3rd Engrossment - 81st Legislature (1999 - 2000) Posted on 12/15/2009 12:00am
Engrossments | ||
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Introduction | Posted on 02/08/1999 | |
1st Engrossment | Posted on 03/18/1999 | |
2nd Engrossment | Posted on 03/01/2000 | |
3rd Engrossment | Posted on 03/02/2000 |
1.1 A bill for an act 1.2 relating to health; regulating complementary and 1.3 alternative health care practitioners; establishing 1.4 civil penalties; amending Minnesota Statutes 1999 1.5 Supplement, sections 13.99, by adding a subdivision; 1.6 147.09; and 214.01, subdivision 2; proposing coding 1.7 for new law as Minnesota Statutes, chapter 146A. 1.8 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 1.9 COMPLEMENTARY AND ALTERNATIVE HEALTH CARE 1.10 FREEDOM OF ACCESS ACT 1.11 Section 1. Minnesota Statutes 1999 Supplement, section 1.12 13.99, is amended by adding a subdivision to read: 1.13 Subd. 42c. [UNLICENSED COMPLEMENTARY AND ALTERNATIVE 1.14 HEALTH CARE PRACTITIONERS AND CLIENTS.] Data obtained by the 1.15 commissioner of health on unlicensed complementary and 1.16 alternative health care practitioners and clients are classified 1.17 under sections 146A.06 and 146A.08. 1.18 Sec. 2. [146A.01] [DEFINITIONS.] 1.19 Subdivision 1. [TERMS.] As used in this chapter, the 1.20 following terms have the meanings given them. 1.21 Subd. 2. [COMMISSIONER.] "Commissioner" means the 1.22 commissioner of health or the commissioner's designee. 1.23 Subd. 3. [COMPLEMENTARY AND ALTERNATIVE HEALTH CARE 1.24 CLIENT.] "Complementary and alternative health care client" 1.25 means an individual who receives services from an unlicensed 1.26 complementary and alternative health care practitioner. 2.1 Subd. 4. [COMPLEMENTARY AND ALTERNATIVE HEALTH CARE 2.2 PRACTICES.] (a) "Complementary and alternative health care 2.3 practices" means the broad domain of complementary and 2.4 alternative healing methods and treatments, including but not 2.5 limited to: (1) acupressure; (2) anthroposophy; (3) aroma 2.6 therapy; (4) ayurveda; (5) cranial sacral therapy; (6) 2.7 culturally traditional healing practices; (7) detoxification 2.8 practices and therapies; (8) energetic healing; (9) polarity 2.9 therapy; (10) folk practices; (11) healing practices utilizing 2.10 food, food supplements, nutrients, and the physical forces of 2.11 heat, cold, water, touch, and light; (12) Gerson therapy and 2.12 colostrum therapy; (13) healing touch; (14) herbology or 2.13 herbalism; (15) homeopathy; (16) iridology; (17) body work, 2.14 massage, and massage therapy; (18) meditation; (19) mind-body 2.15 healing practices; (20) naturopathy; (21) noninvasive 2.16 instrumentalities; and (22) traditional Oriental practices, such 2.17 as Qi Gong energy healing. 2.18 (b) Complementary and alternative health care practices, in 2.19 and of themselves, do not include surgery, x-ray radiation, 2.20 administering or dispensing legend drugs and controlled 2.21 substances, practices that invade the human body by puncture of 2.22 the skin, setting fractures, the use of medical devices as 2.23 defined in section 147A.01, any practice included in the 2.24 practice of dentistry as defined in section 150A.05, subdivision 2.25 1, or the manipulation or adjustment of articulations of joints 2.26 or the spine as described in section 146.23 or 148.01. 2.27 (c) Complementary and alternative health care practices do 2.28 not include practices that are permitted under section 147.09, 2.29 clause (11), or 148.271, clause (5). 2.30 Subd. 5. [OFFICE OF UNLICENSED COMPLEMENTARY AND 2.31 ALTERNATIVE HEALTH CARE PRACTICE OR OFFICE.] "Office of 2.32 unlicensed complementary and alternative health care practice" 2.33 or "office" means the office of unlicensed complementary and 2.34 alternative health care practice established in section 146A.02. 2.35 Subd. 6. [PATIENT-IDENTIFYING DATA.] "Patient-identifying 2.36 data" means data that identifies a patient directly or that 3.1 identifies characteristics which reasonably could uniquely 3.2 identify a specific patient circumstantially. 3.3 Subd. 7. [ROSTER DATA.] "Roster data" means, with regard 3.4 to an enrollee of a health plan company or group purchaser, an 3.5 enrollee's name, address, telephone number, date of birth, 3.6 gender, and enrollment status under a group purchaser's health 3.7 plan. Roster data means, with regard to a patient of a 3.8 provider, the patient's name, address, telephone number, date of 3.9 birth, gender, and date or dates treated, including, if 3.10 applicable, the date of admission and the date of discharge. 3.11 Subd. 8. [UNLICENSED COMPLEMENTARY AND ALTERNATIVE HEALTH 3.12 CARE PRACTITIONER.] "Unlicensed complementary and alternative 3.13 health care practitioner" means a person who: 3.14 (1) is not licensed or registered by a health-related 3.15 licensing board or the commissioner of health, or does not hold 3.16 oneself out to the public as licensed or registered by a 3.17 health-related licensing board or the commissioner of health 3.18 when engaging in complementary and alternative health care 3.19 practices; 3.20 (2) has not had a license or registration issued by a 3.21 health-related licensing board or the commissioner of health 3.22 revoked or has not been disciplined in any manner at any time in 3.23 the past, unless the right to engage in complementary and 3.24 alternative health care practices has been established by order 3.25 of the commissioner of health; 3.26 (3) is engaging in complementary and alternative health 3.27 care practices; and 3.28 (4) is providing complementary and alternative health care 3.29 services for remuneration or is holding oneself out to the 3.30 public as a practitioner of complementary and alternative health 3.31 care practices. 3.32 Sec. 3. [146A.02] [OFFICE OF UNLICENSED COMPLEMENTARY AND 3.33 ALTERNATIVE HEALTH CARE PRACTICE.] 3.34 Subdivision 1. [CREATION.] The office of unlicensed 3.35 complementary and alternative health care practice is created in 3.36 the department of health to investigate complaints and take and 4.1 enforce disciplinary actions against all unlicensed 4.2 complementary and alternative health care practitioners for 4.3 violations of prohibited conduct, as defined in section 4.4 146A.08. The office shall also serve as a clearinghouse on 4.5 complementary and alternative health care practices and 4.6 unlicensed complementary and alternative health care 4.7 practitioners through the dissemination of objective information 4.8 to consumers and through the development and performance of 4.9 public education activities, including outreach, regarding the 4.10 provision of complementary and alternative health care practices 4.11 and unlicensed complementary and alternative health care 4.12 practitioners who provide these services. 