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[Introduced][Amended][Status][Bill Documents][Fiscal Note][Bills Directory]

S.B. 186 Enrolled

             1     

UTAH MEDICAL PRACTICE ACT AMENDMENTS

             2     
2011 GENERAL SESSION

             3     
STATE OF UTAH

             4     
Chief Sponsor: J. Stuart Adams

             5     
House Sponsor: Paul Ray

             6     
             7      LONG TITLE
             8      General Description:
             9          This bill amends the Utah Medical Practice Act and the Utah Osteopathic Medical
             10      Practice Act by clarifying policies and procedures.
             11      Highlighted Provisions:
             12          This bill:
             13          .    amends definitions;
             14          .    prohibits an individual from using the title "doctor," "M.D." or "D.O." in a
             15      misleading manner;
             16          .    clarifies licensing requirements;
             17          .    clarifies disciplinary procedures; and
             18          .    makes technical changes.
             19      Money Appropriated in this Bill:
             20          None
             21      Other Special Clauses:
             22          None
             23      Utah Code Sections Affected:
             24      AMENDS:
             25          58-1-501, as last amended by Laws of Utah 2010, Chapter 180
             26          58-37-6, as last amended by Laws of Utah 2010, Chapter 287
             27          58-67-102, as last amended by Laws of Utah 2010, Chapter 101
             28          58-67-302, as last amended by Laws of Utah 2009, Chapter 183
             29          58-67-302.5, as last amended by Laws of Utah 2008, Chapter 250


             30          58-67-304, as last amended by Laws of Utah 2005, Chapter 94
             31          58-67-305, as last amended by Laws of Utah 2005, Chapter 2
             32          58-67-401, as enacted by Laws of Utah 1996, Chapter 248
             33          58-67-403, as enacted by Laws of Utah 1996, Chapter 248
             34          58-67-503, as enacted by Laws of Utah 1996, Chapter 248
             35          58-68-102, as last amended by Laws of Utah 2010, Chapter 101
             36          58-68-302, as last amended by Laws of Utah 2009, Chapter 183
             37          58-68-304, as last amended by Laws of Utah 2005, Chapter 94
             38          58-68-305, as last amended by Laws of Utah 2005, Chapter 2
             39          58-68-401, as enacted by Laws of Utah 1996, Chapter 248
             40          58-68-403, as enacted by Laws of Utah 1996, Chapter 248
             41          58-68-503, as enacted by Laws of Utah 1996, Chapter 248
             42      REPEALS AND REENACTS:
             43          58-67-402, as last amended by Laws of Utah 2008, Chapter 382
             44          58-68-402, as last amended by Laws of Utah 2008, Chapter 382
             45     
             46      Be it enacted by the Legislature of the state of Utah:
             47          Section 1. Section 58-1-501 is amended to read:
             48           58-1-501. Unlawful and unprofessional conduct.
             49          (1) "Unlawful conduct" means conduct, by any person, that is defined as unlawful
             50      under this title and includes:
             51          (a) practicing or engaging in, representing oneself to be practicing or engaging in, or
             52      attempting to practice or engage in any occupation or profession requiring licensure under this
             53      title if the person is:
             54          (i) not licensed to do so or not exempted from licensure under this title; or
             55          (ii) restricted from doing so by a suspended, revoked, restricted, temporary,
             56      probationary, or inactive license;
             57          (b) impersonating another licensee or practicing an occupation or profession under a


             58      false or assumed name, except as permitted by law;
             59          (c) knowingly employing any other person to practice or engage in or attempt to
             60      practice or engage in any occupation or profession licensed under this title if the employee is
             61      not licensed to do so under this title;
             62          (d) knowingly permitting the person's authority to practice or engage in any occupation
             63      or profession licensed under this title to be used by another, except as permitted by law;
             64          (e) obtaining a passing score on a licensure examination, applying for or obtaining a
             65      license, or otherwise dealing with the division or a licensing board through the use of fraud,
             66      forgery, or intentional deception, misrepresentation, misstatement, or omission; or
             67          (f) (i) issuing, or aiding and abetting in the issuance of, an order or prescription for a
             68      drug or device to a person located in this state:
             69          (A) without prescriptive authority conferred by a license issued under this title, or by
             70      an exemption to licensure under this title; or
             71          (B) with prescriptive authority conferred by an exception issued under this title or a
             72      multistate practice privilege recognized under this title, if the prescription was issued without
             73      first obtaining information, in the usual course of professional practice, that is sufficient to
             74      establish a diagnosis, to identify underlying conditions, and to identify contraindications to the
             75      proposed treatment; and
             76          (ii) Subsection (1)(f)(i) does not apply to treatment rendered in an emergency, on-call
             77      or cross coverage situation, provided that the person who issues the prescription has
             78      prescriptive authority conferred by a license under this title, or is exempt from licensure under
             79      this title.
             80          (2) "Unprofessional conduct" means conduct, by a licensee or applicant, that is defined
             81      as unprofessional conduct under this title or under any rule adopted under this title and
             82      includes:
             83          (a) violating, or aiding or abetting any other person to violate, any statute, rule, or order
             84      regulating an occupation or profession under this title;
             85          (b) violating, or aiding or abetting any other person to violate, any generally accepted


             86      professional or ethical standard applicable to an occupation or profession regulated under this
             87      title;
             88          (c) engaging in conduct that results in conviction, a plea of nolo contendere, or a plea
             89      of guilty or nolo contendere which is held in abeyance pending the successful completion of
             90      probation with respect to a crime of moral turpitude or any other crime that, when considered
             91      with the functions and duties of the occupation or profession for which the license was issued
             92      or is to be issued, bears a reasonable relationship to the licensee's or applicant's ability to safely
             93      or competently practice the occupation or profession;
             94          (d) engaging in conduct that results in disciplinary action, including reprimand,
             95      censure, diversion, probation, suspension, or revocation, by any other licensing or regulatory
             96      authority having jurisdiction over the licensee or applicant in the same occupation or profession
             97      if the conduct would, in this state, constitute grounds for denial of licensure or disciplinary
             98      proceedings under Section 58-1-401 ;
             99          (e) engaging in conduct, including the use of intoxicants, drugs, narcotics, or similar
             100      chemicals, to the extent that the conduct does, or might reasonably be considered to, impair the
             101      ability of the licensee or applicant to safely engage in the occupation or profession;
             102          (f) practicing or attempting to practice an occupation or profession regulated under this
             103      title despite being physically or mentally unfit to do so;
             104          (g) practicing or attempting to practice an occupation or profession regulated under this
             105      title through gross incompetence, gross negligence, or a pattern of incompetency or negligence;
             106          (h) practicing or attempting to practice an occupation or profession requiring licensure
             107      under this title by any form of action or communication which is false, misleading, deceptive,
             108      or fraudulent;
             109          (i) practicing or attempting to practice an occupation or profession regulated under this
             110      title beyond the scope of the licensee's competency, abilities, or education;
             111          (j) practicing or attempting to practice an occupation or profession regulated under this
             112      title beyond the scope of the licensee's license;
             113          (k) verbally, physically, mentally, or sexually abusing or exploiting any person through


             114      conduct connected with the licensee's practice under this title or otherwise facilitated by the
             115      licensee's license;
             116          (l) acting as a supervisor without meeting the qualification requirements for that
             117      position that are defined by statute or rule;
             118          (m) issuing, or aiding and abetting in the issuance of, an order or prescription for a drug
             119      or device:
             120          (i) without first obtaining information in the usual course of professional practice, that
             121      is sufficient to establish a diagnosis, to identify conditions, and to identify contraindications to
             122      the proposed treatment; or
             123          (ii) with prescriptive authority conferred by an exception issued under this title, or a
             124      multi-state practice privilege recognized under this title, if the prescription was issued without
             125      first obtaining information, in the usual course of professional practice, that is sufficient to
             126      establish a diagnosis, to identify underlying conditions, and to identify contraindications to the
             127      proposed treatment; or
             128          (n) violating a provision of Section 58-1-501.5 .
             129          Section 2. Section 58-37-6 is amended to read:
             130           58-37-6. License to manufacture, produce, distribute, dispense, administer, or
             131      conduct research -- Issuance by division -- Denial, suspension, or revocation -- Records
             132      required -- Prescriptions.
             133          (1) (a) The division may adopt rules relating to the licensing and control of the
             134      manufacture, distribution, production, prescription, administration, dispensing, conducting of
             135      research with, and performing of laboratory analysis upon controlled substances within this
             136      state.
             137          (b) The division may assess reasonable fees to defray the cost of issuing original and
             138      renewal licenses under this chapter pursuant to Section 63J-1-504 .
             139          (2) (a) (i) Every person who manufactures, produces, distributes, prescribes, dispenses,
             140      administers, conducts research with, or performs laboratory analysis upon any controlled
             141      substance in Schedules II through V within this state, or who proposes to engage in


