as introduced - 83rd Legislature (2003 - 2004) Posted on 12/15/2009 12:00am
1.1 A bill for an act 1.2 relating to professions; providing for licensure of 1.3 surgical assistants; authorizing rulemaking; providing 1.4 civil penalties; amending Minnesota Statutes 2002, 1.5 sections 13.383, by adding a subdivision; 62A.3092, 1.6 subdivision 2; 62J.52, subdivision 2; 62J.54, 1.7 subdivision 2; 116.79, subdivision 1; 116J.70, 1.8 subdivision 2a; 116L.12, subdivision 6; 144.054, 1.9 subdivision 2; 147.09; 147.091, subdivision 1; 214.18, 1.10 subdivision 5; 256B.0625, by adding a subdivision; 1.11 319B.02, subdivision 19; 319B.40; proposing coding for 1.12 new law as Minnesota Statutes, chapter 147E. 1.13 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 1.14 ARTICLE 1 1.15 Section 1. [147E.01] [DEFINITIONS.] 1.16 Subdivision 1. [SCOPE.] For the purpose of this chapter 1.17 the terms defined in this section have the meanings given them. 1.18 Subd. 2. [BOARD.] "Board" means the board of medical 1.19 practice or its designee. 1.20 Subd. 3. [DIRECT SUPERVISION.] "Direct supervision" means 1.21 the supervision of a surgical assistant by an operating 1.22 physician and requires that the operating physician authorize 1.23 the procedure, remain in the facility while the procedure is 1.24 performed, and approve the work performed, but does not require 1.25 that the operating physician be present with the patient during 1.26 the procedure. 1.27 Subd. 4. [OPERATING PHYSICIAN.] "Operating physician" 1.28 means a person currently licensed in good standing as a 1.29 physician or osteopath under chapter 147. 2.1 Subd. 5. [SURGICAL ASSISTANT.] "Surgical assistant" means 2.2 a person who is not an operating physician and who is certified 2.3 by the Liaison Council on Certification for the Surgical 2.4 Technologist (LCC-ST) as a certified surgical 2.5 technician/certified surgical assistant (CST/CSA) and is 2.6 licensed under this chapter to provide aid to operating 2.7 physicians in exposure, hemostasis, and other technical 2.8 functions that help an operating physician perform a safe 2.9 operation with optimal results for the patient. In addition, 2.10 the surgical assistant demonstrates the principles of safe 2.11 positioning of the surgical patient, provides visualization of 2.12 the operative site during the operative procedure, demonstrates 2.13 the proper techniques to assist the surgeon in providing 2.14 hemostasis, demonstrates the appropriate techniques to assist 2.15 with the closure of body planes, expedites the operative 2.16 procedure by anticipating the needs of the surgeon, demonstrates 2.17 advanced knowledge of normal and pathological anatomy and 2.18 physiology, and demonstrates knowledge of emergency situations. 2.19 Sec. 2. [147E.02] [QUALIFICATIONS FOR LICENSURE.] 2.20 Except as otherwise provided in this chapter, an individual 2.21 must be licensed by the board before the individual may practice 2.22 as a surgical assistant. 2.23 The board may grant licensure as a surgical assistant to an 2.24 applicant who: 2.25 (1) submits an application on forms approved by the board; 2.26 (2) pays the appropriate fee as determined by the board; 2.27 (3) has successfully completed the first assistant national 2.28 certification examination provided by the Liaison Council on 2.29 Certification for the Surgical Technologist (LCC-ST), the 2.30 National Surgical Assistants Association (NSAA), or a successor 2.31 agency as approved by the board, and has met the requirements 2.32 for its certification set forth by the LCC-ST, NSAA, or a 2.33 successor agency as approved by the board; 2.34 (4) certifies that the applicant is mentally and physically 2.35 able to engage safely in practice as a surgical assistant; 2.36 (5) has no licensure, certification, or registration as a 3.1 surgical assistant under current discipline, revocation, 3.2 suspension, or probation for cause resulting from the 3.3 applicant's practice as a surgical assistant, unless the board 3.4 considers the condition and agrees to licensure; and 3.5 (6) has been approved by the board. 3.6 Sec. 3. [147E.03] [PROTECTED TITLES AND RESTRICTIONS ON 3.7 USE.] 3.8 Subdivision 1. [PROTECTED TITLES.] No individual may use 3.9 the title "Minnesota licensed surgical assistant," "licensed 3.10 surgical assistant," or "surgical assistant," in connection with 3.11 the individual's name, or any other words, letters, 3.12 abbreviations, or insignia indicating or implying that the 3.13 individual is licensed with the state unless the individual is 3.14 licensed according to this chapter. 3.15 Subd. 2. [HEALTH CARE PRACTITIONERS.] Individuals 3.16 practicing in a health care occupation are not restricted in the 3.17 provision of services included in this chapter as long as they 3.18 do not hold themselves out as surgical assistants by or through 3.19 the titles provided in subdivision 1 in association with 3.20 provision of these services. 3.21 Subd. 3. [IDENTIFICATION OF LICENSED PRACTITIONERS.] 3.22 Surgical assistants in Minnesota must wear name tags which 3.23 identify them as surgical assistants. 3.24 Subd. 4. [SANCTIONS.] Individuals who hold themselves out 3.25 as surgical assistants by or through any of the titles provided 3.26 in subdivision 1 without prior licensure are subject to 3.27 sanctions or actions against continuing the activity according 3.28 to section 214.11, or other authority. 3.29 Sec. 4. [147E.04] [TEMPORARY PERMIT.] 3.30 The board may issue a temporary permit to practice to a 3.31 surgical assistant eligible for licensure under this chapter 3.32 only if the application for licensure is complete, all 3.33 requirements have been met, and the nonrefundable fee described 3.34 in section 147E.16 has been paid. The permit remains valid only 3.35 until the meeting of the board at which a decision is made on 3.36 the application for licensure. 4.1 "Temporary licensure" means the status of a person who has 4.2 satisfied the education requirement specified in this chapter 4.3 and is enrolled in the next examination required in this chapter 4.4 or is awaiting examination results. Temporary licensure expires 4.5 90 days after completion of the next examination sequence, or 4.6 after one year, whichever is sooner, for those enrolled in the 4.7 next examination; and upon receipt of the examination results 4.8 for those awaiting examination results. 4.9 Sec. 5. [147E.05] [INACTIVE LICENSURE.] 4.10 Surgical assistants who notify the board in writing on 4.11 forms prescribed by the board may elect to place their licensure 4.12 on an inactive status. Surgical assistants with an inactive 4.13 licensure are excused from payment of renewal fees and must not 4.14 practice as surgical assistants. Persons who engage in practice 4.15 while their licenses are lapsed or on inactive status are 4.16 considered to be practicing without licensure, which is grounds 4.17 for discipline under section 147E.13. Surgical assistants 4.18 requesting restoration from inactive status must pay the current 4.19 renewal fees and all unpaid back-fees and must meet the criteria 4.20 for renewal specified in section 147E.07. 4.21 Sec. 6. [147E.06] [CANCELLATION OF LICENSURE FOR 4.22 NONRENEWAL.] 4.23 The board must not renew, reissue, reinstate, or restore a 4.24 license that has lapsed and has not been renewed within two 4.25 annual renewal cycles. A surgical assistant whose license is 4.26 canceled for nonrenewal must obtain a new license by applying 4.27 for licensure and fulfilling all requirements then in existence 4.28 for initial licensure to practice as a surgical assistant. 4.29 Sec. 7. [147E.07] [RENEWAL.] 4.30 A person who holds a license as a surgical assistant must, 4.31 upon notification from the board, renew the license by: 4.32 (1) submitting the appropriate fee as determined by the 4.33 board; 4.34 (2) completing the appropriate forms; and 4.35 (3) meeting any other requirements of the board. 4.36 Sec. 8. [147E.08] [EXEMPTIONS.] 5.1 (a) This chapter does not apply to, control, prevent, or 5.2 restrict the practice, service, or activities of persons listed 5.3 in section 147.09, clauses (1) to (13), persons regulated under 5.4 section 214.01, subdivision 2, or persons defined in section 5.5 144.1495, subdivision 1, paragraphs (a) to (d). 5.6 (b) Nothing in this chapter may be construed to require 5.7 licensure of: 5.8 (1) a person licensed in this state under any other law 5.9 from engaging in the practice for which that person is licensed, 5.10 including, but not limited to, a physician assistant or nurse 5.11 performing surgery-related tasks within the scope of that 5.12 person's license; 5.13 (2) a student engaging in the practice as a surgical 5.14 technologist or surgical assistant under the direct supervision 5.15 of an operating physician as part of that student's program of 5.16 study at a school approved by the board or in preparation to 5.17 qualify for the examination as prescribed under section 147E.02; 5.18 (3) a person assisting in surgery at an operating 5.19 physician's discretion; 5.20 (4) a surgical assistant student enrolled in a surgeon 5.21 assistant educational program accredited by the Liaison Council 5.22 on Certification for the Surgical Technologist or by its 5.23 successor agency, as approved by the board; or 5.24 (5) a surgical assistant employed in the service of the 5.25 federal government while performing duties incident to that 5.26 employment. 