Representative Justin L. Fawson proposes the following substitute bill:


1     
PODIATRIC PHYSICIAN AMENDMENTS

2     
2015 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: David P. Hinkins

5     
House Sponsor: Justin L. Fawson

6     

7     LONG TITLE
8     General Description:
9          This bill amends provisions related to podiatric physicians.
10     Highlighted Provisions:
11          This bill:
12          ▸     modifies qualifications for licensure as a podiatric physician; and
13          ▸     modifies the scope of practice of a podiatric physician.
14     Money Appropriated in this Bill:
15          None
16     Other Special Clauses:
17          None
18     Utah Code Sections Affected:
19     AMENDS:
20          58-5a-102, as last amended by Laws of Utah 1996, Chapter 232
21          58-5a-302, as last amended by Laws of Utah 2009, Chapter 183
22          58-5a-306, as last amended by Laws of Utah 1996, Chapter 232
23          58-5a-501, as enacted by Laws of Utah 1993, Chapter 211
24     ENACTS:
25          58-5a-103, Utah Code Annotated 1953
26     

27     Be it enacted by the Legislature of the state of Utah:
28          Section 1. Section 58-5a-102 is amended to read:
29          58-5a-102. Definitions.
30          In addition to the definitions under Section 58-1-102, as used in this chapter:
31          (1) "Board" means the Podiatric Physician Board created in Section 58-5a-201.
32          (2) "Indirect supervision" means the same as that term is defined by the division by
33     rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
34          (3) "Medical assistant" means an unlicensed individual working under the indirect
35     supervision of a licensed podiatric physician and engaging in specific tasks assigned by the
36     licensed podiatric physician in accordance with the standards and ethics of the podiatry
37     profession.
38          [(2)] (4) "Practice of podiatry" means the diagnosis and treatment of conditions
39     affecting the human foot and ankle and their manifestations of systemic conditions by all
40     appropriate and lawful means, subject to [the following provisions:] Section 58-5a-103.
41          [(a) surgical procedures may be performed upon all bones of the foot and ankle, with
42     the exception of the following procedures:]
43          [(i) ankle fusion;]
44          [(ii) massive ankle reconstruction; and]
45          [(iii) reduction of trimalleolar fractures of the ankle;]
46          [(b) surgical treatment of any condition of the ankle and governing and related
47     structures of the foot and ankle above the ankle shall be:]
48          [(i) performed in an ambulatory surgical facility, general acute hospital, or a specialty
49     hospital, as defined in Section 26-21-2; and]
50          [(ii) subject to review by a quality care review body which includes qualified licensed
51     physicians and surgeons.]
52          [(3) (a)] (5) "Unlawful conduct" [as defined in Section 58-1-501 includes the following
53     conduct by a person not licensed under this chapter] includes:
54          (a) the conduct that constitutes unlawful conduct under Section 58-1-501; and
55          (b) for an individual who is not licensed under this chapter:
56          (i) using the title or name podiatric physician, podiatrist, podiatric surgeon, foot doctor,
57     foot specialist, or D.P.M.; or
58          (ii) implying or representing [he] that the individual is qualified to practice podiatry.
59          [(b) "Unlawful conduct" as defined in Section 58-1-501 includes the following conduct
60     by a person licensed under this chapter:]
61          [(i) administering general anesthesia; or]
62          [(ii) amputating the foot.]
63          [(4)] (6) "Unprofessional conduct" [as defined in Section 58-1-501 and as may be
64     further defined by rule,] includes, for an individual licensed under this chapter:
65          (a) the conduct that constitutes unprofessional conduct under Section 58-1-501;
66          [(a)] (b) communicating to a third party, without the consent of the patient, information
67     [acquired] the individual acquires in treating the patient [that is necessary to enable the
68     podiatric physician to treat the patient], except as necessary for professional consultation
69     regarding treatment of [a] the patient;
70          [(b)] (c) allowing [one's] the individual's name or license [as a podiatric physician] to
71     be used by [another person] an individual who is not licensed to practice podiatry [in this state]
72     under this chapter;
73          [(c)] (d) except as described in Section 58-5a-306, employing, directly or indirectly,
74     any unlicensed [person] individual to practice podiatry;
75          [(d) use of] (e) using alcohol or drugs, to the extent [a licensee's ability to safely
76     engage in the practice of podiatry is impaired] the individual's use of alcohol or drugs impairs
