Administrative Rule Review Report AR07-060
Legislative Service Office
24-Oct-07
AGENCY: Board of Medicine.
DATE SUBMITTED: October 22, 2007.
SUBJECT: Chapter 1, License Eligibility, Application and Interviews; Chapter 2, Examination for Licensure; Chapter 3, Practice of Medicine; Chapter 4, Disciplinary Complaints Against Physicians; and Chapter 5, Conduct of Disciplinary Proceedings Against Physician Assistants.
NATURE OF RULES: Legislative and Procedural.
STATUTORY AUTHORITY: W.S. 33-26-202(b)(v)
DETERMINATION OF PROCEDURAL COMPLIANCE BASED UPON INFORMATION
SUBMITTED BY THE AGENCY TO LSO:
Notice of the proposed adoption of new rules was provided by the LSO as required by W.S. 28-9-103(d). No comments have been receive to date.
SUMMARY OF RULES:
These amendments to the rules of the Wyoming Board of Medicine are in response to statutory changes to the Medical Practice Act in 2006 Session Laws, Chapter 58 and to clarify and supplement existing rules. The proposed rules amend Chapters 1 through 5 of the Wyoming Board of Medicine regulations. In addition to the following specified amendments, the proposed rules correct statutory citations and grammatical errors throughout Chapters 1-5.
Chapter 1 (License Eligibility, Application and Interviews), Section 2 (Purpose) is amended to include requirements for "training licensure", "license renewal" and the establishment of "criteria" for license applicants. Section 3 (Definitions) is amended by adding new definitions of "Attending Physician", "Full Board Interview", "Physician/patient Relationship" and by amending the existing definitions of "Impaired", "Lapsed", "Practicing Medicine" and "Reactivation". Section 4 (Eligibility for licensure) statutory requirements for licensure are amended to include the requirements found at W.S. 33-26-303 and further requires an applicant subject to conditions or restrictions of another state's medical licensing board to have those conditions or restrictions removed before becoming eligible for licensure by the WBE. Amendments to Section 4 also delineate the requirements for international medical graduates to become licensed in Wyoming and allow persons who have pled guilty or been convicted of a felony to apply for licensure, though their application may be rejected based solely upon the felony conviction or guilty plea. Section 5 (Licensure) is amended by: 1) limiting the availability of inactive licenses to Wyoming residents who do not intend to practice medicine, write prescriptions or engage in clinical activity and also explicitly prohibits an inactive license holder from prescribing medications; 2) repealing the "Volunteer license" and creating in its place an "Emeritus license" for physicians who reside in Wyoming but who either do not engage in active clinical practice, have retired or wish to provide clinical care without remuneration ("Emeritus license holders are subject to the continuing medical education requirements of Chapter 3, Section 6); 3) creating a "Training license" in conjunction with the UW Family Medicine Residency Program which does not confer upon the licensee the authority to independently prescribe medications; and 4) amending the "Licensure Application Interviews" process. Section 6 (Temporary license) is amended to set the effective date of a temporary license from the date of issuance until 8:00 a.m. on the next scheduled interview date established by the Board. Section 7 (Exemption from licensure) is amended to explicitly exempt the defined term "Medical students" from the licensure requirements listed in the regulations; exempting physician assistants rendering aid at the scene of an emergency from the licensure requirements; and exempting physicians or physician assistants licensed in another state or country responding to a State of Emergency declared by the Governor of Wyoming from the license requirements for the duration of the emergency. Section 8 (Fees) is amended to increase license fees 15 to 100% depending on the license type. Section 9 (Reinstatement of Licenses) is amended to allow for reinstatement of a license suspended upon court order without a Board hearing upon an order removing the original suspension. Section 10 (License Renewal) creates a schedule for licenses to be renewed annually on 3 separate dates, as determined by the first letter of the licensee's surname. Section 10 also creates an extension period, at the Board discretion, for those applicants who can provide good cause of their failure to submit applications in a timely manner.
Chapter 2 (Examination for Licensure), Section 3 (Composite testing) is amended to clarify that certain combinations of "USMLE" (defined as the three-part examination for medical licensure in the United States, replacing the FLEX and National Boards) are no longer acceptable as prerequisites to eligibility for "USMLE Step 3" and that only successful completion of "USMLE Steps 1 and 2 are acceptable prerequisites for eligibility to sit for "USMLE Step 3".
Chapter 3 (Practice of Medicine), Section 2 (Board Ordered Testing) is amended to require applicant/licensees who have been or are now in a chemical or alcohol treatment program to execute releases to enable the Board to receive reports and communicate with testing facilities that are mandated to monitor the applicant/licensee's recovery. Section 5 is renamed "Terminate relationship" from "Physician/patient relationship". Section 5 requires a physician to give written notice 30 days prior to terminating a physician/patient relationship. Section 6 (Practice Coverage) is a new section that provides guidelines for physicians to follow to provide patients with medical coverage when the physician is not available. Failure to adequately address coverage needs may result in the imposition of disciplinary action pursuant to W.S. 33-26-402.
Chapter 4 (Rules of Practice and Procedure for Disciplinary Complaints Against Physicians), Section 4 (Disciplinary Proceedings) is amended to add the Board vice president to the disciplinary action screening process and allows the president, vice president or secretary of the Board to be appointed as a petitioner in a case they have screened. Section 4 is further amended to: 1) require that a subpoena ordered by the Board or its hearing officer shall only be issued at the request of a party to the contested case; 2) specify the procedure to be followed if a respondent in a contested case before a hearing panel fails to appear; and 3) require Board counsel to assist the hearing panel in drafting findings of facts and conclusions of law to be submitted to the Board for approval and adoption in a contested case. Section 6 (Board Review of Initial License, Temporary License, Reactivation and Reinstatement Applications) is amended to allow an applicant to withdraw the application after the personal interview and/or subsequent investigation.
Chapter 5 (Rules of Practice and Procedure for the Licensure of and for the Conduct of Disciplinary Proceedings Against Physician Assistants), Section 4 (Scope of Practice) is amended to allow a physician to supervise up to 3 physician assistants. Section 5 (Locum tenens licensure) is amended to change the requirements for when a physician assistant may be granted temporary license to practice as a locum tenens provider ("locum tenens" is defined in the rules to mean the temporary provision of services for a period not to exceed 60 days per calendar year). Section 15 (Disciplinary Proceedings) is amended to add the Board vice president to the disciplinary action screening process for physician assistants. Section 18 (General Provisions) is amended to allow a supervising physician to act as a back-up supervising physician for up to 3 physician assistants (in addition to the 3 physician assistants the supervising physician is primarily responsible for).
FINDINGS:
The rules appear to be within the scope of statutory authority and legislative intent.
STAFF RECOMMENDATION:
That the rules be placed on the Consent List and be approved by the Council as submitted by the Board.
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Matthew D. Obrecht
Staff Attorney
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David K. Gruver
Assistant Director
MDO/