4th Engrossment - 79th Legislature (1995 - 1996) Posted on 12/15/2009 12:00am
1.1 A bill for an act 1.2 relating to occupations and professions; board of 1.3 medical practice; providing for the registration of 1.4 physician assistants by the board of medical practice; 1.5 providing for rulemaking; providing penalties; 1.6 amending Minnesota Statutes 1994, sections 116J.70, 1.7 subdivision 2a; 136A.1356, subdivision 1; 144.335, 1.8 subdivision 1; 148B.60, subdivision 3; 151.01, 1.9 subdivision 23; 151.37, subdivision 2a; 214.23, 1.10 subdivision 1; and 604A.01, subdivision 2; proposing 1.11 coding for new law as Minnesota Statutes, chapter 1.12 147A; repealing Minnesota Statutes 1994, sections 1.13 147.34; 147.35; and 147.36; Minnesota Rules, parts 1.14 5600.2600; 5600.2605; 5600.2610; 5600.2615; 5600.2620; 1.15 5600.2625; 5600.2630; 5600.2635; 5600.2640; 5600.2645; 1.16 5600.2650; 5600.2655; 5600.2660; 5600.2665; and 1.17 5600.2670. 1.18 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 1.19 ARTICLE 1 1.20 Section 1. [147A.01] [DEFINITIONS.] 1.21 Subdivision 1. [SCOPE.] For the purpose of this chapter 1.22 the terms defined in this section have the meanings given them. 1.23 Subd. 2. [ACTIVE STATUS.] "Active status" means the status 1.24 of a person who has met all the qualifications of a physician 1.25 assistant, has a physician-physician assistant agreement in 1.26 force, and is registered. 1.27 Subd. 3. [ADMINISTER.] "Administer" means the delivery by 1.28 a physician assistant authorized to prescribe legend drugs, a 1.29 single dose of a legend drug, including controlled substances, 1.30 to a patient by injection, inhalation, ingestion, or by any 1.31 other immediate means, and the delivery by a physician assistant 2.1 ordered by a physician a single dose of a legend drug by 2.2 injection, inhalation, ingestion, or by any other immediate 2.3 means. 2.4 Subd. 4. [AGREEMENT.] "Agreement" means the document 2.5 described in section 147A.20. 2.6 Subd. 5. [ALTERNATE SUPERVISING PHYSICIAN.] "Alternate 2.7 supervising physician" means a Minnesota licensed physician 2.8 listed in the physician-physician assistant agreement who is 2.9 responsible for supervising the physician assistant when the 2.10 main supervising physician is unavailable. The alternate 2.11 supervising physician shall accept full medical responsibility 2.12 for the performance, practice, and activities of the physician 2.13 assistant while under the supervision of the alternate 2.14 supervising physician. 2.15 Subd. 6. [BOARD.] "Board" means the board of medical 2.16 practice or its designee. 2.17 Subd. 7. [CONTROLLED SUBSTANCES.] "Controlled substances" 2.18 has the meaning given it in section 152.01, subdivision 4. 2.19 Subd. 8. [DELEGATION FORM.] "Delegation form" means the 2.20 form used to indicate the categories of drugs for which the 2.21 authority to prescribe, administer, and dispense has been 2.22 delegated to the physician assistant and signed by the 2.23 supervising physician, any alternate supervising physicians, and 2.24 the physician assistant. This form is part of the agreement 2.25 described in section 147A.20, and shall be maintained by the 2.26 supervising physician and physician assistant at the address of 2.27 record. Copies shall be provided to the board upon request. 2.28 "Addendum to the delegation form" means a separate listing of 2.29 the schedules and categories of controlled substances, if any, 2.30 for which the physician assistant has been delegated the 2.31 authority to prescribe, administer, and dispense. The addendum 2.32 shall be maintained as a separate document as described above. 2.33 Subd. 9. [DIAGNOSTIC ORDER.] "Diagnostic order" means a 2.34 directive to perform a procedure or test, the purpose of which 2.35 is to determine the cause and nature of a pathological condition 2.36 or disease. 3.1 Subd. 10. [DRUG.] "Drug" has the meaning given it in 3.2 section 151.01, subdivision 5, including controlled substances 3.3 as defined in section 152.01, subdivision 4. 3.4 Subd. 11. [DRUG CATEGORY.] "Drug category" means one of 3.5 the categories listed on the delegation form. 3.6 Subd. 12. [INACTIVE STATUS.] "Inactive status" means the 3.7 status of a person who has met all the qualifications of a 3.8 physician assistant, and is registered, but does not have a 3.9 physician-physician assistant agreement in force. 3.10 Subd. 13. [INTERNAL PROTOCOL.] "Internal protocol" means a 3.11 document written by the supervising physician and the physician 3.12 assistant which specifies the policies and procedures which will 3.13 apply to the physician assistant's prescribing, administering, 3.14 and dispensing of legend drugs and medical devices, including 3.15 controlled substances as defined in section 152.01, subdivision 3.16 4, and lists the specific categories of drugs and medical 3.17 devices, with any exceptions or conditions, that the physician 3.18 assistant is authorized to prescribe, administer, and dispense. 3.19 The supervising physician and physician assistant shall maintain 3.20 the protocol at the address of record. Copies shall be provided 3.21 to the board upon request. 3.22 Subd. 14. [LEGEND DRUG.] "Legend drug" has the meaning 3.23 given it in section 151.01, subdivision 17. 3.24 Subd. 15. [LOCUM TENENS PERMIT.] "Locum tenens permit" 3.25 means time specific temporary permission for a physician 3.26 assistant to practice as a physician assistant in a setting 3.27 other than the practice setting established in the 3.28 physician-physician assistant agreement. 3.29 Subd. 16. [MEDICAL DEVICE.] "Medical device" means durable 3.30 medical equipment and assistive or rehabilitative appliances, 3.31 objects, or products that are required to implement the overall 3.32 plan of care for the patient and that are restricted by federal 3.33 law to use upon prescription by a licensed practitioner. 3.34 Subd. 17. [PHYSICIAN.] "Physician" means a person 3.35 currently licensed in good standing as a physician or osteopath 3.36 under chapter 147. 4.1 Subd. 18. [PHYSICIAN ASSISTANT OR REGISTERED PHYSICIAN 4.2 ASSISTANT.] "Physician assistant" or "registered physician 4.3 assistant" means a person registered pursuant to this section 4.4 who is qualified by academic or practical training or both to 4.5 provide patient services as specified in this chapter, under the 4.6 supervision of a supervising physician. 4.7 Subd. 19. [PRACTICE SETTING DESCRIPTION.] "Practice 4.8 setting description" means a signed record submitted to the 4.9 board on forms provided by the board, on which: 4.10 (1) the supervising physician assumes full medical 4.11 responsibility for the medical care rendered by a physician 4.12 assistant; 4.13 (2) is recorded the address and phone number of record of 4.14 each supervising physician and alternate, and the physicians' 4.15 medical license numbers and DEA number; 4.16 (3) is recorded the address and phone number of record of 4.17 the physician assistant and the physician assistant's 4.18 registration number and DEA number; 4.19 (4) is recorded whether the physician assistant has been 4.20 delegated prescribing, administering, and dispensing authority; 4.21 (5) is recorded the practice setting, address or addresses 4.22 and phone number or numbers of the physician assistant; and 4.23 (6) is recorded a statement of the type, amount, and 4.24 frequency of supervision. 