77     the individual's ability to practice podiatry;
78          [(e)] (f) unlawfully prescribing, selling, or giving away any prescription drug, including
79     controlled substances, as defined in Section 58-37-2;
80          [(f)] (g) gross incompetency in the practice of podiatry;
81          [(g)] (h) willfully and intentionally making a false statement or entry in hospital
82     records, medical records, or reports;
83          [(h)] (i) willfully making a false statement in reports or claim forms to governmental
84     agencies or insurance companies with the intent to secure payment not rightfully due; [or]
85          [(i)] (j) willfully using false or fraudulent advertising[.]; and
86          (k) conduct the division defines as unprofessional conduct by rule made in accordance
87     with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
88          Section 2. Section 58-5a-103 is enacted to read:
89          58-5a-103. Scope of practice.
90          (1) Subject to Subsections (4) and (5), an individual licensed as a podiatric physician
91     under this chapter may perform a surgical procedure on a bone of the foot or ankle, except that
92     the individual may not perform:
93          (a) ankle fusion;
94          (b) massive ankle reconstruction; or
95          (c) reduction of a trimalleolar ankle fracture;
96          (2) Notwithstanding Subsections (1)(a), (1)(b), and (1)(c), subject to Subsections (4)
97     and (5), an individual licensed as a podiatric physician under this chapter that meets the
98     additional training requirements described in Subsection (3) may perform a surgical procedure
99     that is related to the treatment of a foot or ankle condition, including the treatment of a foot or
100     ankle condition that involves the soft tissues, including tendons, ligaments, and nerves, of the
101     foot or ankle, except that the individual may only:
102          (a) treat a fracture of the tibia if at least one portion of the fracture line enters the ankle
103     joint;
104          (b) treat a foot or ankle condition using hardware, including screws, plates, staples,
105     pins, and wires, if at least one portion of the hardware system is attached to a bony structure at
106     or below the ankle mortise; and
107          (c) place hardware for the treatment of soft tissues in the foot or ankle no more
108     proximal than the distal 10 centimeters of the tibia.
109          (3) An individual licensed as a podiatric physician under this chapter may not perform
110     the procedures described in Subsection (2) unless the individual:
111          (a) (i) graduated on or after June 1, 2006 from a three-year residency program in
112     podiatric medicine and surgery that was accredited, at the time of graduation, by the Council on
113     Podiatric Medical Education; and
114          (ii) is board certified in reconstructive rearfoot and ankle surgery by the American
115     Board of Foot and Ankle Surgery;
116          (b) (i) graduated on or after June 1, 2006 from a three-year residency program in
117     podiatric medicine and surgery that was accredited, at the time of graduation, by the Council on
118     Podiatric Medical Education;
119          (ii) is board qualified in reconstructive rearfoot ankle surgery by the American Board
120     of Foot and Ankle Surgery; and
121          (iii) provides the division documentation that the podiatric physician has completed
122     training or experience, that the division determines is acceptable, in standard or advanced
123     midfoot, rearfoot, and ankle procedures; or
124          (c) (i) graduated before June 1, 2006, from a residency program in podiatric medicine
125     and surgery that was at least two years in length and that was accredited, at the time of
126     graduation, by the Council on Podiatric Medical Education;
127          (ii) (A) is board certified in reconstructive rearfoot ankle surgery by the American
128     Board of Foot and Ankle Surgery;
129          (B) if the residency described in Subsection (3)(c)(i) is a PSR-24 24-month podiatric
130     surgical residency, provides proof that the individual completed the residency, to a hospital that
131     is accredited by the Joint Commission and meets the hospital's credentialing criteria for foot
132     and ankle surgery; or
133          (C) in addition to the residency described in Subsection (3)(c)(i), has completed a
134     fellowship in foot and ankle surgery that was accredited by the Council on Podiatric Medical
135     Education at the time of completion; and
136          (iii) provides the division documentation that the podiatric physician has completed
137     training and experience, that the division determines is acceptable, in standard or advanced
138     midfoot, rearfoot, and ankle procedures.
