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S1448.................................................by HEALTH AND WELFARE
PHYSICIAN ASSISTANT - Amends existing law to provide for licensure of
physician assistants by the Board of Medicine.
02/13 Senate intro - 1st rdg - to printing
02/16 Rpt prt - to Health/Wel
02/24 Rpt out - rec d/p - to 2nd rdg
02/25 2nd rdg - to 3rd rdg
02/27 3rd rdg - PASSED - 32-1-2
AYES--Andreason, Boatright, Branch, Bunderson, Burtenshaw, Cameron,
Crow, Danielson, Darrington, Deide, Dunklin, Frasure, Geddes, Hansen,
Ingram, Ipsen, Keough, King, Lee, Noh, Parry, Richardson, Riggs,
Risch, Sandy, Schroeder, Sorensen, Stennett, Sweeney, Thorne,
Wheeler, Whitworth
NAYS--Hawkins
Absent and excused--McLaughlin, Twiggs
Floor Sponsors - Crow, Danielson
Title apvd - to House
03/02 House intro - 1st rdg - to Health/Wel
03/13 Rpt out - rec d/p - to 2nd rdg
03/16 2nd rdg - to 3rd rdg
03/17 3rd rdg - PASSED - 62-0-8
AYES -- Alltus, Barraclough, Barrett, Bell, Bieter, Black(23), Boe,
Bruneel, Callister, Campbell, Chase, Clark, Crane, Crow, Cuddy, Deal,
Denney, Ellsworth, Field(20), Geddes, Hadley, Henbest, Hornbeck,
Jaquet, Jones(9), Jones(22), Judd, Kellogg, Kempton, Kendell,
Kjellander, Kunz, Lake, Linford, Loertscher, Mader, Marley, McKague,
Meyer, Miller, Mortensen, Newcomb, Pischner, Pomeroy, Reynolds,
Richman, Ridinger, Robison, Sali, Schaefer, Stevenson, Stoicheff,
Stone, Stubbs, Taylor, Tilman, Tippets, Trail, Watson, Wheeler,
Zimmermann, Mr Speaker
NAYS -- None
Absent and excused -- Bivens, Black(15), Field(13), Gagner, Gould,
Hansen, Jones(20), Wood
Floor Sponsor - Bieter
Title apvd - to Senate
03/18 To enrol
03/19 Rpt enrol - Pres signed - Sp signed
03/20 To Governor - Governor signed
Session Law Chapter 177
Effective: 07/01/98
S1448|||| LEGISLATURE OF THE STATE OF IDAHO |||| Fifty-fourth Legislature Second Regular Session - 1998IN THE SENATE SENATE BILL NO. 1448 BY HEALTH AND WELFARE COMMITTEE 1 AN ACT 2 RELATING TO LICENSING PHYSICIAN ASSISTANTS; AMENDING SECTION 54-1803, IDAHO 3 CODE, TO DEFINE THE TERM "PHYSICIAN ASSISTANT"; AMENDING SECTION 54-1804, 4 IDAHO CODE, TO AUTHORIZE A PHYSICIAN ASSISTANT LICENSED BY THE BOARD OF 5 MEDICINE TO ENGAGE IN CERTAIN ACTIVITIES; AMENDING SECTION 54-1807, IDAHO 6 CODE, TO REQUIRE LICENSURE OF PHYSICIAN ASSISTANTS; AMENDING SECTION 7 54-1813, IDAHO CODE, TO PROVIDE APPLICATION TO A PHYSICIAN ASSISTANT AND 8 TO MAKE TECHNICAL CORRECTIONS; AND AMENDING SECTION 54-1814, IDAHO CODE, 9 TO DELETE REFERENCE TO PHYSICIAN'S ASSISTANT, TO PROVIDE THAT PHYSICIAN 10 ASSISTANTS LICENSED BY THE BOARD OF MEDICINE ARE SUBJECT TO DISCIPLINARY 11 PROCEDURES BY THE BOARD AND TO MAKE A TECHNICAL CORRECTION. 12 Be It Enacted by the Legislature of the State of Idaho: 13 SECTION 1. That Section 54-1803, Idaho Code, be, and the same is hereby 14 amended to read as follows: 15 54-1803. DEFINITIONS. (1) The "practice of medicine" means: 16 (a) To investigate, diagnose, treat, correct, or prescribe for any human 17 disease, ailment, injury, infirmity, deformity, or other condition, physi- 18 cal or mental, by any means or instrumentality, or 19 (b) To apply principles or techniques of medical science in the preven- 20 tion of any of the conditions listed in subsection (a) of this section, or 21 (c) To offer, undertake, attempt to do or hold oneself out as able to do 22 any of the acts described in subsections (a) and (b) of this section. 23 (2) The word "board" means the state board of medicine. 24 (3) The term "physician" means any person who holds a license to practice 25 medicine and surgery, osteopathic medicine and surgery, or osteopathic medi- 26 cine, provided further, that others authorized by law to practice any of the 27 healing arts shall not be considered physicians for the purposes of this chap- 28 ter. 29 (4) A "license to practice medicine and surgery" means a license issued 30 by the board to a person who was graduated from an acceptable school of medi- 31 cine and who has fulfilled the licensing requirements of this chapter. 32 (5) A "license to practice osteopathic medicine and surgery" means a 33 license issued by the board to a person who either graduated from an accept- 34 able osteopathic school of medicine subsequent to January 1, 1963, or who has 35 been licensed by endorsement of a license issued by another state where a com- 36 posite examining board exists and where physicians licensed to practice medi- 37 cine and surgery and osteopathic physicians take the same examination and hold 38 equal licenses, and who has fulfilled the licensing requirements of this chap- 39 ter. 40 (6) A "license to practice osteopathic medicine" means a license issued 41 by the state board of medicine to a person who graduated from an acceptable 42 osteopathic school of medicine and who prior to January 1, 1963 has fulfilled 43 the licensing requirements of this chapter. 