4.13 Subd. 2. [RULEMAKING.] The commissioner shall adopt rules 4.14 necessary to implement, administer, or enforce provisions of 4.15 this chapter pursuant to chapter 14. The commissioner may not 4.16 adopt rules that restrict or prohibit persons from engaging in 4.17 complementary and alternative health care practices on the basis 4.18 of education, training, experience, or supervision. 4.19 Sec. 4. [146A.025] [MALTREATMENT OF MINORS.] 4.20 Nothing in this chapter shall restrict the ability of a 4.21 local welfare agency, local law enforcement agency, the 4.22 commissioner of human services, or the state to take action 4.23 regarding the maltreatment of minors under section 609.378 or 4.24 626.556. A parent who obtains complementary and alternative 4.25 health care for the parent's minor child is not relieved of the 4.26 duty to seek necessary medical care. A complementary or 4.27 alternative health care practitioner who is providing services 4.28 to a child who is not receiving necessary medical care must make 4.29 a report under section 626.556. A complementary or alternative 4.30 health care provider is a mandated reporter under section 4.31 626.556, subdivision 3. 4.32 Sec. 5. [146A.03] [REPORTING OBLIGATIONS.] 4.33 Subdivision 1. [PERMISSION TO REPORT.] A person who has 4.34 knowledge of any conduct constituting grounds for disciplinary 4.35 action relating to complementary and alternative health care 4.36 practices under this chapter may report the violation to the 5.1 office. 5.2 Subd. 2. [INSTITUTIONS.] A state agency, political 5.3 subdivision, agency of a local unit of government, private 5.4 agency, hospital, clinic, prepaid medical plan, or other health 5.5 care institution or organization located in this state shall 5.6 report to the office any action taken by the agency, 5.7 institution, or organization or any of its administrators or 5.8 medical or other committees to revoke, suspend, restrict, or 5.9 condition an unlicensed complementary and alternative health 5.10 care practitioner's privilege to practice or treat complementary 5.11 and alternative health care clients in the institution or, as 5.12 part of the organization, any denial of privileges or any other 5.13 disciplinary action for conduct that might constitute grounds 5.14 for disciplinary action by the office under this chapter. The 5.15 institution, organization, or governmental entity shall also 5.16 report the resignation of any unlicensed complementary and 5.17 alternative health care practitioners prior to the conclusion of 5.18 any disciplinary action proceeding for conduct that might 5.19 constitute grounds for disciplinary action under this chapter or 5.20 prior to the commencement of formal charges but after the 5.21 practitioner had knowledge that formal charges were contemplated 5.22 or were being prepared. 5.23 Subd. 3. [PROFESSIONAL SOCIETIES.] A state or local 5.24 professional society for unlicensed complementary and 5.25 alternative health care practitioners shall report to the office 5.26 any termination, revocation, or suspension of membership or any 5.27 other disciplinary action taken against an unlicensed 5.28 complementary and alternative health care practitioner. If the 5.29 society has received a complaint that might be grounds for 5.30 discipline under this chapter against a member on which it has 5.31 not taken any disciplinary action, the society shall report the 5.32 complaint and the reason why it has not taken action on it or 5.33 shall direct the complainant to the office. 5.34 Subd. 4. [LICENSED PROFESSIONALS.] A licensed health 5.35 professional shall report to the office personal knowledge of 5.36 any conduct that the licensed health professional reasonably 6.1 believes constitutes grounds for disciplinary action under this 6.2 chapter by any unlicensed complementary and alternative health 6.3 care practitioner, including conduct indicating that the 6.4 individual may be medically incompetent or may be medically or 6.5 physically unable to engage safely in the provision of 6.6 services. If the information was obtained in the course of a 6.7 client relationship, the client is an unlicensed complementary 6.8 and alternative health care practitioner, and the treating 6.9 individual successfully counsels the other practitioner to limit 6.10 or withdraw from practice to the extent required by the 6.11 impairment, the office may deem this limitation of or withdrawal 6.12 from practice to be sufficient disciplinary action. 6.13 Subd. 5. [INSURERS.] Four times each year as prescribed by 6.14 the commissioner, each insurer authorized to sell insurance 6.15 described in section 60A.06, subdivision 1, clause (13), and 6.16 providing professional liability insurance to unlicensed 6.17 complementary and alternative health care practitioners or the 6.18 medical joint underwriting association under chapter 62F shall 6.19 submit to the office a report concerning the unlicensed 6.20 complementary and alternative health care practitioners against 6.21 whom malpractice settlements or awards have been made. The 6.22 response must contain at least the following information: 6.23 (1) the total number of malpractice settlements or awards 6.24 made; 6.25 (2) the date the malpractice settlements or awards were 6.26 made; 6.27 (3) the allegations contained in the claim or complaint 6.28 leading to the settlements or awards made; 6.29 (4) the dollar amount of each malpractice settlement or 6.30 award; 6.31 (5) the regular address of the practice of the unlicensed 6.32 complementary and alternative health care practitioner against 6.33 whom an award was made or with whom a settlement was made; and 6.34 (6) the name of the unlicensed complementary and 6.35 alternative health care practitioner against whom an award was 6.36 made or with whom a settlement was made. 7.1 The insurance company shall, in addition to the above 7.2 information, submit to the office any information, records, and 7.3 files, including clients' charts and records, it possesses that 7.4 tend to substantiate a charge that an unlicensed complementary 7.5 and alternative health care practitioner may have engaged in 7.6 conduct violating this chapter. 7.7 Subd. 6. [COURTS.] The court administrator of district 7.8 court or any other court of competent jurisdiction shall report 7.9 to the office any judgment or other determination of the court 7.10 that adjudges or includes a finding that an unlicensed 7.11 complementary and alternative health care practitioner is 7.12 mentally ill, mentally incompetent, guilty of a felony, guilty 7.13 of a violation of federal or state narcotics laws or controlled 7.14 substances act, or guilty of abuse or fraud under Medicare or 7.15 Medicaid; or that appoints a guardian of the unlicensed 7.16 complementary and alternative health care practitioner under 7.17 sections 525.54 to 525.61 or commits an unlicensed complementary 7.18 and alternative health care practitioner under chapter 253B. 7.19 Subd. 7. [SELF-REPORTING.] An unlicensed complementary and 7.20 alternative health care practitioner shall report to the office 7.21 any personal action that would require that a report be filed 7.22 with the office by any person, health care facility, business, 7.23 or organization pursuant to subdivisions 2 to 5. The 7.24 practitioner shall also report the revocation, suspension, 7.25 restriction, limitation, or other disciplinary action against 7.26 the practitioner's license, certificate, registration, or right 7.27 of practice in another state or jurisdiction for offenses that 7.28 would be subject to disciplinary action in this state and also 7.29 report the filing of charges regarding the practitioner's 7.30 license, certificate, registration, or right of practice in 7.31 another state or jurisdiction. 