             142      manufacturing, producing, distributing, prescribing, dispensing, administering, conducting
             143      research with, or performing laboratory analysis upon controlled substances included in
             144      Schedules II through V within this state shall obtain a license issued by the division.
             145          (ii) The division shall issue each license under this chapter in accordance with a
             146      two-year renewal cycle established by rule. The division may by rule extend or shorten a
             147      renewal period by as much as one year to stagger the renewal cycles it administers.
             148          (b) Persons licensed to manufacture, produce, distribute, prescribe, dispense,
             149      administer, conduct research with, or perform laboratory analysis upon controlled substances in
             150      Schedules II through V within this state may possess, manufacture, produce, distribute,
             151      prescribe, dispense, administer, conduct research with, or perform laboratory analysis upon
             152      those substances to the extent authorized by their license and in conformity with this chapter.
             153          (c) The following persons are not required to obtain a license and may lawfully possess
             154      controlled substances under this section:
             155          (i) an agent or employee, except a sales representative, of any registered manufacturer,
             156      distributor, or dispenser of any controlled substance, if the agent or employee is acting in the
             157      usual course of the person's business or employment; however, nothing in this subsection shall
             158      be interpreted to permit an agent, employee, sales representative, or detail man to maintain an
             159      inventory of controlled substances separate from the location of the person's employer's
             160      registered and licensed place of business;
             161          (ii) a motor carrier or warehouseman, or an employee of a motor carrier or
             162      warehouseman, who possesses any controlled substance in the usual course of the person's
             163      business or employment; and
             164          (iii) an ultimate user, or any person who possesses any controlled substance pursuant to
             165      a lawful order of a practitioner.
             166          (d) The division may enact rules waiving the license requirement for certain
             167      manufacturers, producers, distributors, prescribers, dispensers, administrators, research
             168      practitioners, or laboratories performing analysis if consistent with the public health and safety.
             169          (e) A separate license is required at each principal place of business or professional


             170      practice where the applicant manufactures, produces, distributes, dispenses, conducts research
             171      with, or performs laboratory analysis upon controlled substances.
             172          (f) The division may enact rules providing for the inspection of a licensee or applicant's
             173      establishment, and may inspect the establishment according to those rules.
             174          (3) (a) Upon proper application, the division shall license a qualified applicant to
             175      manufacture, produce, distribute, conduct research with, or perform laboratory analysis upon
             176      controlled substances included in Schedules I through V, unless it determines that issuance of a
             177      license is inconsistent with the public interest. The division shall not issue a license to any
             178      person to prescribe, dispense, or administer a Schedule I controlled substance. In determining
             179      public interest, the division shall consider whether or not the applicant has:
             180          (i) maintained effective controls against diversion of controlled substances and any
             181      Schedule I or II substance compounded from any controlled substance into other than
             182      legitimate medical, scientific, or industrial channels;
             183          (ii) complied with applicable state and local law;
             184          (iii) been convicted under federal or state laws relating to the manufacture, distribution,
             185      or dispensing of substances;
             186          (iv) past experience in the manufacture of controlled dangerous substances;
             187          (v) established effective controls against diversion; and
             188          (vi) complied with any other factors that the division establishes that promote the
             189      public health and safety.
             190          (b) Licenses granted under Subsection (3)(a) do not entitle a licensee to manufacture,
             191      produce, distribute, conduct research with, or perform laboratory analysis upon controlled
             192      substances in Schedule I other than those specified in the license.
             193          (c) (i) Practitioners shall be licensed to administer, dispense, or conduct research with
             194      substances in Schedules II through V if they are authorized to administer, dispense, or conduct
             195      research under the laws of this state.
             196          (ii) The division need not require a separate license for practitioners engaging in
             197      research with nonnarcotic controlled substances in Schedules II through V where the licensee is


             198      already licensed under this chapter in another capacity.
             199          (iii) With respect to research involving narcotic substances in Schedules II through V,
             200      or where the division by rule requires a separate license for research of nonnarcotic substances
             201      in Schedules II through V, a practitioner shall apply to the division prior to conducting
             202      research.
             203          (iv) Licensing for purposes of bona fide research with controlled substances by a
             204      practitioner considered qualified may be denied only on a ground specified in Subsection (4),
             205      or upon evidence that the applicant will abuse or unlawfully transfer or fail to safeguard
             206      adequately the practitioner's supply of substances against diversion from medical or scientific
             207      use.
             208          (v) Practitioners registered under federal law to conduct research in Schedule I
             209      substances may conduct research in Schedule I substances within this state upon furnishing the
             210      division evidence of federal registration.
             211          (d) Compliance by manufacturers, producers, and distributors with the provisions of
             212      federal law respecting registration, excluding fees, entitles them to be licensed under this
             213      chapter.
             214          (e) The division shall initially license those persons who own or operate an
             215      establishment engaged in the manufacture, production, distribution, dispensation, or
             216      administration of controlled substances prior to April 3, 1980, and who are licensed by the
             217      state.
             218          (4) (a) Any license pursuant to Subsection (2) or (3) may be denied, suspended, placed
             219      on probation, or revoked by the division upon finding that the applicant or licensee has:
             220          (i) materially falsified any application filed or required pursuant to this chapter;
             221          (ii) been convicted of an offense under this chapter or any law of the United States, or
             222      any state, relating to any substance defined as a controlled substance;
             223          (iii) been convicted of a felony under any other law of the United States or any state
             224      within five years of the date of the issuance of the license;
             225          (iv) had a federal registration or license denied, suspended, or revoked by competent


             226      federal authority and is no longer authorized to [engage in the manufacturing, distribution, or
             227      dispensing of] manufacture, distribute, prescribe, or dispense controlled substances;
             228          (v) had the licensee's license suspended or revoked by competent authority of another
             229      state for violation of laws or regulations comparable to those of this state relating to the
             230      manufacture, distribution, or dispensing of controlled substances;
             231          (vi) violated any division rule that reflects adversely on the licensee's reliability and
             232      integrity with respect to controlled substances;
             233          (vii) refused inspection of records required to be maintained under this chapter by a
             234      person authorized to inspect them; or
             235          (viii) prescribed, dispensed, administered, or injected an anabolic steroid for the
             236      purpose of manipulating human hormonal structure so as to:
             237          (A) increase muscle mass, strength, or weight without medical necessity and without a
             238      written prescription by any practitioner in the course of the practitioner's professional practice;
             239      or
             240          (B) improve performance in any form of human exercise, sport, or game.
             241          (b) The division may limit revocation or suspension of a license to a particular
             242      controlled substance with respect to which grounds for revocation or suspension exist.
             243          (c) (i) Proceedings to deny, revoke, or suspend a license shall be conducted pursuant to
             244      this section and in accordance with the procedures set forth in Title 58, Chapter 1, Division of
             245      Occupational and Professional Licensing Act, and conducted in conjunction with the
             246      appropriate representative committee designated by the director of the department.
             247          (ii) Nothing in this Subsection (4)(c) gives the Division of Occupational and
             248      Professional Licensing exclusive authority in proceedings to deny, revoke, or suspend licenses,
             249      except where the division is designated by law to perform those functions, or, when not
             250      designated by law, is designated by the executive director of the Department of Commerce to
             251      conduct the proceedings.
             252          (d) (i) The division may suspend any license simultaneously with the institution of
             253      proceedings under this section if it finds there is an imminent danger to the public health or


             254      safety.
             255          (ii) Suspension shall continue in effect until the conclusion of proceedings, including
             256      judicial review, unless withdrawn by the division or dissolved by a court of competent
             257      jurisdiction.
             258          (e) (i) If a license is suspended or revoked under this Subsection (4), all controlled
             259      substances owned or possessed by the licensee may be placed under seal in the discretion of the
             260      division.
             261          (ii) Disposition may not be made of substances under seal until the time for taking an
             262      appeal has lapsed, or until all appeals have been concluded, unless a court, upon application,
             263      orders the sale of perishable substances and the proceeds deposited with the court.
             264          (iii) If a revocation order becomes final, all controlled substances shall be forfeited.
             265          (f) The division shall notify promptly the Drug Enforcement Administration of all
             266      orders suspending or revoking a license and all forfeitures of controlled substances.
             267          (g) If an individual's Drug Enforcement Administration registration is denied, revoked,
             268      surrendered, or suspended, the division shall immediately suspend the individual's controlled
             269      substance license, which shall only be reinstated by the division upon reinstatement of the
             270      federal registration, unless the division has taken further administrative action under
             271      Subsection (4)(a)(iv), which would be grounds for the continued denial of the controlled
             272      substance license.
             273          (5) (a) Persons licensed under Subsection (2) or (3) shall maintain records and
             274      inventories in conformance with the record keeping and inventory requirements of federal and
             275      state law and any additional rules issued by the division.
             276          (b) (i) Every physician, dentist, naturopathic physician, veterinarian, practitioner, or
             277      other person who is authorized to administer or professionally use a controlled substance shall
             278      keep a record of the drugs received by him and a record of all drugs administered, dispensed, or
             279      professionally used by him otherwise than by a prescription.
             280          (ii) A person using small quantities or solutions or other preparations of those drugs for
             281      local application has complied with this Subsection (5)(b) if the person keeps a record of the


