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

S.B. 186

             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 "O.D." 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[.]; or
             80          (g) using the designation "doctor," "Dr.", or a comparable designation in a manner
             81      which might cause a reasonable person to believe the individual using the designation is a
             82      doctor licensed under this title, if the individual is not licensed under this title, provided that an
             83      individual who has received an earned doctorate may use the designation of the degree if it is
             84      followed by "Not Licensed" or "Not Licensed in Utah" in the same size and style of lettering.
             85          (2) "Unprofessional conduct" means conduct, by a licensee or applicant, that is defined
             86      as unprofessional conduct under this title or under any rule adopted under this title and
             87      includes:
             88          (a) violating, or aiding or abetting any other person to violate, any statute, rule, or order
             89      regulating an occupation or profession under this title;


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


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


             152      renewal period by as much as one year to stagger the renewal cycles it administers.
             153          (b) Persons licensed to manufacture, produce, distribute, prescribe, dispense,
             154      administer, conduct research with, or perform laboratory analysis upon controlled substances in
             155      Schedules II through V within this state may possess, manufacture, produce, distribute,
             156      prescribe, dispense, administer, conduct research with, or perform laboratory analysis upon
             157      those substances to the extent authorized by their license and in conformity with this chapter.
             158          (c) The following persons are not required to obtain a license and may lawfully possess
             159      controlled substances under this section:
             160          (i) an agent or employee, except a sales representative, of any registered manufacturer,
             161      distributor, or dispenser of any controlled substance, if the agent or employee is acting in the
             162      usual course of the person's business or employment; however, nothing in this subsection shall
             163      be interpreted to permit an agent, employee, sales representative, or detail man to maintain an
             164      inventory of controlled substances separate from the location of the person's employer's
             165      registered and licensed place of business;
             166          (ii) a motor carrier or warehouseman, or an employee of a motor carrier or
             167      warehouseman, who possesses any controlled substance in the usual course of the person's
             168      business or employment; and
             169          (iii) an ultimate user, or any person who possesses any controlled substance pursuant to
             170      a lawful order of a practitioner.
             171          (d) The division may enact rules waiving the license requirement for certain
             172      manufacturers, producers, distributors, prescribers, dispensers, administrators, research
             173      practitioners, or laboratories performing analysis if consistent with the public health and safety.
             174          (e) A separate license is required at each principal place of business or professional
             175      practice where the applicant manufactures, produces, distributes, dispenses, conducts research
             176      with, or performs laboratory analysis upon controlled substances.
             177          (f) The division may enact rules providing for the inspection of a licensee or applicant's
             178      establishment, and may inspect the establishment according to those rules.
             179          (3) (a) Upon proper application, the division shall license a qualified applicant to
             180      manufacture, produce, distribute, conduct research with, or perform laboratory analysis upon
             181      controlled substances included in Schedules I through V, unless it determines that issuance of a
             182      license is inconsistent with the public interest. The division shall not issue a license to any


             183      person to prescribe, dispense, or administer a Schedule I controlled substance. In determining
             184      public interest, the division shall consider whether or not the applicant has:
             185          (i) maintained effective controls against diversion of controlled substances and any
             186      Schedule I or II substance compounded from any controlled substance into other than
             187      legitimate medical, scientific, or industrial channels;
             188          (ii) complied with applicable state and local law;
             189          (iii) been convicted under federal or state laws relating to the manufacture, distribution,
             190      or dispensing of substances;
             191          (iv) past experience in the manufacture of controlled dangerous substances;
             192          (v) established effective controls against diversion; and
             193          (vi) complied with any other factors that the division establishes that promote the
             194      public health and safety.
             195          (b) Licenses granted under Subsection (3)(a) do not entitle a licensee to manufacture,
             196      produce, distribute, conduct research with, or perform laboratory analysis upon controlled
             197      substances in Schedule I other than those specified in the license.
             198          (c) (i) Practitioners shall be licensed to administer, dispense, or conduct research with
             199      substances in Schedules II through V if they are authorized to administer, dispense, or conduct
             200      research under the laws of this state.
             201          (ii) The division need not require a separate license for practitioners engaging in
             202      research with nonnarcotic controlled substances in Schedules II through V where the licensee is
             203      already licensed under this chapter in another capacity.
             204          (iii) With respect to research involving narcotic substances in Schedules II through V,
             205      or where the division by rule requires a separate license for research of nonnarcotic substances
             206      in Schedules II through V, a practitioner shall apply to the division prior to conducting
             207      research.
             208          (iv) Licensing for purposes of bona fide research with controlled substances by a
             209      practitioner considered qualified may be denied only on a ground specified in Subsection (4),
             210      or upon evidence that the applicant will abuse or unlawfully transfer or fail to safeguard
             211      adequately the practitioner's supply of substances against diversion from medical or scientific
             212      use.
             213          (v) Practitioners registered under federal law to conduct research in Schedule I


             214      substances may conduct research in Schedule I substances within this state upon furnishing the
             215      division evidence of federal registration.
             216          (d) Compliance by manufacturers, producers, and distributors with the provisions of
             217      federal law respecting registration, excluding fees, entitles them to be licensed under this
             218      chapter.
             219          (e) The division shall initially license those persons who own or operate an
             220      establishment engaged in the manufacture, production, distribution, dispensation, or
             221      administration of controlled substances prior to April 3, 1980, and who are licensed by the
             222      state.
             223          (4) (a) Any license pursuant to Subsection (2) or (3) may be denied, suspended, placed
             224      on probation, or revoked by the division upon finding that the applicant or licensee has:
             225          (i) materially falsified any application filed or required pursuant to this chapter;
             226          (ii) been convicted of an offense under this chapter or any law of the United States, or
             227      any state, relating to any substance defined as a controlled substance;
             228          (iii) been convicted of a felony under any other law of the United States or any state
             229      within five years of the date of the issuance of the license;
             230          (iv) had a federal license denied, suspended, or revoked by competent federal authority
             231      and is no longer authorized to [engage in the manufacturing, distribution, or dispensing of]
             232      manufacture, distribute, prescribe, or dispense controlled substances;
             233          (v) had the licensee's license suspended or revoked by competent authority of another
             234      state for violation of laws or regulations comparable to those of this state relating to the
             235      manufacture, distribution, or dispensing of controlled substances;
             236          (vi) violated any division rule that reflects adversely on the licensee's reliability and
             237      integrity with respect to controlled substances;
             238          (vii) refused inspection of records required to be maintained under this chapter by a
             239      person authorized to inspect them; or
             240          (viii) prescribed, dispensed, administered, or injected an anabolic steroid for the
             241      purpose of manipulating human hormonal structure so as to:
             242          (A) increase muscle mass, strength, or weight without medical necessity and without a
             243      written prescription by any practitioner in the course of the practitioner's professional practice;
             244      or


