PRINTER'S NO. 1453
No. 1158 Session of 1985
INTRODUCED BY BELL, OCTOBER 16, 1985
REFERRED TO CONSUMER PROTECTION AND PROFESSIONAL LICENSURE, OCTOBER 16, 1985
AN ACT 1 Relating to the right to practice medicine and surgery and the 2 right to practice medically related acts; reestablishing the 3 State Board of Medical Education and Licensure as the State 4 Board of Medicine and providing for its composition, powers 5 and duties; providing for the issuance of licenses and the 6 suspension and revocation of licenses; providing penalties; 7 and making repeals. 8 TABLE OF CONTENTS 9 Section 1. Short title. 10 Section 2. Definitions. 11 Section 3. State Board of Medicine. 12 Section 4. Impaired professionals. 13 Section 5. Consultants. 14 Section 6. Fees, fines and civil penalties. 15 Section 7. Reports of the board. 16 Section 8. Fees. 17 Section 9. Regulatory powers of the board. 18 Section 10. Procedure, oaths and subpoenas. 19 Section 11. Unauthorized practice of medicine and surgery.
1 Section 12. Clinical clerks. 2 Section 13. Midwifery. 3 Section 14. Physician assistants. 4 Section 15. Drugless therapist. 5 Section 16. Certified registered nurse practitioner. 6 Section 17. Consultation. 7 Section 18. Delegation of duties to health care professional or 8 technician. 9 Section 19. Federal medical personnel. 10 Section 20. Osteopathic act. 11 Section 21. Other health care professionals. 12 Section 22. Acts outside nonphysician license or certificate. 13 Section 23. Licenses and certificates; general qualification. 14 Section 24. Standards for medical training facilities. 15 Section 25. Examinations. 16 Section 26. Licenses and certificates; biennial registration. 17 Section 27. Certification of license or certificate. 18 Section 28. Reciprocity or endorsement. 19 Section 29. License to practice medicine and surgery. 20 Section 30. License without restriction. 21 Section 31. License with restriction. 22 Section 32. Graduate license. 23 Section 33. Institutional license. 24 Section 34. Temporary license. 25 Section 35. Extraterritorial license. 26 Section 36. Nurse-midwife certificate. 27 Section 37. Physician assistant certificate. 28 Section 38. Reporting of multiple licensure. 29 Section 39. Injunctions against unlawful practice. 30 Section 40. Penalties. 19850S1158B1453 - 2 -
1 Section 41. Temporary and automatic suspensions. 2 Section 42. Reasons for refusal, revocation, suspension or 3 other corrective actions against a licensee or 4 certificate holder. 5 Section 43. Types of corrective action. 6 Section 44. Reinstatement of license, certificate or 7 registration. 8 Section 45. Surrender of suspended or revoked license. 9 Section 46. Reestablishment. 10 Section 47. Severability. 11 Section 48. Repeals. 12 Section 49. Applicability of act. 13 Section 50. Existing board. 14 Section 51. Existing rules and regulations. 15 Section 52. Existing licenses, certificates and registrations. 16 Section 53. Effective date. 17 The General Assembly of the Commonwealth of Pennsylvania 18 hereby enacts as follows: 19 Section 1. Short title. 20 This act shall be known and may be cited as the Medical 21 Practice Act of 1985. 22 Section 2. Definitions. 23 The following words and phrases when used in this act shall 24 have the meanings given to them in this section unless the 25 context clearly indicates otherwise: 26 "Accredited medical college." An institution of higher 27 learning which has been fully accredited by the Association of 28 American Medical Colleges, its successors or assigns, or the 29 American Medical Association, either directly or through their 30 respective accrediting bodies, as an agency to provide courses 19850S1158B1453 - 3 -
1 in the art and science of medicine and surgery and empowered to 2 grant Academic Degrees in Medicine. 3 "Affiliate." A member of a group of two or more medical 4 training facilities legally united by an agreement of 5 affiliation, approved by the board and formed to enhance the 6 potential of all participants in the provision of health care 7 and medical education. 8 "Applicant." An applicant for any license or certificate 9 issued by the board. 10 "Board." The State Board of Medicine. 11 "Clinical clerk." An undergraduate student in good standing 12 in an accredited medical college who is assigned to provide 13 medical services in a hospital by the medical college and the 14 hospital. 15 "Commissioner." The Commissioner of Professional and 16 Occupational Affairs in the Department of State. 17 "Doctor of osteopathy or osteopathic doctor." An individual 18 licensed to practice osteopathic medicine and surgery by the 19 State Board of Osteopathic Medical Examiners. 20 "Graduate medical training." Training approved or recognized 21 by the board which is either: 22 (1) accredited as graduate medical education by the 23 Accreditation Council for Graduate Medical Education or by 24 any other accrediting body recognized by the board for the 25 purpose of accrediting graduate medical education; or 26 (2) provided by a hospital accredited by the Joint 27 Commission on Accreditation of Hospitals, its successors or 28 assigns, and is acceptable to an American specialty board 29 towards the training it requires for the certification it 30 issues in a medical specialty or subspecialty. 19850S1158B1453 - 4 -
1 "Healing arts." The science and skill of diagnosis and 2 treatment in any manner whatsoever of disease or any ailment of 3 the human body. 4 "Health care professional." An individual, other than a 5 physician assistant, who is authorized to practice some 6 component of the healing arts by a license, permit, certificate 7 or registration issued by a Commonwealth licensing agency or 8 board. 9 "Hospital." An institution licensed or regulated as a 10 hospital by the Department of Health or the Department of Public 11 Welfare or a facility owned or operated by the Federal 12 Government and accredited by the Joint Commission on 13 Accreditation of Hospitals as a hospital. 14 "Medical doctor." An individual who has acquired one of the 15 following licenses to practice medicine and surgery issued by 16 the board: 17 (1) License without restriction. 18 (2) License with restriction. 19 (3) Graduate license. 20 (4) Institutional license. 21 (5) Temporary license. 22 (6) Extraterritorial license. 23 "Medical service." Activity which lies within the scope of 24 the practice of medicine and surgery. 25 "Medical training facility." A medical college, hospital or 26 other institution which provides courses in the art and science 27 of medicine and surgery and related subjects for the purpose of 28 enabling a matriculant to qualify for a license or practice 29 medicine and surgery, graduate medical training, midwife 30 certificate or physician assistant certificate. 19850S1158B1453 - 5 -
1 "Medicine and surgery." The art and science of which the 2 objectives are the cure of diseases and the preservation of the 3 health of man, including the practice of the healing art with or 4 without drugs, except healing by spiritual means or prayer. 5 "Midwife or nurse-midwife." An individual who is licensed as 6 a midwife by the board. 7 "Physician." A medical doctor or doctor of osteopathy. 8 "Physician assistant." An individual who is certified as a 9 physician assistant by the board. 10 "Professional." A medical doctor, midwife, physician 11 assistant, drugless therapist, or an applicant for a license or 12 certificate the board may issue. 13 "Resident." A medical doctor who is participating in 14 graduate training. 15 "Technician." A person, other than a health care 16 professional or physician assistant, who through training, 17 education or experience has achieved expertise in the technical 18 details of a subject or occupation which is a component of the 19 healing art. 20 "Unaccredited medical college." An institution of higher 21 learning which provides courses in the art and science of 22 medicine and surgery and related subjects, is empowered to grant 23 professional degrees in medicine, is not accredited by the 24 Association of American Medical Colleges, its successors or 25 assigns, or the American Medical Association, either directly or 26 through their respective accrediting bodies, and is listed by 27 the World Health Organization, its successors or assigns, or is 28 otherwise recognized as a medical college by the country in 29 which it is situated. 30 Section 3. State Board of Medicine. 19850S1158B1453 - 6 -