5.27 Sec. 9. [147E.09] [SCOPE OF PRACTICE, DELEGATION.] 5.28 A surgical assistant may assist the operating physician in 5.29 the performance of any surgical procedure, working under the 5.30 operating physician's direction. However, nothing in this 5.31 chapter may be construed as to allow surgical assistants to 5.32 administer any type of medication. 5.33 Sec. 10. [147E.10] [GROUNDS FOR DISCIPLINARY ACTION.] 5.34 Subdivision 1. [GROUNDS LISTED.] The board may refuse to 5.35 grant licensure or may impose disciplinary action as described 5.36 in this subdivision against any surgical assistant. The 6.1 following conduct is prohibited and is grounds for disciplinary 6.2 action: 6.3 (1) failure to demonstrate the qualifications or satisfy 6.4 the requirements for licensure contained in this chapter or 6.5 rules of the board; the burden of proof is on the applicant to 6.6 demonstrate such qualifications or satisfaction of such 6.7 requirements; 6.8 (2) obtaining licensure by fraud or cheating, or attempting 6.9 to subvert the examination process, including, but not limited 6.10 to: 6.11 (i) conduct that violates the security of examination 6.12 materials, such as removing examination materials from the 6.13 examination room or having unauthorized possession of any 6.14 portion of a future, current, or previously administered 6.15 licensing examination; 6.16 (ii) conduct that violates the standard of test 6.17 administration, such as communicating with another examinee 6.18 during administration of the examination, copying another 6.19 examinee's answers, permitting another examinee to copy one's 6.20 answers, or possessing unauthorized materials; and 6.21 (iii) impersonating an examinee or permitting an 6.22 impersonator to take the examination on one's own behalf; 6.23 (3) conviction, during the previous five years, of a felony 6.24 reasonably related to the practice of surgical assistance 6.25 including a conviction of an offense which if committed in this 6.26 state would be deemed a felony without regard to its designation 6.27 elsewhere, or a criminal proceeding where a finding or verdict 6.28 of guilt is made or returned but the adjudication of guilt is 6.29 either withheld or not entered; 6.30 (4) revocation, suspension, restriction, limitation, or 6.31 other disciplinary action against the person's surgical 6.32 assistant credentials in another state or jurisdiction, failure 6.33 to report to the board that charges regarding the person's 6.34 credentials have been brought in another state or jurisdiction, 6.35 or having been refused licensure or registration by any other 6.36 state or jurisdiction; 7.1 (5) advertising that is false or misleading, violates any 7.2 rule of the board, or claims without substantiation the positive 7.3 cure of any disease or professional superiority to or greater 7.4 skill than that possessed by another surgical assistant; 7.5 (6) violating a rule adopted by the board or an order of 7.6 the board, a state, or federal law that relates to the practice 7.7 of a surgical assistant, or in part regulates the practice of a 7.8 surgical assistant, including without limitation sections 7.9 148A.02, 609.344, and 609.345, or a state or federal narcotics 7.10 or controlled substance law; 7.11 (7) engaging in any unethical conduct; conduct likely to 7.12 deceive, defraud, or harm the public, or demonstrating a willful 7.13 or careless disregard for the health, welfare, or safety of a 7.14 patient; or practice that is professionally incompetent, in that 7.15 it may create unnecessary danger to a patient's life, health, or 7.16 safety, in any of which cases, proof of actual injury need not 7.17 be established; 7.18 (8) adjudication as mentally incompetent, mentally ill or 7.19 mentally retarded, or as a chemically dependent person, a person 7.20 dangerous to the public, a sexually dangerous person, or a 7.21 person who has a sexual psychopathic personality by a court of 7.22 competent jurisdiction, within or without this state; such 7.23 adjudication automatically suspends a license for its duration 7.24 unless the board orders otherwise; 7.25 (9) engaging in unprofessional conduct including any 7.26 departure from or the failure to conform to the minimal 7.27 standards of acceptable and prevailing practice in which 7.28 proceeding actual injury to a patient need not be established; 7.29 (10) inability to practice with reasonable skill and safety 7.30 to patients by reason of illness, drunkenness, use of drugs, 7.31 narcotics, chemicals, or any other type of material, or as a 7.32 result of any mental or physical condition, including 7.33 deterioration through the aging process or loss of motor skills; 7.34 (11) revealing a privileged communication from or relating 7.35 to a patient except when otherwise required or permitted by law; 7.36 (12) any use of the title "Physician," "Doctor," or "Dr."; 8.1 (13) improper management of medical records, including 8.2 failure to maintain adequate medical records, to comply with a 8.3 patient's request made pursuant to section 144.335, or to 8.4 furnish a medical record or report required by law; 8.5 (14) engaging in abusive or fraudulent billing practices, 8.6 including violations of the federal Medicare and Medicaid laws 8.7 or state medical assistance laws; 8.8 (15) becoming addicted or habituated to a drug or 8.9 intoxicant; 8.10 (16) engaging in conduct with a patient which is sexual or 8.11 may reasonably be interpreted by the patient as sexual, or in 8.12 any verbal behavior which is seductive or sexually demeaning to 8.13 a patient; 8.14 (17) failure to make reports as required by section 147E.11 8.15 or to cooperate with an investigation of the board as required 8.16 by section 147E.12, subdivision 3; 8.17 (18) knowingly providing false or misleading information 8.18 that is directly related to the care of that patient unless done 8.19 for an accepted therapeutic purpose such as the administration 8.20 of a placebo; or 8.21 (19) aiding suicide or aiding attempted suicide in 8.22 violation of section 609.215 as established by any of the 8.23 following: 8.24 (i) a copy of the record of criminal conviction or plea of 8.25 guilty for a felony in violation of section 609.215, subdivision 8.26 1 or 2; 8.27 (ii) a copy of the record of a judgment of contempt of 8.28 court for violating an injunction issued under section 609.215, 8.29 subdivision 4; 8.30 (iii) a copy of the record of a judgment assessing damages 8.31 under section 609.215, subdivision 5; or 8.32 (iv) a finding by the board that the person violated 8.33 section 609.215, subdivision 1 or 2. The board shall 8.34 investigate any complaint of a violation of section 609.215, 8.35 subdivision 1 or 2. 8.36 Subd. 2. [EFFECTIVE DATES, AUTOMATIC SUSPENSION.] A 9.1 suspension, revocation, condition, limitation, qualification, or 9.2 restriction of a licensure is in effect pending determination of 9.3 an appeal unless the court, upon petition and for good cause 9.4 shown, orders otherwise. 9.5 A surgical assistant licensee is automatically suspended if: 9.6 (1) a guardian of the person of a licensee is appointed by 9.7 order of a court pursuant to sections 525.54 to 525.61; or 9.8 (2) the licensee is committed by order of a court pursuant 9.9 to chapter 253B. 9.10 The licensee remains suspended until the licensee is restored to 9.11 capacity by a court and, upon petition by the licensee, the 9.12 suspension is terminated by the board after a hearing. 9.13 Subd. 3. [CONDITIONS ON REISSUED LICENSE.] In its 9.14 discretion, the board may restore and reissue a surgical 9.15 assistant license, but may impose as a condition any 9.16 disciplinary or corrective measure that it might originally have 9.17 imposed. 9.18 Subd. 4. [TEMPORARY SUSPENSION OF LICENSE.] In addition to 9.19 any other remedy provided by law, the board may, without a 9.20 hearing, temporarily suspend the license of a surgical assistant 9.21 if the board finds that the surgical assistant has violated a 9.22 statute or rule which the board is empowered to enforce and 9.23 continued practice by the surgical assistant would create a 9.24 serious risk of harm to the public. The suspension takes effect 9.25 upon written notice to the surgical assistant specifying the 9.26 statute or rule violated. The suspension remains in effect 9.27 until the board issues a final order in the matter after a 9.28 hearing. At the time it issues the suspension notice, the board 9.29 shall schedule a disciplinary hearing to be held pursuant to the 9.30 Administrative Procedure Act. 9.31 The surgical assistant must be provided with at least 20 9.32 days' notice of any hearing held pursuant to this subdivision. 9.33 The hearing must be scheduled to begin no later than 30 days 9.34 after the issuance of the suspension order. 9.35 Subd. 5. [EVIDENCE.] In disciplinary actions alleging a 9.36 violation of subdivision 1, clause (3) or (4), a copy of the 10.1 judgment or proceeding under the seal of the court administrator 10.2 or of the administrative agency that entered it is admissible 10.3 into evidence without further authentication and constitutes 10.4 prima facie evidence of its contents. 