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As Reported by the Senate Health, Human Services
and Aging Committee
123rd General Assembly
Regular Session
1999-2000 | Sub. S. B. No. 56 |
SENATORS WHITE-DRAKE-CUPP-CARNES-MUMPER-SHOEMAKER-
SCHAFRATH-PRENTISS-KEARNS
A BILL
To amend section 4731.22 and to enact section 4731.31 of the Revised Code to
permit rural hospitals to employ physicians.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That section 4731.22 be amended and section 4731.31 of the Revised
Code be enacted to read as follows:
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 treatment 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 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, 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 treatment 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 treatment 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 treatment 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) Engaging 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 state agency
responsible for regulating the practice of medicine and surgery, osteopathic
medicine and surgery, podiatry, or the limited branches of medicine in
another state, 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 perform
the responsibilities agreed to by the
physician in the protocol
established between the physician and an advanced practice nurse
in accordance with section 4723.56 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 maintain 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 and practice in
accordance with the 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.
(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 treatment 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 other licensing boards and governmental agencies
that are investigating alleged professional misconduct and with law
enforcement agencies and other governmental
agencies that are investigating or prosecuting alleged criminal offenses. A
board or agency 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 board or agency that applies when the board or agency is dealing with
other information in its possession. The information may
be admitted into evidence in a criminal trial 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 treatment 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 treatment in lieu of conviction 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. 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. 4731.31. (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.
(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 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.
Section 2. That existing section 4731.22 of the Revised Code is hereby
repealed.
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