HF 2494

as introduced - 93rd Legislature (2023 - 2024) Posted on 03/13/2023 04:02pm

A bill for an act
relating to health; modifying licensure requirements for the practice of medicine
and acupuncture; repealing professional corporation rules; amending Minnesota
Statutes 2022, sections 147.02, subdivision 1; 147.03, subdivision 1; 147.037,
subdivision 1; 147.141; 147A.16; 147B.02, subdivisions 4, 7; repealing Minnesota
Rules, parts 5610.0100; 5610.0200; 5610.0300.

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

Section 1.

Minnesota Statutes 2022, section 147.02, subdivision 1, is amended to read:

Subdivision 1.

United States or Canadian medical school graduates.

The board shall
issue a license to practice medicine to a person not currently licensed in another state or
Canada and who meets the requirements in paragraphs (a) to (i).

(a) An applicant for a license shall file a written application on forms provided by the
board, showing to the board's satisfaction that the applicant is of good moral character and
satisfies the requirements of this section.

(b) The applicant shall present evidence satisfactory to the board of being a graduate of
a medical or osteopathic medical school located in the United States, its territories or Canada,
and approved by the board based upon its faculty, curriculum, facilities, accreditation by a
recognized national accrediting organization approved by the board, and other relevant data,
or is currently enrolled in the final year of study at the school.

(c) The applicant must have passed an examination as described in clause (1) or (2).

(1) The applicant must have passed a comprehensive examination for initial licensure
prepared and graded by the National Board of Medical Examiners, the Federation of State
Medical Boards, the Medical Council of Canada, the National Board of Osteopathic
Examiners, or the appropriate state board that the board determines acceptable. The board
shall by rule determine what constitutes a passing score in the examination.

(2) The applicant taking the United States Medical Licensing Examination (USMLE)
or Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) must
have passed steps or levels one, two, and three. Step or level three must be passed within
five years of passing step or level two, or before the end of residency training. The applicant
must pass each of steps or levels one, two, and three with passing scores as recommended
by the USMLE program or National Board of Osteopathic Medical Examiners within three
attempts. The applicant taking combinations of Federation of State Medical Boards, National
Board of Medical Examiners, and USMLE may be accepted only if the combination is
approved by the board as comparable to existing comparable examination sequences and
all examinations are completed prior to the year 2000.

(d) The applicant shall 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 deleted text begin or other graduate training approved in
advance by the board as meeting standards similar to those of a national accrediting
organization deleted text end .

(e) The applicant may make arrangements with the executive director to appear in person
before the board or its designated representative to show that the applicant satisfies the
requirements of this section. The board may establish as internal operating procedures the
procedures or requirements for the applicant's personal presentation.

(f) The applicant shall pay a nonrefundable fee established by the board. Upon application
or notice of license renewal, the board must provide notice to the applicant and to the person
whose license is scheduled to be issued or renewed of any additional fees, surcharges, or
other costs which the person is obligated to pay as a condition of licensure. The notice must:

(1) state the dollar amount of the additional costs; and

(2) clearly identify to the applicant the payment schedule of additional costs.

(g) The applicant must not be under license suspension or revocation by the licensing
board of the state or jurisdiction in which the conduct that caused the suspension or revocation
occurred.

(h) The applicant must not have engaged in conduct warranting disciplinary action
against a licensee, or have been subject to disciplinary action other than as specified in
paragraph (g). If the applicant does not satisfy the requirements stated in this paragraph,
the board may issue a license only on the applicant's showing that the public will be protected
through issuance of a license with conditions and limitations the board considers appropriate.

(i) If the examination in paragraph (c) was passed more than ten years ago, the applicant
must either:

(1) pass the special purpose examination of the Federation of State Medical Boards with
a score of 75 or better within three attempts; or

(2) have a current certification by a specialty board of the American Board of Medical
Specialties, of the American Osteopathic Association, the Royal College of Physicians and
Surgeons of Canada, or of the College of Family Physicians of Canada.

Sec. 2.

Minnesota Statutes 2022, section 147.03, subdivision 1, is amended to read:

Subdivision 1.