10.5 Subd. 6. [MENTAL EXAMINATION; ACCESS TO MEDICAL DATA.] (a) 10.6 If the board has probable cause to believe that a surgical 10.7 assistant comes under subdivision 1, clause (1), it may direct 10.8 the surgical assistant to submit to a mental or physical 10.9 examination. For the purpose of this subdivision, every 10.10 surgical assistant licensed under this chapter is deemed to have 10.11 consented to submit to a mental or physical examination when 10.12 directed in writing by the board and further to have waived all 10.13 objections to the admissibility of the examining physicians' 10.14 testimony or examination reports on the ground that they 10.15 constitute a privileged communication. Failure of a surgical 10.16 assistant to submit to an examination when directed constitutes 10.17 an admission of the allegations against the surgical assistant, 10.18 unless the failure was due to circumstance beyond the surgical 10.19 assistant's control, in which case a default and final order may 10.20 be entered without the taking of testimony or presentation of 10.21 evidence. A surgical assistant affected under this subdivision 10.22 must, at reasonable intervals, be given an opportunity to 10.23 demonstrate that the surgical assistant can resume competent 10.24 practice with reasonable skill and safety to patients. In any 10.25 proceeding under this subdivision, neither the record of 10.26 proceedings nor the orders entered by the board may be used 10.27 against a surgical assistant in any other proceeding. 10.28 (b) In addition to ordering a physical or mental 10.29 examination, the board may, notwithstanding sections 13.384, 10.30 144.651, or any other law limiting access to medical or other 10.31 health data, obtain medical data and health records relating to 10.32 a surgical assistant or applicant without the surgical 10.33 assistant's or applicant's consent if the board has probable 10.34 cause to believe that a surgical assistant comes under 10.35 subdivision 1, clause (1). 10.36 (c) The medical data may be requested from a provider, as 11.1 defined in section 144.335, subdivision 1, paragraph (b), an 11.2 insurance company, or a government agency, including the 11.3 department of human services. A provider, insurance company, or 11.4 government agency must comply with any written request of the 11.5 board under this subdivision and is not liable in any action for 11.6 damages for releasing the data requested by the board if the 11.7 data are released pursuant to a written request under this 11.8 subdivision, unless the information is false and the provider 11.9 giving the information knew, or had reason to believe, the 11.10 information was false. Information obtained under this 11.11 subdivision is classified as private under chapter 13. 11.12 Subd. 7. [TAX CLEARANCE CERTIFICATE.] (a) In addition to 11.13 the provisions of subdivision 1, the board may not issue or 11.14 renew a license if the commissioner of revenue notifies the 11.15 board and the surgical assistant or applicant for licensure that 11.16 the surgical assistant or applicant owes the state delinquent 11.17 taxes in the amount of $500 or more. The board may issue or 11.18 renew the license only if: 11.19 (1) the commissioner of revenue issues a tax clearance 11.20 certificate; and 11.21 (2) the commissioner of revenue, the surgical assistant, or 11.22 the applicant forwards a copy of the clearance to the board. 11.23 The commissioner of revenue may issue a clearance certificate 11.24 only if the surgical assistant or applicant does not owe the 11.25 state any uncontested delinquent taxes. 11.26 (b) For purposes of this subdivision, the following terms 11.27 have the meanings given: 11.28 (1) "taxes" are all taxes payable to the commissioner of 11.29 revenue, including penalties and interest due on those taxes, 11.30 and 11.31 (2) "delinquent taxes" do not include a tax liability if: 11.32 (i) an administrative or court action that contests the 11.33 amount or validity of the liability has been filed or served; 11.34 (ii) the appeal period to contest the tax liability has not 11.35 expired; or 11.36 (iii) the licensee or applicant has entered into a payment 12.1 agreement to pay the liability and is current with the payments. 12.2 (c) When a surgical assistant or applicant is required to 12.3 obtain a clearance certificate under this subdivision, a 12.4 contested case hearing must be held if the surgical assistant or 12.5 applicant requests a hearing in writing to the commissioner of 12.6 revenue within 30 days of the date of the notice provided in 12.7 paragraph (a). The hearing must be held within 45 days of the 12.8 date the commissioner of revenue refers the case to the office 12.9 of administrative hearings. Notwithstanding any law to the 12.10 contrary, the licensee or applicant must be served with 20 days' 12.11 notice in writing specifying the time and place of the hearing 12.12 and the allegations against the surgical assistant or 12.13 applicant. The notice may be served personally or by mail. 12.14 (d) The board shall require all surgical assistants and 12.15 applicants to provide their social security numbers and 12.16 Minnesota business identification numbers on all license 12.17 applications. Upon request of the commissioner of revenue, the 12.18 board must provide to the commissioner of revenue a list of all 12.19 surgical assistants and applicants, including their names and 12.20 addresses, social security numbers, and business identification 12.21 numbers. The commissioner of revenue may request a list of the 12.22 registrants and applicants no more than once each calendar year. 12.23 Sec. 11. [147E.11] [REPORTING OBLIGATIONS.] 12.24 Subdivision 1. [PERMISSION TO REPORT.] A person who has 12.25 knowledge of any conduct constituting grounds for discipline 12.26 under this chapter may report the violation to the board. 12.27 Subd. 2. [INSTITUTIONS.] Any hospital, clinic, prepaid 12.28 medical plan, or other health care institution or organization 12.29 located in this state must report to the board any action taken 12.30 by the institution or organization, any of its administrators, 12.31 or its medical or other committees to revoke, suspend, restrict, 12.32 or condition a surgical assistant's privilege to practice or 12.33 treat patients in the institution or as part of the 12.34 organization, any denial of privileges, or any other 12.35 disciplinary action. The institution or organization must also 12.36 report the resignation of any surgical assistant prior to the 13.1 conclusion of any disciplinary proceeding or prior to the 13.2 commencement of formal charges but after the surgical assistant 13.3 had knowledge that formal charges were contemplated or in 13.4 preparation. Each report made under this subdivision must state 13.5 the nature of the action taken, state in detail the reasons for 13.6 the action, and identify the specific patient medical records 13.7 upon which the action was based. No report is required of a 13.8 surgical assistant voluntarily limiting the surgical assistant's 13.9 practice at a hospital provided that the surgical assistant 13.10 notifies all hospitals at which the surgical assistant has 13.11 privileges of the voluntary limitation and the reasons for it. 13.12 Subd. 3. [SURGICAL ASSISTANT ORGANIZATIONS.] A state or 13.13 local surgical assistant organization must report to the board 13.14 any termination, revocation, or suspension of membership or any 13.15 other disciplinary action taken against a surgical assistant. 13.16 If the society has received a complaint that might be grounds 13.17 for discipline under this chapter against a member surgical 13.18 assistant on which it has not taken any disciplinary action, the 13.19 society must report the complaint and the reason why it has not 13.20 taken action on it or shall direct the complainant to the board 13.21 of medical practice. This subdivision does not apply to a 13.22 surgical assistant organization when it performs peer review 13.23 functions as an agent of an outside entity, organization, or 13.24 system. 13.25 Subd. 4. [LICENSED PROFESSIONALS.] Licensed health 13.26 professionals and persons holding residency permits under 13.27 section 147.0391 must report to the board personal knowledge of 13.28 any conduct that the person reasonably believes constitutes 13.29 grounds for disciplinary action under this chapter by a surgical 13.30 assistant, including any conduct indicating that the person may 13.31 be incompetent, may have engaged in unprofessional conduct, or 13.32 may be medically or physically unable to engage safely in 13.33 practice as a surgical assistant. No report is required if the 13.34 information was obtained in the course of a physician-patient 13.35 relationship if the patient is a surgical assistant, and the 13.36 treating physician successfully counsels the person to limit or 14.1 withdraw from practice to the extent required by the impairment. 14.2 Subd. 5. [INSURERS.] Four times each year as prescribed by 14.3 the board, each insurer authorized to sell insurance described 14.4 in section 60A.06, subdivision 1, clause (13), and providing 14.5 professional liability insurance to surgical assistants, and any 14.6 medical clinic, hospital, political subdivision, or other entity 14.7 that self-insures and provides professional liability coverage 14.8 to surgical assistants, must submit to the board a report 14.9 concerning the surgical assistants against whom professional 14.10 malpractice settlements or awards have been made to the 14.11 plaintiff. 