1 (a) Establishment.--The State Board of Medicine shall 2 consist of the commissioner, the Secretary of Health, two 3 members appointed by the Governor who shall be persons 4 representing the public at large and seven members appointed by 5 the Governor, six of whom shall be medical doctors with 6 unrestricted licenses to practice medicine and surgery in this 7 Commonwealth for five years immediately preceding their 8 appointment, and one who shall be a nurse midwife, physician 9 assistant or certified registered nurse practitioner licensed or 10 certified under the laws of this Commonwealth. 11 (b) Terms of office.--The term of each professional and 12 public member of the board shall be four years or until his or 13 her successor has been appointed and qualified, but not longer 14 than six months beyond the four-year period. In the event that 15 any of said members shall die or resign during his or her term, 16 a successor shall be appointed in the same way and with the same 17 qualifications and shall hold office for the unexpired term. No 18 member shall be eligible to serve more than two consecutive 19 terms. 20 (c) Quorum.--A majority of the members of the board serving 21 in accordance with law shall constitute a quorum for purposes of 22 conducting the business of the board. A member may not be 23 counted as part of a quorum or vote on any issue unless he or 24 she is physically in attendance at the meeting. 25 (d) Chairman.--The board shall select annually a chairman 26 from among its professional members. 27 (e) Compensation.--Each member of the board, except the 28 Commissioner and the Secretary of Health, shall receive $60 per 29 diem when actually attending to the work of the board. Members 30 shall also receive the amount of reasonable traveling, hotel and 19850S1158B1453 - 7 -
1 other necessary expenses incurred in the performance of their 2 duties in accordance with Commonwealth regulations. 3 (f) Sunset.--The board is subject to evaluation, review and 4 termination within five years and in the manner provided in the 5 act of December 22, 1981 (P.L.508, No.142), known as the Sunset 6 Act. 7 (g) Attendance at meetings.--A member of the board who fails 8 to attend three consecutive meetings shall forfeit his or her 9 seat unless the commissioner, upon written request from the 10 member, finds that the member should be excused from a meeting 11 because of illness or the death of a family member. 12 (h) Attendance at training seminars.--A public member who 13 fails to attend statutorily mandated training seminars in 14 accordance with section 21 of the act of November 26, 1978 15 (P.L.1223, No.292), entitled "An act amending the act of April 16 9, 1929 (P.L.177, No.175), entitled 'An act providing for and 17 reorganizing the conduct of the executive and administrative 18 work of the Commonwealth by the Executive Department thereof and 19 the administrative departments, boards, commissions, and 20 officers thereof, including the boards of trustees of State 21 Normal Schools, or Teachers Colleges; abolishing, creating, 22 reorganizing or authorizing the reorganization of certain 23 administrative departments, boards, and commissions; defining 24 the powers and duties of the Governor and other executive and 25 administrative officers, and of the several administrative 26 departments, boards, commissions, and officers; fixing the 27 salaries of the Governor, Lieutenant Governor, and certain other 28 executive and administrative officers; providing for the 29 appointment of certain administrative officers, and of all 30 deputies and other assistants and employes in certain 19850S1158B1453 - 8 -
1 departments, boards, and commissions; and prescribing the manner 2 in which the number and compensation of the deputies and all 3 other assistants and employes of certain departments, boards and 4 commissions shall be determined,' adding members of the public 5 at large to certain licensing boards, changing the name of the 6 State Board of Osteopathic Examiners, adding a dental hygienist 7 to the State Dental Council and Examining Board, including the 8 State Board of Psychologist Examiners, the State Board of Public 9 Accountants and the State Board of Landscape Architects within 10 the act, making editorial changes, further providing for the 11 powers and duties of the Bureau of Professional and Occupational 12 Affairs and the Bureau of Consumer Protection and making 13 repeals," shall forfeit his or her seat unless the commissioner, 14 upon written request form the public member, finds that the 15 public member should be excused from a meeting because of 16 illness or the death of a family member. 17 (i) Meetings.--The board shall meet at least once every two 18 months, and at such additional times as may be necessary to 19 conduct the business of the board. 20 (j) Executive secretary.--The board, with the approval of 21 the commissioner, shall appoint and fix the compensation of an 22 executive secretary who shall be responsible for the day to day 23 operation of the board and administration of board activities. 24 Section 4. Impaired professionals. 25 (a) Appointment of Disciplinary Advisory Committee.--The 26 board, with the approval of the commissioner, shall appoint a 27 Disciplinary Advisory Committee composed of three medical 28 doctors, not members of the board, who shall be compensated at 29 the same rate as members of the board and who shall receive the 30 amount of reasonable traveling, hotel and other necessary 19850S1158B1453 - 9 -
1 expenses incurred in the performance of their duties in 2 accordance with Commonwealth regulations. 3 (b) Recommendations involving potential disciplinary 4 actions.--The committee shall review and make recommendations to 5 the board on cases involving potential disciplinary actions 6 under this act. 7 (c) Liaison.--The committee shall act as a liaison between 8 the board and treatment programs, such as Alcoholics Anonymous, 9 Narcotics Anonymous, psychological counseling and impaired 10 professional support groups, which are approved by the board and 11 which provide services to licensees or certificate holders under 12 this act. 13 (d) Review of corrective action by the board.--The board may 14 defer and ultimately dismiss any of the types of corrective 15 action set forth in this act for an impaired professional so 16 long as the professional is progressing satisfactorily in an 17 approved treatment program, provided that the provisions of this 18 subsection shall not apply to a professional convicted of a 19 felonious act prohibited by the act of April 14, 1972 (P.L.233, 20 No.64), known as The Controlled Substance, Drug, Device and 21 Cosmetic Act, or the conviction of a felony relating to a 22 controlled substance in a court of law of the United States or 23 any other state, territory or country. An approved program 24 provider shall, upon request, disclose to the Disciplinary 25 Advisory Committee all information in its possession regarding 26 an impaired professional in treatment. 27 (e) Voluntary suspension or limitation.--An impaired 28 professional who enrolls in an approved treatment program shall 29 request a voluntary suspension of his or her license or 30 certificate or agree to a limitation of his or her ability to 19850S1158B1453 - 10 -
1 practice. Failure to do so disqualifies the professional from 2 the impaired professional program and shall activate an 3 immediate investigation and disciplinary proceeding by the 4 board. 5 (f) Failure to satisfactorily progress.--If, in the opinion 6 of the committee after consultation with the provider, an 7 impaired professional who is enrolled in an approved treatment 8 has not progressed satisfactorily, the committee shall disclose 9 to the board all information in its possession regarding the 10 professional; and such disclosure shall constitute the basis for 11 instituting proceedings to suspend or revoke the license or 12 certificate of said professional. 13 (g) Immunity.--An approved program provider who makes a 14 disclosure pursuant to this subsection shall not be subject to 15 civil liability for such disclosure or its consequences. 16 (h) Reports to the board.--Any hospital or health care 17 facility, licensee, certificate holder, peer or colleague who 18 knows or has evidence to suspect a professional has an addictive 19 disease, is diverting a controlled substance, or is mentally or 20 physically incompetent to carry out the duties of his or her 21 license or certificate, shall make, or cause to be made, a 22 report to the board. Any person or facility who reports pursuant 23 to this section in good faith and without malice shall be immune 24 from any civil or criminal liability arising from such report. 25 Failure to provide such report within a reasonable time from 26 receipt of knowledge of impairment shall subject the person or 27 facility to a fine not to exceed $1,000. The board shall levy 28 this penalty only after affording the accused party the 29 opportunity for a hearing, as provided in Title 2 of the 30 Pennsylvania Consolidated Statutes (relating to administrative 19850S1158B1453 - 11 -