             245          (B) improve performance in any form of human exercise, sport, or game.
             246          (b) The division may limit revocation or suspension of a license to a particular
             247      controlled substance with respect to which grounds for revocation or suspension exist.
             248          (c) (i) Proceedings to deny, revoke, or suspend a license shall be conducted pursuant to
             249      this section and in accordance with the procedures set forth in Title 58, Chapter 1, Division of
             250      Occupational and Professional Licensing Act, and conducted in conjunction with the
             251      appropriate representative committee designated by the director of the department.
             252          (ii) Nothing in this Subsection (4)(c) gives the Division of Occupational and
             253      Professional Licensing exclusive authority in proceedings to deny, revoke, or suspend licenses,
             254      except where the division is designated by law to perform those functions, or, when not
             255      designated by law, is designated by the executive director of the Department of Commerce to
             256      conduct the proceedings.
             257          (d) (i) The division may suspend any license simultaneously with the institution of
             258      proceedings under this section if it finds there is an imminent danger to the public health or
             259      safety.
             260          (ii) Suspension shall continue in effect until the conclusion of proceedings, including
             261      judicial review, unless withdrawn by the division or dissolved by a court of competent
             262      jurisdiction.
             263          (e) (i) If a license is suspended or revoked under this Subsection (4), all controlled
             264      substances owned or possessed by the licensee may be placed under seal in the discretion of the
             265      division.
             266          (ii) Disposition may not be made of substances under seal until the time for taking an
             267      appeal has lapsed, or until all appeals have been concluded, unless a court, upon application,
             268      orders the sale of perishable substances and the proceeds deposited with the court.
             269          (iii) If a revocation order becomes final, all controlled substances shall be forfeited.
             270          (f) The division shall notify promptly the Drug Enforcement Administration of all
             271      orders suspending or revoking a license and all forfeitures of controlled substances.
             272          (g) If an individual's Drug Enforcement Administration registration is denied, revoked,
             273      surrendered, or suspended, the division shall immediately suspend the individual's controlled
             274      substance license, which shall only be reinstated by the division upon reinstatement of the
             275      federal registration, unless the division has taken further administrative action under


             276      Subsection (4)(a)(iv), which would be grounds for the continued denial of the controlled
             277      substance license.
             278          (5) (a) Persons licensed under Subsection (2) or (3) shall maintain records and
             279      inventories in conformance with the record keeping and inventory requirements of federal and
             280      state law and any additional rules issued by the division.
             281          (b) (i) Every physician, dentist, naturopathic physician, veterinarian, practitioner, or
             282      other person who is authorized to administer or professionally use a controlled substance shall
             283      keep a record of the drugs received by him and a record of all drugs administered, dispensed, or
             284      professionally used by him otherwise than by a prescription.
             285          (ii) A person using small quantities or solutions or other preparations of those drugs for
             286      local application has complied with this Subsection (5)(b) if the person keeps a record of the
             287      quantity, character, and potency of those solutions or preparations purchased or prepared by
             288      him, and of the dates when purchased or prepared.
             289          (6) Controlled substances in Schedules I through V may be distributed only by a
             290      licensee and pursuant to an order form prepared in compliance with division rules or a lawful
             291      order under the rules and regulations of the United States.
             292          (7) (a) A person may not write or authorize a prescription for a controlled substance
             293      unless the person is:
             294          (i) a practitioner authorized to prescribe drugs and medicine under the laws of this state
             295      or under the laws of another state having similar standards; and
             296          (ii) licensed under this chapter or under the laws of another state having similar
             297      standards.
             298          (b) A person other than a pharmacist licensed under the laws of this state, or the
             299      pharmacist's licensed intern, as required by Sections 58-17b-303 and 58-17b-304 , may not
             300      dispense a controlled substance.
             301          (c) (i) A controlled substance may not be dispensed without the written prescription of
             302      a practitioner, if the written prescription is required by the federal Controlled Substances Act.
             303          (ii) That written prescription shall be made in accordance with Subsection (7)(a) and in
             304      conformity with Subsection (7)(d).
             305          (iii) In emergency situations, as defined by division rule, controlled substances may be
             306      dispensed upon oral prescription of a practitioner, if reduced promptly to writing on forms


             307      designated by the division and filed by the pharmacy.
             308          (iv) Prescriptions reduced to writing by a pharmacist shall be in conformity with
             309      Subsection (7)(d).
             310          (d) Except for emergency situations designated by the division, a person may not issue,
             311      fill, compound, or dispense a prescription for a controlled substance unless the prescription is
             312      signed by the prescriber in ink or indelible pencil or is signed with an electronic signature of
             313      the prescriber as authorized by division rule, and contains the following information:
             314          (i) the name, address, and registry number of the prescriber;
             315          (ii) the name, address, and age of the person to whom or for whom the prescription is
             316      issued;
             317          (iii) the date of issuance of the prescription; and
             318          (iv) the name, quantity, and specific directions for use by the ultimate user of the
             319      controlled substance.
             320          (e) A prescription may not be written, issued, filled, or dispensed for a Schedule I
             321      controlled substance.
             322          (f) Except when administered directly to an ultimate user by a licensed practitioner,
             323      controlled substances are subject to the following restrictions:
             324          (i) (A) A prescription for a Schedule II substance may not be refilled.
             325          (B) A Schedule II controlled substance may not be filled in a quantity to exceed a
             326      one-month's supply, as directed on the daily dosage rate of the prescriptions.
             327          (ii) A Schedule III or IV controlled substance may be filled only within six months of
             328      issuance, and may not be refilled more than six months after the date of its original issuance or
             329      be refilled more than five times after the date of the prescription unless renewed by the
             330      practitioner.
             331          (iii) All other controlled substances in Schedule V may be refilled as the prescriber's
             332      prescription directs, but they may not be refilled one year after the date the prescription was
             333      issued unless renewed by the practitioner.
             334          (iv) Any prescription for a Schedule II substance may not be dispensed if it is not
             335      presented to a pharmacist for dispensing by a pharmacist or a pharmacy intern within 30 days
             336      after the date the prescription was issued, or 30 days after the dispensing date, if that date is
             337      specified separately from the date of issue.


             338          (v) A practitioner may issue more than one prescription at the same time for the same
             339      Schedule II controlled substance, but only under the following conditions:
             340          (A) no more than three prescriptions for the same Schedule II controlled substance may
             341      be issued at the same time;
             342          (B) no one prescription may exceed a 30-day supply;
             343          (C) a second or third prescription shall include the date of issuance and the date for
             344      dispensing; and
             345          (D) unless the practitioner determines there is a valid medical reason to the contrary,
             346      the date for dispensing a second or third prescription may not be fewer than 30 days from the
             347      dispensing date of the previous prescription.
             348          (vi) Each prescription for a controlled substance may contain only one controlled
             349      substance per prescription form and may not contain any other legend drug or prescription
             350      item.
             351          (g) An order for a controlled substance in Schedules II through V for use by an
             352      inpatient or an outpatient of a licensed hospital is exempt from all requirements of this
             353      Subsection (7) if the order is:
             354          (i) issued or made by a prescribing practitioner who holds an unrestricted registration
             355      with the federal Drug Enforcement Administration, and an active Utah controlled substance
             356      license in good standing issued by the division under this section, or a medical resident who is
             357      exempted from licensure under Subsection 58-1-307 (1)(c);
             358          (ii) authorized by the prescribing practitioner treating the patient and the prescribing
             359      practitioner designates the quantity ordered;
             360          (iii) entered upon the record of the patient, the record is signed by the prescriber
             361      affirming the prescriber's authorization of the order within 48 hours after filling or
             362      administering the order, and the patient's record reflects the quantity actually administered; and
             363          (iv) filled and dispensed by a pharmacist practicing the pharmacist's profession within
             364      the physical structure of the hospital, or the order is taken from a supply lawfully maintained by
             365      the hospital and the amount taken from the supply is administered directly to the patient
             366      authorized to receive it.
             367          (h) A practitioner licensed under this chapter may not prescribe, administer, or
             368      dispense a controlled substance to a child, without first obtaining the consent required in


