RULES AND REGULATIONS
STATE BOARD OF OSETOPATHIC MEDICINE
[49 PA. CODE CH. 25]
Biennial Renewal Fees
[32 Pa.B. 3220] The State Board of Osteopathic Medicine (Board) amends § 25.231 (relating to schedule of fees), by increasing the biennial renewal fee for physicians to read as set forth in Annex A.
A. Effective Date
This final-omitted rulemaking will be effective upon publication in the Pennsylvania Bulletin. The new fee will take effect for the biennial renewal period November 2002--October 2004.
B. Statutory Authority
The statutory authority for this final-omitted rulemaking is section 13.1 of the Osteopathic Medical Practice Act (act) (63 P. S. § 271.13a).
C. Background and Purpose
Section 13.1(a) of the act requires the Board to increase fees by regulation if the revenues raised by fees, fines and civil penalties are not sufficient to meet expenditures over a 2-year period. The Board raises virtually all its revenue through fees. The biennial license renewal fee is the most substantial revenue-generating fee of the fees charged by the Board. If the Board anticipates that its revenue will not meet its expenditures, the Board must increase its revenue. The Board last increased its biennial renewal fees on November 1, 1996.
The act mandates that the Board protect the public by adopting rules and regulations that govern the practice of medicine. In addition, the Board is generally mandated to promote public health, safety and welfare, which are accomplished through Board initiatives and coordination with other agencies and departments in the Commonwealth.
The Medical Care Availability and Reduction of Error Act (Mcare Act) (40 P. S. §§ 1303.101--1303.910), amended the act in several significant ways that will increase the operational costs of the Board. The additional duties assigned to the Board include the obligation to commence investigations within 4 years of receipt of notice of: a complaint with regard to a medical professional liability action that is filed against the physician; information regarding disciplinary action taken against the physician by a health care licensing authority of another state; information regarding sentencing of the physician for an offense as provided in section 15 of the act (63 P. S. § 271.15); or information regarding an arrest of the physician for any of the following offenses in this Commonwealth or another state: 18 Pa.C.S. Chapter 25 (relating to criminal homicide); 18 Pa.C.S. § 2702 (relating to aggravated assault); 18 Pa.C.S. Chapter 31 (relating to sexual offenses); or a violation of The Controlled Substance, Drug, Device and Cosmetic Act (35 P. S. §§ 780-101--780-144). Importantly, the Board will have authority to initiate disciplinary action against a physician for a single act of negligence. Currently the Board's authority is limited to multiple acts of negligence or a single act of gross negligence.
During 2000, the Bureau of Professional and Occupational Affairs (BPOA) received 1,046 complaints against physicians. During the consideration of the Mcare Act, the Insurance Federation of Pennsylvania estimated that approximately 7,000 medical malpractice civil complaints were filed in 2001. Enforcement of the notification requirements is expected to generate additional cases. Accordingly, the Board anticipates a substantial increase in complaints filed against physicians under the Mcare Act provisions.
Consequently the Board will require additional resources to fulfill its additional obligations under the act. During the development of the Mcare Act, the General Assembly was aware additional Board resources were necessary to implement the requirements under the act. These resources include staff, equipment, space, supplies, furniture and support resources such as contracts for expert witnesses. These additional resources will be needed in the Board's Administrative Office, the Bureau of Enforcement and Investigations, the Complaints Office, the Legal Office and the Office of Hearing Examiner. The additional operational resources and complement necessary to implement the Mcare Act are estimated to result in $5,379,031 in increased costs per year between the State Board of Medicine and the Board.
At its May 8, 2002, Board meeting, the Board reviewed a summary of its revenues and expenses. The summary, prepared by the BPOA Revenue Office and the Bureau of Finance and Operations, shows that for the Board to support its pro rata portion of the increase, the Board must raise the biennial renewal fee to meet or exceed projected expenditures and thereby comply with section 13.1 of the act.
FINANCIAL ACTUAL PROJECTED PROJECTED PROJECTED PROJECTED PROJECTED STATUS FY 00-01 FY 01-02 FY 02-03 FY 03-04 FY 04-05 FY 05-06 Beginning Balance: $366,411.48 $752,043.78 $320,515.94 $98,910.94 ($1,175,089.06) ($1,660,089.06) Revenue: 946,451.00 112,000.00 950,000.00 112,000.00 950,000.00 112,000.00 Prior Yr. Returned Funds: 0.00 88,472.16 0.00 0.00 0.00 0.00 Total Revenue: 1,312,862.48 952,515.94 1,270,515.94 210,910.94 (225,089.06) (1,548,089.06) Expenses: 560,818.70 632,000.00 1,171,605.00 1,386,000.00 1,469,000.00 1,485,000.00 Remaining Balance: 752,043.78 320,515.94 98,910.94 (1,175,089.06) (1,660,089.06) (3,033,089.06)
As the foregoing indicates, a significant deficit of $1.17 million is projected by the end of Fiscal Year 2003-2004. Without the fee increase the deficit grows to over $1.66 million by the end of Fiscal Year 2004-2005 and over $3.03 million by the end of Fiscal Year 2005-2006. This deficit is compounded and more critical since this Board fiscally stands on its own and is not contained within the Professional Licensure Augmentation Account (PLAA).
