This document includes House Committee Amendments incorporated into the bill on Tue, Feb 6, 2024 at 10:16 AM by housengrossing.
Representative Paul A. Cutler proposes the following substitute bill:


1     
PODIATRIST PRACTICE AMENDMENTS

2     
2024 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Paul A. Cutler

5     
Senate Sponsor: Curtis S. Bramble

6     

7     LONG TITLE
8     General Description:
9          This bill modifies provisions regarding podiatric physicians.
10     Highlighted Provisions:
11          This bill:
12          ▸     allows a podiatric physician to perform wound debridement on the limbs and torso,
13     under certain conditions.
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 2023, Chapter 328
21          58-5a-103, as last amended by Laws of Utah 2023, Chapter 328
22     

23     Be it enacted by the Legislature of the state of Utah:
24          Section 1. Section 58-5a-102 is amended to read:
25          58-5a-102. Definitions.

26          In addition to the definitions under Section 58-1-102, as used in this chapter:
27          (1) "Assisted living facility" means the same as that term is defined in Section
28     26B-2-201.
29          [(1)] (2) "Board" means the Podiatric Physician Board created in Section 58-5a-201.
30          [(2)] (3) "Indirect supervision" means the same as that term is defined by the division
31     by rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
32          [(3)] (4) "Medical assistant" means an unlicensed individual working under the indirect
33     supervision of a licensed podiatric physician and engaging in specific tasks assigned by the
34     licensed podiatric physician in accordance with the standards and ethics of the podiatry
35     profession.
36          [(4)] (5) "Practice of podiatry" means, subject to Section 58-5a-103, the diagnosis and
37     treatment of conditions affecting the human foot and ankle and their manifestations of systemic
38     conditions, and wound debridement on the limbs and torso, by all appropriate and lawful
39     means[, subject to Section 58-5a-103].
40          [(5)] (6) "Unlawful conduct" includes:
41          (a) the conduct that constitutes unlawful conduct under Section 58-1-501; and
42          (b) for an individual who is not licensed under this chapter:
43          (i) using the title or name podiatric physician, podiatrist, podiatric surgeon, foot doctor,
44     foot specialist, or D.P.M.; or
45          (ii) implying or representing that the individual is qualified to practice podiatry.
46          [(6)] (7) (a) "Unprofessional conduct" includes, for an individual licensed under this
47     chapter:
48          (i) the conduct that constitutes unprofessional conduct under Section 58-1-501;
49          (ii) communicating to a third party, without the consent of the patient, information the
50     individual acquires in treating the patient, except as necessary for professional consultation
51     regarding treatment of the patient;
52          (iii) allowing the individual's name or license to be used by an individual who is not
53     licensed to practice podiatry under this chapter;
54          (iv) except as described in Section 58-5a-306, employing, directly or indirectly, any
55     unlicensed individual to practice podiatry;
56          (v) using alcohol or drugs, to the extent the individual's use of alcohol or drugs impairs

57     the individual's ability to practice podiatry;
58          (vi) unlawfully prescribing, selling, or giving away any prescription drug, including
59     controlled substances, as defined in Section 58-37-2;
60          (vii) gross incompetency in the practice of podiatry;
61          (viii) willfully and intentionally making a false statement or entry in hospital records,
62     medical records, or reports;
63          (ix) willfully making a false statement in reports or claim forms to governmental
64     agencies or insurance companies with the intent to secure payment not rightfully due;
65          (x) willfully using false or fraudulent advertising;
66          (xi) conduct the division defines as unprofessional conduct by rule made in accordance
67     with Title 63G, Chapter 3, Utah Administrative Rulemaking Act;
68          (xii) falsely making an entry in, or altering, a medical record with the intent to conceal:
69          (A) a wrongful or negligent act or omission of an individual licensed under this chapter
70     or an individual under the direction or control of an individual licensed under this chapter; or
71          (B) conduct described in Subsections [(6)(a)(i)] (7)(a)(i) through (xi) or Subsection
72     58-1-501(1); or
73          (xiii) violating the requirements of Title 26B, Chapter 4, Part 2, Cannabinoid Research
74     and Medical Cannabis.
75          (b) "Unprofessional conduct" does not include, in accordance with Title 26B, Chapter
76     4, Part 2, Cannabinoid Research and Medical Cannabis, when registered as a qualified medical
77     provider or acting as a limited medical provider, as those terms are defined in Section
78     26B-4-201, recommending the use of medical cannabis within the scope of a practice of
79     podiatry.
80          Section 2. Section 58-5a-103 is amended to read:
81          58-5a-103. Scope of practice.
82          (1) Subject to the provisions of this section, an individual licensed as a podiatric
83     physician under this chapter may perform:
84          (a) a surgical procedure on a bone of the foot or ankle[.]; and
85          (b) biological, enzymatic, autolytic, and mechanical wound debridement on the limbs
86     and torso, if Ĥ→ [
:
87          (i)
] ←Ĥ
the podiatric physician is certified by the American Board of Wound Management