4.25 Subd. 20. [PRESCRIBE.] "Prescribe" means to direct, order, 4.26 or designate by means of a prescription the preparation, use of, 4.27 or manner of using a drug or medical device. 4.28 Subd. 21. [PRESCRIPTION.] "Prescription" means a signed 4.29 written order, or an oral order reduced to writing, given by a 4.30 physician assistant authorized to prescribe drugs for patients 4.31 in the course of the physician assistant's practice, issued for 4.32 an individual patient and containing the information required in 4.33 the delegation form. 4.34 Subd. 22. [REGISTRATION.] "Registration" is the process by 4.35 which the board determines that an applicant has been found to 4.36 meet the standards and qualifications found in this section. 5.1 Subd. 23. [SUPERVISING PHYSICIAN.] "Supervising physician" 5.2 means a Minnesota licensed physician who accepts full medical 5.3 responsibility for the performance, practice, and activities of 5.4 a physician assistant under an agreement as described in section 5.5 147A.20. A supervising physician shall not supervise more than 5.6 two full-time equivalent physician assistants simultaneously. 5.7 Subd. 24. [SUPERVISION.] "Supervision" means overseeing 5.8 the activities of, and accepting responsibility for, the medical 5.9 services rendered by a physician assistant. The constant 5.10 physical presence of the supervising physician is not required 5.11 so long as the supervising physician and physician assistant are 5.12 or can be easily in contact with one another by radio, 5.13 telephone, or other telecommunication device. The scope and 5.14 nature of the supervision shall be defined by the individual 5.15 physician-physician assistant agreement. 5.16 Subd. 25. [TEMPORARY REGISTRATION.] "Temporary 5.17 registration" means the status of a person who has satisfied the 5.18 education requirement specified in this chapter; is enrolled in 5.19 the next examination required in this chapter; or is awaiting 5.20 examination results; has a physician-physician assistant 5.21 agreement in force as required by this chapter, and has 5.22 submitted a practice setting description to the board. Such 5.23 provisional registration shall expire 90 days after completion 5.24 of the next examination sequence, or after one year, whichever 5.25 is sooner, for those enrolled in the next examination; and upon 5.26 receipt of the examination results for those awaiting 5.27 examination results. The registration shall be granted by the 5.28 board or its designee. 5.29 Subd. 26. [THERAPEUTIC ORDER.] "Therapeutic order" means 5.30 an order given to another for the purpose of treating or curing 5.31 a patient in the course of a physician assistant's practice. 5.32 Therapeutic orders may be written or verbal, but do not include 5.33 the prescribing of legend drugs or medical devices unless 5.34 prescribing authority has been delegated within the 5.35 physician-physician assistant agreement. 5.36 Subd. 27. [VERBAL ORDER.] "Verbal order" means an oral 6.1 order given to another for the purpose of treating or curing a 6.2 patient in the course of a physician assistant's practice. 6.3 Verbal orders do not include the prescribing of legend drugs 6.4 unless prescribing authority has been delegated within the 6.5 physician-physician assistant agreement. 6.6 Sec. 2. [147A.02] [QUALIFICATIONS FOR REGISTRATION.] 6.7 Except as otherwise provided in this chapter, an individual 6.8 shall be registered by the board before the individual may 6.9 practice as a physician assistant. 6.10 The board may grant registration as a physician assistant 6.11 to an applicant who: 6.12 (1) submits an application on forms approved by the board; 6.13 (2) pays the appropriate fee as determined by the board; 6.14 (3) has current certification from the National Commission 6.15 on Certification of Physician Assistants, or its successor 6.16 agency as approved by the board; 6.17 (4) certifies that the applicant is mentally and physically 6.18 able to engage safely in practice as a physician assistant; 6.19 (5) has no licensure, certification, or registration as a 6.20 physician assistant under current discipline, revocation, 6.21 suspension, or probation for cause resulting from the 6.22 applicant's practice as a physician assistant, unless the board 6.23 considers the condition and agrees to licensure; 6.24 (6) has a physician-physician assistant agreement, and 6.25 internal protocol and prescribing delegation form, if the 6.26 physician assistant has been delegated prescribing authority, as 6.27 described in section 147A.18 in place at the address of record; 6.28 (7) submits to the board a practice setting description and 6.29 any other information the board deems necessary to evaluate the 6.30 applicant's qualifications; and 6.31 (8) has been approved by the board. 6.32 All persons registered as physician assistants as of June 6.33 30, 1995, are eligible for continuing registration renewal. All 6.34 persons applying for registration after that date shall be 6.35 registered according to this chapter. 6.36 Sec. 3. [147A.03] [PROTECTED TITLES AND RESTRICTIONS ON 7.1 USE.] 7.2 Subdivision 1. [PROTECTED TITLES.] No individual may use 7.3 the titles "Minnesota Registered Physician Assistant," 7.4 "Registered Physician Assistant," "Physician Assistant," or "PA" 7.5 in connection with the individual's name, or any other words, 7.6 letters, abbreviations, or insignia indicating or implying that 7.7 the individual is registered with the state unless they have 7.8 been registered according to this chapter. 7.9 Subd. 2. [HEALTH CARE PRACTITIONERS.] Individuals 7.10 practicing in a health care occupation are not restricted in the 7.11 provision of services included in this chapter as long as they 7.12 do not hold themselves out as physician assistants by or through 7.13 the titles provided in subdivision 1 in association with 7.14 provision of these services. 7.15 Subd. 3. [IDENTIFICATION OF REGISTERED PRACTITIONERS.] 7.16 Physician assistants in Minnesota shall wear name tags which 7.17 identify them as physician assistants. 7.18 Subd. 4. [SANCTIONS.] Individuals who hold themselves out 7.19 as physician assistants by or through any of the titles provided 7.20 in subdivision 1 without prior registration shall be subject to 7.21 sanctions or actions against continuing the activity according 7.22 to section 214.11, or other authority. 7.23 Sec. 4. [147A.04] [TEMPORARY PERMIT.] 7.24 The board may issue a temporary permit to practice to a 7.25 physician assistant eligible for registration under this chapter 7.26 only if the application for registration is complete, all 7.27 requirements have been met, and a nonrefundable fee set by the 7.28 board has been paid. The permit remains valid only until the 7.29 meeting of the board at which a decision is made on the 7.30 application for registration. 7.31 Sec. 5. [147A.05] [INACTIVE REGISTRATION.] 7.32 Physician assistants who notify the board in writing on 7.33 forms prescribed by the board may elect to place their 7.34 registrations on an inactive status. Physician assistants with 7.35 an inactive registration shall be excused from payment of 7.36 renewal fees and shall not practice as physician assistants. 8.1 Persons who engage in practice while their registrations are 8.2 lapsed or on inactive status shall be considered to be 8.3 practicing without registration, which shall be grounds for 8.4 discipline under section 147A.13. Physician assistants 8.5 requesting restoration from inactive status shall be required to 8.6 pay the current renewal fees and all unpaid back-fees and shall 8.7 be required to meet the criteria for renewal specified in 8.8 section 147A.07. 