1 law and procedure). 2 Section 5. Consultants. 3 The board shall establish consultant panels or use individual 4 consultants, as it deems appropriate, to assist it in carrying 5 out its responsibilities. The board may not delegate any of its 6 final decisionmaking responsibilities to a consultant or panel 7 of consultants. 8 Section 6. Fees, fines and civil penalties. 9 (a) Setting of fees.--All fees required under this act shall 10 be fixed by the board by regulation and shall be subject to the 11 act of June 25, 1982 (P.L.633, No.181), known as the Regulatory 12 Review Act. If the revenues raised by fees, fines and civil 13 penalties imposed under this act are not sufficient to meet 14 expenditures over a two-year period, the board shall increase 15 those fees by regulation so that the projected revenues will 16 meet or exceed projected expenditures. 17 (b) Inadequate fees.--If the Bureau of Professional and 18 Occupational Affairs determines that the fees established by the 19 board under subsection (a) are inadequate to meet the minimum 20 enforcement efforts required by this act, then the bureau after 21 consultation with the board and subject to the Regulatory Review 22 Act, shall increase the fees by regulation in an amount that 23 adequate revenues are raised to meet the required enforcement 24 effort. 25 (c) Disposition.--All fees, fines and civil penalties 26 imposed in accordance with this act and collected in accordance 27 with section 907(a) of the act of October 15, 1975 (P.L.390, 28 No.111), known as the Health Care Services Malpractice Act, 29 along with any interest generated thereby, shall be for the 30 exclusive use by the board in carrying out the provisions of 19850S1158B1453 - 12 -
1 this act, and shall be annually appropriated for that purpose. 2 Section 7. Reports of the board. 3 (a) Reports to Department of State.--The board shall submit 4 annually to the Department of State an estimate of the financial 5 requirements of the board for its administrative, investigative, 6 legal and miscellaneous expenses. 7 (b) Reports to House and Senate Appropriations Committees.-- 8 The board shall submit annually to the House and Senate 9 Appropriations Committees, 15 days after the Governor has 10 submitted his budget to the General Assembly, a copy of the 11 budget request for the upcoming fiscal year which the board 12 previously submitted to the department. 13 (c) Reports to other House and Senate committees.--The board 14 shall submit annually a report to the Professional Licensure 15 Committee of the House of Representatives and to the Consumer 16 Protection and Professional Licensure Committee of the Senate a 17 description of the types of complaints received, status of 18 cases, board action which has been taken and the length of time 19 from the initial complaint to final board resolution. The report 20 shall also include a statement of the numbers and types of 21 licenses granted and a statement on physician assistant use in 22 this Commonwealth, including geographic location and practice 23 settings. 24 Section 8. Fees. 25 The board may charge a reasonable fee, as set by the board by 26 regulation, for all examinations, registrations, certifications, 27 licensures or applications permitted by this act or the 28 regulations thereunder. 29 Section 9. Regulatory powers of the board. 30 The board, in the exercise of its duties under this act, 19850S1158B1453 - 13 -
1 shall have the power to adopt such regulations as are reasonably 2 necessary to carry out the purposes of this act. Regulations 3 shall be adopted in conformity with the provisions of the act of 4 July 31, 1968 (P.L.769, No.240), referred to as the Commonwealth 5 Documents Law, and the act of June 25, 1982 (P.L.633, No.181), 6 known as the Regulatory Review Act. 7 Section 10. Procedure, oaths and subpoenas. 8 (a) All actions of the board.--All actions of the board 9 shall be taken subject to the right of notice, hearing and 10 adjudication, and the right of appeal therefrom, in accordance 11 with the provisions in Title 2 of the Pennsylvania Consolidated 12 Statutes (relating to administrative law and procedure). 13 (b) Disciplinary proceedings.--All disciplinary proceedings 14 conducted by hearing examiners shall be conducted in accordance 15 with sections 901 through 905 of the act of October 15, 1975 16 (P.L.390, No.111), known as the Health Care Services Malpractice 17 Act. 18 (c) Subpoena power.--The board shall have the authority to 19 issue subpoenas, upon application of an attorney responsible for 20 representing the Commonwealth in disciplinary matters before the 21 board, for the purpose of investigating alleged violations of 22 the disciplinary provisions and administered by the board. The 23 board shall have the power to subpoena witnesses, to administer 24 oaths, to examine witnesses or to take testimony or compel the 25 production of books, records, papers and documents as it may 26 deem necessary or proper in and pertinent to any proceeding, 27 investigation or hearing held by it. Medical records may not be 28 subpoenaed without consent of the patient or without order of a 29 court of competent jurisdiction on a showing that the records 30 are reasonably necessary for the conduct of the investigation. 19850S1158B1453 - 14 -
1 The court may impose such limitations on the scope of the 2 subpoena as are necessary to prevent unnecessary intrusion in 3 patient confidential information. The board is authorized to 4 apply to Commonwealth Court to enforce its subpoenas. 5 Section 11. Unauthorized practice of medicine and surgery. 6 No person other than a medical doctor shall engage in any of 7 the following conduct except as authorized or exempted in this 8 act: 9 (1) Practice medicine and surgery. 10 (2) Purport to practice medicine and surgery. 11 (3) Hold forth as authorized to practice medicine and 12 surgery through use of a title, including, but not 13 necessarily limited to medical doctor, doctor of medicine, 14 doctor of medicine and surgery, doctor of a designated 15 disease, physician, physician of a designated disease, or any 16 abbreviation for the foregoing. 17 (4) Otherwise hold forth as authorized to practice 18 medicine and surgery. 19 Section 12. Clinical clerks. 20 (a) Authorized services.--A clinical clerk may perform the 21 following services in a hospital to which the clerk is assigned, 22 provided the services are performed within the restrictions 23 contained in or authorized by this section: 24 (1) Make notes on a patient's chart. 25 (2) Conduct a physical examination. 26 (3) Perform a medical procedure or laboratory test. 27 (b) Regulations.--A clinical clerk shall not perform a 28 medical service unless the performance of such by the clinical 29 clerk under the circumstances is consistent with the standards 30 of acceptable medical practice embraced by the medical doctor 19850S1158B1453 - 15 -
1 community in this Commonwealth. The board shall promulgate 2 regulations which define the medical services those standards 3 permit a clinical clerk to perform and the circumstances under 4 which those standards permit a clinical clerk to perform a 5 medical service. 6 (c) Supervision.--A clinical clerk shall not perform a 7 medical service without the direct and immediate supervision of 8 the medical doctor members of the medical staff or residents at 9 the hospital in which the service is performed. The board shall 10 promulgate regulations which define the supervision required by 11 those standards. 12 (d) Drugs.--A clinical clerk shall not prescribe or dispense 13 drugs. 14 (e) Notes on patients' charts.--Notes made on a patient's 15 chart by a clinical clerk become official only when 16 countersigned by a medical doctor member of the hospital's 17 medical staff or resident beyond a first-year level of graduate 18 medical education at the hospital. 19 (f) Other licenses or certificates.--Nothing in this section 20 or the regulations authorized by this section shall be construed 21 to prohibit a clinical clerk who is licensed or certified to 22 practice a profession by a Commonwealth agency or board from 23 practicing within the scope of that license or certificate or as 24 otherwise authorized by law. 25 Section 13. Midwifery. 26 (a) Previous licensure.--A midwife who has been licensed 27 previously by the board may continue to practice midwifery in 28 accordance with regulations promulgated by the board. 29 (b) Use of title.--A midwife may use the title midwife, 30 nurse-midwife or an appropriate abbreviation of those titles. 47 19850S1158B1453 - 16 -
