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Sub. S. B. No. 279 As Reported by the Senate Health, Human Services and Aging CommitteeAs Reported by the Senate Health, Human Services and Aging Committee
127th General Assembly | Regular Session | 2007-2008 |
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A BILL
To amend sections 4730.03, 4730.09, 4731.19,
4731.281,
4731.293, and 4760.131 of the Revised
Code
regarding certain
State Medical Board
procedures,
restrictions on
physician
assistants, and
admission to the massage or
cosmetic therapist
examination.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 4730.03, 4730.09, 4731.19, 4731.281,
4731.293, and 4760.131 of the Revised Code be amended to read as
follows:
Sec. 4730.03. Nothing in this chapter shall:
(A) Be construed to affect or interfere with the
performance
of duties of any medical personnel in who are either of the
following:
(1) In active service
in the army, navy, coast guard, marine
corps, air force, public
health service, or marine hospital
service of the United States
while so serving;
(2) Employed by the veterans administration of the United
States while so employed;
(B) Prevent any person from
performing any of the services a
physician assistant may be
authorized to perform, if the person's
professional scope of
practice established under any
other chapter
of the Revised Code authorizes the person to perform the
services;
(C) Prohibit a physician from delegating responsibilities
to
any nurse or other qualified person who does not hold a
certificate to practice as a
physician assistant, provided that
the individual does not
hold the individual out to be a physician
assistant;
(D) Be construed as authorizing a
physician assistant
independently to
order or direct the execution of procedures or
techniques by a
registered nurse or licensed practical nurse in
the care and
treatment of a person in any setting, except to the
extent that the physician assistant is authorized to do so by the
physician supervisory plan approved under section 4730.17 of the
Revised Code for the physician who is responsible for supervising
the physician assistant or the policies of the health care
facility in which the physician assistant is practicing;
(E) Authorize a physician assistant to engage in
the practice
of optometry, except to the extent that the
physician assistant is
authorized by a supervising physician
acting in accordance with
this chapter to perform routine visual
screening, provide medical
care prior to or following eye
surgery, or assist in the care of
diseases of the eye;
(F) Be construed as authorizing a physician assistant to
prescribe any drug or device to perform or induce an abortion, or
as otherwise authorizing a physician assistant to perform or
induce an abortion.
Sec. 4730.09. (A) Under a physician supervisory plan approved
under section 4730.17 of the Revised Code, a physician assistant
may provide any or all of the following services without approval
by the state medical board as special services:
(1) Obtaining comprehensive patient histories;
(2) Performing physical examinations, including audiometry
screening, routine visual screening, and pelvic, rectal, and
genital-urinary examinations, when indicated;
(3) Ordering, performing, or ordering and performing routine
diagnostic procedures, as indicated;
(4) Identifying normal and abnormal findings on histories,
physical examinations, and commonly performed diagnostic studies;
(5) Assessing patients and developing and implementing
treatment plans for patients;
(6) Monitoring the effectiveness of therapeutic
interventions;
(7) Exercising physician-delegated prescriptive authority
pursuant to a certificate to prescribe issued under this chapter;
(8) Carrying out or relaying the supervising physician's
orders for the administration of medication, to the extent
permitted by law;
(9) Providing patient education;
(10) Instituting and changing orders on patient charts;
(11) Performing developmental screening examinations on
children with regard to neurological, motor, and mental functions;
(12) Performing wound care management, suturing minor
lacerations and removing the sutures, and incision and drainage of
uncomplicated superficial abscesses;
(13) Removing superficial foreign bodies;
(14) Administering intravenous fluids;
(15) Inserting a foley or cudae catheter into the urinary
bladder and removing the catheter;
(16) Removing intrauterine devices;
(17) Performing biopsies of superficial lesions;
(18) Making appropriate referrals as directed by the
supervising physician;
(19) Removing norplant capsules;
(20) Performing penile duplex ultrasound;
(21) Changing of a tracheostomy;
(22) Performing bone marrow aspirations from the posterior
iliac crest;
(23) Performing bone marrow biopsies from the posterior iliac
crest;
(24) Performing cystograms;
(25) Performing nephrostograms after physician placement of
nephrostomy tubes;
(26) Fitting or inserting family planning devices, including
intrauterine devices, diaphragms, and cervical caps;
(27) Removing cervical polyps;
(28) Performing nerve conduction testing;
(29) Performing endometrial biopsies;
(30) Inserting filiform and follower catheters;
(31) Performing arthrocentesis of the knee;
(32) Performing knee joint injections;
(33) Performing endotracheal intubation with successful
completion of an advanced cardiac life support course;
(34) Performing lumbar punctures;
(35) In accordance with rules adopted by the board, using
light-based medical devices for the purpose of hair removal;
(36) Administering, monitoring, or maintaining local
anesthesia, as defined in section 4730.091 of the Revised Code;
(37) Applying or removing a cast or splint;
(38) Performing other services that are within the
supervising physician's normal course of practice and expertise,
if the services are included in any model physician supervisory
plan approved under section 4730.06 of the Revised Code or the
services are designated by the board by rule or other means as
services that are not subject to approval as special services.
