H. B. 2910
(By Delegates Eldridge, Staggers, Guthrie,
Argento, Hatfield, Long, Hutchins, Martin and Miley)
[Introduced February 7, 2007; referred to the
Committee on the Judiciary.]
A BILL to amend and reenact §30-3-12 and §30-3-16 of the Code of
West Virginia, 1931, as amended, all relating to the biennial
renewal of a license to practice medicine, podiatry or as a
physician assistant; providing for the expiration of a license
if continuing education requirements are not timely met and
documented to the Board of Medicine; setting fee to be paid
for the reinstatement of an expired license within one year;
and requiring a new application after one year of license
expiration.
Be it enacted by the Legislature of West Virginia:
That §30-3-12 and §30-3-16 of the Code of West Virginia, 1931,
as amended, be amended and reenacted, all to read as follows:
ARTICLE 3. WEST VIRGINIA MEDICAL PRACTICE ACT.
§30-3-12. Biennial renewal of license to practice medicine and
surgery or podiatry; continuing education; rules; fee; inactive license.
(a) A license to practice medicine and surgery or podiatry in
this state is valid for a term of two years and shall be renewed
upon a receipt of a reasonable fee, as set by the board, submission
of an application on forms provided by the board and, beginning
with the biennial renewal application forms completed by licensees
and submitted to the board in one thousand nine hundred
ninety-three, a certification in accordance with rules and
regulations promulgated by the board in accordance with chapter
twenty-nine-a of this code of participation in and successful
completion of a minimum of fifty hours of continuing medical or
podiatric education satisfactory to the board, as appropriate to
the particular license, during the preceding two-year period.
Continuing medical education satisfactory to the board is
continuing medical education designated as Category I by the
American Medical Association or the Academy of Family Physicians
and continuing podiatric education satisfactory to the board is
continuing podiatric education approved by the council on podiatric
education.
In addition, the Legislature hereby finds and declares that it
is in the public interest to encourage alternate categories of
continuing education satisfactory to the board for physicians and
podiatrists. In order to provide adequate notice of the same to
physicians and podiatrists, no later than the first day of June, one thousand nine hundred ninety-one, the board shall file rules
under the provisions of section fifteen, article three, chapter
twenty-nine-a of this code, delineating any alternate categories of
continuing medical or podiatric education which may be considered
satisfactory to the board and any procedures for board approval of
such continuing education.
Notwithstanding any provision of this chapter to the contrary,
failure to timely submit to the board a certification in accordance
with rules and regulations promulgated by the board in accordance
with chapter twenty-nine-a of this code of successful completion of
a minimum of fifty hours of continuing medical or podiatric
education satisfactory to the board, as appropriate to the
particular license, shall, beginning the first day of July,
one
thousand nine hundred ninety-three two thousand seven, result in
the automatic
suspension expiration of any license to practice
medicine and surgery or podiatry until such time as the
certification in accordance with rules and regulations promulgated
by the board in accordance with chapter twenty-nine-a of this code,
with all supporting written documentation, is submitted to and
approved by the board.
A licensee shall pay the renewal fee and if
reinstatement is sought within one year of automatic expiration, a
reinstatement fee equal to fifty percent of the renewal fee. After
one year of license expiration, a licensee shall make a new
application and provide supporting written documentation with the required certification.
Any individual who accepts the privilege of practicing
medicine and surgery or podiatry in this state is required to
provide supporting written documentation of the continuing
education represented as received within thirty days of receipt of
a written request to do so by the board. If a licensee fails or
refuses to provide supporting written documentation of the
continuing education represented as received as required in this
section, such failure or refusal to provide supporting written
documentation is prima facie evidence of renewing a license to
practice medicine and surgery or podiatry by fraudulent
misrepresentation.
(b) The board may renew, on an inactive basis, the license of
a physician or podiatrist who is currently licensed to practice
medicine and surgery or podiatry in, but is not actually
practicing, medicine and surgery or podiatry in this state. A
physician or podiatrist holding an inactive license shall not
practice medicine and surgery or podiatry in this state. His or
her inactive license may be converted by the board to an active one
upon a written request to the board that accounts for his or her
period of inactivity to the satisfaction of the board:
Provided,
That beginning on the first day of July, one thousand nine hundred
ninety-three, such licensee submits written documentation of
participation in and successful completion of a minimum of fifty hours of continuing medical or podiatric education satisfactory to
the board, as appropriate to the particular license, during each
preceding two-year period. An inactive license may be obtained
upon receipt of a reasonable fee, as set by the board, and
submission of an application on forms provided by the board on a
biennial basis.