1 (c) Other licenses or certificates.--Nothing in this section 2 or the regulations authorized by this section shall be construed 3 to prohibit a midwife who is licensed or certified to practice 4 another profession by a Commonwealth agency or board from 5 practicing within the scope of that license or certificate or as 6 otherwise authorized by law. 7 Section 14. Physician assistants. 8 (a) Authorized services.--A physician assistant may perform 9 a medical service delegated by an approved physician and as 10 approved by the appropriate board. An approved physician is a 11 physician identified in the writing required by subsection (e). 12 (b) Use of title.--A physician assistant may use the title 13 physician assistant or an appropriate abbreviation for that 14 title, such as P.A. 15 (c) Regulations.--The board shall promulgate regulations 16 which define the services and circumstances under which a 17 physician assistant may perform a medical service. 18 (d) Supervision.--A physician assistant shall not perform a 19 medical service without the supervision and personal direction 20 of an approved physician. The board shall promulgate regulations 21 which define the supervision and personal direction required by 22 those standards. 23 (e) Written agreement.--A physician assistant shall not 24 provide a medical service without a written agreement with one 25 or more physicians which provides for all of the following: 26 (1) Identifies and is signed by each physician the 27 physician assistant will be assisting. 28 (2) Describes the manner in which the physician 29 assistant will be assisting each named physician. 30 (3) Describes the nature and degree of supervision and 19850S1158B1453 - 17 -
1 direction each named physician will provide the physician 2 assistant. 3 (4) Designates one of the named physicians as having the 4 primary responsibility for supervising and directing the 5 physician assistant. 6 (5) Has been approved by the board as satisfying the 7 foregoing and as consistent with the restrictions contained 8 in or authorized by this section. 9 A physician assistant shall not assist a physician in a manner 10 not described in the agreement or without the nature and degree 11 of supervision and direction described in the agreement. The 12 physician designated as having primary responsibility for the 13 physician assistant shall not have primary responsibility for 14 more than two physician assistants. 15 (f) Drugs.--A physician assistant shall not independently 16 prescribe or dispense drugs. The board and the State Board of 17 Pharmacy shall jointly promulgate regulations which permit a 18 physician assistant to prescribe and dispense drugs at the 19 direction of a physician. 20 (g) Supervision.--A physician assistant may be employed by a 21 medical care facility under the supervision and direction of an 22 approved physician or group of such physicians, provided one of 23 those physicians is designated as having the primary 24 responsibility for supervising and directing the physician 25 assistant and provided that a physician assistant shall not be 26 responsible to more than three physicians. 27 (h) Reimbursement.--For reimbursement purposes a physician 28 assistant shall be an employee subject to the normal employer- 29 employee reimbursement procedures. 30 (i) Eye services.--No medical services may be performed by a 19850S1158B1453 - 18 -
1 physician assistant under this act which include the measurement 2 of the range or powers of human vision or the determination of 3 the refractive status of the human eye. This subsection does not 4 prohibit the performance of routine vision screenings or the 5 performance of refractive screenings in the physician's office. 6 (j) Chiropractic practice.--Nothing in this act shall be 7 construed to allow physician assistants to practice 8 chiropractic. 9 (k) Other licenses or certificates.--Nothing in this section 10 or the regulations authorized by this section shall be construed 11 to prohibit a physician assistant who is licensed or certified 12 to practice another professional by a Commonwealth agency or 13 board from practicing within the scope of that license or 14 certificate or as otherwise authorized by law. 15 Section 15. Drugless therapist. 16 (a) Previous licensure.--A drugless therapist who has been 17 licensed previously by the board may continue to provide 18 drugless therapy in accordance with the regulations promulgated 19 by the board. 20 (b) Drugs.--A drugless therapist shall not prescribe or 21 dispense drugs. 22 (c) Other licenses or certificates.--Nothing in this section 23 or the regulations authorized by this section shall be construed 24 to prohibit a drugless therapist who is licensed or certified to 25 practice another profession by a Commonwealth agency or board 26 from practicing within the scope of that license or certificate 27 or as otherwise authorized by law. 28 Section 16. Certified registered nurse practitioner. 29 (a) General rule.--A certified registered nurse practitioner 30 shall act in accordance with regulations authorized by this 19850S1158B1453 - 19 -
1 section. 2 (b) Regulations.--The board and the State Board of Nurse 3 Examiners shall jointly promulgate regulations authorizing a 4 certified registered nurse practitioner to perform acts of 5 medical diagnoses and prescription of medical, therapeutic, 6 diagnostic or corrective measures. 7 (c) Other licenses or certificates.--Nothing in this section 8 or the regulations authorized by this section shall be construed 9 to prohibit a certified registered nurse practitioner who is 10 licensed or certified to practice another profession by a 11 Commonwealth agency or board from practicing within the scope of 12 that license or certificate as otherwise authorized by law. 13 Section 17. Consultation. 14 A person authorized to practice medicine or surgery or 15 osteopathy without restriction by any other state may, upon 16 request by a medical doctor, provide consultation to the medical 17 doctor regarding the treatment of a patient under the care of 18 the medical doctor. 19 Section 18. Delegation of duties to health care professional or 20 technician. 21 (a) General rule.--A health care professional or technician 22 may perform a medical service if: 23 (1) The performance of the service was delegated by a 24 medical doctor. 25 (2) The delegation is consistent with the standards of 26 acceptable medical practice embraced by the medical doctor 27 community in this Commonwealth. 28 (3) The delegation is not prohibited by regulations 29 promulgated by the board. 30 (4) The delegation is not prohibited by statutes or 19850S1158B1453 - 20 -
1 regulations relating to other licensed health care 2 professionals. 3 (b) Regulations.--The board may promulgate regulations which 4 establish criteria pursuant to which a medical doctor may 5 delegate the performance of medical services, preclude a medical 6 doctor from delegating the performance of certain types of 7 medical services, or otherwise limit the ability of a medical 8 doctor to delegate medical services. 9 (c) Responsibility.--Nothing in this section shall be 10 construed to limit the medical doctor's responsibility for the 11 medical service delegated to the health care professional or 12 technician. 13 Section 19. Federal medical personnel. 14 Nothing in this act shall be construed to prohibit a medical 15 doctor in the medical service of the Armed Forces of the United 16 States, the United States Public Health Service or the Veterans' 17 Administration, or a federal employee, from discharging official 18 duties. 19 Section 20. Osteopathic act. 20 (a) General rule.--Nothing in this act shall be construed to 21 prohibit a doctor of osteopathy from practicing osteopathic 22 medicine and surgery. 23 (b) Specific authorization.--Nothing in this act shall be 24 construed to prohibit a person authorized to practice 25 osteopathic medicine and surgery by the act of October 5, 1978 26 (P.L.1109, No.261), known as the Osteopathic Medical Practice 27 Act, to practice as authorized by that act. 28 Section 21. Other health care professionals. 29 Nothing in this act shall be construed to prohibit a health 30 care professional from practicing that profession within the 19850S1158B1453 - 21 -
1 scope of the health care professional's license or certificate 2 or as otherwise authorized by the law, including using the title 3 authorized by the professional's licensing act. 4 Section 22. Acts outside nonmedical doctor license or 5 certificate. 6 (a) Medical doctor involvement.--In the event the law, 7 including this act, conditions a person's authorization to 8 perform one or more medical services upon medical doctor 9 involvement, and the person performs a covered service without 10 the required involvement, the person shall be deemed to have 11 acted outside the scope of the person's license or certificate. 12 (b) Included involvements.--The medical doctor involvement 13 referred to in subsection (a) shall include, but shall not 14 necessarily be limited to, any of the following: 15 (1) An order. 16 (2) Direction or supervision. 17 (3) Presence. 18 (4) Immediate availability. 19 (5) Referral. 20 (6) Consultation. 21 Section 23. Licenses and certificates; general qualification. 22 (a) Types of licenses and certificates.--The board may grant 23 the following licenses and certificates: 24 (1) License without restriction. 25 (2) License with restriction. 26 (3) Graduate license. 27 (4) Institutional license. 28 (5) Temporary license. 29 (6) Extraterritorial license. 30 (7) Midwife certificate. 19850S1158B1453 - 22 -
