PRIOR PRINTER'S NO. 275

PRINTER'S NO.  2059

  

THE GENERAL ASSEMBLY OF PENNSYLVANIA

  

HOUSE BILL

 

No.

255

Session of

2009

  

  

INTRODUCED BY SCAVELLO, SIPTROTH, PEIFER, BAKER, BEYER, DONATUCCI, GEORGE, HELM, HENNESSEY, KILLION, KIRKLAND, KORTZ, KOTIK, MILLER, MILNE, MOUL, O'NEILL, PASHINSKI, PICKETT, READSHAW, REICHLEY, VULAKOVICH, WATSON, YOUNGBLOOD AND ROHRER, FEBRUARY 5, 2009

  

  

AS REPORTED FROM COMMITTEE ON PROFESSIONAL LICENSURE, HOUSE OF REPRESENTATIVES, AS AMENDED, JUNE 9, 2009   

  

  

  

AN ACT

  

1

Amending the act of March 2, 1956 (1955 P.L.1206, No.375),

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2

entitled, as reenacted and amended, "An act relating to and

3

defining the practice of podiatry; conferring powers and

4

imposing duties on the State Board of Podiatry Examiners and

5

the Department of State; requiring licensure; providing for

6

the granting, cancellation, suspension and revocation of

7

licenses; preserving the rights of existing licenses;

8

providing for the promulgation of rules and regulations;

9

transfer of jurisdiction and records to the board; regulation

10

of schools of chiropody and podiatry; reciprocity; and

11

providing penalties, and remedies," further providing for

12

definitions, for exclusive jurisdiction of the board, for

13

reporting of multiple licensure and for practice by

14

unregistered persons; providing for prosthetists, orthotists,

15

orthotic fitters and pedorthists; further providing for

16

penalties, for refusal to grant, suspension and revocation,

17

for reinstatement of license, certificate or registration,

18

for display of license and certificate and for injunction or

19

other process; and providing for expungement.

20

Amending the act of December 20, 1985 (P.L.457, No.112),

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21

entitled "An act relating to the right to practice medicine

22

and surgery and the right to practice medically related acts;

23

reestablishing the State Board of Medical Education and

24

Licensure as the State Board of Medicine and providing for

25

its composition, powers and duties; providing for the

26

issuance of licenses and certificates and the suspension and

27

revocation of licenses and certificates; providing penalties;

28

and making repeals," adding definitions; and providing for

29

licensure of prosthetists, orthotists, pedorthists and

30

orthotic fitters.

 


1

The General Assembly of the Commonwealth of Pennsylvania

2

hereby enacts as follows:

3

Section 1.  Section 2 of the act of March 2, 1956 (1955 P.L.

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4

1206, No. 375), known as the Podiatry Practice Act, reenacted

5

and amended August 24, 1963 (P.L.1199, No.505) and amended Dec.

6

20, 1985 (P.L.384, No.107), is amended by adding subsections to

7

read:

8

Section 2.  Definitions.--The following words or phrases,

9

unless the context clearly indicates otherwise, shall have the

10

meanings ascribed to them in this section:

11

* * *

12

(d)  "Custom-fabricated device" shall mean a prosthesis,

13

orthosis or pedorthic device that is fabricated to original

14

measurements or a mold for use by a patient in accordance with a

15

prescription and which requires substantial clinical and

16

technical judgment in its design and fitting.

17

(e)  "Custom-fitted device" shall mean a prefabricated

18

prosthesis, orthosis or pedorthic device that is sized or

19

modified for use by the patient in accordance with a

20

prescription and which requires substantial clinical judgment

21

and substantive alteration for appropriate use.

22

(f)  "Orthotic fitter" shall mean an individual who is

23

licensed to practice orthotics, pursuant to a licensed

24

physician's written prescription, whose scope of practice is

25

limited to fitting:

26

(1)  Prefabricated cervical orthoses not requiring more than

27

minor modification.

28

(2)  Pressure gradient hose.

29

(3)  Trusses.

30

(4)  Custom-molded therapeutic footwear.

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1

(5)  Custom-molded foot orthoses.

2

(6)  Prefabricated spinal orthoses, except for those used in

3

the treatment of scoliosis, rigid body jackets made of

4

thermoformable materials, and "halo" devices.

5

(7)  Prefabricated orthoses of the upper and lower

6

extremities.

7

(g)  "Orthotics" shall mean evaluating, measuring, designing,

8

fabricating, assembling, fitting, adjusting or servicing an

9

orthosis for the correction or alleviation of neuromuscular or

10

musculoskeletal dysfunction, disease, injury or deformity, as

11

provided in this act.

12

(h)  "Orthotist" shall mean an individual other than an

13

orthotic fitter licensed under this act to practice orthotics.

14

(i)  "Over-the-counter" shall mean a prefabricated, mass-

15

produced item that is prepackaged and requires no professional

16

advice or judgment in either size selection or use, including

17

fabric or elastic supports, corsets, generic arch supports and

18

elastic hose.

19

(j)  "Pedorthic device" shall mean therapeutic shoes, shoe

20

modifications made for therapeutic purposes, partial foot

21

prostheses, foot orthoses and below-the-knee pedorthic

22

modalities. Pedorthic devices do not include nontherapeutic,

23

accommodative inlays and nontherapeutic accommodative footwear,

24

regardless of method of manufacture; unmodified, nontherapeutic

25

over-the-counter shoes; or prefabricated unmodified and/or

26

unmodifiable foot care and foot wear products, accommodative

27

means designed with a primary goal of conforming to the

28

individual's anatomy, and therapeutic devices are devices that

29

address a medical condition, while nontherapeutic devices are

30

devices that do not address a medical condition.