14.12 Any medical clinic, hospital, political subdivision, or 14.13 other entity which provides liability coverage on behalf of a 14.14 surgical assistant must submit to the board a report concerning 14.15 settlements or awards paid on behalf of a surgical assistant, 14.16 and any settlements or awards paid by a clinic, hospital, 14.17 political subdivision, or other entity on its own behalf because 14.18 of care rendered by a surgical assistant. The report must be 14.19 made to the board within 30 days of a settlement. The report 14.20 must contain at least the following information: 14.21 (1) the total number of medical malpractice settlements or 14.22 awards made to the plaintiff; 14.23 (2) the date the medical malpractice settlements or awards 14.24 to the plaintiff were made; 14.25 (3) the allegations contained in the claim or complaint 14.26 leading to the settlements or awards made to the plaintiff; 14.27 (4) the dollar amount of each medical malpractice 14.28 settlement or award; 14.29 (5) the regular address of the practice of the surgical 14.30 assistant against whom an award was made or with whom a 14.31 settlement was made; and 14.32 (6) the name of the surgical assistant against whom an 14.33 award was made or with whom a settlement was made. 14.34 The insurance company must, in addition to the above 14.35 information, report to the board any information it possesses 14.36 that tends to substantiate a charge that a surgical assistant 15.1 may have engaged in conduct violating this chapter. 15.2 Subd. 6. [COURTS.] The court administrator of district 15.3 court or any other court of competent jurisdiction must report 15.4 to the board any judgment or other determination of the court 15.5 which adjudges or includes a finding that a surgical assistant 15.6 is mentally ill, mentally incompetent, guilty of a felony, 15.7 guilty of a violation of federal or state narcotics laws or 15.8 controlled substances act, or guilty of an abuse or fraud under 15.9 Medicare or Medicaid, appoints a guardian of the surgical 15.10 assistant pursuant to sections 525.54 to 525.61, or commits a 15.11 surgical assistant pursuant to chapter 253B. 15.12 Subd. 7. [SELF-REPORTING.] A surgical assistant must 15.13 report to the board any personal action that is a violation of 15.14 this chapter. 15.15 Subd. 8. [DEADLINES; FORMS.] Reports required by 15.16 subdivisions 2 to 7 must be submitted not later than 30 days 15.17 after the occurrence of the reportable event or transaction. 15.18 The board may provide forms for the submission of reports 15.19 required by this section, may require that reports be submitted 15.20 on the forms provided, and may adopt rules necessary to assure 15.21 prompt and accurate reporting. 15.22 Subd. 9. [SUBPOENAS.] The board may issue subpoenas for 15.23 the production of any reports required by subdivisions 2 to 7 or 15.24 any related documents. 15.25 Sec. 12. [147E.12] [IMMUNITY.] 15.26 Subdivision 1. [REPORTING.] Any person, health care 15.27 facility, business, or organization is immune from civil 15.28 liability or criminal prosecution for submitting a report to the 15.29 board pursuant to this chapter or for otherwise reporting to the 15.30 board violations or alleged violations of this chapter. All 15.31 such reports are confidential and absolutely privileged 15.32 communications. 15.33 Subd. 2. [INVESTIGATION; INDEMNIFICATION.] (a) Members of 15.34 the board, persons employed by the board, and consultants 15.35 retained by the board for the purpose of investigation of 15.36 violations or the preparation and management of charges of 16.1 violations of this chapter on behalf of the board are immune 16.2 from civil liability and criminal prosecution for any actions, 16.3 transactions, or publications in the execution of, or relating 16.4 to, their duties under this chapter. 16.5 (b) For purposes of this section, a member of the board or 16.6 a consultant described in paragraph (a) is considered a state 16.7 employee under section 3.736, subdivision 9. 16.8 Subd. 3. [SURGICAL ASSISTANT COOPERATION.] A surgical 16.9 assistant who is the subject of an investigation by or on behalf 16.10 of the board must cooperate fully with the investigation. 16.11 Cooperation includes responding fully and promptly to any 16.12 question raised by or on behalf of the board relating to the 16.13 subject of the investigation and providing copies of patient 16.14 medical records, as reasonably requested by the board, to assist 16.15 the board in its investigation. The board must pay for copies 16.16 requested. If the board does not have a written consent from a 16.17 patient permitting access to the patient's records, the surgical 16.18 assistant must delete any data in the record which identifies 16.19 the patient before providing it to the board. The board must 16.20 maintain any records obtained pursuant to this section as 16.21 investigative data pursuant to chapter 13. 16.22 Sec. 13. [147E.13] [FORMS OF DISCIPLINARY ACTION.] 16.23 When the board finds that a licensed surgical assistant has 16.24 violated a provision of this chapter, it may do one or more of 16.25 the following: 16.26 (1) revoke the license; 16.27 (2) suspend the license; 16.28 (3) impose limitations or conditions on the surgical 16.29 assistant's practice, including limiting the scope of practice 16.30 to designated field specialties; impose retraining or 16.31 rehabilitation requirements; require practice under additional 16.32 supervision; or condition continued practice on demonstration of 16.33 knowledge or skills by appropriate examination or other review 16.34 of skill and competence; 16.35 (4) impose a civil penalty not exceeding $10,000 for each 16.36 separate violation, the amount of the civil penalty to be fixed 17.1 so as to deprive the surgical assistant of any economic 17.2 advantage gained by reason of the violation charged or to 17.3 reimburse the board for the cost of the investigation and 17.4 proceeding; 17.5 (5) order the surgical assistant to provide unremunerated 17.6 professional service under supervision at a designated public 17.7 hospital, clinic, or other health care institution; or 17.8 (6) censure or reprimand the surgical assistant. 17.9 Upon judicial review of any board disciplinary action taken 17.10 under this chapter, the reviewing court must seal the 17.11 administrative record, except for the board's final decision, 17.12 and must not make the administrative record available to the 17.13 public. 17.14 Sec. 14. [147E.14] [SURGICAL ASSISTANT ACCOUNTABILITY.] 17.15 Subdivision 1. [INVESTIGATION.] The board must maintain 17.16 and keep current a file containing the reports and complaints 17.17 filed against surgical assistants in the state. Each complaint 17.18 filed with the board pursuant to section 214.10, subdivision 1, 17.19 must be investigated according to section 214.10, subdivision 2. 17.20 Whenever the files maintained by the board show that a 17.21 medical malpractice settlement or award to the plaintiff has 17.22 been made against a surgical assistant as reported by insurers 17.23 pursuant to this chapter, the executive director of the board 17.24 must notify the board and the board may authorize a review of 17.25 the surgical assistant's practice. 17.26 Subd. 2. [ATTORNEY GENERAL INVESTIGATION.] When the board 17.27 initiates a review of a surgical assistant's practice, it must 17.28 notify the attorney general who must investigate the matter in 17.29 the same manner as provided in section 214.10. If an 17.30 investigation is to be made, the attorney general must notify 17.31 the surgical assistant, and, if the incident being investigated 17.32 occurred there, the administrator and chief of staff at the 17.33 medical care facilities in which the surgical assistant serves. 17.34 Subd. 3. [ACCESS TO HOSPITAL RECORDS.] The board has 17.35 access to hospital and medical records of a patient treated by 17.36 the surgical assistant under review if the patient signs a 18.1 written consent form permitting such access. If no consent form 18.2 has been signed, the hospital or surgical assistant must first 18.3 delete data in the record which identifies the patient before 18.4 providing it to the board. 18.5 Sec. 15. [147E.15] [IDENTIFICATION REQUIREMENTS.] 18.6 Surgical assistants licensed under this chapter must keep 18.7 their licenses available for inspection at their primary place 18.8 of business and shall, when engaged in their professional 18.9 activities, wear a name tag identifying themselves as a 18.10 "surgical assistant." 18.11 Sec. 16. [147E.16] [FEES.] 18.12 The fees charged by the board are set at the following rate: 18.13 (1) licensure, .......; 18.14 (2) renewal, .......; 18.15 (3) locum tenens permits, .......; and 18.16 (4) temporary licensure, ........ 18.17 Sec. 17. [147E.17] [CONTINUING EDUCATION REQUIREMENTS.] 18.18 Subdivision 1. [AMOUNT OF EDUCATION REQUIRED.] Applicants 18.19 for licensure renewal or relicensure must either attest to and 18.20 document successful completion of at least 100 contact hours of 18.21 continuing education within the six years immediately preceding 18.22 licensure renewal, relicensure, or attest to and document taking 18.23 the national certifying examination required by this chapter 18.24 within the past two years. 