1 (8) Physician assistant certificate. 2 (b) Qualifications.--The board shall not issue a license or 3 certificate to an applicant unless the applicant establishes 4 with evidence, verified by an affidavit or affirmation of the 5 applicant, that the applicant satisfies the qualifications for 6 the license or certificate contained in or authorized by this 7 act. 8 (c) Refusal.--The board may refuse to issue a license or 9 certificate to an applicant based upon a ground for such action 10 contained in section 43. 11 (d) Limitation.--The board shall not refuse to issue a 12 license or certificate to an applicant unless the applicant has 13 been afforded the procedural protections required by this act. 14 (e) Action on application.--The application, upon filing by 15 the applicant of the evidence required under subsection (b) and 16 the expiration of a period of 90 days, shall be deemed to meet 17 the requirements of this act and become effective, the license 18 or certificate shall be deemed issued, and the board shall take 19 no action against the applicant for practicing without a license 20 or certificate, unless within that period the application has 21 been disapproved by the board or proceedings have been initiated 22 against the applicant under this act. 23 Section 24. Standards for medical training facilities. 24 (a) General rule.--The educational qualifications for 25 acceptance as a matriculant in a medical college or other 26 medical training facility incorporated within this Commonwealth 27 and the curricula and training to be offered by such medical 28 colleges or other medical training facility shall meet the 29 requirements set by the board and any accrediting body which may 30 be recognized by the board. 19850S1158B1453 - 23 -
1 (b) Duties of the board.--It shall be the duty of the board, 2 in its discretion, periodically to ascertain the character of 3 the instruction and the facilities possessed by each of the 4 medical colleges and other medical training facilities offering 5 or desiring to offer medical training in accordance with the 6 requirements of this act. In shall further be the duty of the 7 board, by inspection and otherwise, to ascertain the facilities 8 and qualifications of medical colleges and other medical 9 training facilities outside this Commonwealth, whose graduates 10 or trainees desire to obtain licensure, graduate medical 11 training or certification in this Commonwealth, provided further 12 that the board shall have the authority to refuse to license 13 graduates of any such medical institutions, colleges or 14 hospitals which in its judgment do not meet similar standards 15 for medical training and facilities as are required of medical 16 institutions in this Commonwealth. In enforcing this provision, 17 the board shall give due notice to any medical institution, 18 college or hospital upon which it has rendered a decision that 19 its training and facilities do not meet the standards required 20 by the board. 21 (c) Refusal of recognition.--In the event that the board 22 determines that a medical training facility has failed to 23 provide adequate facilities, curricula or training, the board 24 shall not recognize the education or degrees obtained from the 25 medical training facility during the period of inadequacy. 26 Section 25. Examinations. 27 (a) General rule.--The board may require an applicant to 28 take and pass an examination to the satisfaction of the board. 29 (b) Proficiency in English language.--In addition to any 30 other examination required by this act or by regulation of the 19850S1158B1453 - 24 -
1 board, applicants for a license or certificate, whose principal 2 language is other than English, may also be required to 3 demonstrate, by examination, proficiency in the English language 4 to any agency considered competent by the board. 5 (c) Authority to call in medical consultants.--For the 6 purpose of conducting all examinations, the board shall have the 7 privilege of calling to its aid medical consultants who shall be 8 compensated for their services at a reasonable rate in an amount 9 as determined, from time to time, by the board in addition to 10 all incurred expenses. 11 (d) Examining agency.--When the board accepts an examination 12 given by an examining agency, the board may establish the 13 criteria for passing, or may accept the criteria for passing, 14 established by the examining agency. If the examination is 15 offered in parts, the board may establish, by regulation, a time 16 period in which the entire examination must be successfully 17 completed. The board may establish, by regulation, a maximum 18 number of examination attempts it will recognize for the purpose 19 of receiving a passing score on an examination recognized but 20 not given by the board. 21 Section 26. Licenses and certificates; biennial registration. 22 (a) Issuance of licenses and certificates.--All applicants 23 who have complied with the requirements of the board, and who 24 shall have passed a final examination, and who have otherwise 25 complied with the provisions of this act, shall receive from the 26 commissioner, or whoever exercises equivalent authority acting 27 for the board, a license or certificate entitling them to the 28 right to practice in this Commonwealth. Each such license or 29 certificate shall be duly recorded in the office of the board, 30 in a record to be properly kept for that purpose which shall be 19850S1158B1453 - 25 -
1 open to public inspection and a certified copy of said record 2 shall be received as evidence in all courts in this Commonwealth 3 in the trial of any case. 4 (b) Renewals.--It shall be the duty of all persons now or 5 hereafter licensed or certified to be registered with the board 6 and, thereafter, to register in like manner at such intervals 7 and by such methods as the board shall determine by regulations, 8 but in no case shall such renewal period be longer than two 9 years. The form and method of such registration shall be 10 determined by the board. 11 (c) Fees.--Each person so registering with the board shall 12 pay, for each biennial registration, a reasonable fee which, if 13 any, shall accompany the application for such registration. 14 (d) Evidence of registration.--Upon receiving a proper 15 application for such registration accompanied by the fee, if 16 any, above provided for, the board shall issue a certificate of 17 registration to the applicant. Said certificate together with 18 its renewals shall be good and sufficient evidence of 19 registration under the provisions of this act. 20 Section 27. Certification of license or certificate. 21 The status of a license or certificate issued by the board 22 shall be certified by the board to other jurisdictions or 23 persons upon formal application and payment of a reasonable fee. 24 Section 28. Reciprocity or endorsement. 25 Reciprocity or endorsement may be established at the 26 discretion of the board. As used in this section, the term 27 "reciprocity" means the act of the board and a licensing 28 authority in another jurisdiction, each recognizing that the 29 requirements for a license or certificate in this Commonwealth 30 and in the other jurisdiction are equivalent, issuing a license 19850S1158B1453 - 26 -
1 or certificate to an applicant who possesses a similar license 2 or certificate in the other jurisdiction. As used in this 3 section, the term "endorsement" means the issuance of a license 4 or certificate by the board to an applicant who does not meet 5 standard requirements, if the applicant has achieved cumulative 6 qualifications which are accepted by the board as being 7 equivalent to the standard requirements for the license or 8 certificate. 9 Section 29. License to practice medicine and surgery. 10 An individual is not qualified for a license to practice 11 medicine and surgery unless the individual has received an 12 academic degree in medicine and surgery from a medical college 13 and the individual satisfies the other qualifications for the 14 license contained in or authorized by this act. 15 Section 30. License without restriction. 16 (a) General rule.--A license without restriction empowers 17 the licensee to practice medicine and surgery without any 18 restriction or limitation. 19 (b) Graduates of accredited medical colleges.--No license 20 without restriction may be issued to a graduate of an approved 21 medical college unless the applicant has completed successfully 22 as a resident two years of approved graduate medical training. 23 (c) Graduates of unaccredited medical colleges.--No license 24 without restriction may be issued to a graduate of an unapproved 25 medical college unless the applicant has completed successfully 26 as a resident three years of approved graduate medical training, 27 educational requirements prescribed by the board and 28 certification by the Educational Council for Foreign Medical 29 Graduates, or its successors. 30 (d) Examinations.--The board shall hold at least two 19850S1158B1453 - 27 -