8.9 Sec. 6. [147A.06] [CANCELLATION OF REGISTRATION FOR 8.10 NONRENEWAL.] 8.11 The board shall not renew, reissue, reinstate, or restore a 8.12 registration that has lapsed on or after July 1, 1996, and has 8.13 not been renewed within two annual renewal cycles starting July 8.14 1, 1997. A registrant whose registration is canceled for 8.15 nonrenewal must obtain a new registration by applying for 8.16 registration and fulfilling all requirements then in existence 8.17 for an initial registration to practice as a physician assistant. 8.18 Sec. 7. [147A.07] [RENEWAL.] 8.19 A person who holds a registration as a physician assistant 8.20 shall, upon notification from the board, renew the registration 8.21 by: 8.22 (1) submitting the appropriate fee as determined by the 8.23 board; 8.24 (2) completing the appropriate forms; 8.25 (3) meeting any other requirements of the board; 8.26 (4) submitting a revised and updated practice setting 8.27 description showing evidence of annual review of the 8.28 physician-physician assistant supervisory agreement. 8.29 Sec. 8. [147A.08] [EXEMPTIONS.] 8.30 (a) This chapter does not apply to, control, prevent, or 8.31 restrict the practice, service, or activities of persons listed 8.32 in section 147.09, clauses (1) to (6) and (8) to (13), persons 8.33 regulated under section 214.01, subdivision 2, or persons 8.34 defined in section 136A.1356, subdivision 1, paragraphs (a) to 8.35 (d). 8.36 (b) Nothing in this chapter shall be construed to require 9.1 registration of: 9.2 (1) a physician assistant student enrolled in a physician 9.3 assistant or surgeon assistant educational program accredited by 9.4 the Committee on Allied Health Education and Accreditation or by 9.5 its successor agency approved by the board; 9.6 (2) a physician assistant employed in the service of the 9.7 federal government while performing duties incident to that 9.8 employment; or 9.9 (3) technicians, other assistants, or employees of 9.10 physicians who perform delegated tasks in the office of a 9.11 physician but who do not identify themselves as a physician 9.12 assistant. 9.13 Sec. 9. [147A.09] [SCOPE OF PRACTICE, DELEGATION.] 9.14 Subdivision 1. [SCOPE OF PRACTICE.] Physician assistants 9.15 shall practice medicine only with physician supervision. 9.16 Physician assistants may perform those duties and 9.17 responsibilities as delegated in the physician-physician 9.18 assistant agreement and delegation forms maintained at the 9.19 address of record by the supervising physician and physician 9.20 assistant, including the prescribing, administering, and 9.21 dispensing of medical devices and drugs, excluding anesthetics, 9.22 other than local anesthetics, injected in connection with an 9.23 operating room procedure, inhaled anesthesia and spinal 9.24 anesthesia. 9.25 Patient service must be limited to: 9.26 (1) services within the training and experience of the 9.27 physician assistant; 9.28 (2) services customary to the practice of the supervising 9.29 physician; 9.30 (3) services delegated by the supervising physician; and 9.31 (4) services within the parameters of the laws, rules, and 9.32 standards of the facilities in which the physician assistant 9.33 practices. 9.34 Nothing in this chapter authorizes physician assistants to 9.35 perform duties regulated by the boards listed in section 214.01, 9.36 subdivision 2, other than the board of medical practice, and 10.1 except as provided in this section. 10.2 Subd. 2. [DELEGATION.] Patient services may include, but 10.3 are not limited to, the following, as delegated by the 10.4 supervising physician and authorized in the agreement: 10.5 (1) taking patient histories and developing medical status 10.6 reports; 10.7 (2) performing physical examinations; 10.8 (3) interpreting and evaluating patient data; 10.9 (4) ordering or performing diagnostic procedures; 10.10 (5) ordering or performing therapeutic procedures; 10.11 (6) providing instructions regarding patient care, disease 10.12 prevention, and health promotion; 10.13 (7) assisting the supervising physician in patient care in 10.14 the home and in health care facilities; 10.15 (8) creating and maintaining appropriate patient records; 10.16 (9) transmitting or executing specific orders at the 10.17 direction of the supervising physician; 10.18 (10) prescribing, administering, and dispensing legend 10.19 drugs and medical devices if this function has been delegated by 10.20 the supervising physician pursuant to and subject to the 10.21 limitations of section 147.34 and chapter 151. Physician 10.22 assistants who have been delegated the authority to prescribe 10.23 controlled substances shall maintain a separate addendum to the 10.24 delegation form which lists all schedules and categories of 10.25 controlled substances which the physician assistant has the 10.26 authority to prescribe. This addendum shall be maintained with 10.27 the physician-physician assistant agreement, and the delegation 10.28 form at the address of record; 10.29 (11) for physician assistants not delegated prescribing 10.30 authority, administering legend drugs and medical devices 10.31 following prospective review for each patient by and upon 10.32 direction of the supervising physician; 10.33 (12) functioning as an emergency medical technician with 10.34 permission of the ambulance service and in compliance with 10.35 section 144.804, subdivision 2, paragraph (c), and ambulance 10.36 service rules adopted by the commissioner of health; and 11.1 (13) initiating evaluation and treatment procedures 11.2 essential to providing an appropriate response to emergency 11.3 situations. 11.4 Orders of physician assistants shall be considered the 11.5 orders of their supervising physicians in all practice-related 11.6 activities, including, but not limited to, the ordering of 11.7 diagnostic, therapeutic, and other medical services. 11.8 Sec. 10. [147A.10] [SATELLITE SETTINGS.] 11.9 Physician assistants may render services in a setting 11.10 geographically remote from the supervising physician. 11.11 Sec. 11. [147A.11] [EXCLUSIONS OF LIMITATIONS ON 11.12 EMPLOYMENT.] 11.13 Nothing in this chapter shall be construed to limit the 11.14 employment arrangement of a physician assistant registered under 11.15 this chapter. 11.16 Sec. 12. [147A.13] [GROUNDS FOR DISCIPLINARY ACTION.] 11.17 Subdivision 1. [GROUNDS LISTED.] The board may refuse to 11.18 grant registration or may impose disciplinary action as 11.19 described in this subdivision against any physician assistant. 11.20 The following conduct is prohibited and is grounds for 11.21 disciplinary action: 11.22 (1) failure to demonstrate the qualifications or satisfy 11.23 the requirements for registration contained in this chapter or 11.24 rules of the board. The burden of proof shall be upon the 11.25 applicant to demonstrate such qualifications or satisfaction of 11.26 such requirements; 11.27 (2) obtaining registration by fraud or cheating, or 11.28 attempting to subvert the examination process. Conduct which 11.29 subverts or attempts to subvert the examination process 11.30 includes, but is not limited to: 11.31 (i) conduct which violates the security of the examination 11.32 materials, such as removing examination materials from the 11.33 examination room or having unauthorized possession of any 11.34 portion of a future, current, or previously administered 11.35 licensing examination; 11.36 (ii) conduct which violates the standard of test 12.1 administration, such as communicating with another examinee 12.2 during administration of the examination, copying another 12.3 examinee's answers, permitting another examinee to copy one's 12.4 answers, or possessing unauthorized materials; and 12.5 (iii) impersonating an examinee or permitting an 12.6 impersonator to take the examination on one's own behalf; 12.7 (3) conviction, during the previous five years, of a felony 12.8 reasonably related to the practice of physician assistant. 