1     
PHYSICIAN CERTIFICATION

2     
2018 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Michael K. McKell

5     
Senate Sponsor: ____________

6     

7     LONG TITLE
8     General Description:
9          This bill enacts language related to certain physician certifications.
10     Highlighted Provisions:
11          This bill:
12          ▸     prohibits the following from requiring that a physician maintain certain
13     certifications:
14               •     a health care facility for purposes of employment, privileges, or reimbursement;
15               •     a managed care organization or other third party for purposes of reimbursement;
16     and
17               •     the Division of Occupational and Professional Licensing for purposes of
18     licensing; and
19          ▸     makes technical and conforming changes.
20     Money Appropriated in this Bill:
21          None
22     Other Special Clauses:
23          None
24     Utah Code Sections Affected:
25     AMENDS:
26          58-67-302, as last amended by Laws of Utah 2012, Chapters 162 and 225
27          58-67-302.5, as last amended by Laws of Utah 2011, Chapter 214

28          58-68-302, as last amended by Laws of Utah 2012, Chapters 162 and 225
29     ENACTS:
30          26-21-30, Utah Code Annotated 1953
31          31A-45-305, Utah Code Annotated 1953
32     

33     Be it enacted by the Legislature of the state of Utah:
34          Section 1. Section 26-21-30 is enacted to read:
35          26-21-30. Prohibition on certain physician certification requirements.
36          A health care facility may not require for purposes of employment, privileges, or
37     reimbursement, that a physician, as defined in Section 58-67-102, secure maintenance of
38     certification by a nationally recognized accrediting organization that specializes in a specific
39     area of medicine that includes continuous reexamination to measure core competencies in
40     practice of medicine, as defined in Section 58-67-102, as a requirement for maintaining
41     certification.
42          Section 2. Section 31A-45-305 is enacted to read:
43          31A-45-305. Prohibition on certain physician certification requirements.
44          A managed care organization or other third party may not require for purposes of
45     reimbursement that a physician, as defined in Section 58-67-102, secure maintenance of
46     certification by a nationally recognized accrediting organization that specializes in a specific
47     area of medicine that includes continuous reexamination to measure core competencies in
48     practice of medicine, as defined in Section 58-67-102, as a requirement for maintaining
49     certification.
50          Section 3. Section 58-67-302 is amended to read:
51          58-67-302. Qualifications for licensure.
52          (1) An applicant for licensure as a physician and surgeon, except as set forth in
53     Subsection (2), shall:
54          (a) submit an application in a form prescribed by the division, which may include:
55          (i) submissions by the applicant of information maintained by practitioner data banks,
56     as designated by division rule, with respect to the applicant;
57          (ii) a record of professional liability claims made against the applicant and settlements
58     paid by or on behalf of the applicant; and

59          (iii) authorization to use a record coordination and verification service approved by the
60     division in collaboration with the board;
61          (b) pay a fee determined by the department under Section 63J-1-504;
62          (c) be of good moral character;
63          (d) provide satisfactory documentation of having successfully completed a program of
64     professional education preparing an individual as a physician and surgeon, as evidenced by:
65          (i) having received an earned degree of doctor of medicine from an LCME accredited
66     medical school or college; or
67          (ii) if the applicant graduated from a medical school or college located outside the
68     United States or its territories, submitting a current certification by the Educational
69     Commission for Foreign Medical Graduates or any successor organization approved by the
70     division in collaboration with the board;
71          (e) satisfy the division and board that the applicant:
72          (i) has successfully completed 24 months of progressive resident training in a program
73     approved by the ACGME, the Royal College of Physicians and Surgeons, the College of
74     Family Physicians of Canada, or any similar body in the United States or Canada approved by
75     the division in collaboration with the board; or
76          (ii) (A) has successfully completed 12 months of resident training in an ACGME
77     approved program after receiving a degree of doctor of medicine as required under Subsection
78     (1)(d);
79          (B) has been accepted in and is successfully participating in progressive resident
80     training in an ACGME approved program within Utah, in the applicant's second or third year
81     of postgraduate training; and
82          (C) has agreed to surrender to the division the applicant's license as a physician and
83     surgeon without any proceedings under Title 63G, Chapter 4, Administrative Procedures Act,
84     and has agreed the applicant's license as a physician and surgeon will be automatically revoked
85     by the division if the applicant fails to continue in good standing in an ACGME approved
86     progressive resident training program within the state;
87          (f) pass the licensing examination sequence required by division rule made in
88     collaboration with the board;
89          (g) be able to read, write, speak, understand, and be understood in the English language