7.32 Subd. 8. [DEADLINES; FORMS.] Reports required by 7.33 subdivisions 2 to 7 must be submitted not later than 30 days 7.34 after the reporter learns of the occurrence of the reportable 7.35 event or transaction. The office may provide forms for the 7.36 submission of reports required by this section, may require that 8.1 reports be submitted on the forms provided, and may adopt rules 8.2 necessary to ensure prompt and accurate reporting. 8.3 Sec. 6. [146A.04] [IMMUNITY.] 8.4 Subdivision 1. [REPORTING.] Any person other than an 8.5 unlicensed complementary and alternative health care 8.6 practitioner on whom violations or alleged violations of this 8.7 chapter are reported, health care facility, business, or 8.8 organization is immune from civil liability or criminal 8.9 prosecution for submitting a report to the office, for otherwise 8.10 reporting to the office violations or alleged violations of this 8.11 chapter, or for cooperating with an investigation of a report, 8.12 except as provided in this subdivision. Any person who 8.13 knowingly or recklessly makes a false report is liable in a 8.14 civil suit for any damages suffered by the person or persons so 8.15 reported and for any punitive damages set by the court or jury. 8.16 An action requires clear and convincing evidence that the 8.17 defendant made the statement with knowledge of falsity or with 8.18 reckless disregard for its truth or falsity. The report or 8.19 statement or any statement made in cooperation with an 8.20 investigation or as part of a disciplinary proceeding is 8.21 privileged except in an action brought under this subdivision. 8.22 Subd. 2. [INVESTIGATION.] The commissioner and employees 8.23 of the department of health and other persons engaged in the 8.24 investigation of violations and in the preparation, 8.25 presentation, and management of and testimony pertaining to 8.26 charges of violations of this chapter are absolutely immune from 8.27 civil liability and criminal prosecution for any actions, 8.28 transactions, or publications in the execution of, or relating 8.29 to, their duties under this chapter. 8.30 Sec. 7. [146A.05] [DISCIPLINARY RECORD ON JUDICIAL 8.31 REVIEW.] 8.32 Upon judicial review of any disciplinary action taken by 8.33 the commissioner under this chapter, the reviewing court shall 8.34 seal the administrative record, except for the commissioner's 8.35 final decision, and shall not make the administrative record 8.36 available to the public. 9.1 Sec. 8. [146A.06] [PROFESSIONAL COOPERATION; UNLICENSED 9.2 PRACTITIONER.] 9.3 Subdivision 1. [COOPERATION.] An unlicensed complementary 9.4 and alternative health care practitioner who is the subject of 9.5 an investigation, or who is questioned in connection with an 9.6 investigation, by or on behalf of the office shall cooperate 9.7 fully with the investigation. Cooperation includes responding 9.8 fully and promptly to any question raised by or on behalf of the 9.9 office relating to the subject of the investigation, whether 9.10 tape recorded or not; providing copies of client records, as 9.11 reasonably requested by the office, to assist the office in its 9.12 investigation; and appearing at conferences or hearings 9.13 scheduled by the commissioner. If the office does not have a 9.14 written consent from a client permitting access to the client's 9.15 records, the unlicensed complementary and alternative health 9.16 care practitioner shall delete any patient-identifying data and 9.17 roster data in the record before providing it to the office. 9.18 The office shall maintain any records obtained pursuant to this 9.19 section as investigative data pursuant to section 13.41. If an 9.20 unlicensed complementary and alternative health care 9.21 practitioner refuses to give testimony or produce any documents, 9.22 books, records, or correspondence on the basis of the fifth 9.23 amendment to the Constitution of the United States, the 9.24 commissioner may compel the unlicensed complementary and 9.25 alternative health care practitioner to provide the testimony or 9.26 information; however, the testimony or evidence may not be used 9.27 against the practitioner in any criminal proceeding. Challenges 9.28 to requests of the office may be brought before the appropriate 9.29 agency or court. 9.30 Subd. 2. [CLASSIFICATION OF DATA.] The commissioner shall 9.31 maintain any records, other than client records, obtained as 9.32 part of an investigation as investigative data under section 9.33 13.41. Client records are classified as private under chapter 9.34 13 and must be protected as such in the records of the office 9.35 and in any administrative or judicial proceeding unless the 9.36 unlicensed complementary and alternative health care client 10.1 authorizes the office in writing to make public the identity of 10.2 the client or a portion or all of the client's records. 10.3 Subd. 3. [EXCHANGING INFORMATION.] (a) The office shall 10.4 establish internal operating procedures for: 10.5 (1) exchanging information with state boards; agencies, 10.6 including the office of ombudsman for mental health and mental 10.7 retardation; health-related and law enforcement facilities; 10.8 departments responsible for licensing health-related 10.9 occupations, facilities, and programs; and law enforcement 10.10 personnel in this and other states; and 10.11 (2) coordinating investigations involving matters within 10.12 the jurisdiction of more than one regulatory agency. 10.13 (b) The procedures for exchanging information must provide 10.14 for the forwarding to the entities described in paragraph (a), 10.15 clause (1), of information and evidence, including the results 10.16 of investigations, that are relevant to matters within the 10.17 regulatory jurisdiction of the organizations in paragraph (a). 10.18 The data have the same classification in the hands of the agency 10.19 receiving the data as they have in the hands of the agency 10.20 providing the data. 10.21 (c) The office shall establish procedures for exchanging 10.22 information with other states regarding disciplinary action 10.23 against unlicensed complementary and alternative health care 10.24 practitioners. 