18.25 Subd. 2. [TYPE OF EDUCATION REQUIRED.] Approved continuing 18.26 education equivalent to category 1, 2, or 3 credit hours are as 18.27 defined by the American Osteopathic Association Bureau of 18.28 Professional Education, the Royal College of Physicians and 18.29 Surgeons of Canada, the Association of Surgical Technologists, 18.30 organizations that have reciprocal arrangements with the 18.31 physician recognition award program of the American Medical 18.32 Association, or other bodies approved by the board. 18.33 Sec. 18. [147E.18] [PROCEDURES.] 18.34 The board must establish, in writing, internal operating 18.35 procedures for receiving and investigating complaints, accepting 18.36 and processing applications, granting licenses, and imposing 19.1 enforcement actions. The written internal operating procedures 19.2 may include procedures for sharing complaint information with 19.3 government agencies in this and other states. Procedures for 19.4 sharing complaint information must be consistent with the 19.5 requirements for handling government data under chapter 13. 19.6 Sec. 19. [147E.19] [SURGICAL ASSISTANT ADVISORY COUNCIL.] 19.7 Subdivision 1. [MEMBERSHIP.] (a) The surgical assistant 19.8 advisory council is created and is composed of seven persons 19.9 appointed by the board. The seven persons must include: 19.10 (1) two public members, as defined in section 214.02; 19.11 (2) three surgical assistants licensed under this chapter; 19.12 and 19.13 (3) two licensed physicians with experience supervising 19.14 surgical assistants. 19.15 (b) No member shall serve more than a total of two terms. 19.16 If a member is appointed for a partial term and serves more than 19.17 half of that term it shall be considered a full term. 19.18 Subd. 2. [ORGANIZATION.] The council shall be organized 19.19 and administered under section 15.059, except that the advisory 19.20 council expires on June 30, 2012. 19.21 Subd. 3. [DUTIES.] The council must advise the board 19.22 regarding: 19.23 (1) surgical assistant licensure standards; 19.24 (2) enforcement of grounds for discipline; 19.25 (3) distribution of information regarding surgical 19.26 assistant licensure standards; 19.27 (4) applications and recommendations of applicants for 19.28 licensure or relicensure; and 19.29 (5) complaints and recommendations to the board regarding 19.30 disciplinary matters and proceedings concerning applicants and 19.31 surgical assistants according to sections 214.10; 214.103; and 19.32 214.13, subdivisions 6 and 7. 19.33 The council shall perform other duties authorized for the 19.34 council by chapter 214 as directed by the board. 19.35 Sec. 20. [147E.20] [INITIAL LICENSURE.] 19.36 Surgical assistants must be licensed under this chapter no 20.1 later than July 1, 2003. 20.2 Sec. 21. [INITIAL ADVISORY COUNSEL.] 20.3 (a) Notwithstanding Minnesota Statutes, section 147E.19, 20.4 the four members of the advisory council required by that 20.5 section to be surgical assistants, who are appointed to the 20.6 initial advisory committee, need not be licensed under this act 20.7 but must satisfy the qualifications for licensure provided in 20.8 Minnesota Statutes, section 147E.02, clauses (3) to (5), and 20.9 must have been engaged in the practice of surgical assistance a 20.10 minimum of three years. 20.11 (b) Two members of the initial advisory committee appointed 20.12 must have an initial term of one year, two members an initial 20.13 term of two years, and three members an initial term of three 20.14 years. 20.15 ARTICLE 2 20.16 Section 1. Minnesota Statutes 2002, section 13.383, is 20.17 amended by adding a subdivision to read: 20.18 Subd. 5a. [SURGICAL ASSISTANTS.] Data obtained by the 20.19 medical practices board relating to surgical assistants are 20.20 classified under section 147E.10, subdivision 6; 147E.12; and 20.21 147E.18. 20.22 Sec. 2. Minnesota Statutes 2002, section 62A.3092, 20.23 subdivision 2, is amended to read: 20.24 Subd. 2. [REQUIREMENT.] Coverage described in subdivision 20.25 1 that provides for payment for surgical first assisting 20.26 benefits or services shall be construed as providing for payment 20.27 for a registered nurse or licensed surgical assistant who 20.28 performs first assistant functions and services that are within 20.29 the scope of practice of a registered nurse or licensed surgical 20.30 assistant. 20.31 Sec. 3. Minnesota Statutes 2002, section 62J.52, 20.32 subdivision 2, is amended to read: 20.33 Subd. 2. [UNIFORM BILLING FORM HCFA 1500.] (a) On and 20.34 after January 1, 1996, all noninstitutional health care services 20.35 rendered by providers in Minnesota except dental or pharmacy 20.36 providers, that are not currently being billed using an 21.1 equivalent electronic billing format, must be billed using the 21.2 health insurance claim form HCFA 1500, except as provided in 21.3 subdivision 5. 21.4 (b) The instructions and definitions for the use of the 21.5 uniform billing form HCFA 1500 shall be in accordance with the 21.6 manual developed by the administrative uniformity committee 21.7 entitled standards for the use of the HCFA 1500 form, dated 21.8 February 1994, as further defined by the commissioner. 21.9 (c) Services to be billed using the uniform billing form 21.10 HCFA 1500 include physician services and supplies, durable 21.11 medical equipment, noninstitutional ambulance services, 21.12 independent ancillary services including occupational therapy, 21.13 physical therapy, speech therapy and audiology, podiatry 21.14 services, optometry services, mental health licensed 21.15 professional services, substance abuse licensed professional 21.16 services, nursing practitioner professional services, certified 21.17 registered nurse anesthetists, chiropractors, physician 21.18 assistants, surgical assistants, laboratories, medical 21.19 suppliers, and other health care providers such as day activity 21.20 centers and freestanding ambulatory surgical centers. 21.21 Sec. 4. Minnesota Statutes 2002, section 62J.54, 21.22 subdivision 2, is amended to read: 21.23 Subd. 2. [UNIQUE IDENTIFICATION NUMBER FOR INDIVIDUAL 21.24 HEALTH CARE PROVIDERS.] (a) Not later than 24 months after the 21.25 date on which a unique health identifier for health care 21.26 providers is adopted or established under United States Code, 21.27 title 42, sections 1320d to 1320d-8 (1996 and subsequent 21.28 amendments), all group purchasers and health care providers in 21.29 Minnesota shall use a unique identification number to identify 21.30 an individual health care provider, except as provided in 21.31 paragraph (b). 21.32 (b) Small health plans, as defined by the federal Secretary 21.33 of Health and Human Services under United States Code, title 42, 21.34 section 1320d-4 (1996 and subsequent amendments), shall use a 21.35 unique identification number to identify an individual health 21.36 care provider no later than 36 months after the date on which a 22.1 unique health identifier for health care providers is adopted or 22.2 established under United States Code, title 42, sections 1320d 22.3 to 1320d-8 (1996 and subsequent amendments). 22.4 (c) The unique health identifier for health care providers 22.5 adopted or established by the federal Secretary of Health and 22.6 Human Services under United States Code, title 42, sections 22.7 1320d to 1320d-8 (1996 and subsequent amendments), shall be used 22.8 as the unique identification number for individual health care 22.9 providers. 22.10 (d) Individual providers required to have a unique health 22.11 identifier are: 22.12 (1) physicians licensed under chapter 147; 22.13 (2) dentists licensed under chapter 150A; 22.14 (3) chiropractors licensed under chapter 148; 22.15 (4) podiatrists licensed under chapter 153; 22.16 (5) physician assistants as defined under section 147A.01; 22.17 (6) surgical assistants licensed under chapter 147E; 22.18 (7) advanced practice nurses as defined under section 22.19 62A.15; 22.20
(7)(8) doctors of optometry licensed under section 148.57; 22.21 (8)(9) pharmacists licensed under chapter 151; 22.22 (9)(10) individual providers who may bill Medicare for 22.23 medical and other health services as defined in United States 22.24 Code, title 42, section 1395x(s); 22.25 (10)(11) individual providers who are providers for state 22.26 and federal health care programs administered by the 22.27 commissioner of human services; and 22.28 (11)(12) other individual providers as required by the 22.29 federal Secretary of Health and Human Services under United 22.30 States Code, title 42, sections 1320d to 1320d-8 (1996 and 22.31 subsequent amendments). 22.32 Providers shall obtain a unique health identifier from the 22.33 federal Secretary of Health and Human Services using the process 22.34 prescribed by the Secretary. 22.35 (e) Only the unique individual health care provider 22.36 identifier shall be used for purposes of submitting and 23.1 receiving claims, and in conjunction with other data collection 23.2 and reporting functions. 23.3 (f) The commissioner of health may contract with the 23.4 federal Secretary of Health and Human Services or the 23.5 Secretary's agent to implement this subdivision. 23.6 Sec. 5. Minnesota Statutes 2002, section 116.79, 23.7 subdivision 1, is amended to read: 23.8 Subdivision 1. [PREPARATION OF MANAGEMENT PLANS.] (a) To 23.9 the extent applicable to the facility, a person in charge of a 23.10 facility that generates, stores, decontaminates, incinerates, or 23.11 disposes of infectious or pathological waste must prepare a 23.12 management plan for the infectious or pathological waste handled 23.13 by the facility. A person may prepare a common management plan 23.14 for all generating facilities owned and operated by the person. 