility of the individual compelled to be
examined. Failure to submit to a mental or physical examination
or consent to an HIV test ordered by the board
constitutes an admission of the allegations against the
individual
unless the failure is due to circumstances beyond the individual's control,
and a default and final order may be entered without the taking
of testimony or presentation of evidence. If the board finds an
individual unable to practice because of the reasons
set forth in
this division, the board shall require the individual
to submit to
care, counseling, or treatment by physicians approved or
designated by the board, as a condition for initial, continued,
reinstated, or renewed authority to practice. An
individual
affected under this division shall be
afforded an opportunity to demonstrate to the board the ability to
resume practice in compliance with acceptable and prevailing
standards under the provisions of the individual's certificate.
For the
purpose of this division, any individual who
applies for or receives a certificate to
practice under this chapter accepts the privilege of
practicing in
this state and, by so doing, shall be
deemed to have given consent to submit to a mental or
physical examination when directed to do so in writing by the
board, and to have waived all objections to the admissibility of
testimony or examination reports that constitute a privileged
communication. (20) Except when civil penalties are imposed under section 4731.225
or 4731.281 of the Revised Code, and subject to section
4731.226 of the Revised Code, violating or
attempting to violate, directly or indirectly, or assisting in or
abetting the violation of, or conspiring to violate, any
provisions of this chapter or any rule promulgated by the board. This division does not apply to a violation or attempted
violation of, assisting in or abetting the violation of, or a
conspiracy to violate, any provision of this chapter or any rule
adopted by the board that would preclude the making
of a
report by a physician of an employee's use of a drug of abuse, or
of a condition of an employee other than one involving the use of
a drug of abuse, to the employer of the employee as described in
division (B) of section 2305.33 of the Revised Code. Nothing
in this division affects the
immunity from civil liability conferred by that section upon a
physician who makes either type of report in accordance with
division (B) of that section. As used in this division,
"employee," "employer," and "physician" have the same meanings as
in section 2305.33 of the Revised Code. (21) The violation of any abortion rule adopted by the
public health council pursuant to section 3701.341 of the Revised
Code; (22) Any of the following actions taken by the agency
responsible for regulating the practice of medicine and surgery, osteopathic
medicine and surgery, podiatry podiatric medicine and surgery,
or the limited branches of medicine in
another jurisdiction, for any reason other than the
nonpayment of fees: the
limitation, revocation, or suspension of an individual's license
to practice; acceptance of an
individual's license surrender; denial of a license; refusal to
renew or reinstate
a license; imposition of probation; or
issuance of an order of censure or other reprimand; (23) The violation of section 2919.12 of the Revised Code
or the performance or inducement of an abortion upon a pregnant
woman with actual knowledge that the conditions specified in
division (B) of section 2317.56 of the Revised Code have not been
satisfied or with a heedless indifference as to whether those
conditions have been satisfied, unless an affirmative defense as
specified in division (H)(2) of that section would apply in a
civil action authorized by division (H)(1) of that section; (24) The revocation, suspension, restriction, reduction,
or termination of clinical privileges by the United
States department of
defense or department of veterans
affairs or the termination or suspension of a certificate of
registration to prescribe drugs by the drug enforcement
administration of the United States department of
justice; (25) Termination or suspension from participation in the medicare or
medicaid
programs by the department of health and human services or other
responsible agency for any act or acts that also would
constitute a violation of division (B)(2), (3), (6), (8), or (19)
of this section; (26) Impairment of ability to practice according to
acceptable and prevailing standards of care because of habitual
or excessive use or abuse of drugs, alcohol, or other substances
that impair ability to practice. For the purposes of this division, any individual authorized to practice
by this chapter accepts
the privilege of
practicing in this state subject to supervision by the board. By
filing an application for or
holding a
certificate to practice under this chapter, an
individual shall
be deemed to have given consent to submit to a mental or
physical examination when ordered to do so by the board in
writing, and to have waived all objections to the admissibility
of testimony or examination reports that constitute privileged
communications. If it has reason to believe that any individual authorized to practice by
this chapter or any applicant for
certification to practice suffers such impairment, the board may compel
the
individual to submit to a mental or physical examination, or
both. The expense of the examination is the
responsibility of the individual
compelled to be examined. Any
mental or physical examination required under this division shall
be undertaken by a treatment provider or physician who is qualified to
conduct the examination and who is chosen by the
board. Failure to submit to a mental or physical
examination ordered by the board constitutes an admission of the
allegations against the individual unless the failure is due to
circumstances beyond the individual's control, and a default and
final order may be entered without the taking of testimony or
presentation of evidence. If the board determines that the
individual's ability to practice is impaired, the board shall
suspend the individual's certificate or deny the
individual's application and shall require
the individual, as a condition for initial, continued,
reinstated, or renewed certification to practice, to
submit to treatment. Before being eligible to apply for reinstatement of a
certificate suspended under this division, the
impaired practitioner shall
demonstrate to the board the ability
to resume practice in
compliance with acceptable and prevailing standards of care under
the provisions of the practitioner's certificate. The
demonstration shall
include, but shall not be limited to, the following: (a) Certification from a treatment provider approved under
section 4731.25 of the Revised Code that the
individual has
successfully completed any required inpatient treatment; (b) Evidence of continuing full compliance with an
aftercare contract or consent agreement; (c) Two written reports indicating that the individual's
ability to practice has been assessed and that the individual has
been found capable of practicing according to acceptable and prevailing
standards of care. The reports shall be made by individuals or
providers approved by the board for making the assessments and
shall describe the basis for their determination. The board may reinstate a certificate suspended under
this
division after that demonstration and after the individual has
entered into a written consent agreement. When the impaired practitioner resumes practice, the board shall
require continued
monitoring of the individual. The
monitoring shall include, but not be
limited to, compliance with the written consent agreement entered
into before reinstatement or with conditions imposed by board
order after a hearing, and, upon termination of the consent
agreement, submission to the board for at least two years of
annual written progress reports made under penalty of perjury
stating whether the individual has maintained
sobriety. (27) A second or subsequent violation of section 4731.66
or 4731.69 of the Revised Code; (28) Except as provided in division (N) of this section: (a) Waiving the payment of all or any part of a
deductible or copayment that a patient, pursuant to a health
insurance or health care policy, contract, or plan that covers
the individual's services, otherwise would be
required
to pay if the waiver is used as an enticement to a patient or group of
patients to receive health care services from that
individual; (b) Advertising that the individual will waive the
payment of all or
any part of a deductible or copayment that a patient, pursuant to
a health insurance or health care policy, contract, or plan that
covers the individual's services, otherwise would
be
required to pay. (29) Failure to use universal blood and body fluid
precautions established by rules adopted under section 4731.051
of the Revised Code; (30) Failure of a collaborating physician to fulfill
the responsibilities agreed to by the
physician
and an advanced practice nurse
participating in a pilot program under section 4723.52 of the Revised Code; (31) Failure to provide notice to, and receive
acknowledgment of the
notice from, a patient when required by section 4731.143 of the Revised Code
prior to providing nonemergency professional services, or failure to maintain
that notice in the patient's file; (32) Failure of a physician supervising a physician assistant to
maintain supervision in accordance with the requirements of Chapter
4730. of the Revised Code and the rules adopted under that chapter; (33) Failure of a physician or podiatrist to enter into a standard care
arrangement with a clinical nurse specialist, certified nurse-midwife, or
certified nurse practitioner with whom the physician or podiatrist is in
collaboration pursuant to section 4731.27 of the Revised Code
or failure to fulfill the responsibilities of collaboration after entering
into a standard care arrangement; (34) Failure to comply with the terms of a consult agreement
entered into with a pharmacist pursuant to section 4729.39 of the
Revised Code; (35) Failure to cooperate in an investigation conducted by
the board under division (F) of this section, including
failure to comply with a subpoena or order issued by the board
or failure to answer truthfully a question presented by the
board at a deposition or in written interrogatories, except that
failure to cooperate with an investigation shall not constitute
grounds for discipline under this section if a court of
competent jurisdiction has issued an order that either quashes a
subpoena or permits the individual to withhold the testimony or
evidence in issue; (36) Failure to supervise an acupuncturist in accordance with
Chapter 4762. of the Revised Code and the board's rules for supervision of an
acupuncturist; (37) Failure to supervise an anesthesiologist assistant in accordance with
Chapter 4760. of the Revised Code and the board's rules for supervision of an
anesthesiologist assistant. (C) Disciplinary actions taken by the board under divisions
(A) and (B) of this section shall be taken pursuant to an
adjudication under Chapter 119. of the Revised Code, except that in lieu of an
adjudication, the board may enter into a consent agreement with an
individual to resolve an allegation of a violation of this chapter or any rule
adopted under it. A consent agreement, when ratified by an
affirmative vote of not fewer than six members of the board,
shall constitute the findings and order of the board with
respect to the matter addressed in the agreement. If the board
refuses to ratify a consent agreement, the admissions and
findings contained in the consent agreement shall be of no force
or effect. (D) For purposes of divisions (B)(10), (12), and (14) of this
section, the commission of the act may be established by a
finding by the board, pursuant to an adjudication under
Chapter 119. of the Revised Code, that the individual committed the act.
