ENGROSSED
COMMITTEE SUBSTITUTE
FOR
Senate Bill No. 474
(By Senators Stollings, Foster and Jenkins)
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[Originating in the Committee on Government Organization;
reported February 26, 2007.]
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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 licenses to
practice medicine and surgery, podiatry and to work as a
physician assistant; requiring licenses to automatically
expire if required continuing education is not timely
documented to the Board of Medicine; specifying requirements
for reinstatement of license; and criminal penalties.
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
(b) The license shall be renewed:
(1) Upon a receipt of a reasonable fee, as set by the board;
(2) 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,
(3) 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.
(c) The application may not require disclosure of a voluntary
agreement entered into pursuant to subsection (h), section nine of
this article.
(d) 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 alternate categories
approved by the board.
(e) Continuing podiatric education satisfactory to the board
is continuing podiatric education approved by the Council on
Podiatric Education and alternate categories
approved by the board.
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.
(f) Notwithstanding any provision of this chapter to the
contrary, beginning the first day of July
, two thousand seven,
failure to timely submit to the board a certification in accordance
with rules 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 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
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.
(g) If a license is automatically expired and reinstatement is
sought within one year of the automatic expiration, the former
licensee shall:
(1) Provide certification
with supporting written
documentation of the successful completion of the required
continuing education;
(2)
Pay a renewal fee; and
(3) Pay
a reinstatement fee equal to fifty percent of the
renewal fee.
(h) If a license is automatically expired and
more than one
year has passed since the automatic expiration, the former licensee
shall:
(1) Apply for a new license;
(2) Provide certification
with supporting written
documentation of the successful completion of the required
continuing education; and
(3) Pay such fees as determined by the board.
(i) 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) (j) 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.
(k) His or her An inactive license may be converted by the
board to an active one license
upon a written request by the
licensee to the board that:
(1) 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
and
(2) 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.
(l) 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) (m) The board shall may 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:
(4) (1) "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) (2) "Health care facility" means any licensed hospital,
nursing home, extended care facility, state health or mental
institution, clinic or physician's office;
(1) (3) "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) (4) "Physician assistant-midwife" means a physician
assistant who meets all qualifications set forth under subdivision
(1) (3) 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; and
(3) (5) "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.
(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, theboard 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) (n) 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 (d)
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;
and
(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.
(f) 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)(g) 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.
(h) 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)(i) 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)(j) 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)(k) 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)(l) 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)(m) 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) (n) 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 72-
hour supply without refill; and
(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) (i) 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)(o) 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.
(p) 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) (n) 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.
(q) 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)(r) 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,
(s) 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.
(t) Notwithstanding any provision of this chapter to the
contrary, beginning the first day of July
, two thousand seven,
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.
(u) If a license is automatically expired and reinstatement is sought within one year of the automatic expiration, the former
licensee shall:
(1) Provide certification
with supporting written
documentation of the successful completion of the required
continuing education;
(2)
Pay a renewal fee; and
(3) Pay
a reinstatement fee equal to fifty percent of the
renewal fee.
(v) If a license is automatically expired and
more than one
year has passed since the automatic expiration, the former licensee
shall:
(1) Apply for a new license;
(2) Provide certification
with supporting written
documentation of the successful completion of the required
continuing education; and
(3) Pay such fees as determined by the board.
(p)(w) 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 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)(x) 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.
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