10.25 (d) The office shall forward to another governmental agency 10.26 any complaints received by the office that do not relate to the 10.27 office's jurisdiction but that relate to matters within the 10.28 jurisdiction of the other governmental agency. The agency to 10.29 which a complaint is forwarded shall advise the office of the 10.30 disposition of the complaint. A complaint or other information 10.31 received by another governmental agency relating to a statute or 10.32 rule that the office is empowered to enforce must be forwarded 10.33 to the office to be processed in accordance with this section. 10.34 (e) The office shall furnish to a person who made a 10.35 complaint a description of the actions of the office relating to 10.36 the complaint. 11.1 Sec. 9. [146A.07] [PROFESSIONAL ACCOUNTABILITY.] 11.2 The office shall maintain and keep current a file 11.3 containing the reports and complaints filed against unlicensed 11.4 complementary and alternative health care practitioners within 11.5 the commissioner's jurisdiction. Each complaint filed with the 11.6 office must be investigated. If the files maintained by the 11.7 office show that a malpractice settlement or award has been made 11.8 against an unlicensed complementary and alternative health care 11.9 practitioner, as reported by insurers under section 146A.03, 11.10 subdivision 5, the commissioner may authorize a review of the 11.11 practitioner's practice by the staff of the office. 11.12 Sec. 10. [146A.08] [PROHIBITED CONDUCT.] 11.13 Subdivision 1. [PROHIBITED CONDUCT.] The commissioner may 11.14 impose disciplinary action as described in section 146A.09 11.15 against any unlicensed complementary and alternative health care 11.16 practitioner. The following conduct is prohibited and is 11.17 grounds for disciplinary action: 11.18 (1) Conviction of a crime, including a finding or verdict 11.19 of guilt, an admission of guilt, or a no-contest plea, in any 11.20 court in Minnesota or any other jurisdiction in the United 11.21 States, reasonably related to engaging in complementary and 11.22 alternative health care practices. Conviction, as used in this 11.23 subdivision, includes a conviction of an offense which, if 11.24 committed in this state, would be deemed a felony, gross 11.25 misdemeanor, or misdemeanor, without regard to its designation 11.26 elsewhere, or a criminal proceeding where a finding or verdict 11.27 of guilty is made or returned but the adjudication of guilt is 11.28 either withheld or not entered. 11.29 (2) Conviction of any crime against a person. For purposes 11.30 of this chapter, a crime against a person means violations of 11.31 the following: sections 609.185; 609.19; 609.195; 609.20; 11.32 609.205; 609.21; 609.215; 609.221; 609.222; 609.223; 609.224; 11.33 609.2242; 609.23; 609.231; 609.2325; 609.233; 609.2335; 609.235; 11.34 609.24; 609.245; 609.25; 609.255; 609.26, subdivision 1, clause 11.35 (1) or (2); 609.265; 609.342; 609.343; 609.344; 609.345; 11.36 609.365; 609.498, subdivision 1; 609.50, subdivision 1, clause 12.1 (1); 609.561; 609.562; 609.595; and 609.72, subdivision 3. 12.2 (3) Failure to comply with the self-reporting requirements 12.3 of section 146A.03, subdivision 7. 12.4 (4) Engaging in sexual contact with a complementary and 12.5 alternative health care client or former client, engaging in 12.6 contact that may be reasonably interpreted by a client as 12.7 sexual, engaging in any verbal behavior that is seductive or 12.8 sexually demeaning to the patient, or engaging in sexual 12.9 exploitation of a client or former client. For purposes of this 12.10 clause, "former client" means a person who has obtained services 12.11 from the unlicensed complementary and alternative health care 12.12 practitioner within the past two years. 12.13 (5) Advertising that is false, fraudulent, deceptive, or 12.14 misleading. 12.15 (6) Conduct likely to deceive, defraud, or harm the public 12.16 or demonstrating a willful or careless disregard for the health, 12.17 welfare, or safety of a complementary and alternative health 12.18 care client; or any other practice that may create unnecessary 12.19 danger to any client's life, health, or safety, in any of which 12.20 cases, harm or the potential for harm must be recognizable and 12.21 not remote and proof of actual injury need not be established. 12.22 (7) Adjudication as mentally incompetent or as a person who 12.23 is dangerous to self or adjudication pursuant to chapter 253B as 12.24 chemically dependent, mentally ill, mentally retarded, mentally 12.25 ill and dangerous to the public, or as a sexual psychopathic 12.26 personality or sexually dangerous person. 12.27 (8) Inability to engage in complementary and alternative 12.28 health care practices with reasonable safety to complementary 12.29 and alternative health care clients based on but not limited to 12.30 illness; drunkenness; or use of drugs, narcotics, chemicals, or 12.31 any other type of material or as a result of any mental or 12.32 physical condition including deterioration through the aging 12.33 process or loss of motor skills. 12.34 (9) The habitual overindulgence in the use of or the 12.35 dependence on intoxicating liquors. 12.36 (10) Improper or unauthorized personal or other use of any 13.1 legend drugs as defined in chapter 151, any chemicals as defined 13.2 in chapter 151, or any controlled substance as defined in 13.3 chapter 152. 13.4 (11) Revealing a communication from, or relating to, a 13.5 complementary and alternative health care client except when 13.6 otherwise required or permitted by law. 13.7 (12) Failure to comply with a complementary and alternative 13.8 health care client's request made under section 144.335 or to 13.9 furnish a complementary and alternative health care client 13.10 record or report required by law. 13.11 (13) Splitting fees or promising to pay a portion of a fee 13.12 to any other professional other than for services rendered by 13.13 the other professional to the complementary and alternative 13.14 health care client. 13.15 (14) Engaging in abusive or fraudulent billing practices, 13.16 including violations of the federal Medicare and Medicaid laws 13.17 or state medical assistance laws. 13.18 (15) Failure to make reports as required by section 146A.03 13.19 or cooperate with an investigation of the office. 13.20 (16) Obtaining money, property, or services from a 13.21 complementary and alternative health care client, other than 13.22 reasonable fees for services provided to the client, through the 13.23 use of undue influence, harassment, duress, deception, or fraud. 13.24 (17) Undertaking or continuing a professional relationship 13.25 with a complementary and alternative health care client in which 13.26 the objectivity of the unlicensed complementary and alternative 13.27 health care practitioner would be impaired. 13.28 (18) Failure to provide a complementary and alternative 13.29 health care client with a copy of the client bill of rights or 13.30 violation of any provision of the client bill of rights. 