PRIOR PRINTER'S NOS. 1453, 1513, 1605 PRINTER'S NO. 1608
No. 1158 Session of 1985
INTRODUCED BY BELL, OCTOBER 16, 1985
AS AMENDED ON THIRD CONSIDERATION, NOVEMBER 20, 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. 19 Section 11. Clinical clerks. 20 Section 12. Midwifery.
1 Section 13. Physician assistants. 2 Section 14. Drugless therapist. 3 Section 15. Certified registered nurse practitioner. 4 Section 16. Consultation. 5 Section 17. Delegation of duties to health care practitioner 6 or technician. 7 Section 18. Federal medical personnel. 8 Section 19. Osteopathic act. 9 Section 20. Other health care practitioners. 10 Section 21. Acts outside nonphysician license or certificate. 11 Section 22. Licenses and certificates; general qualification. 12 Section 23. Standards for medical training facilities. 13 Section 24. Examinations. 14 Section 25. Licenses and certificates; biennial registration. 15 Section 26. Certification of license or certificate. 16 Section 27. Reciprocity or endorsement. 17 Section 28. License to practice medicine and surgery. 18 Section 29. License without restriction. 19 Section 30. License with restriction. 20 Section 31. Graduate license. 21 Section 32. Institutional license. 22 Section 33. Temporary license. 23 Section 34. Extraterritorial license. 24 Section 35. Nurse-midwife license. 25 Section 36. Physician assistant certificate. 26 Section 37. Reporting of multiple licensure. 27 Section 38. Injunctions against unlawful practice. 28 Section 39. Penalties. 29 Section 40. Temporary and automatic suspensions. 30 Section 41. Reasons for refusal, revocation, suspension or 19850S1158B1608 - 2 -
1 other corrective actions against a licensee or 2 certificate holder. 3 Section 42. Types of corrective action. 4 Section 43. Reinstatement of license, certificate or 5 registration. 6 Section 44. Surrender of suspended or revoked license. 7 Section 45. Reestablishment. 8 Section 46. Severability. 9 Section 47. Repeals. 10 Section 48. Applicability of act. 11 Section 49. Existing board. 12 Section 50. Existing rules and regulations. 13 Section 51. Existing licenses, certificates and registrations. 14 Section 52. Effective date. 15 The General Assembly of the Commonwealth of Pennsylvania 16 hereby enacts as follows: 17 Section 1. Short title. 18 This act shall be known and may be cited as the Medical 19 Practice Act of 1985. 20 Section 2. Definitions. 21 The following words and phrases when used in this act shall 22 have the meanings given to them in this section unless the 23 context clearly indicates otherwise: 24 "Accredited medical college." An institution of higher 25 learning which has been fully accredited by the Association of 26 American Medical Colleges, its successors or assigns, or the 27 American Medical Association, either directly or through their 28 respective accrediting bodies, as an agency to provide courses 29 in the art and science of medicine and surgery and empowered to 30 grant Academic Degrees in Medicine. 19850S1158B1608 - 3 -
1 "Affiliate." A member of a group of two or more medical 2 training facilities legally united by an agreement of 3 affiliation, approved by the board and formed to enhance the 4 potential of all participants in the provision of health care 5 and medical education. 6 "Applicant." An applicant for any license or certificate 7 issued by the board. 8 "Board." The State Board of Medicine. 9 "Board regulated practitioner." A medical doctor, midwife, 10 physician assistant, drugless therapist, or an applicant for a 11 license or certificate the board may issue. 12 "Clinical clerk." An undergraduate student in good standing 13 in an accredited medical college who is assigned to provide 14 medical services in a hospital by the medical college and the 15 hospital. 16 "Commissioner." The Commissioner of Professional and 17 Occupational Affairs in the Department of State. 18 "Doctor of osteopathy or osteopathic doctor." An individual 19 licensed to practice osteopathic medicine and surgery by the 20 State Board of Osteopathic Medical Examiners. 21 "Graduate medical training." Training approved or recognized 22 by the board which is either: 23 (1) accredited as graduate medical education by the 24 Accreditation Council for Graduate Medical Education or by 25 any other accrediting body recognized by the board for the 26 purpose of accrediting graduate medical education; or 27 (2) provided by a hospital accredited by the Joint 28 Commission on Accreditation of Hospitals, its successors or 29 assigns, and is acceptable to an American specialty board 30 towards the training it requires for the certification it 19850S1158B1608 - 4 -
1 issues in a medical specialty or subspecialty. 2 "Healing arts." The science and skill of diagnosis and 3 treatment in any manner whatsoever of disease or any ailment of 4 the human body. 5 "Health care practitioner." An individual, other than a 6 physician assistant, who is authorized to practice some 7 component of the healing arts by a license, permit, certificate 8 or registration issued by a Commonwealth licensing agency or 9 board. 10 "Hospital." An institution licensed or regulated as a 11 hospital by the Department of Health or the Department of Public 12 Welfare or a facility owned or operated by the Federal 13 Government and accredited by the Joint Commission on 14 Accreditation of Hospitals as a hospital. 15 "Medical doctor." An individual who has acquired one of the 16 following licenses to practice medicine and surgery issued by 17 the board: 18 (1) License without restriction. 19 (2) License with restriction. 20 (3) Graduate license. 21 (4) Institutional license. 22 (5) Temporary license. 23 (6) Extraterritorial license. 24 "Medical service." Activity which lies within the scope of 25 the practice of medicine and surgery. 26 "Medical training facility." A medical college, hospital or 27 other institution which provides courses in the art and science 28 of medicine and surgery and related subjects for the purpose of 29 enabling a matriculant to qualify for a license or practice 30 medicine and surgery, graduate medical training, midwife 19850S1158B1608 - 5 -
1 certificate or physician assistant certificate. 2 "Medicine and surgery." The art and science of which the 3 objectives are the cure of diseases and the preservation of the 4 health of man, including the practice of the healing art with or 5 without drugs, except healing by spiritual means or prayer. 6 "Midwife or nurse-midwife." An individual who is licensed as 7 a midwife by the board. 8 "Physician." A medical doctor or doctor of osteopathy. 9 "Physician assistant." An individual who is certified as a 10 physician assistant by the board. 11 "Resident." A medical doctor who is participating in 12 graduate training. 13 "Technician." A person, other than a health care 14 practitioner or physician assistant, who through training, 15 education or experience has achieved expertise in the technical 16 details of a subject or occupation which is a component of the 17 healing art. 18 "Unaccredited medical college." An institution of higher 19 learning which provides courses in the art and science of 20 medicine and surgery and related subjects, is empowered to grant 21 professional degrees in medicine, is not accredited by the 22 Association of American Medical Colleges, its successors or 23 assigns, or the American Medical Association, either directly or 24 through their respective accrediting bodies, and is listed by 25 the World Health Organization, its successors or assigns, or is 26 otherwise recognized as a medical college by the country in 27 which it is situated. 28 Section 3. State Board of Medicine. 29 (a) Establishment.--The State Board of Medicine shall 30 consist of the commissioner, the Secretary of Health, two 19850S1158B1608 - 6 -
1 members appointed by the Governor who shall be persons 2 representing the public at large and seven members appointed by 3 the Governor, six of whom shall be medical doctors with 4 unrestricted licenses to practice medicine and surgery in this 5 Commonwealth for five years immediately preceding their 6 appointment, and one who shall be a nurse midwife, physician 7 assistant or certified registered nurse practitioner licensed or 8 certified under the laws of this Commonwealth. 9 (b) Terms of office.--The term of each professional and 10 public member of the board shall be four years or until his or 11 her successor has been appointed and qualified, but not longer 12 than six months beyond the four-year period. In the event that 13 any of said members shall die or resign or otherwise becomes 14 disqualified during his or her term, a successor shall be 15 appointed in the same way and with the same qualifications and 16 shall hold office for the unexpired term. No member shall be 17 eligible for appointment to serve more than two consecutive 18 terms. 19 (c) Quorum.--A majority of the members of the board serving 20 in accordance with law shall constitute a quorum for purposes of 21 conducting the business of the board. Except for temporary and 22 automatic suspensions under section 40, a member may not be 23 counted as part of a quorum or vote on any issue unless he or 24 she is physically in attendance at the meeting. 25 (d) Chairman.--The board shall select annually a chairman 26 from among its professional members. 27 (e) Compensation.--Each member of the board, except the 28 commissioner and the Secretary of Health, shall receive $60 per 29 diem when actually attending to the work of the board. Members 30 shall also receive the amount of reasonable traveling, hotel and 19850S1158B1608 - 7 -