90     and demonstrate proficiency to the satisfaction of the board if requested by the board;
91          (h) meet with the board and representatives of the division, if requested, for the
92     purpose of evaluating the applicant's qualifications for licensure;
93          (i) designate:
94          (i) a contact person for access to medical records in accordance with the federal Health
95     Insurance Portability and Accountability Act; and
96          (ii) an alternate contact person for access to medical records, in the event the original
97     contact person is unable or unwilling to serve as the contact person for access to medical
98     records; and
99          (j) establish a method for notifying patients of the identity and location of the contact
100     person and alternate contact person, if the applicant will practice in a location with no other
101     persons licensed under this chapter.
102          (2) An applicant for licensure as a physician and surgeon by endorsement who is
103     currently licensed to practice medicine in any state other than Utah, a district or territory of the
104     United States, or Canada shall:
105          (a) be currently licensed with a full unrestricted license in good standing in any state,
106     district, or territory of the United States, or Canada;
107          (b) have been actively engaged in the legal practice of medicine in any state, district, or
108     territory of the United States, or Canada for not less than 6,000 hours during the five years
109     immediately preceding the date of application for licensure in Utah;
110          (c) comply with the requirements for licensure under Subsections (1)(a) through (d),
111     (1)(e)(i), and (1)(g) through (j);
112          (d) have passed the licensing examination sequence required in Subsection (1)(f) or
113     another medical licensing examination sequence in another state, district or territory of the
114     United States, or Canada that the division in collaboration with the board by rulemaking
115     determines is equivalent to its own required examination;
116          (e) not have any investigation or action pending against any health care license of the
117     applicant, not have a health care license that was suspended or revoked in any state, district or
118     territory of the United States, or Canada, and not have surrendered a health care license in lieu
119     of a disciplinary action, unless:
120          (i) the license was subsequently reinstated as a full unrestricted license in good

121     standing; or
122          (ii) the division in collaboration with the board determines to its satisfaction, after full
123     disclosure by the applicant, that:
124          (A) the conduct has been corrected, monitored, and resolved; or
125          (B) a mitigating circumstance exists that prevents its resolution, and the division in
126     collaboration with the board is satisfied that, but for the mitigating circumstance, the license
127     would be reinstated;
128          (f) submit to a records review, a practice history review, and comprehensive
129     assessments, if requested by the division in collaboration with the board; and
130          (g) produce satisfactory evidence that the applicant meets the requirements of this
131     Subsection (2) to the satisfaction of the division in collaboration with the board.
132          (3) An applicant for licensure by endorsement may engage in the practice of medicine
133     under a temporary license while the applicant's application for licensure is being processed by
134     the division, provided:
135          (a) the applicant submits a complete application required for temporary licensure to the
136     division;
137          (b) the applicant submits a written document to the division from:
138          (i) a health care facility licensed under Title 26, Chapter 21, Health Care Facility
139     Licensing and Inspection Act, stating that the applicant is practicing under the:
140          (A) invitation of the health care facility; and
141          (B) the general supervision of a physician practicing at the facility; or
142          (ii) two individuals licensed under this chapter, whose license is in good standing and
143     who practice in the same clinical location, both stating that:
144          (A) the applicant is practicing under the invitation and general supervision of the
145     individual; and
146          (B) the applicant will practice at the same clinical location as the individual;
147          (c) the applicant submits a signed certification to the division that the applicant meets
148     the requirements of Subsection (2);
149          (d) the applicant does not engage in the practice of medicine until the division has
150     issued a temporary license;
151          (e) the temporary license is only issued for and may not be extended or renewed

152     beyond the duration of one year from issuance; and
153          (f) the temporary license expires immediately and prior to the expiration of one year
154     from issuance, upon notification from the division that the applicant's application for licensure
155     by endorsement is denied.
156          (4) The division shall issue a temporary license under Subsection (3) within 15
157     business days after the applicant satisfies the requirements of Subsection (3).
158          (5) The division may not require the following as a requirement for licensure:
159          (a) a post-residency board certification [as a requirement for licensure.]; or
160          (b) maintenance of certification by a nationally recognized accrediting organization
161     that specializes in a specific area of medicine that includes continuous reexamination to
162     measure core competencies in practice of medicine as a requirement for maintaining
163     certification.
164          Section 4. Section 58-67-302.5 is amended to read:
165          58-67-302.5. Licensing of graduates of foreign medical schools.
166          (1) Notwithstanding any other provision of law to the contrary, an individual enrolled
167     in a medical school outside the United States, its territories, the District of Columbia, or
168     Canada is eligible for licensure as a physician and surgeon in this state if the individual has
169     satisfied the following requirements:
170          (a) meets all the requirements of Subsection 58-67-302(1), except for Subsection
171     58-67-302(1)(d);
172          (b) has studied medicine in a medical school located outside the United States which is
173     recognized by an organization approved by the division;
174          (c) has completed all of the formal requirements of the foreign medical school except
175     internship or social service;
176          (d) has attained a passing score on the educational commission for foreign medical
177     graduates examination or other qualifying examinations such as the United States Medical
178     Licensing Exam parts I and II, which are approved by the division or a medical school
179     approved by the division;
180          (e) has satisfactorily completed one calendar year of supervised clinical training under
181     the direction of a United States medical education setting accredited by the liaison committee
182     for graduate medical education and approved by the division;