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1

(k)  "Pedorthics" shall mean shall mean evaluating, treatment

2

planning, patient managing, measuring, designing, fabricating,

3

assembling, fitting, adjusting or servicing necessary to

4

accomplish the application of a pedorthic device for the

5

prevention or amelioration of painful and/or disabling

6

conditions related to the lower extremities.

7

(l)  "Pedorthist" shall mean an individual licensed under

8

this act to practice pedorthics.

9

(m)  "Podiatrist" shall mean an individual licensed by the

10

board under this act.

11

(n)  "Prefabricated orthosis" shall mean a brace or support

12

designed to provide for alignment, correction or prevention of

13

neuromuscular or musculoskeletal dysfunction, disease, injury or

14

deformity. The term does not include fabric or elastic support,

15

corsets, arch supports, low-temperature plastic splints,

16

trusses, elastic hose, canes, crutches, soft cervical collars,

17

dental appliances or other similar devices carried in stock and

18

sold as over-the-counter items by a drug store, department

19

store, corset shop or surgical supply facility.

20

(o)  "Prosthesis" shall mean a custom-designed, custom-

21

fabricated, custom-fitted or custom-modified device to replace

22

an absent external limb for purposes of restoring physiological

23

function or cosmesis. The term does not include artificial eyes,

24

ears, fingers or toes, dental appliances, cosmetic devices such

25

as artificial breasts, eyelashes or wigs or other devices that

26

do not have a significant impact on the musculoskeletal

27

functions of the body.

28

(p)  "Prosthetics" shall mean evaluating, measuring,

29

designing, fabricating, assembling, fitting, adjusting or

30

servicing a prosthesis.

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1

(q)  "Prosthetist" shall mean an individual licensed under

2

this act to practice prosthetics.

3

(r)  "Expungement" shall mean the removal of a disciplinary

4

record, accomplished by:

5

(1)  Permanently sealing the affected record from public

6

access.

7

(2)  Deeming the proceedings to which the affected record

8

refers as not having occurred.

9

(3)  Except with respect to any subsequent application for

10

expungement, affording the affected party the right to represent

11

that no record exists regarding the subject matter of the

12

affected record.

13

(s)  "NCCA" shall mean the National Commission for Certifying

14

Agencies.

15

(t)  "NOCA" shall mean the National Organization for

16

Competency Assurance.

17

Section 2.  Sections 5, 9.2 and 12 of the act, amended or

18

added December 20, 1985 (P.L.384, No.107), are amended to read:

19

Section 5.  Exclusive Jurisdiction of Board.--From and after

20

the effective date of this act, the board shall exercise

21

exclusive jurisdiction over all persons licensed, or to be

22

licensed, and registered to practice podiatric medicine,

23

prosthetics, orthotics, pedorthics or orthotic fitting in this

24

Commonwealth.

25

Section 9.2.  Reporting of Multiple Licensure.--Any licensed

26

podiatrist, prosthetist, orthotist, pedorthist or orthotic

27

fitter of this Commonwealth who is also licensed to practice

28

podiatric medicine, prosthetics, orthotics, pedorthics, orthotic

29

fitting or surgery in any other state, territory or country

30

shall report this information to the board on the biennial

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1

registration application. Any disciplinary action taken in other

2

states shall be reported to the board on the biennial

3

registration application or within ninety days of final

4

disposition, whichever is sooner. Multiple licensure shall be

5

noted by the board on the podiatrist's record, and such state,

6

territory or country shall be notified by the board of any

7

disciplinary actions taken against said podiatrist in this

8

Commonwealth.

9

Section 12.  Practice by Unregistered Persons.--Any person

10

who is not a licensed, and registered as a podiatrist,

11

prosthetist, orthotist, pedorthist or orthotic fitter shall not

12

practice podiatric medicine, prosthetics, orthotics, pedorthics

13

or orthotic fitting nor in any written or printed circular or in

14

any business card, letterhead or sign or otherwise assume the

15

title "Chiropodist," "Podiatrist," "Prosthetist," "Orthotist,"

16

"Pedorthist," "Orthotic Fitter," "DSC," "DPM," "Doctor of

17

Podiatric Medicine," "Foot Specialist," "Foot Correctionist,"

18

"Pedopractor" nor any other title, name or description implying

19

or calculated to lead to the belief that he is qualified to

20

practice podiatric medicine.

21

Section 3.  The act is amended by adding a section to read:

22

Section 12.1.  Prosthetists, orthotists, pedorthists and

23

orthotic fitters.--(a)  To qualify for licensure to practice

24

prosthetics, orthotics, orthotic fitting or pedorthics, an

25

applicant shall:

26

(1)  Be of good moral character.

27

(2)  Possess a high school diploma or its equivalent.

28

(3)  Complete the amount of formal training which shall 

29

include any hours of classroom education and clinical practice

30

established and approved by a prosthetic, orthotic and pedorthic

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1

credentialing organization recognized by NOCA and accredited by

2

NCCA.

3

(4)  Complete a qualified work experience program or

4

internship in prosthetics, orthotics or pedorthics in accordance

5

with any standards, guidelines or procedures established and

6

approved by the board.