(c) The board shall not require any physician or podiatrist
who is retired or retiring from the active practice of medicine and
surgery or the practice of podiatry and who is voluntarily
surrendering their license to return to the board the license
certificate issued to them by the board.
§30-3-16. Physician assistants; definitions; Board of Medicine
rules; annual report; licensure; temporary license;
relicensure; job description required; revocation or
suspension of licensure; responsibilities of
supervising physician; legal responsibility for
physician assistants; reporting by health care
facilities; identification; limitations on employment
and duties; fees; continuing education; unlawful
representation of physician assistant as a physician;
criminal penalties.
(a) As used in this section:
(1) "Physician assistant" means an assistant to a physician who is a graduate of an approved program of instruction in primary
health care or surgery, has attained a baccalaureate or master's
degree, has passed the national certification examination and is
qualified to perform direct patient care services under the
supervision of a physician;
(2) "Physician assistant-midwife" means a physician assistant
who meets all qualifications set forth under subdivision (1) of
this subsection and fulfills the requirements set forth in
subsection (d) of this section; is subject to all provisions of
this section; and assists in the management and care of a woman and
her infant during the prenatal, delivery and postnatal periods;
(3) "Supervising physician" means a doctor or doctors of
medicine or podiatry permanently licensed in this state who assume
legal and supervisory responsibility for the work or training of
any physician assistant under his or her supervision;
(4) "Approved program" means an educational program for
physician assistants approved and accredited by the committee on
allied health education and accreditation on behalf of the American
medical association or its successor; and
(5) "Health care facility" means any licensed hospital,
nursing home, extended care facility, state health or mental
institution, clinic or physician's office.
(b) The board shall promulgate rules pursuant to the
provisions of article three, chapter twenty-nine-a of this code governing the extent to which physician assistants may function in
this state. The rules shall provide that the physician assistant
is limited to the performance of those services for which he or she
is trained and that he or she performs only under the supervision
and control of a physician permanently licensed in this state, but
that supervision and control does not require the personal presence
of the supervising physician at the place or places where services
are rendered if the physician assistant's normal place of
employment is on the premises of the supervising physician. The
supervising physician may send the physician assistant off the
premises to perform duties under his or her direction, but a
separate place of work for the physician assistant may not be
established. In promulgating the rules, the board shall allow the
physician assistant to perform those procedures and examinations
and in the case of certain authorized physician assistants to
prescribe at the direction of his or her supervising physician in
accordance with subsection (l) of this section those categories of
drugs submitted to it in the job description required by this
section. Certain authorized physician assistants may pronounce
death in accordance with the rules proposed by the board which
receive legislative approval. The board shall compile and publish
an annual report that includes a list of currently licensed
physician assistants and their employers and location in the state.
(c) The board shall license as a physician assistant any person who files an application together with a proposed job
description and furnishes satisfactory evidence to it that he or
she has met the following standards:
(1) He or she is a graduate of an approved program of
instruction in primary health care or surgery;
(2) He or she has passed the certifying examination for a
primary care physician assistant administered by the national
commission on certification of physician assistants and has
maintained certification by that commission so as to be currently
certified;
(3) He or she is of good moral character; and
(4) He or she has attained a baccalaureate or master's degree.
(d) The board shall license as a physician assistant-midwife
any person who meets the standards set forth under subsection (c)
of this section and, in addition thereto, the following standards:
(1) He or she is a graduate of a school of midwifery
accredited by the American college of nurse-midwives;
(2) He or she has passed an examination approved by the board;
(3) He or she practices midwifery under the supervision of a
board certified obstetrician, gynecologist or a board certified
family practice physician who routinely practices obstetrics.