13.31 (19) Violating any order issued by the commissioner. 13.32 (20) Failure to comply with any provision of sections 13.33 146A.01 to 146A.11 and the rules adopted under those sections. 13.34 (21) Failure to comply with any additional disciplinary 13.35 grounds established by the commissioner by rule. 13.36 (22) Revocation, suspension, restriction, limitation, or 14.1 other disciplinary action against any health care license, 14.2 certificate, registration, or right to practice of the 14.3 unlicensed complementary and alternative health care 14.4 practitioner in this or another state or jurisdiction for 14.5 offenses that would be subject to disciplinary action in this 14.6 state or failure to report to the office that charges regarding 14.7 the practitioner's license, certificate, registration, or right 14.8 of practice have been brought in this or another state or 14.9 jurisdiction unless right to practice is established by the 14.10 commissioner order. 14.11 (23) Use of the title "doctor," "Dr.," or "physician" alone 14.12 or in combination with any other words, letters, or insignia to 14.13 describe the complementary and alternative health care practices 14.14 the practitioner provides. 14.15 (24) Failure to provide a complementary and alternative 14.16 health care client with a recommendation that the client see a 14.17 health care provider who is licensed or registered by a 14.18 health-related licensing board or the commissioner of health, if 14.19 there is a reasonable likelihood that, based on the health 14.20 condition of the client, the client needs to be seen by a 14.21 licensed or registered health care provider. 14.22 Subd. 2. [LESS CUSTOMARY APPROACH.] The fact that a 14.23 complementary and alternative health care practice may be a less 14.24 customary approach to health care shall not constitute the basis 14.25 of a disciplinary action per se. 14.26 Subd. 3. [EVIDENCE.] In disciplinary actions alleging a 14.27 violation of subdivision 1, clause (1), (2), (3), or (7), a copy 14.28 of the judgment or proceeding under the seal of the court 14.29 administrator or of the administrative agency that entered the 14.30 same is admissible into evidence without further authentication 14.31 and constitutes prima facie evidence of its contents. 14.32 Subd. 4. [EXAMINATION; ACCESS TO MEDICAL DATA.] (a) If the 14.33 commissioner has probable cause to believe that an unlicensed 14.34 complementary and alternative health care practitioner has 14.35 engaged in conduct prohibited by subdivision 1, clause (7), (8), 14.36 (9), or (10), the commissioner may issue an order directing the 15.1 practitioner to submit to a mental or physical examination or 15.2 chemical dependency evaluation. For the purpose of this 15.3 subdivision, every unlicensed complementary and alternative 15.4 health care practitioner is deemed to have consented to submit 15.5 to a mental or physical examination or chemical dependency 15.6 evaluation when ordered to do so in writing by the commissioner 15.7 and further to have waived all objections to the admissibility 15.8 of the testimony or examination reports of the health care 15.9 provider performing the examination or evaluation on the grounds 15.10 that the same constitute a privileged communication. Failure of 15.11 an unlicensed complementary and alternative health care 15.12 practitioner to submit to an examination or evaluation when 15.13 ordered, unless the failure was due to circumstances beyond the 15.14 practitioner's control, constitutes an admission that the 15.15 unlicensed complementary and alternative health care 15.16 practitioner violated subdivision 1, clause (7), (8), (9), or 15.17 (10), based on the factual specifications in the examination or 15.18 evaluation order and may result in a default and final 15.19 disciplinary order being entered after a contested case 15.20 hearing. An unlicensed complementary and alternative health 15.21 care practitioner affected under this paragraph shall at 15.22 reasonable intervals be given an opportunity to demonstrate that 15.23 the practitioner can resume the provision of complementary and 15.24 alternative health care practices with reasonable safety to 15.25 clients. In any proceeding under this paragraph, neither the 15.26 record of proceedings nor the orders entered by the commissioner 15.27 shall be used against an unlicensed complementary and 15.28 alternative health care practitioner in any other proceeding. 15.29 (b) In addition to ordering a physical or mental 15.30 examination or chemical dependency evaluation, the commissioner 15.31 may, notwithstanding section 13.42, 144.651, 595.02, or any 15.32 other law limiting access to medical or other health data, 15.33 obtain medical data and health records relating to an unlicensed 15.34 complementary and alternative health care practitioner without 15.35 the practitioner's consent if the commissioner has probable 15.36 cause to believe that a practitioner has engaged in conduct 16.1 prohibited by subdivision 1, clause (7), (8), (9), or (10). The 16.2 medical data may be requested from a provider as defined in 16.3 section 144.335, subdivision 1, paragraph (b), an insurance 16.4 company, or a government agency, including the department of 16.5 human services. A provider, insurance company, or government 16.6 agency shall comply with any written request of the commissioner 16.7 under this subdivision and is not liable in any action for 16.8 damages for releasing the data requested by the commissioner if 16.9 the data are released pursuant to a written request under this 16.10 subdivision, unless the information is false and the person or 16.11 organization giving the information knew or had reason to 16.12 believe the information was false. Information obtained under 16.13 this subdivision is private data under section 13.41. 16.14 Sec. 11. [146A.09] [DISCIPLINARY ACTIONS.] 16.15 Subdivision 1. [FORMS OF DISCIPLINARY ACTION.] When the 16.16 commissioner finds that an unlicensed complementary and 16.17 alternative health care practitioner has violated any provision 16.18 of this chapter, the commissioner may take one or more of the 16.19 following actions, only against the individual practitioner: 16.20 (1) revoke the right to practice; 16.21 (2) suspend the right to practice; 16.22 (3) impose limitations or conditions on the practitioner's 16.23 provision of complementary and alternative health care 16.24 practices, impose rehabilitation requirements, or require 16.25 practice under supervision; 16.26 (4) impose a civil penalty not exceeding $10,000 for each 16.27 separate violation, the amount of the civil penalty to be fixed 16.28 so as to deprive the practitioner of any economic advantage 16.29 gained by reason of the violation charged or to reimburse the 16.30 office for all costs of the investigation and proceeding; 16.31 (5) censure or reprimand the practitioner; 16.32 (6) impose a fee on the practitioner to reimburse