HOUSE AMENDED
        PRIOR PRINTER'S NOS. 1453, 1513, 1605,        PRINTER'S NO. 1682
        1608

THE GENERAL ASSEMBLY OF PENNSYLVANIA


SENATE BILL

No. 1158 Session of 1985


        INTRODUCED BY BELL, OCTOBER 16, 1985

        AS REPORTED FROM COMMITTEE ON PROFESSIONAL LICENSURE, HOUSE OF
           REPRESENTATIVES, AS AMENDED, DECEMBER 9, 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
     6     certificates and the suspension and revocation of licenses
     7     and certificates; providing penalties; 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.  Regulatory powers of the board.
    17  Section 9.  Procedure, oaths and subpoenas.
    18  Section 10.  Unauthorized practice of medicine and surgery.


     1  Section 11.  Clinical clerks.
     2  Section 12.  Midwifery.
     3  Section 13.  Physician assistants.
     4  Section 14.  Drugless therapist.
     5  Section 15.  Certified registered nurse practitioner.
     6  Section 16.  Consultation.
     7  Section 17.  Delegation of duties to health care practitioner or
     8                 technician.
     9  Section 18.  Federal medical personnel.
    10  Section 19.  Osteopathic act.
    11  Section 20.  Other health care practitioners.
    12  Section 21.  Acts outside nonphysician license or certificate.
    13  Section 22.  Licenses and certificates; general qualification.
    14  Section 23.  Standards for medical training facilities.
    15  Section 24.  Examinations.
    16  Section 25.  Licenses and certificates; biennial registration.
    17  Section 26.  Certification of license or certificate.
    18  Section 27.  Reciprocity or endorsement.
    19  Section 28.  License to practice medicine and surgery.
    20  Section 29.  License without restriction.
    21  Section 30.  License with restriction. INTERIM LIMITED LICENSE.   <--
    22  Section 31.  Graduate license.
    23  Section 32.  Institutional license.
    24  Section 33.  Temporary license.
    25  Section 34.  Extraterritorial license.
    26  Section 35.  Nurse-midwife license.
    27  Section 36.  Physician assistant certificate.
    28  Section 37.  Reporting of multiple licensure.
    29  Section 38.  Injunctions against unlawful practice.
    30  Section 39.  Penalties.
    19850S1158B1682                  - 2 -

     1  Section 40.  Temporary and automatic suspensions.
     2  Section 41.  Reasons for refusal, revocation, suspension or
     3                 other corrective actions against a licensee or
     4                 certificate holder.
     5  Section 42.  Types of corrective action.
     6  Section 43.  Reinstatement of license, certificate or
     7                 registration.
     8  Section 44.  Surrender of suspended or revoked license,           <--
     9                 CERTIFICATE OR REGISTRATION.
    10  SECTION 45.  RADIOLOGIC PROCEDURES; EDUCATION AND TRAINING        <--
    11                 REQUIRED.
    12  Section 45 46.  Reestablishment.                                  <--
    13  Section 46 47.  Severability.                                     <--
    14  Section 47 48.  Repeals.                                          <--
    15  Section 48 49.  Applicability of act.                             <--
    16  Section 49 50.  Existing board.                                   <--
    17  Section 50 51.  Existing rules and regulations.                   <--
    18  Section 51 52.  Existing licenses, certificates and               <--
    19                 registrations.
    20  Section 52 53.  Effective date.                                   <--
    21     The General Assembly of the Commonwealth of Pennsylvania
    22  hereby enacts as follows:
    23  Section 1.  Short title.
    24     This act shall be known and may be cited as the Medical
    25  Practice Act of 1985.
    26  Section 2.  Definitions.
    27     The following words and phrases when used in this act shall
    28  have the meanings given to them in this section unless the
    29  context clearly indicates otherwise:
    30     "Accredited medical college."  An institution of higher
    19850S1158B1682                  - 3 -

     1  learning which has been fully accredited by the Association of
     2  American Medical Colleges, its successors or assigns, or the
     3  American Medical Association, either directly or through their
     4  respective accrediting bodies, as an agency to provide courses
     5  in the art and science of medicine and surgery and empowered to
     6  grant Academic Degrees in Medicine.
     7     "Affiliate."  A member of a group of two or more medical
     8  training facilities legally united by an agreement of
     9  affiliation, approved by the board and formed to enhance the
    10  potential of all participants in the provision of health care
    11  and medical education.
    12     "Applicant."  An applicant for any license or certificate
    13  issued by the board.
    14     "Board."  The State Board of Medicine.
    15     "Board regulated practitioner."  A medical doctor, midwife,
    16  physician assistant, drugless therapist, or an applicant for a
    17  license or certificate the board may issue.
    18     "Clinical clerk."  An undergraduate student in good standing
    19  in an accredited medical college who is assigned to provide
    20  medical services in a hospital by the medical college and the
    21  hospital.
    22     "Commissioner."  The Commissioner of Professional and
    23  Occupational Affairs in the Department of State.
    24     CONVICTION."  A JUDGMENT OF GUILT, AN ADMISSION OF GUILT, OR   <--
    25  A PLEA OF NOLO CONTENDERE.
    26     "Doctor of osteopathy or osteopathic doctor."  An individual
    27  licensed to practice osteopathic medicine and surgery by the
    28  State Board of Osteopathic Medical Examiners.
    29     "Graduate medical training."  Training approved or recognized
    30  by the board which is either:
    19850S1158B1682                  - 4 -

     1         (1)  accredited as graduate medical education by the
     2     Accreditation Council for Graduate Medical Education or by
     3     any other accrediting body recognized by the board for the
     4     purpose of accrediting graduate medical education; or
     5         (2)  provided by a hospital accredited by the Joint
     6     Commission on Accreditation of Hospitals, its successors or
     7     assigns, and is acceptable to an American specialty board
     8     towards the training it requires for the certification it
     9     issues in a medical specialty or subspecialty.
    10     "Healing arts."  The science and skill of diagnosis and
    11  treatment in any manner whatsoever of disease or any ailment of
    12  the human body.
    13     "Health care practitioner."  An individual, other than a
    14  physician assistant, who is authorized to practice some
    15  component of the healing arts by a license, permit, certificate
    16  or registration issued by a Commonwealth licensing agency or
    17  board.
    18     "Hospital."  An institution licensed or regulated as a
    19  hospital by the Department of Health or the Department of Public
    20  Welfare or a facility owned or operated by the Federal
    21  Government and accredited by the Joint Commission on
    22  Accreditation of Hospitals as a hospital.
    23     "Medical doctor."  An individual who has acquired one of the
    24  following licenses to practice medicine and surgery issued by
    25  the board:
    26         (1)  License without restriction.
    27         (2)  License with restriction INTERIM LIMITED LICENSE.     <--
    28         (3)  Graduate license.
    29         (4)  Institutional license.
    30         (5)  Temporary license.
    19850S1158B1682                  - 5 -

     1         (6)  Extraterritorial license.
     2     "Medical service."  Activity which lies within the scope of
     3  the practice of medicine and surgery.
     4     "Medical training facility."  A medical college, hospital or
     5  other institution which provides courses in the art and science
     6  of medicine and surgery and related subjects for the purpose of
     7  enabling a matriculant to qualify for a license or TO practice    <--
     8  medicine and surgery, graduate medical training, midwife
     9  certificate or physician assistant certificate.
    10     "Medicine and surgery."  The art and science of which the
    11  objectives are the cure of diseases and the preservation of the
    12  health of man, including the practice of the healing art with or
    13  without drugs, except healing by spiritual means or prayer.
    14     "Midwife or nurse-midwife."  An individual who is licensed as
    15  a midwife by the board.
    16     "Physician."  A medical doctor or doctor of osteopathy.
    17     "Physician assistant."  An individual who is certified as a
    18  physician assistant by the board.
    19     "Resident."  A medical doctor who is participating in
    20  graduate training.
    21     "Technician."  A person, other than a health care
    22  practitioner or physician assistant, who through training,
    23  education or experience has achieved expertise in the technical
    24  details of a subject or occupation which is a component of the
    25  healing art.
    26     "Unaccredited medical college."  An institution of higher
    27  learning which provides courses in the art and science of
    28  medicine and surgery and related subjects, is empowered to grant
    29  professional degrees in medicine, is not accredited by the
    30  Association of American Medical Colleges, its successors or
    19850S1158B1682                  - 6 -

     1  assigns, or the American Medical Association, either directly or
     2  through their respective accrediting bodies, and is listed by
     3  the World Health Organization, its successors or assigns, or is
     4  otherwise recognized as a medical college by the country in
     5  which it is situated.
     6  Section 3.  State Board of Medicine.
     7     (a)  Establishment.--The State Board of Medicine shall
     8  consist of the commissioner, the Secretary of Health, two
     9  members appointed by the Governor who shall be persons
    10  representing the public at large and seven members appointed by
    11  the Governor, six of whom shall be medical doctors with
    12  unrestricted licenses to practice medicine and surgery in this
    13  Commonwealth for five years immediately preceding their
    14  appointment, and one who shall be a nurse midwife, physician
    15  assistant or certified registered nurse practitioner licensed or
    16  certified under the laws of this Commonwealth. ALL PROFESSIONAL   <--
    17  AND PUBLIC MEMBERS OF THE BOARD SHALL BE APPOINTED BY THE
    18  GOVERNOR, WITH THE ADVICE AND CONSENT OF A MAJORITY OF THE
    19  MEMBERS ELECTED TO THE SENATE.
    20     (b)  Terms of office.--The term of each professional and
    21  public member of the board shall be four years or until his or
    22  her successor has been appointed and qualified, but not longer
    23  than six months beyond the four-year period. In the event that
    24  any of said members shall die or resign or otherwise becomes      <--
    25  BECOME disqualified during his or her term, a successor shall be  <--
    26  appointed in the same way and with the same qualifications and
    27  shall hold office for the unexpired term. No member shall be
    28  eligible for appointment to serve more than two consecutive
    29  terms. THE GOVERNOR SHALL ASSURE THAT NURSE MIDWIVES, PHYSICIAN   <--
    30  ASSISTANTS, AND CERTIFIED REGISTERED NURSE PRACTITIONERS ARE
    19850S1158B1682                  - 7 -