7

(5)  Pass all examinations that are required for

8

certification by a prosthetic, orthotic or pedorthic

9

credentialing organization recognized by NOCA and accredited by

10

NCCA.

11

(6)  Have fulfilled all educational and training requirements

12

consistent with those required for certification by a

13

prosthetic, orthotic and pedorthic credentialing organization

14

recognized by the NOCA and accredited by the NCCA.

15

(7)  Paid a fee as established by the board by regulation.

16

(8)  Not be addicted to alcohol, narcotics or other habit-

17

forming drugs.

18

(9)  Not been convicted of a felony under the act of April

19

14, 1972 (P.L.233, No.64), known as "The Controlled Substance,

20

Drug, Device and Cosmetic Act," or of an offense under the laws

21

of another jurisdiction which, if committed in this

22

Commonwealth, would be a felony under "The Controlled Substance,

23

Drug, Device and Cosmetic Act," unless the following apply:

24

(i)  Ten years have elapsed from the date of conviction.

25

(ii)  The applicant satisfactorily demonstrates to the board

26

that the applicant has made significant progress in personal

27

rehabilitation since the conviction and the licensure of the

28

applicant is not expected to create a substantial risk of harm

29

to the health and safety of the applicant's clients or the

30

public or a substantial risk of further criminal violations.

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1

(iii)  The applicant otherwise satisfies the qualifications

2

required under this act.

3

The term "convicted" shall include a judgment, an admission of

4

guilt or a plea of nolo contendere.

5

(b)  A license issued pursuant to this section shall be valid

6

for two years and may be renewed biennially with the board as

7

provided in subsection (j). A license and a temporary practice

8

permit are not transferable.

9

(c)  Prior to administering the first treatment, a

10

prosthetist, orthotist, orthotics fitter or pedorthist shall do

11

all of the following:

12

(1)  Ensure the patient has secured a written referral for

13

treatment using prosthetics, orthotics or pedorthics from a

14

physician or podiatrist. A referral under this paragraph shall

15

place conditions and restrictions on the course of treatment if

16

required as a matter of sound medical practice.

17

(2)  Ensure the patient has undergone a medical diagnostic

18

examination or has had the results of a recently performed

19

medical diagnostic examination reviewed by a physician or

20

podiatrist.

21

(3)  Keep a copy of the referral and the results of the

22

medical diagnostic examination in the patient's file.

23

(d)  Nothing in this section shall prohibit students enrolled

24

in a prosthetics, orthotics, orthotics fitter or pedorthics

25

educational program from performing prosthetics, orthotics or

26

pedorthics in the course of their instruction, provided a

27

physician or podiatrist is readily available for consultations

28

and that a prosthetist, orthotist or pedorthist, respectively,

29

is on site and responsible for the direct supervision of

30

students.

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1

(e)  Nothing in this section shall prohibit faculty teaching

2

in a prosthetic, orthotic, orthotics fitter or pedorthic

3

educational program or guest lecturers from performing

4

prosthetics, orthotics or pedorthics in the course of student

5

instruction or during professional development seminars,

6

provided the individuals are licensed as a prosthetist,

7

orthotist or pedorthist in this Commonwealth or another

8

jurisdiction recognized by the Commonwealth and obtain temporary

9

licensure in this Commonwealth.

10

(f)  Nothing in this section shall be construed to prevent:

11

(1)  An occupational therapist licensed by the Commonwealth

12

from engaging in the practice in which the occupational

13

therapist is licensed.

14

(2)  A physical therapist licensed by the Commonwealth from

15

engaging in the practice in which the physical therapist is

16

licensed.

17

(3)  A physician licensed by the Commonwealth from engaging

18

in the practice in which the physician is licensed.

19

(4)  A podiatrist licensed by the Commonwealth from engaging

20

in the practice in which the podiatrist is licensed.

21

(5)  The practice of prosthetics, orthotics or pedorthics by

22

an individual who is employed by the Federal Government while in

23

the discharge of the employee's official duties.

24

(g)  Commencing two years after the effective date of this

25

section, individuals shall not practice or hold themselves out

26

as being able to practice prosthetics, orthotics, orthotics

27

fitter or pedorthics in this Commonwealth unless the individuals

28

are licensed in accordance with this section.

29

(h)  Within two years after the effective date of this

30

section, individuals holding a national certification as a

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1

prosthetist, orthotist or a prosthetist/orthotist in accordance

2

with this section may apply for and shall be granted prosthetic

3

or orthotic licensure under this section upon payment of the

4

required fee. Beginning two years after the effective date of

5

this section, applicants for licensure as a prosthetist or an

6

orthotist shall meet the requirements of this section.

7

(i)  The board may issue a temporary practice permit to an

8

applicant in order to permit the applicant to practice

9

prosthetics, orthotics, orthotics fitter or pedorthics under

10

this section during the six-month period immediately preceding

11

completion of the applicant's education program. The temporary

12

practice permit shall be nonrenewable and expire on the earlier

13

of six months from the date of issuance, or the date the

14

applicant fails any board required licensing examination.

15

(j)  To renew a license, a licensee must:

16

(1)  File a renewal application with the board.

17

(2)  Pay a fee established by regulation of the board.

18

(3)  For prosthestists and orthotists, provide certification

19

of successful completion of a minimum of twenty-four hours of

20

continuing education during the immediately preceding two years.