The board
does not have jurisdiction under those divisions if
the trial court renders a final judgment in the individual's favor and
that judgment is based upon an
adjudication on
the merits. The board has jurisdiction under those
divisions if the trial court issues an order of
dismissal upon technical or procedural grounds. (E) The sealing of conviction records by any court shall have
no effect upon a prior board order entered under this section
or upon the board's jurisdiction to take action under this section if,
based upon a plea of guilty,
a judicial finding of guilt, or a
judicial finding of eligibility for intervention in
lieu of conviction, the board issued a notice of opportunity for
a hearing prior to the court's order to seal the records. The
board shall not be required to seal, destroy, redact, or
otherwise modify its records to reflect the court's sealing of
conviction records. (F)(1) The board shall investigate evidence that appears
to show that a person has violated any provision of this
chapter or any rule adopted under it. Any person may report to the board
in a signed writing
any information that the person may have that appears to show a
violation of any provision of this chapter or any rule
adopted under it. In the absence of bad
faith, any person who reports information of that nature or who testifies
before the board in any adjudication conducted under
Chapter 119. of the Revised Code shall not be liable
in damages in a civil action as a result of the report or
testimony. Each
complaint or allegation of a violation received by the
board shall be assigned a case number and shall be recorded by
the board. (2) Investigations of alleged violations of this chapter or any rule
adopted under it shall
be supervised by the supervising member elected by the board in
accordance with section 4731.02 of the Revised Code and by the
secretary as provided in section 4731.39 of the Revised Code. The president
may designate another member of the board to
supervise the investigation in place of the supervising member. No member of
the board who supervises the investigation of a case
shall participate in further adjudication of the case. (3) In investigating a possible violation of
this chapter or any rule adopted
under this chapter, the board
may administer oaths, order the taking of depositions, issue
subpoenas, and compel the attendance of witnesses and production
of books, accounts, papers, records, documents, and testimony, except
that a
subpoena for patient record information shall not be issued without
consultation with the attorney general's office and approval of
the secretary and supervising member
of the board. Before issuance of a
subpoena for patient record information, the
secretary and supervising member shall
determine
whether there is probable cause to believe that the complaint filed alleges a
violation of this chapter or any rule adopted under it and that the records
sought are relevant
to the alleged violation and material to the investigation.
The subpoena may apply only to records that cover a
reasonable period of time surrounding the
alleged violation. On failure to comply with any subpoena
issued by the board and after reasonable notice to the person
being subpoenaed, the board may move for an order compelling the
production of persons or records pursuant to the Rules of Civil
Procedure. A subpoena issued by the board may be served by a sheriff,
the sheriff's deputy, or a board employee designated by the
board. Service of a subpoena issued by the board may be
made by delivering a copy of the subpoena to the
person named therein, reading it to the person, or leaving it at
the person's usual place of residence. When the person being
served is a person whose practice is authorized by this chapter,
service of the subpoena may be made by certified mail,
restricted delivery, return receipt requested, and the subpoena
shall be deemed served on the date delivery is made or the date
the person refuses to accept delivery. A sheriff's deputy who serves a subpoena shall receive the same fees as a
sheriff. Each witness who
appears before the board in
obedience to a subpoena shall receive the fees
and mileage provided for witnesses in civil cases in the courts
of common pleas. (4) All hearings and investigations of the board shall be
considered civil actions for the purposes of section 2305.251 of
the Revised Code. (5) Information received by the board pursuant to an
investigation is confidential and not subject to discovery in any civil
action. The board shall conduct all investigations and proceedings
in a manner that protects the
confidentiality of patients and persons who file complaints with the
board. The
board shall not make public the names or any other identifying
information about patients or complainants unless proper consent is
given or, in the case of a patient, a
waiver of the patient privilege exists under division (B) of
section 2317.02 of the Revised Code, except that consent
or a waiver of that nature is not required if the board
possesses reliable and
substantial evidence that no bona fide physician-patient
relationship exists. The board may
share any information it receives pursuant to an investigation, including
patient records and patient record
information, with law
enforcement agencies, other licensing boards, and other
governmental
agencies that are prosecuting, adjudicating, or investigating alleged
violations of statutes or administrative rules. An agency
or board that receives the information shall comply with the same
requirements regarding confidentiality as those with which the state medical
board must comply, notwithstanding any conflicting provision
of the Revised Code or procedure
of the agency or board that applies when it is dealing with
other information in its possession. In a judicial proceeding,
the information
may
be admitted into evidence only in accordance with
the Rules of Evidence, but the court shall require
that appropriate measures are taken to ensure that
confidentiality is maintained with respect to any part of the information that
contains names or other identifying information about patients or complainants
whose confidentiality was protected by the state medical board when the
information was in the board's possession. Measures to ensure confidentiality
that may be taken by the court include sealing its records or deleting
specific information
from its records. (6) On a quarterly basis, the board shall prepare a report
that documents the disposition of all cases during the preceding
three months. The report shall contain the following information
for each case with which the board has completed its activities: (a) The case number assigned to the complaint or alleged
violation; (b) The type of certificate to practice, if
any, held by the individual against whom the complaint is
directed; (c) A description of the allegations contained in the
complaint; (d) The disposition of the case. The report shall state how many cases are still pending
and shall be prepared in a manner that
protects the identity
of each person involved in each case. The report shall be a
public record under section 149.43 of the Revised Code. (G) If the secretary and supervising member determine that
there is clear and convincing evidence that
an individual has violated division (B) of this section and that the
individual's continued practice presents a
danger of
immediate and serious harm to the public, they may recommend that
the board suspend the individual's
certificate to practice without a
prior hearing. Written allegations shall be prepared for consideration by the
board. The board, upon review of those allegations and by an
affirmative vote
of not fewer than six of its members, excluding the secretary and
supervising member, may suspend a certificate without a prior
hearing. A telephone conference call may be utilized for
reviewing the allegations and taking the vote on the
summary suspension. The board shall issue a written order of suspension by
certified mail or in person in accordance with section 119.07 of
the Revised Code. The order shall not be subject to
suspension
by the court during pendency of any appeal filed under section
119.12 of the Revised Code. If the individual
subject to the summary suspension requests
an adjudicatory hearing by the board, the date set for the
hearing shall be within fifteen days, but not earlier than seven
days, after the individual
requests the hearing,
unless otherwise agreed to by both the board and the individual. Any summary suspension imposed under this division shall
remain in effect, unless reversed on appeal, until a final
adjudicative order issued by the board pursuant to this section
and Chapter 119. of the Revised Code becomes effective. The
board shall issue its final adjudicative order within sixty days
after completion of its hearing. A failure to issue the order
within sixty days shall result in dissolution of the summary
suspension order but shall not invalidate any subsequent, final
adjudicative order. (H) If the board takes action under division
(B)(9), (11), or (13) of this section and the judicial
finding of guilt, guilty plea, or judicial finding of