             282      quantity, character, and potency of those solutions or preparations purchased or prepared by
             283      him, and of the dates when purchased or prepared.
             284          (6) Controlled substances in Schedules I through V may be distributed only by a
             285      licensee and pursuant to an order form prepared in compliance with division rules or a lawful
             286      order under the rules and regulations of the United States.
             287          (7) (a) A person may not write or authorize a prescription for a controlled substance
             288      unless the person is:
             289          (i) a practitioner authorized to prescribe drugs and medicine under the laws of this state
             290      or under the laws of another state having similar standards; and
             291          (ii) licensed under this chapter or under the laws of another state having similar
             292      standards.
             293          (b) A person other than a pharmacist licensed under the laws of this state, or the
             294      pharmacist's licensed intern, as required by Sections 58-17b-303 and 58-17b-304 , may not
             295      dispense a controlled substance.
             296          (c) (i) A controlled substance may not be dispensed without the written prescription of
             297      a practitioner, if the written prescription is required by the federal Controlled Substances Act.
             298          (ii) That written prescription shall be made in accordance with Subsection (7)(a) and in
             299      conformity with Subsection (7)(d).
             300          (iii) In emergency situations, as defined by division rule, controlled substances may be
             301      dispensed upon oral prescription of a practitioner, if reduced promptly to writing on forms
             302      designated by the division and filed by the pharmacy.
             303          (iv) Prescriptions reduced to writing by a pharmacist shall be in conformity with
             304      Subsection (7)(d).
             305          (d) Except for emergency situations designated by the division, a person may not issue,
             306      fill, compound, or dispense a prescription for a controlled substance unless the prescription is
             307      signed by the prescriber in ink or indelible pencil or is signed with an electronic signature of
             308      the prescriber as authorized by division rule, and contains the following information:
             309          (i) the name, address, and registry number of the prescriber;


             310          (ii) the name, address, and age of the person to whom or for whom the prescription is
             311      issued;
             312          (iii) the date of issuance of the prescription; and
             313          (iv) the name, quantity, and specific directions for use by the ultimate user of the
             314      controlled substance.
             315          (e) A prescription may not be written, issued, filled, or dispensed for a Schedule I
             316      controlled substance.
             317          (f) Except when administered directly to an ultimate user by a licensed practitioner,
             318      controlled substances are subject to the following restrictions:
             319          (i) (A) A prescription for a Schedule II substance may not be refilled.
             320          (B) A Schedule II controlled substance may not be filled in a quantity to exceed a
             321      one-month's supply, as directed on the daily dosage rate of the prescriptions.
             322          (ii) A Schedule III or IV controlled substance may be filled only within six months of
             323      issuance, and may not be refilled more than six months after the date of its original issuance or
             324      be refilled more than five times after the date of the prescription unless renewed by the
             325      practitioner.
             326          (iii) All other controlled substances in Schedule V may be refilled as the prescriber's
             327      prescription directs, but they may not be refilled one year after the date the prescription was
             328      issued unless renewed by the practitioner.
             329          (iv) Any prescription for a Schedule II substance may not be dispensed if it is not
             330      presented to a pharmacist for dispensing by a pharmacist or a pharmacy intern within 30 days
             331      after the date the prescription was issued, or 30 days after the dispensing date, if that date is
             332      specified separately from the date of issue.
             333          (v) A practitioner may issue more than one prescription at the same time for the same
             334      Schedule II controlled substance, but only under the following conditions:
             335          (A) no more than three prescriptions for the same Schedule II controlled substance may
             336      be issued at the same time;
             337          (B) no one prescription may exceed a 30-day supply;


             338          (C) a second or third prescription shall include the date of issuance and the date for
             339      dispensing; and
             340          (D) unless the practitioner determines there is a valid medical reason to the contrary,
             341      the date for dispensing a second or third prescription may not be fewer than 30 days from the
             342      dispensing date of the previous prescription.
             343          (vi) Each prescription for a controlled substance may contain only one controlled
             344      substance per prescription form and may not contain any other legend drug or prescription
             345      item.
             346          (g) An order for a controlled substance in Schedules II through V for use by an
             347      inpatient or an outpatient of a licensed hospital is exempt from all requirements of this
             348      Subsection (7) if the order is:
             349          (i) issued or made by a prescribing practitioner who holds an unrestricted registration
             350      with the federal Drug Enforcement Administration, and an active Utah controlled substance
             351      license in good standing issued by the division under this section, or a medical resident who is
             352      exempted from licensure under Subsection 58-1-307 (1)(c);
             353          (ii) authorized by the prescribing practitioner treating the patient and the prescribing
             354      practitioner designates the quantity ordered;
             355          (iii) entered upon the record of the patient, the record is signed by the prescriber
             356      affirming the prescriber's authorization of the order within 48 hours after filling or
             357      administering the order, and the patient's record reflects the quantity actually administered; and
             358          (iv) filled and dispensed by a pharmacist practicing the pharmacist's profession within
             359      the physical structure of the hospital, or the order is taken from a supply lawfully maintained by
             360      the hospital and the amount taken from the supply is administered directly to the patient
             361      authorized to receive it.
             362          (h) A practitioner licensed under this chapter may not prescribe, administer, or
             363      dispense a controlled substance to a child, without first obtaining the consent required in
             364      Section 78B-3-406 of a parent, guardian, or person standing in loco parentis of the child except
             365      in cases of an emergency. For purposes of this Subsection (7)(h), "child" has the same


             366      meaning as defined in Section 78A-6-105 , and "emergency" means any physical condition
             367      requiring the administration of a controlled substance for immediate relief of pain or suffering.
             368          (i) A practitioner licensed under this chapter may not prescribe or administer dosages
             369      of a controlled substance in excess of medically recognized quantities necessary to treat the
             370      ailment, malady, or condition of the ultimate user.
             371          (j) A practitioner licensed under this chapter may not prescribe, administer, or dispense
             372      any controlled substance to another person knowing that the other person is using a false name,
             373      address, or other personal information for the purpose of securing the controlled substance.
             374          (k) A person who is licensed under this chapter to manufacture, distribute, or dispense
             375      a controlled substance may not manufacture, distribute, or dispense a controlled substance to
             376      another licensee or any other authorized person not authorized by this license.
             377          (l) A person licensed under this chapter may not omit, remove, alter, or obliterate a
             378      symbol required by this chapter or by a rule issued under this chapter.
             379          (m) A person licensed under this chapter may not refuse or fail to make, keep, or
             380      furnish any record notification, order form, statement, invoice, or information required under
             381      this chapter.
             382          (n) A person licensed under this chapter may not refuse entry into any premises for
             383      inspection as authorized by this chapter.
             384          (o) A person licensed under this chapter may not furnish false or fraudulent material
             385      information in any application, report, or other document required to be kept by this chapter or
             386      willfully make any false statement in any prescription, order, report, or record required by this
             387      chapter.
             388          (8) (a) (i) Any person licensed under this chapter who is found by the division to have
             389      violated any of the provisions of Subsections (7)(k) through [(7)](o) is subject to a penalty not
             390      to exceed $5,000. The division shall determine the procedure for adjudication of any violations
             391      in accordance with Sections 58-1-106 and 58-1-108 .
             392          (ii) The division shall deposit all penalties collected under Subsection (8)(a)(i) in the
             393      General Fund as a dedicated credit to be used by the division under Subsection 58-37f-502 (1).


             394          (b) Any person who knowingly and intentionally violates Subsections (7)(h) through
             395      [(7)](j) is:
             396          (i) upon first conviction, guilty of a class B misdemeanor;
             397          (ii) upon second conviction, guilty of a class A misdemeanor; and
             398          (iii) on third or subsequent conviction, guilty of a third degree felony.
             399          (c) Any person who knowingly and intentionally violates Subsections (7)(k) through
             400      [(7)](o) shall upon conviction be guilty of a third degree felony.
             401          (9) Any information communicated to any licensed practitioner in an attempt to
             402      unlawfully procure, or to procure the administration of, a controlled substance is not considered
             403      to be a privileged communication.
             404          Section 3. Section 58-67-102 is amended to read:
             405           58-67-102. Definitions.
             406          In addition to the definitions in Section 58-1-102 , as used in this chapter:
             407          (1) "ACGME" means the Accreditation Council for Graduate Medical Education of the
             408      American Medical Association.
             409          (2) "Administrative penalty" means a monetary fine or citation imposed by the division
             410      for acts or omissions determined to constitute unprofessional or unlawful conduct, in
             411      accordance with a fine schedule established by the division in collaboration with the board, as a
             412      result of an adjudicative proceeding conducted in accordance with Title 63G, Chapter 4,
             413      Administrative Procedures Act.
             414          (3) "Board" means the Physicians Licensing Board created in Section 58-67-201 .
             415          (4) "Diagnose" means:
             416          (a) to examine in any manner another person, parts of a person's body, substances,
             417      fluids, or materials excreted, taken, or removed from a person's body, or produced by a person's
             418      body, to determine the source, nature, kind, or extent of a disease or other physical or mental
             419      condition;
             420          (b) to attempt to conduct an examination or determination described under Subsection
             421      (4)(a);