21

For orthotic fitters and pedorthists, provide certification of

22

successful completion of a minimum of thirteen hours of

23

continuing education during the immediately preceding two years.

24

Certification of continuing education credit hours submitted by

25

the prosthetist, orthotist, orthotic fitter or pedorthist shall

26

be properly signed as being correct and true. No credit may be

27

given for courses in office management or practice building. The

28

board may waive all or part of the continuing education

29

requirement to a licensee who shows to the satisfaction of the

30

board that the licensee was unable to complete the requirement

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1

due to illness, emergency or hardship.

2

(k)  The Department of Education shall approve any

3

prosthetics, orthotics, orthotics fitter or pedorthics

4

educational program that meets the relevant and appropriate

5

requirements of 22 Pa. Code (relating to education) and 24

6

Pa.C.S. Ch. 65 (relating to private colleges, universities and

7

seminaries) and that meets or exceeds the standards required for

8

prosthetics, orthotics, orthotics fitter or pedorthics programs

9

established by an accrediting agency recognized by the United

10

States Department of Education.

11

(l)  An individual licensed to practice prosthetics,

12

orthotics, orthotic fitting or pedorthics in this Commonwealth

13

shall maintain a level of professional liability insurance

14

coverage in the minimum amount of one million dollars

15

($1,000,000) per occurrence or claims made. Failure to maintain

16

insurance coverage as required shall subject the licensee to

17

disciplinary proceedings. The board shall accept from a licensee

18

as satisfactory evidence of insurance coverage any of the

19

following:

20

(i)  self-insurance;

21

(ii)  personally purchased liability insurance; or

22

(iii)  professional liability insurance coverage provided by

23

the individual licensee's employer or similar insurance coverage

24

acceptable to the board.

25

(m)  An applicant under this section shall provide proof that

26

the applicant has obtained professional liability insurance in

27

accordance with subsection (l). It is sufficient if the

28

applicant files with the application a copy of a letter from the

29

applicant's professional liability insurance carrier indicating

30

the applicant will be covered against professional liability in

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1

the required amounts effective upon the issuance of the

2

applicant's license to practice prosthetics, orthotics, orthotic

3

fitting or pedorthics in this Commonwealth. Upon issuance of the

4

license, the licensee has thirty days to submit to the board the

5

certificate of insurance or a copy of the policy declaration

6

page.

7

(n)  The board may issue a license to practice prosthetics,

8

orthotics, orthotic fitting or pedorthics in this Commonwealth

9

without examination to an applicant holding a license to

10

practice prosthetics, orthotics, orthotic fitting or pedorthics

11

from another state who submits proof satisfactory to the board

12

the applicant:

13

(1)  Is of good moral character.

14

(2)  Meets requirements for national certification.

15

(3)  Holds a license to practice prosthetics, orthotics,

16

orthotic fitting or pedorthics that is in good standing from

17

another state.

18

(4)  Has, at a minimum, been actively engaged in the practice

19

of prosthetics, orthotics, orthotic fitting or pedorthics for

20

five of the last seven years immediately preceding the filing of

21

the application for licensure by endorsement with the board.

22

(5)  Has submitted an application accompanied by the

23

application fee.

24

(6)  Has not been convicted of a felony under "The Controlled

25

Substance, Drug, Device and Cosmetic Act" or an offense under

26

the laws of another jurisdiction, which, if committed in this

27

Commonwealth, would be a felony under "The Controlled Substance,

28

Drug, Device and Cosmetic Act," unless:

29

(i)  Ten years have elapsed from the date of conviction.

30

(ii)  The applicant satisfactorily demonstrates to the board

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1

that the applicant has made significant progress in personal

2

rehabilitation since the conviction such that licensure of the

3

applicant should not be expected to create a substantial risk of

4

harm to the health and safety of the applicant's clients or the

5

public or a substantial risk of further criminal violation.

6

(iii)  The applicant otherwise satisfies the qualifications

7

contained in or authorized by this act.

8

As used in this paragraph, the term "convicted" includes a

9

judgment, an admission of guilt or a plea of nolo contendere.

10

Section 4.  Sections 13, 16, 16.2, 18 and 19 of the act,

11

amended or added December 20, 1985 (P.L.384, No.107), are

12

amended to read: 

13

Section 13.  Penalties.--(a)  Any person violating any of the

14

provisions of this act, or any rule or regulation of the board,

15

shall be guilty of a misdemeanor, and, upon conviction thereof,

16

shall be sentenced to pay a fine of not more than one thousand

17

dollars ($1,000), or undergo imprisonment for not more than six

18

months for the first violation. On the second and each

19

subsequent conviction, he shall be sentenced to pay a fine of

20

not more than two thousand dollars ($2,000), or undergo

21

imprisonment for not less than six months nor more than one year

22

in jail, or both.

23

(b)  In addition to any other civil remedy or criminal

24

penalty provided for in this act, the board, by a vote of the

25

majority of the maximum number of the authorized membership of

26

the board as provided by law, or by a vote of the majority of

27

the duly qualified and confirmed membership or a minimum of four

28

members, whichever is greater, may levy a civil penalty of up to

29

[one thousand dollars ($1,000)] ten thousand dollars ($10,000) 

30

on any current licensee who violates any provision of this act

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1

or on any person who practices podiatric medicine without being

2

properly licensed to do so under this act. The board shall levy

3

this penalty only after affording the accused party the

4

opportunity for a hearing, as provided in Title 2 of the

5

Pennsylvania Consolidated Statutes (relating to administrative

6

law and procedure).