12.9 Conviction as used in this subdivision includes a conviction of 12.10 an offense which if committed in this state would be deemed a 12.11 felony without regard to its designation elsewhere, or a 12.12 criminal proceeding where a finding or verdict of guilt is made 12.13 or returned but the adjudication of guilt is either withheld or 12.14 not entered; 12.15 (4) revocation, suspension, restriction, limitation, or 12.16 other disciplinary action against the person's physician 12.17 assistant credentials in another state or jurisdiction, failure 12.18 to report to the board that charges regarding the person's 12.19 credentials have been brought in another state or jurisdiction, 12.20 or having been refused registration by any other state or 12.21 jurisdiction; 12.22 (5) advertising which is false or misleading, violates any 12.23 rule of the board, or claims without substantiation the positive 12.24 cure of any disease or professional superiority to or greater 12.25 skill than that possessed by another physician assistant; 12.26 (6) violating a rule adopted by the board or an order of 12.27 the board, a state, or federal law which relates to the practice 12.28 of a physician assistant, or in part regulates the practice of a 12.29 physician assistant, including without limitation sections 12.30 148A.02, 609.344, and 609.345, or a state or federal narcotics 12.31 or controlled substance law; 12.32 (7) engaging in any unethical conduct; conduct likely to 12.33 deceive, defraud, or harm the public, or demonstrating a willful 12.34 or careless disregard for the health, welfare, or safety of a 12.35 patient; or practice which is professionally incompetent, in 12.36 that it may create unnecessary danger to any patient's life, 13.1 health, or safety, in any of which cases, proof of actual injury 13.2 need not be established; 13.3 (8) failure to adhere to the provisions of the 13.4 physician-physician assistant agreement; 13.5 (9) engaging in the practice of medicine beyond that 13.6 allowed by the physician-physician assistant agreement, 13.7 including the delegation form or the addendum to the delegation 13.8 form, or aiding or abetting an unlicensed person in the practice 13.9 of medicine; 13.10 (10) adjudication as mentally incompetent, mentally ill or 13.11 mentally retarded, or as a chemically dependent person, a person 13.12 dangerous to the public, a sexually dangerous person, or a 13.13 person who has a sexual psychopathic personality by a court of 13.14 competent jurisdiction, within or without this state. Such 13.15 adjudication shall automatically suspend a registration for its 13.16 duration unless the board orders otherwise; 13.17 (11) engaging in unprofessional conduct. Unprofessional 13.18 conduct includes any departure from or the failure to conform to 13.19 the minimal standards of acceptable and prevailing practice in 13.20 which proceeding actual injury to a patient need not be 13.21 established; 13.22 (12) inability to practice with reasonable skill and safety 13.23 to patients by reason of illness, drunkenness, use of drugs, 13.24 narcotics, chemicals, or any other type of material, or as a 13.25 result of any mental or physical condition, including 13.26 deterioration through the aging process or loss of motor skills; 13.27 (13) revealing a privileged communication from or relating 13.28 to a patient except when otherwise required or permitted by law; 13.29 (14) any use of the title "Physician," "Doctor," or "Dr."; 13.30 (15) improper management of medical records, including 13.31 failure to maintain adequate medical records, to comply with a 13.32 patient's request made pursuant to section 144.335, or to 13.33 furnish a medical record or report required by law; 13.34 (16) engaging in abusive or fraudulent billing practices, 13.35 including violations of the federal Medicare and Medicaid laws 13.36 or state medical assistance laws; 14.1 (17) becoming addicted or habituated to a drug or 14.2 intoxicant; 14.3 (18) prescribing a drug or device for other than medically 14.4 accepted therapeutic, experimental, or investigative purposes 14.5 authorized by a state or federal agency or referring a patient 14.6 to any health care provider as defined in section 144.335 for 14.7 services or tests not medically indicated at the time of 14.8 referral; 14.9 (19) engaging in conduct with a patient which is sexual or 14.10 may reasonably be interpreted by the patient as sexual, or in 14.11 any verbal behavior which is seductive or sexually demeaning to 14.12 a patient; 14.13 (20) failure to make reports as required by section 609.215 14.14 or to cooperate with an investigation of the board as required 14.15 by section 609.215; 14.16 (21) knowingly providing false or misleading information 14.17 that is directly related to the care of that patient unless done 14.18 for an accepted therapeutic purpose such as the administration 14.19 of a placebo; 14.20 (22) aiding suicide or aiding attempted suicide in 14.21 violation of section 609.215 as established by any of the 14.22 following: 14.23 (i) a copy of the record of criminal conviction or plea of 14.24 guilty for a felony in violation of section 609.215, subdivision 14.25 1 or 2; 14.26 (ii) a copy of the record of a judgment of contempt of 14.27 court for violating an injunction issued under section 609.215, 14.28 subdivision 4; 14.29 (iii) a copy of the record of a judgment assessing damages 14.30 under section 609.215, subdivision 5; or 14.31 (iv) a finding by the board that the person violated 14.32 section 609.215, subdivision 1 or 2. The board shall 14.33 investigate any complaint of a violation of section 609.215, 14.34 subdivision 1 or 2; or 14.35 (23) failure to maintain annually reviewed and updated 14.36 physician-physician assistant agreements, internal protocols, or 15.1 prescribing delegation forms for each physician-physician 15.2 assistant practice relationship, or failure to provide copies of 15.3 such documents upon request by the board. 15.4 Subd. 2. [EFFECTIVE DATES, AUTOMATIC SUSPENSION.] A 15.5 suspension, revocation, condition, limitation, qualification, or 15.6 restriction of a registration shall be in effect pending 15.7 determination of an appeal unless the court, upon petition and 15.8 for good cause shown, orders otherwise. 15.9 A physician assistant registration is automatically 15.10 suspended if: 15.11 (1) a guardian of the person of a registrant is appointed 15.12 by order of a court pursuant to sections 525.54 to 525.61, for 15.13 reasons other than the minority of the registrant; or 15.14 (2) the registrant is committed by order of a court 15.15 pursuant to chapter 253B. The registration remains suspended 15.16 until the registrant is restored to capacity by a court and, 15.17 upon petition by the registrant, the suspension is terminated by 15.18 the board after a hearing. 