             422          (c) to hold oneself out as making or to represent that one is making an examination or
             423      determination as described in Subsection (4)(a); or
             424          (d) to make an examination or determination as described in Subsection (4)(a) upon or
             425      from information supplied directly or indirectly by another person, whether or not in the
             426      presence of the person making or attempting the diagnosis or examination.
             427          (5) "LCME" means the Liaison Committee on Medical Education of the American
             428      Medical Association.
             429          (6) "Medical assistant" means an unlicensed individual working under the direct and
             430      immediate supervision of a licensed physician and surgeon and engaged in specific tasks
             431      assigned by the licensed physician and surgeon in accordance with the standards and ethics of
             432      the profession.
             433          (7) "Physician" means both physicians and surgeons licensed under Section 58-67-301 ,
             434      Utah Medical Practice Act, and osteopathic physicians and surgeons licensed under Section
             435      58-68-301 , Utah Osteopathic Medical Practice Act.
             436          (8) "Practice of medicine" means:
             437          (a) to diagnose, treat, correct, administer anesthesia, or prescribe for any human
             438      disease, ailment, injury, infirmity, deformity, pain or other condition, physical or mental, real
             439      or imaginary, or to attempt to do so, by any means or instrumentality, and by an individual in
             440      Utah or outside the state upon or for any human within the state, except that conduct described
             441      in this Subsection (8)(a) that is performed by a person legally and in accordance with a license
             442      issued under another chapter of this title does not constitute the practice of medicine;
             443          (b) when a person not licensed as a physician directs a licensee under this chapter to
             444      withhold or alter the health care services that the licensee has ordered, but practice of medicine
             445      does not include any conduct under Subsection 58-67-501 (2);
             446          (c) to maintain an office or place of business for the purpose of doing any of the acts
             447      described in Subsection (8)(a) whether or not for compensation; or
             448          (d) to use, in the conduct of any occupation or profession pertaining to the diagnosis or
             449      treatment of human diseases or conditions in any printed material, stationery, letterhead,


             450      envelopes, signs, or advertisements, the designation "doctor," "doctor of medicine,"
             451      "physician," "surgeon," "physician and surgeon," "Dr.," "M.D.," or any combination of these
             452      designations in any manner which might cause a reasonable person to believe the individual
             453      using the designation is a licensed physician and surgeon, and if the party using the designation
             454      is not a licensed physician and surgeon, the designation must additionally contain the
             455      description of the branch of the healing arts for which the person has a license, provided that an
             456      individual who has received an earned degree of doctor of medicine degree but is not a licensed
             457      physician and surgeon in Utah may use the designation "M.D." if it is followed by "Not
             458      Licensed" or "Not Licensed in Utah" in the same size and style of lettering.
             459          (9) "Prescription device" means an instrument, apparatus, implement, machine,
             460      contrivance, implant, in vitro reagent, or other similar or related article, and any component
             461      part or accessory, which is required under federal or state law to be prescribed by a practitioner
             462      and dispensed by or through a person or entity licensed under this chapter or exempt from
             463      licensure under this chapter.
             464          (10) "Prescription drug" means a drug that is required by federal or state law or rule to
             465      be dispensed only by prescription or is restricted to administration only by practitioners.
             466          (11) "SPEX" means the Special Purpose Examination of the Federation of State
             467      Medical Boards.
             468          (12) "Unlawful conduct" is as defined in Sections 58-1-501 and 58-67-501 .
             469          (13) "Unprofessional conduct" is as defined in Sections 58-1-501 and 58-67-502 , and
             470      as may be further defined by division rule.
             471          Section 4. Section 58-67-302 is amended to read:
             472           58-67-302. Qualifications for licensure.
             473          (1) An applicant for licensure as a physician and surgeon, except as set forth in
             474      Subsection (2), shall:
             475          (a) submit an application in a form prescribed by the division, which may include:
             476          (i) submissions by the applicant of information maintained by practitioner data banks,
             477      as designated by division rule, with respect to the applicant; [and]


             478          (ii) a record of professional liability claims made against the applicant and settlements
             479      paid by or on behalf of the applicant; and
             480          (iii) authorization to use a record coordination and verification service approved by the
             481      division in collaboration with the board;
             482          (b) pay a fee determined by the department under Section 63J-1-504 ;
             483          (c) be of good moral character;
             484          (d) provide satisfactory documentation of having successfully completed a program of
             485      professional education preparing an individual as a physician and surgeon, as evidenced by
             486      [having received an earned degree of doctor of medicine from]:
             487          [(i) an LCME accredited medical school or college; or]
             488          [(ii) a medical school or college located outside of the United States or its jurisdictions
             489      which at the time of the applicant's graduation, met criteria for LCME accreditation;]
             490          (i) having received an earned degree of doctor of medicine from an LCME accredited
             491      medical school or college; or
             492          (ii) if the applicant graduated from a medical school or college located outside the
             493      United States or its territories, submitting a current certification by the Educational
             494      Commission for Foreign Medical Graduates or any successor organization approved by the
             495      division in collaboration with the board;
             496          [(e) hold a current certification by the Educational Commission for Foreign Medical
             497      Graduates or any successor organization approved by the division in collaboration with the
             498      board, if the applicant graduated from a medical school or college located outside of the United
             499      States or its jurisdictions;]
             500          [(f)] (e) satisfy the division and board that the applicant:
             501          (i) has successfully completed 24 months of progressive resident training in a program
             502      approved by the ACGME, the Royal College of Physicians and Surgeons, the College of
             503      Family Physicians of Canada, or any similar body in the United States or Canada approved by
             504      the division in collaboration with the board; or
             505          (ii) (A) has successfully completed 12 months of resident training in an ACGME


             506      approved program after receiving a degree of doctor of medicine as required under Subsection
             507      (1)(d);
             508          (B) has been accepted in and is successfully participating in progressive resident
             509      training in an ACGME approved program within Utah, in the applicant's second or third year
             510      of postgraduate training; and
             511          (C) has agreed to surrender to the division the applicant's license as a physician and
             512      surgeon without any proceedings under Title 63G, Chapter 4, Administrative Procedures Act,
             513      and has agreed the applicant's license as a physician and surgeon will be automatically revoked
             514      by the division if the applicant fails to continue in good standing in an ACGME approved
             515      progressive resident training program within the state;
             516          [(g)] (f) pass the licensing examination sequence required by division rule made in
             517      collaboration with the board;
             518          [(h)] (g) be able to read, write, speak, understand, and be understood in the English
             519      language and demonstrate proficiency to the satisfaction of the board if requested by the board;
             520          [(i)] (h) meet with the board and representatives of the division, if requested, for the
             521      purpose of evaluating the applicant's qualifications for licensure;
             522          [(j)] (i) designate:
             523          (i) a contact person for access to medical records in accordance with the federal Health
             524      Insurance Portability and Accountability Act; and
             525          (ii) an alternate contact person for access to medical records, in the event the original
             526      contact person is unable or unwilling to serve as the contact person for access to medical
             527      records; and
             528          [(k)] (j) establish a method for notifying patients of the identity and location of the
             529      contact person and alternate contact person, if the applicant will practice in a location with no
             530      other persons licensed under this chapter.
             531          (2) An applicant for licensure as a physician and surgeon by endorsement who is
             532      currently licensed to practice medicine in any state other than Utah, a district or territory of the
             533      United States, or Canada shall:


             534          (a) be currently licensed with a full unrestricted license in good standing in any state,
             535      district, or territory of the United States, or Canada;
             536          (b) have been actively engaged in the legal practice of medicine in any state, district, or
             537      territory of the United States, or Canada for not less than 6,000 hours during the five years
             538      immediately preceding the date of application for licensure in Utah;
             539          [(c) not have any action pending against the applicant's license;]
             540          [(d) not have a license that was suspended or revoked in any state, unless the license
             541      was subsequently reinstated as a full unrestricted license in good standing; and]
             542          (c) comply with the requirements for licensure under Subsection (1)(a) through (d),
             543      (1)(e)(i), and (1)(g) through (j);
             544          (d) have passed the licensing examination sequence required in Subsection (1)(f) or
             545      another medical licensing examination sequence in another state, district or territory of the
             546      United States, or Canada that the division in collaboration with the board by rulemaking
             547      determines is equivalent to its own required examination;
             548          (e) not have any investigation or action pending against any health care license of the
             549      applicant, not have a health care license that was suspended or revoked in any state, district or
             550      territory of the United States, or Canada, and not have surrendered a health care license in lieu
             551      of a disciplinary action, unless:
             552          (i) the license was subsequently reinstated as a full unrestricted license in good
             553      standing; or
             554          (ii) the division in collaboration with the board determines to its satisfaction, after full
             555      disclosure by the applicant, that:
             556          (A) the conduct has been corrected, monitored, and resolved; or
             557          (B) a mitigating circumstance exists that prevents its resolution, and the division in
             558      collaboration with the board is satisfied that, but for the mitigating circumstance, the license
             559      would be reinstated;
             560          (f) submit to a records review, a practice history review, and comprehensive
             561      assessments, if requested by the division in collaboration with the board; and


