RULES AND REGULATIONS
Title 49—PROFESSIONAL AND VOCATIONAL STANDARDS
STATE BOARD OF MEDICINE
[ 49 PA. CODE CHS. 16 AND 17 ]
MCARE Amendments
[42 Pa.B. 5484]
[Saturday, August 25, 2012]The State Board of Medicine (Board) amends §§ 16.1, 16.18, 16.31—16.35, 17.4, 17.6 and 17.7 to read as set forth in Annex A.
Effective Date
This final-omitted rulemaking will be effective upon publication in the Pennsylvania Bulletin.
Statutory Authority
Section 8 of the Medical Practice Act of 1985 (act) (63 P. S. § 422.8) authorizes the Board to adopt regulations that are reasonably necessary to carry out the purposes of the act.
Omission of Proposed Rulemaking
Under section 204 of the act of July 31, 1968 (P. L. 769, No. 240) (45 P. S. § 1204), known as the Commonwealth Documents Law (CDL), the Board is authorized to omit proposed rulemaking in sections 201 and 202 of the CDL (45 P. S. §§ 1201 and 1202) if the Board finds that the criteria in section 204 of the CDL are met.
Throughout the Board's regulations are references to the Health Care Services Malpractice Act, which was repealed by the act of March 20, 2002 (P. L. 154, No. 13) (Act 13). Act 13 also enacted the Medical Care Availability and Reduction of Error (MCARE) Act (MCARE Act) (40 P. S. §§ 1303.101—1303.910). Under the authority of section 204(3) of the CDL, notice of proposed rulemaking has been omitted as unnecessary because the amendments are required to delete references to the repealed Health Care Services Malpractice Act and to replace them, as applicable, with references to the MCARE Act.
Background and Need for Amendments
Due to the repeal of the Health Care Services Malpractice Act and enactment of the MCARE Act, the Board's regulations are amended to reference the current applicable law. In addition, because the MCARE Act applies to both physicians and nurse-midwives, the Board is amending references to the requirements of the MCARE Act to include both physicians and nurse-midwives.
Description of Amendments
The Board is amending §§ 16.1, 16.18, 16.31—16.35, 17.4, 17.6 and 17.7 to delete references and citations to the Health Care Services Malpractice Act and replace these references and citations to the applicable sections of the MCARE Act.
The Board is also amending the references to ''physicians and surgeons'' in these sections by replacing them with references to ''physicians and nurse-midwives'' because: (1) the Board no longer uses the term ''physicians and surgeons'' to refer to its physician licensees; and (2) the MCARE Act applies to both physicians and nurse-midwives.
Fiscal Impact
This final-omitted rulemaking will not have fiscal impact on the Board, its licensees, the private sector, the general public or political subdivisions.
Paperwork Requirements
This final-omitted rulemaking will not create additional paperwork for the Board, its licensees, the private sector, the general public or political subdivisions.
Sunset Date
The Board continuously monitors the effectiveness of its regulations. Therefore, a sunset date has not been assigned.
Regulatory Review
Under section 5.1(c) of the Regulatory Review Act (71 P. S. § 745.5a(c)), on June 26, 2012, the Board submitted a copy of the final-omitted rulemaking and a copy of a Regulatory Analysis Form to the Independent Regulatory Review Commission (IRRC) and to the Chairpersons of the Senate Consumer Protection and Professional Licensure Committee (SCP/PLC) and the House Professional Licensure Committee (HPLC). On the same date, the regulations were 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(j.2) of the Regulatory Review Act, on August 1, 2012, the final-omitted rulemaking was deemed approved by the HPLC and SCP/PLC. Under section 5.1(e) of the Regulatory Review Act, IRRC met on August 2, 2012, and approved the final-omitted rulemaking.
Additional Information
For additional information about the final-omitted rulemaking, submit inquiries to Teresa Lazo, Counsel, State Board of Medicine, P. O. Box 2649, Harrisburg, PA 17105-2649, (717) 783-7200.
Findings
The Board finds that:
(1) Public notice of the Board's intention to amend its regulations under the procedures in sections 201 and 202 of the CDL has been omitted under the authority of section 204 of the CDL because public comment is unnecessary in that this final-omitted rulemaking deletes references to a repealed statute and replaces them with references to the current statute.