             369      Section 78B-3-406 of a parent, guardian, or person standing in loco parentis of the child except
             370      in cases of an emergency. For purposes of this Subsection (7)(h), "child" has the same
             371      meaning as defined in Section 78A-6-105 , and "emergency" means any physical condition
             372      requiring the administration of a controlled substance for immediate relief of pain or suffering.
             373          (i) A practitioner licensed under this chapter may not prescribe or administer dosages
             374      of a controlled substance in excess of medically recognized quantities necessary to treat the
             375      ailment, malady, or condition of the ultimate user.
             376          (j) A practitioner licensed under this chapter may not prescribe, administer, or dispense
             377      any controlled substance to another person knowing that the other person is using a false name,
             378      address, or other personal information for the purpose of securing the controlled substance.
             379          (k) A person who is licensed under this chapter to manufacture, distribute, or dispense
             380      a controlled substance may not manufacture, distribute, or dispense a controlled substance to
             381      another licensee or any other authorized person not authorized by this license.
             382          (l) A person licensed under this chapter may not omit, remove, alter, or obliterate a
             383      symbol required by this chapter or by a rule issued under this chapter.
             384          (m) A person licensed under this chapter may not refuse or fail to make, keep, or
             385      furnish any record notification, order form, statement, invoice, or information required under
             386      this chapter.
             387          (n) A person licensed under this chapter may not refuse entry into any premises for
             388      inspection as authorized by this chapter.
             389          (o) A person licensed under this chapter may not furnish false or fraudulent material
             390      information in any application, report, or other document required to be kept by this chapter or
             391      willfully make any false statement in any prescription, order, report, or record required by this
             392      chapter.
             393          (8) (a) (i) Any person licensed under this chapter who is found by the division to have
             394      violated any of the provisions of Subsections (7)(k) through [(7)](o) is subject to a penalty not
             395      to exceed $5,000. The division shall determine the procedure for adjudication of any violations
             396      in accordance with Sections 58-1-106 and 58-1-108 .
             397          (ii) The division shall deposit all penalties collected under Subsection (8)(a)(i) in the
             398      General Fund as a dedicated credit to be used by the division under Subsection 58-37f-502 (1).
             399          (b) Any person who knowingly and intentionally violates Subsections (7)(h) through


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


             431      presence of the person making or attempting the diagnosis or examination.
             432          (5) "LCME" means the Liaison Committee on Medical Education of the American
             433      Medical Association.
             434          (6) "Medical assistant" means an unlicensed individual working under the direct [and
             435      immediate] or indirect supervision of a licensed physician and surgeon and engaged in specific
             436      tasks assigned by the licensed physician and surgeon in accordance with the standards and
             437      ethics of the profession, and as may be further defined in rule by the division in collaboration
             438      with the board, not to exceed the scope of this definition.
             439          (7) "Physician" means both physicians and surgeons licensed under Section 58-67-301 ,
             440      Utah Medical Practice Act, and osteopathic physicians and surgeons licensed under Section
             441      58-68-301 , Utah Osteopathic Medical Practice Act.
             442          (8) "Practice of medicine" means:
             443          (a) to diagnose, treat, correct, administer anesthesia, or prescribe for any human
             444      disease, ailment, injury, infirmity, deformity, pain or other condition, physical or mental, real
             445      or imaginary, or to attempt to do so, by any means or instrumentality, and by an individual in
             446      Utah or outside the state upon or for any human within the state, except that conduct described
             447      in this Subsection (8)(a) that is performed by a person legally and in accordance with a license
             448      issued under another chapter of this title does not constitute the practice of medicine;
             449          (b) when a person not licensed as a physician directs a licensee under this chapter to
             450      withhold or alter the health care services that the licensee has ordered, but practice of medicine
             451      does not include any conduct under Subsection 58-67-501 (2);
             452          (c) to maintain an office or place of business for the purpose of doing any of the acts
             453      described in Subsection (8)(a) whether or not for compensation; or
             454          (d) to use, in the conduct of any occupation or profession pertaining to the diagnosis or
             455      treatment of human diseases or conditions in any printed material, stationery, letterhead,
             456      envelopes, signs, or advertisements, the designation "doctor," "doctor of medicine,"
             457      "physician," "surgeon," "physician and surgeon," "Dr.," "M.D.," or any combination of these
             458      designations in any manner which might cause a reasonable person to believe the individual
             459      using the designation is a licensed physician and surgeon, and if the party using the designation
             460      is not a licensed physician and surgeon, the designation must additionally contain the
             461      description of the branch of the healing arts for which the person has a license, provided that an


             462      individual who has received an earned degree of doctor of medicine degree but is not a licensed
             463      physician and surgeon in Utah may use the designation "M.D." if it is followed by "Not
             464      Licensed" or "Not Licensed in Utah" in the same size and style of lettering.
             465          (9) "Prescription device" means an instrument, apparatus, implement, machine,
             466      contrivance, implant, in vitro reagent, or other similar or related article, and any component
             467      part or accessory, which is required under federal or state law to be prescribed by a practitioner
             468      and dispensed by or through a person or entity licensed under this chapter or exempt from
             469      licensure under this chapter.
             470          (10) "Prescription drug" means a drug that is required by federal or state law or rule to
             471      be dispensed only by prescription or is restricted to administration only by practitioners.
             472          (11) "SPEX" means the Special Purpose Examination of the Federation of State
             473      Medical Boards.
             474          (12) "Unlawful conduct" is as defined in Sections 58-1-501 and 58-67-501 .
             475          (13) "Unprofessional conduct" is as defined in Sections 58-1-501 and 58-67-502 , and
             476      as may be further defined by division rule.
             477          Section 4. Section 58-67-302 is amended to read:
             478           58-67-302. Qualifications for licensure.
             479          (1) An applicant for licensure as a physician and surgeon, except as set forth in
             480      Subsection (2), shall:
             481          (a) submit an application in a form prescribed by the division, which may include:
             482          (i) submissions by the applicant of information maintained by practitioner data banks,
             483      as designated by division rule, with respect to the applicant; [and]
             484          (ii) a record of professional liability claims made against the applicant and settlements
             485      paid by or on behalf of the applicant; and
             486          (iii) authorization to use a record coordination and verification service approved by the
             487      division in collaboration with the board;
             488          (b) pay a fee determined by the department under Section 63J-1-504 ;
             489          (c) be of good moral character;
             490          (d) provide satisfactory documentation of having successfully completed a program of
             491      professional education preparing an individual as a physician and surgeon, as evidenced by
             492      [having received an earned degree of doctor of medicine from]:


             493          [(i) an LCME accredited medical school or college; or]
             494          [(ii) a medical school or college located outside of the United States or its jurisdictions
             495      which at the time of the applicant's graduation, met criteria for LCME accreditation;]
             496          (i) having received an earned degree of doctor of medicine from an LCME accredited
             497      medical school or college; or
             498          (ii) if the applicant graduated from a medical school or college located outside the
             499      United States, its territories, or Canada, submitting a current certification by the Educational
             500      Commission for Foreign Medical Graduates or any successor organization approved by the
             501      division in collaboration with the board;
             502          [(e) hold a current certification by the Educational Commission for Foreign Medical
             503      Graduates or any successor organization approved by the division in collaboration with the
             504      board, if the applicant graduated from a medical school or college located outside of the United
             505      States or its jurisdictions;]
             506          [(f)] (e) satisfy the division and board that the applicant:
             507          (i) has successfully completed 24 months of progressive resident training in a program
             508      approved by the ACGME, the Royal College of Physicians and Surgeons, the College of
             509      Family Physicians of Canada, or any similar body in the United States or Canada approved by
             510      the division in collaboration with the board; or
             511          (ii) (A) has successfully completed 12 months of resident training in an ACGME
             512      approved program after receiving a degree of doctor of medicine as required under Subsection
             513      (1)(d);
             514          (B) has been accepted in and is successfully participating in progressive resident
             515      training in an ACGME approved program within Utah, in the applicant's second or third year
             516      of postgraduate training; and
             517          (C) has agreed to surrender to the division the applicant's license as a physician and
             518      surgeon without any proceedings under Title 63G, Chapter 4, Administrative Procedures Act,
             519      and has agreed the applicant's license as a physician and surgeon will be automatically revoked
             520      by the division if the applicant fails to continue in good standing in an ACGME approved
             521      progressive resident training program within the state;
             522          [(g)] (f) pass the licensing examination sequence required by division rule made in
             523      collaboration with the board;