1 examinations for applicants for a license without restriction 2 each year. Special examinations may be designated by the board. 3 The examinations shall be held at such times and places as 4 designated by the board. In case of failure at any such 5 examination, the applicant shall have, after the expiration of 6 six months and within two years, the privilege of a second 7 examination by the board. In case of failure in a second 8 examination, or after the expiration of two years, the applicant 9 must thereafter successfully complete, as a resident, one year 10 of graduate medical training approved by the board, apply de 11 novo, and qualify under the conditions in existence at the time 12 of the application. 13 Section 31. License with restriction. 14 (a) General rule.--A license with restriction empowers the 15 licensee to practice medicine and surgery with such restrictions 16 or limitations as may be established by the board, including 17 restrictions in the scope of permitted practice, a requirement 18 that the applicant take one or more refresher educational 19 courses or mandated submission of medical care, counseling or 20 treatment. 21 (b) Prerequisite.--No license with restriction may by issued 22 unless the applicant has otherwise been issued, or is qualified 23 to be issued, a license without restriction in accordance with 24 this act. 25 (c) Disciplinary proceedings or voluntary request.--The 26 board may issue a license with restriction only upon completion 27 of disciplinary proceedings in accordance with this act or upon 28 a voluntary request of the applicant. 29 Section 32. Graduate license. 30 (a) General rule.--A graduate license empowers the licensee 19850S1158B1453 - 28 -
1 to participate for a period of up to 12 consecutive months in 2 graduate medical training within the complex of the hospital to 3 which the licensee is assigned. 4 (b) Requirements.--No graduate license may be issued unless 5 the applicant is a graduate of an accredited medical college or 6 an unaccredited medical college and has received a medical 7 degree. A graduate license may be issued to an applicant who 8 holds the equivalent of a license without restriction granted by 9 another state or territory of the United States or the Dominion 10 of Canada. 11 (c) Extensions; waivers.--The board may extend the validity 12 of a graduate license upon application when such action is 13 warranted. In the event a graduate license holder is issued a 14 license without restriction and wishes to continue graduate 15 medical training, the graduate license holder shall complete and 16 keep current a form satisfactory to the board containing 17 information desired by the board on the graduate medical 18 training program. A graduate of an unaccredited medical college, 19 who does not possess all of the qualifications for the issuance 20 of a graduate license but desires to train in a hospital within 21 this Commonwealth in an area of advanced medical training, may 22 have the unmet qualifications waived by the board if the board 23 determines that the applicant possesses the technical skills and 24 educational background to participate in such training and that 25 its issuance is beneficial to the health, safety and welfare of 26 the general public of this Commonwealth. 27 Section 33. Institutional license. 28 (a) General rule.--An institutional license empowers the 29 licensee to teach or practice medicine and surgery in one of the 30 medical colleges, affiliates or hospitals within this 19850S1158B1453 - 29 -
1 Commonwealth. 2 (b) Requirements.--No institutional license may be issued 3 unless the applicant: 4 (1) is a graduate of an unaccredited medical college who 5 has attained through professional growth and teaching 6 experience the status of teacher; or 7 (2) is not otherwise licensed to practice medicine and 8 surgery in this Commonwealth but has achieved outstanding 9 medical skills in a particular area of medicine and surgery 10 and wishes to practice, demonstrate or teach with those 11 outstanding medical skills. 12 (c) Determinations by the board.--The board shall issue an 13 institutional license only when it determines that its issuance 14 is beneficial to the health, safety and welfare of the general 15 public of this Commonwealth. A person granted an institutional 16 license who subsequently desires to obtain a license without 17 restriction shall be required to meet all of the requirements of 18 such license as set forth in this act. 19 Section 34. Temporary license. 20 (a) General rule.--A temporary license empowers the licensee 21 to: 22 (1) teach medicine and surgery or participate in a 23 medical procedure necessary for the well-being of a specified 24 patient within this Commonwealth; or 25 (2) practice medicine and surgery at a camp or resort 26 for no more than three months. 27 (b) Requirements.--No temporary license may be issued unless 28 the applicant holds the equivalent of a license without 29 restriction granted by another state, territory or country. 30 (c) Additional conditions.--The board may impose any 19850S1158B1453 - 30 -
1 appropriate limitation in scope, duration or site of practice on 2 the temporary license. Temporary licensees shall be deemed 3 health care providers who conduct 50% or less of their health 4 care business or practice within this Commonwealth for the 5 purposes of the act of October 15, 1975 (P.L.390, No.111), known 6 as the Health Care Services Malpractice Act. 7 Section 35. Extraterritorial license. 8 (a) General rule.--An extraterritorial license empowers the 9 licensee residing in or maintaining the office of practice in 10 any adjoining state near the boundary line between such state 11 and this Commonwealth, whose medical practice extends into this 12 Commonwealth, to practice medicine and surgery with or without 13 restriction in this Commonwealth on such patients. 14 (b) Requirements.--No extraterritorial license may be issued 15 unless the applicant holds the equivalent of a license without 16 restriction granted by a state adjoining this Commonwealth. 17 (c) Additional conditions.--An extraterritorial license may 18 be granted by the board so long as the board is provided with: 19 (1) An application for the license, which shall include 20 information on malpractice insurance coverage compliance. 21 (2) A copy of the current license in the state of 22 residence and primary practice certified by the authorized 23 licensing body of such state. 24 The exercise of the discretion of the board in granting such a 25 license will depend primarily upon the needs of patients in this 26 Commonwealth, the availability of medical care in the specific 27 area involved and whether the adjoining state of licensure 28 reciprocates by extending similar privileges to medical doctors 29 who reside and have their office of practice in this 30 Commonwealth. Such a license will be automatically revoked if 19850S1158B1453 - 31 -
1 such medical doctor relocates the office of practice or 2 residence. A medical doctor granted such a license has the duty 3 to inform the board of any changes in practice which may in any 4 way affect the maintenance of the license. 5 Section 36. Nurse-midwife certificate. 6 (a) General rule.--A nurse-midwife certificate empowers the 7 licensee to practice midwifery in this Commonwealth as provided 8 in this act. The board shall formulate and issue such rules and 9 regulations, from time to time, as may be necessary for the 10 examination, licensing and proper conduct of the practice of 11 midwifery. 12 (b) Requirements.--No nurse-midwife certificate will be 13 issued unless the applicant is a registered nurse licensed in 14 this Commonwealth. 15 (c) Examinations.--The board will conduct at least two 16 examinations each year. In the case of failure at the first 17 examination, the applicant shall have the privilege of a second 18 examination. In case of failure in the second examination, the 19 applicant shall apply de novo and qualify under the conditions 20 in force at the time of the third examination. No applicant will 21 be admitted to the examination who is unable to present, at the 22 time of application, evidence of a satisfactory course in 23 midwifery from an approved institution. 24 Section 37. Physician assistant certificate. 25 (a) General rule.--A physician assistant certificate 26 empowers the holder to assist a medical doctor in the provision 27 of medical care and services under the supervision and direction 28 of that medical doctor as provided in this act. 29 (b) Requirements.--No physician assistant certificate may be 30 issued to the applicant unless the requirements set forth by 19850S1158B1453 - 32 -