(2) The amendment of the Board's regulations in the manner provided in this order is necessary and appropriate for the administration of the act.
Order
The Board, acting under its authorizing statute, orders that:
(a) The regulations of the Board, 49 Pa. Code Chapters 16 and 17, are amended by amending §§ 16.1, 16.18, 16.31—16.35, 17.4, 17.6 and 17.7 to read as set forth in Annex A, with ellipses referring to the existing text of the regulations.
(b) 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 Board shall certify this order and Annex A and deposit them with the Legislative Reference Bureau as required by law.
(d) This order shall take effect upon publication in the Pennsylvania Bulletin.
JAMES W. FREEMAN, M.D.,
Chairperson(Editor's Note: For the text of the order of the Independent Regulatory Review Commission relating to this document, see 42 Pa.B. 5452 (August 18, 2012).)
Fiscal Note: 16A-4925. 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 16. STATE BOARD OF MEDICINE—GENERAL PROVISIONS
Subchapter A. BASIC DEFINITIONS AND INFORMATION § 16.1. Definitions.
The following words and terms, when used in this chapter and Chapters 17 and 18 (relating to State Board of Medicine—medical doctors; and State Board of Medicine—practitioners other than medical doctors), have the following meanings, unless the context clearly indicates otherwise:
* * * * * Immediate family member—A parent, spouse, child or adult sibling residing in the same household.
MCARE Act—The Medical Care Availability and Reduction of Error (MCARE) Act (40 P. S. §§ 1303.101—1303.910).
NBME—The National Board of Medical Examiners of the United States, Inc.
* * * * *
Subchapter B. GENERAL LICENSE, CERTIFICATION AND REGISTRATION PROVISIONS § 16.18. Volunteer license.
* * * * * (e) Renewal of license. A volunteer license shall be renewed biennially on forms provided by the Board. The applicant is exempt from payment of the biennial renewal fee of § 16.13 (relating to licensure, certification, examination and registration fees), and is exempt from the requirements with regard to the maintenance of liability insurance coverage under section 711 of the MCARE Act (40 P. S. § 1303.711) as provided in section 9 of the Volunteer Health Services Act (35 P. S. § 449.49).
* * * * *
Subchapter D. HEALTH CARE PROFESSIONAL LIABILITY § 16.31. Notification.
(a) Applicants for original licensure. A physician who has successfully met the qualifications for licensure will be notified by letter that he may enter upon the practice of medicine in this Commonwealth only after complying with section 711 of the MCARE Act (40 P. S. § 1303.711) by making prompt application for medical liability insurance.
(b) Licensees applying for biennial renewal. A licensee applying for biennial renewal will be notified with the renewal application that if he practices in this Commonwealth he is required to furnish satisfactory proof of compliance with the medical professional liability insurance and Medical Care Availability and Reduction of Error Fund provisions in sections 711 and 712 of the MCARE Act (40 P. S. §§ 1303.711 and 1303.712) as a condition of practice.
§ 16.32. Requirements of the MCARE Act.
(a) Except as provided in subsections (b) and (c), a physician or nurse-midwife shall maintain the required amount of professional liability insurance, or have an approved self-insurance plan, and pay the required Medical Care Availability and Reduction of Error (MCARE) Fund assessment as a condition of practice under sections 711 and 712 of the MCARE Act (40 P. S. §§ 1303.711 and 1303.712). Failure to comply with this section subjects the physician or nurse-midwife to disciplinary action by the Board.
(b) A physician or nurse-midwife practicing solely as a Federal employee is not required to participate in the professional liability insurance program, nor is the physician or nurse-midwife required to comply with the MCARE Act.
(c) A physician or nurse-midwife who provides no medical service in this Commonwealth is not required to pay the MCARE Fund assessment or comply with the insurance requirements of the MCARE Act. Proof of nonpractice must be furnished by notarized statement.
§ 16.33. Certification of noncompliers; noncompliance letters.