139          (4) An individual licensed as a podiatric physician under this chapter may not perform
140     an amputation proximal to Chopart's joint.
141          (5) An individual licensed as a podiatric physician under this chapter may not perform
142     a surgical treatment on an ankle, on a governing structure of the foot or ankle above the ankle,
143     or on a structure related to the foot or ankle above the ankle, unless the individual performs the
144     surgical treatment:
145          (a) in an ambulatory surgical facility, a general acute hospital, or a specialty hospital, as
146     defined in Section 26-21-2; and
147          (b) subject to review by a quality care review body that includes qualified, licensed
148     physicians and surgeons.
149          Section 3. Section 58-5a-302 is amended to read:
150          58-5a-302. Qualifications to practice podiatry.
151          An applicant for licensure to practice podiatry shall:
152          (1) submit an application in a form as prescribed by the division;
153          (2) pay a fee as determined by the department under Section 63J-1-504;
154          (3) be of good moral character;
155          (4) be a graduate of a college of podiatric medicine accredited by the Council of
156     Podiatric Education;
157          (5) if licensed on or after July 1, 2015, have completed [one year] two years of
158     postgraduate training in a residency program recognized by the board; and
159          (6) pass examinations required by rule.
160          Section 4. Section 58-5a-306 is amended to read:
161          58-5a-306. Exemptions from licensure.
162          The following persons may practice podiatry, subject to stated circumstances and
163     limitations, without being licensed under this chapter:
164          (1) a podiatric physician serving in the armed forces of the United States, the United
165     States Public Health Service, the United States Department of Veterans Affairs, or other federal
166     agencies while engaged in activities regulated under this chapter as a part of his employment
167     with that federal agency if the individual holds a valid license to practice podiatry issued by any
168     other state or jurisdiction recognized by the division;
169          (2) a student engaged in activities that constitute the practice of podiatry while in
170     training in a recognized school approved by the division to the extent the activities are under
171     the supervision of qualified faculty or staff and the activities are a defined part of the training
172     program;
173          (3) a person engaged in an internship, residency, preceptorship, postceptorship,
174     fellowship, apprenticeship, or on-the-job training program approved by the division while
175     under the supervision of qualified persons;
176          (4) a person residing in another state and licensed to practice podiatry there, who is
177     called in for a consultation by a person licensed in this state and services provided are limited
178     to that consultation or who is invited by a recognized school, association, society, or other body
179     approved by the division to conduct a lecture, clinic, or demonstration of the practice of
180     podiatry so long as that individual does not establish a place of business or regularly engage in
181     the practice of podiatry in the state;
182          (5) a person licensed under the laws of this state to practice or engage in any other
183     occupation or profession while engaged in the lawful, professional, and competent practice of
184     that occupation or profession; [and]
185          (6) persons who fit or sell corrective shoes, arch supports, or similar devices, to the
186     extent their acts and practices involve only the fitting and selling of these items[.]; or
187          (7) a medical assistant working under the indirect supervision of a licensed podiatric
188     physician, if the medical assistant:
189          (a) engages only in tasks appropriately delegated by the licensed podiatric physician in
190     accordance with the standards and ethics of the practice of podiatry, and consistent with this
191     chapter;
192          (b) does not perform surgical procedures;
193          (c) does not prescribe prescription medications;
194          (d) does not administer anesthesia, except for a local anesthetic; and
195          (e) does not engage in other practices or procedures defined by the division by rule
196     made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, and in
197     collaboration with the board.
198          Section 5. Section 58-5a-501 is amended to read:
199          58-5a-501. Unlawful conduct -- Penalties.
200          Any person who engages in unlawful conduct as defined in this chapter is guilty of a
201     third degree felony, except that a violation of Subsection 58-5a-102[(3)(a)](5) is a class A
202     misdemeanor.