1 other necessary expenses incurred in the performance of their 2 duties in accordance with Commonwealth regulations. 3 (f) Sunset.--The board is subject to evaluation, review and 4 termination in the manner provided in the act of December 22, 5 1981 (P.L.508, No.142), known as the Sunset Act. 6 (g) Attendance at meetings.--A member of the board who fails 7 to attend three consecutive meetings shall forfeit his or her 8 seat unless the commissioner, upon written request from the 9 member, finds that the member should be excused from a meeting 10 because of illness or the death of a family member. 11 (h) Attendance at training seminars.--A public member who 12 fails to attend two consecutive statutorily mandated training 13 seminars in accordance with section 813(e) of the act of April 14 9, 1929 (P.L.177, No.175), known as The Administrative Code of 15 1929, shall forfeit his or her seat unless the commissioner, 16 upon written request from the public member, finds that the 17 public member should be excused from a meeting because of 18 illness or the death of a family member. 19 (i) Meetings.--The board shall meet at least once every two 20 months, and at such additional times as may be necessary to 21 conduct the business of the board. 22 (j) Executive secretary.--The board, with the approval of 23 the commissioner, shall appoint and fix the compensation of an 24 executive secretary who shall be responsible for the day-to-day 25 operation of the board and administration of board activities. 26 Section 4. Impaired professionals. 27 (a) Appointment of Disciplinary Advisory Committee.--The 28 board, with the approval of the commissioner, shall appoint a 29 Disciplinary Advisory Committee composed of three medical 30 doctors, not members of the board, who shall be compensated at 19850S1158B1608 - 8 -
1 the same rate as members of the board and who shall receive the 2 amount of reasonable traveling, hotel and other necessary 3 expenses incurred in the performance of their duties in 4 accordance with Commonwealth regulations. 5 (b) Recommendations involving potential disciplinary 6 actions.--The board may refer to the committee cases involving 7 potential disciplinary actions under this act. Upon such 8 referral, the committee shall review the case and make 9 recommendations to the board within such time as the board shall 10 designate; provided, that once the committee has accepted an 11 impaired professional in an approved treatment program in 12 accordance with this section, the committee may not thereafter 13 accept referral of a disciplinary case regarding that individual 14 from the board. 15 (c) Liaison.--The committee shall act as a liaison between 16 the board and treatment programs, such as alcohol and drug 17 treatment programs licensed by the Department of Health, 18 psychological counseling and impaired professional support 19 groups, which are approved by the board and which provide 20 services to licensees or certificate holders under this act. 21 (d) Review of corrective action by the board.--The board may 22 defer and ultimately dismiss any of the types of corrective 23 action set forth in this act for an impaired professional so 24 long as the professional is progressing satisfactorily in an 25 approved treatment program, provided that the provisions of this 26 subsection shall not apply to a professional convicted of a 27 felonious act prohibited by the act of April 14, 1972 (P.L.233, 28 No.64), known as The Controlled Substance, Drug, Device and 29 Cosmetic Act, or the conviction of a felony relating to a 30 controlled substance in a court of law of the United States or 19850S1158B1608 - 9 -
1 any other state, territory or country. An approved program 2 provider shall, upon request, disclose to the Disciplinary 3 Advisory Committee all information in its possession regarding 4 an impaired professional in treatment. 5 (e) Voluntary suspension or limitation.--An impaired 6 professional who enrolls in an approved treatment program shall, 7 if necessary, agree to a limitation of his or her ability to 8 practice. Failure to do so disqualifies the professional from 9 the impaired professional program and shall activate an 10 immediate investigation and disciplinary proceeding by the 11 board. 12 (f) Failure to satisfactorily progress.--If, in the opinion 13 of the committee after consultation with the provider, an 14 impaired professional who is enrolled in an approved treatment 15 has not progressed satisfactorily, the committee shall disclose 16 to the board all information in its possession regarding the 17 professional; and such disclosure shall constitute the basis for 18 instituting proceedings to suspend or revoke the license or 19 certificate of said professional. 20 (g) Immunity.--An approved program provider who makes a 21 disclosure pursuant to this subsection shall not be subject to 22 civil liability for such disclosure or its consequences. 23 (h) Reports to the board.--Any hospital or health care 24 facility, peer or colleague who knows or has evidence to suspect 25 a professional has an addictive disease, is diverting a 26 controlled substance, or is mentally or physically incompetent 27 to carry out the duties of his or her license or certificate, 28 shall make, or cause to be made, a report to the board: Provided 29 that any person or facility who acts in a treatment capacity to 30 an impaired professional in an approved treatment program is 19850S1158B1608 - 10 -
1 exempt from the mandatory reporting requirements of this 2 subsection. Any person or facility who reports pursuant to this 3 section in good faith and without malice shall be immune from 4 any civil or criminal liability arising from such report. 5 Failure to provide such report within a reasonable time from 6 receipt of knowledge of impairment shall subject the person or 7 facility to a fine not to exceed $1,000. The board shall levy 8 this penalty only after affording the accused party the 9 opportunity for a hearing, as provided in Title 2 of the 10 Pennsylvania Consolidated Statutes (relating to administrative 11 law and procedure). 12 Section 5. Consultants. 13 The board shall establish consultant panels or use individual 14 consultants, as it deems appropriate, to assist it in carrying 15 out its responsibilities. The board may not delegate any of its 16 final decisionmaking responsibilities to a consultant or panel 17 of consultants. 18 Section 6. Fees, fines and civil penalties. 19 (a) Setting of fees.--All fees required under this act shall 20 be fixed by the board by regulation and shall be subject to the 21 act of June 25, 1982 (P.L.633, No.181), known as the Regulatory 22 Review Act. If the revenues raised by fees, fines and civil 23 penalties imposed under this act are not sufficient to meet 24 expenditures over a two-year period, the board shall increase 25 those fees by regulation so that the projected revenues will 26 meet or exceed projected expenditures. 27 (b) Inadequate fees.--If the Bureau of Professional and 28 Occupational Affairs determines that the fees established by the 29 board under subsection (a) are inadequate to meet the minimum 30 enforcement efforts required by this act, then the bureau after 19850S1158B1608 - 11 -
1 consultation with the board and subject to the Regulatory Review 2 Act, shall increase the fees by regulation in an amount that 3 adequate revenues are raised to meet the required enforcement 4 effort. 5 (c) Disposition.--All fees, fines and civil penalties 6 imposed in accordance with this act and collected in accordance 7 with section 907(a) of the act of October 15, 1975 (P.L.390, 8 No.111), known as the Health Care Services Malpractice Act, 9 along with any interest generated thereby, shall be for the 10 exclusive use by the board in carrying out the provisions of 11 this act, and shall be annually appropriated for that purpose. 12 (d) Charging of fees.--The board may charge a reasonable 13 fee, as set by the board by regulation, for all examinations, 14 registrations, certificates, licensures or applications 15 permitted by this act or the regulations thereunder. 16 Section 7. Reports of the board. 17 (a) Reports to Department of State.--The board shall submit 18 annually to the Department of State an estimate of the financial 19 requirements of the board for its administrative, investigative, 20 legal and miscellaneous expenses. 21 (b) Reports to House and Senate Appropriations Committees.-- 22 The board shall submit annually to the House and Senate 23 Appropriations Committees, 15 days after the Governor has 24 submitted his budget to the General Assembly, a copy of the 25 budget request for the upcoming fiscal year which the board 26 previously submitted to the department. 27 (c) Reports to other House and Senate committees.--The board 28 shall submit annually a report to the Professional Licensure 29 Committee of the House of Representatives and to the Consumer 30 Protection and Professional Licensure Committee of the Senate a 19850S1158B1608 - 12 -