             524          [(h)] (g) be able to read, write, speak, understand, and be understood in the English
             525      language and demonstrate proficiency to the satisfaction of the board if requested by the board;
             526          [(i)] (h) meet with the board and representatives of the division, if requested, for the
             527      purpose of evaluating the applicant's qualifications for licensure;
             528          [(j)] (i) designate:
             529          (i) a contact person for access to medical records in accordance with the federal Health
             530      Insurance Portability and Accountability Act; and
             531          (ii) an alternate contact person for access to medical records, in the event the original
             532      contact person is unable or unwilling to serve as the contact person for access to medical
             533      records; and
             534          [(k)] (j) establish a method for notifying patients of the identity and location of the
             535      contact person and alternate contact person, if the applicant will practice in a location with no
             536      other persons licensed under this chapter.
             537          (2) An applicant for licensure as a physician and surgeon by endorsement who is
             538      currently licensed to practice medicine in any state other than Utah, a district or territory of the
             539      United States, or Canada shall:
             540          (a) be currently licensed with a full unrestricted license in good standing in any state,
             541      district, or territory of the United States, or Canada;
             542          (b) have been actively engaged in the legal practice of medicine in any state, district, or
             543      territory of the United States, or Canada for not less than 6,000 hours during the five years
             544      immediately preceding the date of application for licensure in Utah;
             545          [(c) not have any action pending against the applicant's license;]
             546          [(d) not have a license that was suspended or revoked in any state, unless the license
             547      was subsequently reinstated as a full unrestricted license in good standing; and]
             548          (c) comply with the requirements for licensure under Subsection (1)(a) through (d) and
             549      (1)(e)(i);
             550          (d) have passed the licensing examination sequence required in Subsection (1)(f) or
             551      another medical licensing examination sequence in another state, district or territory of the
             552      United States, or Canada that the division in collaboration with the board by rulemaking
             553      determines is equivalent to its own required examination;
             554          (e) not have any investigation or action pending against any health care license of the


             555      applicant, not have a health care license that was suspended or revoked in any state, district or
             556      territory of the United States, or Canada, and not have surrendered a health care license in lieu
             557      of a disciplinary action, unless:
             558          (i) the license was subsequently reinstated as a full unrestricted license in good
             559      standing; or
             560          (ii) the division in collaboration with the board determines to its satisfaction, after full
             561      disclosure by the applicant, that:
             562          (A) the conduct has been corrected, monitored, and resolved; or
             563          (B) a mitigating circumstance exists that prevents its resolution, and the division in
             564      collaboration with the board is satisfied that, but for the mitigating circumstance, the license
             565      would be reinstated;
             566          (f) submit to a records review, a practice history review, and physical and
             567      psychological assessments, if requested by the division in collaboration with the board; and
             568          [(e)] (g) produce satisfactory evidence [of] that the [applicant's qualifications, identity,
             569      and good standing] applicant meets the requirements of this Subsection (2) to the satisfaction
             570      of the division in collaboration with the board.
             571          (3) An applicant for licensure by endorsement may engage in the practice of medicine
             572      under a temporary license while the applicant's application for licensure is being processed by
             573      the division, provided:
             574          (a) the applicant submits a complete application required for temporary licensure to the
             575      division;
             576          (b) the applicant submits a written document to the division from:
             577          (i) a health care facility licensed under Title 26, Chapter 21, Health Care Facility
             578      Licensing and Inspection Act, stating that the applicant is practicing under the invitation of the
             579      health care facility; or
             580          (ii) two individuals licensed under this chapter, whose license is in good standing and
             581      who practice in the same clinical location, both stating that:
             582          (A) the applicant is practicing under the invitation of the individual; and
             583          (B) the applicant will practice at the same clinical location as the individual;
             584          (c) the applicant submits a signed certification to the division that the applicant meets
             585      the requirements of Subsection (2);


             586          (d) the applicant does not engage in the practice of medicine until the division has
             587      issued a temporary license;
             588          (e) the temporary license is only issued for and may not be extended beyond the
             589      duration of one year from issuance; and
             590          (f) the temporary license expires immediately and prior to the expiration of one year
             591      from issuance, upon notification from the division that the applicant's application for licensure
             592      by endorsement is denied.
             593          (4) The division shall issue a temporary license under Subsection (3) within 15
             594      business days after the applicant satisfies the requirements of Subsection (3).
             595          Section 5. Section 58-67-302.5 is amended to read:
             596           58-67-302.5. Licensing of graduates of foreign medical schools.
             597          (1) Notwithstanding any other provision of law to the contrary, an individual enrolled
             598      in a medical school outside the United States, its territories, the District of Columbia, or
             599      Canada is eligible for licensure as a physician and surgeon in this state if the individual has
             600      satisfied the following requirements:
             601          (a) meets all the requirements of [Section] Subsection 58-67-302 (1), except for
             602      Subsection 58-67-302 (1)(d);
             603          (b) has studied medicine in a medical school located outside the United States which is
             604      recognized by an organization approved by the division;
             605          (c) has completed all of the formal requirements of the foreign medical school except
             606      internship or social service;
             607          (d) has attained a passing score on the educational commission for foreign medical
             608      graduates examination or other qualifying examinations such as the United States Medical
             609      Licensing Exam parts I and II, which are approved by the division or a medical school
             610      approved by the division;
             611          (e) has satisfactorily completed one calendar year of supervised clinical training under
             612      the direction of a United States medical education setting accredited by the liaison committee
             613      for graduate medical education and approved by the division;
             614          (f) has completed the postgraduate hospital training required by Subsection
             615      58-67-302 (1)[(f)](e)(i); and
             616          (g) has passed the examination required by the division of all applicants for licensure.


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


             648      continuing education hours required for license renewal under this section are increased or
             649      decreased proportionally.
             650          Section 7. Section 58-67-305 is amended to read:
             651           58-67-305. Exemptions from licensure.
             652          In addition to the exemptions from licensure in Section 58-1-307 , the following
             653      individuals may engage in the described acts or practices without being licensed under this
             654      chapter:
             655          (1) an individual rendering aid in an emergency, when no fee or other consideration of
             656      value for the service is charged, received, expected, or contemplated;
             657          (2) an individual administering a domestic or family remedy;
             658          (3) (a) (i) a person engaged in the sale of vitamins, health foods, dietary supplements,
             659      herbs, or other products of nature, the sale of which is not otherwise prohibited by state or
             660      federal law; and
             661          (ii) a person acting in good faith for religious reasons, as a matter of conscience, or
             662      based on a personal belief, when obtaining or providing any information regarding health care
             663      and the use of any product under Subsection (3)(a)(i); and
             664          (b) Subsection (3)(a) does not:
             665          (i) allow a person to diagnose any human disease, ailment, injury, infirmity, deformity,
             666      pain, or other condition; or
             667          (ii) prohibit providing truthful and non-misleading information regarding any of the
             668      products under Subsection (3)(a)(i);
             669          (4) a person engaged in good faith in the practice of the religious tenets of any church
             670      or religious belief, without the use of prescription drugs;
             671          (5) an individual authorized by the Department of Health under Section 26-1-30 , to
             672      withdraw blood to determine the alcohol or drug content pursuant to Section 41-6a-523 ;
             673          (6) a medical assistant while working under the direct [and immediate] or indirect
             674      supervision of a licensed physician and surgeon, to the extent the medical assistant is engaged
             675      in tasks appropriately delegated by the supervisor in accordance with the standards and ethics
             676      of the practice of medicine, and as may be further defined in rule by the division in
             677      collaboration with the board, not to exceed the scope of this definition;
             678          (7) an individual engaging in the practice of medicine when:


             679          (a) the individual is licensed in good standing as a physician in another state with no
             680      licensing action pending and no less than 10 years of professional experience;
             681          (b) the services are rendered as a public service and for a noncommercial purpose;
             682          (c) no fee or other consideration of value is charged, received, expected, or
             683      contemplated for the services rendered beyond an amount necessary to cover the proportionate
             684      cost of malpractice insurance; and
             685          (d) the individual does not otherwise engage in unlawful or unprofessional conduct;
             686      [and]
             687          (8) an individual providing expert testimony in a legal proceeding[.]; and
             688          (9) an individual who is invited by a school, association, society, or other body
             689      approved by the division to conduct a clinic or demonstration of the practice of medicine in
             690      which patients are treated, if:
             691          (a) the individual does not establish a place of business in this state;
             692          (b) the individual does not regularly engage in the practice of medicine in this state;
             693          (c) the individual holds a current license in good standing to practice medicine issued
             694      by another state, district or territory of the United States, or Canada;
             695          (d) the primary purpose of the event is the training of others in the practice of
             696      medicine; and
             697          (e) neither the patient nor an insurer is billed for the services performed.
             698          Section 8. Section 58-67-401 is amended to read:
             699           58-67-401. Grounds for denial of license -- Disciplinary proceedings.
             700          Grounds for division action [regarding the following are under Section] are set forth in
             701      Sections 58-1-401 [:] and 58-67-503 .
             702          [(1) refusing to issue a license to an applicant or refusing to renew the license of a
             703      licensee;]
             704          [(2) revoking, suspending, restricting, or placing on probation the license of a
             705      licensee;]
             706          [(3) assessing an administrative penalty; and]
             707          [(4) issuing a public or private reprimand to a licensee or issuing a cease and desist
             708      order.]
             709          Section 9. Section 58-67-402 is repealed and reenacted to read:


             710          58-67-402. Authority to assess penalty.
             711          The division in collaboration with the board may assess penalties as described in
             712      Section 58-67-503 .
             713          Section 10. Section 58-67-403 is amended to read:
             714           58-67-403. Revocation of license -- Nondisciplinary.
             715          Revocation by the division of a license under Subsection 58-67-302 (1)[(f)](e) for
             716      failure to continue on a resident training program for reasons other than unprofessional or
             717      unlawful conduct is a nondisciplinary action and may not be reported by the division as a
             718      disciplinary action against the licensee.
             719          Section 11. Section 58-67-503 is amended to read:
             720           58-67-503. Penalties and administrative actions for unlawful and unprofessional
             721      conduct.
             722          (1) Any person who violates the unlawful conduct provisions of Section 58-67-501 [, or
             723      Subsection] or Section 58-1-501 [(1)(a) or 58-1-501 (1)(c)] is guilty of a third degree felony.
             724          [(2) The division may assess administrative penalties in accordance with the provisions
             725      of Section 58-67-402 for acts of unprofessional conduct.]
             726          (2) (a) Subject to Subsection (4), the division may punish unprofessional or unlawful
             727      conduct by:
             728          (i) assessing administrative penalties; or
             729          (ii) taking other appropriate administrative action.
             730          (b) A monetary administrative penalty imposed under this section shall be deposited in
             731      the Physician Education Fund created in Section 58-67a-1 .
             732          (3) If a licensee has been convicted of unlawful conduct, described in Section
             733      58-67-501 , before an administrative proceeding regarding the same conduct, the division may
             734      not assess an additional administrative fine under this chapter for the same conduct.
             735          (4) (a) If the division concludes that an individual has violated provisions of Section
             736      58-67-501 , Section 58-67-502 , the Division of Occupational and Professional Licensing Act,
             737      the Utah Controlled Substances Act, or any rule or order issued with respect to these
             738      provisions, and disciplinary action is appropriate, the director or director's designee shall:
             739          (i) issue a citation to the individual;
             740          (ii) attempt to negotiate a stipulated settlement; or


             741          (iii) notify the individual that an adjudicative proceeding conducted under Title 63G,
             742      Chapter 4, Administrative Procedures Act, will be commenced and the individual is invited to
             743      appear.
             744          (b) The division may take the following action against an individual who is in violation
             745      of a provision described in Subsection (4)(a), as evidenced by an uncontested citation, a
             746      stipulated settlement, or a finding of violation in an adjudicative proceeding:
             747          (i) assess a fine of up to $10,000 per single violation or up to $2,000 per day of
             748      ongoing violation, whichever is greater, in accordance with a fine schedule established by rule;
             749      or
             750          (ii) order to cease and desist from the behavior that constitutes a violation of the
             751      provisions described in Subsection (4)(a).
             752          (c) An individual's license may not be suspended or revoked through a citation.
             753          (d) Each citation issued under this section shall:
             754          (i) be in writing;
             755          (ii) clearly describe or explain:
             756          (A) the nature of the violation, including a reference to the provision of the chapter,
             757      rule, or order alleged to have been violated;
             758          (B) that the recipient must notify the division in writing within 20 calendar days from
             759      the day on which the citation is served if the recipient wishes to contest the citation at a hearing
             760      conducted under Title 63G, Chapter 4, Administrative Procedures Act; and
             761          (C) the consequences of failure to timely contest the citation or pay the fine assessed by
             762      the citation within the time specified in the citation; and
             763          (iii) be served in accordance with the Utah Rules of Civil Procedure.
             764          (e) If the individual to whom the citation is issued fails to request a hearing to contest
             765      the citation within 20 calendar days from the day on which the citation is served, the citation
             766      becomes the final order of the division and is not subject to further agency review. The period
             767      to contest the citation may be extended by the division for cause.
             768          (f) The division may refuse to issue or renew or suspend, revoke, or place on probation
             769      the license of an individual who fails to comply with a citation after the citation becomes final.
             770          (g) The failure of an applicant for licensure to comply with a citation after it becomes
             771      final is a ground for denial of license.


             772          (h) No citation may be issued under this section after six months from the day on
             773      which the violation last occurred.
             774          Section 12. Section 58-68-102 is amended to read:
             775           58-68-102. Definitions.
             776          In addition to the definitions in Section 58-1-102 , as used in this chapter:
             777          (1) "ACGME" means the Accreditation Council for Graduate Medical Education of the
             778      American Medical Association.
             779          (2) "Administrative penalty" means a monetary fine imposed by the division for acts or
             780      omissions determined to constitute unprofessional or unlawful conduct, as a result of an
             781      adjudicative proceeding conducted in accordance with Title 63G, Chapter 4, Administrative
             782      Procedures Act.
             783          (3) "AOA" means the American Osteopathic Association.
             784          (4) "Board" means the Osteopathic [Physicians] Physician and Surgeon's Licensing
             785      Board created in Section 58-68-201 .
             786          (5) "Diagnose" means:
             787          (a) to examine in any manner another person, parts of a person's body, substances,
             788      fluids, or materials excreted, taken, or removed from a person's body, or produced by a person's
             789      body, to determine the source, nature, kind, or extent of a disease or other physical or mental
             790      condition;
             791          (b) to attempt to conduct an examination or determination described under Subsection
             792      (5)(a);
             793          (c) to hold oneself out as making or to represent that one is making an examination or
             794      determination as described in Subsection (5)(a); or
             795          (d) to make an examination or determination as described in Subsection (5)(a) upon or
             796      from information supplied directly or indirectly by another person, whether or not in the
             797      presence of the person making or attempting the diagnosis or examination.
             798          (6) "Medical assistant" means an unlicensed individual working under the direct [and
             799      immediate] or indirect supervision of a licensed osteopathic physician and surgeon and
             800      engaged in specific tasks assigned by the licensed osteopathic physician and surgeon in
             801      accordance with the standards and ethics of the profession, and as may be further defined in
             802      rule by the division in collaboration with the board, not to exceed the scope of this definition.