             562          [(e)] (g) produce satisfactory evidence [of] that the [applicant's qualifications, identity,
             563      and good standing] applicant meets the requirements of this Subsection (2) to the satisfaction
             564      of the division in collaboration with the board.
             565          (3) An applicant for licensure by endorsement may engage in the practice of medicine
             566      under a temporary license while the applicant's application for licensure is being processed by
             567      the division, provided:
             568          (a) the applicant submits a complete application required for temporary licensure to the
             569      division;
             570          (b) the applicant submits a written document to the division from:
             571          (i) a health care facility licensed under Title 26, Chapter 21, Health Care Facility
             572      Licensing and Inspection Act, stating that the applicant is practicing under the invitation of the
             573      health care facility; or
             574          (ii) two individuals licensed under this chapter, whose license is in good standing and
             575      who practice in the same clinical location, both stating that:
             576          (A) the applicant is practicing under the invitation of the individual; and
             577          (B) the applicant will practice at the same clinical location as the individual;
             578          (c) the applicant submits a signed certification to the division that the applicant meets
             579      the requirements of Subsection (2);
             580          (d) the applicant does not engage in the practice of medicine until the division has
             581      issued a temporary license;
             582          (e) the temporary license is only issued for and may not be extended beyond the
             583      duration of one year from issuance; and
             584          (f) the temporary license expires immediately and prior to the expiration of one year
             585      from issuance, upon notification from the division that the applicant's application for licensure
             586      by endorsement is denied.
             587          (4) The division shall issue a temporary license under Subsection (3) within 15
             588      business days after the applicant satisfies the requirements of Subsection (3).
             589          Section 5. Section 58-67-302.5 is amended to read:


             590           58-67-302.5. Licensing of graduates of foreign medical schools.
             591          (1) Notwithstanding any other provision of law to the contrary, an individual enrolled
             592      in a medical school outside the United States, its territories, the District of Columbia, or
             593      Canada is eligible for licensure as a physician and surgeon in this state if the individual has
             594      satisfied the following requirements:
             595          (a) meets all the requirements of [Section] Subsection 58-67-302 (1), except for
             596      Subsection 58-67-302 (1)(d);
             597          (b) has studied medicine in a medical school located outside the United States which is
             598      recognized by an organization approved by the division;
             599          (c) has completed all of the formal requirements of the foreign medical school except
             600      internship or social service;
             601          (d) has attained a passing score on the educational commission for foreign medical
             602      graduates examination or other qualifying examinations such as the United States Medical
             603      Licensing Exam parts I and II, which are approved by the division or a medical school
             604      approved by the division;
             605          (e) has satisfactorily completed one calendar year of supervised clinical training under
             606      the direction of a United States medical education setting accredited by the liaison committee
             607      for graduate medical education and approved by the division;
             608          (f) has completed the postgraduate hospital training required by Subsection
             609      58-67-302 (1)[(f)](e)(i); and
             610          (g) has passed the examination required by the division of all applicants for licensure.
             611          (2) Satisfaction of the requirements of Subsection (1) is in lieu of:
             612          (a) the completion of any foreign internship or social service requirements; and
             613          (b) the certification required by Subsection 58-67-302 (1)[(e)](d).
             614          (3) Individuals who satisfy the requirements of Subsections (1)(a) through (f) shall be
             615      eligible for admission to graduate medical education programs within the state, including
             616      internships and residencies, which are accredited by the liaison committee for graduate medical
             617      education.


             618          (4) A document issued by a medical school located outside the United States shall be
             619      considered the equivalent of a degree of doctor of medicine for the purpose of licensure as a
             620      physician and surgeon in this state if:
             621          (a) the foreign medical school is recognized by an organization approved by the
             622      division;
             623          (b) the document granted by the foreign medical school is issued after the completion
             624      of all formal requirements of the medical school except internship or social service; and
             625          (c) the foreign medical school certifies that the person to whom the document was
             626      issued has satisfactorily completed the requirements of Subsection (1)(c).
             627          (5) The provisions for licensure under this section shall be known as the "fifth pathway
             628      program."
             629          Section 6. Section 58-67-304 is amended to read:
             630           58-67-304. License renewal requirements.
             631          (1) As a condition precedent for license renewal, each licensee shall, during each
             632      two-year licensure cycle or other cycle defined by division rule:
             633          (a) complete qualified continuing professional education requirements in accordance
             634      with the number of hours and standards defined by division rule made in collaboration with the
             635      board;
             636          (b) appoint a contact person for access to medical records and an alternate contact
             637      person for access to medical records in accordance with Subsection 58-67-302 (1)[(j)](i); and
             638          (c) if the licensee practices medicine in a location with no other persons licensed under
             639      this chapter, provide some method of notice to the licensee's patients of the identity and
             640      location of the contact person and alternate contact person for the licensee.
             641          (2) If a renewal period is extended or shortened under Section 58-67-303 , the
             642      continuing education hours required for license renewal under this section are increased or
             643      decreased proportionally.
             644          Section 7. Section 58-67-305 is amended to read:
             645           58-67-305. Exemptions from licensure.


             646          In addition to the exemptions from licensure in Section 58-1-307 , the following
             647      individuals may engage in the described acts or practices without being licensed under this
             648      chapter:
             649          (1) an individual rendering aid in an emergency, when no fee or other consideration of
             650      value for the service is charged, received, expected, or contemplated;
             651          (2) an individual administering a domestic or family remedy;
             652          (3) (a) (i) a person engaged in the sale of vitamins, health foods, dietary supplements,
             653      herbs, or other products of nature, the sale of which is not otherwise prohibited by state or
             654      federal law; and
             655          (ii) a person acting in good faith for religious reasons, as a matter of conscience, or
             656      based on a personal belief, when obtaining or providing any information regarding health care
             657      and the use of any product under Subsection (3)(a)(i); and
             658          (b) Subsection (3)(a) does not:
             659          (i) allow a person to diagnose any human disease, ailment, injury, infirmity, deformity,
             660      pain, or other condition; or
             661          (ii) prohibit providing truthful and non-misleading information regarding any of the
             662      products under Subsection (3)(a)(i);
             663          (4) a person engaged in good faith in the practice of the religious tenets of any church
             664      or religious belief, without the use of prescription drugs;
             665          (5) an individual authorized by the Department of Health under Section 26-1-30 , to
             666      withdraw blood to determine the alcohol or drug content pursuant to Section 41-6a-523 ;
             667          (6) a medical assistant while working under the direct and immediate supervision of a
             668      licensed physician and surgeon, to the extent the medical assistant is engaged in tasks
             669      appropriately delegated by the supervisor in accordance with the standards and ethics of the
             670      practice of medicine;
             671          (7) an individual engaging in the practice of medicine when:
             672          (a) the individual is licensed in good standing as a physician in another state with no
             673      licensing action pending and no less than 10 years of professional experience;


             674          (b) the services are rendered as a public service and for a noncommercial purpose;
             675          (c) no fee or other consideration of value is charged, received, expected, or
             676      contemplated for the services rendered beyond an amount necessary to cover the proportionate
             677      cost of malpractice insurance; and
             678          (d) the individual does not otherwise engage in unlawful or unprofessional conduct;
             679      [and]
             680          (8) an individual providing expert testimony in a legal proceeding[.]; and
             681          (9) an individual who is invited by a school, association, society, or other body
             682      approved by the division to conduct a clinic or demonstration of the practice of medicine in
             683      which patients are treated, if:
             684          (a) the individual does not establish a place of business in this state;
             685          (b) the individual does not regularly engage in the practice of medicine in this state;
             686          (c) the individual holds a current license in good standing to practice medicine issued
             687      by another state, district or territory of the United States, or Canada;
             688          (d) the primary purpose of the event is the training of others in the practice of
             689      medicine; and
             690          (e) neither the patient nor an insurer is billed for the services performed.
             691          Section 8. Section 58-67-401 is amended to read:
             692           58-67-401. Grounds for denial of license -- Disciplinary proceedings.
             693          Grounds for division action [regarding the following are under Section] are set forth in
             694      Sections 58-1-401 [:] and 58-67-503 .
             695          [(1) refusing to issue a license to an applicant or refusing to renew the license of a
             696      licensee;]
             697          [(2) revoking, suspending, restricting, or placing on probation the license of a
             698      licensee;]
             699          [(3) assessing an administrative penalty; and]
             700          [(4) issuing a public or private reprimand to a licensee or issuing a cease and desist
             701      order.]