1 description of the types of complaints received, status of 2 cases, board action which has been taken and the length of time 3 from the initial complaint to final board resolution. The report 4 shall also include a statement of the numbers and types of 5 licenses granted and a statement on physician assistant use in 6 this Commonwealth, including geographic location and practice 7 settings. 8 Section 8. Regulatory powers of the board. 9 The board, in the exercise of its duties under this act, 10 shall have the power to adopt such regulations as are reasonably 11 necessary to carry out the purposes of this act. Regulations 12 shall be adopted in conformity with the provisions of the act of 13 July 31, 1968 (P.L.769, No.240), referred to as the Commonwealth 14 Documents Law, and the act of June 25, 1982 (P.L.633, No.181), 15 known as the Regulatory Review Act. 16 Section 9. Procedure, oaths and subpoenas. 17 (a) All actions of the board.--All actions of the board 18 shall be taken subject to the right of notice, hearing and 19 adjudication, and the right of appeal therefrom, in accordance 20 with the provisions in Title 2 of the Pennsylvania Consolidated 21 Statutes (relating to administrative law and procedure). 22 (b) Disciplinary proceedings.--All disciplinary proceedings 23 conducted by hearing examiners shall be conducted in accordance 24 with sections 901 through 905 of the act of October 15, 1975 25 (P.L.390, No.111), known as the Health Care Services Malpractice 26 Act. 27 (c) Subpoena power.--The board shall have the authority to 28 issue subpoenas, upon application of an attorney responsible for 29 representing the Commonwealth in disciplinary matters before the 30 board, for the purpose of investigating alleged violations of 19850S1158B1608 - 13 -
1 the disciplinary provisions administered by the board. The board 2 shall have the power to subpoena witnesses, to administer oaths, 3 to examine witnesses or to take testimony or compel the 4 production of books, records, papers and documents as it may 5 deem necessary or proper in and pertinent to any proceeding, 6 investigation or hearing held by it. Medical records may not be 7 subpoenaed without consent of the patient or without order of a 8 court of competent jurisdiction on a showing that the records 9 are reasonably necessary for the conduct of the investigation. 10 The court may impose such limitations on the scope of the 11 subpoena as are necessary to prevent unnecessary intrusion in 12 patient confidential information. The board is authorized to 13 apply to Commonwealth Court to enforce its subpoenas. 14 Section 10. Unauthorized practice of medicine and surgery. 15 No person other than a medical doctor shall engage in any of 16 the following conduct except as authorized or exempted in this 17 act: 18 (1) Practice medicine and surgery. 19 (2) Purport to practice medicine and surgery. 20 (3) Hold forth as authorized to practice medicine and 21 surgery through use of a title, including, but not 22 necessarily limited to, medical doctor, doctor of medicine, 23 doctor of medicine and surgery, doctor of a designated 24 disease, physician, physician of a designated disease, or any 25 abbreviation for the foregoing. 26 (4) Otherwise hold forth as authorized to practice 27 medicine and surgery. 28 Section 11. Clinical clerks. 29 (a) Authorized services.--A clinical clerk may perform the 30 following services in a hospital to which the clerk is assigned, 19850S1158B1608 - 14 -
1 provided the services are performed within the restrictions 2 contained in or authorized by this section: 3 (1) Make notes on a patient's chart. 4 (2) Conduct a physical examination. 5 (3) Perform a medical procedure or laboratory test. 6 (b) Regulations.--A clinical clerk shall not perform a 7 medical service unless the performance of such by the clinical 8 clerk under the circumstances is consistent with the standards 9 of acceptable medical practice embraced by the medical doctor 10 community in this Commonwealth. The board shall promulgate 11 regulations which define the medical services those standards 12 permit a clinical clerk to perform and the circumstances under 13 which those standards permit a clinical clerk to perform a 14 medical service. 15 (c) Supervision.--A clinical clerk shall not perform a 16 medical service without the direct and immediate supervision of 17 the medical doctor members of the medical staff or residents at 18 the hospital in which the service is performed. The board shall 19 promulgate regulations which define the supervision required by 20 those standards. 21 (d) Drugs.--A clinical clerk shall not prescribe or dispense 22 drugs. 23 (e) Notes on patients' charts.--Notes made on a patient's 24 chart by a clinical clerk become official only when 25 countersigned by a medical doctor member of the hospital's 26 medical staff or resident beyond a first-year level of graduate 27 medical education at the hospital. 28 (f) Other licenses or certificates.--Nothing in this section 29 or the regulations authorized by this section shall be construed 30 to prohibit a clinical clerk who is licensed or certified to 19850S1158B1608 - 15 -
1 practice a profession by a Commonwealth agency or board from 2 practicing within the scope of that license or certificate or as 3 otherwise authorized by law. 4 Section 12. Midwifery. 5 (a) Previous licensure.--A midwife who has been licensed 6 previously by the board may continue to practice midwifery in 7 accordance with regulations promulgated by the board. 8 (b) Use of title.--A midwife may use the title midwife, 9 nurse-midwife or an appropriate abbreviation of those titles. 10 (c) Other licenses or certificates.--Nothing in this section 11 or the regulations authorized by this section shall be construed 12 to prohibit a midwife who is licensed or certified to practice 13 another profession by a Commonwealth agency or board from 14 practicing within the scope of that license or certificate or as 15 otherwise authorized by law. 16 Section 13. Physician assistants. 17 (a) Authorized services.--A physician assistant may perform 18 a medical service delegated by an approved physician and as 19 approved by the appropriate board. An approved physician is a 20 physician identified in the writing required by subsection (e). 21 (b) Use of title.--A physician assistant may use the title 22 physician assistant or an appropriate abbreviation for that 23 title, such as "P.A.-C." 24 (c) Regulations.--The board shall promulgate regulations 25 which define the services and circumstances under which a 26 physician assistant may perform a medical service. 27 (d) Supervision.--A physician assistant shall not perform a 28 medical service without the supervision and personal direction 29 of an approved physician. The board shall promulgate regulations 30 which define the supervision and personal direction required by 19850S1158B1608 - 16 -
1 those standards. 2 (e) Written agreement.--A physician assistant shall not 3 provide a medical service without a written agreement with one 4 or more physicians which provides for all of the following: 5 (1) Identifies and is signed by each physician the 6 physician assistant will be assisting. 7 (2) Describes the manner in which the physician 8 assistant will be assisting each named physician. 9 (3) Describes the nature and degree of supervision and 10 direction each named physician will provide the physician 11 assistant. 12 (4) Designates one of the named physicians as having the 13 primary responsibility for supervising and directing the 14 physician assistant. 15 (5) Has been approved by the board as satisfying the 16 foregoing and as consistent with the restrictions contained 17 in or authorized by this section. 18 A physician assistant shall not assist a physician in a manner 19 not described in the agreement or without the nature and degree 20 of supervision and direction described in the agreement. The 21 physician designated as having primary responsibility for the 22 physician assistant shall not have primary responsibility for 23 more than two physician assistants. 24 (f) Drugs.--A physician assistant shall not independently 25 prescribe or dispense drugs. The board and the State Board of 26 Pharmacy shall jointly promulgate regulations which permit a 27 physician assistant to prescribe and dispense drugs at the 28 direction of a physician. 29 (g) Supervision.--A physician assistant may be employed by a 30 medical care facility under the supervision and direction of an 19850S1158B1608 - 17 -
1 approved physician or group of such physicians, provided one of 2 those physicians is designated as having the primary 3 responsibility for supervising and directing the physician 4 assistant and provided that a physician assistant shall not be 5 responsible to more than three physicians. 6 (h) Reimbursement.--For reimbursement purposes a physician 7 assistant shall be an employee subject to the normal employer- 8 employee reimbursement procedures. 9 (i) Eye services.--No medical services may be performed by a 10 physician assistant under this act which include the measurement 11 of the range or powers of human vision or the determination of 12 the refractive status of the human eye. This subsection does not 13 prohibit the performance of routine vision screenings or the 14 performance of refractive screenings in the physician's office. 15 (j) Chiropractic practice.--Nothing in this act shall be 16 construed to allow physician assistants to practice 17 chiropractic. 18 (k) Other licenses or certificates.--Nothing in this section 19 or the regulations authorized by this section shall be construed 20 to prohibit a physician assistant who is licensed or certified 21 to practice another profession by a Commonwealth agency or board 22 from practicing within the scope of that license or certificate 23 or as otherwise authorized by law. 24 Section 14. Drugless therapist. 25 (a) Previous licensure.--A drugless therapist who has been 26 licensed previously by the board may continue to provide 27 drugless therapy in accordance with the regulations promulgated 28 by the board. 29 (b) Drugs.--A drugless therapist shall not prescribe or 30 dispense drugs. 19850S1158B1608 - 18 -