     1  APPOINTED TO FOUR-YEAR TERMS ON A ROTATING BASIS SO THAT OF
     2  EVERY THREE APPOINTMENTS TO A FOUR-YEAR TERM, ONE IS A NURSE
     3  MIDWIFE, ONE IS A PHYSICIAN ASSISTANT, AND ONE IS A CERTIFIED
     4  REGISTERED NURSE PRACTITIONER.
     5     (c)  Quorum.--A majority of the members of the board serving
     6  in accordance with law shall constitute a quorum for purposes of
     7  conducting the business of the board. Except for temporary and
     8  automatic suspensions under section 40, a member may not be
     9  counted as part of a quorum or vote on any issue unless he or
    10  she is physically in attendance at the meeting.
    11     (d)  Chairman.--The board shall select annually a chairman
    12  from among its professional members.                              <--
    13     (e)  Compensation.--Each member of the board, except the
    14  commissioner and the Secretary of Health, shall receive $60 per
    15  diem when actually attending to the work of the board. Members
    16  shall also receive the amount of reasonable traveling, hotel and
    17  other necessary expenses incurred in the performance of their
    18  duties in accordance with Commonwealth regulations.
    19     (f)  Sunset.--The board is subject to evaluation, review and
    20  termination in the manner provided in the act of December 22,
    21  1981 (P.L.508, No.142), known as the Sunset Act.
    22     (g)  Attendance at meetings.--A member of the board who fails
    23  to attend three consecutive meetings shall forfeit his or her
    24  seat unless the commissioner, upon written request from the
    25  member, finds that the member should be excused from a meeting
    26  because of illness or the death of a family member.
    27     (h)  Attendance at training seminars.--A public member who
    28  fails to attend two consecutive statutorily mandated training
    29  seminars in accordance with section 813(e) of the act of April
    30  9, 1929 (P.L.177, No.175), known as The Administrative Code of
    19850S1158B1682                  - 8 -

     1  1929, shall forfeit his or her seat unless the commissioner,
     2  upon written request from the public member, finds that the
     3  public member should be excused from a meeting because of
     4  illness or the death of a family member.
     5     (i)  Meetings.--The board shall meet at least once every two
     6  months, and at such additional times as may be necessary to
     7  conduct the business of the board.
     8     (j)  Executive secretary.--The board, with the approval of
     9  the commissioner, shall appoint and fix the compensation of an
    10  executive secretary who shall be responsible for the day-to-day
    11  operation of the board and administration of board activities.
    12  Section 4.  Impaired professionals.
    13     (a)  Appointment of Disciplinary Advisory Committee.--The      <--
    14  board, with the approval of the commissioner, shall appoint a
    15  Disciplinary Advisory Committee composed of three medical
    16  doctors, not members of the board, who shall be compensated at
    17  the same rate as members of the board and who shall receive the
    18  amount of reasonable traveling, hotel and other necessary
    19  expenses incurred in the performance of their duties in
    20  accordance with Commonwealth regulations.
    21     (b)  Recommendations involving potential disciplinary
    22  actions.--The board may refer to the committee cases involving
    23  potential disciplinary actions under this act. Upon such
    24  referral, the committee shall review the case and make
    25  recommendations to the board within such time as the board shall
    26  designate; provided, that once the committee has accepted an
    27  impaired professional in an approved treatment program in
    28  accordance with this section, the committee may not thereafter
    29  accept referral of a disciplinary case regarding that individual
    30  from the board.
    19850S1158B1682                  - 9 -

     1     (c)  Liaison.--The committee shall act as a liaison between
     2  the board and treatment programs, such as alcohol and drug
     3  treatment programs licensed by the Department of Health,
     4  psychological counseling and impaired professional support
     5  groups, which are approved by the board and which provide
     6  services to licensees or certificate holders under this act.
     7     (d)  Review of corrective action by the board.--The board may
     8  defer and ultimately dismiss any of the types of corrective
     9  action set forth in this act for an impaired professional so
    10  long as the professional is progressing satisfactorily in an
    11  approved treatment program, provided that the provisions of this
    12  subsection shall not apply to a professional convicted of a
    13  felonious act prohibited by the act of April 14, 1972 (P.L.233,
    14  No.64), known as The Controlled Substance, Drug, Device and
    15  Cosmetic Act, or the conviction of a felony relating to a
    16  controlled substance in a court of law of the United States or
    17  any other state, territory or country. An approved program
    18  provider shall, upon request, disclose to the Disciplinary
    19  Advisory Committee all information in its possession regarding
    20  an impaired professional in treatment.
    21     (e)  Voluntary suspension or limitation.--An impaired
    22  professional who enrolls in an approved treatment program shall,
    23  if necessary, agree to a limitation of his or her ability to
    24  practice. Failure to do so disqualifies the professional from
    25  the impaired professional program and shall activate an
    26  immediate investigation and disciplinary proceeding by the
    27  board.
    28     (f)  Failure to satisfactorily progress.--If, in the opinion
    29  of the committee after consultation with the provider, an
    30  impaired professional who is enrolled in an approved treatment
    19850S1158B1682                 - 10 -

     1  has not progressed satisfactorily, the committee shall disclose
     2  to the board all information in its possession regarding the
     3  professional; and such disclosure shall constitute the basis for
     4  instituting proceedings to suspend or revoke the license or
     5  certificate of said professional.
     6     (g)  Immunity.--An approved program provider who makes a
     7  disclosure pursuant to this subsection shall not be subject to
     8  civil liability for such disclosure or its consequences.
     9     (h)  Reports to the board.--Any hospital or health care
    10  facility, peer or colleague who knows or has evidence to suspect
    11  a professional has an addictive disease, is diverting a
    12  controlled substance, or is mentally or physically incompetent
    13  to carry out the duties of his or her license or certificate,
    14  shall make, or cause to be made, a report to the board: Provided
    15  that any person or facility who acts in a treatment capacity to
    16  an impaired professional in an approved treatment program is
    17  exempt from the mandatory reporting requirements of this
    18  subsection. Any person or facility who reports pursuant to this
    19  section in good faith and without malice shall be immune from
    20  any civil or criminal liability arising from such report.
    21  Failure to provide such report within a reasonable time from
    22  receipt of knowledge of impairment shall subject the person or
    23  facility to a fine not to exceed $1,000. The board shall levy
    24  this penalty only after affording the accused party the
    25  opportunity for a hearing, as provided in Title 2 of the
    26  Pennsylvania Consolidated Statutes (relating to administrative
    27  law and procedure).
    28     (A)  CONSULTANTS.--THE BOARD, WITH THE APPROVAL OF THE         <--
    29  COMMISSIONER, SHALL APPOINT AND FIX THE COMPENSATION OF A
    30  PROFESSIONAL CONSULTANT WHO IS A LICENSEE OF THE BOARD, OR SUCH
    19850S1158B1682                 - 11 -

     1  OTHER PROFESSIONAL AS THE BOARD MAY DETERMINE, WITH EDUCATION
     2  AND EXPERIENCE IN THE IDENTIFICATION, TREATMENT AND
     3  REHABILITATION OF PERSONS WITH PHYSICAL OR MENTAL IMPAIRMENTS.
     4  SUCH CONSULTANT SHALL BE ACCOUNTABLE TO THE BOARD AND SHALL ACT
     5  AS A LIAISON BETWEEN THE BOARD AND TREATMENT PROGRAMS, SUCH AS
     6  ALCOHOL AND DRUG TREATMENT PROGRAMS LICENSED BY THE DEPARTMENT
     7  OF HEALTH, PSYCHOLOGICAL COUNSELING AND IMPAIRED PROFESSIONAL
     8  SUPPORT GROUPS, WHICH ARE APPROVED BY THE BOARD AND WHICH
     9  PROVIDE SERVICES TO LICENSEES UNDER THIS ACT.
    10     (B)  ELIGIBILITY AND DISCLOSURE.--THE BOARD MAY DEFER AND
    11  ULTIMATELY DISMISS ANY OF THE TYPES OF CORRECTIVE ACTION SET
    12  FORTH IN THIS ACT FOR AN IMPAIRED PROFESSIONAL SO LONG AS THE
    13  PROFESSIONAL IS PROGRESSING SATISFACTORILY IN AN APPROVED
    14  TREATMENT PROGRAM, PROVIDED THAT THE PROVISIONS OF THIS
    15  SUBSECTION SHALL NOT APPLY TO A PROFESSIONAL CONVICTED OF A
    16  FELONIOUS ACT PROHIBITED BY THE ACT OF APRIL 14, 1972 (P.L.233,
    17  NO.64), KNOWN AS THE CONTROLLED SUBSTANCE, DRUG, DEVICE AND
    18  COSMETIC ACT, OR CONVICTED OF A FELONY RELATING TO A CONTROLLED
    19  SUBSTANCE IN A COURT OF LAW OF THE UNITED STATES OR ANY OTHER
    20  STATE, TERRITORY OR COUNTRY. AN APPROVED PROGRAM PROVIDER SHALL,
    21  UPON REQUEST, DISCLOSE TO THE CONSULTANT SUCH INFORMATION IN ITS
    22  POSSESSION REGARDING AN IMPAIRED PROFESSIONAL IN TREATMENT WHICH
    23  THE PROGRAM PROVIDER IS NOT PROHIBITED FROM DISCLOSING BY AN ACT
    24  OF THIS COMMONWEALTH, ANOTHER STATE, OR THE UNITED STATES. SUCH
    25  REQUIREMENT OF DISCLOSURE BY AN APPROVED PROGRAM PROVIDER SHALL
    26  APPLY IN THE CASE OF IMPAIRED PROFESSIONALS WHO ENTER INTO AN
    27  AGREEMENT IN ACCORDANCE WITH THIS SECTION, IMPAIRED
    28  PROFESSIONALS WHO ARE THE SUBJECT OF A BOARD INVESTIGATION OR
    29  DISCIPLINARY PROCEEDING, AND IMPAIRED PROFESSIONALS WHO
    30  VOLUNTARILY ENTER A TREATMENT PROGRAM OTHER THAN UNDER THE
    19850S1158B1682                 - 12 -