             702          Section 9. Section 58-67-402 is repealed and reenacted to read:
             703          58-67-402. Authority to assess penalty.
             704          The division in collaboration with the board may assess penalties as described in
             705      Section 58-67-503 .
             706          Section 10. Section 58-67-403 is amended to read:
             707           58-67-403. Revocation of license -- Nondisciplinary.
             708          Revocation by the division of a license under Subsection 58-67-302 (1)[(f)](e) for
             709      failure to continue on a resident training program for reasons other than unprofessional or
             710      unlawful conduct is a nondisciplinary action and may not be reported by the division as a
             711      disciplinary action against the licensee.
             712          Section 11. Section 58-67-503 is amended to read:
             713           58-67-503. Penalties and administrative actions for unlawful and unprofessional
             714      conduct.
             715          (1) Any person who violates the unlawful conduct provisions of Section 58-67-501 [, or
             716      Subsection] or Section 58-1-501 [(1)(a) or 58-1-501 (1)(c)] is guilty of a third degree felony.
             717          [(2) The division may assess administrative penalties in accordance with the provisions
             718      of Section 58-67-402 for acts of unprofessional conduct.]
             719          (2) (a) Subject to Subsection (4), the division may punish unprofessional or unlawful
             720      conduct by:
             721          (i) assessing administrative penalties; or
             722          (ii) taking other appropriate administrative action.
             723          (b) A monetary administrative penalty imposed under this section shall be deposited in
             724      the Physician Education Fund created in Section 58-67a-1 .
             725          (3) If a licensee has been convicted of unlawful conduct, described in Section
             726      58-67-501 , before an administrative proceeding regarding the same conduct, the division may
             727      not assess an additional administrative fine under this chapter for the same conduct.
             728          (4) (a) If the division concludes that an individual has violated provisions of Section
             729      58-67-501 , Section 58-67-502 , the Division of Occupational and Professional Licensing Act,


             730      the Utah Controlled Substances Act, or any rule or order issued with respect to these
             731      provisions, and disciplinary action is appropriate, the director or director's designee shall:
             732          (i) issue a citation to the individual;
             733          (ii) attempt to negotiate a stipulated settlement; or
             734          (iii) notify the individual that an adjudicative proceeding conducted under Title 63G,
             735      Chapter 4, Administrative Procedures Act, will be commenced and the individual is invited to
             736      appear.
             737          (b) The division may take the following action against an individual who is in violation
             738      of a provision described in Subsection (4)(a), as evidenced by an uncontested citation, a
             739      stipulated settlement, or a finding of violation in an adjudicative proceeding:
             740          (i) assess a fine of up to $10,000 per single violation or up to $2,000 per day of
             741      ongoing violation, whichever is greater, in accordance with a fine schedule established by rule;
             742      or
             743          (ii) order to cease and desist from the behavior that constitutes a violation of the
             744      provisions described in Subsection (4)(a).
             745          (c) An individual's license may not be suspended or revoked through a citation.
             746          (d) Each citation issued under this section shall:
             747          (i) be in writing;
             748          (ii) clearly describe or explain:
             749          (A) the nature of the violation, including a reference to the provision of the chapter,
             750      rule, or order alleged to have been violated;
             751          (B) that the recipient must notify the division in writing within 20 calendar days from
             752      the day on which the citation is served if the recipient wishes to contest the citation at a hearing
             753      conducted under Title 63G, Chapter 4, Administrative Procedures Act; and
             754          (C) the consequences of failure to timely contest the citation or pay the fine assessed by
             755      the citation within the time specified in the citation; and
             756          (iii) be served in accordance with the Utah Rules of Civil Procedure.
             757          (e) If the individual to whom the citation is issued fails to request a hearing to contest


             758      the citation within 20 calendar days from the day on which the citation is served, the citation
             759      becomes the final order of the division and is not subject to further agency review. The period
             760      to contest the citation may be extended by the division for cause.
             761          (f) The division may refuse to issue or renew or suspend, revoke, or place on probation
             762      the license of an individual who fails to comply with a citation after the citation becomes final.
             763          (g) The failure of an applicant for licensure to comply with a citation after it becomes
             764      final is a ground for denial of license.
             765          (h) No citation may be issued under this section after six months from the day on
             766      which the violation last occurred.
             767          Section 12. Section 58-68-102 is amended to read:
             768           58-68-102. Definitions.
             769          In addition to the definitions in Section 58-1-102 , as used in this chapter:
             770          (1) "ACGME" means the Accreditation Council for Graduate Medical Education of the
             771      American Medical Association.
             772          (2) "Administrative penalty" means a monetary fine imposed by the division for acts or
             773      omissions determined to constitute unprofessional or unlawful conduct, as a result of an
             774      adjudicative proceeding conducted in accordance with Title 63G, Chapter 4, Administrative
             775      Procedures Act.
             776          (3) "AOA" means the American Osteopathic Association.
             777          (4) "Board" means the Osteopathic [Physicians] Physician and Surgeon's Licensing
             778      Board created in Section 58-68-201 .
             779          (5) "Diagnose" means:
             780          (a) to examine in any manner another person, parts of a person's body, substances,
             781      fluids, or materials excreted, taken, or removed from a person's body, or produced by a person's
             782      body, to determine the source, nature, kind, or extent of a disease or other physical or mental
             783      condition;
             784          (b) to attempt to conduct an examination or determination described under Subsection
             785      (5)(a);


             786          (c) to hold oneself out as making or to represent that one is making an examination or
             787      determination as described in Subsection (5)(a); or
             788          (d) to make an examination or determination as described in Subsection (5)(a) upon or
             789      from information supplied directly or indirectly by another person, whether or not in the
             790      presence of the person making or attempting the diagnosis or examination.
             791          (6) "Medical assistant" means an unlicensed individual working under the direct and
             792      immediate supervision of a licensed osteopathic physician and surgeon and engaged in specific
             793      tasks assigned by the licensed osteopathic physician and surgeon in accordance with the
             794      standards and ethics of the profession.
             795          (7) "Physician" means both physicians and surgeons licensed under Section 58-67-301 ,
             796      Utah Medical Practice Act, and osteopathic physicians and surgeons licensed under Section
             797      58-68-301 , Utah Osteopathic Medical Practice Act.
             798          (8) "Practice of osteopathic medicine" means:
             799          (a) to diagnose, treat, correct, administer anesthesia, or prescribe for any human
             800      disease, ailment, injury, infirmity, deformity, pain, or other condition, physical or mental, real
             801      or imaginary, or to attempt to do so, by any means or instrumentality, which in whole or in part
             802      is based upon emphasis of the importance of the musculoskeletal system and manipulative
             803      therapy in the maintenance and restoration of health, by an individual in Utah or outside of the
             804      state upon or for any human within the state, except that conduct described in this Subsection
             805      (8)(a) that is performed by a person legally and in accordance with a license issued under
             806      another chapter of this title does not constitute the practice of medicine;
             807          (b) when a person not licensed as a physician directs a licensee under this chapter to
             808      withhold or alter the health care services that the licensee has ordered, but practice of medicine
             809      does not include any conduct under Subsection 58-68-501 (2);
             810          (c) to maintain an office or place of business for the purpose of doing any of the acts
             811      described in Subsection (8)(a) whether or not for compensation; or
             812          (d) to use, in the conduct of any occupation or profession pertaining to the diagnosis or
             813      treatment of human diseases or conditions, in any printed material, stationery, letterhead,


             814      envelopes, signs, or advertisements, the designation "doctor," "doctor of osteopathic medicine,"
             815      "osteopathic physician," "osteopathic surgeon," "osteopathic physician and surgeon," "Dr.,"
             816      "D.O.," or any combination of these designations in any manner which might cause a
             817      reasonable person to believe the individual using the designation is a licensed osteopathic
             818      physician, and if the party using the designation is not a licensed osteopathic physician, the
             819      designation must additionally contain the description of the branch of the healing arts for which
             820      the person has a license, provided that an individual who has received an earned degree of
             821      doctor of osteopathic medicine but is not a licensed osteopathic physician and surgeon in Utah
             822      may use the designation "D.O." if it is followed by "Not Licensed" or "Not Licensed in Utah"
             823      in the same size and style of lettering.
             824          (9) "Prescription device" means an instrument, apparatus, implement, machine,
             825      contrivance, implant, in vitro reagent, or other similar or related article, and any component
             826      part or accessory, which is required under federal or state law to be prescribed by a practitioner
             827      and dispensed by or through a person or entity licensed under this chapter or exempt from
             828      licensure under this chapter.
             829          (10) "Prescription drug" means a drug that is required by federal or state law or rule to
             830      be dispensed only by prescription or is restricted to administration only by practitioners.
             831          (11) "SPEX" means the Special Purpose Examination of the Federation of State
             832      Medical Boards.
             833          (12) "Unlawful conduct" is as defined in Sections 58-1-501 and 58-68-501 .
             834          (13) "Unprofessional conduct" is as defined in Sections 58-1-501 and 58-68-502 and as
             835      may be further defined by division rule.
             836          Section 13. Section 58-68-302 is amended to read:
             837           58-68-302. Qualifications for licensure.
             838          (1) An applicant for licensure as an osteopathic physician and surgeon, except as set
             839      forth in Subsection (2) [or (3)], shall:
             840          (a) submit an application in a form prescribed by the division, which may include:
             841          (i) submissions by the applicant of information maintained by practitioner data banks,