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 drugless therapist who is licensed or certified to 4 practice another profession by a Commonwealth agency or board 5 from practicing within the scope of that license or certificate 6 or as otherwise authorized by law. 7 Section 15. Certified registered nurse practitioner. 8 (a) General rule.--A certified registered nurse practitioner 9 shall act in accordance with regulations authorized by this 10 section. 11 (b) Regulations.--The board and the State Board of Nurse 12 Examiners shall jointly promulgate regulations authorizing a 13 certified registered nurse practitioner to perform acts of 14 medical diagnoses and prescription of medical, therapeutic, 15 diagnostic or corrective measures. 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 certified registered nurse practitioner who is 19 licensed or certified to practice another profession by a 20 Commonwealth agency or board from practicing within the scope of 21 that license or certificate as otherwise authorized by law. 22 Section 16. Consultation. 23 A person authorized to practice medicine or surgery or 24 osteopathy without restriction by any other state may, upon 25 request by a medical doctor, provide consultation to the medical 26 doctor regarding the treatment of a patient under the care of 27 the medical doctor. 28 Section 17. Delegation of duties to health care practitioner or 29 technician. 30 (a) General rule.--A health care practitioner or technician 19850S1158B1608 - 19 -
1 may perform a medical service if: 2 (1) The performance of the service was delegated by a 3 medical doctor. 4 (2) The delegation is consistent with the standards of 5 acceptable medical practice embraced by the medical doctor 6 community in this Commonwealth. 7 (3) The delegation is not prohibited by regulations 8 promulgated by the board. 9 (4) The delegation is not prohibited by statutes or 10 regulations relating to other licensed health care 11 practitioners. 12 (b) Regulations.--The board may promulgate regulations which 13 establish criteria pursuant to which a medical doctor may 14 delegate the performance of medical services, preclude a medical 15 doctor from delegating the performance of certain types of 16 medical services, or otherwise limit the ability of a medical 17 doctor to delegate medical services. 18 (c) Responsibility.--Nothing in this section shall be 19 construed to limit the medical doctor's responsibility for the 20 medical service delegated to the health care practitioner or 21 technician. 22 Section 18. Federal medical personnel. 23 Nothing in this act shall be construed to prohibit a medical 24 doctor in the medical service of the armed forces of the United 25 States, the United States Public Health Service or the Veterans' 26 Administration, or a Federal employee, from discharging official 27 duties. 28 Section 19. Osteopathic act. 29 (a) General rule.--Nothing in this act shall be construed to 30 prohibit a doctor of osteopathy from practicing osteopathic 19850S1158B1608 - 20 -
1 medicine and surgery. 2 (b) Specific authorization.--Nothing in this act shall be 3 construed to prohibit a person authorized to practice 4 osteopathic medicine and surgery by the act of October 5, 1978 5 (P.L.1109, No.261), known as the Osteopathic Medical Practice 6 Act, to practice as authorized by that act. 7 Section 20. Other health care practitioners. 8 Nothing in this act shall be construed to prohibit a health 9 care practitioner from practicing that profession within the 10 scope of the health care practitioner's license or certificate 11 or as otherwise authorized by the law, including using the title 12 authorized by the practitioner's licensing act. 13 Section 21. Acts outside nonmedical doctor license or 14 certificate. 15 (a) Medical doctor involvement.--In the event the law, 16 including this act, conditions a person's authorization to 17 perform one or more medical services upon medical doctor 18 involvement, and the person performs a covered service without 19 the required involvement, the person shall be deemed to have 20 acted outside the scope of the person's license or certificate. 21 (b) Included involvements.--The medical doctor involvement 22 referred to in subsection (a) shall include, but shall not 23 necessarily be limited to, any of the following: 24 (1) An order. 25 (2) Direction or supervision. 26 (3) Presence. 27 (4) Immediate availability. 28 (5) Referral. 29 (6) Consultation. 30 Section 22. Licenses and certificates; general qualification. 19850S1158B1608 - 21 -
1 (a) Types of licenses and certificates.--The board may grant 2 the following licenses and certificates: 3 (1) License without restriction. 4 (2) License with restriction. 5 (3) Graduate license. 6 (4) Institutional license. 7 (5) Temporary license. 8 (6) Extraterritorial license. 9 (7) Midwife license. 10 (8) Physician assistant certificate. 11 (b) Qualifications.--The board shall not issue a license or 12 certificate to an applicant unless the applicant establishes 13 with evidence, verified by an affidavit or affirmation of the 14 applicant, that the applicant is of legal age, is of good moral 15 character and is not addicted to the intemperate use of alcohol 16 or the habitual use of narcotics or other habit-forming drugs, 17 and that the applicant has completed the educational 18 requirements prescribed by the board, and otherwise satisfies 19 the qualifications for the license or certificate contained in 20 or authorized by this act. THE BOARD SHALL NOT ISSUE A LICENSE <-- 21 OR CERTIFICATE TO AN APPLICANT WHO HAS BEEN CONVICTED 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 OF AN OFFENSE UNDER THE LAWS OF ANOTHER JURISDICTION WHICH IF 25 COMMITTED IN THIS COMMONWEALTH WOULD BE A FELONY UNDER THE 26 CONTROLLED SUBSTANCE, DRUG, DEVICE AND COSMETIC ACT, UNLESS: 27 (1) AT LEAST TEN YEARS HAVE ELAPSED FROM THE DATE OF 28 CONVICTION; 29 (2) THE APPLICANT SATISFACTORILY DEMONSTRATES TO THE 30 BOARD THAT HE HAS MADE SIGNIFICANT PROGRESS IN PERSONAL 19850S1158B1608 - 22 -
1 REHABILITATION SINCE THE CONVICTION SUCH THAT LICENSURE OF 2 THE APPLICANT SHOULD NOT BE EXPECTED TO CREATE A SUBSTANTIAL 3 RISK OF HARM TO THE HEALTH AND SAFETY OF HIS PATIENTS OR THE 4 PUBLIC OR A SUBSTANTIAL RISK OF FURTHER CRIMINAL VIOLATIONS; 5 AND 6 (3) THE APPLICANT OTHERWISE SATISFIES THE QUALIFICATIONS 7 CONTAINED IN OR AUTHORIZED BY THIS ACT. 8 AS USED IN THIS SECTION THE TERM "CONVICTED" SHALL INCLUDE A 9 JUDGMENT, AND ADMISSION OF GUILT OR A PLEA OF NOLO CONTENDERE. 10 (c) Refusal.--The board may refuse to issue a license or 11 certificate to an applicant based upon a ground for such action 12 contained in section 41. 13 (d) Limitation.--The board shall not refuse to issue a 14 license or certificate to an applicant unless the applicant has 15 been afforded the procedural protections required by this act. 16 (e) Action on application.--The application, upon filing by 17 the applicant of the evidence required under subsection (b) and 18 the expiration of a period of 90 days, shall be deemed to meet 19 the requirements of this act and become effective, the license 20 or certificate shall be deemed issued, and the board shall take 21 no action against the applicant for practicing without a license 22 or certificate, unless within that period the application has 23 been disapproved by the board or proceedings have been initiated 24 against the applicant under this act. 25 Section 23. Standards for medical training facilities. 26 (a) General rule.--The educational qualifications for 27 acceptance as a matriculant in a medical college or other 28 medical training facility incorporated within this Commonwealth 29 and the curricula and training to be offered by such medical 30 colleges or other medical training facility shall meet the 19850S1158B1608 - 23 -
1 requirements set by the board and any accrediting body which may 2 be recognized by the board. 3 (b) Duties of the board.--It shall be the duty of the board, 4 in its discretion, periodically to ascertain the character of 5 the instruction and the facilities possessed by each of the 6 medical colleges and other medical training facilities offering 7 or desiring to offer medical training in accordance with the 8 requirements of this act. In shall further be the duty of the 9 board, by inspection and otherwise, to ascertain the facilities 10 and qualifications of medical colleges and other medical 11 training facilities outside this Commonwealth, whose graduates 12 or trainees desire to obtain licensure, graduate medical 13 training or certification in this Commonwealth, provided further 14 that the board shall have the authority to refuse to license 15 graduates of any such medical institutions, colleges or 16 hospitals which in its judgment do not meet similar standards 17 for medical training and facilities as are required of medical 18 institutions in this Commonwealth. In enforcing this provision, 19 the board shall give due notice to any medical institution, 20 college or hospital upon which it has rendered a decision that 21 its training and facilities do not meet the standards required 22 by the board. 23 (c) Refusal of recognition.--In the event that the board 24 determines that a medical training facility has failed to 25 provide adequate facilities, curricula or training, the board 26 shall not recognize the education or degrees obtained from the 27 medical training facility during the period of inadequacy. 28 Section 24. Examinations. 29 (a) General rule.--The board may require an applicant to 30 take and pass an examination to the satisfaction of the board. 19850S1158B1608 - 24 -
