1998 Legislation
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SENATE BILL NO. 1448 – Physician assistant, license


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Daily Data Tracking History

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
      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

Bill Text


 ||||              LEGISLATURE OF THE STATE OF IDAHO             ||||
Fifty-fourth Legislature                 Second Regular Session - 1998

                                      IN THE SENATE

                                   SENATE BILL NO. 1448

                             BY HEALTH AND WELFARE COMMITTEE

 1                                        AN ACT

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.


 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) The    word     term  "physician 's 
12    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  's  
16    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:

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  resident  or
42        physician's assistant  who is registered with the board as  provided
43        in this chapter and while engaged in programs authorized pursuant to rules
44          and  regulations  of 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;


 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


 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  's    assistants  must   register with the
 6      be licensed by the  board  prior  to  the  commencement  of
 7    activities which may involve the practice of medicine in this state. The 
 8    registration    licensure  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 's  assistants on the basis of
11    completed courses of study or programs of instruction they have received. Upon
12    completion of  registration     licensure  ,  the  board
13    shall  authorize  physician 's  assistants to assist a physician or
14    group of physicians who are qualified and  approved  by  the  board  to  
15    employ      supervise  physician 's  assistants to
16    engage in activities as limited by the board. The board shall fix a  reg-
17    istration   license  fee, and  registration  
18    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 by 
22    regulation   rule  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  by  regulation   rule  provide
34    for temporary registration of externs, interns, residents .   
35    and  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   resident  
43    or  physician's assistant  in 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.


 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 's  assistants 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 / Fiscal Impact


                              STATEMENT OF 
                                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.
                                       CONTACT: Marvin Sparrell, PA-C     322-4468
                                       Becky Goldsmith, PA-C    422-1000, ext 7132
                                       Trish Berglund, PA-C     385-0110