15.19 Subd. 3. [CONDITIONS ON REISSUED REGISTRATION.] In its 15.20 discretion, the board may restore and reissue a physician 15.21 assistant registration, but may impose as a condition any 15.22 disciplinary or corrective measure which it might originally 15.23 have imposed. 15.24 Subd. 4. [TEMPORARY SUSPENSION OF REGISTRATION.] In 15.25 addition to any other remedy provided by law, the board may, 15.26 without a hearing, temporarily suspend the registration of a 15.27 physician assistant if the board finds that the physician 15.28 assistant has violated a statute or rule which the board is 15.29 empowered to enforce and continued practice by the physician 15.30 assistant would create a serious risk of harm to the public. 15.31 The suspension shall take effect upon written notice to the 15.32 physician assistant, specifying the statute or rule violated. 15.33 The suspension shall remain in effect until the board issues a 15.34 final order in the matter after a hearing. At the time it 15.35 issues the suspension notice, the board shall schedule a 15.36 disciplinary hearing to be held pursuant to the administrative 16.1 procedure act. 16.2 The physician assistant shall be provided with at least 20 16.3 days notice of any hearing held pursuant to this subdivision. 16.4 The hearing shall be scheduled to begin no later than 30 days 16.5 after the issuance of the suspension order. 16.6 Subd. 5. [EVIDENCE.] In disciplinary actions alleging a 16.7 violation of subdivision 1, clause (3) or (4), a copy of the 16.8 judgment or proceeding under the seal of the court administrator 16.9 or of the administrative agency which entered it shall be 16.10 admissible into evidence without further authentication and 16.11 shall constitute prima facie evidence of the contents thereof. 16.12 Subd. 6. [MENTAL EXAMINATION; ACCESS TO MEDICAL DATA.] (a) 16.13 If the board has probable cause to believe that a physician 16.14 assistant comes under subdivision 1, clause (1), it may direct 16.15 the physician assistant to submit to a mental or physical 16.16 examination. For the purpose of this subdivision, every 16.17 physician assistant registered under this chapter is deemed to 16.18 have consented to submit to a mental or physical examination 16.19 when directed in writing by the board and further to have waived 16.20 all objections to the admissibility of the examining physicians' 16.21 testimony or examination reports on the ground that the same 16.22 constitute a privileged communication. Failure of a physician 16.23 assistant to submit to an examination when directed constitutes 16.24 an admission of the allegations against the physician assistant, 16.25 unless the failure was due to circumstance beyond the physician 16.26 assistant's control, in which case a default and final order may 16.27 be entered without the taking of testimony or presentation of 16.28 evidence. A physician assistant affected under this subdivision 16.29 shall at reasonable intervals be given an opportunity to 16.30 demonstrate that the physician assistant can resume competent 16.31 practice with reasonable skill and safety to patients. In any 16.32 proceeding under this subdivision, neither the record of 16.33 proceedings nor the orders entered by the board shall be used 16.34 against a physician assistant in any other proceeding. 16.35 (b) In addition to ordering a physical or mental 16.36 examination, the board may, notwithstanding sections 13.42, 17.1 144.651, or any other law limiting access to medical or other 17.2 health data, obtain medical data and health records relating to 17.3 a registrant or applicant without the registrant's or 17.4 applicant's consent if the board has probable cause to believe 17.5 that a physician assistant comes under subdivision 1, clause (1). 17.6 The medical data may be requested from a provider, as 17.7 defined in section 144.335, subdivision 1, paragraph (b), an 17.8 insurance company, or a government agency, including the 17.9 department of human services. A provider, insurance company, or 17.10 government agency shall comply with any written request of the 17.11 board under this subdivision and is not liable in any action for 17.12 damages for releasing the data requested by the board if the 17.13 data are released pursuant to a written request under this 17.14 subdivision, unless the information is false and the provider 17.15 giving the information knew, or had reason to believe, the 17.16 information was false. Information obtained under this 17.17 subdivision is classified as private under chapter 13. 17.18 Subd. 7. [TAX CLEARANCE CERTIFICATE.] (a) In addition to 17.19 the provisions of subdivision 1, the board may not issue or 17.20 renew a registration if the commissioner of revenue notifies the 17.21 board and the registrant or applicant for registration that the 17.22 registrant or applicant owes the state delinquent taxes in the 17.23 amount of $500 or more. The board may issue or renew the 17.24 registration only if: 17.25 (1) the commissioner of revenue issues a tax clearance 17.26 certificate; and 17.27 (2) the commissioner of revenue, the registrant, or the 17.28 applicant forwards a copy of the clearance to the board. 17.29 The commissioner of revenue may issue a clearance certificate 17.30 only if the registrant or applicant does not owe the state any 17.31 uncontested delinquent taxes. 17.32 (b) For purposes of this subdivision, the following terms 17.33 have the meanings given: 17.34 (1) "Taxes" are all taxes payable to the commissioner of 17.35 revenue, including penalties and interest due on those taxes, 17.36 and 18.1 (2) "Delinquent taxes" do not include a tax liability if: 18.2 (i) an administrative or court action that contests the 18.3 amount or validity of the liability has been filed or served; 18.4 (ii) the appeal period to contest the tax liability has not 18.5 expired; or 18.6 (iii) the licensee or applicant has entered into a payment 18.7 agreement to pay the liability and is current with the payments. 18.8 (c) When a registrant or applicant is required to obtain a 18.9 clearance certificate under this subdivision, a contested case 18.10 hearing must be held if the registrant or applicant requests a 18.11 hearing in writing to the commissioner of revenue within 30 days 18.12 of the date of the notice provided in paragraph (a). The 18.13 hearing must be held within 45 days of the date the commissioner 18.14 of revenue refers the case to the office of administrative 18.15 hearings. Notwithstanding any law to the contrary, the licensee 18.16 or applicant must be served with 20 days' notice in writing 18.17 specifying the time and place of the hearing and the allegations 18.18 against the registrant or applicant. The notice may be served 18.19 personally or by mail. 18.20 (d) The board shall require all registrants or applicants 18.21 to provide their social security number and Minnesota business 18.22 identification number on all registration applications. Upon 18.23 request of the commissioner of revenue, the board must provide 18.24 to the commissioner of revenue a list of all registrants and 18.25 applicants, including their names and addresses, social security 18.26 numbers, and business identification numbers. The commissioner 18.27 of revenue may request a list of the registrants and applicants 18.28 no more than once each calendar year. 18.29 Sec. 13. [147A.14] [REPORTING OBLIGATIONS.] 