1 (b) Proficiency in English language.--In addition to any 2 other examination required by this act or by regulation of the 3 board, applicants for a license or certificate, whose principal 4 language is other than English, may also be required to 5 demonstrate, by examination, proficiency in the English language 6 to any agency considered competent by the board. 7 (c) Authority to call in medical consultants.--For the 8 purpose of conducting all examinations, the board shall have the 9 privilege of calling to its aid medical consultants who shall be 10 compensated for their services at a reasonable rate in an amount 11 as determined, from time to time, by the board in addition to 12 all incurred expenses, in accordance with Commonwealth 13 regulations. 14 (d) Examining agency.--When the board accepts an examination 15 given by an examining agency, the board may establish the 16 criteria for passing, or may accept the criteria for passing, 17 established by the examining agency. If the examination is 18 offered in parts, the board may establish, by regulation, a time 19 period in which the entire examination must be successfully 20 completed. The board may establish, by regulation, a maximum 21 number of examination attempts it will recognize for the purpose 22 of receiving a passing score on an examination recognized but 23 not given by the board. 24 Section 25. Licenses and certificates; biennial registration. 25 (a) Issuance of licenses and certificates.--All applicants 26 who have complied with the requirements of the board, and who 27 shall have passed a final examination, and who have otherwise 28 complied with the provisions of this act, shall receive from the 29 commissioner, or whoever exercises equivalent authority acting 30 for the board, a license or certificate entitling them to the 19850S1158B1608 - 25 -
1 right to practice in this Commonwealth. Each such license or 2 certificate shall be duly recorded in the office of the board, 3 in a record to be properly kept for that purpose which shall be 4 open to public inspection and a certified copy of said record 5 shall be received as evidence in all courts in this Commonwealth 6 in the trial of any case. 7 (b) Renewals.--It shall be the duty of all persons now or 8 hereafter licensed or certified to be registered with the board 9 and, thereafter, to register in like manner at such intervals 10 and by such methods as the board shall determine by regulations, 11 but in no case shall such renewal period be longer than two 12 years. The form and method of such registration shall be 13 determined by the board. 14 (c) Fees.--Each person so registering with the board shall 15 pay, for each biennial registration, a reasonable fee which, if 16 any, shall accompany the application for such registration. 17 (d) Evidence of registration.--Upon receiving a proper 18 application for such registration accompanied by the fee, if 19 any, above provided for, the board shall issue a certificate of 20 registration to the applicant. Said certificate together with 21 its renewals shall be good and sufficient evidence of 22 registration under the provisions of this act. 23 Section 26. Certification of license or certificate. 24 The status of a license or certificate issued by the board 25 shall be certified by the board to other jurisdictions or 26 persons upon formal application and payment of a reasonable fee. 27 Section 27. Reciprocity or endorsement. 28 Reciprocity or endorsement may be established at the 29 discretion of the board. As used in this section, the term 30 "reciprocity" means the act of the board and a licensing 19850S1158B1608 - 26 -
1 authority in another jurisdiction, each recognizing that the 2 requirements for a license or certificate in this Commonwealth 3 and in the other jurisdiction are equivalent, issuing a license 4 or certificate to an applicant who possesses a similar license 5 or certificate in the other jurisdiction. As used in this 6 section, the term "endorsement" means the issuance of a license 7 or certificate by the board to an applicant who does not meet 8 standard requirements, if the applicant has achieved cumulative 9 qualifications which are accepted by the board as being 10 equivalent to the standard requirements for the license or 11 certificate. 12 Section 28. License to practice medicine and surgery. 13 An individual is not qualified for a license to practice 14 medicine and surgery unless the individual has received an 15 academic degree in medicine and surgery from a medical college 16 and the individual satisfies the other qualifications for the 17 license contained in or authorized by this act. 18 Section 29. License without restriction. 19 (a) General rule.--A license without restriction empowers 20 the licensee to practice medicine and surgery without any 21 restriction or limitation. 22 (b) Graduates of accredited medical colleges.--No license 23 without restriction may be issued to a graduate of an accredited 24 medical college unless the applicant has completed successfully 25 as a resident two years of approved graduate medical training. 26 (c) Graduates of unaccredited medical colleges.--No license 27 without restriction may be issued to a graduate of an 28 unaccredited medical college unless the applicant has completed 29 successfully as a resident three years of approved graduate 30 medical training, educational requirements prescribed by the 19850S1158B1608 - 27 -
1 board and certification by the Educational Council for Foreign 2 Medical Graduates, or its successors. 3 (d) Examinations.--The board shall hold at least two 4 examinations for applicants for a license without restriction 5 each year. Special examinations may be designated by the board. 6 The examinations shall be held at such times and places as 7 designated by the board. In case of failure at any such 8 examination, the applicant shall have, after the expiration of 9 six months and within two years, the privilege of a second 10 examination by the board. In case of failure in a second 11 examination, or after the expiration of two years, the applicant 12 must thereafter successfully complete, as a resident, one year 13 of graduate medical training approved by the board, apply de 14 novo, and qualify under the conditions in existence at the time 15 of the application. 16 Section 30. License with restriction. 17 (a) General rule.--A license with restriction empowers the 18 licensee to practice medicine and surgery with such restrictions 19 or limitations as may be established by the board, including 20 restrictions in the scope of permitted practice, a requirement 21 that the applicant take one or more refresher educational 22 courses or mandated submission of medical care, counseling or 23 treatment. 24 (b) Prerequisite.--No license with restriction may by issued 25 unless the applicant has otherwise been issued, or is qualified 26 to be issued, a license without restriction in accordance with 27 this act. 28 (c) Disciplinary proceedings or voluntary request.--The 29 board may issue a license with restriction only upon completion 30 of disciplinary proceedings in accordance with this act or upon 19850S1158B1608 - 28 -
1 a voluntary request of the applicant. 2 Section 31. Graduate license. 3 (a) General rule.--A graduate license empowers the licensee 4 to participate for a period of up to 12 consecutive months in 5 graduate medical training within the complex of the hospital to 6 which the licensee is assigned and any satellite facility or 7 other training location utilized in the graduate training 8 program. 9 (b) Requirements.--No graduate license may be issued unless 10 the applicant is a graduate of an accredited medical college or 11 an unaccredited medical college and has received a medical 12 degree. A graduate license may be issued to an applicant who 13 holds the equivalent of a license without restriction granted by 14 another state or territory of the United States or the Dominion 15 of Canada. 16 (c) Extensions; waivers.--The board may extend the validity 17 of a graduate license upon application when such action is 18 warranted. In the event a graduate license holder is issued a 19 license without restriction and wishes to continue graduate 20 medical training, the graduate license holder shall complete and 21 keep current a form satisfactory to the board containing 22 information desired by the board on the graduate medical 23 training program. A graduate of an unaccredited medical college, 24 who does not possess all of the qualifications for the issuance 25 of a graduate license but desires to train in a hospital within 26 this Commonwealth in an area of advanced medical training, may 27 have the unmet qualifications waived by the board if the board 28 determines that the applicant possesses the technical skills and 29 educational background to participate in such training and that 30 its issuance is beneficial to the health, safety and welfare of 19850S1158B1608 - 29 -