1 this act and such rules and regulations issued by the board are 2 met, including requirements for the physician assistant 3 certificate of training and educational programs which shall be 4 formulated by the board in accordance with such national 5 criteria as are established by national organizations or 6 societies as the board may accept. 7 (c) Criteria.--The board shall grant physician assistant 8 certificates to applicants who have fulfilled the following 9 criteria: 10 (1) Satisfactory performance on the proficiency 11 examination to the extent that a proficiency examination 12 exists. 13 (2) Satisfactory completion of a certified program for 14 the training and education of physician assistants. 15 (d) Biennial renewal.--A physician assistant certificate 16 shall be subject to biennial renewal by the board. 17 (e) Description of manner of assistance.--The application 18 shall include a written request from the applicant's supervising 19 medical doctor who shall file with the board a description of 20 the manner in which the physician assistant will assist the 21 supervising medical doctor, which description shall be subject 22 to the approval of the board. 23 Section 38. Reporting of multiple licensure. 24 Any licensed medical doctor in this Commonwealth who is also 25 licensed to practice medicine and surgery in any other state, 26 territory or country shall report this information to the board 27 on the biennial registration application. Any disciplinary 28 action taken in other states must be reported to the board on 29 the biennial registration application. Multiple licensure will 30 be noted on the medical doctor's record and such state, 19850S1158B1453 - 33 -
1 territory or country will be notified of any disciplinary 2 actions taken against said medical doctor in this Commonwealth. 3 Section 39. Injunctions against unlawful practice. 4 It shall be unlawful for any person to practice, or attempt 5 to offer to practice, medicine and surgery, as defined in this 6 act, without having at the time of so doing a valid, unexpired, 7 unrevoked and unsuspended license issued under this act. The 8 unlawful practice of medicine and surgery as defined in this act 9 may be enjoined by the courts on petition of the board or by the 10 commissioner. In any such proceeding it shall not be necessary 11 to show that any person is individually injured by the actions 12 complained of. If the respondent is found guilty of the unlawful 13 practice of medicine and surgery, the court shall enjoin him 14 from so practicing unless and until he has been duly licensed. 15 Procedure in such cases shall be the same as in any other 16 injunction suit. The remedy by injunction hereby given is in 17 addition to any other civil or criminal prosecution and 18 punishment. 19 Section 40. Penalties. 20 (a) General rule.--Any person, or the responsible officer or 21 employee of any corporation or partnership, institution or 22 association, violating any provisions of this act, or any rule 23 or regulation of the board commits of a misdemeanor of the third 24 degree and shall, upon conviction, be sentenced to pay a fine of 25 not more than $2,000 or to imprisonment for not more than six 26 months, or both, for the first violation. On the second and each 27 subsequent conviction, he or she shall be sentenced to pay a 28 fine of not less than $5,000 nor more than $20,000 or to 29 imprisonment for not less than six months nor more than one 30 year, or both. 19850S1158B1453 - 34 -
1 (b) Civil penalties.--In addition to any other civil remedy 2 or criminal penalty provided for in this act, the board, by a 3 vote of the majority of the maximum number of the authorized 4 membership of the board as provided by law, or by a vote of the 5 majority of the duly qualified and confirmed membership or a 6 minimum of four members, whichever is greater, may levy a civil 7 penalty of up to $1,000 on any current licensee who violates any 8 provision of this act or on any person who practices medicine or 9 other areas of practice regulated by the board without being 10 properly licensed or certificated to do so under this act. The 11 board shall levy this penalty only after affording the accused 12 party the opportunity for a hearing, as provided in Title 2 of 13 the Pennsylvania Consolidated Statutes (relating to 14 administrative law and procedure). The board shall, within six 15 months after the effective date of this act, adopt regulations 16 establishing guidelines setting forth the amounts and 17 circumstances for which a fine may be imposed. No fines may be 18 imposed in accordance with this subsection until the board has 19 adopted the required regulations. 20 Section 41. Temporary and automatic suspensions. 21 (a) Temporary suspensions.--A license or certificate issued 22 under this act may be temporarily suspended under circumstances 23 as determined by the board to be an immediate and clear danger 24 to the public health and safety. The board shall issue an order 25 to that effect without a hearing, but upon due notice, to the 26 licensee or certificate holder concerned at his or her last 27 known address, which shall include a written statement of all 28 allegations against the licensee or certificate holder. The 29 provisions of section 10 shall not apply to temporary 30 suspension. The board shall thereupon commence formal action to 19850S1158B1453 - 35 -
1 suspend, revoke and restrict the license or certificate of the 2 person concerned as otherwise provided for in this act. All 3 actions shall be taken promptly and without delay. Within 30 4 days following the issuance of an order temporarily suspending a 5 license, the board shall conduct or cause to be conducted, a 6 preliminary hearing to determine that there is a prima facie 7 case supporting the suspension. The licensee or certificate 8 holder whose license or certificate has been temporarily 9 suspended may be present at the preliminary hearing and may be 10 represented by council, cross-examine witnesses, inspect 11 physical evidence, call witnesses, offer evidence and testimony 12 and make a record of the proceedings. If it is determined that 13 there is not a prima facie case, the suspended license shall be 14 immediately restored. The temporary suspension shall remain in 15 effect until vacated by the board, but in no event longer than 16 180 days. 17 (b) Automatic suspensions.--A license or certificate issued 18 under this act shall automatically be suspended upon the legal 19 commitment to an institution of a licensee or certificate holder 20 because of mental incompetency from any cause upon filing with 21 the board a certified copy of such commitment, conviction of a 22 felony under the act of April 14, 1972 (P.L.233, No.64), known 23 as The Controlled Substance, Drug, Device and Cosmetic Act, or 24 conviction of an offense under the laws of another jurisdiction, 25 which if committed in this Commonwealth, would be a felony under 26 The Controlled Substance, Drug, Device and Cosmetic Act. As used 27 in this section the term "conviction" shall include a judgment, 28 an admission of guilt or a plea of nolo contendere. Automatic 29 suspension under this subsection shall not be stayed pending any 30 appeal of a conviction. Restoration of such license or 19850S1158B1453 - 36 -
1 certificate shall be made as hereinafter provided in the case of 2 revocation or suspension of such license or certificate. 3 Section 42. Reasons for refusal, revocation, suspension or 4 other corrective actions against a licensee or 5 certificate holder. 6 The board shall have authority to impose disciplinary or 7 corrective measures on a professional for any or all of the 8 following reasons: 9 (1) Failing to demonstrate the qualifications or 10 standards for a license, certification or registration 11 contained in this act, or regulations of the board. 12 (2) Making misleading, deceptive, untrue or fraudulent 13 representations in the practice of the profession or 14 practicing fraud or deceit, either alone or as a conspirator 15 in obtaining a license, certification or registration, or in 16 obtaining admission to a medical college. 17 (3) Being convicted of a felony, a misdemeanor relating 18 to a health profession, or receiving probation without 19 verdict, disposition in lieu of trial or an accelerated 20 rehabilitative disposition in the disposition of felony 21 charges, in the courts of this Commonwealth, a Federal court 22 or a court of any other state, territory or country. 23 (4) Having a license or other authorization to practice 24 the profession revoked or suspended or having other 25 disciplinary action taken, or an application for a license or 26 other authorization refused, revoked or suspended by a proper 27 licensing authority of another state, territory or country, 28 or a branch of the federal government. 29 (5) Being unable to practice the profession with 30 reasonable skill and safety to patients by reason of illness, 19850S1158B1453 - 37 -