18.30 Subdivision 1. [PERMISSION TO REPORT.] A person who has 18.31 knowledge of any conduct constituting grounds for discipline 18.32 under this chapter may report the violation to the board. 18.33 Subd. 2. [INSTITUTIONS.] Any hospital, clinic, prepaid 18.34 medical plan, or other health care institution or organization 18.35 located in this state shall report to the board any action taken 18.36 by the institution or organization, any of its administrators, 19.1 or its medical or other committees to revoke, suspend, restrict, 19.2 or condition a physician assistant's privilege to practice or 19.3 treat patients in the institution or as part of the 19.4 organization, any denial of privileges, or any other 19.5 disciplinary action. The institution or organization shall also 19.6 report the resignation of any physician assistants prior to the 19.7 conclusion of any disciplinary proceeding, or prior to the 19.8 commencement of formal charges but after the physician assistant 19.9 had knowledge that formal charges were contemplated or in 19.10 preparation. Each report made under this subdivision must state 19.11 the nature of the action taken, state in detail the reasons for 19.12 the action, and identify the specific patient medical records 19.13 upon which the action was based. No report shall be required of 19.14 a physician assistant voluntarily limiting the practice of the 19.15 physician assistant at a hospital provided that the physician 19.16 assistant notifies all hospitals at which the physician 19.17 assistant has privileges of the voluntary limitation and the 19.18 reasons for it. 19.19 Subd. 3. [PHYSICIAN ASSISTANT ORGANIZATIONS.] A state or 19.20 local physician assistant organization shall report to the board 19.21 any termination, revocation, or suspension of membership or any 19.22 other disciplinary action taken against a physician assistant. 19.23 If the society has received a complaint which might be grounds 19.24 for discipline under this chapter against a member physician 19.25 assistant on which it has not taken any disciplinary action, the 19.26 society shall report the complaint and the reason why it has not 19.27 taken action on it or shall direct the complainant to the board 19.28 of medical practice. This subdivision does not apply to a 19.29 physician assistant organization when it performs peer review 19.30 functions as an agent of an outside entity, organization, or 19.31 system. 19.32 Subd. 4. [LICENSED PROFESSIONALS.] Licensed health 19.33 professionals and persons holding residency permits under 19.34 section 147.0391, shall report to the board personal knowledge 19.35 of any conduct which the person reasonably believes constitutes 19.36 grounds for disciplinary action under this chapter by a 20.1 physician assistant, including any conduct indicating that the 20.2 person may be incompetent, or may have engaged in unprofessional 20.3 conduct or may be medically or physically unable to engage 20.4 safely in practice as a physician assistant. No report shall be 20.5 required if the information was obtained in the course of a 20.6 physician-patient relationship if the patient is a physician 20.7 assistant, and the treating physician successfully counsels the 20.8 person to limit or withdraw from practice to the extent required 20.9 by the impairment. 20.10 Subd. 5. [INSURERS.] Four times each year as prescribed by 20.11 the board, each insurer authorized to sell insurance described 20.12 in section 60A.06, subdivision 1, clause (13), and providing 20.13 professional liability insurance to physician assistants, and 20.14 any medical clinic, hospital, political subdivision, or other 20.15 entity that self-insures and provides professional liability 20.16 coverage to physician assistants, shall submit to the board a 20.17 report concerning the physician assistants against whom 20.18 professional malpractice settlements or awards have been made to 20.19 the plaintiff. 20.20 Any medical clinic, hospital, political subdivision, or 20.21 other entity which provides liability coverage on behalf of a 20.22 physician assistant shall submit to the board a report 20.23 concerning settlements or awards paid on behalf of a physician 20.24 assistant, and any settlements or awards paid by a clinic, 20.25 hospital, political subdivision, or other entity on its own 20.26 behalf because of care rendered by a physician assistant. The 20.27 report shall be made to the board within 30 days of any 20.28 settlement. The report must contain at least the following 20.29 information: 20.30 (1) the total number of medical malpractice settlements or 20.31 awards made to the plaintiff; 20.32 (2) the date the medical malpractice settlements or awards 20.33 to the plaintiff were made; 20.34 (3) the allegations contained in the claim or complaint 20.35 leading to the settlements or awards made to the plaintiff; 20.36 (4) the dollar amount of each medical malpractice 21.1 settlement or award; 21.2 (5) the regular address of the practice of the physician 21.3 assistant against whom an award was made or with whom a 21.4 settlement was made; and 21.5 (6) the name of the physician assistant against whom an 21.6 award was made or with whom a settlement was made. 21.7 The insurance company shall, in addition to the above 21.8 information, report to the board any information it possesses 21.9 which tends to substantiate a charge that a physician assistant 21.10 may have engaged in conduct violating this chapter. 21.11 Subd. 6. [COURTS.] The court administrator of district 21.12 court or any other court of competent jurisdiction shall report 21.13 to the board any judgment or other determination of the court 21.14 which adjudges or includes a finding that a physician assistant 21.15 is mentally ill, mentally incompetent, guilty of a felony, or 21.16 guilty of a violation of federal or state narcotics laws or 21.17 controlled substances act, guilty of an abuse or fraud under 21.18 Medicare or Medicaid, appoints a guardian of the physician 21.19 assistant pursuant to section 525.54 to 525.61 or commits a 21.20 physician assistant pursuant to chapter 253B. 21.21 Subd. 7. [SELF-REPORTING.] A physician assistant shall 21.22 report to the board any personal action which is a violation of 21.23 this chapter. 21.24 Subd. 8. [DEADLINES; FORMS.] Reports required by 21.25 subdivisions 2 to 7 must be submitted not later than 30 days 21.26 after the occurrence of the reportable event or transaction. 21.27 The board may provide forms for the submission of reports 21.28 required by this section, may require that reports be submitted 21.29 on the forms provided, and may adopt rules necessary to assure 21.30 prompt and accurate reporting. 21.31 Subd. 9. [SUBPOENAS.] The board may issue subpoenas for 21.32 the production of any reports required by subdivisions 2 to 7 or 21.33 any related documents. 21.34 Sec. 14. [147A.15] [IMMUNITY.] 21.35 Subdivision 1. [REPORTING.] Any person, health care 21.36 facility, business, or organization is immune from civil 22.1 liability or criminal prosecution for submitting a report to the 22.2 board pursuant to this chapter or for otherwise reporting to the 22.3 board violations or alleged violations of this chapter. All 22.4 such reports are confidential and absolutely privileged 22.5 communications. 