1 the general public of this Commonwealth. 2 Section 32. Institutional license. 3 (a) General rule.--An institutional license empowers the 4 licensee to teach or practice medicine and surgery in one of the 5 medical colleges, affiliates or hospitals within this 6 Commonwealth. 7 (b) Requirements.--No institutional license may be issued 8 unless the applicant: 9 (1) is a graduate of an unaccredited medical college who 10 has attained through professional growth and teaching 11 experience the status of teacher; or 12 (2) is not otherwise licensed to practice medicine and 13 surgery in this Commonwealth but has achieved outstanding 14 medical skills in a particular area of medicine and surgery 15 and wishes to practice, demonstrate or teach with those 16 outstanding medical skills. 17 (c) Determinations by the board.--The board shall issue an 18 institutional license valid for no more than three years, as the 19 board shall determine and only when it determines that its 20 issuance is beneficial to the health, safety and welfare of the 21 general public of this Commonwealth. A person granted an 22 institutional license who subsequently desires to obtain a 23 license without restriction shall be required to meet all of the 24 requirements of such license as set forth in this act. 25 Section 33. Temporary license. 26 (a) General rule.--A temporary license empowers the licensee 27 to: 28 (1) teach medicine and surgery or participate in a 29 medical procedure necessary for the well-being of a specified 30 patient within this Commonwealth; or 19850S1158B1608 - 30 -
1 (2) practice medicine and surgery at a camp or resort 2 for no more than three months. 3 (b) Requirements.--No temporary license may be issued unless 4 the applicant holds the equivalent of a license without 5 restriction granted by another state, territory or country. 6 (c) Additional conditions.--The board may impose any 7 appropriate limitation in scope, duration or site of practice on 8 the temporary license. Temporary licensees shall be deemed 9 health care providers who conduct 50% or less of their health 10 care business or practice within this Commonwealth for the 11 purposes of the act of October 15, 1975 (P.L.390, No.111), known 12 as the Health Care Services Malpractice Act. 13 Section 34. Extraterritorial license. 14 (a) General rule.--An extraterritorial license empowers the 15 licensee residing in or maintaining the office of practice in 16 any adjoining state near the boundary line between such state 17 and this Commonwealth, whose medical practice extends into this 18 Commonwealth, to practice medicine and surgery with or without 19 restriction in this Commonwealth on such patients. 20 (b) Requirements.--No extraterritorial license may be issued 21 unless the applicant holds the equivalent of a license without 22 restriction granted by a state adjoining this Commonwealth. 23 (c) Additional conditions.--An extraterritorial license may 24 be granted by the board so long as the board is provided with: 25 (1) An application for the license, which shall include 26 information on malpractice insurance coverage compliance. 27 (2) A certification by the authorized licensing body of 28 such state of the current license in the state of residence 29 and primary practice. 30 The exercise of the discretion of the board in granting such a 19850S1158B1608 - 31 -
1 license will depend primarily upon the needs of patients in this 2 Commonwealth, the availability of medical care in the specific 3 area involved and whether the adjoining state of licensure 4 reciprocates by extending similar privileges to medical doctors 5 who reside and have their office of practice in this 6 Commonwealth. Such a license will be automatically revoked if 7 such medical doctor relocates the office of practice or 8 residence. A medical doctor granted such a license has the duty 9 to inform the board of any changes in practice which may in any 10 way affect the maintenance of the license. 11 Section 35. Nurse-midwife license. 12 (a) General rule.--A nurse-midwife license empowers the 13 licensee to practice midwifery in this Commonwealth as provided 14 in this act. The board shall formulate and issue such rules and 15 regulations, from time to time, as may be necessary for the 16 examination, licensing and proper conduct of the practice of 17 midwifery. 18 (b) Requirements.--No nurse-midwife license will be issued 19 unless the applicant is a registered nurse licensed in this 20 Commonwealth. An applicant for a midwife license must have 21 completed an academic and clinical program of study in midwifery 22 which has been approved by the board or an accrediting body 23 recognized by the board. 24 Section 36. Physician assistant certificate. 25 (a) General rule.--A physician assistant certificate 26 empowers the holder to assist a medical doctor in the provision 27 of medical care and services under the supervision and direction 28 of that medical doctor as provided in this act. 29 (b) Requirements.--No physician assistant certificate may be 30 issued to the applicant unless the requirements set forth by 19850S1158B1608 - 32 -
1 this act and such rules and regulations issued by the board are 2 met, including requirements for the physician assistant 3 certificate of training and educational programs which shall be 4 formulated by the board in accordance with such national 5 criteria as are established by national organizations or 6 societies as the board may accept. 7 (c) Criteria.--The board shall grant physician assistant 8 certificates to applicants who have fulfilled the following 9 criteria: 10 (1) Satisfactory performance on the proficiency 11 examination to the extent that a proficiency examination 12 exists. 13 (2) Satisfactory completion of a certified program for 14 the training and education of physician assistants. 15 (d) Biennial renewal.--A physician assistant certificate 16 shall be subject to biennial renewal by the board. 17 (e) Description of manner of assistance.--The application 18 shall include a written request from the applicant's supervising 19 medical doctor who shall file with the board a description of 20 the manner in which the physician assistant will assist the 21 supervising medical doctor, which description shall be subject 22 to the approval of the board. 23 Section 37. Reporting of multiple licensure. 24 Any licensed medical doctor in this Commonwealth who is also 25 licensed to practice medicine and surgery in any other state, 26 territory or country shall report this information to the board 27 on the biennial registration application or within 90 days of 28 final disposition, whichever is sooner. Any disciplinary action 29 taken in other states must be reported to the board on the 30 biennial registration application. Multiple licensure will be 19850S1158B1608 - 33 -
1 noted on the medical doctor's record and such state, territory 2 or country will be notified of any disciplinary actions taken 3 against said medical doctor in this Commonwealth. 4 Section 38. Injunctions against unlawful practice. 5 It shall be unlawful for any person to practice, or attempt 6 to offer to practice, medicine and surgery, as defined in this 7 act, without having at the time of so doing a valid, unexpired, 8 unrevoked and unsuspended license issued under this act. The 9 unlawful practice of medicine and surgery as defined in this act 10 may be enjoined by the courts on petition of the board or by the 11 commissioner. In any such proceeding it shall not be necessary 12 to show that any person is individually injured by the actions 13 complained of. If it is determined the respondent has engaged in 14 the unlawful practice of medicine and surgery, the court shall 15 enjoin him from so practicing unless and until he has been duly 16 licensed. Procedure in such cases shall be the same as in any 17 other injunction suit. The remedy by injunction hereby given is 18 in addition to any other civil or criminal prosecution and 19 punishment. 20 Section 39. Penalties. 21 (a) General rule.--Any person, or the responsible officer or 22 employee of any corporation or partnership, institution or 23 association, violating any provisions of this act, or any rule 24 or regulation of the board commits of a misdemeanor of the third 25 degree and shall, upon conviction, be sentenced to pay a fine of 26 not more than $2,000 or to imprisonment for not more than six 27 months, or both, for the first violation. On the second and each 28 subsequent conviction, he or she shall be sentenced to pay a 29 fine of not less than $5,000 nor more than $20,000 or to 30 imprisonment for not less than six months nor more than one 19850S1158B1608 - 34 -
1 year, or both. 2 (b) Civil penalties.--In addition to any other civil remedy 3 or criminal penalty provided for in this act, the board, by a 4 vote of the majority of the maximum number of the authorized 5 membership of the board as provided by law, or by a vote of the 6 majority of the duly qualified and confirmed membership or a 7 minimum of four members, whichever is greater, may levy a civil 8 penalty of up to $1,000 on any current licensee who violates any 9 provision of this act or on any person who practices medicine or 10 other areas of practice regulated by the board without being 11 properly licensed or certificated to do so under this act. The 12 board shall levy this penalty only after affording the accused 13 party the opportunity for a hearing, as provided in Title 2 of 14 the Pennsylvania Consolidated Statutes (relating to 15 administrative law and procedure). The board shall, within six 16 months after the effective date of this act, adopt guidelines 17 setting forth the amounts and circumstances for which a fine may 18 be imposed. No fines may be imposed in accordance with this 19 subsection until the board has adopted the required guidelines. 20 Nothing in this subsection shall be construed to give the board 21 authority to impose a civil penalty upon any person licensed by 22 another licensing board when acting within the scope of practice 23 of that profession. 24 Section 40. Temporary and automatic suspensions. 25 (a) Temporary suspensions.--A license or certificate issued 26 under this act may be temporarily suspended under circumstances 27 as determined by the board to be an immediate and clear danger 28 to the public health and safety. The board shall issue an order 29 to that effect without a hearing, but upon due notice, to the 30 licensee or certificate holder concerned at his or her last 19850S1158B1608 - 35 -