7

(c)  As part of its sanction, the board may assess the costs

8

of investigation underlying a disciplinary action against a

9

respondent found in violation of the disciplinary provisions

10

administered by the board in a disciplinary proceeding pending

11

before the board for final determination. The cost of

12

investigation shall not include any associated legal fees or any

13

cost of prosecution.

14

Section 16.  Refusal to Grant, Suspension and Revocation.--

15

(a)  The board may refuse to grant and may suspend or revoke or

16

cancel a license or a registration for the following reasons:

17

(1)  The practice of fraud or deceit in obtaining or

18

attempting to obtain a license or in obtaining admission to a

19

school of podiatric medicine or surgery.

20

(2)  Pleading guilty or nolo contendere to, or being found

21

guilty, or receiving probation without verdict, disposition in

22

lieu of trial, or an Accelerated Rehabilitative Disposition in

23

the disposition of felony charges or an offense in connection

24

with the practice of podiatric medicine or involving moral

25

turpitude by a court of competent jurisdiction, or a jury.

26

(3)  Gross incompetency, gross immorality, negligence or

27

misconduct in carrying on of such profession.

28

(4)  Violation of any of the provisions of this act, or the

29

rules and regulations of the board.

30

(5)  Loaning, borrowing or using the registration or license

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1

to practice podiatry of another, or knowingly aiding or abetting

2

in any way the granting of an improper license or registration.

3

(6)  That said applicant or licensee is addicted to alcohol

4

or drugs or has been convicted of a felonious act prohibited by

5

the act of April 14, 1972 (P.L.233, No.64), known as "The

6

Controlled Substance, Drug, Device and Cosmetic Act," or

7

convicted of a felony relating to a controlled substance in a

8

court of law of the United States or any other state, territory

9

or country, or if he or she is or shall become mentally

10

incompetent. An applicant's statement on the application

11

declaring the absence of a conviction shall be deemed

12

satisfactory evidence of the absence of a conviction unless the

13

board has some evidence to the contrary. In enforcing this

14

paragraph, the board shall, upon probable cause, have authority

15

to compel a podiatrist to submit to a mental or physical

16

examination by a physician or a psychologist approved by the

17

board. Failure of a podiatrist to submit to such examination

18

when directed by the board, unless such failure is due to

19

circumstances beyond his or her control, shall constitute an

20

admission of the allegations against him or her, consequent upon

21

which a default and final order may be entered without the

22

taking of testimony or presentation of evidence. A podiatrist

23

affected under this paragraph shall at reasonable intervals be

24

afforded an opportunity to demonstrate that he or she can resume

25

a competent practice of podiatry with reasonable skill and

26

safety to patients.

27

(7)  Knowingly making substantial misrepresentations.

28

(8)  Unethical conduct or misleading, fraudulent or unethical

29

advertising.

30

(9)  Soliciting patronage other than by legitimate

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1

advertisement, or paying a commission or agreeing to pay a

2

commission to any person or persons for soliciting or for

3

business secured, or paying any gratuity to any person with

4

intent to have such person aid in securing business, or like

5

unprofessional conduct.

6

(10)  Having a license to practice podiatric medicine,

7

prosthetics, orthotics, pedorthics or orthotic fitting 

8

suspended, revoked or refused or receiving other disciplinary

9

action by the proper podiatry, prosthetics, orthotics,

10

pedorthics or orthotic fitting licensing authority of another

11

state, territory or country.

12

(11)  Acting in such a manner as to present an immediate and

13

clear danger to the public health or safety.

14

(12)  Failing to provide information, documents or records

15

requested by the board, or a representative of the board, in

16

connection with the investigation or prosecution of a

17

disciplinary matter under this act.

18

(b)  When the board finds that the license of any person may

19

be refused, revoked or suspended under the terms of subsection

20

(a), the board may:

21

(1)  Deny the application for a license.

22

(2)  Administer a public reprimand.

23

(3)  Revoke, suspend, limit or otherwise restrict a license

24

as determined by the board.

25

(4)  Require a licensee to submit to the care, counseling or

26

treatment of a physician or a psychologist designated by the

27

board.

28

(5)  Suspend enforcement of its finding thereof and place a

29

licensee on probation with the right to vacate the probationary

30

order for noncompliance.

- 16 -

 


1

(6)  Restore or reissue, in its discretion, a suspended

2

license to practice podiatric medicine and impose any

3

disciplinary or corrective measure which it might originally

4

have imposed.

5

Section 16.2.  Reinstatement of License, Certificate or

6

Registration.--Unless ordered to do so by Commonwealth Court or

7

an appeal therefrom, the board shall not reinstate the license,

8

certificate or registration of a person to practice podiatric

9

medicine, prosthetics, orthotics, pedorthics or orthotic fitting 

10

pursuant to this act which has been revoked. Any person whose

11

license, certificate or registration has been revoked may apply

12

for reinstatement after a period of at least five years but must

13

meet all of the licensing qualifications of this act for the

14

license applied for, including the examination requirement, if

15

he or she desires to practice at any time after such revocation.

16

Section 18.  Display of License and Certificate.--Every

17

holder of a license or certificate of registration shall display

18

the same in a conspicuous place wherein such person shall

19

practice podiatric medicine, prosthetics, orthotics, pedorthics

20

or orthotic fitting.