1 addiction to drugs or alcohol, having been convicted of a 2 felonious act prohibited by the act of April 14, 1972 3 (P.L.233, No.64), known as The Controlled Substance, Drug, 4 Device and Cosmetic Act, or convicted of a felony relating to 5 a controlled substance in a court of law of the United States 6 or any other state, territory or country, or if he or she is 7 or shall become mentally incompetent. An applicant's 8 statement on the application declaring the absence of a 9 conviction shall be deemed satisfactory evidence of the 10 absence of a conviction unless the board has some evidence to 11 the contrary. In enforcing this paragraph, the board shall, 12 upon probable cause, have authority to compel a professional 13 to submit to a mental or physical examination by physicians 14 approved by the board. Failure of a professional to submit to 15 such examination when directed by the board, unless such 16 failure is due to circumstances beyond his or her control, 17 shall constitute an admission of the allegations against him 18 or her, consequent upon which a default and final order may 19 be entered without the taking of testimony or presentation of 20 evidence. A professional affected under this paragraph shall 21 at reasonable intervals be afforded an opportunity to 22 demonstrate that he or she can resume a competent practice of 23 his or her profession with reasonable skill and safety to 24 patients. 25 (6) Violating a lawful regulation promulgated by the 26 board or violating a lawful order of the board previously 27 entered by the board in a disciplinary proceeding. 28 (7) Knowingly maintaining a professional connection or 29 association with any person who is in violation of this act 30 or regulations of the board or knowingly aiding, assisting, 19850S1158B1453 - 38 -
1 procuring or advising any unlicensed person to practice a 2 profession contrary to this act, or regulations of the board. 3 (8) Being guilty of immoral or unprofessional conduct. 4 Unprofessional conduct shall include departure from or 5 failing to conform to an ethical or quality standard of the 6 profession. 7 (i) The ethical standards of a profession are those 8 ethical tenets which are embraced by the professional 9 community in this Commonwealth. 10 (ii) A professional departs from, or fails to 11 conform to, a quality standard of the profession when the 12 professional provides a medical service at a level 13 beneath the accepted standard of care. The board may 14 promulgate regulations which define the accepted standard 15 of care. In the event the board has not promulgated an 16 applicable regulation, the accepted standard of care for 17 a professional is that which would be normally exercised 18 by the average professional of the same kind in this 19 Commonwealth under the circumstances, including locality 20 and whether the professional is or purports to be a 21 specialist in the area. 22 (9) Acting is such manner as to present an immediate and 23 clear danger to publish health or safety. 24 (10) Acting outside the scope of a license or 25 certificate. 26 Section 43. Types of corrective action. 27 (a) Authorized actions.--When the board is empowered to take 28 disciplinary or corrective action against a professional under 29 the provisions of this act or pursuant to other statutory 30 authority, the board may: 19850S1158B1453 - 39 -
1 (1) Deny the application for a license, certificate or 2 any other privilege granted by the board. 3 (2) Administer a public reprimand with or without 4 probation. 5 (3) Administer a private reprimand with or without 6 probation. 7 (4) Revoke, suspend, limit or otherwise restrict a 8 license or certificate. 9 (5) Require the professional to submit to the care, 10 counseling or treatment of a physician or other health care 11 professional designated by the board. 12 (6) Require the professional to take refresher 13 educational courses. 14 (7) Suspend enforcement of any suspension, other than 15 that imposed in accordance with section 42, or revocation and 16 place a professional on probation with the right to vacate 17 the probationary order from noncompliance. 18 (8) Impose a monetary penalty in accordance with this 19 act. 20 (b) Failure to comply with conditions.--Failure of a 21 professional to comply with conditions set forth by the board 22 shall be grounds for reconsideration of the matter and 23 institution of formal charges against the licensee or 24 certificate holder. 25 Section 44. Reinstatement of license, certificate or 26 registration. 27 Unless ordered to do so by Commonwealth Court or an appeal 28 therefrom, the board shall not reinstate the license, 29 certificate or registration of a person to practice medicine 30 pursuant to this act which has been revoked. Any person whose 19850S1158B1453 - 40 -
1 license, certificate or registration has been revoked may apply 2 for reinstatement, after a period of at least five years, but 3 must meet all of the licensing qualifications of this act for 4 the license applied for, to include the examination requirement, 5 if he or she desires to practice at any time after such 6 revocation. 7 Section 45. Surrender of suspended or revoked license. 8 The board shall require a person whose license, certificate 9 or registration has been suspended or revoked to return, in such 10 manner as the board directs, the license, certificate or 11 registration. A person who fails to do so commits a misdemeanor 12 of the third degree. 13 Section 46. Reestablishment. 14 This act, with respect to the State Board of Medical 15 Education and Licensure, shall constitute the legislation 16 required to reestablish an agency pursuant to the act of 17 December 22, 1981 (P.L.508, No.142), known as the Sunset Act. 18 Section 47. Severability. 19 The provisions of this act are severable. If any provision of 20 this act or its application to any person or circumstance is 21 held invalid, the invalidity shall not affect other provisions 22 or applications of this act which can be given effect without 23 the invalid provision or application. 24 Section 48. Repeals. 25 (a) Repeals.--Section 412 of the Act of April 9, 1929 26 (P.L.177, No.175), know as The Administrative Code of 1929, is 27 repealed. 28 (b) The act of July 20, 1974 (P.L.551, No.190), known as the 29 Medical Practice Act of 1974, is repealed. 30 (c) All other acts and parts of acts are repealed insofar as 19850S1158B1453 - 41 -
1 they are inconsistent with this act. 2 Section 48. Applicability of Act. 3 (a) General rule.--The provisions of this act shall not 4 apply either directly or indirectly, by intent or purpose, to 5 affect the practice of: 6 (1) Chiropractic, as authorized by the act of August 10, 7 1951 (P.L.1182, No.264), known as the Chiropractic 8 Registration Act of 1951. 9 (2) Dentistry, as authorized by the act of May 1, 1933 10 (P.L.216, No.76), known as The Dental Law. 11 (3) Optometry, as authorized by the act of June 6, 1980 12 (P.L.197, No.57), known as the Optometric Practice and 13 Licensure Act. 14 (4) Osteopathy, as authorized by the act of October 5, 15 1978 (P.L.1109, No.261), known as the Osteopathic Medical 16 Practice Act. 17 (5) Pharmacy, as authorized by the acts of April 14, 18 1972 (P.L.233, No.64), known as The Controlled Substance, 19 Drug, Device and Cosmetic Act, and September 27, 1961 20 (P.L.1700, No.699), known as the Pharmacy Act. 21 (6) Physical Therapy, as authorized by the act of 22 October 10, 1975 (P.L.383, No.110), known as the Physical 23 Therapy Practice Act. 24 (7) Podiatry, as authorized by the act of March 2, 1956 25 (P.L.1206, No.375), known as the Podiatry Act of 1956. 26 (8) Professional Nursing, as authorized by the act of 27 May 22, 1951 (P.L.317, No.69), known as The Professional 28 Nursing Law. 29 (9) Psychologists, as authorized by the act of March 23, 30 1972 (P.L.136, No.52), referred to as the Psychologists 19850S1158B1453 - 42 -
1 License Act. 2 (b) Exemption.--This act shall not be construed so as to 3 give the Board of Medicine any jurisdiction over any of the 4 schools or colleges of the methods exempted in this section. 5 (c) No application to practice of hypnosis.--The provisions 6 of this act shall not apply either directly or indirectly, by 7 intent or purpose, to the practice of hypnosis. 8 Section 50. Existing board. 9 The presently confirmed members of the State Board of Medical 10 Education and Licensure constituted under section 412 of the act 11 of April 9, 1929 (P.L.177, No.175), known as The Administrative 12 Code of 1929, as of December 31, 1985, shall continue to serve 13 as board members until their present terms of office expire. 14 Section 51. Existing rules and regulations. 15 Each rule and regulation of the board in effect on December 16 31, 1985, not inconsistent with this act, shall remain in effect 17 after such date until repealed or amended by the board. 18 Section 52. Existing licenses, certificates and registrations. 19 Any person who holds a valid license, certificate or 20 registration issued by the State Board of Medical Education and 21 Licensure under the act of July 20, 1974 (P.L.551, No.190), 22 known as the Medical Practice Act of 1974, relating to the 23 practice of medicine, prior to the effective date of this act 24 shall, on and after the effective date hereof, be deemed 25 licensed, certificated or registered by the State Board of 26 Medicine as provided for in this act. 27 Section 53. Effective date. 28 This act shall take effect January 1, 1986. J10L63CHF/19850S1158B1453 - 43 -