     1  PROVISIONS OF THIS SECTION BUT WHO FAIL TO COMPLETE THE PROGRAM
     2  SUCCESSFULLY OR TO ADHERE TO AN AFTERCARE PLAN DEVELOPED BY THE
     3  PROGRAM PROVIDER.
     4     (C)  AGREEMENT WITH BOARD.--AN IMPAIRED PROFESSIONAL WHO
     5  ENROLLS IN AN APPROVED TREATMENT PROGRAM SHALL ENTER INTO AN
     6  AGREEMENT WITH THE BOARD UNDER WHICH THE PROFESSIONAL'S LICENSE
     7  SHALL BE SUSPENDED OR REVOKED BUT ENFORCEMENT OF THAT SUSPENSION
     8  OR A REVOCATION MAY BE STAYED FOR THE LENGTH OF TIME THE
     9  PROFESSIONAL REMAINS IN THE PROGRAM AND MAKES SATISFACTORY
    10  PROGRESS, COMPLIES WITH THE TERMS OF THE AGREEMENT AND ADHERES
    11  TO ANY LIMITATIONS ON HIS PRACTICE IMPOSED BY THE BOARD TO
    12  PROTECT THE PUBLIC. FAILURE TO ENTER INTO SUCH AN AGREEMENT
    13  SHALL DISQUALIFY THE PROFESSIONAL FROM THE IMPAIRED PROFESSIONAL
    14  PROGRAM AND SHALL ACTIVATE AN IMMEDIATE INVESTIGATION AND
    15  DISCIPLINARY PROCEEDING BY THE BOARD.
    16     (D)  DISCIPLINARY ACTION.--IF, IN THE OPINION OF THE
    17  CONSULTANT AFTER CONSULTATION WITH THE PROVIDER, AN IMPAIRED
    18  PROFESSIONAL WHO IS ENROLLED IN AN APPROVED TREATMENT PROGRAM
    19  HAS NOT PROGRESSED SATISFACTORILY, THE CONSULTANT SHALL DISCLOSE
    20  TO THE BOARD ALL INFORMATION IN HIS POSSESSION REGARDING SAID
    21  PROFESSIONAL, AND THE BOARD SHALL INSTITUTE PROCEEDINGS TO
    22  DETERMINE IF THE STAY OF THE ENFORCEMENT OF THE SUSPENSION OR
    23  REVOCATION OF THE IMPAIRED PROFESSIONAL'S LICENSE SHALL BE
    24  VACATED.
    25     (E)  IMMUNITY.--AN APPROVED PROGRAM PROVIDER WHO MAKES A
    26  DISCLOSURE PURSUANT TO THIS SECTION SHALL NOT BE SUBJECT TO
    27  CIVIL LIABILITY FOR SUCH DISCLOSURE OR ITS CONSEQUENCES.
    28     (F)  REPORTS TO THE BOARD.--ANY HOSPITAL OR HEALTH CARE
    29  FACILITY, PEER OR COLLEAGUE WHO HAS SUBSTANTIAL EVIDENCE THAT A
    30  PROFESSIONAL HAS AN ACTIVE ADDICTIVE DISEASE FOR WHICH THE
    19850S1158B1682                 - 13 -

     1  PROFESSIONAL IS NOT RECEIVING TREATMENT, IS DIVERTING A
     2  CONTROLLED SUBSTANCE OR IS MENTALLY OR PHYSICALLY INCOMPETENT TO
     3  CARRY OUT THE DUTIES OF HIS OR HER LICENSE SHALL MAKE OR CAUSE
     4  TO BE MADE A REPORT TO THE BOARD: PROVIDED, THAT ANY PERSON OR
     5  FACILITY WHO ACTS IN A TREATMENT CAPACITY TO AN IMPAIRED
     6  PHYSICIAN IN AN APPROVED TREATMENT PROGRAM IS EXEMPT FROM THE
     7  MANDATORY REPORTING REQUIREMENTS OF THIS SUBSECTION. ANY PERSON
     8  OR FACILITY WHO REPORTS PURSUANT TO THIS SECTION IN GOOD FAITH
     9  AND WITHOUT MALICE SHALL BE IMMUNE FROM ANY CIVIL OR CRIMINAL
    10  LIABILITY ARISING FROM SUCH REPORT. FAILURE TO PROVIDE SUCH
    11  REPORT WITHIN A REASONABLE TIME FROM RECEIPT OF KNOWLEDGE OF
    12  IMPAIRMENT SHALL SUBJECT THE PERSON OR FACILITY TO A FINE NOT TO
    13  EXCEED $1,000. THE BOARD SHALL LEVY THIS PENALTY ONLY AFTER
    14  AFFORDING THE ACCUSED PARTY THE OPPORTUNITY FOR A HEARING, AS
    15  PROVIDED IN TITLE 2 OF THE PENNSYLVANIA CONSOLIDATED STATUTES
    16  (RELATING TO ADMINISTRATIVE LAW AND PROCEDURE).
    17  Section 5.  Consultants.
    18     The board shall establish consultant panels or use             <--
    19  individual, WITH THE APPROVAL OF THE COMMISSIONER, MAY USE        <--
    20  consultants, as it deems appropriate, to assist it in carrying
    21  out its responsibilities. The board may not delegate any of its
    22  final decisionmaking responsibilities to a consultant or panel
    23  of consultants.
    24  Section 6.  Fees, fines and civil penalties.
    25     (a)  Setting of fees.--All fees required under this act shall
    26  be fixed by the board by regulation and shall be subject to the
    27  act of June 25, 1982 (P.L.633, No.181), known as the Regulatory
    28  Review Act. If the revenues raised by fees, fines and civil
    29  penalties imposed under this act are not sufficient to meet
    30  expenditures over a two-year period, the board shall increase
    19850S1158B1682                 - 14 -

     1  those fees by regulation so that the projected revenues will
     2  meet or exceed projected expenditures.
     3     (b)  Inadequate fees.--If the Bureau of Professional and
     4  Occupational Affairs determines that the fees established by the
     5  board under subsection (a) are inadequate to meet the minimum
     6  enforcement efforts required by this act, then the bureau after
     7  consultation with the board and subject to the Regulatory Review
     8  Act, shall increase the fees by regulation in an amount that
     9  adequate revenues are raised to meet the required enforcement
    10  effort.
    11     (c)  Disposition.--All fees, fines and civil penalties
    12  imposed in accordance with this act and collected in accordance
    13  with section 907(a) of the act of October 15, 1975 (P.L.390,
    14  No.111), known as the Health Care Services Malpractice Act,
    15  along with any interest generated thereby, shall be for the       <--
    16  exclusive use by OF the board in carrying out the provisions of   <--
    17  this act, and shall be annually appropriated for that purpose.
    18     (d)  Charging of fees.--The board may charge a reasonable
    19  fee, as set by the board by regulation, for all examinations,
    20  registrations, certificates, licensures or applications
    21  permitted by this act or the regulations thereunder.
    22  Section 7.  Reports of the board.
    23     (a)  Reports to Department of State.--The board shall submit
    24  annually to the Department of State an estimate of the financial
    25  requirements of the board for its administrative, investigative,
    26  legal and miscellaneous expenses.
    27     (b)  Reports to House and Senate Appropriations Committees.--
    28  The board shall submit annually to the House and Senate
    29  Appropriations Committees, 15 days after the Governor has
    30  submitted his budget to the General Assembly, a copy of the
    19850S1158B1682                 - 15 -

     1  budget request for the upcoming fiscal year which the board
     2  previously submitted to the department.
     3     (c)  Reports to other House and Senate committees.--The board
     4  shall submit annually a report to the Professional Licensure
     5  Committee of the House of Representatives and to the Consumer
     6  Protection and Professional Licensure Committee of the Senate
     7  CONTAINING a description of the types of complaints received,     <--
     8  status of cases, board action which has been taken and the
     9  length of time from the initial complaint to final board
    10  resolution. The report shall also include a statement of the
    11  numbers and types of licenses granted and a statement on
    12  physician assistant use in this Commonwealth, including
    13  geographic location and practice settings.
    14  Section 8.  Regulatory powers of the board.
    15     The board, in the exercise of its duties under this act,
    16  shall have the power to adopt such regulations as are reasonably
    17  necessary to carry out the purposes of this act. Regulations
    18  shall be adopted in conformity with the provisions of the act of
    19  July 31, 1968 (P.L.769, No.240), referred to as the Commonwealth
    20  Documents Law, and the act of June 25, 1982 (P.L.633, No.181),
    21  known as the Regulatory Review Act.
    22  Section 9.  Procedure, oaths and subpoenas.
    23     (a)  All actions of the board.--All actions of the board
    24  shall be taken subject to the right of notice, hearing and
    25  adjudication, and the right of appeal therefrom, in accordance
    26  with the provisions in Title 2 of the Pennsylvania Consolidated
    27  Statutes (relating to administrative law and procedure).
    28     (b)  Disciplinary proceedings.--All disciplinary proceedings
    29  conducted by hearing examiners shall be conducted in accordance
    30  with sections 901 through 905 of the act of October 15, 1975
    19850S1158B1682                 - 16 -

     1  (P.L.390, No.111), known as the Health Care Services Malpractice
     2  Act.
     3     (c)  Subpoena power.--The board shall have the authority to
     4  issue subpoenas, upon application of an attorney responsible for
     5  representing the Commonwealth in disciplinary matters before the
     6  board, for the purpose of investigating alleged violations of
     7  the disciplinary provisions administered by the board. The board
     8  shall have the power to subpoena witnesses, to administer oaths,
     9  to examine witnesses or AND to take testimony or compel the       <--
    10  production of books, records, papers and documents as it may
    11  deem necessary or proper in and pertinent to any proceeding,
    12  investigation or hearing held by it. Medical records may not be
    13  subpoenaed without consent of the patient or without order of a
    14  court of competent jurisdiction on a showing that the records
    15  are reasonably necessary for the conduct of the investigation.
    16  The court may impose such limitations on the scope of the
    17  subpoena as are necessary to prevent unnecessary intrusion in     <--
    18  INTO patient confidential information. The board is authorized    <--
    19  to apply to Commonwealth Court to enforce its subpoenas.
    20     (D)  REPORTS TO THE BOARD.--AN ATTORNEY RESPONSIBLE FOR        <--
    21  REPRESENTING THE COMMONWEALTH IN DISCIPLINARY MATTERS BEFORE THE
    22  BOARD SHALL NOTIFY THE BOARD IMMEDIATELY UPON RECEIVING
    23  NOTIFICATION OF AN ALLEGED VIOLATION OF THIS ACT. THE BOARD
    24  SHALL MAINTAIN CURRENT RECORDS OF ALL REPORTS OF ALLEGED
    25  VIOLATIONS AND PERIODICALLY REVIEW THE RECORDS FOR THE PURPOSE
    26  OF DETERMINING THAT EACH ALLEGED VIOLATION HAS BEEN RESOLVED IN
    27  A TIMELY MANNER.
    28  Section 10.  Unauthorized practice of medicine and surgery.
    29     No person other than a medical doctor shall engage in any of
    30  the following conduct except as authorized or exempted in this
    19850S1158B1682                 - 17 -