The Director of the Medical Care Availability and Reduction of Error (MCARE) Fund will furnish the Board office with a certification of the names of those licensed physicians and nurse-midwives who are not in compliance with the MCARE Act or have not demonstrated compliance. Upon receipt of the certification, the Board will forward a letter to the physician or nurse-midwife requiring the physician or nurse-midwife to either furnish sufficient evidence of compliance to the Office of the MCARE Fund or to request a hearing.
§ 16.34. Formal hearings for noncompliance.
A physician or nurse-midwife who has requested a hearing or who has failed to demonstrate compliance with the MCARE Act will be issued a citation and notice of hearing. The formal hearings will be conducted under Subchapter E (relating to medical disciplinary process and procedures).
§ 16.35. Penalty.
Failure to comply with the MCARE Act, the regulations issued thereunder and this subchapter may result in discipline of a licensee after a formal hearing.
CHAPTER 17. STATE BOARD OF MEDICINE—MEDICAL DOCTORS
Subchapter A. LICENSURE OF MEDICAL DOCTORS § 17.4. Extraterritorial license.
(a) An extraterritorial license authorizes a medical doctor who possesses a license to practice medicine and surgery without restriction or an equivalent license, in a state adjoining this Commonwealth, to practice medicine and surgery in this Commonwealth.
(b) An extraterritorial license will be issued under the following circumstances:
(1) The applicant shall satisfy the following:
(i) Possess a license to practice medicine and surgery without restriction or an equivalent license in a state adjoining this Commonwealth.
(ii) Reside in or maintain an office of practice in the adjoining state near its boundary line with this Commonwealth and desire to extend that practice into this Commonwealth.
(iii) Submit evidence with the application that the applicant is in compliance with professional liability insurance responsibilities imposed by the MCARE Act.
(iv) Arrange for the licensing authority of the adjoining state to file a certification with the Board, issued by that licensing authority, attesting to the fact that the applicant is licensed in that state.
(v) Satisfy the qualifications listed in § 16.12 (relating to general qualifications for licenses and certificates).
(2) The licensing authority of the adjoining state shall reciprocate by extending the same privileges to medical doctors licensed in this Commonwealth.
(c) An extraterritorial license is automatically revoked if the licensee relocates a residence or office of practice, the location of which was relevant to the issuance of the license.
(d) If a medical doctor who holds an extraterritorial license intends to change a residence or office of practice, the location of which was relevant to the issuance of the license, the doctor shall advise the Board, in writing, prior to doing so. If the doctor continues to qualify for an extraterritorial license after the change in residence or office of practice, the doctor may apply for a new extraterritorial license by submitting an application provided by the Board and paying the required fee.
§ 17.6. Temporary license.
* * * * * (h) Temporary licensees are considered health care providers who conduct 50% or less of their health care business or practice within this Commonwealth for purposes of the MCARE Act.
* * * * * § 17.7. Interim limited license.
(a) A person who holds a graduate license is limited to providing medical services embraced within the graduate medical training program in which the person is participating unless that person also holds an interim limited license or other license issued by the Board, other than a graduate license.
(b) An interim limited license empowers the licensee to provide medical services, other than authorized by the graduate medical training program, for a period of up to 12 consecutive months. The Board may extend the validity of an interim limited license for a period of up to 12 additional consecutive months, but no more than one extension may be granted.
(c) To qualify for an interim limited license, an applicant shall satisfy the following:
(1) Be a graduate of an accredited medical college.
(2) Hold a valid graduate license.
(3) Have successfully completed a year of graduate medical training.
(4) Have passed an examination specified in § 17.1(a)(1) (relating to license without restriction).
(5) Provide a detailed written statement of the medical services to be provided beyond the parameters of the graduate medical training program.
(6) Have the written approval of the director of the graduate medical training program to provide the enumerated services.
(7) Present evidence of having made arrangements for professional liability insurance coverage in accordance with the MCARE Act.
(8) Satisfy the qualifications listed in § 16.12 (relating to general qualifications for licenses and certificates).
(9) Be evaluated by the Board as having received ample education and training to perform the specified medical services.
[Pa.B. Doc. No. 12-1636. Filed for public inspection August 24, 2012, 9:00 a.m.]
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