the 16.33 office for all or part of the cost of the proceedings resulting 16.34 in disciplinary action including, but not limited to, the amount 16.35 paid by the office for services from the office of 16.36 administrative hearings, attorney fees, court reports, 17.1 witnesses, reproduction of records, staff time, and expense 17.2 incurred by the staff of the office of unlicensed complementary 17.3 and alternative health care practice; or 17.4 (7) any other action justified by the case. 17.5 Subd. 2. [DISCOVERY; SUBPOENAS.] In all matters relating 17.6 to the lawful activities of the office, the commissioner may 17.7 issue subpoenas and compel the attendance of witnesses and the 17.8 production of all necessary papers, books, records, documents, 17.9 and other evidentiary material. Any person failing or refusing 17.10 to appear or testify regarding any matter about which the person 17.11 may be lawfully questioned or failing to produce any papers, 17.12 books, records, documents, or other evidentiary materials in the 17.13 matter to be heard, after having been required by order of the 17.14 commissioner or by a subpoena of the commissioner to do so may, 17.15 upon application to the district court in any district, be 17.16 ordered to comply with the order or subpoena. The commissioner 17.17 may administer oaths to witnesses or take their affirmation. 17.18 Depositions may be taken within or without the state in the 17.19 manner provided by law for the taking of depositions in civil 17.20 actions. A subpoena or other process may be served upon a 17.21 person it names anywhere within the state by any officer 17.22 authorized to serve subpoenas or other process in civil actions 17.23 in the same manner as prescribed by law for service of process 17.24 issued out of the district court of this state. 17.25 Subd. 2a. [HEARINGS.] If the commissioner proposes to take 17.26 action against the practitioner as described in subdivision 1, 17.27 the commissioner must first notify the practitioner against whom 17.28 the action is proposed to be taken and provide the practitioner 17.29 with an opportunity to request a hearing under the contested 17.30 case provisions of chapter 14. If the practitioner does not 17.31 request a hearing by notifying the commissioner within 30 days 17.32 after service of the notice of the proposed action, the 17.33 commissioner may proceed with the action without a hearing. 17.34 Subd. 3. [REINSTATEMENT.] The commissioner may at the 17.35 commissioner's discretion reinstate the right to practice and 17.36 may impose any disciplinary measure listed under subdivision 1. 18.1 Subd. 4. [TEMPORARY SUSPENSION.] In addition to any other 18.2 remedy provided by law, the commissioner may, acting through a 18.3 person to whom the commissioner has delegated this authority and 18.4 without a hearing, temporarily suspend the right of an 18.5 unlicensed complementary and alternative health care 18.6 practitioner to practice if the commissioner's delegate finds 18.7 that the practitioner has violated a statute or rule that the 18.8 commissioner is empowered to enforce and continued practice by 18.9 the practitioner would create a serious risk of harm to others. 18.10 The suspension is in effect upon service of a written order on 18.11 the practitioner specifying the statute or rule violated. The 18.12 order remains in effect until the commissioner issues a final 18.13 order in the matter after a hearing or upon agreement between 18.14 the commissioner and the practitioner. Service of the order is 18.15 effective if the order is served on the practitioner or counsel 18.16 of record personally or by first class mail. Within ten days of 18.17 service of the order, the commissioner shall hold a hearing on 18.18 the sole issue of whether there is a reasonable basis to 18.19 continue, modify, or lift the suspension. Evidence presented by 18.20 the office or practitioner shall be in affidavit form only. The 18.21 practitioner or the counsel of record may appear for oral 18.22 argument. Within five working days after the hearing, the 18.23 commissioner shall issue the commissioner's order and, if the 18.24 suspension is continued, schedule a contested case hearing 18.25 within 45 days after issuance of the order. The administrative 18.26 law judge shall issue a report within 30 days after closing of 18.27 the contested case hearing record. The commissioner shall issue 18.28 a final order within 30 days after receipt of that report. 18.29 Subd. 5. [AUTOMATIC SUSPENSION.] The right of an 18.30 unlicensed complementary and alternative health care 18.31 practitioner to practice is automatically suspended if (1) a 18.32 guardian of an unlicensed complementary and alternative health 18.33 care practitioner is appointed by order of a court under 18.34 sections 525.54 to 525.61, or (2) the practitioner is committed 18.35 by order of a court pursuant to chapter 253B. The right to 18.36 practice remains suspended until the practitioner is restored to 19.1 capacity by a court and, upon petition by the practitioner, the 19.2 suspension is terminated by the commissioner after a hearing or 19.3 upon agreement between the commissioner and the practitioner. 19.4 Sec. 12. [146A.10] [ADDITIONAL REMEDIES.] 19.5 Subdivision 1. [CEASE AND DESIST.] (a) The commissioner 19.6 may issue a cease and desist order to stop a person from 19.7 violating or threatening to violate a statute, rule, or order 19.8 which the office has issued or is empowered to enforce. The 19.9 cease and desist order must state the reason for its issuance 19.10 and give notice of the person's right to request a hearing under 19.11 sections 14.57 to 14.62. If, within 15 days of service of the 19.12 order, the subject of the order fails to request a hearing in 19.13 writing, the order is the final order of the commissioner and is 19.14 not reviewable by a court or agency. 19.15 (b) A hearing must be initiated by the office not later 19.16 than 30 days from the date of the office's receipt of a written 19.17 hearing request. Within 30 days of receipt of the 19.18 administrative law judge's report, the commissioner shall issue 19.19 a final order modifying, vacating, or making permanent the cease 19.20 and desist order as the facts require. The final order remains 19.21 in effect until modified or vacated by the commissioner. 19.22 (c) When a request for a stay accompanies a timely hearing 19.23 request, the commissioner may, in the commissioner's discretion, 19.24 grant the stay. If the commissioner does not grant a requested 19.25 stay, the commissioner shall refer the request to the office of 19.26 administrative hearings within three working days of receipt of 19.27 the request. Within ten days after receiving the request from 19.28 the commissioner, an administrative law judge shall issue a 19.29 recommendation to grant or deny the stay. The commissioner 19.30 shall grant or deny the stay within five days of receiving the 19.31 administrative law judge's recommendation. 