21

Section 19.  Injunction or Other Process.--It shall be

22

unlawful for any person to practice or attempt to offer to

23

practice podiatric medicine, prosthetics, orthotics, pedorthics

24

or orthotic fitting as defined in this act, without having at

25

the time of so doing a valid, unexpired, unrevoked and

26

unsuspended license issued under this act. The unlawful practice

27

of podiatric medicine, prosthetics, orthotics, pedorthics or

28

orthotic fitting, as defined in this act may be enjoined by the

29

courts on petition of the board or the Commissioner of

30

Professional and Occupational Affairs. In any such proceeding,

- 17 -

 


1

it shall not be necessary to show that any person is

2

individually injured by the actions complained of. If it is

3

found that the respondent has engaged in the unlawful practice

4

of podiatric medicine, prosthetics, orthotics, pedorthics or

5

orthotic fitting, the court shall enjoin him or her from so

6

practicing unless and until he or she has been duly licensed.

7

Procedure in such cases shall be the same as in any other

8

injunction suit. The remedy by injunction hereby given is in

9

addition to any other civil or criminal prosecution and

10

punishment.

11

Section 5.  The act is amended by adding a section to read:

12

Section 23.  Expungement.--To expunge a disciplinary record

13

of a certificate holder, registrant or licensee subject to the

14

following conditions:

15

(1)  The certificate holder, registrant or licensee shall

16

make written application to the board for expungement no earlier

17

than four years from the effective date of the disciplinary

18

record.

19

(2)  The disciplinary record shall be the only disciplinary

20

record the certificate holder, registrant or licensee has with

21

the board.

22

(3)  The certificate holder, registrant or licensee shall

23

have no disciplinary record previously expunged.

24

(4)  The disciplinary record shall have involved either the

25

imposition of a civil penalty against the certificate holder,

26

registrant or licensee for a violation under authority of

27

section 5(a) of the act of July 2, 1993 (P.L.345, No.48),

28

entitled "An act empowering the General Counsel or his designee

29

to issue subpoenas for certain licensing board activities;

30

providing for hearing examiners in the Bureau of Professional

- 18 -

 


1

and Occupational Affairs; providing additional powers to the

2

Commissioner of Professional and Occupational Affairs; and

3

further providing for civil penalties and license suspension",

4

or the imposition of discipline against the certificate holder,

5

registrant or licensee for a violation that, at the time of

6

application for expungement, would be prosecuted under authority

7

of section 5(a) of the act of July 2, 1993 (P.L.345, No.48).

8

Section 6.  This act shall take effect in 60 days.

9

Section 1.  Section 2 of the act of December 20, 1985

<--

10

(P.L.457, No.112), known as the Medical Practice Act of 1985, is

11

amended by adding definitions to read:

12

Section 2.  Definitions.

13

The following words and phrases when used in this act shall

14

have the meanings given to them in this section unless the

15

context clearly indicates otherwise:

16

* * *

17

"Accommodative."  Designed with a primary goal of conforming

18

to an individual's anatomy.

19

* * *

20

"Custom-fabricated device."  A prosthesis, orthosis or

21

pedorthic device that is fabricated to original measurements or

22

a mold for use by a patient in accordance with a prescription or

23

work order and which requires substantial clinical and technical

24

judgment in its design and fitting.

25

"Custom-fitted device."  A prefabricated prosthesis, orthosis

26

or pedorthic device that is sized or modified for use by the

27

patient in accordance with a prescription or work order and

28

which requires substantial clinical judgment and substantive

29

alteration for appropriate use.

30

* * *

- 19 -

 


1

"NCCA."  The National Commission for Certifying Agencies or

2

its successor.

3

"NOCA."  The National Organization for Competency Assurance

4

or its successor.

5

"Nontherapeutic devices."  Devices that do not address a

6

medical condition.

7

"Orthotic fitter."  An individual who is licensed under this

8

act to practice orthotics pursuant to a written prescription of

9

a physician, podiatrist, certified registered nurse practitioner

10

or physician assistant or pursuant to a work order.

11

"Orthotics."  Evaluating, measuring, designing, fabricating,

12

assembling, fitting, adjusting or servicing an orthosis for the

13

correction or alleviation of neuromuscular or musculoskeletal

14

dysfunction, disease, injury or deformity, as provided in this

15

act.

16

"Orthotist."  An individual other than an orthotic fitter

17

licensed under this act to practice orthotics pursuant to a

18

written prescription of a physician, podiatrist, certified

19

registered nurse practitioner or physician assistant or pursuant

20

to a work order.

21

"Over-the-counter prostheses, orthoses and pedorthic

22

devices."  Prefabricated, mass-produced items that are

23

prepackaged and require no professional advice or judgment in

24

either size selection or use, including fabric or elastic

25

supports, corsets, generic arch supports and elastic hose.

26

"Pedorthic device."  Includes therapeutic shoes, shoe

27

modifications made for therapeutic purposes, partial foot

28

prostheses, foot orthoses and below-the-knee pedorthic

29

modalities. The term does not include nontherapeutic,

30

accommodative inlays and nontherapeutic accommodative footwear,

- 20 -

 


1

regardless of method of manufacture; unmodified, nontherapeutic

2

over-the-counter shoes; or prefabricated unmodified or

3

unmodifiable foot care and footwear products.

