SF 509

3rd Engrossment - 94th Legislature (2025 - 2026)

Posted on 11/05/2025 01:33 p.m.

A bill for an act
relating to health; amending licensing requirements for graduates of foreign medical
schools; authorizing the commissioner of health to remedy certain violations by
employers of limited license holders; requiring employers of limited license holders
to carry medical malpractice insurance; requiring limited license holders to provide
periodic certification to the medical board; modifying application and license fees;
amending Minnesota Statutes 2024, sections 144.99, subdivision 1; 147.01,
subdivision 7; 147.037, by adding a subdivision.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2024, section 144.99, subdivision 1, is amended to read:

Subdivision 1.

Remedies available.

The provisions of chapters 103I and 157 and sections
115.71 to 115.77; 144.12, subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), (14),
and (15); 144.1201 to 144.1204; 144.121; 144.1215; 144.1222; 144.35; 144.381 to 144.385;
144.411 to 144.417; 144.495; 144.71 to 144.74; 144.9501 to 144.9512; 144.97 to 144.98;
144.992; new text begin 147.037, subdivision 1b, paragraph (d); new text end 326.70 to 326.785; 327.10 to 327.131;
and 327.14 to 327.28 and all rules, orders, stipulation agreements, settlements, compliance
agreements, licenses, registrations, certificates, and permits adopted or issued by the
department or under any other law now in force or later enacted for the preservation of
public health may, in addition to provisions in other statutes, be enforced under this section.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2026.
new text end

Sec. 2.

Minnesota Statutes 2024, section 147.01, subdivision 7, is amended to read:

Subd. 7.

Physician application and license fees.

(a) The board may charge the following
nonrefundable application and license fees processed pursuant to sections 147.02, 147.03,
147.037, 147.0375, and 147.38:

(1) physician application fee, $200;

(2) physician annual registration renewal fee, $192;

(3) physician endorsement to other states, $40;

(4) physician emeritus license, $50;

(5) physician late fee, $60;

new text begin (6) nonrenewable 24-month limited license, $392;
new text end

new text begin (7) initial physician license for limited license holder, $192;
new text end

deleted text begin (6) deleted text end new text begin (8) new text end duplicate license fee, $20;

deleted text begin (7) deleted text end new text begin (9) new text end certification letter fee, $25;

deleted text begin (8) deleted text end new text begin (10) new text end education or training program approval fee, $100;

deleted text begin (9) deleted text end new text begin (11) new text end report creation and generation fee, $60 per hour;

deleted text begin (10) deleted text end new text begin (12) new text end examination administration fee (half day), $50;

deleted text begin (11) deleted text end new text begin (13) new text end examination administration fee (full day), $80;

deleted text begin (12) deleted text end new text begin (14) new text end fees developed by the Interstate Commission for determining physician
qualification to register and participate in the interstate medical licensure compact, as
established in rules authorized in and pursuant to section 147.38, not to exceed $1,000; and

deleted text begin (13) deleted text end new text begin (15) new text end verification fee, $25.

(b) The board may prorate the initial annual license fee. All licensees are required to
pay the full fee upon license renewal. The revenue generated from the fee must be deposited
in an account in the state government special revenue fund.

Sec. 3.

Minnesota Statutes 2024, section 147.037, is amended by adding a subdivision to
read:

new text begin Subd. 1b. new text end

new text begin Limited license. new text end

new text begin (a) A limited license under this section is valid for one
24-month period and is not renewable or eligible for reapplication. The board may issue a
limited license, valid for 24 months, to any person who satisfies the requirements of
subdivision 1, paragraphs (a) to (c) and (e) to (g), and who:
new text end

new text begin (1) pursuant to a license or other authorization to practice, has practiced medicine, as
defined in section 147.081, subdivision 3, clauses (2) to (4), for at least 60 months in the
previous 12 years outside of the United States;
new text end

new text begin (2) submits sufficient evidence of an offer to practice within the context of a collaborative
agreement within a hospital or clinical setting where the limited license holder and physicians
work together to provide patient care;
new text end

new text begin (3) provides services in a designated rural area or underserved urban community as
defined in section 144.1501; and
new text end

new text begin (4) submits two letters of recommendation in support of a limited license, which must
include one letter from a physician with whom the applicant previously worked and one
letter from an administrator of the hospital or clinical setting in which the applicant previously
worked. The letters of recommendation must attest to the applicant's good medical standing.
The board may accept alternative forms of proof that demonstrate good medical standing
where there are extenuating circumstances that prevent an applicant from providing letters.
new text end

new text begin (b) For purposes of this subdivision, a person has satisfied the requirements of subdivision
1, paragraph (e), if the person has passed steps or levels one and two of the USMLE or the
COMLEX-USA with passing scores as recommended by the USMLE program or National
Board of Osteopathic Medical Examiners within three attempts.
new text end

new text begin (c) A person issued a limited license under this subdivision must not be required to
present evidence satisfactory to the board of the completion of one year of graduate clinical
medical training in a program accredited by a national accrediting organization approved
by the board.
new text end

new text begin (d) An employer of a limited license holder must pay the limited license holder at least
an amount equivalent to a medical resident in a comparable field. The employer must carry
medical malpractice insurance covering a limited license holder for the duration of the
employment. The commissioner of health may issue a correction order under section 144.99,
subdivision 3, requiring an employer to comply with this paragraph. An employer must not
retaliate against or discipline an employee for raising a complaint or pursuing enforcement
relating to this paragraph.
new text end