22.6 Subd. 2. [INVESTIGATION; INDEMNIFICATION.] (a) Members of 22.7 the board, persons employed by the board, and consultants 22.8 retained by the board for the purpose of investigation of 22.9 violations or the preparation and management of charges of 22.10 violations of this chapter on behalf of the board are immune 22.11 from civil liability and criminal prosecution for any actions, 22.12 transactions, or publications in the execution of, or relating 22.13 to, their duties under this chapter. 22.14 (b) For purposes of this section, a member of the board or 22.15 a consultant described in paragraph (a) is considered a state 22.16 employee under section 3.736, subdivision 9. 22.17 Subd. 3. [PHYSICIAN ASSISTANT COOPERATION.] A physician 22.18 assistant who is the subject of an investigation by or on behalf 22.19 of the board shall cooperate fully with the investigation. 22.20 Cooperation includes responding fully and promptly to any 22.21 question raised by or on behalf of the board relating to the 22.22 subject of the investigation and providing copies of patient 22.23 medical records, as reasonably requested by the board, to assist 22.24 the board in its investigation. The board shall pay for copies 22.25 requested. If the board does not have a written consent from a 22.26 patient permitting access to the patient's records, the 22.27 physician assistant shall delete any data in the record which 22.28 identifies the patient before providing it to the board. The 22.29 board shall maintain any records obtained pursuant to this 22.30 section as investigative data pursuant to chapter 13. 22.31 Sec. 15. [147A.16] [FORMS OF DISCIPLINARY ACTION.] 22.32 When the board finds that a registered physician assistant 22.33 has violated a provision of this chapter, it may do one or more 22.34 of the following: 22.35 (1) revoke the registration; 22.36 (2) suspend the registration; 23.1 (3) impose limitations or conditions on the physician 23.2 assistant's practice, including limiting the scope of practice 23.3 to designated field specialties; impose retraining or 23.4 rehabilitation requirements; require practice under additional 23.5 supervision; or condition continued practice on demonstration of 23.6 knowledge or skills by appropriate examination or other review 23.7 of skill and competence; 23.8 (4) impose a civil penalty not exceeding $10,000 for each 23.9 separate violation, the amount of the civil penalty to be fixed 23.10 so as to deprive the physician assistant of any economic 23.11 advantage gained by reason of the violation charged or to 23.12 reimburse the board for the cost of the investigation and 23.13 proceeding; 23.14 (5) order the physician assistant to provide unremunerated 23.15 professional service under supervision at a designated public 23.16 hospital, clinic, or other health care institution; or 23.17 (6) censure or reprimand the registered physician assistant. 23.18 Upon judicial review of any board disciplinary action taken 23.19 under this chapter, the reviewing court shall seal the 23.20 administrative record, except for the board's final decision, 23.21 and shall not make the administrative record available to the 23.22 public. 23.23 Sec. 16. [147A.17] [PHYSICIAN ASSISTANT ACCOUNTABILITY.] 23.24 Subdivision 1. [INVESTIGATION.] The board shall maintain 23.25 and keep current a file containing the reports and complaints 23.26 filed against physician assistants in the state. Each complaint 23.27 filed with the board pursuant to section 214.10, subdivision 1, 23.28 shall be investigated according to section 214.10, subdivision 2. 23.29 Whenever the files maintained by the board show that a 23.30 medical malpractice settlement or award to the plaintiff has 23.31 been made against a physician assistant as reported by insurers 23.32 pursuant to this chapter, the executive director of the board 23.33 shall notify the board and the board may authorize a review of 23.34 the physician assistant's practice. 23.35 Subd. 2. [ATTORNEY GENERAL INVESTIGATION.] When the board 23.36 initiates a review of a physician assistant's practice, it shall 24.1 notify the attorney general who shall investigate the matter in 24.2 the same manner as provided in section 214.10. If an 24.3 investigation is to be made, the attorney general shall notify 24.4 the physician assistant, and, if the incident being investigated 24.5 occurred there, the administrator and chief of staff at the 24.6 medical care facilities in which the physician assistant serves. 24.7 Subd. 3. [ACCESS TO HOSPITAL RECORDS.] The board shall 24.8 have access to hospital and medical records of a patient treated 24.9 by the physician assistant under review if the patient signs a 24.10 written consent form permitting such access. If no consent form 24.11 has been signed, the hospital or physician assistant shall first 24.12 delete data in the record which identifies the patient before 24.13 providing it to the board. 24.14 Sec. 17. [147A.18] [DELEGATED AUTHORITY TO PRESCRIBE, 24.15 DISPENSE, AND ADMINISTER DRUGS AND MEDICAL DEVICES.] 24.16 Subdivision 1. [DELEGATION.] (a) A supervising physician 24.17 may delegate to a physician assistant who is registered with the 24.18 board, certified by the National Commission on Certification of 24.19 Physician Assistants or successor agency approved by the board, 24.20 and who is under the supervising physician's supervision, the 24.21 authority to prescribe, dispense, and administer legend drugs, 24.22 medical devices, and controlled substances subject to the 24.23 requirements in this section. The authority to dispense 24.24 includes, but is not limited to, the authority to request, 24.25 receive, and dispense sample drugs. This authority to dispense 24.26 extends only to those drugs described in the written agreement 24.27 developed under paragraph (b). 24.28 (b) The agreement between the physician assistant and 24.29 supervising physician and any alternate supervising physicians 24.30 must include a statement by the supervising physician regarding 24.31 delegation or nondelegation of the functions of prescribing, 24.32 dispensing, and administering of legend drugs and medical 24.33 devices to the physician assistant. The statement must include 24.34 a protocol indicating categories of drugs for which the 24.35 supervising physician delegates prescriptive and dispensing 24.36 authority. The delegation must be appropriate to the physician 25.1 assistant's practice and within the scope of the physician 25.2 assistant's training. Physician assistants who have been 25.3 delegated the authority to prescribe, dispense, and administer 25.4 legend drugs and medical devices shall provide evidence of 25.5 current certification by the National Commission on 25.6 Certification of Physician Assistants or its successor agency 25.7 when registering or reregistering as physician assistants. 25.8 Physician assistants who have been delegated the authority to 25.9 prescribe controlled substances must present evidence of the 25.10 certification and hold a valid DEA certificate. Supervising 25.11 physicians shall retrospectively review, on a daily basis, the 25.12 prescribing, dispensing, and administering of legend and 25.13 controlled drugs and medical devices by physician assistants, 25.14 when this authority has been delegated to the physician 25.15 assistant as part of the delegation agreement between the 25.16 physician and the physician assistant. During each daily 25.17 review, the supervising physician shall document by signature 25.18 and date that the prescriptive, administering, and dispensing 25.19 practice of the physician assistant has been reviewed. 