     1  act:
     2         (1)  Practice medicine and surgery.
     3         (2)  Purport to practice medicine and surgery.
     4         (3)  Hold forth as authorized to practice medicine and
     5     surgery through use of a title, including, but not
     6     necessarily limited to, medical doctor, doctor of medicine,
     7     doctor of medicine and surgery, doctor of a designated
     8     disease, physician, physician of a designated disease, or any
     9     abbreviation for the foregoing.
    10         (4)  Otherwise hold forth as authorized to practice
    11     medicine and surgery.
    12  Section 11.  Clinical clerks.
    13     (a)  Authorized services.--A clinical clerk may perform the
    14  following services in a hospital to which the clerk is assigned,
    15  provided the services are performed within the restrictions
    16  contained in or authorized by this section:
    17         (1)  Make notes on a patient's chart.
    18         (2)  Conduct a physical examination.
    19         (3)  Perform a medical procedure or laboratory test.
    20     (b)  Regulations.--A clinical clerk shall not perform a
    21  medical service unless the performance of such by the clinical
    22  clerk under the circumstances is consistent with THE REGULATIONS  <--
    23  PROMULGATED BY THE BOARD AND the standards of acceptable medical
    24  practice embraced by the medical doctor community in this
    25  Commonwealth. The board shall promulgate regulations which
    26  define the medical services those standards permit a clinical
    27  clerk to perform and the circumstances under which those
    28  standards permit a clinical clerk to perform a medical service.
    29     (c)  Supervision.--A clinical clerk shall not perform a
    30  medical service without the direct and immediate supervision of
    19850S1158B1682                 - 18 -

     1  the medical doctor members of the medical staff or residents at
     2  the hospital in which the service is performed. The board shall
     3  promulgate regulations which define the supervision required by
     4  those standards.
     5     (d)  Drugs.--A clinical clerk shall not prescribe or dispense
     6  drugs.
     7     (e)  Notes on patients' charts.--Notes made on a patient's
     8  chart by a clinical clerk become official only when
     9  countersigned by a medical doctor member of the hospital's
    10  medical staff or resident beyond a first-year level of graduate
    11  medical education at the hospital.
    12     (f)  Other licenses or certificates.--Nothing in this section
    13  or the regulations authorized by this section shall be construed
    14  to prohibit a clinical clerk who is licensed or certified to
    15  practice a profession by a Commonwealth agency or board from
    16  practicing within the scope of that license or certificate or as
    17  otherwise authorized by law.
    18  Section 12.  Midwifery.
    19     (a)  Previous licensure.--A midwife who has been licensed
    20  previously by the board may continue to practice midwifery in
    21  accordance with regulations promulgated by the board.
    22     (b)  Use of title.--A midwife may use the title midwife,
    23  nurse-midwife or an appropriate abbreviation of those titles.
    24     (c)  Other licenses or certificates.--Nothing in this section
    25  or the regulations authorized by this section shall be construed
    26  to prohibit a midwife who is licensed or certified to practice
    27  another profession by a Commonwealth agency or board from
    28  practicing within the scope of that license or certificate or as
    29  otherwise authorized by law.
    30  Section 13.  Physician assistants.
    19850S1158B1682                 - 19 -

     1     (a)  Authorized services.--A physician assistant may perform
     2  a medical service delegated by an approved physician and as
     3  approved by the appropriate board. An approved physician is a
     4  physician identified in the writing required by subsection (e).
     5     (b)  Use of title.--A physician assistant may use the title
     6  physician assistant or an appropriate abbreviation for that
     7  title, such as "P.A.-C."
     8     (c)  Regulations.--The board shall promulgate regulations
     9  which define the services and circumstances under which a
    10  physician assistant may perform a medical service.
    11     (d)  Supervision.--A physician assistant shall not perform a
    12  medical service without the supervision and personal direction
    13  of an approved physician. The board shall promulgate regulations
    14  which define the supervision and personal direction required by
    15  those standards.
    16     (e)  Written agreement.--A physician assistant shall not
    17  provide a medical service without a written agreement with one
    18  or more physicians which provides for all of the following:
    19         (1)  Identifies and is signed by each physician the
    20     physician assistant will be assisting.
    21         (2)  Describes the manner in which the physician
    22     assistant will be assisting each named physician.
    23         (3)  Describes the nature and degree of supervision and
    24     direction each named physician will provide the physician
    25     assistant.
    26         (4)  Designates one of the named physicians as having the
    27     primary responsibility for supervising and directing the
    28     physician assistant.
    29         (5)  Has been approved by the board as satisfying the
    30     foregoing and as consistent with the restrictions contained
    19850S1158B1682                 - 20 -

     1     in or authorized by this section.
     2  A physician assistant shall not assist a physician in a manner
     3  not described in the agreement or without the nature and degree
     4  of supervision and direction described in the agreement. The
     5  physician designated as having primary responsibility for the
     6  physician assistant shall not have primary responsibility for
     7  more than two physician assistants.
     8     (f)  Drugs.--A physician assistant shall not independently
     9  prescribe or dispense drugs. The board and the State Board of     <--
    10  Pharmacy shall jointly promulgate regulations which permit a      <--
    11  physician assistant to prescribe and dispense drugs at the
    12  direction of a physician. THE BOARD SHALL REQUEST THE COMMENTS    <--
    13  AND RECOMMENDATIONS OF THE STATE BOARD OF PHARMACY.
    14     (g)  Supervision.--A physician assistant may be employed by a
    15  medical care facility under the supervision and direction of an
    16  approved physician or group of such physicians, provided one of
    17  those physicians is designated as having the primary
    18  responsibility for supervising and directing the physician
    19  assistant and provided that a physician assistant shall not be
    20  responsible to more than three physicians.
    21     (h)  Reimbursement.--For reimbursement purposes a physician
    22  assistant shall be an employee subject to the normal employer-
    23  employee reimbursement procedures.
    24     (i)  Eye services.--No medical services may be performed by a
    25  physician assistant under this act which include the measurement
    26  of the range or powers of human vision or the determination of
    27  the refractive status of the human eye. This subsection does not
    28  prohibit the performance of routine vision screenings or the
    29  performance of refractive screenings in the physician's office.
    30     (j)  Chiropractic practice.--Nothing in this act shall be
    19850S1158B1682                 - 21 -

     1  construed to allow physician assistants to practice
     2  chiropractic.
     3     (k)  Other licenses or certificates.--Nothing in this section
     4  or the regulations authorized by this section shall be construed
     5  to prohibit a physician assistant who is licensed or certified
     6  to practice another profession by a Commonwealth agency or board
     7  from practicing within the scope of that license or certificate
     8  or as otherwise authorized by law.
     9  Section 14.  Drugless therapist.
    10     (a)  Previous licensure.--A drugless therapist who has been
    11  licensed previously by the board may continue to provide
    12  drugless therapy in accordance with the regulations promulgated
    13  by the board.
    14     (b)  Drugs.--A drugless therapist shall not prescribe or
    15  dispense drugs.
    16     (c)  Other licenses or certificates.--Nothing in this section
    17  or the regulations authorized by this section shall be construed
    18  to prohibit a drugless therapist who is licensed or certified to
    19  practice another profession by a Commonwealth agency or board
    20  from practicing within the scope of that license or certificate
    21  or as otherwise authorized by law.
    22  Section 15.  Certified registered nurse practitioner.
    23     (a)  General rule.--A certified registered nurse practitioner
    24  shall act in accordance with regulations authorized by this
    25  section.
    26     (b)  Regulations.--The board and the State Board of Nurse
    27  Examiners shall jointly promulgate regulations authorizing a
    28  certified registered nurse practitioner to perform acts of
    29  medical diagnoses and prescription of medical, therapeutic,
    30  diagnostic or corrective measures.
    19850S1158B1682                 - 22 -

     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 certified registered nurse practitioner who is
     4  licensed or certified to practice another profession by a
     5  Commonwealth agency or board from practicing within the scope of
     6  that license or certificate as otherwise authorized by law.
     7  Section 16.  Consultation.
     8     A person authorized to practice medicine or surgery or
     9  osteopathy without restriction by any other state may, upon
    10  request by a medical doctor, provide consultation to the medical
    11  doctor regarding the treatment of a patient under the care of
    12  the medical doctor.
    13  Section 17.  Delegation of duties to health care practitioner or
    14                 technician.
    15     (a)  General rule.--A MEDICAL DOCTOR MAY DELEGATE TO A health  <--
    16  care practitioner or technician may perform THE PERFORMANCE OF a  <--
    17  medical service if:
    18         (1)  The performance of the service was delegated by a     <--
    19     medical doctor.
    20         (2) (1)  The delegation is consistent with the standards
    21     of acceptable medical practice embraced by the medical doctor
    22     community in this Commonwealth.
    23         (3) (2)  The delegation is not prohibited by regulations   <--
    24     promulgated by the board.
    25         (4) (3)  The delegation is not prohibited by statutes or   <--
    26     regulations relating to other licensed health care
    27     practitioners.
    28     (b)  Regulations.--The board may promulgate regulations which
    29  establish criteria pursuant to which a medical doctor may
    30  delegate the performance of medical services, preclude a medical
    19850S1158B1682                 - 23 -

     1  doctor from delegating the performance of certain types of
     2  medical services, or otherwise limit the ability of a medical
     3  doctor to delegate medical services.
     4     (c)  Responsibility.--Nothing in this section shall be         <--
     5  construed to limit the A MEDICAL DOCTOR SHALL BE RESPONSIBLE FOR  <--
     6  THE MEDICAL SERVICES DELEGATED TO THE HEALTH CARE PRACTITIONER
     7  OR TECHNICIAN IN ACCORDANCE WITH SUBSECTIONS (A) AND (B). A
     8  medical doctor's responsibility for the medical service
     9  delegated to the health care practitioner or technician IS NOT    <--
    10  LIMITED BY ANY PROVISIONS OF THIS SECTION.
    11  Section 18.  Federal medical personnel.
    12     Nothing in this act shall be construed to prohibit a medical
    13  doctor in the medical service of the armed forces of the United
    14  States, the United States Public Health Service or the Veterans'
    15  Administration, or a Federal employee, from discharging official
    16  duties.
    17  Section 19.  Osteopathic act.
    18     (a)  General rule.--Nothing in this act shall be construed to
    19  prohibit a doctor of osteopathy from practicing osteopathic
    20  medicine and surgery.
    21     (b)  Specific authorization.--Nothing in this act shall be
    22  construed to prohibit a person authorized to practice
    23  osteopathic medicine and surgery by the act of October 5, 1978
    24  (P.L.1109, No.261), known as the Osteopathic Medical Practice
    25  Act, to practice as authorized by that act.
    26  Section 20.  Other health care practitioners.
    27     Nothing in this act shall be construed to prohibit a health
    28  care practitioner from practicing that profession within the
    29  scope of the health care practitioner's license or certificate
    30  or as otherwise authorized by the law, including using the title
    19850S1158B1682                 - 24 -