4

"Pedorthics."  Evaluating, measuring, designing, fabricating,

5

assembling, fitting, adjusting or servicing necessary to

6

accomplish the application of a pedorthic device for the

7

prevention or amelioration of painful or disabling conditions

8

related to the lower extremities.

9

"Pedorthist."  An individual licensed under this act to

10

practice pedorthics pursuant to a written prescription of a

11

physician, podiatrist, certified registered nurse practitioner

12

or physician assistant or pursuant to a work order.

13

"Podiatrist."  An individual licensed under the act of March

14

2, 1956 (1955 P.L.1206, No.375), known as the Podiatry Practice

15

Act, to practice podiatry.

16

* * *

17

"Prefabricated orthosis."  A brace or support designed to

18

provide for alignment, correction or prevention of neuromuscular

19

or musculoskeletal dysfunction, disease, injury or deformity.

20

The term does not include fabric or elastic support, corsets,

21

arch supports, low-temperature plastic splints, trusses, elastic

22

hose, canes, crutches, soft cervical collars, dental appliances

23

or other similar devices carried in stock and sold as over-the-

24

counter items by a drug store, department store, corset shop or

25

surgical supply facility.

26

* * *

27

"Prosthesis."  A custom-designed, custom-fabricated, custom-

28

fitted or custom-modified device to replace an absent external

29

limb for purposes of restoring physiological function or

30

cosmesis. The term does not include artificial eyes, ears,

- 21 -

 


1

fingers or toes, dental appliances, cosmetic devices, such as

2

artificial breasts, eyelashes or wigs, or other devices that do

3

not have a significant impact on the musculoskeletal functions

4

of the body.

5

"Prosthetics."  Evaluating, measuring, designing,

6

fabricating, assembling, fitting, adjusting or servicing a

7

prosthesis.

8

"Prosthetist."  An individual licensed under this act to

9

practice prosthetics pursuant to a written prescription of a

10

physician, podiatrist, certified registered nurse practitioner

11

or physician assistant or pursuant to a work order.

12

* * *

13

"Therapeutic devices."  Devices that address a medical

14

condition.

15

* * *

16

Section 2.  The act is amended by adding a section to read:

17

Section 13.4.  Prosthetists, orthotists, pedorthists and

18

orthotic fitters.

19

(a)  Licensure qualifications.--To qualify for licensure to

20

practice prosthetics, orthotics, pedorthics or orthotic fitting,

21

an applicant shall:

22

(1)  Be of good moral character.

23

(2)  Possess a high school diploma or its equivalent.

24

(3)  Have fulfilled all educational and training required

25

for certification by a prosthetic, orthotic, pedorthic and

26

orthotic fitting credentialing organization recognized by

27

NOCA and accredited by NCCA and any additional requirements

28

as required by the board.

29

(4)  Pass all examinations that are required for

30

certification by a prosthetic, orthotic, pedorthic or

- 22 -

 


1

orthotic fitting credentialing organization recognized by

2

NOCA and accredited by NCCA.

3

(5)  Submit an application and fee as prescribed by the

4

board by regulation.

5

(6)  Not be addicted to alcohol, narcotics or other

6

habit-forming drugs.

7

(7)  Not been convicted of a felony under the act of

8

April 14, 1972 (P.L.233, No.64), known as The Controlled

9

Substance, Drug, Device and Cosmetic Act, or of an offense

10

under the laws of another jurisdiction which, if committed in

11

this Commonwealth, would be a felony under The Controlled

12

Substance, Drug, Device and Cosmetic Act, unless the

13

following apply:

14

(i)  Ten years have elapsed from the date of

15

conviction.

16

(ii)  The applicant satisfactorily demonstrates to

17

the board that the applicant has made significant

18

progress in personal rehabilitation since the conviction

19

and the licensure of the applicant is not expected to

20

create a substantial risk of harm to the health and

21

safety of the applicant's clients or the public or a

22

substantial risk of further criminal violations.

23

(iii)  The applicant otherwise satisfies the

24

qualifications required under this act.

25

(b)  Term of license.--A license issued pursuant to this

26

section shall be valid for two years and may be renewed

27

biennially with the board as provided in subsection (g). 

28

(c)  Treatment requirements.--Prior to administering the

29

first treatment, a prosthetist, orthotist, pedorthist or

30

orthotics fitter shall do all of the following:

- 23 -

 


1

(1)  Ensure the patient has secured a prescription or

2

work order for treatment using prosthetics, orthotics,

3

pedorthics or orthotic fitting from a physician, podiatrist,

4

certified registered nurse practitioner or physician

5

assistant. A prescription or work order under this paragraph

6

shall place conditions and restrictions on the course of

7

treatment if required as a matter of sound medical practice.

8

(2)  Ensure the patient has undergone a medical

9

diagnostic examination or has had the results of a recently

10

performed medical diagnostic examination reviewed by a

11

physician, podiatrist, certified registered nurse

12

practitioner or physician assistant.

13

(3)  Keep a copy of the prescription or work order and,

14

if provided, the results of the medical diagnostic

15

examination in the patient's file.

16

(d)  Exceptions.--

17

(1)  Nothing in this section shall prohibit students

18

enrolled in a prosthetics, orthotics, pedorthics or orthotics

19

fitter educational program from performing prosthetics,

20

orthotics, pedorthics or orthotic fitting in the course of

21

their instruction, provided that a physician or podiatrist is

22

readily available for consultations and that a prosthetist,

23

orthotist, pedorthist or orthotic fitter, respectively, is on

24

site and responsible for the direct supervision of students.