Endorsement; reciprocity.

(a) The board may issue a license to practice
medicine to any person who satisfies the requirements in paragraphs (b) to (e).

(b) The applicant shall satisfy all the requirements established in section 147.02,
subdivision 1, paragraphs (a), (b), (d), (e), and (f).

(c) The applicant shall:

(1) have passed an examination prepared and graded by the Federation of State Medical
Boards, the National Board of Medical Examiners, or the United States Medical Licensing
Examination (USMLE) program in accordance with section 147.02, subdivision 1, paragraph
(c), clause (2); the National Board of Osteopathic Medical Examiners; or the Medical Council
of Canada; and

(2) have a current license from the equivalent licensing agency in another state or Canada
and, if the examination in clause (1) was passed more than ten years ago, either:

(i) pass the Special Purpose Examination of the Federation of State Medical Boards deleted text begin with
a score of 75 or better deleted text end new text begin (SPEX) new text end within three attempts; or

(ii) have a current certification by a specialty board of the American Board of Medical
Specialties, of the American Osteopathic Association, the Royal College of Physicians and
Surgeons of Canada, or of the College of Family Physicians of Canada; or

(3) if the applicant fails to meet the requirement established in section 147.02, subdivision
1, paragraph (c), clause (2), because the applicant failed to pass new text begin within the permitted three
attempts new text end each of steps new text begin or levels new text end one, two, and three of the USMLE deleted text begin within the required three
attempts deleted text end new text begin or the Comprehensive Osteopathic Medical Licensing Examination
(COMLEX-USA) new text end , the applicant may be granted a license provided the applicant:

(i) has passed each of steps new text begin or levels new text end one, two, and three new text begin within no more than four attempts
for any of the three steps or levels new text end with passing scores as recommended by the USMLE new text begin or
COMLEX-USA new text end program deleted text begin within no more than four attempts for any of the three steps deleted text end ;

(ii) is currently licensed in another state; and

(iii) has current certification by a specialty board of the American Board of Medical
Specialties, the American Osteopathic Association deleted text begin Bureau of Professional Education deleted text end , the
Royal College of Physicians and Surgeons of Canada, or the College of Family Physicians
of Canada.

(d) The applicant must not be under license suspension or revocation by the licensing
board of the state or jurisdiction in which the conduct that caused the suspension or revocation
occurred.

(e) The applicant must not have engaged in conduct warranting disciplinary action against
a licensee deleted text begin , deleted text end or have been subject to disciplinary action other than as specified in paragraph
(d). If an applicant does not satisfy the requirements stated in this paragraph, the board may
issue a license only on the applicant's showing that the public will be protected through
issuance of a license with conditions or limitations the board considers appropriate.

(f) Upon the request of an applicant, the board may conduct the final interview of the
applicant by teleconference.

Sec. 3.

Minnesota Statutes 2022, section 147.037, subdivision 1, is amended to read:

Subdivision 1.

Requirements.

The board shall issue a license to practice medicine to
any person who satisfies the requirements in paragraphs (a) to (g).

(a) The applicant shall satisfy all the requirements established in section 147.02,
subdivision 1, paragraphs (a), (e), (f), (g), and (h).

(b) The applicant shall present evidence satisfactory to the board that the applicant is a
graduate of a medical or osteopathic school approved by the board as equivalent to accredited
United States or Canadian schools based upon its faculty, curriculum, facilities, accreditation,
or other relevant data. If the applicant is a graduate of a medical or osteopathic program
that is not accredited by the Liaison Committee for Medical Education or the American
Osteopathic Association, the applicant may use the Federation of State Medical Boards'
Federation Credentials Verification Service (FCVS) or its successor. If the applicant uses
this service as allowed under this paragraph, the physician application fee may be less than
$200 but must not exceed the cost of administering this paragraph.

(c) The applicant shall present evidence satisfactory to the board that the applicant has
been awarded a certificate by the Educational Council for Foreign Medical Graduates, and
the applicant has a working ability in the English language sufficient to communicate with
patients and physicians and to engage in the practice of medicine.