19.32 (d) In the event of noncompliance with a cease and desist 19.33 order, the commissioner may institute a proceeding in Hennepin 19.34 county district court to obtain injunctive relief or other 19.35 appropriate relief, including a civil penalty payable to the 19.36 office not exceeding $10,000 for each separate violation. 20.1 Subd. 2. [INJUNCTIVE RELIEF.] In addition to any other 20.2 remedy provided by law, including the issuance of a cease and 20.3 desist order under subdivision 1, the commissioner may in the 20.4 commissioner's own name bring an action in Hennepin county 20.5 district court for injunctive relief to restrain an unlicensed 20.6 complementary and alternative health care practitioner from a 20.7 violation or threatened violation of any statute, rule, or order 20.8 which the commissioner is empowered to regulate, enforce, or 20.9 issue. A temporary restraining order must be granted in the 20.10 proceeding if continued activity by a practitioner would create 20.11 a serious risk of harm to others. The commissioner need not 20.12 show irreparable harm. 20.13 Subd. 3. [ADDITIONAL POWERS.] The issuance of a cease and 20.14 desist order or injunctive relief granted under this section 20.15 does not relieve a practitioner from criminal prosecution by a 20.16 competent authority or from disciplinary action by the 20.17 commissioner. 20.18 Sec. 13. [146A.11] [COMPLEMENTARY AND ALTERNATIVE HEALTH 20.19 CARE CLIENT BILL OF RIGHTS.] 20.20 Subdivision 1. [SCOPE.] All unlicensed complementary and 20.21 alternative health care practitioners shall provide to each 20.22 complementary and alternative health care client prior to 20.23 providing treatment a written copy of the complementary and 20.24 alternative health care client bill of rights. A copy must also 20.25 be posted in a prominent location in the office of the 20.26 unlicensed complementary and alternative health care 20.27 practitioner. Reasonable accommodations shall be made for those 20.28 clients who cannot read or who have communication impairments 20.29 and those who do not read or speak English. The complementary 20.30 and alternative health care client bill of rights shall include 20.31 the following: 20.32 (1) the name, title, business address, and telephone number 20.33 of the unlicensed complementary and alternative health care 20.34 practitioner; 20.35 (2) the degrees, training, experience, or other 20.36 qualifications of the practitioner, followed by the following 21.1 statement in bold print: 21.2 "THE STATE OF MINNESOTA HAS NOT ADOPTED ANY EDUCATIONAL AND 21.3 TRAINING STANDARDS FOR UNLICENSED COMPLEMENTARY AND ALTERNATIVE 21.4 HEALTH CARE PRACTITIONERS. THIS STATEMENT OF CREDENTIALS IS FOR 21.5 INFORMATION PURPOSES ONLY. 21.6 The practices of an unlicensed complementary and 21.7 alternative health care practitioner do not constitute a 21.8 diagnosis from a licensed physician, chiropractor, or 21.9 acupuncture practitioner. If a client desires a diagnosis from 21.10 a licensed physician, chiropractor, or acupuncture practitioner, 21.11 or services from a physician, chiropractor, nurse, osteopath, 21.12 physical therapist, dietitian, nutritionist, acupuncture 21.13 practitioner, athletic trainer, or any other type of health care 21.14 provider, the client may seek such services at any time."; 21.15 (3) the name, business address, and telephone number of the 21.16 practitioner's supervisor, if any; 21.17 (4) notice that a complementary and alternative health care 21.18 client has the right to file a complaint with the practitioner's 21.19 supervisor, if any, and the procedure for filing complaints; 21.20 (5) the name, address, and telephone number of the office 21.21 of unlicensed complementary and alternative health care practice 21.22 and notice that a client may file complaints with the office; 21.23 (6) the practitioner's fees per unit of service, the 21.24 practitioner's method of billing for such fees, the names of any 21.25 insurance companies that have agreed to reimburse the 21.26 practitioner, or health maintenance organizations with whom the 21.27 practitioner contracts to provide service, whether the 21.28 practitioner accepts Medicare, medical assistance, or general 21.29 assistance medical care, and whether the practitioner is willing 21.30 to accept partial payment, or to waive payment, and in what 21.31 circumstances; 21.32 (7) a statement that the client has a right to reasonable 21.33 notice of changes in services or charges; 21.34 (8) a brief summary, in plain language, of the theoretical 21.35 approach used by the practitioner in treating patients; 21.36 (9) notice that the client has a right to complete and 22.1 current information concerning the practitioner's assessment and 22.2 recommended course of treatment, including the expected duration 22.3 of treatment; 22.4 (10) a statement that clients may expect courteous 22.5 treatment and to be free from verbal, physical, or sexual abuse 22.6 by the practitioner; 22.7 (11) a statement that client records and transactions with 22.8 the practitioner are confidential, unless release of these 22.9 records is authorized in writing by the client, or otherwise 22.10 provided by law; 22.11 (12) a statement of the client's right to be allowed access 22.12 to records and written information from records in accordance 22.13 with section 144.335; 22.14 (13) a statement that other services may be available in 22.15 the community, including where information concerning services 22.16 is available; 22.17 (14) a statement that the client has the right to choose 22.18 freely among available practitioners and to change practitioners 22.19 after services have begun, within the limits of health 22.20 insurance, medical assistance, or other health programs; 22.21 (15) a statement that the client has a right to coordinated 22.22 transfer when there will be a change in the provider of 22.23 services; 22.24 (16) a statement that the client may refuse services or 22.25 treatment, unless otherwise provided by law; and 22.26 (17) a statement that the client may assert the client's 22.27 rights without retaliation. 22.28 Subd. 2. [ACKNOWLEDGMENT BY CLIENT.] Prior to the 22.29 provision of any service, a complementary and alternative health 22.30 care client must sign a written statement attesting that the 22.31 client has received the complementary and alternative health 22.32 care client bill of rights. 22.33 Sec. 14. Minnesota Statutes 1999 Supplement, section 22.34 147.09, is amended to read: 22.35 147.09 [EXEMPTIONS.] 22.36 Section 147.081 does not apply to, control, prevent or 23.1 restrict the practice, service, or activities of: 23.2 (1) A person who is a commissioned medical officer of, a 23.3 member of, or employed by, the armed forces of the United 23.4 States, the United States Public Health Service, the Veterans 23.5 Administration, any federal institution or any federal agency 23.6 while engaged in the performance of official duties within this 23.7 state, if the person is licensed elsewhere. 