25

(2)  Nothing in this section shall prohibit an individual

26

from engaging in the practice for which that individual is

27

licensed or certified to practice or to act within the scope

28

of that license or certification held in this Commonwealth.

29

Nothing in this act shall prohibit an individual who is

30

employed by the Federal Government from engaging in the

- 24 -

 


1

practice of a prosthetist, orthotist, pedorthist or orthotic

2

fitter while in the discharge of the employee's official

3

duties.

4

(3)  Nothing in this section shall prohibit the sale of

5

over-the-counter prostheses, orthoses or pedorthic devices.

6

(4)  Nothing in this section shall prohibit a

7

representative of a medical device manufacturer registered

8

with the United States Food and Drug Administration from

9

measuring, fitting and adjusting orthoses when the

10

representative is supervised by a physician or other licensed

11

health care professional.

12

(e)  License requirement effective.--Commencing two years

13

after the effective date of this section, individuals shall not

14

practice or hold themselves out as being able to practice

15

prosthetics, orthotics, pedorthics or orthotic fitting in this

16

Commonwealth unless the individuals are licensed in accordance

17

with this section.

18

(f)  License without examination.--Within two years after the

19

effective date of this section, an individual may be granted a

20

prosthetic, orthotic, pedorthotic or orthotic fitting license by

21

the board if the individual:

22

(1)  Complies with subsection (a)(1), (2), (5), (6) and

23

(7); and

24

(2)  Complies with one of the following:

25

(i)  Holds a national certification as a prosthetist,

26

orthotist, pedorthist or orthotic fitter.

27

(ii)  Has been in active, continuous practice for the

28

three years immediately preceding the effective date of

29

this section.

30

(g)  License renewal.--To renew a license, a licensee must:

- 25 -

 


1

(1)  File a renewal application with the board.

2

(2)  Pay a fee established by regulation by the board.

3

(3)  Complete continuing education as required by the

4

board. The following apply:

5

(i)  Certification of continuing education credit

6

hours submitted by the prosthetist, orthotist, pedorthist

7

or orthotic fitter shall be verified as being correct and

8

true.

9

(ii)  No credit may be given for courses in office

10

management or practice building.

11

(iii)  The board may waive all or part of the

12

continuing education requirements to a licensee who shows

13

to the satisfaction of the board that the licensee was

14

unable to complete the requirement due to illness,

15

emergency or hardship.

16

(h)  Orthotic fitter scope of practice.--The scope of

17

practice of an orthotic fitter is limited to measuring, fitting,

18

dispensing and adjusting prefabricated devices not requiring

19

more than minor modification of:

20

(1)  Cervical soft foam collars.

21

(2)  Thoraco-lumbo-sacral orthoses.

22

(3)  Lumbo-sacral orthoses.

23

(4)  Knee orthoses.

24

(5)  Ankle foot orthoses.

25

(6)  Foot orthoses.

26

(7)  Elbow orthoses.

27

(8)  Shoulder orthoses.

28

(9)  Abdominal and pelvic:

29

(i)  Trusses.

30

(ii)  Flexible supports.

- 26 -

 


1

(iii)  Maternity supports.

2

(10)  Compression devices:

3

(i)  Lymphedema garments.

4

(ii)  Compression garments.

5

(iii)  Burn garments.

6

(11)  Breast prosthesis and ancillary supplies.

7

(i)  Liability insurance coverage.--An individual licensed to

8

practice prosthetics, orthotics, pedorthics or orthotic fitting

9

in this Commonwealth shall maintain a level of professional

10

liability insurance coverage in the minimum amount of $1,000,000

11

per occurrence or claims made and shall verify to the board the

12

required coverage. Failure to maintain insurance coverage as

13

required shall subject the licensee to disciplinary proceedings.

14

The licensee must provide proof of coverage to the board upon

15

request. The board shall accept from a licensee as satisfactory

16

evidence of insurance coverage any of the following:

17

(1)  Personally purchased liability insurance.

18

(2)  Professional liability insurance coverage provided

19

by the individual licensee's employer or similar insurance

20

coverage acceptable to the board.

21

(j)  Practice by unregistered persons.–-Any person who is not

22

licensed as a prosthetist, orthotist, pedorthist or orthotic

23

fitter shall not practice prosthetics, orthotics, pedorthics or

24

orthotic fitting nor in any written or printed circular or in

25

any business card, letterhead or sign or otherwise assume the

26

title "Prosthetist," "Orthotist," "Pedorthist" or "Orthotic

27

Fitter" nor any other title, abbreviation, name or description

28

implying or calculated to lead to the belief that he is

29

qualified to practice prosthetics, orthotics, pedorthics or

30

orthotic fitting.

- 27 -

 


1

Section 3.  The board shall promulgate regulations to

2

implement the amendment or addition of sections 2 and 13.4 of

3

the act within 18 months of the effective date of this section.

4

The amendment or addition of sections 2 and 13.4 of the act

5

shall not be enforceable by the State Board of Medicine until

6

the publication of final regulations under this section or 24

7

months following the effective date of this section, whichever

8

occurs first.

9

Section 4.  This act shall take effect immediately.

- 28 -

 


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