SF 1018

1st Engrossment - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

A bill for an act
relating to health occupations; changing provisions for physical therapy
licensure; amending Minnesota Statutes 2006, sections 148.65, by adding
a subdivision; 148.76, subdivision 2; Minnesota Statutes 2007 Supplement,
section 148.75; repealing Minnesota Rules, parts 5601.0100, subparts 5, 6, 7,
8; 5601.1200; 5601.1800; 5601.1900.

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

Section 1.

Minnesota Statutes 2006, section 148.65, is amended by adding a
subdivision to read:

Subd. 9.

Licensed health care professional or licensed health care provider.

"Licensed health care professional" or "licensed health care provider" means a person
licensed in good standing in Minnesota to practice medicine, osteopathy, chiropractic,
podiatry, dentistry, or advanced practice nursing.

Sec. 2.

Minnesota Statutes 2007 supplement, section 148.75, is amended to read:

148.75 DISCIPLINARY ACTION.

(a) The board may impose disciplinary action specified in paragraph (b) against an
applicant or licensee whom the board, by a preponderance of the evidence, determines:

(1) has violated a statute, rule, order, or agreement for corrective action that the
board issued or is otherwise authorized or empowered to enforce;

(2) is unable to practice physical therapy with reasonable skill and safety by reason
of any mental or physical illness or condition, including deterioration through the aging
process or loss of motor skills, or use of alcohol, drugs, narcotics, chemicals, or any
other type of material;

(3) has been convicted of or has pled guilty or nolo contendere to a felony or other
crime, an element of which is dishonesty or fraud, or has been shown to have engaged
in acts or practices tending to show that the applicant or licensee is incompetent or has
engaged in conduct reflecting adversely on the applicant's or licensee's ability or fitness to
engage in the practice of physical therapy;

(4) has been convicted of violating any state or federal narcotic law;

(5) has obtained or attempted to obtain a license or approval of continuing education
activities, or passed an examination, by fraud or deception;

(6) has engaged in unprofessional conduct or any other conduct which has the
potential for causing harm to the public, including any departure from or failure to
conform to the minimum standards of acceptable and prevailing practice without actual
injury having to be established;

(7) has engaged in gross negligence in the practice of physical therapy as a physical
therapist;

(8) has treated human ailments by physical therapy after an initial 30-day 90-day
period of patient admittance to treatment has lapsed, except by the order or referral of a
person licensed in this state in the practice of medicine as defined in section 147.081, the
practice of chiropractic as defined in section 148.01, the practice of podiatry as defined in
section 153.01, or the practice of dentistry as defined in section 150A.05, or the practice
of advance practice nursing as defined in section 148.171, subdivision 3, when orders or
referrals are made in and whose license is in collaboration with a physician, chiropractor,
podiatrist, or dentist, and whose license is in good standing; or when a previous diagnosis
exists indicating an ongoing condition warranting physical therapy treatment, subject
to periodic review defined by board of physical therapy rule. The 90-day limitation of
treatment by a physical therapist without an order or referral does not apply to prevention,
wellness, education, or exercise;

(9) has treated human ailments, without referral, by physical therapy treatment
without first having practiced one year under a physician's orders as verified by the board's
records for a physical therapist licensed less than one year, has treated human ailments,
without referral, by physical therapy treatment without first having practiced one year in
collaboration with a physical therapist with more than one year of experience or under a
physician's orders or referrals as verified by the board's records;

(10) has failed to consult with the patient's licensed health care provider, or licensed
health care professional, who prescribed the physical therapy treatment if the treatment is
altered by the physical therapist from the original written order. The provision does not
include written orders to "evaluate and treat";

(11) has inappropriately delegated to a physical therapist assistant or inappropriately
assigned tasks to an aide, or inadequately supervised a student physical therapist, physical
therapist assistant, student physical therapist assistant, or a physical therapy aide;

(12) has practiced as a physical therapist performing medical diagnosis, the practice
of medicine as defined in section 147.081, or the practice of chiropractic as defined
in section 148.01;

(13) has failed to comply with a reasonable request to obtain appropriate clearance
for mental or physical conditions that would interfere with the ability to practice physical
therapy, and that may be potentially harmful to patients;

(14) has divided fees with, or paying or promising to pay a commission or part of the
fee to, any person who contacts the physical therapist for consultation or sends patients to
the physical therapist for treatment;

(15) has engaged in an incentive payment arrangement, other than that prohibited
by clause (14), that tends to promote physical therapy overuse, that allows the referring
person or person who controls the availability of physical therapy services to a client to
profit unreasonably as a result of patient treatment;

(16) has failed to refer to a licensed health care professional a patient whose medical
condition at the time of evaluation has been determined by the physical therapist to be
beyond the scope of practice of a physical therapist;