     1  authorized by the practitioner's licensing act.
     2  Section 21.  Acts outside nonmedical doctor license or
     3                 certificate.
     4     (a)  Medical doctor involvement.--In the event the law,
     5  including this act, conditions a person's authorization to
     6  perform one or more medical services upon medical doctor
     7  involvement, and the person performs a covered service without
     8  the required involvement, the person shall be deemed to have
     9  acted outside the scope of the person's license or certificate.
    10     (b)  Included involvements.--The medical doctor involvement
    11  referred to in subsection (a) shall include, but shall not
    12  necessarily be limited to, any of the following:
    13         (1)  An order.
    14         (2)  Direction or supervision.
    15         (3)  Presence.
    16         (4)  Immediate availability.
    17         (5)  Referral.
    18         (6)  Consultation.
    19     (C)  LIMITATION ON PROVIDING SERVICES.--NOTHING HEREIN SHALL   <--
    20  BE CONSTRUED AS AUTHORIZING A HEALTH CARE PRACTITIONER OR
    21  TECHNICIAN TO PERFORM ANY MEDICAL SERVICE WHICH IS NOT WITHIN
    22  THE SCOPE OF THAT PERSON'S PRACTICE, AS DEFINED BY THE
    23  PRACTITIONER'S LICENSING ACT UNDER WHICH THAT PERSON IS
    24  LICENSED, CERTIFICATED OR REGISTERED.
    25  Section 22.  Licenses and certificates; general qualification.
    26     (a)  Types of licenses and certificates.--The board may grant
    27  the following licenses and certificates:
    28         (1)  License without restriction.
    29         (2)  License with restriction. INTERIM LIMITED LICENSE.    <--
    30         (3)  Graduate license.
    19850S1158B1682                 - 25 -

     1         (4)  Institutional license.
     2         (5)  Temporary license.
     3         (6)  Extraterritorial license.
     4         (7)  Midwife license.
     5         (8)  Physician assistant certificate.
     6     (b)  Qualifications.--The board shall not issue a license or
     7  certificate to an applicant unless the applicant establishes
     8  with evidence, verified by an affidavit or affirmation of the
     9  applicant, that the applicant is of legal age, is of good moral
    10  character and is not addicted to the intemperate use of alcohol
    11  or the habitual use of narcotics or other habit-forming drugs,
    12  and that the applicant has completed the educational
    13  requirements prescribed by the board, and otherwise satisfies
    14  the qualifications for the license or certificate contained in
    15  or authorized by this act. The board shall not issue a license
    16  or certificate to an applicant who has been convicted of a
    17  felony under the act of April 14, 1972 (P.L.233, No.64), known
    18  as The Controlled Substance, Drug, Device and Cosmetic Act, or
    19  of an offense under the laws of another jurisdiction which if
    20  committed in this Commonwealth would be a felony under The
    21  Controlled Substance, Drug, Device and Cosmetic Act, unless:
    22         (1)  at least ten years have elapsed from the date of
    23     conviction;
    24         (2)  the applicant satisfactorily demonstrates to the
    25     board that he has made significant progress in personal
    26     rehabilitation since the conviction such that licensure of
    27     the applicant should not be expected to create a substantial
    28     risk of harm to the health and safety of his patients or the
    29     public or a substantial risk of further criminal violations;
    30     and
    19850S1158B1682                 - 26 -

     1         (3)  the applicant otherwise satisfies the qualifications
     2     contained in or authorized by this act.
     3  As used in this section the term "convicted" shall include a
     4  judgment, and admission of guilt or a plea of nolo contendere.
     5     (c)  Refusal.--The board may refuse to issue a license or
     6  certificate to an applicant based upon a ground for such action
     7  contained in section 41.
     8     (d)  Limitation.--The board shall not refuse to issue a
     9  license or certificate to an applicant unless the applicant has
    10  been afforded the procedural protections required by this act.
    11     (e)  Action on application.--The application, upon filing by   <--
    12  the applicant of the evidence required under subsection (b) and
    13  the expiration of a period of 90 days, shall be deemed to meet
    14  the requirements of this act and become effective, the license
    15  or certificate shall be deemed issued, and the board shall take
    16  no action against the applicant for practicing without a license
    17  or certificate, unless within that period the application has
    18  been disapproved by the board or proceedings have been initiated
    19  against the applicant under this act.
    20  Section 23.  Standards for medical training facilities.
    21     (a)  General rule.--The educational qualifications for
    22  acceptance as a matriculant in a medical college or other
    23  medical training facility incorporated within this Commonwealth
    24  and the curricula and training to be offered by such medical
    25  colleges or other medical training facility shall meet the
    26  requirements set by the board and any accrediting body which may
    27  be recognized by the board.
    28     (b)  Duties of the board.--It shall be the duty of the board,
    29  in its discretion, periodically to ascertain the character of
    30  the instruction and the facilities possessed by each of the
    19850S1158B1682                 - 27 -

     1  medical colleges and other medical training facilities offering
     2  or desiring to offer medical training in accordance with the
     3  requirements of this act. In shall further be the duty of the
     4  board, by inspection and otherwise, to ascertain the facilities
     5  and qualifications of medical colleges and other medical
     6  training facilities outside this Commonwealth, whose graduates
     7  or trainees desire to obtain licensure, graduate medical
     8  training or certification in this Commonwealth, provided further
     9  that the board shall have the authority to refuse to license
    10  graduates of any such medical institutions, colleges or
    11  hospitals which in its judgment do not meet similar standards
    12  for medical training and facilities as are required of medical
    13  institutions in this Commonwealth. In enforcing this provision,
    14  the board shall give due notice to any medical institution,
    15  college or hospital upon which it has rendered a decision that
    16  its training and facilities do not meet the standards required
    17  by the board.
    18     (c)  Refusal of recognition.--In the event that the board
    19  determines that a medical training facility has failed to
    20  provide adequate facilities, curricula or training, the board
    21  shall not recognize the education or degrees obtained from the
    22  medical training facility during the period of inadequacy.
    23  Section 24.  Examinations.
    24     (a)  General rule.--The board may require an applicant to
    25  take and pass an examination to the satisfaction of the board.
    26     (b)  Proficiency in English language.--In addition to any
    27  other examination required by this act or by regulation of the
    28  board, applicants for a license or certificate, whose principal
    29  language is other than English, may also be required to
    30  demonstrate, by examination, proficiency in the English language
    19850S1158B1682                 - 28 -

     1  to any agency considered competent by the board.
     2     (c)  Authority to call in medical consultants.--For the        <--
     3  purpose of conducting all examinations, the board shall have the
     4  privilege of calling to its aid medical consultants who shall be
     5  compensated for their services at a reasonable rate in an amount
     6  as determined, from time to time, by the board in addition to
     7  all incurred expenses, in accordance with Commonwealth
     8  regulations.
     9     (C)  THIRD-PARTY TESTING.--ALL WRITTEN, ORAL AND PRACTICAL     <--
    10  EXAMINATIONS SHALL BE PREPARED AND ADMINISTERED BY A QUALIFIED
    11  AND APPROVED PROFESSIONAL TESTING ORGANIZATION IN THE MANNER
    12  PRESCRIBED FOR WRITTEN EXAMINATIONS BY THE PROVISIONS OF SECTION
    13  812.1 OF THE ACT OF APRIL 9, 1929 (P.L.177, NO.175), KNOWN AS
    14  THE ADMINISTRATIVE CODE OF 1929.
    15     (d)  Examining agency.--When the board accepts an examination
    16  given by an examining agency, the board may establish the
    17  criteria for passing, or may accept the criteria for passing,
    18  established by the examining agency. If the examination is
    19  offered in parts, the board may establish, by regulation, a time
    20  period in which the entire examination must be successfully
    21  completed. The board may establish, by regulation, a maximum
    22  number of examination attempts it will recognize for the purpose
    23  of receiving a passing score on an examination recognized but
    24  not given by the board.
    25  Section 25.  Licenses and certificates; biennial registration.
    26     (a)  Issuance of licenses and certificates.--All applicants
    27  who have complied with the requirements of the board, and who
    28  shall have passed a final examination, and who have otherwise     <--
    29  complied with the provisions of this act, shall receive from the
    30  commissioner, or whoever exercises equivalent authority acting
    19850S1158B1682                 - 29 -

     1  for the board, a license or certificate entitling them to the
     2  right to practice in this Commonwealth. Each such license or
     3  certificate shall be duly recorded in the office of the board,
     4  in a record to be properly kept for that purpose which shall be
     5  open to public inspection and a certified copy of said record
     6  shall be received as evidence in all courts in this Commonwealth
     7  in the trial of any case.
     8     (b)  Renewals.--It shall be the duty of all persons now or
     9  hereafter licensed or certified to be registered with the board
    10  and, thereafter, to register in like manner at such intervals
    11  and by such methods as the board shall determine by regulations,
    12  but in no case shall such renewal period be longer than two
    13  years. The form and method of such registration shall be
    14  determined by the board.
    15     (c)  Fees.--Each person so registering with the board shall
    16  pay, for each biennial registration, a reasonable fee which, if
    17  any, shall accompany the application for such registration.
    18     (d)  Evidence of registration.--Upon receiving a proper
    19  application for such registration accompanied by the fee, if
    20  any, above provided for, the board shall issue a certificate of
    21  registration to the applicant. Said certificate together with
    22  its renewals shall be good and sufficient evidence of
    23  registration under the provisions of this act.
    24  Section 26.  Certification of license or certificate.
    25     The status of a license or certificate issued by the board
    26  shall be certified by the board to other jurisdictions or
    27  persons upon formal application and payment of a reasonable fee.
    28  Section 27.  Reciprocity or endorsement.
    29     Reciprocity or endorsement may be established at the
    30  discretion of the board. As used in this section, the term
    19850S1158B1682                 - 30 -