(d) The applicant shall 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 deleted text begin or other graduate training approved in
advance by the board as meeting standards similar to those of a national accrediting
organization deleted text end . This requirement does not apply new text begin to an applicant who is admitted pursuant to
the rules of the United States Department of Labor and new text end :

(1) deleted text begin to an applicant deleted text end who deleted text begin is deleted text end new text begin was new text end admitted as a permanent immigrant to the United States
on or before October 1, 1991, as a person of exceptional ability in the sciences according
to Code of Federal Regulations, title 20, section 656.22(d); or

(2) deleted text begin to an applicant holding deleted text end new text begin who holds new text end a valid license to practice medicine in another
country and new text begin was new text end issued a permanent immigrant visa after October 1, 1991, as a person of
extraordinary ability in the field of science or as an outstanding professor or researcher
according to Code of Federal Regulations, title 8, section 204.5(h) and (i), or a temporary
nonimmigrant visa as a person of extraordinary ability in the field of science according to
Code of Federal Regulations, title 8, section 214.2(o) deleted text begin , deleted text end new text begin .
new text end

deleted text begin provided that a person under clause (1) or (2) is admitted pursuant to rules of the United
States Department of Labor.
deleted text end

(e) The applicant must:

(1) have passed an examination prepared and graded by the Federation of State Medical
Boards, the United States Medical Licensing Examination new text begin (USMLE) new text end program in accordance
with section 147.02, subdivision 1, paragraph (c), clause (2), or the Medical Council of
Canada; and

(2) if the examination in clause (1) was passed more than ten years ago, either:

(i) pass the Special Purpose Examination of the Federation of State Medical Boards deleted text begin with
a score of 75 or better within three attempts deleted text end new text begin (SPEX) or the Comprehensive Osteopathic
Medical Variable-Purpose Examination of the National Board of Osteopathic Medical
Examiners (COMVEX). The applicant must pass the SPEX or COMVEX within no more
than three attempts of taking the SPEX, COMVEX, or a combination of the SPEX and
COMVEX new text end ; or

(ii) have a current certification by a specialty board of the American Board of Medical
Specialties, deleted text begin of deleted text end the American Osteopathic Association, deleted text begin of deleted text end the Royal College of Physicians
and Surgeons of Canada, or deleted text begin of deleted text end the College of Family Physicians of Canada; or

(3) if the applicant fails to meet the requirement established in section 147.02, subdivision
1, paragraph (c), clause (2), because the applicant failed to pass new text begin within the permitted three
attempts new text end each of steps new text begin or levels new text end one, two, and three of the USMLE deleted text begin within the required three
attempts deleted text end new text begin or the Comprehensive Osteopathic Medical Licensing Examination
(COMLEX-USA) new text end , the applicant may be granted a license provided the applicant:

(i) has passed each of steps new text begin or levels new text end one, two, and three new text begin within no more than four attempts
for any of the three steps or levels new text end with passing scores as recommended by the USMLE new text begin or
COMLEX-USA new text end program deleted text begin within no more than four attempts for any of the three steps deleted text end ;

(ii) is currently licensed in another state; and

(iii) has current certification by a specialty board of the American Board of Medical
Specialties, the American Osteopathic Association, the Royal College of Physicians and
Surgeons of Canada, or the College of Family Physicians of Canada.

(f) The applicant must not be under license suspension or revocation by the licensing
board of the state or jurisdiction in which the conduct that caused the suspension or revocation
occurred.

(g) The applicant must not have engaged in conduct warranting disciplinary action
against a licensee deleted text begin , deleted text end or have been subject to disciplinary action other than as specified in
paragraph (f). If an applicant does not satisfy the requirements stated in this paragraph, the
board may issue a license only on the applicant's showing that the public will be protected
through issuance of a license with conditions or limitations the board considers appropriate.

Sec. 4.