             842      as designated by division rule, with respect to the applicant; [and]
             843          (ii) a record of professional liability claims made against the applicant and settlements
             844      paid by or on behalf of the applicant; and
             845          (iii) authorization to use a record coordination and verification service approved by the
             846      division in collaboration with the board;
             847          (b) pay a fee determined by the department under Section 63J-1-504 ;
             848          (c) be of good moral character;
             849          (d) provide satisfactory documentation of having successfully completed a program of
             850      professional education preparing an individual as an osteopathic physician and surgeon, as
             851      evidenced by [having received an earned degree of doctor of osteopathic medicine from:(i) an
             852      AOA approved medical school or college; or (ii)]:
             853          (i) having received an earned degree of doctor of osteopathic medicine from an AOA
             854      approved medical school or college; or
             855          (ii) submitting a current certification by the Educational Commission for Foreign
             856      Medical Graduates or any successor organization approved by the division in collaboration
             857      with the board, if the applicant is graduated from an osteopathic medical school or college
             858      located outside of the United States or its [jurisdictions] territories which at the time of the
             859      applicant's graduation, met criteria for accreditation by the AOA;
             860          [(e) hold a current certification by the Educational Commission for Foreign Medical
             861      Graduates or any successor organization approved by the division in collaboration with the
             862      board, if the applicant graduated from a medical school or college located outside of the United
             863      States or its jurisdictions;]
             864          [(f)] (e) satisfy the division and board that the applicant:
             865          (i) has successfully completed 24 months of progressive resident training in an
             866      ACGME or AOA approved program after receiving a degree of doctor of osteopathic medicine
             867      required under Subsection (1)(d); or
             868          (ii) (A) has successfully completed 12 months of resident training in an ACGME or
             869      AOA approved program after receiving a degree of doctor of osteopathic medicine as required


             870      under Subsection (1)(d);
             871          (B) has been accepted in and is successfully participating in progressive resident
             872      training in an ACGME or AOA approved program within Utah, in the applicant's second or
             873      third year of postgraduate training; and
             874          (C) has agreed to surrender to the division the applicant's license as an osteopathic
             875      physician and surgeon without any proceedings under Title 63G, Chapter 4, Administrative
             876      Procedures Act, and has agreed the applicant's license as an osteopathic physician and surgeon
             877      will be automatically revoked by the division if the applicant fails to continue in good standing
             878      in an ACGME or AOA approved progressive resident training program within the state;
             879          [(g)] (f) pass the licensing examination sequence required by division rule, as made in
             880      collaboration with the board;
             881          [(h)] (g) be able to read, write, speak, understand, and be understood in the English
             882      language and demonstrate proficiency to the satisfaction of the board, if requested by the board;
             883          [(i)] (h) meet with the board and representatives of the division, if requested for the
             884      purpose of evaluating the applicant's qualifications for licensure;
             885          [(j)] (i) designate:
             886          (i) a contact person for access to medical records in accordance with the federal Health
             887      Insurance Portability and Accountability Act; and
             888          (ii) an alternate contact person for access to medical records, in the event the original
             889      contact person is unable or unwilling to serve as the contact person for access to medical
             890      records; and
             891          [(k)] (j) establish a method for notifying patients of the identity and location of the
             892      contact person and alternate contact person, if the applicant will practice in a location with no
             893      other persons licensed under this chapter.
             894          (2) An applicant for licensure as an osteopathic physician and surgeon [qualifying
             895      under the] by endorsement [provision of Section 58-1-302 ] who is currently licensed to
             896      practice osteopathic medicine in any state other than Utah, a district or territory of the United
             897      States, or Canada shall:


             898          (a) be currently licensed with a full unrestricted license in good standing in [another
             899      jurisdiction as set forth in Section 58-1-302 ] any state, district or territory of the United States,
             900      or Canada;
             901          (b) have been actively engaged in the legal practice of osteopathic medicine in any
             902      state, district or territory of the United States, or Canada for not less than 6,000 hours during
             903      the five years immediately preceding the day on which the applicant applied for licensure in
             904      Utah;
             905          [(b) (i)] (c) [document having met all] comply with the requirements for licensure
             906      under [Subsection] Subsections (1)(a) through (d), (1)(e)(i), and (1)(g) through (j) [except, if an
             907      applicant received licensure in another state or jurisdiction based upon only 12 months
             908      residency training after graduation from medical school, the applicant may qualify for licensure
             909      in Utah by endorsement only if licensed in the other state prior to July 1, 1996; or];
             910          [(ii) document having obtained licensure in another state or jurisdiction whose
             911      licensure requirements were at the time of obtaining licensure equal to licensure requirements
             912      at that time in Utah;]
             913          [(c) have passed the SPEX examination within 12 months preceding the date of
             914      application for licensure in Utah if the date on which the applicant passed qualifying
             915      examinations for licensure is greater than five years prior to the date of the application for
             916      licensure in Utah, or meet medical specialty certification requirements which may be
             917      established by division rule made in collaboration with the board;]
             918          [(d) have been actively engaged in the practice as an osteopathic physician and surgeon
             919      for not less than 6,000 hours during the five years immediately preceding the date of
             920      application for licensure in Utah;]
             921          [(e) meet with the board and representatives of the division, if requested for the
             922      purpose of evaluating the applicant's qualifications for licensure; and]
             923          [(f) not have a license that was suspended or revoked in any state, unless the license
             924      was subsequently reinstated as a full unrestricted license in good standing.]
             925          (d) have passed the licensing examination sequence required in Subsection (1)(f) or


             926      another medical licensing examination sequence in another state, district or territory of the
             927      United States, or Canada that the division in collaboration with the board by rulemaking
             928      determines is equivalent to its own required examination;
             929          (e) not have any investigation or action pending against any health care license of the
             930      applicant, not have a health care license that was suspended or revoked in any state, district or
             931      territory of the United States, or Canada, and not have surrendered a health care license in lieu
             932      of a disciplinary action, unless:
             933          (i) the license was subsequently reinstated as a full unrestricted license in good
             934      standing; or
             935          (ii) the division in collaboration with the board determines, after full disclosure by the
             936      applicant, that:
             937          (A) the conduct has been corrected, monitored, and resolved; or
             938          (B) a mitigating circumstance exists that prevents its resolution, and the division in
             939      collaboration with the board is satisfied that, but for the mitigating circumstance, the license
             940      would be reinstated;
             941          (f) submit to a records review, a practice review history, and physical and
             942      psychological assessments, if requested by the division in collaboration with the board; and
             943          (g) produce evidence that the applicant meets the requirements of this Subsection (2) to
             944      the satisfaction of the division in collaboration with the board.
             945          [(3) An applicant for licensure as an osteopathic physician and surgeon, who has been
             946      licensed as an osteopathic physician in Utah, who has allowed the applicant's license in Utah to
             947      expire for nonpayment of license fees, and who is currently licensed in good standing in
             948      another state or jurisdiction of the United States shall:]
             949          [(a) submit an application in a form prescribed by the division;]
             950          [(b) pay a fee determined by the department under Section 63J-1-504 ;]
             951          [(c) be of good moral character;]
             952          [(d) have passed the SPEX examination within 12 months preceding the date of
             953      application for licensure in Utah if the date on which the applicant passed qualifying


             954      examinations for licensure is greater than five years prior to the date of the application for
             955      licensure in Utah;]
             956          [(e) have been actively engaged in the practice as an osteopathic physician for not
             957      fewer than 6,000 hours during the five years immediately preceding the date of application for
             958      licensure; and]
             959          [(f) meet with the board and representatives of the division, if requested for the purpose
             960      of evaluating the applicant's qualifications for licensure.]
             961          [(4)] (3) An applicant for licensure by endorsement may engage in the practice of
             962      medicine under a temporary license while the applicant's application for licensure is being
             963      processed by the division, provided:
             964          (a) the applicant submits a complete application required for temporary licensure to the
             965      division;
             966          (b) the applicant submits a written document to the division from:
             967          (i) a health care facility licensed under Title 26, Chapter 21, Health Care Facility
             968      Licensing and Inspection Act, stating that the applicant is practicing under the invitation of the
             969      health care facility; or
             970          (ii) two individuals licensed under this chapter, whose license is in good standing and
             971      who practice in the same clinical location, both stating that:
             972          (A) the applicant is practicing under the invitation of the individual; and
             973          (B) the applicant will practice at the same clinical location as the individual;
             974          (c) the applicant submits a signed certification to the division that the applicant meets
             975      the requirements of Subsection (2);
             976          (d) the applicant does not engage in the practice of medicine until the division has
             977      issued a temporary license;
             978          (e) the temporary license is only issued for and may not be extended beyond the
             979      duration of one year from issuance; and
             980          (f) the temporary license expires immediately and prior to the expiration of one year
             981      from issuance, upon notification from the division that the applicant's application for licensure