23.15 If a single plan is prepared to cover multiple facilities, the 23.16 plan must identify common policy and procedures for the 23.17 facilities and any management procedures that are facility 23.18 specific. The plan must identify each generating facility 23.19 covered by the plan. A management plan must list all 23.20 physicians, dentists, chiropractors, podiatrists, veterinarians, 23.21 certified nurse practitioners, certified nurse 23.22 midwives, surgical assistants, or physician assistants, employed 23.23 by, under contract to, or working at the generating facilities, 23.24 except hospitals or laboratories. A management plan from a 23.25 hospital must list the number of licensed beds and from a 23.26 laboratory must list the number of generating employees. 23.27 (b) The management plan must describe, to the extent the 23.28 information is applicable to the facility: 23.29 (1) the type of infectious waste and pathological waste 23.30 that the person generates or handles; 23.31 (2) the segregation, packaging, labeling, collection, 23.32 storage, and transportation procedures for the infectious waste 23.33 or pathological waste that will be followed; 23.34 (3) the decontamination or disposal methods for the 23.35 infectious or pathological waste that will be used; 23.36 (4) the transporters and disposal facilities that will be 24.1 used for the infectious waste; 24.2 (5) the steps that will be taken to minimize the exposure 24.3 of employees to infectious agents throughout the process of 24.4 disposing of infectious or pathological wastes; and 24.5 (6) the name of the individual responsible for the 24.6 management of the infectious waste or pathological waste. 24.7 (c) If the generator mails sharps for storage, 24.8 decontamination, or disposal, the plan must specify how the 24.9 generator will comply with applicable federal laws and rules. 24.10 The plan must also specify the name, address, and telephone 24.11 number of the facility to which the sharps are mailed, the name 24.12 of the person who receives the sharps at the facility, and the 24.13 annual amount mailed to the facility. If the facility to which 24.14 the sharps are mailed is not the disposal facility, the plan 24.15 must also identify the disposal facility. 24.16 (d) The management plan must be kept at the facility. 24.17 (e) To the extent applicable to the facility, management 24.18 plans must be accompanied by a statement of the quantity of 24.19 infectious and pathological waste generated, decontaminated, 24.20 stored, incinerated, or disposed of at the facility during the 24.21 previous two-year period. Quantities shall be reported in 24.22 pounds. 24.23 (f) A management plan must be updated at least once every 24.24 two years. 24.25 Sec. 6. Minnesota Statutes 2002, section 116J.70, 24.26 subdivision 2a, is amended to read: 24.27 Subd. 2a. [LICENSE; EXCEPTIONS.] "Business license" or 24.28 "license" does not include the following: 24.29 (1) any occupational license or registration issued by a 24.30 licensing board listed in section 214.01 or any occupational 24.31 registration issued by the commissioner of health pursuant to 24.32 section 214.13; 24.33 (2) any license issued by a county, home rule charter city, 24.34 statutory city, township, or other political subdivision; 24.35 (3) any license required to practice the following 24.36 occupation regulated by the following sections: 25.1 (i) abstracters regulated pursuant to chapter 386; 25.2 (ii) accountants regulated pursuant to chapter 326A; 25.3 (iii) adjusters regulated pursuant to chapter 72B; 25.4 (iv) architects regulated pursuant to chapter 326; 25.5 (v) assessors regulated pursuant to chapter 270; 25.6 (vi) athletic trainers regulated pursuant to chapter 148; 25.7 (vii) attorneys regulated pursuant to chapter 481; 25.8 (viii) auctioneers regulated pursuant to chapter 330; 25.9 (ix) barbers regulated pursuant to chapter 154; 25.10 (x) beauticians regulated pursuant to chapter 155A; 25.11 (xi) boiler operators regulated pursuant to chapter 183; 25.12 (xii) chiropractors regulated pursuant to chapter 148; 25.13 (xiii) collection agencies regulated pursuant to chapter 25.14 332; 25.15 (xiv) cosmetologists regulated pursuant to chapter 155A; 25.16 (xv) dentists, registered dental assistants, and dental 25.17 hygienists regulated pursuant to chapter 150A; 25.18 (xvi) detectives regulated pursuant to chapter 326; 25.19 (xvii) electricians regulated pursuant to chapter 326; 25.20 (xviii) mortuary science practitioners regulated pursuant 25.21 to chapter 149A; 25.22 (xix) engineers regulated pursuant to chapter 326; 25.23 (xx) insurance brokers and salespersons regulated pursuant 25.24 to chapter 60A; 25.25 (xxi) certified interior designers regulated pursuant to 25.26 chapter 326; 25.27 (xxii) midwives regulated pursuant to chapter 147D; 25.28 (xxiii) nursing home administrators regulated pursuant to 25.29 chapter 144A; 25.30 (xxiv) optometrists regulated pursuant to chapter 148; 25.31 (xxv) osteopathic physicians regulated pursuant to chapter 25.32 147; 25.33 (xxvi) pharmacists regulated pursuant to chapter 151; 25.34 (xxvii) physical therapists regulated pursuant to chapter 25.35 148; 25.36 (xxviii) physician assistants regulated pursuant to chapter 26.1 147A; 26.2 (xxix) surgical assistants licensed under chapter 147E; 26.3 (xxx) physicians and surgeons regulated pursuant to chapter 26.4 147; 26.5 (xxx)(xxxi) plumbers regulated pursuant to chapter 326; 26.6 (xxxi)(xxxii) podiatrists regulated pursuant to chapter 26.7 153; 26.8 (xxxii)(xxxiii) practical nurses regulated pursuant to 26.9 chapter 148; 26.10 (xxxiii)(xxxiv) professional fund raisers regulated 26.11 pursuant to chapter 309; 26.12 (xxxiv)(xxxv) psychologists regulated pursuant to chapter 26.13 148; 26.14 (xxxv)(xxxvi) real estate brokers, salespersons, and 26.15 others regulated pursuant to chapters 82 and 83; 26.16 (xxxvi)(xxxvii) registered nurses regulated pursuant to 26.17 chapter 148; 26.18 (xxxvii)(xxxviii) securities brokers, dealers, agents, and 26.19 investment advisers regulated pursuant to chapter 80A; 26.20 (xxxviii)(xxxix) steamfitters regulated pursuant to 26.21 chapter 326; 26.22 (xxxix)(xl) teachers and supervisory and support personnel 26.23 regulated pursuant to chapter 125; 26.24 (xl)(xli) veterinarians regulated pursuant to chapter 156; 26.25 (xli)(xlii) water conditioning contractors and installers 26.26 regulated pursuant to chapter 326; 26.27 (xlii)(xliii) water well contractors regulated pursuant to 26.28 chapter 103I; 26.29 (xliii)(xliv) water and waste treatment operators 26.30 regulated pursuant to chapter 115; 26.31 (xliv)(xlv) motor carriers regulated pursuant to chapter 26.32 221; 26.33 (xlv)(xlvi) professional firms regulated under chapter 26.34 319B; 26.35 (xlvi)(xlvii) real estate appraisers regulated pursuant to 26.36 chapter 82B; 27.1 (xlvii)(xlviii) residential building contractors, 27.2 residential remodelers, residential roofers, manufactured home 27.3 installers, and specialty contractors regulated pursuant to 27.4 chapter 326; 27.5 (4) any driver's license required pursuant to chapter 171; 27.6 (5) any aircraft license required pursuant to chapter 360; 27.7 (6) any watercraft license required pursuant to chapter 27.8 86B; 27.9 (7) any license, permit, registration, certification, or 27.10 other approval pertaining to a regulatory or management program 27.11 related to the protection, conservation, or use of or 27.12 interference with the resources of land, air, or water, which is 27.13 required to be obtained from a state agency or instrumentality; 27.14 and 27.15 (8) any pollution control rule or standard established by 27.16 the pollution control agency or any health rule or standard 27.17 established by the commissioner of health or any licensing rule 27.18 or standard established by the commissioner of human services. 27.19 Sec. 7. Minnesota Statutes 2002, section 116L.12, 27.20 subdivision 6, is amended to read: 27.21 Subd. 6. [INELIGIBLE WORKER CATEGORIES.] Grants shall not 27.22 be made to alleviate shortages of physicians, physician 27.23 assistants, surgical assistants, or advanced practice nurses. 27.24 Sec. 8. Minnesota Statutes 2002, section 144.054, 27.25 subdivision 2, is amended to read: 27.26 Subd. 2. [HIV; HBV.] The commissioner may subpoena 27.27 privileged medical information of patients who may have been 27.28 exposed by a licensed dental hygienist, dentist, physician, 27.29 nurse, podiatrist, or surgical assistant, a registered dental 27.30 assistant, or a physician's assistant who is infected with the 27.31 human immunodeficiency virus (HIV) or hepatitis B virus (HBV) 27.32 when the commissioner has determined that it may be necessary to 27.33 notify those patients that they may have been exposed to HIV or 27.34 HBV. 27.35 Sec. 9. Minnesota Statutes 2002, section 147.09, is 27.36 amended to read: 28.1 147.09 [EXEMPTIONS.] 