Minnesota Statutes 2022, section 147.141, is amended to read:

147.141 FORMS OF DISCIPLINARY ACTION.

When the board finds that a licensed physician or a physician registered under section
147.032 has violated a provision or provisions of sections 147.01 to 147.22, it may do one
or more of the following:

(1) revoke the license;

(2) suspend the license;

(3) revoke or suspend registration to perform interstate telehealth;

(4) impose limitations or conditions on the physician's practice of medicine, including
new text begin limiting new text end the deleted text begin limitation of deleted text end scope of practice to designated field specialties; deleted text begin the imposition of deleted text end new text begin
imposing new text end retraining or rehabilitation requirements; deleted text begin the requirement of deleted text end new text begin requiring new text end practice
under supervision; or deleted text begin the deleted text end conditioning deleted text begin of deleted text end continued practice on demonstration of knowledge
or skills by appropriate examination or other review of skill and competence;

(5) impose a civil penalty not exceeding $10,000 for each separate violation, the amount
of the civil penalty to be fixed deleted text begin so as deleted text end to deprive the physician of any economic advantage
gained by reason of the violation charged or to reimburse the board for the cost of the
investigation and proceeding;

(6) order the physician to provide unremunerated professional service under supervision
at a designated public hospital, clinic, or other health care institution; or

(7) censure or reprimand the licensed physician.

Sec. 5.

Minnesota Statutes 2022, section 147A.16, is amended to read:

147A.16 FORMS OF DISCIPLINARY ACTION.

new text begin (a) new text end When the board finds that a licensed physician assistant has violated a provision of
this chapter, it may do one or more of the following:

(1) revoke the license;

(2) suspend the license;

(3) impose limitations or conditions on the physician assistant's practice, including
limiting the scope of practice to designated field specialties; imposing retraining or
rehabilitation requirements; or limiting practice until demonstration of knowledge or skills
by appropriate examination or other review of skill and competence;

(4) impose a civil penalty not exceeding $10,000 for each separate violation, the amount
of the civil penalty to be fixed deleted text begin so as deleted text end to deprive the physician assistant of any economic
advantage gained by reason of the violation charged or to reimburse the board for the cost
of the investigation and proceeding; or

(5) censure or reprimand the licensed physician assistant.

new text begin (b) new text end Upon judicial review of any board disciplinary action taken under this chapter, the
reviewing court shall seal the administrative record, except for the board's final decision,
and shall not make the administrative record available to the public.

Sec. 6.

Minnesota Statutes 2022, section 147B.02, subdivision 4, is amended to read:

Subd. 4.

Exceptions.

(a) The following persons may practice acupuncture within the
scope of their practice without an acupuncture license:

(1) a physician licensed under chapter 147;

(2) an osteopathic physician licensed under chapter 147;

(3) a chiropractor licensed under chapter 148;

deleted text begin (4) a person who is studying in a formal course of study or tutorial intern program
approved by the acupuncture advisory council established in section 147B.05 so long as
the person's acupuncture practice is supervised by a licensed acupuncturist or a person who
is exempt under clause (5);
deleted text end

deleted text begin (5) deleted text end new text begin (4) new text end a visiting acupuncturist practicing acupuncture within an instructional setting for
the sole purpose of teaching at a school registered with the Minnesota Office of Higher
Education, who may practice without a license for a period of one year, with two one-year
extensions permitted; and

deleted text begin (6) deleted text end new text begin (5) new text end a visiting acupuncturist who is in the state for the sole purpose of providing a
tutorial or workshop not to exceed 30 days in one calendar year.

(b) This chapter does not prohibit a person who does not have an acupuncturist license
from practicing specific noninvasive techniques, such as acupressure, that are within the
scope of practice as set forth in section 147B.06, subdivision 4.

Sec. 7.

Minnesota Statutes 2022, section 147B.02, subdivision 7, is amended to read:

Subd. 7.

Licensure requirements.

(a) deleted text begin After June 30, 1997, deleted text end An applicant for licensure
must:

(1) submit a completed application for licensure on forms provided by the board, which
must include the applicant's name and address of record, which shall be public;

(2) unless licensed under subdivision 5 or 6, submit deleted text begin a notarized copy of a deleted text end new text begin evidence
satisfactory to the board of new text end current NCCAOM certification;

(3) sign a statement that the information in the application is true and correct to the best
of the applicant's knowledge and belief;

(4) submit with the application all fees required; and

(5) sign a waiver authorizing the board to obtain access to the applicant's records in this
state or any state in which the applicant has engaged in the practice of acupuncture.