eligibility for intervention in lieu of conviction is
overturned on appeal,
upon
exhaustion of the criminal appeal, a petition for reconsideration
of the order may be filed with the board along with appropriate
court documents. Upon receipt of a petition of that
nature and supporting court documents, the board shall reinstate the
individual's certificate to practice. The
board may then hold an adjudication under Chapter 119. of the Revised Code to
determine whether the individual
committed
the act in question. Notice of an opportunity for a hearing
shall be given in accordance with Chapter 119. of the Revised Code. If the
board finds, pursuant to an adjudication held under this division,
that the individual committed
the act or if
no hearing is requested, the board may order any of the sanctions
identified under division (B) of this section. (I) The certificate to practice issued to an individual under
this chapter and the individual's practice in this
state are automatically suspended as of the date the individual pleads
guilty to, is found by a judge
or jury to be guilty of, or is subject to a judicial
finding of eligibility for intervention in lieu of conviction in this state
or treatment or intervention in lieu of conviction in another
jurisdiction for
any of the following
criminal offenses in this state or a
substantially equivalent criminal offense in another jurisdiction: aggravated
murder, murder, voluntary
manslaughter, felonious assault, kidnapping, rape, sexual
battery, gross sexual imposition, aggravated arson, aggravated
robbery, or aggravated burglary. Continued
practice after suspension shall be considered practicing
without a certificate. The board shall notify the
individual subject to the suspension by certified mail or in person in
accordance with section 119.07 of the Revised Code. If an
individual whose certificate is suspended under this
division fails to make a timely request for an adjudication under
Chapter 119. of the Revised Code,
the board shall enter a final order permanently revoking the
individual's certificate to practice. (J) If the board is required by
Chapter 119. of the Revised Code to give notice of an
opportunity for a hearing and if the individual subject to the notice
does not timely request a
hearing in accordance with section
119.07 of the Revised Code, the board is not required
to hold a hearing, but may adopt, by an affirmative vote of
not fewer than
six of its members, a final order that contains the board's
findings. In that final order, the board may order any of the
sanctions identified under division
(A) or (B) of this section. (K) Any action taken by the board under division (B) of
this section resulting in a suspension from practice shall be
accompanied by a written statement of the conditions under which
the individual's certificate to practice may be
reinstated. The board
shall adopt rules governing conditions to be imposed for
reinstatement. Reinstatement of a certificate suspended pursuant
to division (B) of this section requires an affirmative vote of
not fewer than six members of the board. (L) When the board
refuses to grant a certificate to an applicant,
revokes an individual's
certificate to practice, refuses to register an applicant, or
refuses to reinstate an individual's certificate to practice,
the board may specify that its action is permanent. An
individual subject to a permanent action taken by the board is
forever thereafter ineligible to hold a certificate to practice
and the board shall not accept an application for reinstatement of the
certificate or for issuance of a new certificate. (M) Notwithstanding any other provision of the Revised
Code, all of the following apply: (1) The surrender of a certificate issued under this
chapter shall not be effective
unless or until accepted by the board. Reinstatement of a
certificate surrendered to the board requires an affirmative vote
of not fewer than six members of the board. (2) An application for a certificate made
under the
provisions of this chapter
may not be withdrawn without approval of the board. (3) Failure by an individual to renew a certificate
of registration in accordance with this chapter shall not remove or limit the
board's
jurisdiction to take any disciplinary action under this section
against the individual. (N) Sanctions shall not be imposed under division
(B)(28) of this section against any person who
waives deductibles and copayments as follows: (1) In compliance with the health benefit plan that
expressly allows such a practice. Waiver of the deductibles or
copayments shall be made only with the full knowledge and consent of
the plan purchaser, payer, and third-party administrator. Documentation of
the consent shall be made available to the board upon request. (2) For professional services rendered to any other person
authorized to practice pursuant to this chapter,
to the extent allowed by this
chapter and rules adopted by the board. (O) Under the board's investigative duties described in
this
section and subject to division (F) of this section, the
board shall
develop and implement a quality intervention program designed to improve
through remedial
education the clinical and communication skills of individuals authorized
under this chapter to practice medicine and surgery, osteopathic medicine and
surgery, and podiatry podiatric medicine and surgery. In
developing and implementing the quality intervention program, the board may do
all of the following: (1) Offer in appropriate cases as determined by the board an educational
and assessment program pursuant to an investigation the
board conducts under this section; (2) Select providers of educational and assessment services, including a
quality intervention program panel of case reviewers; (3) Make referrals to educational and
assessment service providers and
approve individual educational programs recommended by those providers. The
board shall monitor the progress of each individual
undertaking a recommended individual educational
program. (4) Determine what constitutes successful completion of an
individual educational program and require further monitoring of the
individual who completed the program or other
action that the board determines to be appropriate; (5) Adopt rules in accordance with Chapter 119. of the Revised Code to
further
implement the quality intervention program. An individual who participates in an individual
educational program pursuant
to this division shall pay the financial obligations arising from that
educational program. Sec. 4731.222. Before restoring to good standing a
certificate issued under this chapter that has been in a
suspended or inactive state for any cause for more than two
years, or before issuing a certificate pursuant to section
4731.18, 4731.29, 4731.295, 4731.57, or 4731.571 of the
Revised Code to an applicant who for more than two years has not been
engaged in the practice of medicine,
osteopathic medicine, podiatry podiatric medicine and surgery,
or a limited branch of
medicine as an active practitioner, as a
participant in a
program of graduate medical education, as defined in section
4731.091 of the Revised Code, as a student in a college of podiatry
determined by the board to be in good standing, or as a student in a
school, college, or institution giving instruction in a limited branch of
medicine determined by the board to be in good standing under section 4731.19
of the Revised Code, the
state medical board may require the applicant to pass an oral or
written examination, or both, to determine the applicant's
present fitness to resume practice. The authority of the board to impose terms and conditions
includes the following: (A) Requiring the applicant to obtain additional training
and to pass an examination upon completion of such training; (B) Restricting or limiting the extent, scope, or type of
practice of the applicant. The board shall consider the moral background and the
activities of the applicant during the period of suspension or
inactivity, in accordance with section 4731.08 of the Revised
Code. Sec. 4731.224. (A) Within sixty days after the
imposition of any formal disciplinary action
taken by any health care facility, including a hospital,
health care facility operated by a health insuring
corporation, ambulatory surgical center, or similar
facility, against any individual holding a
valid
certificate to practice issued pursuant to this chapter, the chief
administrator or executive officer of the facility shall report
to the state medical board the name of the
individual, the action taken by the facility, and a summary of the
underlying facts leading to the action taken. Upon request, the board shall
be provided certified copies of the patient records that
were the basis for the facility's action. Prior to release to
the board, the summary shall be approved by the peer review
committee that reviewed the case or by the governing board
of
the facility. As used in this division, "formal disciplinary
action" means any action
resulting in the revocation,
restriction, reduction, or termination of clinical privileges for
violations of professional ethics, or for reasons of medical
incompetence, medical malpractice, or drug or alcohol abuse.