             803          (7) "Physician" means both physicians and surgeons licensed under Section 58-67-301 ,
             804      Utah Medical Practice Act, and osteopathic physicians and surgeons licensed under Section
             805      58-68-301 , Utah Osteopathic Medical Practice Act.
             806          (8) "Practice of osteopathic medicine" means:
             807          (a) to diagnose, treat, correct, administer anesthesia, or prescribe for any human
             808      disease, ailment, injury, infirmity, deformity, pain, or other condition, physical or mental, real
             809      or imaginary, or to attempt to do so, by any means or instrumentality, which in whole or in part
             810      is based upon emphasis of the importance of the musculoskeletal system and manipulative
             811      therapy in the maintenance and restoration of health, by an individual in Utah or outside of the
             812      state upon or for any human within the state, except that conduct described in this Subsection
             813      (8)(a) that is performed by a person legally and in accordance with a license issued under
             814      another chapter of this title does not constitute the practice of medicine;
             815          (b) when a person not licensed as a physician directs a licensee under this chapter to
             816      withhold or alter the health care services that the licensee has ordered, but practice of medicine
             817      does not include any conduct under Subsection 58-68-501 (2);
             818          (c) to maintain an office or place of business for the purpose of doing any of the acts
             819      described in Subsection (8)(a) whether or not for compensation; or
             820          (d) to use, in the conduct of any occupation or profession pertaining to the diagnosis or
             821      treatment of human diseases or conditions, in any printed material, stationery, letterhead,
             822      envelopes, signs, or advertisements, the designation "doctor," "doctor of osteopathic medicine,"
             823      "osteopathic physician," "osteopathic surgeon," "osteopathic physician and surgeon," "Dr.,"
             824      "D.O.," or any combination of these designations in any manner which might cause a
             825      reasonable person to believe the individual using the designation is a licensed osteopathic
             826      physician, and if the party using the designation is not a licensed osteopathic physician, the
             827      designation must additionally contain the description of the branch of the healing arts for which
             828      the person has a license, provided that an individual who has received an earned degree of
             829      doctor of osteopathic medicine degree but is not a licensed osteopathic physician and surgeon
             830      in Utah may use the designation "D.O." if it is followed by "Not Licensed" or "Not Licensed in
             831      Utah" in the same size and style of lettering.
             832          (9) "Prescription device" means an instrument, apparatus, implement, machine,
             833      contrivance, implant, in vitro reagent, or other similar or related article, and any component


             834      part or accessory, which is required under federal or state law to be prescribed by a practitioner
             835      and dispensed by or through a person or entity licensed under this chapter or exempt from
             836      licensure under this chapter.
             837          (10) "Prescription drug" means a drug that is required by federal or state law or rule to
             838      be dispensed only by prescription or is restricted to administration only by practitioners.
             839          (11) "SPEX" means the Special Purpose Examination of the Federation of State
             840      Medical Boards.
             841          (12) "Unlawful conduct" is as defined in Sections 58-1-501 and 58-68-501 .
             842          (13) "Unprofessional conduct" is as defined in Sections 58-1-501 and 58-68-502 and as
             843      may be further defined by division rule.
             844          Section 13. Section 58-68-302 is amended to read:
             845           58-68-302. Qualifications for licensure.
             846          (1) An applicant for licensure as an osteopathic physician and surgeon, except as set
             847      forth in Subsection (2) [or (3)], shall:
             848          (a) submit an application in a form prescribed by the division, which may include:
             849          (i) submissions by the applicant of information maintained by practitioner data banks,
             850      as designated by division rule, with respect to the applicant; [and]
             851          (ii) a record of professional liability claims made against the applicant and settlements
             852      paid by or on behalf of the applicant; and
             853          (iii) authorization to use a record coordination and verification service approved by the
             854      division in collaboration with the board;
             855          (b) pay a fee determined by the department under Section 63J-1-504 ;
             856          (c) be of good moral character;
             857          (d) provide satisfactory documentation of having successfully completed a program of
             858      professional education preparing an individual as an osteopathic physician and surgeon, as
             859      evidenced by [having received an earned degree of doctor of osteopathic medicine from:(i) an
             860      AOA approved medical school or college; or (ii)]:
             861          (i) having received an earned degree of doctor of osteopathic medicine from an AOA
             862      approved medical school or college; or
             863          (ii) submitting a current certification by the Educational Commission for Foreign
             864      Medical Graduates or any successor organization approved by the division in collaboration


             865      with the board, if the applicant is graduated from an osteopathic medical school or college
             866      located outside of the United States [or], its [jurisdictions] districts or territories, or Canada
             867      which at the time of the applicant's graduation, met criteria for accreditation by the AOA;
             868          [(e) hold a current certification by the Educational Commission for Foreign Medical
             869      Graduates or any successor organization approved by the division in collaboration with the
             870      board, if the applicant graduated from a medical school or college located outside of the United
             871      States or its jurisdictions;]
             872          [(f)] (e) satisfy the division and board that the applicant:
             873          (i) has successfully completed 24 months of progressive resident training in an
             874      ACGME or AOA approved program after receiving a degree of doctor of osteopathic medicine
             875      required under Subsection (1)(d); or
             876          (ii) (A) has successfully completed 12 months of resident training in an ACGME or
             877      AOA approved program after receiving a degree of doctor of osteopathic medicine as required
             878      under Subsection (1)(d);
             879          (B) has been accepted in and is successfully participating in progressive resident
             880      training in an ACGME or AOA approved program within Utah, in the applicant's second or
             881      third year of postgraduate training; and
             882          (C) has agreed to surrender to the division the applicant's license as an osteopathic
             883      physician and surgeon without any proceedings under Title 63G, Chapter 4, Administrative
             884      Procedures Act, and has agreed the applicant's license as an osteopathic physician and surgeon
             885      will be automatically revoked by the division if the applicant fails to continue in good standing
             886      in an ACGME or AOA approved progressive resident training program within the state;
             887          [(g)] (f) pass the licensing examination sequence required by division rule, as made in
             888      collaboration with the board;
             889          [(h)] (g) be able to read, write, speak, understand, and be understood in the English
             890      language and demonstrate proficiency to the satisfaction of the board, if requested by the board;
             891          [(i)] (h) meet with the board and representatives of the division, if requested for the
             892      purpose of evaluating the applicant's qualifications for licensure;
             893          [(j)] (i) designate:
             894          (i) a contact person for access to medical records in accordance with the federal Health
             895      Insurance Portability and Accountability Act; and