28.2 Section 147.081 does not apply to, control, prevent or 28.3 restrict the practice, service, or activities of: 28.4 (1) A person who is a commissioned medical officer of, a 28.5 member of, or employed by, the armed forces of the United 28.6 States, the United States Public Health Service, the Veterans 28.7 Administration, any federal institution or any federal agency 28.8 while engaged in the performance of official duties within this 28.9 state, if the person is licensed elsewhere. 28.10 (2) A licensed physician from a state or country who is in 28.11 actual consultation here. 28.12 (3) A licensed or registered physician who treats the 28.13 physician's home state patients or other participating patients 28.14 while the physicians and those patients are participating 28.15 together in outdoor recreation in this state as defined by 28.16 section 86A.03, subdivision 3. A physician shall first register 28.17 with the board on a form developed by the board for that 28.18 purpose. The board shall not be required to promulgate the 28.19 contents of that form by rule. No fee shall be charged for this 28.20 registration. 28.21 (4) A student practicing under the direct supervision of a 28.22 preceptor while the student is enrolled in and regularly 28.23 attending a recognized medical school. 28.24 (5) A student who is in continuing training and performing 28.25 the duties of an intern or resident or engaged in postgraduate 28.26 work considered by the board to be the equivalent of an 28.27 internship or residency in any hospital or institution approved 28.28 for training by the board, provided the student has a residency 28.29 permit issued by the board under section 147.0391. 28.30 (6) A person employed in a scientific, sanitary, or 28.31 teaching capacity by the state university, the department of 28.32 children, families, and learning, a public or private school, 28.33 college, or other bona fide educational institution, a nonprofit 28.34 organization, which has tax-exempt status in accordance with the 28.35 Internal Revenue Code, section 501(c)(3), and is organized and 28.36 operated primarily for the purpose of conducting scientific 29.1 research directed towards discovering the causes of and cures 29.2 for human diseases, or the state department of health, whose 29.3 duties are entirely of a research, public health, or educational 29.4 character, while engaged in such duties; provided that if the 29.5 research includes the study of humans, such research shall be 29.6 conducted under the supervision of one or more physicians 29.7 licensed under this chapter. 29.8 (7) Physician's assistants or surgical assistants 29.9 registered or licensed in this state. 29.10 (8) A doctor of osteopathy duly licensed by the state board 29.11 of osteopathy under Minnesota Statutes 1961, sections 148.11 to 29.12 148.16, prior to May 1, 1963, who has not been granted a license 29.13 to practice medicine in accordance with this chapter provided 29.14 that the doctor confines activities within the scope of the 29.15 license. 29.16 (9) Any person licensed by a health related licensing 29.17 board, as defined in section 214.01, subdivision 2, or 29.18 registered by the commissioner of health pursuant to section 29.19 214.13, including psychological practitioners with respect to 29.20 the use of hypnosis; provided that the person confines 29.21 activities within the scope of the license. 29.22 (10) A person who practices ritual circumcision pursuant to 29.23 the requirements or tenets of any established religion. 29.24 (11) A Christian Scientist or other person who endeavors to 29.25 prevent or cure disease or suffering exclusively by mental or 29.26 spiritual means or by prayer. 29.27 (12) A physician licensed to practice medicine in another 29.28 state who is in this state for the sole purpose of providing 29.29 medical services at a competitive athletic event. The physician 29.30 may practice medicine only on participants in the athletic 29.31 event. A physician shall first register with the board on a 29.32 form developed by the board for that purpose. The board shall 29.33 not be required to adopt the contents of the form by rule. The 29.34 physician shall provide evidence satisfactory to the board of a 29.35 current unrestricted license in another state. The board shall 29.36 charge a fee of $50 for the registration. 30.1 (13) A psychologist licensed under section 148.907 or a 30.2 social worker licensed under section 148B.21 who uses or 30.3 supervises the use of a penile or vaginal plethysmograph in 30.4 assessing and treating individuals suspected of engaging in 30.5 aberrant sexual behavior and sex offenders. 30.6 (14) Any person issued a training course certificate or 30.7 credentialed by the emergency medical services regulatory board 30.8 established in chapter 144E, provided the person confines 30.9 activities within the scope of training at the certified or 30.10 credentialed level. 30.11 (15) An unlicensed complementary and alternative health 30.12 care practitioner practicing according to chapter 146A. 30.13 Sec. 10. Minnesota Statutes 2002, section 147.091, 30.14 subdivision 1, is amended to read: 30.15 Subdivision 1. [GROUNDS LISTED.] The board may refuse to 30.16 grant a license, may refuse to grant registration to perform 30.17 interstate telemedicine services, or may impose disciplinary 30.18 action as described in section 147.141 against any physician. 30.19 The following conduct is prohibited and is grounds for 30.20 disciplinary action: 30.21 (a) Failure to demonstrate the qualifications or satisfy 30.22 the requirements for a license contained in this chapter or 30.23 rules of the board. The burden of proof shall be upon the 30.24 applicant to demonstrate such qualifications or satisfaction of 30.25 such requirements. 30.26 (b) Obtaining a license by fraud or cheating, or attempting 30.27 to subvert the licensing examination process. Conduct which 30.28 subverts or attempts to subvert the licensing examination 30.29 process includes, but is not limited to: (1) conduct which 30.30 violates the security of the examination materials, such as 30.31 removing examination materials from the examination room or 30.32 having unauthorized possession of any portion of a future, 30.33 current, or previously administered licensing examination; (2) 30.34 conduct which violates the standard of test administration, such 30.35 as communicating with another examinee during administration of 30.36 the examination, copying another examinee's answers, permitting 31.1 another examinee to copy one's answers, or possessing 31.2 unauthorized materials; or (3) impersonating an examinee or 31.3 permitting an impersonator to take the examination on one's own 31.4 behalf. 31.5 (c) Conviction, during the previous five years, of a felony 31.6 reasonably related to the practice of medicine or osteopathy. 31.7 Conviction as used in this subdivision shall include a 31.8 conviction of an offense which if committed in this state would 31.9 be deemed a felony without regard to its designation elsewhere, 31.10 or a criminal proceeding where a finding or verdict of guilt is 31.11 made or returned but the adjudication of guilt is either 31.12 withheld or not entered thereon. 31.13 (d) Revocation, suspension, restriction, limitation, or 31.14 other disciplinary action against the person's medical license 31.15 in another state or jurisdiction, failure to report to the board 31.16 that charges regarding the person's license have been brought in 31.17 another state or jurisdiction, or having been refused a license 31.18 by any other state or jurisdiction. 31.19 (e) Advertising which is false or misleading, which 31.20 violates any rule of the board, or which claims without 31.21 substantiation the positive cure of any disease, or professional 31.22 superiority to or greater skill than that possessed by another 31.23 physician. 31.24 (f) Violating a rule promulgated by the board or an order 31.25 of the board, a state, or federal law which relates to the 31.26 practice of medicine, or in part regulates the practice of 31.27 medicine including without limitation sections 148A.02, 609.344, 31.28 and 609.345, or a state or federal narcotics or controlled 31.29 substance law. 31.30 (g) Engaging in any unethical conduct; conduct likely to 31.31 deceive, defraud, or harm the public, or demonstrating a willful 31.32 or careless disregard for the health, welfare or safety of a 31.33 patient; or medical practice which is professionally 31.34 incompetent, in that it may create unnecessary danger to any 31.35 patient's life, health, or safety, in any of which cases, proof 31.36 of actual injury need not be established. 32.1 (h) Failure to supervise a physician's assistant or 32.2 surgical assistant or failure to supervise a physician under any 32.3 agreement with the board. 32.4 (i) Aiding or abetting an unlicensed person in the practice 32.5 of medicine, except that it is not a violation of this paragraph 32.6 for a physician to employ, supervise, or delegate functions to a 32.7 qualified person who may or may not be required to obtain a 32.8 license or registration to provide health services if that 32.9 person is practicing within the scope of that person's license 32.10 or registration or delegated authority. 32.11 (j) Adjudication as mentally incompetent, mentally ill or 32.12 mentally retarded, or as a chemically dependent person, a person 32.13 dangerous to the public, a sexually dangerous person, or a 32.14 person who has a sexual psychopathic personality by a court of 32.15 competent jurisdiction, within or without this state. Such 32.16 adjudication shall automatically suspend a license for the 32.17 duration thereof unless the board orders otherwise. 