"Formal disciplinary action" includes a summary action,
an action that takes effect notwithstanding any appeal rights
that may exist, and an action that results in an individual
surrendering clinical privileges while under investigation and
during proceedings regarding the action being taken or in return
for not being investigated or having proceedings held. "Formal
disciplinary action" does not include any
action taken
for the sole reason of failure to maintain records on a timely
basis or failure to attend staff or section meetings. The filing or nonfiling of a report with the board,
investigation by the board, or any disciplinary action taken by
the board, shall not preclude any action by a health care
facility to suspend, restrict, or revoke
the individual's clinical privileges. In the absence of fraud or bad faith, no individual or entity that provides
patient records to the board shall be liable in damages to any
person as a result of providing the records. (B) If any individual authorized to practice under
this chapter or any professional
association or society of such individuals
believes that a violation of any provision of this chapter,
Chapter 4730., 4760., or 4762. of the Revised Code, or any
rule of the
board has
occurred, the individual, association, or
society shall report to the board the information upon
which the belief is based. This division does not require any treatment
provider approved by the board under section 4731.25 of
the Revised Code or any employee, agent, or representative of
such a provider to make reports with respect to an impaired
practitioner participating in treatment or aftercare for
substance abuse as long as the
practitioner maintains participation in accordance with the
requirements of section 4731.25 of the Revised Code, and as
long as the treatment provider
or employee, agent, or representative of the provider has no reason to
believe that the practitioner has violated any provision of this
chapter or any rule adopted under it, other than the provisions of
division (B)(26) of section
4731.22 of the Revised Code. This division does not require
reporting by any member of an impaired practitioner committee
established by a health care facility or by any
representative or agent of a committee or program sponsored by a professional
association or society of
individuals authorized to practice under this chapter
to provide peer
assistance to practitioners with substance abuse problems with
respect to a practitioner who has been referred for examination
to a treatment program approved by the board under section
4731.25 of the Revised Code if the practitioner cooperates with
the referral for examination and with any determination that the
practitioner
should enter treatment and as long as the committee member,
representative, or agent has no reason to believe that the
practitioner has ceased to participate in the treatment program
in accordance with section 4731.25 of the Revised Code or has
violated any provision of this chapter or any rule
adopted under it,
other than the provisions
of division (B)(26) of section 4731.22 of the Revised Code. (C) Any professional association or society composed primarily of
doctors
of medicine and surgery, doctors of osteopathic medicine and
surgery, doctors of podiatry podiatric medicine and surgery, or
practitioners of limited
branches of medicine that suspends or
revokes an individual's membership for violations
of professional ethics, or for reasons of professional
incompetence or professional malpractice, within sixty days after
a final decision shall report to the board, on forms prescribed
and provided by the board, the name of the individual,
the action taken by the professional organization, and a
summary of the underlying facts
leading to the action taken. The filing of a report with the board or decision not to file a report,
investigation by the board, or any disciplinary action taken by
the board, does not preclude a professional organization from
taking disciplinary action against an individual. (D) Any insurer providing professional liability insurance
to an
individual authorized to practice under this chapter, or any other entity
that seeks to indemnify the professional liability of such an
individual, shall notify the board within thirty days after the
final disposition of any written claim for damages where such disposition
results in a payment exceeding twenty-five
thousand dollars. The notice shall contain the
following information: (1) The name and address of the person submitting the
notification; (2) The name and address of the insured who is the subject
of the claim; (3) The name of the person filing the written claim; (4) The date of final disposition; (5) If applicable, the identity of the court in which the
final disposition of the claim took place. (E) The board may investigate possible violations of this
chapter or the rules adopted under it that are brought to its
attention as a result of the
reporting
requirements of this section, except that the board shall
conduct an investigation if a possible violation involves repeated
malpractice. As
used in this division, "repeated malpractice" means three or
more claims for medical malpractice within the previous five-year
period, each resulting in a judgment or settlement in excess of
twenty-five thousand dollars in favor of the claimant, and each
involving negligent conduct by the practicing
individual. (F) All summaries, reports, and records received and
maintained by the board pursuant to this section shall be held in
confidence and shall not be subject to discovery or introduction
in evidence in any federal or state civil action involving a
health care professional or facility arising out of matters
that are the subject of the reporting required by this
section. The board may use the
information obtained only as the basis for an investigation, as
evidence in a disciplinary hearing against an
individual whose practice is regulated under this chapter, or in any
subsequent trial or appeal of a
board action or order. The board may disclose the summaries and reports
it receives under this section only to health care
facility committees within or outside this state
that are involved in credentialing or
recredentialing the individual or in reviewing the
individual's clinical privileges. The board shall indicate whether or not
the information has been verified. Information transmitted by
the board shall be subject to the same confidentiality provisions
as when maintained by the board. (G) Except for reports filed by an individual
pursuant to division (B) of this section, the board shall send a copy
of any reports or summaries it receives
pursuant to this section to the individual who is the subject of the reports
or
summaries. The individual shall have the
right to file a statement with the board concerning the correctness or
relevance of the information. The statement shall at all
times accompany that part of the record in
contention. (H) An individual or entity that,
pursuant to this section, reports to the board or refers an
impaired practitioner to a treatment provider approved by the
board under section 4731.25 of the Revised Code
shall not be subject to suit for
civil damages as a
result of the report, referral, or provision of the information. (I) In the absence of fraud or bad faith, no professional
association or society of individuals authorized to practice under
this chapter that
sponsors a committee or program to provide peer assistance to
practitioners with substance abuse problems, no representative or
agent of such a committee or program, and no member of the state
medical board shall be held liable in damages to any person by
reason of actions taken to refer a practitioner to a treatment
provider approved under section 4731.25 of the Revised Code for
examination or treatment. Sec. 4731.281. (A) On or before the deadline established under division
(B) of this section for applying for renewal
of a certificate of registration, each person
holding a certificate under this chapter to practice medicine and
surgery, osteopathic medicine and surgery, or podiatry podiatric
medicine and surgery shall
certify to the state medical board that in the preceding two years the person
has completed one
hundred hours of continuing medical education. The
certification shall be made upon the application for biennial
registration submitted pursuant to division
(B) of this section. The board shall adopt rules providing for pro rata
reductions by
month of the number of hours of continuing education required
for persons who are in their first registration period, who have a
registration period of less than two years due to initial implementation of
the staggered renewal schedule established under division (B) of this
section, who have
been disabled due to illness or accident, or who have been
absent from the country. In determining whether a course, program, or activity
qualifies for credit as continuing medical education, the board
shall approve all continuing medical education taken
by persons holding a certificate to practice medicine and surgery
that is certified by the Ohio state medical association,
all continuing medical education taken by
persons holding a certificate to practice osteopathic medicine
and surgery that is certified by the Ohio osteopathic
association, and all continuing medical
education taken by persons holding a certificate to practice
podiatry that is certified by the Ohio podiatric medical
association. Each person holding a certificate
to practice under this chapter
shall be given sufficient choice of continuing education programs
to ensure that the person has had a reasonable opportunity to
participate
in continuing education programs that are relevant to the person's
medical
practice in terms of subject matter and level. The board may
require a random sample of persons holding a certificate to
practice under this chapter to submit materials documenting
completion of the continuing medical education requirement during
the preceding registration period, but this provision shall not
limit the board's authority to investigate pursuant to section
4731.22 of the Revised Code. (B)(1) Every person holding a certificate under this chapter to
practice medicine and surgery, osteopathic medicine and surgery,
or podiatry podiatric medicine and surgery wishing to renew that
certificate shall
apply to the board for a certificate of
registration upon an application furnished by the board, and pay to the
board at the time of application a fee of three
hundred five dollars, according to the following
schedule: (a) Persons whose last name begins with the letters "A" through
"B," on or before April 1, 2001, and the first day of April of
every odd-numbered year thereafter; (b) Persons whose last name begins with the letters "C" through