(17) has failed to report to the board other licensees who violate this section;

(18) has engaged in the practice of physical therapy under lapsed or nonrenewed
credentials;

(19) has had a license, certificate, charter, registration, privilege to take an
examination, or other similar authority denied, revoked, suspended, canceled, limited,
reprimanded, or otherwise disciplined, or not renewed for cause in any jurisdiction; or has
surrendered or voluntarily terminated a license or certificate during a board investigation
of a complaint, as part of a disciplinary order, or while under a disciplinary order;

(20) has been subject to a corrective action or similar action in another jurisdiction
or by another regulatory authority; or

(21) has failed to cooperate with an investigation of the board, including responding
fully and promptly to any question raised by or on behalf of the board relating to the
subject of the investigation, executing all releases requested by the board, providing copies
of patient records, as reasonably requested by the board to assist it in its investigation, and
appearing at conferences or hearings scheduled by the board or its staff.

(b) If grounds for disciplinary action exist under paragraph (a), the board may take
one or more of the following actions:

(1) deny the application for licensure;

(2) deny the renewal of the license;

(3) revoke the license;

(4) suspend the license;

(5) impose limitations or conditions on the licensee's practice of physical therapy,
including the: (i) limitation of scope of practice to designated field specialties; (ii)
imposition of retraining or rehabilitation requirements; (iii) requirement of practice under
supervision; or (iv) conditioning of continued practice on demonstration of knowledge or
skills by appropriate examination, monitoring, or other review of skill and competence;

(6) impose a civil penalty not to exceed $10,000 for each separate violation,
the amount of the civil penalty to be fixed so as to deprive the physical therapist of
any economic advantage gained by reason of the violation charged, to discourage
similar violations, or to reimburse the board for the cost of the investigation and
proceeding including, but not limited to, fees paid for services provided by the Office of
Administrative Hearings, legal and investigative services provided by the Office of the
Attorney General, court reporters, witnesses, reproduction of records, board members'
per diem compensation, board staff time, and travel costs and expenses incurred by board
staff and board members;

(7) order the licensee to provide unremunerated service;

(8) censure or reprimand the licensee; or

(9) any other action as allowed by law and justified by the facts of the case.

(c) A license to practice as a physical therapist or physical therapist assistant is
automatically suspended if (1) a guardian of the licensee is appointed by order of a court
pursuant to sections 524.5-101 to 524.5-502, for reasons other than the minority of the
licensee; or (2) the licensee is committed by order of a court pursuant to chapter 253B.
The license remains suspended until the licensee is restored to capacity by a court and,
upon petition by the licensee, the suspension is terminated by the Board of Physical
Therapy after a hearing.

Sec. 3.

Minnesota Statutes 2006, section 148.76, subdivision 2, is amended to read:

Subd. 2.

Prohibitions.

(a) No physical therapist may:

(1) treat human ailments by physical therapy after an initial 30-day 90-day period
of patient admittance to treatment has lapsed, except by the order or referral of a person
licensed in this state to practice medicine as defined in section 147.081, the practice of
chiropractic as defined in section 148.01, the practice of podiatry as defined in section
153.01, the practice of dentistry as defined in section 150A.05, or the practice of advanced
practice nursing as defined in section 62A.15, subdivision 3a, when orders or referrals
are made in collaboration with a physician, chiropractor, podiatrist, or dentist, and whose
license is in good standing; or when a previous diagnosis exists indicating an ongoing
condition warranting physical therapy treatment, subject to periodic review defined by
Board of Physical Therapy rule. The 90-day limitation of treatment by a physical therapist
without an order or referral does not apply to prevention, wellness, education, or exercise;

(2) treat human ailments by physical therapy treatment without first having practiced
one year under a physician's orders as verified by the board's records;

(3) (2) use any chiropractic manipulative technique whose end is the chiropractic
adjustment of an abnormal articulation of the body; and

(4) (3) treat human ailments other than by physical therapy unless duly licensed or
registered to do so under the laws of this state.

(b) No physical therapist licensed less than one year may treat human ailments,
without referral, by physical therapy treatment without first having practiced one year in
collaboration with a physical therapist with more than one year of experience or under a
physician's orders or referrals as verified by the board's records.

Sec. 4. BOARD OF PHYSICAL THERAPY REPORT.

By January 15, 2010, the Board of Physical Therapy must report to the legislature any
disciplinary actions taken against physical therapists whose conduct resulted in physical
harm to a patient, only if that conduct was a result of the statutory changes made in the
2008 legislative session to Minnesota Statutes, sections 148.75 and 148.76, subdivision 2.

Sec. 5. REPEALER.

Minnesota Rules, parts 5601.0100, subparts 5, 6, 7, and 8; 5601.1200; 5601.1800;
and 5601.1900, are repealed.