1 known address, which shall include a written statement of all 2 allegations against the licensee or certificate holder. The 3 provisions of section 9 shall not apply to temporary suspension. 4 The board shall thereupon commence formal action to suspend, 5 revoke and restrict the license or certificate of the person 6 concerned as otherwise provided for in this act. All actions 7 shall be taken promptly and without delay. Within 30 days 8 following the issuance of an order temporarily suspending a 9 license, the board shall conduct or cause to be conducted, a 10 preliminary hearing to determine that there is a prima facie 11 case supporting the suspension. The licensee or certificate 12 holder whose license or certificate has been temporarily 13 suspended may be present at the preliminary hearing and may be 14 represented by council, cross-examine witnesses, inspect 15 physical evidence, call witnesses, offer evidence and testimony 16 and make a record of the proceedings. If it is determined that 17 there is not a prima facie case, the suspended license shall be 18 immediately restored. The temporary suspension shall remain in 19 effect until vacated by the board, but in no event longer than 20 180 days. 21 (b) Automatic suspensions.--A license or certificate issued 22 under this act shall automatically be suspended upon the legal 23 commitment to an institution of a licensee or certificate holder 24 because of mental incompetency from any cause upon filing with 25 the board a certified copy of such commitment, conviction of a 26 felony under the act of April 14, 1972 (P.L.233, No.64), known 27 as The Controlled Substance, Drug, Device and Cosmetic Act, or 28 conviction of an offense under the laws of another jurisdiction, 29 which if committed in this Commonwealth, would be a felony under 30 The Controlled Substance, Drug, Device and Cosmetic Act. As used 19850S1158B1608 - 36 -
1 in this section the term "conviction" shall include a judgment, 2 an admission of guilt or a plea of nolo contendere. Automatic 3 suspension under this subsection shall not be stayed pending any 4 appeal of a conviction. Restoration of such license or 5 certificate shall be made as hereinafter provided in the case of 6 revocation or suspension of such license or certificate. 7 Section 41. Reasons for refusal, revocation, suspension or 8 other corrective actions against a licensee or 9 certificate holder. 10 The board shall have authority to impose disciplinary or 11 corrective measures on a practitioner for any or all of the 12 following reasons: 13 (1) Failing to demonstrate the qualifications or 14 standards for a license, certification or registration 15 contained in this act, or regulations of the board. 16 (2) Making misleading, deceptive, untrue or fraudulent 17 representations in the practice of the profession or 18 practicing fraud or deceit, either alone or as a conspirator 19 in obtaining a license, certification or registration, or in 20 obtaining admission to a medical college. 21 (3) Being convicted of a felony, a misdemeanor relating 22 to a health profession, or receiving probation without 23 verdict, disposition in lieu of trial or an accelerated 24 rehabilitative disposition in the disposition of felony 25 charges, in the courts of this Commonwealth, a Federal court 26 or a court of any other state, territory or country. 27 (4) Having a license or other authorization to practice 28 the profession revoked or suspended or having other 29 disciplinary action taken, or an application for a license or 30 other authorization refused, revoked or suspended by a proper 19850S1158B1608 - 37 -
1 licensing authority of another state, territory or country, 2 or a branch of the Federal Government. 3 (5) Being unable to practice the profession with 4 reasonable skill and safety to patients by reason of illness, 5 addiction to drugs or alcohol, having been convicted of a 6 felonious act prohibited by the act of April 14, 1972 7 (P.L.233, No.64), known as The Controlled Substance, Drug, 8 Device and Cosmetic Act, or convicted of a felony relating to 9 a controlled substance in a court of law of the United States 10 or any other state, territory or country, or if he or she is 11 or shall become mentally incompetent. An applicant's 12 statement on the application declaring the absence of a 13 conviction shall be deemed satisfactory evidence of the 14 absence of a conviction unless the board has some evidence to 15 the contrary. In enforcing this paragraph, the board shall, 16 upon probable cause, have authority to compel a practitioner 17 to submit to a mental or physical examination by physicians 18 approved by the board. Failure of a practitioner to submit to 19 such examination when directed by the board, unless such 20 failure is due to circumstances beyond his or her control, 21 shall constitute an admission of the allegations against him 22 or her, consequent upon which a default and final order may 23 be entered without the taking of testimony or presentation of 24 evidence. A practitioner affected under this paragraph shall 25 at reasonable intervals be afforded an opportunity to 26 demonstrate that he or she can resume a competent practice of 27 his or her profession with reasonable skill and safety to 28 patients. 29 (6) Violating a lawful regulation promulgated by the 30 board or violating a lawful order of the board previously 19850S1158B1608 - 38 -
1 entered by the board in a disciplinary proceeding. 2 (7) Knowingly maintaining a professional connection or 3 association with any person who is in violation of this act 4 or regulations of the board or knowingly aiding, assisting, 5 procuring or advising any unlicensed person to practice a 6 profession contrary to this act, or regulations of the board. 7 (8) Being guilty of immoral or unprofessional conduct. 8 Unprofessional conduct shall include departure from or 9 failing to conform to an ethical or quality standard of the 10 profession. 11 (i) The ethical standards of a profession are those 12 ethical tenets which are embraced by the professional 13 community in this Commonwealth. 14 (ii) A practitioner departs from, or fails to 15 conform to, a quality standard of the profession when the 16 practitioner provides a medical service at a level 17 beneath the accepted standard of care. The board may 18 promulgate regulations which define the accepted standard 19 of care. In the event the board has not promulgated an 20 applicable regulation, the accepted standard of care for 21 a practitioner is that which would be normally exercised 22 by the average professional of the same kind in this 23 Commonwealth under the circumstances, including locality 24 and whether the practitioner is or purports to be a 25 specialist in the area. 26 (9) Acting is such manner as to present an immediate and 27 clear danger to publish health or safety. 28 (10) Acting outside the scope of a license or 29 certificate. 30 Section 42. Types of corrective action. 19850S1158B1608 - 39 -
1 (a) Authorized actions.--When the board is empowered to take 2 disciplinary or corrective action against a practitioner under 3 the provisions of this act or pursuant to other statutory 4 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) Revoke, suspend, limit or otherwise restrict a 12 license or certificate. 13 (5) Require the professional to submit to the care, 14 counseling or treatment of a physician or other health care 15 professional designated by the board. 16 (6) Require the professional to take refresher 17 educational courses. 18 (7) Suspend enforcement of any suspension, other than 19 that imposed in accordance with section 41, or revocation and 20 place a practitioner on probation with the right to vacate 21 the probationary order from noncompliance. 22 (8) Impose a monetary penalty in accordance with this 23 act. 24 (b) Failure to comply with conditions.--Failure of a 25 professional to comply with conditions set forth by the board 26 shall be grounds for reconsideration of the matter and 27 institution of formal charges against the licensee or 28 certificate holder. 29 Section 43. Reinstatement of license, certificate or 30 registration. 19850S1158B1608 - 40 -
1 (A) IN GENERAL.--Unless ordered to do so by Commonwealth <--
2 Court or on appeal therefrom, the board shall not reinstate the
3 license, certificate or registration of a person to practice
4 medicine pursuant to this act which has been revoked. Any EXCEPT <--
5 AS PROVIDED IN SUBSECTION (B), ANY person whose license,
6 certificate or registration has been revoked may apply for
7 reinstatement, after a period of at least five years, but must
8 meet all of the licensing qualifications of this act for the
9 license applied for, to include the examination requirement, if
10 he or she desires to practice at any time after such revocation.