183          (f) has completed the postgraduate hospital training required by Subsection
184     58-67-302(1)(e)(i); and
185          (g) has passed the examination required by the division of all applicants for licensure.
186          (2) Satisfaction of the requirements of Subsection (1) is in lieu of:
187          (a) the completion of any foreign internship or social service requirements; and
188          (b) the certification required by Subsection 58-67-302(1)(d).
189          (3) Individuals who satisfy the requirements of Subsections (1)(a) through (f) shall be
190     eligible for admission to graduate medical education programs within the state, including
191     internships and residencies, which are accredited by the liaison committee for graduate medical
192     education.
193          (4) A document issued by a medical school located outside the United States shall be
194     considered the equivalent of a degree of doctor of medicine for the purpose of licensure as a
195     physician and surgeon in this state if:
196          (a) the foreign medical school is recognized by an organization approved by the
197     division;
198          (b) the document granted by the foreign medical school is issued after the completion
199     of all formal requirements of the medical school except internship or social service; and
200          (c) the foreign medical school certifies that the person to whom the document was
201     issued has satisfactorily completed the requirements of Subsection (1)(c).
202          (5) The division may not require as a requirement for licensure maintenance of
203     certification by a nationally recognized accrediting organization that specializes in a specific
204     area of medicine that includes continuous reexamination to measure core competencies in
205     practice of medicine as a requirement for maintaining certification.
206          [(5)] (6) The provisions for licensure under this section shall be known as the "fifth
207     pathway program."
208          Section 5. Section 58-68-302 is amended to read:
209          58-68-302. Qualifications for licensure.
210          (1) An applicant for licensure as an osteopathic physician and surgeon, except as set
211     forth in Subsection (2), shall:
212          (a) submit an application in a form prescribed by the division, which may include:
213          (i) submissions by the applicant of information maintained by practitioner data banks,

214     as designated by division rule, with respect to the applicant;
215          (ii) a record of professional liability claims made against the applicant and settlements
216     paid by or on behalf of the applicant; and
217          (iii) authorization to use a record coordination and verification service approved by the
218     division in collaboration with the board;
219          (b) pay a fee determined by the department under Section 63J-1-504;
220          (c) be of good moral character;
221          (d) provide satisfactory documentation of having successfully completed a program of
222     professional education preparing an individual as an osteopathic physician and surgeon, as
223     evidenced by:
224          (i) having received an earned degree of doctor of osteopathic medicine from an AOA
225     approved medical school or college; or
226          (ii) submitting a current certification by the Educational Commission for Foreign
227     Medical Graduates or any successor organization approved by the division in collaboration
228     with the board, if the applicant is graduated from an osteopathic medical school or college
229     located outside of the United States or its territories which at the time of the applicant's
230     graduation, met criteria for accreditation by the AOA;
231          (e) satisfy the division and board that the applicant:
232          (i) has successfully completed 24 months of progressive resident training in an
233     ACGME or AOA approved program after receiving a degree of doctor of osteopathic medicine
234     required under Subsection (1)(d); or
235          (ii) (A) has successfully completed 12 months of resident training in an ACGME or
236     AOA approved program after receiving a degree of doctor of osteopathic medicine as required
237     under Subsection (1)(d);
238          (B) has been accepted in and is successfully participating in progressive resident
239     training in an ACGME or AOA approved program within Utah, in the applicant's second or
240     third year of postgraduate training; and
241          (C) has agreed to surrender to the division the applicant's license as an osteopathic
242     physician and surgeon without any proceedings under Title 63G, Chapter 4, Administrative
243     Procedures Act, and has agreed the applicant's license as an osteopathic physician and surgeon
244     will be automatically revoked by the division if the applicant fails to continue in good standing