23.8 (2) A licensed physician from a state or country who is in 23.9 actual consultation here. 23.10 (3) A licensed or registered physician who treats the 23.11 physician's home state patients or other participating patients 23.12 while the physicians and those patients are participating 23.13 together in outdoor recreation in this state as defined by 23.14 section 86A.03, subdivision 3. A physician shall first register 23.15 with the board on a form developed by the board for that 23.16 purpose. The board shall not be required to promulgate the 23.17 contents of that form by rule. No fee shall be charged for this 23.18 registration. 23.19 (4) A student practicing under the direct supervision of a 23.20 preceptor while the student is enrolled in and regularly 23.21 attending a recognized medical school. 23.22 (5) A student who is in continuing training and performing 23.23 the duties of an intern or resident or engaged in postgraduate 23.24 work considered by the board to be the equivalent of an 23.25 internship or residency in any hospital or institution approved 23.26 for training by the board, provided the student has a residency 23.27 permit issued by the board under section 147.0391. 23.28 (6) A person employed in a scientific, sanitary, or 23.29 teaching capacity by the state university, the department of 23.30 children, families, and learning, or by any public or private 23.31 school, college, or other bona fide educational institution, a 23.32 nonprofit organization, which has tax-exempt status in 23.33 accordance with the Internal Revenue Code, section 501(c)(3), 23.34 and is organized and operated primarily for the purpose of 23.35 conducting scientific research directed towards discovering the 23.36 causes of and cures for human diseases, or the state department 24.1 of health, whose duties are entirely of a research, public 24.2 health, or educational character, while engaged in such duties; 24.3 provided that if the research includes the study of humans, such 24.4 research shall be conducted under the supervision of one or more 24.5 physicians licensed under this chapter. 24.6 (7) Physician's assistants registered in this state. 24.7 (8) A doctor of osteopathy duly licensed by the state board 24.8 of osteopathy under Minnesota Statutes 1961, sections 148.11 to 24.9 148.16, prior to May 1, 1963, who has not been granted a license 24.10 to practice medicine in accordance with this chapter provided 24.11 that the doctor confines activities within the scope of the 24.12 license. 24.13 (9) Any person licensed by a health related licensing 24.14 board, as defined in section 214.01, subdivision 2, or 24.15 registered by the commissioner of health pursuant to section 24.16 214.13, including psychological practitioners with respect to 24.17 the use of hypnosis; provided that the person confines 24.18 activities within the scope of the license. 24.19 (10) A person who practices ritual circumcision pursuant to 24.20 the requirements or tenets of any established religion. 24.21 (11) A Christian Scientist or other person who endeavors to 24.22 prevent or cure disease or suffering exclusively by mental or 24.23 spiritual means or by prayer. 24.24 (12) A physician licensed to practice medicine in another 24.25 state who is in this state for the sole purpose of providing 24.26 medical services at a competitive athletic event. The physician 24.27 may practice medicine only on participants in the athletic 24.28 event. A physician shall first register with the board on a 24.29 form developed by the board for that purpose. The board shall 24.30 not be required to adopt the contents of the form by rule. The 24.31 physician shall provide evidence satisfactory to the board of a 24.32 current unrestricted license in another state. The board shall 24.33 charge a fee of $50 for the registration. 24.34 (13) A psychologist licensed under section 148.907 or a 24.35 social worker licensed under section 148B.21 who uses or 24.36 supervises the use of a penile or vaginal plethysmograph in 25.1 assessing and treating individuals suspected of engaging in 25.2 aberrant sexual behavior and sex offenders. 25.3 (14) Any person issued a training course certificate or 25.4 credentialed by the emergency medical services regulatory board 25.5 established in chapter 144E, provided the person confines 25.6 activities within the scope of training at the certified or 25.7 credentialed level. 25.8 (15) An unlicensed complementary and alternative health 25.9 care practitioner practicing according to chapter 146A. 25.10 Sec. 15. Minnesota Statutes 1999 Supplement, section 25.11 214.01, subdivision 2, is amended to read: 25.12 Subd. 2. [HEALTH-RELATED LICENSING BOARD.] "Health-related 25.13 licensing board" means the board of examiners of nursing home 25.14 administrators established pursuant to section 144A.19, the 25.15 office of unlicensed complementary and alternative health care 25.16 practice established pursuant to section 146A.02, the board of 25.17 medical practice created pursuant to section 147.01, the board 25.18 of nursing created pursuant to section 148.181, the board of 25.19 chiropractic examiners established pursuant to section 148.02, 25.20 the board of optometry established pursuant to section 148.52, 25.21 the board of physical therapy established pursuant to section 25.22 148.67, the board of psychology established pursuant to section 25.23 148.90, the board of social work pursuant to section 148B.19, 25.24 the board of marriage and family therapy pursuant to section 25.25 148B.30, the office of mental health practice established 25.26 pursuant to section 148B.61, the alcohol and drug counselors 25.27 licensing advisory council established pursuant to section 25.28 148C.02, the board of dietetics and nutrition practice 25.29 established under section 148.622, the board of dentistry 25.30 established pursuant to section 150A.02, the board of pharmacy 25.31 established pursuant to section 151.02, the board of podiatric 25.32 medicine established pursuant to section 153.02, and the board 25.33 of veterinary medicine, established pursuant to section 156.01. 25.34 Sec. 16. [REPORT TO THE LEGISLATURE.] 25.35 The commissioner of health shall report to the legislature 25.36 by January 1, 2003, on the number and types of complaints 26.1 received against unlicensed complementary and alternative health 26.2 care practitioners pursuant to Minnesota Statutes, chapter 146A, 26.3 the types of practitioners against whom complaints were filed, 26.4 and the locations of the practitioners, the number of 26.5 investigations conducted, and the number and types of 26.6 enforcement actions completed. The report must be filed in 26.7 accordance with Minnesota Statutes, sections 3.195 and 3.197. 26.8 Sec. 17. [EFFECTIVE DATE.] 26.9 Sections 1 to 16 are effective July 1, 2001.