11 (B) REINSTATEMENT AFTER FELONY CONVICTION.--ANY PERSON WHOSE <--
12 LICENSE, CERTIFICATE OR REGISTRATION HAS BEEN SUSPENDED OR
13 REVOKED BECAUSE OF A FELONY CONVICTION UNDER THE ACT OF APRIL
14 14, 1972 (P.L.233, NO.64), KNOWN AS THE CONTROLLED SUBSTANCE,
15 DRUG, DEVICE AND COSMETIC ACT, OR SIMILAR LAW OF ANOTHER
16 JURISDICTION, MAY APPLY FOR REINSTATEMENT AFTER A PERIOD OF AT
17 LEAST TEN YEARS HAS ELAPSED FROM THE DATE OF CONVICTION. THE
18 BOARD MAY REINSTATE THE LICENSE IF THE BOARD IS SATISFIED THAT
19 THE PERSON HAS MADE SIGNIFICANT PROGRESS IN PERSONAL
20 REHABILITATION SINCE THE CONVICTION SUCH THAT HIS REINSTATEMENT
21 SHOULD NOT BE EXPECTED TO CREATE A SUBSTANTIAL RISK OF HARM TO
22 THE HEALTH AND SAFETY OF HIS PATIENTS OR THE PUBLIC OR A
23 SUBSTANTIAL RISK OF FURTHER CRIMINAL VIOLATIONS AND IF THE
24 PERSON MEETS ALL OTHER LICENSING QUALIFICATIONS OF THIS ACT.
25 Section 44. Surrender of suspended or revoked license.
26 The board shall require a person whose license, certificate
27 or registration has been suspended or revoked to return, in such
28 manner as the board directs, the license, certificate or
29 registration. A person who fails to do so commits a misdemeanor
30 of the third degree.
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1 Section 45. Reestablishment. 2 This act, with respect to the State Board of Medical 3 Education and Licensure, shall constitute the legislation 4 required to reestablish an agency pursuant to the act of 5 December 22, 1981 (P.L.508, No.142), known as the Sunset Act. 6 Section 46. Severability. 7 The provisions of this act are severable. If any provision of 8 this act or its application to any person or circumstance is 9 held invalid, the invalidity shall not affect other provisions 10 or applications of this act which can be given effect without 11 the invalid provision or application. 12 Section 47. Repeals. 13 (a) Specific repeals.--Section 412 of the act of April 9, 14 1929 (P.L.177, No.175), know as The Administrative Code of 1929, 15 is repealed. 16 The act of July 20, 1974 (P.L.551, No.190), known as the 17 Medical Practice Act of 1974, is repealed. 18 (b) General repeal.--All other acts and parts of acts are 19 repealed insofar as they are inconsistent with this act. 20 Section 48. Applicability of act. 21 (a) General rule.--The provisions of this act shall not 22 apply either directly or indirectly, by intent or purpose, to 23 affect the practice of: 24 (1) Chiropractic, as authorized by the act of August 10, 25 1951 (P.L.1182, No.264), known as the Chiropractic 26 Registration Act of 1951. 27 (2) Dentistry, as authorized by the act of May 1, 1933 28 (P.L.216, No.76), known as The Dental Law. 29 (3) Optometry, as authorized by the act of June 6, 1980 30 (P.L.197, No.57), known as the Optometric Practice and 19850S1158B1608 - 42 -
1 Licensure Act. 2 (4) Osteopathy, as authorized by the act of October 5, 3 1978 (P.L.1109, No.261), known as the Osteopathic Medical 4 Practice Act. 5 (5) Pharmacy, as authorized by the acts of April 14, 6 1972 (P.L.233, No.64), known as The Controlled Substance, 7 Drug, Device and Cosmetic Act, and September 27, 1961 8 (P.L.1700, No.699), known as the Pharmacy Act. 9 (6) Physical Therapy, as authorized by the act of 10 October 10, 1975 (P.L.383, No.110), known as the Physical 11 Therapy Practice Act. 12 (7) Podiatry, as authorized by the act of March 2, 1956 13 (P.L.1206, No.375), known as the Podiatry Act of 1956. 14 (8) Professional Nursing, as authorized by the act of 15 May 22, 1951 (P.L.317, No.69), known as The Professional 16 Nursing Law. 17 (9) Psychologists, as authorized by the act of March 23, 18 1972 (P.L.136, No.52), referred to as the Psychologists 19 License Act. 20 (b) Exemption.--This act shall not be construed so as to 21 give the Board of Medicine any jurisdiction over any of the 22 schools or colleges of the methods exempted in this section. 23 (c) No application to practice of hypnosis.--The provisions 24 of this act shall not apply either directly or indirectly, by 25 intent or purpose, to the practice of hypnosis. 26 Section 49. Existing board. 27 The presently confirmed members of the State Board of Medical 28 Education and Licensure constituted under section 412 of the act 29 of April 9, 1929 (P.L.177, No.175), known as The Administrative 30 Code of 1929, as of December 31, 1985, shall continue to serve 19850S1158B1608 - 43 -
1 as board members until their present terms of office expire and 2 a successor has been appointed and qualified, but no longer than 3 six months after the effective date of this act. 4 Section 50. Existing rules and regulations. 5 Each rule and regulation of the board in effect on December 6 31, 1985, not inconsistent with this act, shall remain in effect 7 after such date until repealed or amended by the board. Each fee 8 of the board in effect on December 31, 1985, and not 9 inconsistent with this act, shall remain in effect after such 10 date until repealed or amended by the board or the commissioner. 11 Section 51. Existing licenses, certificates and registrations. 12 Any person who holds a valid license, certificate or 13 registration issued by the State Board of Medical Education and 14 Licensure under the act of July 20, 1974 (P.L.551, No.190), 15 known as the Medical Practice Act of 1974, relating to the 16 practice of medicine, prior to the effective date of this act 17 shall, on and after the effective date hereof, be deemed 18 licensed, certificated or registered by the State Board of 19 Medicine as provided for in this act. 20 Section 52. Effective date. 21 This act shall take effect January 1, 1986. J10L63CHF/19850S1158B1608 - 44 -