"D," on or before January 1, 2001, and the first day of January
of every odd-numbered year thereafter; (c) Persons whose last name begins with the
letters "E" through "G," on or before October 1,
2000, and the first
day of October of every
even-numbered year thereafter; (d) Persons whose last name begins
with the letters "H" through
"K," on or before July 1, 2000, and the first day
of July of every even-numbered year thereafter; (e) Persons whose last name begins with the
letters "L" through
"M," on or before April 1, 2000, and the first
day of April of every even-numbered year thereafter; (f) Persons whose last name begins with the
letters "N" through
"R," on or before
January 1, 2000, and the first
day of January of every
even-numbered year thereafter; (g) Persons whose last name begins
with the letters "S," on or before October 1, 1999, and the
first day of October of every odd-numbered year thereafter; (h) Persons whose last name begins
with the letters "T" through "Z," on or before
July 1, 1999, and the first day of July of every
odd-numbered year thereafter. The board shall deposit the
fee in accordance with section 4731.24 of
the Revised Code, except that,
until July 30, 2001, the
board shall deposit twenty dollars of the fee into the state treasury
to the credit of the physician loan repayment fund created by
section 3702.78 of the Revised Code. (2) The board shall mail or cause to be mailed to every person
registered to practice medicine and surgery, osteopathic medicine
and surgery, or podiatry podiatric medicine and surgery, an
application for registration
addressed to the person's last known post-office address or
may cause the application to be sent to
the person through the
secretary of any recognized medical, osteopathic, or podiatric
society, according to the following schedule: (a) To persons whose last name begins with the letters "A"
through "B," on or before January 1, 2001, and the first
day of January of every odd-numbered year thereafter; (b) To persons whose last name begins with the
letters "C" through "D," on or before
October 1, 2000, and the first day of October of every
even-numbered year thereafter; (c) To persons whose last name begins with the
letters "E" through
"G," on or before
July 1, 2000, and the first day
of July of every even-numbered
year thereafter; (d) To persons whose last name begins
with the letters "H" through
"K," on or before
April 1, 2000, and the first
day of April of every
even-numbered year thereafter; (e) To persons whose last name begins with the
letters "L" through
"M," on or before
January 1, 2000, and the first
day of January of every
even-numbered year thereafter; (f) To persons whose last name begins with the
letters "N" through
"R," on or before
October 1, 1999, and the first
day of October of every
odd-numbered year thereafter; (g) To persons whose last name begins
with the letters "S," on or
before July 1, 1999, and the
first day of July of every
odd-numbered year thereafter; (h) To persons whose last name begins
with the letters "T" through
"Z," on or before
April 1, 1999, and the first
day of April of every
odd-numbered year thereafter; Failure of any person to receive an application from
the board shall not excuse the person from the requirements
contained in
this section. The application shall contain proper spaces for the
applicant's signature and the insertion of the required
information, including a statement that the person has
fulfilled the
continuing education requirements imposed by this section. The applicant shall write or cause to be written upon the
application so furnished the applicant's full name,
principal
practice
address and residence address, the number of the applicant's
certificate to
practice, and any other facts for the identification of the
applicant as a person holding a certificate to practice under
this chapter as the board considers necessary. The
applicant shall include with the application a list of the names and addresses
of any clinical nurse specialists, certified nurse-midwives, or certified
nurse practitioners with whom the applicant is currently collaborating,
as defined in section 4723.02 of the Revised Code.
The applicant shall
execute
and deliver the application to the board by mail or in
person. Every person
registered under this section shall give written notice to the
board of any change of principal practice address or residence
address or in the list within thirty days of the change. The applicant shall report any criminal offense that
constitutes grounds for refusal of registration under section
4731.22 of the Revised Code to which the applicant has pleaded
guilty, of which the applicant has been
found guilty, or
for which the applicant has been found eligible for
intervention
in lieu of conviction, since last
signing an application for
a certificate of registration. (C) The board shall issue to any person holding a certificate
under this chapter to practice medicine and surgery, osteopathic
medicine and surgery, or podiatry podiatric medicine and
surgery, upon application and
qualification therefor in accordance with this section, a
certificate of registration under the seal of the board. A
certificate of registration shall be valid for a two-year period,
commencing on
the first day of the third month after the registration fee
is due and expiring on the last day of
the month two years
thereafter. The board shall publish
and
cause to be mailed to each person registered under this section,
upon request, a printed list of the persons so registered. (D) Failure of any certificate holder to register and comply
with this section shall operate automatically to suspend the
holder's
certificate to practice. Continued
practice after the
suspension of the certificate to practice shall be considered as
practicing in violation of section 4731.41,
4731.43, or 4731.60 of the Revised Code.
Subject to section 4731.222 of the Revised Code, the If the
certificate has been suspended pursuant to this division for two years or
less, it may be reinstated. The
board shall reinstate a certificate to practice
for failure to register upon an applicant's submission of the
biennial registration fee, the
applicable monetary penalty, and certification by signature of the
applicant that the applicant has completed the requisite
continuing medical education. The penalty for reinstatement shall be
fifty dollars if
the certificate has been suspended for two years or less and.
If the certificate has been suspended pursuant to this division for more
than two years, it may be restored. In accordance with section 4731.222 of the Revised Code,
the board may restore a certificate to practice for failure to register upon
an
applicant's submission of a restoration application, the biennial registration
fee, and the applicable monetary penalty. The penalty for restoration shall
be one hundred dollars if the certificate has been suspended for more
than two years. The board shall deposit the penalties in
accordance with section 4731.24 of the Revised
Code. (E) If an individual certifies completion of the number of hours
and
type of continuing medical education required to receive a
certificate of registration or reinstatement of a certificate to
practice, and the board finds through the random samples it
conducts under this section or through any other means that the
individual did not complete the requisite continuing medical
education, the board may impose a civil penalty of not more than
five thousand dollars. The board's finding shall be made
pursuant to an adjudication under Chapter 119. of the
Revised Code and by an affirmative vote of not
fewer than six members. A civil penalty imposed under this division may be in
addition to or in lieu of any other action the board may take
under section 4731.22 of the Revised Code. The
board shall deposit civil penalties in accordance with section
4731.24 of the Revised Code. (F) The state medical board may obtain information not
protected by statutory or common law privilege from courts and
other sources concerning malpractice claims against any person
holding a certificate to practice under this chapter or
practicing as provided in section 4731.36 of the Revised Code. Sec. 4731.29. (A) When a person licensed to practice
medicine and surgery or osteopathic medicine and surgery by the
licensing department of another state, a diplomate of the
national board of medical examiners or the national board of
examiners for osteopathic physicians and surgeons, or a
licentiate of the medical council of Canada wishes to remove to
this state to practice, the person
shall file an application with the state medical board. The board may, in its
discretion, by an affirmative vote of not less than six of its
members, issue its certificate to practice medicine and
surgery or osteopathic medicine and surgery without requiring the
applicant to submit to examination, provided the applicant
submits evidence
satisfactory to the board of meeting the same age,
moral character, and educational requirements individuals must meet
under sections 4731.08, 4731.09, 4731.091, and 4731.14 of the
Revised Code and, if applicable, demonstrates proficiency
in spoken English in accordance with division (E) of this
section. (B) The state medical board shall issue or deny its
certificate to practice within sixty days after the receipt of a
complete application under division (A) of this section. Within
thirty days after receipt of an application, the state medical
board shall provide the applicant with written notice of any information
required before an application
can be considered complete for purposes of this section. (C) If an applicant is under investigation pursuant to
section 4731.22 of the Revised Code, the state medical board
shall conclude the investigation within ninety days of receipt of
a complete application unless extended by written consent of the
applicant or unless the board determines that a substantial
question of a violation of this chapter or the rules adopted
under it exists and the board has notified the applicant in writing of the
reasons for the continuation of the investigation. If the board determines
that the applicant is not in violation, it shall
issue a certificate within forty-five days of that determination. (D) A fee of three hundred dollars shall be submitted with
each application for certification under this section. (E)(1) Except as provided in division
(E)(2) of this section, an applicant licensed to practice
medicine and surgery or
osteopathic medicine and surgery by the licensing department of
another state who received that license based in part on
certification from the educational commission for foreign medical
graduates shall demonstrate proficiency in spoken English if the
applicant fulfilled the undergraduate requirements for a certificate
issued
under this section at an institution outside the United States.