(B) Under the policies of a health care facility, the
services a physician assistant may provide are limited to the
services the facility has authorized the physician assistant to
provide for the facility. The services a health care facility may
authorize a physician assistant to provide for the facility
include the following:
(1) Any or all of the services specified in division (A) of
this section;
(2) Assisting in surgery in the health care facility;
(3) Any other services permitted by the policies of the
health care facility, except that the facility may not authorize a
physician assistant to perform a service that is prohibited by
this chapter.
Sec. 4731.19. (A) The state medical board shall determine the
standing of the
schools, colleges, or institutions giving
instruction in the limited
branches of medicine of massage therapy
and cosmetic
therapy. If there shall at any time be such schools,
colleges, or
institutions giving instruction in such limited
branches, the
(B) An
applicant for a
certificate to practice a limited
branch of medicine
shall, as a
condition of admission to the
examination, produce a have one of the following:
(1) A diploma or
certificate
from a school, college, or
institution in good standing as
determined by the
board, showing
the completion of the required courses of
instruction;
(2) A current license, registration, or certificate that is
in good standing in another state for massage therapy or cosmetic
therapy, as applicable;
(3) Certification from a national certification body and a
diploma or certificate from a school, college, or institution
showing completion of a course of instruction that meets course
requirements determined by the board through rules adopted under
section 4731.05 of the Revised Code.
The entrance examiner of the board shall determine the
sufficiency of the
preliminary education of applicants for a
certificate to practice massage
therapy or cosmetic
therapy in the
same manner that sufficiency of preliminary education is
determined
under section 4731.09 of the Revised Code, except
that
the board may adopt rules defining and
establishing for the
limited branch of medicine preliminary educational
requirements
that are
less exacting than those prescribed by such section, as
the nature of the case
may require.
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 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
podiatric medicine and surgery 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 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 letter
"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 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 podiatric medicine and surgery, an
application for a notice of registration renewal
addressed to the
person's last known
post-office address or
may cause the
application notice 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 letter
"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 a notice of
renewal 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 notice shall inform the applicant of the renewal
procedure. The board shall provide the application for
registration renewal in a form determined by the board. The
applicant shall write or cause to be written upon provide in 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 information required by 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
4723.01 of the Revised Code.
The applicant
shall
execute
and
deliver the application to the board by mail or
in
person in a manner prescribed by the board. 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 filing 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 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.
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 a renewal application,
the
biennial registration fee, and the
applicable monetary
penalty. The penalty
for reinstatement shall be
fifty dollars.
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 and
compliance with sections 4776.01 to 4776.04 of the Revised Code.
The board shall not restore to an applicant a certificate to
practice unless the board, in its discretion, decides that the
results of the criminal records check do not make the applicant
ineligible for a certificate issued pursuant to section 4731.14,
4731.56, or 4731.57 of the Revised Code. The penalty for
restoration shall
be
one hundred dollars. 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.
(G) Each mailing sent by the board under division (B)(2) of
this section to a person registered to practice medicine and
surgery or osteopathic medicine and surgery shall inform the
applicant of the reporting requirement established by division (H)
of section 3701.79 of the Revised Code. At the discretion of the
board, the information may be included on the application for
registration or on an
accompanying page.
Sec. 4731.293. (A) The state medical board may issue,
without examination, a visiting medical faculty certificate to
any
person who holds a current, unrestricted license to practice
medicine and surgery or osteopathic medicine and surgery issued
by
another state or country and has been appointed to serve in
this
state on the academic staff of a medical school accredited
by the
liaison committee on medical education or an osteopathic
medical
school accredited by the American osteopathic
association.
(B) An applicant for a visiting medical 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 three
hundred seventy-five dollars.
The board shall maintain a register
of all persons who hold a
visiting medical faculty certificate.
(C) The holder of a visiting medical faculty certificate
may
practice medicine and surgery or osteopathic medicine and
surgery
only as is incidental to his certificate holder's
teaching duties
at the
school or the teaching hospitals affiliated with the
school. 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 medical faculty certificate is valid for
the
shorter of one year three years or the duration of the holder's
appointment to the academic staff of the school. The certificate
may not be renewed.
(E) The board may adopt any rules it considers necessary to
implement this section. The rules shall be adopted in accordance
with Chapter 119. of the Revised Code.
Sec. 4760.131. On receipt of a notice pursuant to
section
2301.373 3123.43 of the Revised Code, the state medical board
shall comply
with that section sections 3123.41 to 3123.50 of the
Revised Code and any applicable rules adopted under section
3123.63 of the Revised Code with respect to a certificate of
registration as an anesthesiologist assistant issued
pursuant to
this chapter.
Section 2. That existing sections 4730.03, 4730.09, 4731.19,
4731.281, 4731.293, and 4760.131 of the Revised Code are hereby
repealed.
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