2 1 (7) The word "person," the word "he" and the word "his" means a natural 2 person. 3 (8) An "acceptable school of medicine" means any school of medicine or 4 school of osteopathic medicine which meets the standards or requirements of a 5 national medical school accrediting organization acceptable to the board. 6 (9) The word "extern" means a bona fide student enrolled in an acceptable 7 school of medicine who has not received his degree. 8 (10) The word "intern" or "resident" means any person who has completed a 9 course of study at an acceptable school of medicine and who is enrolled in a 10 post-graduate medical training program. 11 (11) Thewordterm "physician's12 assistant" means any person who is a graduate of an acceptable training pro- 13 gram and who is qualified by general education, training, experience and per- 14 sonal character to render patient services under the direction of a physician. 15 Nothing in this act shall be construed to authorize physician's16 assistants to perform those specific functions and duties specifically dele- 17 gated by law to those persons licensed as pharmacists under chapter 17, title 18 54, Idaho Code, as dentists or dental hygienists under chapter 9, title 54, 19 Idaho Code, or as optometrists under chapter 15, title 54, Idaho Code. 20 SECTION 2. That Section 54-1804, Idaho Code, be, and the same is hereby 21 amended to read as follows: 22 54-1804. UNLICENSED PRACTICE -- PENALTIES AND REMEDIES RELATING TO UNLI- 23 CENSED PRACTICE. (1) Under the circumstances described and subject in each 24 case to limitations stated, the following persons, though not holding a 25 license to practice medicine in this state, may engage in activities included 26 in the practice of medicine: 27 (a) A medical officer of the armed forces of the United States, of the 28 United States public health service, or of the veteran's administration, 29 while engaged in the performance of his official duties; 30 (b) A person residing in another state or country and authorized to prac- 31 tice medicine there, who is called in consultation by a person licensed in 32 this state to practice medicine, or who for the purpose of furthering med- 33 ical education is invited into this state to conduct a lecture, clinic, or 34 demonstration, while engaged in activities in connection with the consul- 35 tation, lecture, clinic, or demonstration, so long as he does not open an 36 office or appoint a place to meet patients or receive calls in this state; 37 (c) A person authorized to practice medicine in another state or country 38 while rendering medical care in a time of disaster or while caring for an 39 ill or injured person at the scene of an emergency and while continuing to 40 care for such person; 41 (d) An extern, intern,or residentor42physician's assistantwho is registered with the board as provided 43 in this chapter and while engaged in programs authorized pursuant to rules 44and regulationsof the board or a physician assistant 45 licensed by the board ; 46 (e) A person authorized or licensed by this state to engage in activities 47 which may involve the practice of medicine; 48 (f) A person engaged in good faith in the practice of the religious 49 tenets of any church or religious beliefs; 50 (g) A person administering a remedy, diagnostic procedure or advice as 51 specifically directed by a physician; 52 (h) A person rendering aid in an emergency, where no fee for the service 53 is contemplated, charged or received; 3 1 (i) A person administering a family remedy to a member of the family; 2 (j) A person who administers treatment or provides advice regarding the 3 human body and its functions that: 4 (i) Does not use legend drugs or prescription drugs in such prac- 5 tice; 6 (ii) Uses natural elements such as air, heat, water and light; 7 (iii) Only uses class I or class II nonprescription, approved, medi- 8 cal devices as defined in section 513 of the federal food, drug and 9 cosmetic act; 10 (iv) Only uses vitamins, minerals, herbs, natural food products and 11 their extracts, and nutritional supplements; and who 12 (v) Does not perform surgery; 13 (vi) Requires each person receiving services to sign a declaration 14 of informed consent which includes an overview of the health care 15 provider's education which states that the health care provider is 16 not an "M.D." or "D.O.",and is not licensed under the 17 provisions of this chapter. 18 (2) Except as provided in subsection (1) of this section, it shall con- 19 stitute a felony for any person to practice medicine in this state without a 20 license and upon conviction thereof shall be imprisoned in the state prison 21 for a period not to exceed five (5) years, or shall be fined not more than ten 22 thousand dollars ($10,000), or shall be punished by both such fine and impris- 23 onment. 