     1  "reciprocity" means the act of the board and a licensing
     2  authority in another jurisdiction, each recognizing that the
     3  requirements for a license or certificate in this Commonwealth
     4  and in the other jurisdiction are equivalent, issuing a license
     5  or certificate to an applicant who possesses a similar license
     6  or certificate in the other jurisdiction. As used in this
     7  section, the term "endorsement" means the issuance of a license
     8  or certificate by the board to an applicant who does not meet
     9  standard requirements, if the applicant has achieved cumulative
    10  qualifications which are accepted by the board as being
    11  equivalent to the standard requirements for the license or
    12  certificate.
    13  Section 28.  License to practice medicine and surgery.
    14     An individual is not qualified for a license to practice
    15  medicine and surgery unless the individual has received an
    16  academic degree in medicine and surgery from a medical college
    17  and the individual satisfies the other qualifications for the
    18  license contained in or authorized by this act.
    19  Section 29.  License without restriction.
    20     (a)  General rule.--A license without restriction empowers
    21  the licensee to practice medicine and surgery without any
    22  restriction or limitation.
    23     (b)  Graduates of accredited medical colleges.--No license
    24  without restriction may be issued to a graduate of an accredited
    25  medical college unless the applicant has completed successfully
    26  as a resident two years of approved graduate medical training.
    27     (c)  Graduates of unaccredited medical colleges.--No license
    28  without restriction may be issued to a graduate of an
    29  unaccredited medical college unless the applicant has completed
    30  successfully as a resident three years of approved graduate
    19850S1158B1682                 - 31 -

     1  medical training, educational requirements prescribed by the
     2  board and certification by the Educational Council for Foreign
     3  Medical Graduates, or its successors.
     4     (d)  Examinations.--The board shall hold at least two
     5  examinations for applicants for a license without restriction
     6  each year. Special examinations may be designated by the board.
     7  The examinations shall be held at such times and places as
     8  designated by the board. In case of failure at any such
     9  examination, the applicant shall have, after the expiration of
    10  six months and within two years, the privilege of a second
    11  examination by the board. In case of failure in a second
    12  examination, or after the expiration of two years, the applicant
    13  must thereafter successfully complete, as a resident, one year
    14  of graduate medical training approved by the board, apply de
    15  novo, and qualify under the conditions in existence at the time
    16  of the application.
    17  Section 30.  License with restriction.                            <--
    18     (a)  General rule.--A license with restriction empowers the
    19  licensee to practice medicine and surgery with such restrictions
    20  or limitations as may be established by the board, including
    21  restrictions in the scope of permitted practice, a requirement
    22  that the applicant take one or more refresher educational
    23  courses or mandated submission of medical care, counseling or
    24  treatment.
    25     (b)  Prerequisite.--No license with restriction may by issued
    26  unless the applicant has otherwise been issued, or is qualified
    27  to be issued, a license without restriction in accordance with
    28  this act.
    29     (c)  Disciplinary proceedings or voluntary request.--The
    30  board may issue a license with restriction only upon completion
    19850S1158B1682                 - 32 -

     1  of disciplinary proceedings in accordance with this act or upon
     2  a voluntary request of the applicant.
     3  SECTION 30.  INTERIM LIMITED LICENSE.                             <--
     4     (A)  GENERAL RULE.--AN INTERIM LIMITED LICENSE EMPOWERS THE
     5  LICENSEE TO PROVIDE MEDICAL SERVICE OTHER THAN AT THE TRAINING
     6  LOCATION OF THE LICENSEE'S APPROVED GRADUATE TRAINING PROGRAM
     7  FOR A PERIOD OF UP TO 12 CONSECUTIVE MONTHS.
     8     (B)  REQUIREMENTS.--NO INTERIM LIMITED LICENSE MAY BE ISSUED
     9  UNLESS THE APPLICANT IS A GRADUATE OF AN ACCREDITED MEDICAL
    10  COLLEGE AND HOLDS A VALID GRADUATE LICENSE, HAS SUCCESSFULLY
    11  COMPLETED ONE FULL YEAR OF APPROVED GRADUATE TRAINING, HAS
    12  RECEIVED THE WRITTEN APPROVAL OF THE DIRECTOR OF THE GRADUATE
    13  TRAINING PROGRAM, AND IS IN COMPLIANCE WITH APPLICABLE
    14  REGULATIONS OF THE BOARD.
    15     (C)  EXTENSIONS.--THE BOARD, UPON APPLICATION WHEN SUCH
    16  ACTION IS WARRANTED, MAY EXTEND THE VALIDITY OF AN INTERIM
    17  LIMITED LICENSE FOR A PERIOD OF UP TO 12 ADDITIONAL CONSECUTIVE
    18  MONTHS, BUT IN NO EVENT SHALL THE EXTENSION BE FOR A GREATER
    19  PERIOD OF TIME.
    20  Section 31.  Graduate license.
    21     (a)  General rule.--A graduate license empowers the licensee
    22  to participate for a period of up to 12 consecutive months in
    23  graduate medical training within the complex of the hospital to
    24  which the licensee is assigned and any satellite facility or
    25  other training location utilized in the graduate training
    26  program.
    27     (b)  Requirements.--No graduate license may be issued unless
    28  the applicant is a graduate of an accredited medical college or
    29  an unaccredited medical college and has received a medical
    30  degree. A graduate license may be issued to an applicant who
    19850S1158B1682                 - 33 -

     1  holds the equivalent of a license without restriction granted by
     2  another state or territory of the United States or the Dominion
     3  of Canada.
     4     (c)  Extensions; waivers.--The board may extend the validity
     5  of a graduate license upon application when such action is
     6  warranted. In the event a graduate license holder is issued a
     7  license without restriction and wishes to continue graduate
     8  medical training, the graduate license holder shall complete and
     9  keep current a form satisfactory to the board containing
    10  information desired by the board on the ABOUT SAID graduate       <--
    11  medical training program. A graduate of an unaccredited medical
    12  college, who does not possess all of the qualifications for the
    13  issuance of a graduate license but desires to train in a
    14  hospital within this Commonwealth in an area of advanced medical
    15  training, may have the unmet qualifications waived by the board
    16  if the board determines that the applicant possesses the
    17  technical skills and educational background to participate in
    18  such training and that its issuance is beneficial to the health,
    19  safety and welfare of the general public of this Commonwealth.
    20  Section 32.  Institutional license.
    21     (a)  General rule.--An institutional license empowers the
    22  licensee to teach or practice medicine and surgery in one of the
    23  medical colleges, affiliates or hospitals within this
    24  Commonwealth.
    25     (b)  Requirements.--No institutional license may be issued
    26  unless the applicant:
    27         (1)  is a graduate of an unaccredited medical college who
    28     has attained through professional growth and teaching
    29     experience the status of teacher; or
    30         (2)  is not otherwise licensed to practice medicine and
    19850S1158B1682                 - 34 -

     1     surgery in this Commonwealth but has achieved outstanding
     2     medical skills in a particular area of medicine and surgery
     3     and wishes to practice, demonstrate or teach with those
     4     outstanding medical skills.
     5     (c)  Determinations by the board.--The board shall issue an
     6  institutional license valid for no more than three years, as the
     7  board shall determine and only when it determines that its
     8  issuance is beneficial to the health, safety and welfare of the
     9  general public of this Commonwealth. A person granted an
    10  institutional license who subsequently desires to obtain a
    11  license without restriction shall be required to meet all of the
    12  requirements of such license as set forth in this act.
    13  Section 33.  Temporary license.
    14     (a)  General rule.--A temporary license empowers the licensee
    15  to:
    16         (1)  teach medicine and surgery or participate in a
    17     medical procedure necessary for the well-being of a specified
    18     patient within this Commonwealth; or
    19         (2)  practice medicine and surgery at a camp or resort
    20     for no more than three months.
    21     (b)  Requirements.--No temporary license may be issued unless
    22  the applicant holds the equivalent of a license without
    23  restriction granted by another state, territory or country.
    24     (c)  Additional conditions.--The board may impose any
    25  appropriate limitation in scope, duration or site of practice on
    26  the temporary license. Temporary licensees shall be deemed
    27  health care providers who conduct 50% or less of their health
    28  care business or practice within this Commonwealth for the
    29  purposes of the act of October 15, 1975 (P.L.390, No.111), known
    30  as the Health Care Services Malpractice Act.
    19850S1158B1682                 - 35 -

     1  Section 34.  Extraterritorial license.
     2     (a)  General rule.--An extraterritorial license empowers the
     3  licensee residing in or maintaining the office of practice in
     4  any adjoining state near the boundary line between such state
     5  and this Commonwealth, whose medical practice extends into this
     6  Commonwealth, to practice medicine and surgery with or without
     7  restriction in this Commonwealth on such patients.
     8     (b)  Requirements.--No extraterritorial license may be issued
     9  unless the applicant holds the equivalent of a license without
    10  restriction granted by a state adjoining this Commonwealth.
    11     (c)  Additional conditions.--An extraterritorial license may
    12  be granted by the board so long as the board is provided with:
    13         (1)  An application for the license, which shall include
    14     information on malpractice insurance coverage compliance.
    15         (2)  A certification by the authorized licensing body of
    16     such state of the current license in the state of residence
    17     and primary practice.
    18  The exercise of the discretion of the board in granting such a
    19  license will depend primarily upon the needs of patients in this
    20  Commonwealth, the availability of medical care in the specific
    21  area involved and whether the adjoining state of licensure
    22  reciprocates by extending similar privileges to medical doctors
    23  who reside and have their office of practice in this
    24  Commonwealth. Such a license will be automatically revoked if
    25  such medical doctor relocates the office of practice or
    26  residence. A medical doctor granted such a license has the duty
    27  to inform the board of any changes in practice which may in any
    28  way affect the maintenance of the license.
    29  Section 35.  Nurse-midwife license.
    30     (a)  General rule.--A nurse-midwife license empowers the
    19850S1158B1682                 - 36 -

     1  licensee to practice midwifery in this Commonwealth as provided
     2  in this act. The board shall formulate and issue such rules and
     3  regulations, from time to time, as may be necessary for the
     4  examination, licensing and proper conduct of the practice of
     5  midwifery.
     6     (b)  Requirements.--No nurse-midwife license will be issued
     7  unless the applicant is a registered nurse licensed in this
     8  Commonwealth. An applicant for a midwife license must have
     9  completed an academic and clinical program of study in midwifery
    10  which has been approved by the board or an accrediting body
    11  recognized by the board.
    12  Section 36.  Physician assistant certificate.
    13     (a)  General rule.--A physician assistant certificate
    14  empowers the holder to assist a medical doctor in the provision
    15  of medical care and services under the supervision and direction
    16  of that medical doctor as provided in this act.
    17     (b)  Requirements.--No physician assistant certificate may be
    18  issued to the applicant unless the requirements set forth by
    19  this act and such rules and regulations issued by the board are
    20  met, including requirements for the physician assistant
    21  certificate of training and educational programs which shall be
    22  formulated by the board in accordance with such national
    23  criteria as are established by national organizations or
    24  societies as the board may accept.
    25     (c)  Criteria.--The board shall grant physician assistant
    26  certificates to applicants who have fulfilled the following
    27  criteria:
    28         (1)  Satisfactory performance on the proficiency
    29     examination to the extent that a proficiency examination
    30     exists.
    19850S1158B1682                 - 37 -