(e) The board may license as a physician assistant any person
who files an application together with a proposed job description
and furnishes satisfactory evidence that he or she is of good moral character and meets either of the following standards:
(1) He or she is a graduate of an approved program of
instruction in primary health care or surgery prior to the first
day of July, one thousand nine hundred ninety-four, and has passed
the certifying examination for a physician assistant administered
by the national commission on certification of physician assistants
and has maintained certification by that commission so as to be
currently certified; or
(2) He or she had been certified by the board as a physician
assistant then classified as "Type B", prior to the first day of
July, one thousand nine hundred eighty-three.
Licensure of an assistant to a physician practicing the
specialty of ophthalmology is permitted under this section:
Provided, That a physician assistant may not dispense a
prescription for a refraction.
(f) When any graduate of an approved program submits an
application to the board for a physician assistant license,
accompanied by a job description as referenced by this section, the
board shall issue to that applicant a temporary license allowing
that applicant to function as a physician assistant until the
applicant successfully passes the national commission on
certification of physician assistants' certifying examination:
Provided, That the applicant shall sit for and obtain a passing
score on the examination next offered following graduation from the approved program. No applicant shall receive a temporary license
who, following graduation from an approved program, has sat for and
not obtained a passing score on the examination. A physician
assistant who has not been certified by the national board of
medical examiners on behalf of the national commission on
certification of physician assistants will be restricted to work
under the direct supervision of the supervising physician.
A physician assistant who has been issued a temporary license
shall, within thirty days of receipt of written notice from the
national commission on certification of physician assistants of his
or her performance on the certifying examination, notify the board
in writing of his or her results. In the event of failure of that
examination, the temporary license shall expire and terminate
automatically, and the board shall so notify the physician
assistant in writing.
(g) Any physician applying to the board to supervise a
physician assistant shall affirm that the range of medical services
set forth in the physician assistant's job description are
consistent with the skills and training of the supervising
physician and the physician assistant. Before a physician
assistant can be employed or otherwise use his or her skills, the
supervising physician and the physician assistant must obtain
approval of the job description from the board. The board may
revoke or suspend any license of an assistant to a physician for cause, after giving that assistant an opportunity to be heard in
the manner provided by article five, chapter twenty-nine-a of this
code and as set forth in rules duly adopted by the board.
(h) The supervising physician is responsible for observing,
directing and evaluating the work, records and practices of each
physician assistant performing under his or her supervision. He or
she shall notify the board in writing of any termination of his or
her supervisory relationship with a physician assistant within ten
days of the termination. The legal responsibility for any
physician assistant remains with the supervising physician at all
times, including occasions when the assistant under his or her
direction and supervision, aids in the care and treatment of a
patient in a health care facility. In his or her absence, a
supervising physician must designate an alternate supervising
physician, however, the legal responsibility remains with the
supervising physician at all times. A health care facility is not
legally responsible for the actions or omissions of the physician
assistant unless the physician assistant is an employee of the
facility.
(i) The acts or omissions of a physician assistant employed by
health care facilities providing inpatient or outpatient services
shall be the legal responsibility of the facilities. Physician
assistants employed by facilities in staff positions shall be
supervised by a permanently licensed physician.
(j) A health care facility shall report in writing to the
board within sixty days after the completion of the facility's
formal disciplinary procedure, and also after the commencement, and
again after the conclusion, of any resulting legal action, the name
of any physician assistant practicing in the facility whose
privileges at the facility have been revoked, restricted, reduced
or terminated for any cause including resignation, together with
all pertinent information relating to the action. The health care
facility shall also report any other formal disciplinary action
taken against any physician assistant by the facility relating to
professional ethics, medical incompetence, medical malpractice,
moral turpitude or drug or alcohol abuse. Temporary suspension for
failure to maintain records on a timely basis or failure to attend
staff or section meetings need not be reported.
(k) When functioning as a physician assistant, the physician
assistant shall wear a name tag that identifies him or her as a
physician assistant. A two and one-half by three and one-half inch
card of identification shall be furnished by the board upon
licensure of the physician assistant.