The applicant may demonstrate such proficiency only in the manner
described in section 4731.142 of the Revised Code for individuals
attempting to receive certificates issued under section 4731.14
of the Revised Code. (2) An applicant described in division (E)(1) of
this section is not required to demonstrate
proficiency in spoken English if either of the following apply: (a) During the five years immediately preceding the date
of application, the applicant's license has been unrestricted
and the applicant has been actively practicing medicine and
surgery or osteopathic medicine and surgery in the United States. (b) At the beginning of the five-year period preceding the date of
application under this section, the applicant was participating in graduate
medical education, as defined in section 4731.091 of the Revised Code, and since completing
that education has held an unrestricted license and has been actively
practicing medicine and surgery or osteopathic medicine and surgery in the
United States. (c) The applicant was required to demonstrate such
proficiency as a condition of receiving certification from
the
educational commission for foreign medical graduates. Sec. 4731.294. (A) The state medical board may issue,
without examination, a special activity certificate to any person
seeking to practice medicine and surgery or osteopathic medicine
and surgery in conjunction with a special activity, program, or
event taking place in this state. (B) An applicant for a special activity certificate shall hold a
telemedicine certificate issued under section 4731.296 of the Revised Code or submit
evidence satisfactory to the board of all of the
following: (1) He The applicant holds a current, unrestricted license to
practice
medicine and surgery or osteopathic medicine and surgery issued
by another state or country and that within the two-year period
immediately preceding his application, he the applicant
has done one of the
following: (a) Actively practiced medicine and surgery or osteopathic
medicine and surgery in the United States; (b) Participated in a graduate medical education program
accredited by either the accreditation council for graduate
medical education of the American medical association or the
American osteopathic association; (c) Successfully passed the federation licensing
examination established by the federation of state medical
boards, a special examination established by the federation of
state medical boards, or all parts of a standard medical
licensing examination established for purposes of determining the
competence of individuals to practice medicine and surgery or
osteopathic medicine and surgery in the United States. (2) He The applicant meets the same educational requirements
that
individuals must meet under sections 4731.09, 4731.091, and
4731.14 of the Revised Code. (3) His The applicant's practice in conjunction with the
special activity,
program, or event will be in the public interest. (C) The applicant shall pay a fee of one hundred
twenty-five dollars unless the applicant holds a telemedicine certificate
issued under section 4731.296 of the Revised Code. If the applicant holds a telemedicine
certificate, the board shall not charge a fee for issuing a certificate under
this section. The board shall maintain a register of all
persons who hold a special activity certificate. (D) The holder of a special activity certificate may
practice medicine and surgery or osteopathic medicine and surgery
only in conjunction with the special activity, event, or program
for which the certificate is issued. The board may revoke a
certificate on receiving proof satisfactory to the board that the
holder of the certificate has engaged in practice in this state
outside the scope of the certificate or that there are grounds
for action against him the certificate holder under section
4731.22 of the Revised Code. (E) A special activity certificate is valid for the
shorter of thirty days or the duration of the special activity,
program, or event. The certificate may not be renewed. (F) The state medical board shall adopt rules in accordance with
Chapter 119. of the Revised Code that specify how often an applicant may be granted
a certificate under this section. Sec. 4731.296. (A) For the purposes of this section, "the
practice of telemedicine" means the practice of medicine in this state through
the use of any communication, including oral, written, or electronic
communication, by a physician located outside this state. (B) A person who wishes to practice telemedicine in this state
shall file an application with the state medical board, together with a fee in
the amount of the fee described in division (D) of section 4731.29
of the Revised Code. The board may issue, without examination, a telemedicine certificate to
a person who meets all of the following requirements: (1) The person holds a current, unrestricted license to practice medicine
and surgery or osteopathic medicine and surgery issued by another state that
requires license holders to complete at least fifty hours of continuing
medical education every two years. (2) The person's principal place of practice is in that state. (3) The person does not hold a certificate issued under this chapter
authorizing the practice of medicine and surgery or osteopathic medicine and
surgery in this state. (4) The person meets the same age, moral character, and educational
requirements individuals must meet under sections 4731.08, 4731.09, 4731.091,
and 4731.14 of the Revised Code and, if applicable, demonstrates proficiency in spoken
English in accordance with division (E) of section 4731.29
of the Revised Code. (C) The holder of a telemedicine certificate may engage in the
practice of telemedicine in this state. A person holding a telemedicine
certificate shall not practice medicine in person in this state without
obtaining a special activity certificate under section 4731.294 of the Revised Code. (D) The board may revoke a certificate issued under this section
or take other disciplinary action against a certificate holder pursuant to
section 4731.22 of the Revised Code on receiving proof satisfactory to the board that the
certificate holder has
engaged in practice in this state outside the scope of the certificate or that
there are grounds for action against the holder under section 4731.22 of the Revised Code. (E) A telemedicine certificate shall be valid for a period
specified by the board, and the initial renewal shall be in accordance with a
schedule established by the board. Thereafter, the certificate shall be valid
for two years. A certificate may be renewed on application of the holder. To be eligible for renewal, the holder of the certificate shall do both of
the following: (1) Pay a fee in the amount of the fee described in division
(B)(1) of section 4731.281 of the Revised Code; (2) Certify to the board compliance with the continuing medical education
requirements of the state in which the holder's principal place of practice is
located. The board may require a random sample of persons holding a telemedicine
certificate to submit materials documenting completion of the continuing
medical education requirements described in this division. (F) The board shall convert a telemedicine certificate to a
certificate issued under section 4731.29 of the Revised Code on receipt of a written request
from the certificate holder. Once the telemedicine certificate is converted,
the holder is subject to all requirements and privileges attendant to a
certificate issued under section 4731.29 of the Revised Code, including continuing medical
education requirements. Sec. 4731.31. (A) As used in this
section: (1) "Rural hospital" means a hospital agency, as defined in section
140.01 of the Revised
Code, that meets all of the following
criteria: (a) Is in compliance with section 3727.02 of the
Revised Code
and the registration requirement of division
(A) of section 3701.07 of the
Revised
Code; (b) Is located in a county that has a population of
less than one hundred twenty-five thousand. (2) "Physician" means an individual authorized under
Chapter 4731. of the Revised Code
to practice medicine and surgery, osteopathic medicine and surgery, or
podiatry podiatric medicine and surgery. (B) Subject to division
(C) of this section, a rural hospital or a
health care facility that is owned or operated by a rural hospital may employ
a physician. A hospital or facility that employs a physician in accordance
with this section is not engaged in the practice of medicine and surgery,
osteopathic medicine and surgery, or podiatry podiatric medicine and
surgery in violation of section 4731.41,
4731.43, or 4731.60 of the Revised Code. (C) No rural hospital or health care
facility owned or operated by a rural hospital shall
do either of the following: (1) Control the professional clinical judgment exercised within accepted
and
prevailing standards of practice of a physician employed pursuant
to this section in rendering care, treatment, or professional advice to an
individual patient; (2) Require that a physician be employed by the hospital or facility as a
condition of granting the physician privileges to practice within the hospital
or facility. Sec. 4731.34. (A) A person shall be regarded as practicing
medicine and surgery, osteopathic medicine and surgery, or
podiatry podiatric medicine and surgery,
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. physician,"
"D.O.," "D.P.M.,"
or any other title in connection
with the person's name that in any way
that represents the person
as engaged in the practice of medicine, and surgery,
osteopathic medicine and surgery, or podiatry
podiatric medicine and surgery, in any of
its branches, or who examines; (2) Advertises, solicits, or represents in any way
that the person is practicing medicine and surgery, osteopathic
medicine and surgery, or podiatric medicine and surgery, in any of its
branches; (3) In person or, regardless of the person's location, through the use of
any
communication, including oral, written, or electronic communication, does any
of the following: (a) Examines or diagnoses for compensation of any kind, or
prescribes direct or indirect; (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. (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 podiatric medicine and surgery, in any of its
branches, 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 podiatric medicine
and surgery, in any of its
branches. Sec. 4731.341. (A) 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 (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 the Franklin county court of common
pleas or any other
court of competent
jurisdiction. 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. 4731.35. (A) Sections 4731.01 to 4731.47 of the Revised
Code
shall This chapter does not apply to or prohibit in any way the
administration of an
anesthetic anesthesia
by a certified registered nurse anesthetist under the direction
of and in the immediate presence of
a
licensed physician an individual authorized by this chapter to practice
medicine and surgery, osteopathic medicine and surgery, or podiatric medicine
and surgery. (B) This chapter does not prohibit an individual from practicing
as an anesthesiologist assistant in accordance with Chapter 4760.