The biennial renewal period for the Board begins November 2002. To meet the requirements of the act and the Mcare Act, fees must be raised for this period. Accordingly, the Board finds that under section 204(3) of the act of July 31, 1968 (P. L. 769, No. 240) (45 P. S. § 1204(3)) (CDL) good cause exists to adopt the new fee and that publication as proposed rulemaking in this circumstance is impractical and contrary to the public interest as identified by the General Assembly in the Mcare Act.
D. Description of Proposed Amendments
The following table outlines the affected fee and change:
Application Current Fee New Fee Biennial renewal fee $140 $440 E. Compliance with Executive Order 1996-1
In compliance with Executive Order 1996-1, ''Regulatory Review and Promulgation,'' the Board considered the regulation as both required by law and the least restrictive means of covering the costs of services required to be performed by the Board.
F. Fiscal Impact and Paperwork Requirements
The final-omitted rulemaking would increase the biennial renewal fee for physicians in this Commonwealth, but, otherwise, should have no fiscal impact on the private sector, the general public or political subdivisions.
The final-omitted rulemaking would require the Board to alter some of its forms to reflect the new biennial renewal fees; however, the final-omitted rulemaking should create no additional paperwork for the private sector.
G. Sunset Date
The Board continuously monitors the cost effectiveness of its regulations. Therefore, no sunset date has been assigned.
H. Regulatory Review
Under section 5.1(c) of the Regulatory Review Act (71 P. S. § 745.5a(c)), on May 22, 2002, the Board submitted a copy of the final-omitted rulemaking to the Independent Regulatory Review Commission (IRRC), the Senate Consumer Protection and Professional Licensure Committee (SCP/PLC) and the House Professional Licensure Committee (HPLC). On the same date, the final-omitted rulemaking was submitted to the Office of Attorney General for review and approval under the Commonwealth Attorneys Act (71 P. S. §§ 732-101--732-506).
Under section 5.1(d) of the Regulatory Review Act (71 P. S. § 745.5a(d)), the final-omitted rulemaking was deemed approved by the HPLC and the SCP/PLC on June 11, 2002, 2002. Under section 5.1(e) of the Regulatory Review Act, IRRC met on June 13, 2002, and approved the final-omitted regualtion.
I. Additional Information
Interested persons are invited to submit inquiries regarding this final-omitted rulemaking to Gina Bittner, Board Administrator, State Board of Osteopathic Medicine, Post Office Box 2649, Harrisburg, PA 17105-2649, gbittner@state.pa.us.
J. Findings
The Board finds that:
(1) Public notice of its intention to amend its regulations as adopted in this order under sections 201 and 202 of the CDL (45 P. S. §§ 1201 and 1202) has been omitted under the authority contained in section 204(3) of the CDL, because the Board has, for good cause, found that the procedures specified in sections 201 and 202 of the CDL are, in this circumstance, impractical and contrary to the public interest as identified by the General Assembly in the Mcare Act because the Board must increase revenues immediately to meet the obligations imposed on it by the Mcare Act.
(2) The amendment of the regulation of the Board in the manner provided in this order is necessary and appropriate for the administration of its authorizing statute.
K. Order
The Board, acting under its authorizing statute, orders that:
(a) The regulations of the Board, 49 Pa. Code Chapter 25, are amended by amending § 25.231 to read as set forth in Annex A.
(b) The Chairperson of the Board shall submit this order and Annex A to the Office of General Counsel and the Office of Attorney General for approval as to form and legality as required by law.
(c) The Chairperson of the Board shall certify this order and Annex A and deposit them with the Legislative Reference Bureau as required by law.
(d) This order shall become effective immediately upon publication in the Pennsylvania Bulletin.
DANIEL D. DOWD, Jr. D.O.,
Chairperson(Editor's Note: For the text of the order of the Independent Regulatory Commission, relating to this document, see 32 Pa.B. 3183 (June 29, 2002).)
Fiscal Note: 16A-5311. No fiscal impact; (8) recommends adoption.
Annex A
TITLE 49. PROFESSIONAL AND VOCATIONAL STANDARDS
PART I. DEPARTMENT OF STATE
Subpart A. PROFESSIONAL AND OCCUPATIONAL AFFAIRS
CHAPTER 25. STATE BOARD OF OSTEOPATHIC MEDICINE
Subchapter F. FEES § 25.231. Schedule of fees.
An applicant for a license, certificate, registration or service shall pay the following fees at the time of application:
Application for unrestricted license to practice as osteopathic physician--original, reciprocal, boundary or by endorsement $45 Application for short-term camp license as osteopathic physician $30 Osteopathic Manipulative Therapy Examination $87 Temporary training license or graduate training certificate $30 Annual renewal of temporary training license or graduate training certificate $25 Application for physician assistant certificate $30 Application for supervising physician $95 Uncertified verification of any license or permit $15 Certification of any licenses, examination grades or hours $25 Biennial renewal--physicians $440 Biennial renewal--physician assistants $10 Penalty for late biennial renewal--per month or part of month $5 Duplicate license or certificate $5 Application for radiology (ARRT) examinations $25 ARRT Examination in Radiography $20 ARRT Examination in Nuclear Medicine Technology $20 ARRT Examination in Radiation Therapy Technology $20 ARRT Limited Examination in Radiography--Thorax and Extremities $25 ARRT Limited Examination in Radiography--Skull and Sinuses $25 Application for acupuncturist registration $30 Biennial renewal--acupuncturists $25 Application for acupuncturist supervisor registration $30
[Pa.B. Doc. No. 02-1171. Filed for public inspection July 5, 2002, 9:00 a.m.]
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