(b) The board may ask the applicant to provide any additional information necessary to
ensure that the applicant is able to practice with reasonable skill and safety to the public.

(c) The board may investigate information provided by an applicant to determine whether
the information is accurate and complete. The board shall notify an applicant of action taken
on the application and the reasons for denying licensure if licensure is denied.

Sec. 8. new text begin REPEALER.
new text end

new text begin Minnesota Rules, parts 5610.0100; 5610.0200; and 5610.0300, new text end new text begin are repealed.
new text end

APPENDIX

Repealed Minnesota Rule: 23-03495

5610.0100 SWORN STATEMENT TO BOARD.

At the time a professional corporation files with the board the copy of its articles of incorporation as required by Minnesota Statutes, section 319A.08, and annually thereafter when such corporation files with the board its annual report as required by Minnesota Statutes, section 319A.21, it shall file with the board a statement under oath as to each and all of the following:

A.

the address of the registered office of the corporation and the name of its proposed registered agent, if any, for service and process;

B.

the name or names and respective office and residence addresses of the directors and officers of the corporation;

C.

in the case of a corporation organized under Minnesota Statutes, chapter 301, a statement of the aggregate number of issued shares, itemized by classes and the person or persons to whom issued;

D.

in the case of a corporation organized under Minnesota Statutes, chapter 317A, a statement of the names of the members of the corporation if no stock has been issued, or if stock has been issued, a statement of the aggregate number of issued shares, itemized by classes and the person or persons to whom issued;

E.

a description of the nature of the professional services and ancillary services, if any, to be provided by the corporation;

F.

the location or locations of the premises at which the applicant corporation proposes to provide professional services;

G.

a statement listing the name or names of employees, other than members or shareholders of the corporation, who are licensed under Minnesota Statutes, chapter 147, to practice medicine and surgery within the state of Minnesota; and

H.

a statement whether or not all shareholders, members, directors, officers, employees, and agents rendering professional service in Minnesota on behalf of the corporation are licensed to practice medicine and surgery in Minnesota or are otherwise authorized to render the professional service being rendered by the corporation.

5610.0200 SUSPENSION OR REVOCATION OF LICENSE OF SHAREHOLDER, MEMBER, DIRECTOR, OFFICER, EMPLOYEE, OR AGENT.

If the license to practice medicine in Minnesota of any shareholder, member, director, officer, employee, or agent rendering professional service in this state on behalf of the corporation is revoked or suspended by the board, the corporation shall forthwith remove from office and terminate the employment of such shareholder, member, director, officer, employee, or agent, and shall not reinstate in office or reemploy such shareholder, member, director, officer, employee, or agent unless and until the license to practice medicine in Minnesota is restored by the board.

5610.0300 WRITTEN NOTICE REQUIREMENT.

Every professional corporation shall promptly notify the board in writing upon the happening of any of the following events:

A.

the death of any shareholder, member, director, officer, employee, or agent who is licensed to practice medicine in Minnesota;

B.

the revocation or suspension of the license to practice medicine in Minnesota of any shareholder, member, director, officer, employee, or agent;

C.

the amendment of the articles of incorporation or bylaws of the corporation, in which case a copy of such amendment shall be furnished to the board with such notice;

D.

a change in the registered office of the corporation;

E.

a change in the registered agent of the corporation;

F.

the admission, election, or employment of a new shareholder, member, director, officer, employee, or agent of the corporation;

G.

the termination, replacement, or discharge of a shareholder, member, director, officer, employee, or agent, in which case the professional corporation shall notify the board of the date thereof and reason therefor;

H.

a change in the nature of the professional services and ancillary services, if any, provided by the corporation; or

I.

a change in the location or locations of the premises at which the corporation provides or intends to provide professional services.