new text begin (e) The board may issue a full and unrestricted license to practice medicine to a person
who holds a limited license issued pursuant to paragraph (a) and who has:
new text end

new text begin (1) held the limited license for two years and is in good standing to practice medicine
in this state;
new text end

new text begin (2) practiced for a minimum of 1,692 hours per year for each of the previous two years;
new text end

new text begin (3) submitted a letter of recommendation in support of a full and unrestricted license
containing all attestations required under paragraph (i) from any physician who participated
in the collaborative agreement;
new text end

new text begin (4) passed steps or levels one, two, and three of the USMLE or COMLEX-USA with
passing scores as recommended by the USMLE program or National Board of Osteopathic
Medical Examiners within three attempts; and
new text end

new text begin (5) completed 20 hours of continuing medical education.
new text end

new text begin (f) A limited license holder must submit to the board, every six months or upon request,
a statement certifying whether the person is still employed as a physician in this state and
whether the person has been subjected to professional discipline as a result of the person's
practice. The board may suspend or revoke a limited license if a majority of the board
determines that the licensee is no longer employed as a physician in this state by an employer.
The licensee must be granted an opportunity to be heard prior to the board's determination.
Upon request by the limited license holder, the limited license holder may have 90 days to
regain employment. A licensee may change employers during the duration of the limited
license if the licensee has another offer of employment. In the event that a change of
employment occurs, the licensee must still work the number of hours required under
paragraph (e), clause (2), to be eligible for a full and unrestricted license to practice medicine.
new text end

new text begin (g) In addition to any other remedy provided by law, the board may, without a hearing,
temporarily suspend the license of a limited license holder if the board finds that the limited
license holder has violated a statute or rule that the board is empowered to enforce and
continued practice by the limited license holder would create a serious risk of harm to the
public. The suspension shall take effect upon written notice to the limited license holder,
specifying the statute or rule violated. The suspension shall remain in effect until the board
issues a final order in the matter after a hearing. At the time it issues the suspension notice,
the board shall schedule a disciplinary hearing to be held pursuant to the Administrative
Procedure Act. The limited license holder shall be provided with at least 20 days' notice of
any hearing held pursuant to this subdivision. The hearing shall be scheduled to begin no
later than 30 days after the issuance of the suspension order.
new text end

new text begin (h) For purposes of this subdivision, "collaborative agreement" means a mutually agreed
upon plan for the overall working relationship and collaborative arrangement between a
holder of a limited license and one or more physicians licensed under this chapter that
designates the scope of services that can be provided to manage the care of patients. The
limited license holder and one of the collaborating physicians must have experience in
providing care to patients with the same or similar medical conditions. Under the
collaborative agreement, the limited license holder must shadow the collaborating physician
for four weeks, after which time the limited license holder must staff all patient encounters
with the collaborating physician for an additional four weeks. After that time, the
collaborating physician has discretion to allow the limited license holder to see patients
independently and will require the limited license holder to present patients at their discretion.
However, the limited license holder must be supervised by the collaborating physician for
a minimum of two hours per week. A limited license holder may practice medicine without
a collaborating physician physically present, but the limited license holder and collaborating
physicians must be able to easily contact each other by radio, telephone, or other
telecommunication device while the limited license holder practices medicine. The limited
license holder must have one-on-one practice reviews with each collaborating physician,
provided in person or through eye-to-eye electronic media while maintaining visual contact,
for at least two hours per week.
new text end

new text begin (i) At least one collaborating physician must submit a letter to the board, after the limited
license holder has practiced under the license for 12 months, attesting to the following:
new text end

new text begin (1) that the limited license holder has a basic understanding of federal and state laws
regarding the provision of health care, including but not limited to:
new text end

new text begin (i) medical licensing obligations and standards; and
new text end

new text begin (ii) the Health Insurance Portability and Accountability Act, Public Law 104-191;
new text end

new text begin (2) that the limited license holder has a basic understanding of documentation standards;
new text end

new text begin (3) that the limited license holder has a thorough understanding of which medications
are available and unavailable in the United States;
new text end

new text begin (4) that the limited license holder has a thorough understanding of American medical
standards of care;
new text end

new text begin (5) that the limited license holder has demonstrated mastery of each of the following:
new text end

new text begin (i) gathering a history and performing a physical exam;
new text end

new text begin (ii) developing and prioritizing a differential diagnosis following a clinical encounter
and selecting a working diagnosis;
new text end

new text begin (iii) recommending and interpreting common diagnostic and screening tests;
new text end

new text begin (iv) entering and discussing orders and prescriptions;
new text end

new text begin (v) providing an oral presentation of a clinical encounter;
new text end

new text begin (vi) giving a patient handover to transition care responsibly;
new text end

new text begin (vii) recognizing a patient requiring urgent care and initiating an evaluation; and
new text end

new text begin (viii) obtaining informed consent for tests, procedures, and treatments; and
new text end

new text begin (6) that the limited license holder is providing appropriate medical care.
new text end

new text begin (j) The board must not grant a license under this section unless the applicant possesses
federal immigration status that allows the applicant to practice as a physician in the United
States.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2026.
new text end