88     as a Certified Wound Specialist Physician Ĥ→ [
; and] ←Ĥ
89          Ĥ→ [
(ii) the wound debridement is performed in a home health care setting or at an assisted
90     living facility
] ←Ĥ
.
91          (2) Except as provided in Subsections (3) and (4), an individual licensed as a podiatric
92     physician under this chapter may not perform:
93          (a) an ankle fusion;
94          (b) a massive ankle reconstruction; or
95          (c) a reduction of a trimalleolar ankle fracture.
96          (3) An individual licensed as a podiatric physician under this chapter who meets the
97     requirements described in Subsection (4) may only:
98          (a) treat a fracture of the tibia if at least one portion of the fracture line enters the ankle
99     joint;
100          (b) treat a foot or ankle condition using hardware, including screws, plates, staples,
101     pins, and wires, if at least one portion of the hardware system is attached to a bony structure at
102     or below the ankle mortise; and
103          (c) place hardware for the treatment of soft tissues in the foot or ankle no more
104     proximal than the distal 10 centimeters of the tibia.
105          (4) Subject to Subsection (3), an individual licensed as a podiatric physician under this
106     chapter may only perform a procedure described in Subsection (2) if the individual:
107          (a) (i) graduated on or after June 1, 2006, from a three-year residency program in
108     podiatric medicine and surgery that was accredited, at the time of graduation, by the Council on
109     Podiatric Medical Education; and
110          (ii) is board certified in reconstructive rearfoot and ankle surgery by the American
111     Board of Foot and Ankle Surgery;
112          (b) (i) graduated on or after June 1, 2006, from a three-year residency program in
113     podiatric medicine and surgery that was accredited, at the time of graduation, by the Council on
114     Podiatric Medical Education;
115          (ii) is board qualified in reconstructive rearfoot ankle surgery by the American Board
116     of Foot and Ankle Surgery; and
117          (iii) provides the division documentation that the podiatric physician has completed
118     training or experience, which the division determines is acceptable, in standard or advanced

119     rearfoot and ankle procedures; or
120          (c) (i) graduated before June 1, 2006, from a residency program in podiatric medicine
121     and surgery that was at least two years in length and that was accredited, at the time of
122     graduation, by the Council on Podiatric Medical Education;
123          (ii) (A) is board certified in reconstructive rearfoot ankle surgery by the American
124     Board of Foot and Ankle Surgery;
125          (B) if the residency described in Subsection (4)(c)(i) is a PSR-24 24-month podiatric
126     surgical residency, provides proof that the individual completed the residency, to a hospital that
127     is accredited by the Joint Commission, and meets the hospital's credentialing criteria for foot
128     and ankle surgery; or
129          (C) in addition to the residency described in Subsection (4)(c)(i), has completed a
130     fellowship in foot and ankle surgery that was accredited by the Council on Podiatric Medical
131     Education at the time of completion; and
132          (iii) provides the division documentation that the podiatric physician has completed
133     training and experience, which the division determines is acceptable, in standard or advanced
134     rearfoot and ankle procedures.
135          (5) An individual licensed as a podiatric physician under this chapter may not perform
136     an amputation proximal to Chopart's joint.
137          (6) An individual licensed as a podiatric physician under this chapter may not perform
138     a surgical treatment on an ankle, on a governing structure of the foot or ankle above the ankle,
139     or on a structure related to the foot or ankle above the ankle, unless the individual performs the
140     surgical treatment:
141          (a) in an ambulatory surgical facility, a general acute hospital, or a specialty hospital, as
142     defined in Section 26B-2-201; and
143          (b) subject to review by a quality care review body that includes qualified, licensed
144     physicians and surgeons.
145          Section 3. Effective date.
146          This bill takes effect on May 1, 2024.