of the Revised Code. Sec. 4731.36. (A) Sections 4731.01 to 4731.47 of the
Revised Code shall not prohibit service in case of emergency, or
domestic administration of family remedies, or provision of
assistance to another individual who is self-administering drugs. 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
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 providing
consultation with a regular
practitioner of this state; nor shall such sections apply to a
an individual holding a
certificate to practice issued under this chapter who is responsible for the
examination, diagnosis, and treatment of the patient who is the subject of the
consultation, if one of the following applies: (a) The physician or surgeon does not provide consultation in
this
state on a regular or frequent basis. (b) The physician or surgeon provides the consultation
without compensation of any kind, direct or indirect, for the consultation. (c) The consultation is 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 independent review organization accredited by the
superintendent of insurance under section 3901.80 of the Revised
Code for the purpose of external reviews conducted under
sections 1751.84, 1751.85, 3923.67, 3923.68, 3923.76, and 3923.77 of the
Revised Code. (B) 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. (C) This chapter does not apply to an acupuncturist who complies
with Chapter 4762. of the Revised Code. (D) This chapter does not prohibit
the administration of drugs by any of the following: (1) An individual who is licensed or otherwise specifically
authorized by the Revised Code to administer drugs; (2) An individual who is not licensed or otherwise specifically
authorized by the Revised Code to administer drugs, but is
acting
pursuant to the rules for delegation of medical tasks adopted
under section 4731.053 of the Revised Code; (3) An individual specifically authorized to administer drugs pursuant to
a rule adopted under the Revised Code that is in effect on
the effective date of this amendment, as long as the rule remains in effect,
specifically authorizing an individual to administer drugs. (E)
The exemptions described in divisions (A)(3), (4), and (5)
of this section do not apply to a physician or surgeon whose certificate to
practice issued under this chapter is under suspension or has been revoked
or permanently revoked by action of the state medical board. Sec. 4731.51. The practice of podiatry podiatric medicine and
surgery consists of the medical, mechanical,
and surgical treatment of ailments of the foot, the muscles and tendons of the
leg governing the functions of the foot; and superficial lesions of the hand
other than those associated with trauma. Podiatrists are permitted the use of
such preparations, medicines, and drugs as may be necessary for the treatment
of such ailments. The podiatrist may treat the local manifestations of
systemic diseases as they appear in the hand and foot, but the patient shall
be
concurrently referred to a doctor of medicine or a doctor of osteopathic
medicine and surgery for the treatment of the systemic disease itself.
General
anaesthetics may be used under this section only in colleges of
podiatry
podiatric medicine and surgery approved by the medical board pursuant
to section 4731.53 of the
Revised Code
and in hospitals approved by the joint commission on the accreditation of
hospitals, or the American osteopathic association. The use of x-ray or
radium
for therapeutic purposes is not permitted. Sec. 4731.52. Each person who desires to practice podiatry
podiatric medicine and surgery and is not now
authorized to do so shall file with the secretary of the state medical board a
written application, under oath, on a form prescribed by the board and furnish
satisfactory proof that he the applicant is more than eighteen
years of age and of good
moral
character. Sec. 4731.53. At the time an applicant files
an application, the applicant shall file with the secretary of the
state medical board evidence of preliminary education showing that
the applicant has satisfactorily completed at least two years of
collegiate work in
an approved college of arts and sciences in addition to high
school graduation. When the entrance examiner finds the
preliminary education of the applicant sufficient, the entrance
examiner shall issue
a certificate of preliminary examination upon the payment to the
treasurer of the board of a fee of thirty-five
dollars. Such
certificate shall be attested by the secretary. The applicant shall also present a diploma from a college
of podiatry podiatric medicine and surgery in good standing as
defined by the board at the time
the diploma was issued. The applicant shall present an affidavit
that the applicant is the person named in the diploma and is
the lawful possessor thereof stating the applicant's age,
residence, the school at which the applicant obtained
education in podiatry podiatric medicine and surgery, the time
spent in the study of podiatry podiatric medicine and surgery,
and such other facts as the board may require. Sec. 4731.55. The examinations of applicants for certificates to
practice
podiatry podiatric medicine and surgery shall be conducted under
rules prescribed by the state
medical board. An applicant who holds the degree of doctor of
podiatric medicine shall be
examined in subjects pertinent to current podiatric educational
standards. Sec. 4731.56. The state medical board shall issue its certificate to practice
podiatry podiatric medicine and surgery to each applicant who
passes the examination conducted under section
4731.55 of the Revised Code and has paid the treasurer of the state medical
board a certificate issuance fee of three hundred dollars.
Each certificate
shall be signed by the board's president and secretary and attested by its
seal. An affirmative vote of not less than six members of the state medical
board is required for issuance of a certificate. A certificate authorizing the practice of podiatry podiatric
medicine and surgery permits the holder the
use
of the title "physician" or the use of the title "surgeon" when the title is
qualified by letters or words showing that the holder of the certificate is a
practitioner of podiatry podiatric medicine and surgery. The
certificate shall be
prominently displayed in the certificate holder's office or the place where a
major portion of the certificate holder's practice is
conducted. Sec. 4731.57. When a podiatrist licensed by the licensing authority of
another
state wishes to remove to this state to practice his the
podiatrist's profession, the state
medical board may, in its discretion, by an affirmative vote of not less than
six of its members, issue to him the applicant a certificate to
practice podiatry podiatric medicine and surgery without
requiring the applicant to submit to examination, provided he the
applicant meets the
requirements for entrance set forth in section 4731.53 of the Revised Code and
pays a fee of three hundred dollars. Application shall be made on a form
prescribed by the board. Sec. 4731.571. The state medical board may, upon an affirmative vote of not
less than six members, issue a certificate to practice podiatry
podiatric medicine and surgery by endorsement
to an applicant who has successfully passed the written examination of a
recognized national certifying agency in podiatry podiatric medicine
and surgery; provided the written
examination of the certifying agency was, in the opinion of the board,
equivalent to its own examination, and provided further that the applicant
satisfies in all other respects, the requirements for a license as set forth
in
sections 4731.51 to 4731.60 of the Revised Code. Such application to the
board
shall be accompanied by an application fee of three hundred dollars. Sec. 4731.572. (A) The state medical board may issue,
without examination, a visiting podiatric faculty certificate to
any person who holds a current, unrestricted license to practice
podiatry podiatric medicine and surgery issued by another state
or country and has been
appointed to serve in this state on the academic staff of an
approved college of podiatry podiatric medicine and surgery in
good standing, as determined by
the board. (B) An applicant for a visiting podiatric faculty
certificate shall submit evidence satisfactory to the board that
he the applicant meets the requirements of division (A) of this
section. The
applicant shall pay a fee of one hundred twenty-five dollars.