24 (3) Except as provided in subsections (1)(a), (1)(b), and (1)(c) above, 25 it is unlawful for any person to assume or use the title or designation 26 "medical doctor," "medical physician," "osteopathic doctor," "osteopathic phy- 27 sician," "M.D." or "D.O." or any other title, designation, words, letters, 28 abbreviation, sign, card, or device to indicate to the public that such person 29 is licensed to practice medicine pursuant to this chapter unless such person 30 is so licensed, and upon conviction thereof, such person shall be imprisoned 31 not to exceed one (1) year, or shall be fined not more than three thousand 32 dollars ($3,000), or shall be punished by both fine and imprisonment. 33 (4) When a person has been the recipient of services constituting the 34 unlawful practice of medicine, whether or not he knew the rendition of the 35 services was unlawful, proof of the rendition of such unlawful services by the 36 recipient or his personal representative in an action against the provider of 37 such services for damages allegedly caused by the services constitutes prima 38 facie evidence of negligence shifting the burden of proof to such provider of 39 unlawful services. The following damages in addition to any other remedies 40 provided by law may be recovered in such an action: 41 (a) The amount of any fees paid for the unlawful services. 42 (b) Reasonable attorney fees and court costs. 43 (5) The board shall refer all violations of this section made known to it 44 to appropriate prosecuting attorneys. The board may render assistance to a 45 prosecuting attorney in the prosecution of a case pursuant to this section. 46 SECTION 3. That Section 54-1807, Idaho Code, be, and the same is hereby 47 amended to read as follows: 48 54-1807. STATE BOARD OF MEDICINE -- REGISTRATION. (1) Externs, interns 49 and residents must register with the board prior to the commencement of any 50 activities constituting the practice of medicine in this state. Registration 51 shall include disclosure of the applicant's prior education and training, the 52 program or course of study the extern, intern or resident intends to follow, 53 the physicians or group of physicians who will supervise the program or course 4 1 of study, and such other information as the board deems relevant. The board 2 shall reserve the right to approve any such program or course of study and 3 shall require registration by the supervising physician. A registration fee 4 shall be fixed by the board, and registration must be renewed annually. 5 (2) Physician'sassistants mustregister with the6be licensed by the board prior to the commencement of 7 activities which may involve the practice of medicine in this state. The8registrationlicensure requirements shall include passage 9 of an examination acceptable to the board. The board shall determine and limit 10 the scope of activities of physician'sassistants on the basis of 11 completed courses of study or programs of instruction they have received. Upon 12 completion ofregistrationlicensure , the board 13 shall authorize physician'sassistants to assist a physician or 14 group of physicians who are qualified and approved by the board to15employsupervise physician'sassistants to 16 engage in activities as limited by the board. The board shall fix areg-17istrationlicense fee, andregistration18 the license must be renewed annually. 19 SECTION 4. That Section 54-1813, Idaho Code, be, and the same is hereby 20 amended to read as follows: 21 54-1813. TEMPORARY LICENSE AND REGISTRATION. (1) The board may by22regulationrule provide for the issuance of a temporary 23 license to a person licensed to practice medicine and surgery or osteopathic 24 medicine and surgery in some other state, territory or district of the United 25 States or Canada or to a person who is a diplomate of the national board of 26 medical examiners or a diplomate of the national board of examiners for 27 osteopathic physicians and surgeons or to a physician assistant , 28 provided that such temporary license shall be issued only to persons who have 29 made an application for a permanent license in this state. The board shall fix 30 and collect a fee for a temporary license and it shall be valid from the date 31 of issuance to the next regular meeting of the board, unless extended by the 32 board. 33 (2) The board may byregulationrule provide 34 for temporary registration of externs, interns, residents .35and physician's assistants.The board shall fix and collect a fee for 36 the temporary registration and it shall specify the time period of the tempo- 37 rary registration. 