             896          (ii) an alternate contact person for access to medical records, in the event the original
             897      contact person is unable or unwilling to serve as the contact person for access to medical
             898      records; and
             899          [(k)] (j) establish a method for notifying patients of the identity and location of the
             900      contact person and alternate contact person, if the applicant will practice in a location with no
             901      other persons licensed under this chapter.
             902          (2) An applicant for licensure as an osteopathic physician and surgeon [qualifying
             903      under the] by endorsement [provision of Section 58-1-302 ] who is currently licensed to
             904      practice osteopathic medicine in any state other than Utah, a district or territory of the United
             905      States, or Canada shall:
             906          (a) be currently licensed with a full unrestricted license in good standing in [another
             907      jurisdiction as set forth in Section 58-1-302 ] any state, district or territory of the United States,
             908      or Canada;
             909          (b) have been actively engaged in the legal practice of osteopathic medicine in any
             910      state, district or territory of the United States, or Canada for not less than 6,000 hours during
             911      the five years immediately preceding the day on which the applicant applied for licensure in
             912      Utah;
             913          [(b) (i)] (c) [document having met all] comply with the requirements for licensure
             914      under [Subsection] Subsections (1)(a) through (d), (1)(e)(i), and (1)(g) through (j) [except, if an
             915      applicant received licensure in another state or jurisdiction based upon only 12 months
             916      residency training after graduation from medical school, the applicant may qualify for licensure
             917      in Utah by endorsement only if licensed in the other state prior to July 1, 1996; or];
             918          [(ii) document having obtained licensure in another state or jurisdiction whose
             919      licensure requirements were at the time of obtaining licensure equal to licensure requirements
             920      at that time in Utah;]
             921          [(c) have passed the SPEX examination within 12 months preceding the date of
             922      application for licensure in Utah if the date on which the applicant passed qualifying
             923      examinations for licensure is greater than five years prior to the date of the application for
             924      licensure in Utah, or meet medical specialty certification requirements which may be
             925      established by division rule made in collaboration with the board;]
             926          [(d) have been actively engaged in the practice as an osteopathic physician and surgeon


             927      for not less than 6,000 hours during the five years immediately preceding the date of
             928      application for licensure in Utah;]
             929          [(e) meet with the board and representatives of the division, if requested for the
             930      purpose of evaluating the applicant's qualifications for licensure; and]
             931          [(f) not have a license that was suspended or revoked in any state, unless the license
             932      was subsequently reinstated as a full unrestricted license in good standing.]
             933          (d) have passed the licensing examination sequence required in Subsection (1)(f) or
             934      another medical licensing examination sequence in another state, district or territory of the
             935      United States, or Canada that the division in collaboration with the board by rulemaking
             936      determines is equivalent to its own required examination;
             937          (e) not have any investigation or action pending against any health care license of the
             938      applicant, not have a health care license that was suspended or revoked in any state, district, or
             939      territory of the United States, or Canada, and not have surrendered a health care license in lieu
             940      of a disciplinary action, unless:
             941          (i) the license was subsequently reinstated as a full unrestricted license in good
             942      standing; or
             943          (ii) the division in collaboration with the board determines, after full disclosure by the
             944      applicant, that:
             945          (A) the conduct has been corrected, monitored, and resolved; or
             946          (B) a mitigating circumstance exists that prevents its resolution, and the division in
             947      collaboration with the board is satisfied that, but for the mitigating circumstance, the license
             948      would be reinstated;
             949          (f) submit to a records review, a practice review history, and physical and
             950      psychological assessments, if requested by the division in collaboration with the board; and
             951          (g) produce evidence that the applicant meets the requirements of this Subsection (2) to
             952      the satisfaction of the division in collaboration with the board.
             953          [(3) An applicant for licensure as an osteopathic physician and surgeon, who has been
             954      licensed as an osteopathic physician in Utah, who has allowed the applicant's license in Utah to
             955      expire for nonpayment of license fees, and who is currently licensed in good standing in
             956      another state or jurisdiction of the United States shall:]
             957          [(a) submit an application in a form prescribed by the division;]


             958          [(b) pay a fee determined by the department under Section 63J-1-504 ;]
             959          [(c) be of good moral character;]
             960          [(d) have passed the SPEX examination within 12 months preceding the date of
             961      application for licensure in Utah if the date on which the applicant passed qualifying
             962      examinations for licensure is greater than five years prior to the date of the application for
             963      licensure in Utah;]
             964          [(e) have been actively engaged in the practice as an osteopathic physician for not
             965      fewer than 6,000 hours during the five years immediately preceding the date of application for
             966      licensure; and]
             967          [(f) meet with the board and representatives of the division, if requested for the purpose
             968      of evaluating the applicant's qualifications for licensure.]
             969          [(4)] (3) An applicant for licensure by endorsement may engage in the practice of
             970      medicine under a temporary license while the applicant's application for licensure is being
             971      processed by the division, provided:
             972          (a) the applicant submits a complete application required for temporary licensure to the
             973      division;
             974          (b) the applicant submits a written document to the division from:
             975          (i) a health care facility licensed under Title 26, Chapter 21, Health Care Facility
             976      Licensing and Inspection Act, stating that the applicant is practicing under the invitation of the
             977      health care facility; or
             978          (ii) two individuals licensed under this chapter, whose license is in good standing and
             979      who practice in the same clinical location, both stating that:
             980          (A) the applicant is practicing under the invitation of the individual; and
             981          (B) the applicant will practice at the same clinical location as the individual;
             982          (c) the applicant submits a signed certification to the division that the applicant meets
             983      the requirements of Subsection (2);
             984          (d) the applicant does not engage in the practice of medicine until the division has
             985      issued a temporary license;
             986          (e) the temporary license is only issued for and may not be extended beyond the
             987      duration of one year from issuance; and
             988          (f) the temporary license expires immediately and prior to the expiration of one year


             989      from issuance, upon notification from the division that the applicant's application for licensure
             990      by endorsement is denied.
             991          [(5)] (4) The division shall issue a temporary license under Subsection [(4)] (3) within
             992      15 business days after the applicant satisfies the requirements of Subsection [(4)] (3).
             993          Section 14. Section 58-68-304 is amended to read:
             994           58-68-304. License renewal requirements.
             995          (1) As a condition precedent for license renewal, each licensee shall, during each
             996      two-year licensure cycle or other cycle defined by division rule:
             997          (a) complete qualified continuing professional education requirements in accordance
             998      with the number of hours and standards defined by division rule in collaboration with the
             999      board;
             1000          (b) appoint a contact person for access to medical records and an alternate contact
             1001      person for access to medical records in accordance with Subsection 58-68-302 (1)[(j)](i); and
             1002          (c) if the licensee practices osteopathic medicine in a location with no other persons
             1003      licensed under this chapter, provide some method of notice to the licensee's patients of the
             1004      identity and location of the contact person and alternate contact person for access to medical
             1005      records for the licensee in accordance with Subsection 58-68-302 (1)[(k)](j).
             1006          (2) If a renewal period is extended or shortened under Section 58-68-303 , the
             1007      continuing education hours required for license renewal under this section are increased or
             1008      decreased proportionally.
             1009          Section 15. Section 58-68-305 is amended to read:
             1010           58-68-305. Exemptions from licensure.
             1011          In addition to the exemptions from licensure in Section 58-1-307 , the following
             1012      individuals may engage in the described acts or practices without being licensed under this
             1013      chapter:
             1014          (1) an individual rendering aid in an emergency, when no fee or other consideration of
             1015      value for the service is charged, received, expected, or contemplated;
             1016          (2) an individual administering a domestic or family remedy;
             1017          (3) (a) (i) a person engaged in the lawful sale of vitamins, health foods, dietary
             1018      supplements, herbs, or other products of nature, the sale of which is not otherwise prohibited
             1019      by state or federal law; and