The board shall maintain a register of all persons who hold a
visiting podiatric faculty certificate. (C) The holder of a visiting podiatric faculty certificate
may practice podiatry podiatric medicine and surgery only as is
incidental to his the certificate
holder's teaching
duties at the college or the teaching hospitals affiliated with
the college. The board may revoke a certificate on receiving
proof satisfactory to the board that the holder of the
certificate has engaged in practice in this state outside the
scope of the certificate or that there are grounds for action
against him the certificate holder under section 4731.22 of the
Revised Code. (D) A visiting podiatric faculty certificate is valid for
the shorter of one year or the duration of the holder's
appointment to the academic staff of the college. The
certificate may not be renewed. Sec. 4731.60. No person shall practice podiatry podiatric medicine
and surgery without a certificate from
the state medical board; no person shall advertise or announce himself
as a
practitioner of podiatry podiatric medicine and surgery without
a certificate from
the board; no person shall
open or conduct an office or other place for such practice without a
certificate from the board; no person shall conduct an office in the name of
some person who has a certificate to practice podiatry podiatric
medicine and surgery; and no person shall
practice podiatry podiatric medicine and surgery after a
certificate has been revoked, or if suspended,
during
the time of such suspension. A certificate signed by the secretary to which is affixed the official seal of
the board to the effect that it appears from the records of the board that no
such certificate to practice podiatry podiatric medicine and
surgery, in the state has been issued to any
such
person specified therein, or that a certificate, if issued, has been revoked
or
suspended, shall be received as prima-facie evidence of the record of such
board in any court or before any officer of this state. Sec. 4731.66. (A) Except as provided in sections 4731.67
and 4731.68 of the Revised Code, no holder of a certificate under
this chapter to practice medicine and surgery, osteopathic
medicine and surgery, or podiatry podiatric medicine and surgery
shall refer a patient to a
person for a designated
health service if the certificate
holder, or a member of the certificate holder's immediate family,
has either of the following financial relationships with the
person: (1) An ownership or investment interest in the person
whether through debt, equity, or other means; (2) Any compensation arrangement involving any
remuneration, directly or indirectly, overtly or covertly, in
cash or in kind. (B) No person to which a certificate holder has referred a
patient in violation of division (A) of this section shall bill
the patient, any third-party payer, any governmental health care
program, or any other person or governmental entity for the
designated health service
rendered pursuant to the referral. (C) No person shall knowingly enter into an arrangement or
scheme, including a cross-referral arrangement, that has a
principal purpose of assuring referrals by a certificate holder
to a particular person that, if the certificate holder directly
made referrals to such person, would violate division (A) of this
section. Sec. 4731.85. The department of health shall establish a
procedure to provide special recognition annually to one or more
persons issued a certificate under this chapter to practice
medicine and surgery, osteopathic medicine and surgery, or
podiatry podiatric medicine and surgery who volunteer medical
services to medically underserved
areas of this state or to charitable shelters or clinics. Any
person may nominate a certificate holder for consideration by the
department. The department shall annually submit to newspapers of general
circulation and other publications selected by the department a request for
nominations. The request shall describe the required form and content of
nominations and indicate a deadline for submitting nominations. The department may adopt criteria and guidelines for
selecting nominees for recognition. The department shall
publicize the names, professional accomplishments, and service
contributions of the certificate holders that it recognizes under
this section. The department may purchase recognition awards and
take other actions to honor such volunteers. Sec. 4755.40. As used in sections 4755.40 to 4755.56
and 4755.99 of the Revised Code: (A) "Physical therapy" means the evaluation and treatment
of a person by physical measures and the use of therapeutic
exercises and rehabilitative procedures, with or without
assistive devices, for the purpose of preventing, correcting, or
alleviating any disability.
If performed by a person who is adequately trained, physical therapy
includes the design, fabrication, revision, education, and
instruction in the use of various assistive devices including braces, splints,
ambulatory or locomotion devices, wheelchairs, prosthetics, and
orthotics. Physical therapy includes the administration of topical
drugs that have been prescribed by a licensed health professional authorized
to
prescribe drugs, as defined in section 4729.01 of the Revised Code. Physical
therapy also includes the
establishment and modification of physical therapy programs,
treatment planning, instruction, and consultative services.
Physical measures include massage, heat, cold, air, light, water,
electricity, sound, and the performance of tests of neuromuscular
function as an aid to such treatment. Physical therapy does not
include the diagnosis of a patient's disability, the use of
Roentgen rays or radium for diagnostic or therapeutic purposes,
or the use of electricity for cauterization or other surgical
purposes. Physical therapy includes physiotherapy. (B) "Physical therapist" means a person who practices or
teaches physical therapy and includes physiotherapist. (C) "Physical therapist assistant" means a person who
assists in the provision of physical therapy treatments under the
supervision of a physical therapist, or teaches physical therapy
under the supervision of a physical therapist, and includes
physical therapy assistant. (D) "Supervision" means the availability and
responsibility of the supervisor for direction of the actions of
the person supervised. Sec. 4755.60. As used in sections 4755.60 to 4755.65 and
4755.99 of the Revised Code: (A) "Athletic training" means the practice of prevention,
recognition, and assessment of an athletic injury and the
complete management, treatment, disposition, and
reconditioning of acute athletic injuries upon the referral of an individual
authorized under Chapter 4731.
of the Revised
Code to practice medicine and surgery, osteopathic medicine and surgery, or
podiatry, a dentist licensed under Chapter 4715. of the Revised Code, a
physical therapist licensed under this chapter, or a chiropractor
licensed under Chapter 4734. of the Revised Code. Athletic training
includes the administration of topical drugs that have been prescribed by a
licensed health professional authorized to prescribe drugs, as defined in
section 4729.01 of the Revised Code. Athletic
training also includes the organization and administration of
educational programs and athletic facilities, and the education
of and consulting with the public as it pertains to athletic
training. (B) "Athletic trainer" means a person who meets the
qualifications of this chapter for licensure and who is employed
by an educational institution, professional or amateur
organization, athletic facility, or health care facility to
practice athletic training. (C) "The national athletic trainers association, inc."
means the national professional organization of athletic trainers
that provides direction and leadership for quality athletic
training practice, education, and research. (D) "Athletic injury" means any injury sustained by an individual
that affects the individual's participation or performance in sports, games,
recreation, exercise, or other activity that requires physical strength,
agility, flexibility, speed, stamina, or range of motion. SECTION 2 . That existing sections 4725.09, 4725.26, 4731.143, 4731.20,
4731.22,
4731.222, 4731.224, 4731.281, 4731.29, 4731.31, 4731.294, 4731.31, 4731.34,
4731.341, 4731.35,
4731.36, 4731.51, 4731.52, 4731.53, 4731.55, 4731.56,
4731.57, 4731.571, 4731.572, 4731.60, 4731.66, 4731.85, 4755.40, and 4755.60
of the Revised Code are hereby repealed.
SECTION 3 . The amendments made by this act to sections 4731.281, 4731.29,
4731.294,
4731.34, 4731.341, and 4731.36 and enactment of section 4731.296 of the
Revised Code are not intended to modify division (D) of section 1751.08 of the
Revised Code or Ohio Attorney General Opinion 99-044.
SECTION 4 . Not later than August 31, 2001, the State Medical
Board shall complete its initial adoption of rules under section
4731.053 of the Revised Code with respect to physician delegation of
medical tasks to persons who are not licensed or otherwise
specifically authorized by the Revised Code to perform medical
tasks.
SECTION 5 . Section 4731.22 of the Revised Code is presented in this act
as a composite of the section as amended by both
Sub. H.B. 448 and Am. Sub. S.B. 278 of the 123rd General Assembly,
with the new language of neither of the acts shown in capital letters.
This is in recognition of the principle stated in division (B) of section
1.52 of the Revised Code that such amendments are to be
harmonized where not substantively irreconcilable and constitutes
a legislative finding that such is the resulting version in
effect prior to the effective date of this act.
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