(l) A physician assistant may write or sign prescriptions or
transmit prescriptions by word of mouth, telephone or other means
of communication at the direction of his or her supervising
physician. The board shall promulgate rules pursuant to the
provisions of article three, chapter twenty-nine-a of this code governing the eligibility and extent to which a physician assistant
may prescribe at the direction of the supervising physician. The
rules shall include, but not be limited to, the following:
(1) Provisions for approving a state formulary classifying
pharmacologic categories of drugs that may be prescribed by a
physician assistant:
(A) The following categories of drugs shall be excluded from
the formulary: Schedules I and II of the uniform controlled
substances act, anticoagulants, antineoplastic,
radiopharmaceuticals, general anesthetics and radiographic contrast
materials;
(B) Drugs listed under Schedule III shall be limited to a
seventy-two hour supply without refill;
(C) Categories of other drugs may be excluded as determined by
the board;
(2) All pharmacological categories of drugs to be prescribed
by a physician assistant shall be listed in each job description
submitted to the board as required in subsection (g) of this
section;
(3) The maximum dosage a physician assistant may prescribe;
(4) A requirement that to be eligible for prescription
privileges, a physician assistant shall have performed patient care
services for a minimum of two years immediately preceding the
submission to the board of the job description containing prescription privileges and shall have successfully completed an
accredited course of instruction in clinical pharmacology approved
by the board; and
(5) A requirement that to maintain prescription privileges, a
physician assistant shall continue to maintain national
certification as a physician assistant, and in meeting the national
certification requirements shall complete a minimum of ten hours of
continuing education in rational drug therapy in each certification
period. Nothing in this subsection shall be construed to permit a
physician assistant to independently prescribe or dispense drugs.
(m) A supervising physician may not supervise at any one time
more than three full-time physician assistants or their equivalent,
except that a physician may supervise up to four hospital-employed
physician assistants. No physician shall supervise more than four
physician assistants at any one time.
A physician assistant may not sign any prescription, except in
the case of an authorized physician assistant at the direction of
his or her supervising physician in accordance with the provisions
of subsection (l) of this section. A physician assistant may not
perform any service that his or her supervising physician is not
qualified to perform. A physician assistant may not perform any
service that is not included in his or her job description and
approved by the board as provided for in this section.
The provisions of this section do not authorize any physician assistant to perform any specific function or duty delegated by
this code to those persons licensed as chiropractors, dentists,
dental hygienists, optometrists or pharmacists or certified as
nurse anesthetists.
(n) Each application for licensure submitted by a licensed
supervising physician under this section is to be accompanied by a
fee of one hundred dollars. A fee of fifty dollars is to be
charged for the biennial renewal of the license. A fee of
twenty-five dollars is to be charged for any change of supervising
physician.
(o) Beginning with the biennial renewal forms completed by
physician assistants and submitted to the board in the year one
thousand nine hundred ninety-three, as a condition of renewal of
physician assistant license, each physician assistant shall provide
written documentation pursuant to rules promulgated by the board in
accordance with chapter twenty-nine-a of this code of participation
in and successful completion during the preceding two-year period
of continuing education, in the number of hours specified by the
board by rule, designated as Category I by the American medical
association, American academy of physician assistants or the
academy of family physicians, and continuing education, in the
number of hours specified by the board by rule, designated as
Category II by the association or either academy. Notwithstanding
any provision of this chapter to the contrary, failure to timely submit the required written documentation shall result in the
automatic
suspension expiration of any license as a physician
assistant until the written documentation is submitted to and
approved by the board.
A licensee shall pay the renewal fee and if
reinstatement is sought within one year of automatic expiration, a
reinstatement fee equal to fifty percent of the renewal fee. After
one year of license expiration, a licensee shall make a new
application and provide supporting written documentation with the
required certification.
(p) It is unlawful for any physician assistant to represent to
any person that he or she is a physician, surgeon or podiatrist.
Any person who violates the provisions of this subsection is guilty
of a felony and, upon conviction thereof, shall be imprisoned in
the penitentiary a state correctional facility for not less than
one nor more than two years, or be fined not more than two thousand
dollars, or both fined and imprisoned.
(q) All physician assistants holding valid certificates issued
by the board prior to the first day of July, one thousand nine
hundred ninety-two, shall be considered to be licensed under this
section.
NOTE: The purpose of this bill is to provide for the
expiration of a license to practice medicine, podiatry or as a
physician assistant if continuing education requirements are not
timely met and documented to the Board of Medicine by a licensee. The bill establishes a fee for reinstatement within one year and
requires a new application after one year of license expiration.
Strike-throughs indicate language that would be stricken from
the present law, and underscoring indicates new language that would
be added.