             982      by endorsement is denied.
             983          [(5)] (4) The division shall issue a temporary license under Subsection [(4)] (3) within
             984      15 business days after the applicant satisfies the requirements of Subsection [(4)] (3).
             985          Section 14. Section 58-68-304 is amended to read:
             986           58-68-304. License renewal requirements.
             987          (1) As a condition precedent for license renewal, each licensee shall, during each
             988      two-year licensure cycle or other cycle defined by division rule:
             989          (a) complete qualified continuing professional education requirements in accordance
             990      with the number of hours and standards defined by division rule in collaboration with the
             991      board;
             992          (b) appoint a contact person for access to medical records and an alternate contact
             993      person for access to medical records in accordance with Subsection 58-68-302 (1)[(j)](i); and
             994          (c) if the licensee practices osteopathic medicine in a location with no other persons
             995      licensed under this chapter, provide some method of notice to the licensee's patients of the
             996      identity and location of the contact person and alternate contact person for access to medical
             997      records for the licensee in accordance with Subsection 58-68-302 (1)[(k)](j).
             998          (2) If a renewal period is extended or shortened under Section 58-68-303 , the
             999      continuing education hours required for license renewal under this section are increased or
             1000      decreased proportionally.
             1001          Section 15. Section 58-68-305 is amended to read:
             1002           58-68-305. Exemptions from licensure.
             1003          In addition to the exemptions from licensure in Section 58-1-307 , the following
             1004      individuals may engage in the described acts or practices without being licensed under this
             1005      chapter:
             1006          (1) an individual rendering aid in an emergency, when no fee or other consideration of
             1007      value for the service is charged, received, expected, or contemplated;
             1008          (2) an individual administering a domestic or family remedy;
             1009          (3) (a) (i) a person engaged in the lawful sale of vitamins, health foods, dietary


             1010      supplements, herbs, or other products of nature, the sale of which is not otherwise prohibited
             1011      by state or federal law; and
             1012          (ii) a person acting in good faith for religious reasons, as a matter of conscience, or
             1013      based on a personal belief, when obtaining or providing any information regarding health care
             1014      and the use of any product under Subsection (3)(a)(i); and
             1015          (b) Subsection (3)(a) does not:
             1016          (i) permit a person to diagnose any human disease, ailment, injury, infirmity,
             1017      deformity, pain, or other condition; or
             1018          (ii) prohibit providing truthful and non-misleading information regarding any of the
             1019      products under Subsection (3)(a)(i);
             1020          (4) a person engaged in good faith in the practice of the religious tenets of any church
             1021      or religious belief without the use of prescription drugs;
             1022          (5) an individual authorized by the Department of Health under Section 26-1-30 , to
             1023      withdraw blood to determine the alcohol or drug content pursuant to Section 41-6a-523 ;
             1024          (6) a medical assistant while working under the direct and immediate supervision of a
             1025      licensed osteopathic physician, to the extent the medical assistant is engaged in tasks
             1026      appropriately delegated by the supervisor in accordance with the standards and ethics of the
             1027      practice of medicine;
             1028          (7) an individual engaging in the practice of osteopathic medicine when:
             1029          (a) the individual is licensed in good standing as an osteopathic physician in another
             1030      state with no licensing action pending and no less than 10 years of professional experience;
             1031          (b) the services are rendered as a public service and for a noncommercial purpose;
             1032          (c) no fee or other consideration of value is charged, received, expected, or
             1033      contemplated for the services rendered beyond an amount necessary to cover the proportionate
             1034      cost of malpractice insurance; and
             1035          (d) the individual does not otherwise engage in unlawful or unprofessional conduct;
             1036      [and]
             1037          (8) an individual providing expert testimony in a legal proceeding[.]; and


             1038          (9) an individual who is invited by a school, association, society, or other body
             1039      approved by the division in collaboration with the board to conduct a clinic or demonstration of
             1040      the practice of medicine in which patients are treated, if:
             1041          (a) the individual does not establish a place of business in this state;
             1042          (b) the individual does not regularly engage in the practice of medicine in this state;
             1043          (c) the individual holds a current license in good standing to practice medicine issued
             1044      by another state, district or territory of the United States, or Canada;
             1045          (d) the primary purpose of the event is the training of others in the practice of
             1046      medicine; and
             1047          (e) neither the patient nor an insurer is billed for the services performed.
             1048          Section 16. Section 58-68-401 is amended to read:
             1049           58-68-401. Grounds for denial of license -- Disciplinary proceedings.
             1050          Grounds for division action [regarding the following are under Section] are set forth in
             1051      Sections 58-1-401 [:] and 58-68-503 .
             1052          [(1) refusing to issue a license to an applicant or refusing to renew the license of a
             1053      licensee;]
             1054          [(2) revoking, suspending, restricting, placing on probation the license of a licensee;]
             1055          [(3) assessing an administrative penalty; and]
             1056          [(4) issuing of a public or private reprimand to a licensee or issuance of a cease and
             1057      desist order.]
             1058          Section 17. Section 58-68-402 is repealed and reenacted to read:
             1059          58-68-402. Authority to assess penalties.
             1060          The division in collaboration with the board may assess penalties as described in
             1061      Section 58-67-503 .
             1062          Section 18. Section 58-68-403 is amended to read:
             1063           58-68-403. Revocation of license -- Nondisciplinary.
             1064          Revocation by the division of a license under Subsection 58-68-302 (1)[(f)](e) for
             1065      failure to continue on a resident training program for reasons other than unprofessional or


             1066      unlawful conduct is a nondisciplinary action and may not be reported by the division as a
             1067      disciplinary action against the licensee.
             1068          Section 19. Section 58-68-503 is amended to read:
             1069           58-68-503. Penalties and administrative actions for unlawful and unprofessional
             1070      conduct.
             1071          (1) Any person who violates the unlawful conduct provisions of Section 58-68-501 [, or
             1072      Subsection] or Section 58-1-501 [(1)(a) or 58-1-501 (1)(c)] is guilty of a third degree felony.
             1073          [(2) The division may assess administrative penalties in accordance with Section
             1074      58-68-402 , for acts of unprofessional conduct.]
             1075          (2) (a) Subject to Subsection (4), the division may punish unprofessional or unlawful
             1076      conduct by:
             1077          (i) assessing administrative penalties; or
             1078          (ii) taking any other appropriate administrative action.
             1079          (b) A monetary administrative penalty imposed under this section shall be deposited in
             1080      the Physician Education Fund described in Section 58-67a-1 .
             1081          (3) If a licensee is convicted of unlawful conduct, described in Section 58-68-501 ,
             1082      before an administrative proceeding regarding the same conduct, the licensee may not be
             1083      assessed an administrative fine under this chapter for the same conduct.
             1084          (4) (a) If the division concludes that an individual has violated the provisions of
             1085      Section 58-68-501 , Section 58-68-502 , the Division of Occupational and Professional
             1086      Licensing Act, the Utah Controlled Substances Act, or any rule or order issued with respect to
             1087      these provisions, and disciplinary action is appropriate, the director or director's designee shall:
             1088          (i) issue a citation to the individual;
             1089          (ii) attempt to negotiate a stipulated settlement; or
             1090          (iii) notify the individual that an adjudicative proceeding conducted under Title 63G,
             1091      Chapter 4, Administrative Procedures Act, will be commenced and the individual is invited to
             1092      appear.
             1093          (b) The division may take the following action against an individual who is in violation


             1094      of a provision described in Subsection (4)(a), as evidenced by an uncontested citation, a
             1095      stipulated settlement, or a finding of violation in an adjudicative proceeding:
             1096          (i) assess a fine of up to $10,000 per single violation or $2,000 per day of ongoing
             1097      violation, whichever is greater, in accordance with a fine schedule established by rule; or
             1098          (ii) order to cease and desist from the behavior that constitutes a violation of provisions
             1099      described in Subsection (4)(a).
             1100          (c) Except for an administrative fine and a cease and desist order, the licensure
             1101      sanctions cited in Section 58-1-401 may not be assessed through a citation.
             1102          (d) Each citation issued under this section shall:
             1103          (i) be in writing;
             1104          (ii) clearly describe or explain:
             1105          (A) the nature of the violation, including a reference to the provision of the chapter,
             1106      rule, or order alleged to have been violated;
             1107          (B) that the recipient must notify the division in writing within 20 calendar days from
             1108      the day on which the citation is served if the recipient wishes to contest the citation at a hearing
             1109      conducted under Title 63G, Chapter 4, Administrative Procedures Act; and
             1110          (C) the consequences of failure to timely contest the citation or pay the fine assessed by
             1111      the citation within the time specified in the citation; and
             1112          (iii) be served in accordance with the requirements of the Utah Rules of Civil
             1113      Procedure.
             1114          (e) If the individual to whom the citation is issued fails to request a hearing to contest
             1115      the citation within 20 calendar days from the day on which the citation is served, the citation
             1116      becomes the final order of the division and is not subject to further agency review. The period
             1117      to contest the citation may be extended by the division for cause.
             1118          (f) The division may refuse to issue or renew or suspend, revoke, or place on probation
             1119      the license of an individual who fails to comply with a citation after the citation becomes final.
             1120          (g) The failure of an applicant for licensure to comply with a citation after it becomes
             1121      final is a ground for denial of a license.


             1122          (h) No citation may be issued under this section after six months from the day on
             1123      which the last violation occurred.


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