             1020          (ii) a person acting in good faith for religious reasons, as a matter of conscience, or
             1021      based on a personal belief, when obtaining or providing any information regarding health care
             1022      and the use of any product under Subsection (3)(a)(i); and
             1023          (b) Subsection (3)(a) does not:
             1024          (i) permit a person to diagnose any human disease, ailment, injury, infirmity,
             1025      deformity, pain, or other condition; or
             1026          (ii) prohibit providing truthful and non-misleading information regarding any of the
             1027      products under Subsection (3)(a)(i);
             1028          (4) a person engaged in good faith in the practice of the religious tenets of any church
             1029      or religious belief without the use of prescription drugs;
             1030          (5) an individual authorized by the Department of Health under Section 26-1-30 , to
             1031      withdraw blood to determine the alcohol or drug content pursuant to Section 41-6a-523 ;
             1032          (6) a medical assistant while working under the direct [and immediate] or indirect
             1033      supervision of a licensed osteopathic physician, to the extent the medical assistant is engaged in
             1034      tasks appropriately delegated by the supervisor in accordance with the standards and ethics of
             1035      the practice of medicine, and as may be further defined in rule by the division in collaboration
             1036      with the board, not to exceed the scope of this definition;
             1037          (7) an individual engaging in the practice of osteopathic medicine when:
             1038          (a) the individual is licensed in good standing as an osteopathic physician in another
             1039      state with no licensing action pending and no less than 10 years of professional experience;
             1040          (b) the services are rendered as a public service and for a noncommercial purpose;
             1041          (c) no fee or other consideration of value is charged, received, expected, or
             1042      contemplated for the services rendered beyond an amount necessary to cover the proportionate
             1043      cost of malpractice insurance; and
             1044          (d) the individual does not otherwise engage in unlawful or unprofessional conduct;
             1045      [and]
             1046          (8) an individual providing expert testimony in a legal proceeding[.]; and
             1047          (9) an individual who is invited by a school, association, society, or other body
             1048      approved by the division in collaboration with the board to conduct a clinic or demonstration of
             1049      the practice of medicine in which patients are treated, if:
             1050          (a) the individual does not establish a place of business in this state;


             1051          (b) the individual does not regularly engage in the practice of medicine in this state;
             1052          (c) the individual holds a current license in good standing to practice medicine issued
             1053      by another state, district or territory of the United States, or Canada;
             1054          (d) the primary purpose of the event is the training of others in the practice of
             1055      medicine; and
             1056          (e) neither the patient nor an insurer is billed for the services performed.
             1057          Section 16. Section 58-68-401 is amended to read:
             1058           58-68-401. Grounds for denial of license -- Disciplinary proceedings.
             1059          Grounds for division action [regarding the following are under Section] are set forth in
             1060      Sections 58-1-401 [:] and 58-68-503 .
             1061          [(1) refusing to issue a license to an applicant or refusing to renew the license of a
             1062      licensee;]
             1063          [(2) revoking, suspending, restricting, placing on probation the license of a licensee;]
             1064          [(3) assessing an administrative penalty; and]
             1065          [(4) issuing of a public or private reprimand to a licensee or issuance of a cease and
             1066      desist order.]
             1067          Section 17. Section 58-68-402 is repealed and reenacted to read:
             1068          58-68-402. Authority to assess penalties.
             1069          The division may assess penalties under Section 58-67-503 .
             1070          Section 18. Section 58-68-403 is amended to read:
             1071           58-68-403. Revocation of license -- Nondisciplinary.
             1072          Revocation by the division of a license under Subsection 58-68-302 (1)[(f)](e) for
             1073      failure to continue on a resident training program for reasons other than unprofessional or
             1074      unlawful conduct is a nondisciplinary action and may not be reported by the division as a
             1075      disciplinary action against the licensee.
             1076          Section 19. Section 58-68-503 is amended to read:
             1077           58-68-503. Penalties and administrative actions for unlawful and unprofessional
             1078      conduct.
             1079          (1) Any person who violates the unlawful conduct provisions of Section 58-68-501 [, or
             1080      Subsection] or Section 58-1-501 [(1)(a) or 58-1-501 (1)(c)] is guilty of a third degree felony.
             1081          [(2) The division may assess administrative penalties in accordance with Section


             1082      58-68-402 , for acts of unprofessional conduct.]
             1083          (2) (a) Subject to Subsection (4), the division may punish unprofessional or unlawful
             1084      conduct by:
             1085          (i) assessing administrative penalties; or
             1086          (ii) taking any other appropriate administrative action.
             1087          (b) A monetary administrative penalty imposed under this section shall be deposited in
             1088      the Physician Education Fund described in Section 58-67a-1 .
             1089          (3) If a licensee is convicted of unlawful conduct, described in Section 58-68-501 ,
             1090      before an administrative proceeding regarding the same conduct, the licensee may not be
             1091      assessed an administrative fine under this chapter for the same conduct.
             1092          (4) (a) If the division concludes that an individual has violated the provisions of
             1093      Section 58-68-501 , Section 58-68-502 , the Division of Occupational and Professional
             1094      Licensing Act, the Utah Controlled Substances Act, or any rule or order issued with respect to
             1095      these provisions, and disciplinary action is appropriate, the director or director's designee shall:
             1096          (i) issue a citation to the individual;
             1097          (ii) attempt to negotiate a stipulated settlement; or
             1098          (iii) notify the individual that an adjudicative proceeding conducted under Title 63G,
             1099      Chapter 4, Administrative Procedures Act, will be commenced and the individual is invited to
             1100      appear.
             1101          (b) The division may take the following action against an individual who is in violation
             1102      of a provision described in Subsection (4)(a), as evidenced by an uncontested citation, a
             1103      stipulated settlement, or a finding of violation in an adjudicative proceeding:
             1104          (i) assess a fine of up to $10,000 per single violation or $2,000 per day of ongoing
             1105      violation, whichever is greater, in accordance with a fine schedule established by rule; or
             1106          (ii) order to cease and desist from the behavior that constitutes a violation of provisions
             1107      described in Subsection (4)(a).
             1108          (c) Except for an administrative fine and a cease and desist order, the licensure
             1109      sanctions cited in Section 58-1-401 may not be assessed through a citation.
             1110          (d) Each citation issued under this section shall:
             1111          (i) be in writing;
             1112          (ii) clearly describe or explain:


             1113          (A) the nature of the violation, including a reference to the provision of the chapter,
             1114      rule, or order alleged to have been violated;
             1115          (B) that the recipient must notify the division in writing within 20 calendar days from
             1116      the day on which the citation is served if the recipient wishes to contest the citation at a hearing
             1117      conducted under Title 63G, Chapter 4, Administrative Procedures Act; and
             1118          (C) the consequences of failure to timely contest the citation or pay the fine assessed by
             1119      the citation within the time specified in the citation; and
             1120          (iii) be served in accordance with the requirements of the Utah Rules of Civil
             1121      Procedure.
             1122          (e) If the individual to whom the citation is issued fails to request a hearing to contest
             1123      the citation within 20 calendar days from the day on which the citation is served, the citation
             1124      becomes the final order of the division and is not subject to further agency review. The period
             1125      to contest the citation may be extended by the division for cause.
             1126          (f) The division may refuse to issue or renew or suspend, revoke, or place on probation
             1127      the license of an individual who fails to comply with a citation after the citation becomes final.
             1128          (g) The failure of an applicant for licensure to comply with a citation after it becomes
             1129      final is a ground for denial of a license.
             1130          (h) No citation may be issued under this section after six months from the day on
             1131      which the last violation occurred.




Legislative Review Note
    as of 2-22-11 6:18 PM


Office of Legislative Research and General Counsel


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