38 SECTION 5. That Section 54-1814, Idaho Code, be, and the same is hereby 39 amended to read as follows: 40 54-1814. GROUNDS FOR MEDICAL DISCIPLINE. Every person licensed to prac- 41 tice medicine , licensed to practice as a physician assistant or 42 registered as an extern, intern,or resident43or physician's assistantin this state is subject to discipline by the 44 board pursuant to the procedures and powers set forth in section 54-1806A, 45 Idaho Code, upon any of the following grounds: 46 (1) Conviction of a felony, or a crime involving moral turpitude, or the 47 entering of a plea of guilty or the finding of guilt by a jury or court of 48 commission of a felony or a crime involving moral turpitude. 49 (2) Use of false, fraudulent or forged statements or documents, diplomas 50 or credentials in connection with any licensing or other requirements of this 51 act. 5 1 (3) Practicing medicine under a false or assumed name in this or any 2 other state. 3 (4) Advertising the practice of medicine in any unethical or unprofes- 4 sional manner. 5 (5) Knowingly aiding or abetting any person to practice medicine who is 6 not authorized to practice medicine as provided in this chapter. 7 (6) Performing or procuring an unlawful abortion or aiding or abetting 8 the performing or procuring of an unlawful abortion. 9 (7) The provision of health care which fails to meet the standard of 10 health care provided by other qualified physicians in the same community or 11 similar communities, taking into account his training, experience and the 12 degree of expertise to which he holds himself out to the public. 13 (8) Division of fees or gifts or agreement to split or divide fees or 14 gifts received for professional services with any person, institution or cor- 15 poration in exchange for referral. 16 (9) Giving or receiving or aiding or abetting the giving or receiving of 17 rebates, either directly or indirectly. 18 (10) Inability to obtain or renew a license to practice medicine, or revo- 19 cation of, or suspension of a license to practice medicine by any other state, 20 territory, district of the United States or Canada, unless it can be shown 21 that such action was not related to the competence of the person to practice 22 medicine or to any conduct designated herein. 23 (11) Prescribing or furnishing narcotic or hallucinogenic drugs to 24 addicted persons to maintain their addictions and level of usage without 25 attempting to treat the primary condition requiring the use of narcotics. 26 (12) Prescribing or furnishing narcotic, hypnotic, hallucinogenic, stimu- 27 lating or dangerous drugs for other than treatment of any disease, injury or 28 medical condition. 29 (13) Failure to safeguard the confidentiality of medical records or other 30 medical information pertaining to identifiable patients, except as required or 31 authorized by law. 32 (14) The direct promotion by a physician of the sale of drugs, devices, 33 appliances or goods to a patient that are unnecessary and not medically indi- 34 cated. 35 (15) Abandonment of a patient. 36 (16) Wil l fully and intentionally representing that a mani- 37 festly incurable disease or injury or other manifestly incurable condition can 38 be permanently cured. 39 (17) Failure to supervise the activities of externs, interns, residents, 40 nurse practitioners or physician'sassistants as required by the 41 registration documentation of this chapter. 42 (18) Practicing medicine when a license pursuant to this chapter is sus- 43 pended, revoked or inactive. 44 (19) Practicing medicine in violation of a voluntary restriction or terms 45 of probation pursuant to this chapter. 46 (20) Refusing to divulge to the board upon demand the means, method, 47 device or instrumentality used in the treatment of a disease, injury, ailment, 48 or infirmity. 49 (21) Commission of any act constituting a felony or commission of any act 50 constituting a crime involving moral turpitude. 51 (22) Engaging in any conduct which constitutes an abuse or exploitation of 52 a patient arising out of the trust and confidence placed in the physician by 53 the patient.
STATEMENT OF
PURPOSE
RS 07747C1
The purpose of this Legislation is to change the regulation of
Physician Assistants from registration to licensure.
This change would not result in a change in the relationship of
Physician Assistants with the Idaho State Board of Medicine.
Physician Assistants would continue to function as dependent
providers. The reason for the change to licensure is to be able to
work within the requirements of managed care organizations.
None
FISCAL NOTE
CONTACT: Marvin Sparrell, PA-C 322-4468
Becky Goldsmith, PA-C 422-1000, ext 7132
Trish Berglund, PA-C 385-0110
STATEMENT OF PURPOSE/ FISCAL NOTE
S1448