32.18 (k) Engaging in unprofessional conduct. Unprofessional 32.19 conduct shall include any departure from or the failure to 32.20 conform to the minimal standards of acceptable and prevailing 32.21 medical practice in which proceeding actual injury to a patient 32.22 need not be established. 32.23 (l) Inability to practice medicine with reasonable skill 32.24 and safety to patients by reason of illness, drunkenness, use of 32.25 drugs, narcotics, chemicals or any other type of material or as 32.26 a result of any mental or physical condition, including 32.27 deterioration through the aging process or loss of motor skills. 32.28 (m) Revealing a privileged communication from or relating 32.29 to a patient except when otherwise required or permitted by law. 32.30 (n) Failure by a doctor of osteopathy to identify the 32.31 school of healing in the professional use of the doctor's name 32.32 by one of the following terms: osteopathic physician and 32.33 surgeon, doctor of osteopathy, or D.O. 32.34 (o) Improper management of medical records, including 32.35 failure to maintain adequate medical records, to comply with a 32.36 patient's request made pursuant to section 144.335 or to furnish 33.1 a medical record or report required by law. 33.2 (p) Fee splitting, including without limitation: 33.3 (1) paying, offering to pay, receiving, or agreeing to 33.4 receive, a commission, rebate, or remuneration, directly or 33.5 indirectly, primarily for the referral of patients or the 33.6 prescription of drugs or devices; 33.7 (2) dividing fees with another physician or a professional 33.8 corporation, unless the division is in proportion to the 33.9 services provided and the responsibility assumed by each 33.10 professional and the physician has disclosed the terms of the 33.11 division; 33.12 (3) referring a patient to any health care provider as 33.13 defined in section 144.335 in which the referring physician has 33.14 a significant financial interest unless the physician has 33.15 disclosed the physician's own financial interest; and 33.16 (4) dispensing for profit any drug or device, unless the 33.17 physician has disclosed the physician's own profit interest. 33.18 The physician must make the disclosures required in this clause 33.19 in advance and in writing to the patient and must include in the 33.20 disclosure a statement that the patient is free to choose a 33.21 different health care provider. This clause does not apply to 33.22 the distribution of revenues from a partnership, group practice, 33.23 nonprofit corporation, or professional corporation to its 33.24 partners, shareholders, members, or employees if the revenues 33.25 consist only of fees for services performed by the physician or 33.26 under a physician's direct supervision, or to the division or 33.27 distribution of prepaid or capitated health care premiums, or 33.28 fee-for-service withhold amounts paid under contracts 33.29 established under other state law. 33.30 (q) Engaging in abusive or fraudulent billing practices, 33.31 including violations of the federal Medicare and Medicaid laws 33.32 or state medical assistance laws. 33.33 (r) Becoming addicted or habituated to a drug or intoxicant. 33.34 (s) Prescribing a drug or device for other than medically 33.35 accepted therapeutic or experimental or investigative purposes 33.36 authorized by a state or federal agency or referring a patient 34.1 to any health care provider as defined in section 144.335 for 34.2 services or tests not medically indicated at the time of 34.3 referral. 34.4 (t) Engaging in conduct with a patient which is sexual or 34.5 may reasonably be interpreted by the patient as sexual, or in 34.6 any verbal behavior which is seductive or sexually demeaning to 34.7 a patient. 34.8 (u) Failure to make reports as required by section 147.111 34.9 or to cooperate with an investigation of the board as required 34.10 by section 147.131. 34.11 (v) Knowingly providing false or misleading information 34.12 that is directly related to the care of that patient unless done 34.13 for an accepted therapeutic purpose such as the administration 34.14 of a placebo. 34.15 (w) Aiding suicide or aiding attempted suicide in violation 34.16 of section 609.215 as established by any of the following: 34.17 (1) a copy of the record of criminal conviction or plea of 34.18 guilty for a felony in violation of section 609.215, subdivision 34.19 1 or 2; 34.20 (2) a copy of the record of a judgment of contempt of court 34.21 for violating an injunction issued under section 609.215, 34.22 subdivision 4; 34.23 (3) a copy of the record of a judgment assessing damages 34.24 under section 609.215, subdivision 5; or 34.25 (4) a finding by the board that the person violated section 34.26 609.215, subdivision 1 or 2. The board shall investigate any 34.27 complaint of a violation of section 609.215, subdivision 1 or 2. 34.28 (x) Practice of a board-regulated profession under lapsed 34.29 or nonrenewed credentials. 34.30 (y) Failure to repay a state or federally secured student 34.31 loan in accordance with the provisions of the loan. 34.32 (z) Providing interstate telemedicine services other than 34.33 according to section 147.032. 34.34 Sec. 11. Minnesota Statutes 2002, section 214.18, 34.35 subdivision 5, is amended to read: 34.36 Subd. 5. [REGULATED PERSON.] "Regulated person" means a 35.1 licensed dental hygienist, dentist, physician, nurse who is 35.2 currently registered as a registered nurse or licensed practical 35.3 nurse, podiatrist, a registered dental assistant, a physician's 35.4 assistant, a surgical assistant, and for purposes of sections 35.5 214.19, subdivisions 4 and 5; 214.20, paragraph (a); and 214.24, 35.6 a chiropractor. 35.7 Sec. 12. Minnesota Statutes 2002, section 256B.0625, is 35.8 amended by adding a subdivision to read: 35.9 Subd. 28b. [LICENSED SURGICAL ASSISTANT SERVICES.] Medical 35.10 assistance covers services performed by a licensed surgical 35.11 assistant if the service is otherwise covered under this chapter 35.12 as a physician service and if the service is within the scope of 35.13 practice of a licensed surgical assistant as defined in section 35.14 147E.01. 35.15 Sec. 13. Minnesota Statutes 2002, section 319B.02, 35.16 subdivision 19, is amended to read: 35.17 Subd. 19. [PROFESSIONAL SERVICES.] "Professional services" 35.18 means services of the type required or permitted to be furnished 35.19 by a professional under a license, registration, or certificate 35.20 issued by the state of Minnesota to practice medicine and 35.21 surgery under sections 147.01 to 147.22, as a physician 35.22 assistant pursuant to sections 147A.01 to 147A.27, as a surgical 35.23 assistant under chapter 147E, chiropractic under sections 148.01 35.24 to 148.105, registered nursing under sections 148.171 to 35.25 148.285, optometry under sections 148.52 to 148.62, psychology 35.26 under sections 148.88 to 148.98, social work under sections 35.27 148B.18 to 148B.289, dentistry and dental hygiene under sections 35.28 150A.01 to 150A.12, pharmacy under sections 151.01 to 151.40, 35.29 podiatric medicine under sections 153.01 to 153.25, veterinary 35.30 medicine under sections 156.001 to 156.14, architecture, 35.31 engineering, surveying, landscape architecture, geoscience, and 35.32 certified interior design under sections 326.02 to 326.15, 35.33 accountancy under chapter 326A, or law under sections 481.01 to 35.34 481.17, or under a license or certificate issued by another 35.35 state under similar laws. Professional services includes 35.36 services of the type required to be furnished by a professional 36.1 pursuant to a license or other authority to practice law under 36.2 the laws of a foreign nation. 36.3 Sec. 14. Minnesota Statutes 2002, section 319B.40, is 36.4 amended to read: 36.5 319B.40 [PROFESSIONAL HEALTH SERVICES.] 36.6 (a) Individuals who furnish professional services pursuant 36.7 to a license, registration, or certificate issued by the state 36.8 of Minnesota to practice medicine pursuant to sections 147.01 to 36.9 147.22, as a physician assistant pursuant to sections 147A.01 to 36.10 147A.27, as a surgical assistant pursuant to chapter 147E, 36.11 chiropractic pursuant to sections 148.01 to 148.106, registered 36.12 nursing pursuant to sections 148.171 to 148.285, optometry 36.13 pursuant to sections 148.52 to 148.62, psychology pursuant to 36.14 sections 148.88 to 148.98, social work pursuant to sections 36.15 148B.18 to 148B.289, dentistry pursuant to sections 150A.01 to 36.16 150A.12, pharmacy pursuant to sections 151.01 to 151.40, or 36.17 podiatric medicine pursuant to sections 153.01 to 153.26 are 36.18 specifically authorized to practice any of these categories of 36.19 services in combination if the individuals are organized under 36.20 this chapter. 36.21 (b) This authorization does not authorize an individual to 36.22 practice any profession, or furnish a professional service, for 36.23 which the individual is not licensed, registered, or certified, 36.24 but otherwise applies regardless of any contrary provision of a 36.25 licensing statute or rules adopted pursuant to that statute, 36.26 related to practicing and organizing in combination with other 36.27 health services professionals.