245     in an ACGME or AOA approved progressive resident training program within the state;
246          (f) pass the licensing examination sequence required by division rule, as made in
247     collaboration with the board;
248          (g) be able to read, write, speak, understand, and be understood in the English language
249     and demonstrate proficiency to the satisfaction of the board, if requested by the board;
250          (h) meet with the board and representatives of the division, if requested for the purpose
251     of evaluating the applicant's qualifications for licensure;
252          (i) designate:
253          (i) a contact person for access to medical records in accordance with the federal Health
254     Insurance Portability and Accountability Act; and
255          (ii) an alternate contact person for access to medical records, in the event the original
256     contact person is unable or unwilling to serve as the contact person for access to medical
257     records; and
258          (j) establish a method for notifying patients of the identity and location of the contact
259     person and alternate contact person, if the applicant will practice in a location with no other
260     persons licensed under this chapter.
261          (2) An applicant for licensure as an osteopathic physician and surgeon by endorsement
262     who is currently licensed to practice osteopathic medicine in any state other than Utah, a
263     district or territory of the United States, or Canada shall:
264          (a) be currently licensed with a full unrestricted license in good standing in any state,
265     district or territory of the United States, or Canada;
266          (b) have been actively engaged in the legal practice of osteopathic medicine in any
267     state, district or territory of the United States, or Canada for not less than 6,000 hours during
268     the five years immediately preceding the day on which the applicant applied for licensure in
269     Utah;
270          (c) comply with the requirements for licensure under Subsections (1)(a) through (d),
271     (1)(e)(i), and (1)(g) through (j);
272          (d) have passed the licensing examination sequence required in Subsection (1)(f) or
273     another medical licensing examination sequence in another state, district or territory of the
274     United States, or Canada that the division in collaboration with the board by rulemaking
275     determines is equivalent to its own required examination;

276          (e) not have any investigation or action pending against any health care license of the
277     applicant, not have a health care license that was suspended or revoked in any state, district or
278     territory of the United States, or Canada, and not have surrendered a health care license in lieu
279     of a disciplinary action, unless:
280          (i) the license was subsequently reinstated as a full unrestricted license in good
281     standing; or
282          (ii) the division in collaboration with the board determines, after full disclosure by the
283     applicant, that:
284          (A) the conduct has been corrected, monitored, and resolved; or
285          (B) a mitigating circumstance exists that prevents its resolution, and the division in
286     collaboration with the board is satisfied that, but for the mitigating circumstance, the license
287     would be reinstated;
288          (f) submit to a records review, a practice review history, and physical and
289     psychological assessments, if requested by the division in collaboration with the board; and
290          (g) produce evidence that the applicant meets the requirements of this Subsection (2) to
291     the satisfaction of the division in collaboration with the board.
292          (3) An applicant for licensure by endorsement may engage in the practice of medicine
293     under a temporary license while the applicant's application for licensure is being processed by
294     the division, provided:
295          (a) the applicant submits a complete application required for temporary licensure to the
296     division;
297          (b) the applicant submits a written document to the division from:
298          (i) a health care facility licensed under Title 26, Chapter 21, Health Care Facility
299     Licensing and Inspection Act, stating that the applicant is practicing under the:
300          (A) invitation of the health care facility; and
301          (B) the general supervision of a physician practicing at the health care facility; or
302          (ii) two individuals licensed under this chapter, whose license is in good standing and
303     who practice in the same clinical location, both stating that:
304          (A) the applicant is practicing under the invitation and general supervision of the
305     individual; and
306          (B) the applicant will practice at the same clinical location as the individual;

307          (c) the applicant submits a signed certification to the division that the applicant meets
308     the requirements of Subsection (2);
309          (d) the applicant does not engage in the practice of medicine until the division has
310     issued a temporary license;
311          (e) the temporary license is only issued for and may not be extended or renewed
312     beyond the duration of one year from issuance; and
313          (f) the temporary license expires immediately and prior to the expiration of one year
314     from issuance, upon notification from the division that the applicant's application for licensure
315     by endorsement is denied.
316          (4) The division shall issue a temporary license under Subsection (3) within 15
317     business days after the applicant satisfies the requirements of Subsection (3).
318          (5) The division may not require [a post-residency board certification] the following as
319     a requirement for licensure[.]:
320          (a) a post-residency board certification; or
321          (b) maintenance of certification by a nationally recognized accrediting organization
322     that specializes in a specific area of medicine that includes continuous reexamination to
323     measure core competencies in practice of medicine as a requirement for maintaining
324     certification.






Legislative Review Note
Office of Legislative Research and General Counsel