     1         (2)  Satisfactory completion of a certified program for
     2     the training and education of physician assistants.
     3     (d)  Biennial renewal.--A physician assistant certificate
     4  shall be subject to biennial renewal by the board.
     5     (e)  Description of manner of assistance.--The application
     6  shall include a written request from the applicant's supervising
     7  medical doctor who shall file with the board a description of
     8  the manner in which the physician assistant will assist the
     9  supervising medical doctor, which description shall be subject
    10  to the approval of the board.
    11  Section 37.  Reporting of multiple licensure.
    12     Any licensed medical doctor in this Commonwealth who is also
    13  licensed to practice medicine and surgery in any other state,
    14  territory, POSSESSION or country shall report this information    <--
    15  to the board. on the biennial registration application or within  <--
    16  90 days of final disposition, whichever is sooner. Any
    17  disciplinary action taken in other states must SHALL be reported  <--
    18  to the board on the biennial registration application OR WITHIN   <--
    19  90 DAYS OF FINAL DISPOSITION, WHICHEVER IS SOONER. Multiple
    20  licensure will SHALL be noted BY THE BOARD on the medical         <--
    21  doctor's record and such state, territory, POSSESSION or country  <--
    22  will SHALL be notified BY THE BOARD of any disciplinary actions   <--
    23  taken against said medical doctor in this Commonwealth.
    24  Section 38.  Injunctions against unlawful practice.
    25     It shall be unlawful for any person to practice, or attempt
    26  to offer to practice, medicine and surgery, as defined in this
    27  act OR OTHER AREAS OF PRACTICE REQUIRING A LICENSE, CERTIFICATE   <--
    28  OR REGISTRATION FROM THE BOARD, without having at the time of so
    29  doing a valid, unexpired, unrevoked and unsuspended license,      <--
    30  CERTIFICATE OR REGISTRATION issued under this act. The unlawful
    19850S1158B1682                 - 38 -

     1  practice of medicine and surgery OR OTHER AREAS OF PRACTICE       <--
     2  REQUIRING A LICENSE, CERTIFICATE OR REGISTRATION FROM THE BOARD
     3  as defined in this act may be enjoined by the courts on petition
     4  of the board or by the commissioner. In any such proceeding it    <--
     5  shall not be necessary to show that any person is individually
     6  injured by the actions complained of. If it is determined the
     7  respondent has engaged in the unlawful practice of medicine and
     8  surgery, OR OTHER AREAS OF PRACTICE REQUIRING A LICENSE,          <--
     9  CERTIFICATE OR REGISTRATION FROM THE BOARD, the court shall
    10  enjoin him from so practicing unless and until he has been duly
    11  licensed, CERTIFICATED OR REGISTERED. Procedure in such cases     <--
    12  shall be the same as in any other injunction suit. The remedy by
    13  injunction hereby given is in addition to any other civil or
    14  criminal prosecution and punishment.
    15  Section 39.  Penalties.
    16     (a)  General rule.--Any person, or the responsible officer or
    17  employee of any corporation or partnership, institution or
    18  association, violating WHO VIOLATES any provisions of this act,   <--
    19  or any rule or regulation of the board commits of a misdemeanor   <--
    20  of the third degree and shall, upon conviction, be sentenced to
    21  pay a fine of not more than $2,000 or to imprisonment for not
    22  more than six months, or both, for the first violation. On the
    23  second and each subsequent conviction, he or she shall be
    24  sentenced to pay a fine of not less than $5,000 nor more than
    25  $20,000 or to imprisonment for not less than six months nor more
    26  than one year, or both.
    27     (b)  Civil penalties.--In addition to any other civil remedy
    28  or criminal penalty provided for in this act, the board, by a
    29  vote of the majority of the maximum number of the authorized
    30  membership of the board as provided by law, or by a vote of the
    19850S1158B1682                 - 39 -

     1  majority of the duly qualified and confirmed membership or a
     2  minimum of four FIVE members, whichever is greater, may levy a    <--
     3  civil penalty of up to $1,000 on any current licensee who
     4  violates any provision of this act or on any person who
     5  practices medicine or other areas of practice regulated by        <--
     6  REQUIRING A LICENSE, CERTIFICATE OR REGISTRATION FROM the board   <--
     7  without being properly licensed or, certificated OR REGISTERED    <--
     8  to do so under this act. The board shall levy this penalty only
     9  after affording the accused party the opportunity for a hearing,
    10  as provided in Title 2 of the Pennsylvania Consolidated Statutes
    11  (relating to administrative law and procedure). The board shall,  <--
    12  within six months after the effective date of this act, adopt
    13  guidelines setting forth the amounts and circumstances for which
    14  a fine may be imposed. No fines may be imposed in accordance
    15  with this subsection until the board has adopted the required
    16  guidelines. Nothing in this subsection shall be construed to
    17  give the board authority to impose a civil penalty upon any
    18  person licensed by another licensing board when acting within
    19  the scope of practice of that profession.
    20  Section 40.  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 9 shall not apply to temporary suspension.
    30  The board shall thereupon commence formal action to suspend,
    19850S1158B1682                 - 40 -

     1  revoke and OR restrict the license or certificate of the person   <--
     2  concerned as otherwise provided for in this act. All actions
     3  shall be taken promptly and without delay. Within 30 days
     4  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 COUNSEL, 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
    19850S1158B1682                 - 41 -

     1  certificate shall be made as hereinafter provided in the case of
     2  revocation or suspension of such license or certificate.
     3  Section 41.  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 BOARD REGULATED practitioner for any or  <--
     8  all of the 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, POSSESSION    <--
    28     or country, 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,
    19850S1158B1682                 - 42 -

     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, POSSESSION or country, or if    <--
     7     he or she is or shall become mentally incompetent. An
     8     applicant's statement on the application declaring the
     9     absence of a conviction shall be deemed satisfactory evidence
    10     of the absence of a conviction unless the board has some
    11     evidence to the contrary. In enforcing this paragraph, the
    12     board shall, upon probable cause, have authority to compel a
    13     practitioner to submit to a mental or physical examination by
    14     physicians A PHYSICIAN OR A PSYCHOLOGIST approved by the       <--
    15     board. Failure of a practitioner to submit to such
    16     examination when directed by the board, unless such failure
    17     is due to circumstances beyond his or her control, shall
    18     constitute an admission of the allegations against him or
    19     her, consequent upon which a default and final order may be
    20     entered without the taking of testimony or presentation of
    21     evidence. A practitioner affected under this paragraph shall
    22     at reasonable intervals be afforded an opportunity to
    23     demonstrate that he or she can resume a competent practice of
    24     his or her profession with reasonable skill and safety to
    25     patients.
    26         (6)  Violating a lawful regulation promulgated by the
    27     board or violating a lawful order of the board previously
    28     entered by the board in a disciplinary proceeding.
    29         (7)  Knowingly maintaining a professional connection or
    30     association with any person who is in violation of this act
    19850S1158B1682                 - 43 -

     1     or regulations of the board or knowingly aiding, assisting,
     2     procuring or advising any unlicensed person to practice a
     3     profession contrary to this act, or regulations of the board.
     4         (8)  Being guilty of immoral or unprofessional conduct.
     5     Unprofessional conduct shall include departure from or
     6     failing to conform to an ethical or quality standard of the
     7     profession. IN PROCEEDINGS BASED ON THIS PARAGRAPH, ACTUAL     <--
     8     INJURY TO A PATIENT NEED NOT BE ESTABLISHED.
     9             (i)  The ethical standards of a profession are those
    10         ethical tenets which are embraced by the professional
    11         community in this Commonwealth.
    12             (ii)  A practitioner departs from, or fails to
    13         conform to, a quality standard of the profession when the
    14         practitioner provides a medical service at a level
    15         beneath the accepted standard of care. The board may
    16         promulgate regulations which define the accepted standard
    17         of care. In the event the board has not promulgated an
    18         applicable regulation, the accepted standard of care for
    19         a practitioner is that which would be normally exercised
    20         by the average professional of the same kind in this
    21         Commonwealth under the circumstances, including locality
    22         and whether the practitioner is or purports to be a
    23         specialist in the area.
    24         (9)  Acting is IN such manner as to present an immediate   <--
    25     and clear danger to publish PUBLIC health or safety.           <--
    26         (10)  Acting outside the scope of a license or
    27     certificate.
    28         (11)  MAKING A FALSE OR DECEPTIVE BIENNIAL REGISTRATION    <--
    29     WITH THE BOARD.
    30  Section 42.  Types of corrective action.
    19850S1158B1682                 - 44 -

     1     (a)  Authorized actions.--When the board is empowered to take
     2  disciplinary or corrective action against a BOARD REGULATED       <--
     3  practitioner under the provisions of this act or pursuant to
     4  other statutory authority, the board may:
     5         (1)  Deny the application for a license, certificate or
     6     any other privilege granted by the board.
     7         (2)  Administer a public reprimand with or without
     8     probation.
     9         (3)  Administer a private reprimand with or without        <--
    10     probation.
    11         (4) (3)  Revoke, suspend, limit or otherwise restrict a
    12     license or certificate.
    13         (5) (4)  Require the professional BOARD REGULATED          <--
    14     PRACTITIONER to submit to the care, counseling or treatment
    15     of a physician or other health care professional A             <--
    16     PSYCHOLOGIST designated by the board.
    17         (6) (5)  Require the professional BOARD REGULATED          <--
    18     PRACTITIONER to take refresher educational courses.
    19         (7)  Suspend (6)  STAY enforcement of any suspension,      <--
    20     other than that imposed in accordance with section 41, or      <--
    21     revocation and place a practitioner PROFESSIONAL on probation  <--
    22     with the right to vacate the probationary order from FOR       <--
    23     noncompliance.
    24         (8) (7)  Impose a monetary penalty in accordance with      <--
    25     this act.
    26     (b)  Failure to comply with conditions.--Failure of a
    27  professional BOARD REGULATED PRACTITIONER to comply with          <--
    28  conditions set forth by the board shall be grounds for
    29  reconsideration of the matter and institution of formal charges
    30  against the licensee or certificate holder.
    19850S1158B1682                 - 45 -

     1  Section 43.  Reinstatement of license, certificate or
     2                 registration.
     3     (a)  In general.--Unless ordered to do so by Commonwealth
     4  Court or on appeal therefrom, the board shall not reinstate the
     5  license, certificate or registration of a person to practice
     6  medicine OR SURGERY OR OTHER AREAS OF PRACTICE REQUIRING A        <--
     7  LICENSE, CERTIFICATE OR REGISTRATION FROM THE BOARD pursuant to
     8  this act which has been revoked. Except as provided in
     9  subsection (b), any person whose license, certificate or
    10  registration has been revoked may apply for reinstatement, after
    11  a period of at least five years, but must meet all of the
    12  licensing qualifications of this act for the license applied
    13  for, to include the examination requirement, if he or she
    14  desires to practice at any time after such revocation.
    15     (b)  Reinstatement after felony conviction.--Any person whose
    16  license, certificate or registration has been suspended or
    17  revoked because of a felony conviction under the act of April
    18  14, 1972 (P.L.233, No.64), known as The Controlled Substance,
    19  Drug, Device and Cosmetic Act, or similar law of another
    20  jurisdiction, may apply for reinstatement after a period of at
    21  least ten years has elapsed from the date of conviction. The
    22  board may reinstate the license if the board is satisfied that
    23  the person has made significant progress in personal
    24  rehabilitation since the conviction such that his reinstatement
    25  should not be expected to create a substantial risk of harm to
    26  the health and safety of his patients or the public or a
    27  substantial risk of further criminal violations and if the
    28  person meets all other licensing qualifications of this act
    29  INCLUDING THE EXAMINATION REQUIREMENT.                            <--
    30  Section 44.  Surrender of suspended or revoked license,           <--
    19850S1158B1682                 - 46 -

     1                 CERTIFICATE OR REGISTRATION.
     2     The board shall require a person whose license, certificate
     3  or registration has been suspended or revoked to return THE       <--
     4  LICENSE, CERTIFICATE OR REGISTRATION, in such manner as the
     5  board directs, the license, certificate or registration. A        <--
     6  person who fails to do so commits a misdemeanor of the third
     7  degree.
     8  SECTION 45.  RADIOLOGIC PROCEDURES; EDUCATION AND TRAINING        <--
     9                 REQUIRED.
    10     (A)  SUPERVISION.--ON AND AFTER JANUARY 1, 1987, NO AUXILIARY
    11  PERSONNEL SHALL PERFORM RADIOLOGIC PROCEDURES ON THE PREMISES OF
    12  A MEDICAL DOCTOR UNLESS SUCH PERSON IS UNDER THE DIRECT
    13  SUPERVISION OF A MEDICAL DENTIST WHO IS ON THE PREMISES AT THE
    14  TIME THE X-RAY IS TAKEN AND UNLESS SUCH PERSON HAS PASSED AN
    15  EXAMINATION APPROVED BY THE BOARD AND ADMINISTERED IN ACCORDANCE
    16  WITH SECTION 812.1 OF THE ACT OF APRIL 9, 1929 (P.L.177,
    17  NO.175), KNOWN AS THE ADMINISTRATIVE CODE OF 1929.
    18     (B)  EXCLUSION.--THE BOARD SHALL, BY REGULATION, PROVIDE FOR
    19  THE EXCLUSION OF AUXILIARY PERSONNEL FROM PERFORMING RADIOLOGIC
    20  PROCEDURES IF THE CONTINUED PERFORMANCE OF RADIOLOGIC PROCEDURES
    21  BY THE AUXILIARY PERSONNEL IS DETERMINED BY THE BOARD TO POSE A
    22  THREAT TO THE HEALTH, SAFETY OR WELFARE OF THE PUBLIC.
    23     (C)  PENALTY.--IT SHALL BE UNLAWFUL UNDER THIS ACT TO
    24  KNOWINGLY PERMIT RADIOLOGIC PROCEDURES TO BE PERFORMED IN
    25  VIOLATION OF THIS SECTION OR IN VIOLATION OF THE REGULATIONS
    26  PROMULGATED ON ORDERS ISSUED IN ACCORDANCE WITH THIS SECTION.
    27     (D)  EDUCATION AND TESTING.--NO AUXILIARY PERSONNEL WHO HAS
    28  OR OBTAINS A LICENSE, CERTIFICATE OR REGISTRATION ISSUED BY, OR
    29  ON BEHALF OF, A BOARD WITHIN THE BUREAU OF PROFESSIONAL AND
    30  OCCUPATIONAL AFFAIRS SHALL BE REQUIRED TO UNDERGO ANY ADDITIONAL
    19850S1158B1682                 - 47 -

     1  EDUCATION OR TESTING PURSUANT TO THIS SECTION IF RADIOLOGIC
     2  PROCEDURES WERE INCLUDED IN THE EDUCATION OR THE EXAMINATION
     3  WHICH HE OR SHE WAS REQUIRED TO COMPLETE SUCCESSFULLY IN ORDER
     4  TO BE ELIGIBLE FOR SUCH LICENSE, CERTIFICATE OR REGISTRATION.
     5  Section 45 46.  Reestablishment.                                  <--
     6     This act, with respect to the State Board of Medical
     7  Education and Licensure, shall constitute the legislation
     8  required to reestablish an agency pursuant to the act of
     9  December 22, 1981 (P.L.508, No.142), known as the Sunset Act.
    10  Section 46 47.  Severability.                                     <--
    11     The provisions of this act are severable. If any provision of
    12  this act or its application to any person or circumstance is
    13  held invalid, the invalidity shall not affect other provisions
    14  or applications of this act which can be given effect without
    15  the invalid provision or application.
    16  Section 47 48.  Repeals.                                          <--
    17     (a)  Specific repeals.--Section 412 of the act of April 9,
    18  1929 (P.L.177, No.175), know as The Administrative Code of 1929,
    19  is repealed.
    20     The act of July 20, 1974 (P.L.551, No.190), known as the
    21  Medical Practice Act of 1974, is repealed.
    22     (b)  General repeal.--All other acts and parts of acts are
    23  repealed insofar as they are inconsistent with this act.
    24  Section 48 49.  Applicability of act.                             <--
    25     (a)  General rule.--The provisions of this act shall not
    26  apply either directly or indirectly, by intent or purpose, to
    27  affect the practice of:
    28         (1)  Chiropractic, as authorized by the act of August 10,
    29     1951 (P.L.1182, No.264), known as the Chiropractic
    30     Registration Act of 1951.
    19850S1158B1682                 - 48 -

     1         (2)  Dentistry, as authorized by the act of May 1, 1933
     2     (P.L.216, No.76), known as The Dental Law.
     3         (3)  Optometry, as authorized by the act of June 6, 1980
     4     (P.L.197, No.57), known as the Optometric Practice and
     5     Licensure Act.
     6         (4)  Osteopathy, as authorized by the act of October 5,
     7     1978 (P.L.1109, No.261), known as the Osteopathic Medical
     8     Practice Act.
     9         (5)  Pharmacy, as authorized by the acts of April 14,
    10     1972 (P.L.233, No.64), known as The Controlled Substance,
    11     Drug, Device and Cosmetic Act, and September 27, 1961
    12     (P.L.1700, No.699), known as the Pharmacy Act.
    13         (6)  Physical Therapy, as authorized by the act of
    14     October 10, 1975 (P.L.383, No.110), known as the Physical
    15     Therapy Practice Act.
    16         (7)  Podiatry, as authorized by the act of March 2, 1956
    17     (P.L.1206, No.375), known as the Podiatry Act of 1956.
    18         (8)  Professional Nursing, as authorized by the act of
    19     May 22, 1951 (P.L.317, No.69), known as The Professional
    20     Nursing Law.
    21         (9)  Psychologists, as authorized by the act of March 23,
    22     1972 (P.L.136, No.52), referred to as the Psychologists
    23     License Act.
    24     (b)  Exemption.--This act shall not be construed so as to
    25  give the Board of Medicine any jurisdiction over any of the
    26  schools or colleges of the methods exempted in this section.
    27     (c)  No application to practice of hypnosis.--The provisions
    28  of this act shall not apply either directly or indirectly, by
    29  intent or purpose, to the practice of hypnosis.
    30  Section 49 50.  Existing board.                                   <--
    19850S1158B1682                 - 49 -

     1     The presently confirmed members of the State Board of Medical
     2  Education and Licensure constituted under section 412 of the act
     3  of April 9, 1929 (P.L.177, No.175), known as The Administrative
     4  Code of 1929, as of December 31, 1985, shall continue to serve
     5  as board members until their present terms of office expire and   <--
     6  PROVIDED THAT ANY PRESENT BOARD MEMBER WHOSE TERM HAS EXPIRED ON  <--
     7  OR BEFORE THE EFFECTIVE DATE OF THIS ACT SHALL SERVE UNTIL a
     8  successor has been appointed and qualified, but no longer than
     9  six months after the effective date of this act.
    10  Section 50 51.  Existing rules and regulations.                   <--
    11     Each rule and regulation of the board in effect on December
    12  31, 1985, not inconsistent with this act, shall remain in effect
    13  after such date until repealed or amended by the board PROVIDED   <--
    14  THAT THE BOARD SHALL IMMEDIATELY INITIATE THE REPEAL OR
    15  AMENDMENT OF ANY RULE OR REGULATION WHICH IS INCONSISTENT WITH
    16  THE PROVISIONS OF THIS ACT. Each fee of the board in effect on
    17  December 31, 1985, and not inconsistent with this act, shall
    18  remain in effect after such date until repealed or amended by     <--
    19  the board or the commissioner IN ACCORDANCE WITH THE PROVISIONS   <--
    20  OF THIS ACT.
    21  Section 51 52.  Existing licenses, certificates and               <--
    22                 registrations.
    23     Any person who holds a valid license, certificate or
    24  registration issued by the State Board of Medical Education and
    25  Licensure under the act of July 20, 1974 (P.L.551, No.190),
    26  known as the Medical Practice Act of 1974, relating to the
    27  practice of medicine, prior to the effective date of this act
    28  shall, on and after the effective date hereof, be deemed
    29  licensed, certificated or registered by the State Board of
    30  Medicine as provided for in this act.
    19850S1158B1682                 - 50 -

     1  Section 52 53.  Effective date.                                   <--
     2     This act shall take effect January 1, 1986.                    <--
     3     THIS ACT SHALL TAKE EFFECT AS FOLLOWS:                         <--
     4         (1)  SECTION 29(B) AND (C) SHALL TAKE EFFECT JULY 1,
     5     1987.
     6         (2)  THE REMAINDER OF THIS ACT SHALL TAKE EFFECT JANUARY
     7     1, 1986, OR IMMEDIATELY, WHICHEVER IS LATER.
















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