25.20 (c) The board may establish by rule: 25.21 (1) a system of identifying physician assistants eligible 25.22 to prescribe, administer, and dispense legend drugs and medical 25.23 devices; 25.24 (2) a system of identifying physician assistants eligible 25.25 to prescribe, administer, and dispense controlled substances; 25.26 (3) a method of determining the categories of legend and 25.27 controlled drugs and medical devices that each physician 25.28 assistant is allowed to prescribe, administer, and dispense; and 25.29 (4) a system of transmitting to pharmacies a listing of 25.30 physician assistants eligible to prescribe legend and controlled 25.31 drugs and medical devices. 25.32 Subd. 2. [TERMINATION AND REINSTATEMENT OF PRESCRIBING 25.33 AUTHORITY.] (a) The authority of a physician assistant to 25.34 prescribe, dispense, and administer legend drugs and medical 25.35 devices shall end immediately when: 25.36 (1) the agreement is terminated; 26.1 (2) the authority to prescribe, dispense, and administer is 26.2 terminated or withdrawn by the supervising physician; or 26.3 (3) the physician assistant reverts to inactive status, 26.4 loses National Commission on Certification of Physician 26.5 Assistants or successor agency certification, or loses or 26.6 terminates registration status. 26.7 (b) The physician assistant must notify the board in 26.8 writing within ten days of the occurrence of any of the 26.9 circumstances listed in paragraph (a). 26.10 (c) Physician assistants whose authority to prescribe, 26.11 dispense, and administer has been terminated shall reapply for 26.12 reinstatement of prescribing authority under this section and 26.13 meet any requirements established by the board prior to 26.14 reinstatement of the prescribing, dispensing, and administering 26.15 authority. 26.16 Subd. 3. [OTHER REQUIREMENTS AND RESTRICTIONS.] (a) The 26.17 supervising physician and the physician assistant must complete, 26.18 sign, and date an internal protocol which lists each category of 26.19 drug or medical device, or controlled substance the physician 26.20 assistant may prescribe, dispense, and administer. The 26.21 supervising physician and physician assistant shall submit the 26.22 internal protocol to the board upon request. The supervising 26.23 physician may amend the internal protocol as necessary, within 26.24 the limits of the completed delegation form in subdivision 5. 26.25 The supervising physician and physician assistant must sign and 26.26 date any amendments to the internal protocol. Any amendments 26.27 resulting in a change to an addition or deletion to categories 26.28 delegated in the delegation form in subdivision 5 must be 26.29 submitted to the board according to this chapter, along with the 26.30 fee required. 26.31 (b) The supervising physician and physician assistant shall 26.32 review delegation of prescribing, dispensing, and administering 26.33 authority on an annual basis at the time of reregistration. The 26.34 internal protocol must be signed and dated by the supervising 26.35 physician and physician assistant after review. Any amendments 26.36 to the internal protocol resulting in changes to the delegation 27.1 form in subdivision 5 must be submitted to the board according 27.2 to this chapter, along with the fee required. 27.3 (c) Each prescription initiated by a physician assistant 27.4 shall indicate the following: 27.5 (1) the date of issue; 27.6 (2) the name and address of the patient; 27.7 (3) the name and quantity of the drug prescribed; 27.8 (4) directions for use; and 27.9 (5) the name, address, and telephone number of the 27.10 prescribing physician assistant and of the physician serving as 27.11 supervisor. 27.12 (d) In prescribing, dispensing, and administering legend 27.13 drugs and medical devices, including controlled substances as 27.14 defined in section 152.01, subdivision 4, a physician assistant 27.15 must conform with the agreement, chapter 151, and this chapter. 27.16 Subd. 4. [NOTIFICATION OF PHARMACIES.] (a) The board shall 27.17 annually provide to the board of pharmacy and to registered 27.18 pharmacies within the state a list of those physician assistants 27.19 who are authorized to prescribe, administer, and dispense legend 27.20 drugs and medical devices, or controlled substances. 27.21 (b) The board shall provide to the board of pharmacy a list 27.22 of physician assistants authorized to prescribe legend drugs and 27.23 medical devices every two months if additional physician 27.24 assistants are authorized to prescribe or if physician 27.25 assistants have authorization to prescribe withdrawn. 27.26 (c) The list must include the name, address, telephone 27.27 number, and Minnesota registration number of the physician 27.28 assistant, and the name, address, telephone number, and 27.29 Minnesota license number of the supervising physician. 27.30 (d) The board shall provide the form in subdivision 5 to 27.31 pharmacies upon request. 27.32 (e) The board shall make available prototype forms of the 27.33 physician-physician assistant agreement, the internal protocol, 27.34 the delegation form, and the addendum form. 27.35 Subd. 5. [DELEGATION FORM FOR PHYSICIAN ASSISTANT 27.36 PRESCRIBING.] The delegation form for physician assistant 28.1 prescribing must contain a listing by drug category of the 28.2 legend drugs and controlled substances for which prescribing 28.3 authority has been delegated to the physician assistant. 28.4 Sec. 18. [147A.19] [IDENTIFICATION REQUIREMENTS.] 28.5 Physician assistants registered under this chapter shall 28.6 keep their registration available for inspection at their 28.7 primary place of business and shall, when engaged in their 28.8 professional activities, wear a name tag identifying themselves 28.9 as a "physician assistant." 28.10 Sec. 19. [147A.20] [PHYSICIAN AND PHYSICIAN ASSISTANT 28.11 AGREEMENT.] 28.12 (a) A physician assistant and supervising physician must 28.13 sign an agreement which specifies scope of practice and amount 28.14 and manner of supervision as required by the board. The 28.15 agreement must contain: 28.16 (1) a description of the practice setting; 28.17 (2) a statement of practice type/specialty; 28.18 (3) a listing of categories of delegated duties; and 28.19 (4) a description of supervision type, amount, and 28.20 frequency. 28.21 (b) The agreement must be maintained by the supervising 28.22 physician and physician assistant and made available to the 28.23 board upon request. If there is a delegation of prescribing, 28.24 administering, and dispensing of legend drugs, controlled 28.25 substances, and medical devices, the agreement shall include an 28.26 internal protocol and delegation form. Physician assistants 28.27 shall have a separate agreement for each place of employment. 28.28 Agreements must be reviewed and updated on an annual basis. The 28.29 supervising physician and physician assistant must maintain the 28.30 agreement, delegation form, and internal protocol at the address 28.31 of record. Copies shall be provided to the board upon request. 28.32 (c) Physician assistants must provide written notification 28.33 to the board within 30 days of the following: 28.34 (1) name change; 28.35 (2) address of record change; 28.36 (3) telephone number of record change; and 29.1 (4) addition or deletion of alternate supervising physician 29.2 provided that the information submitted includes, for an 29.3 additional alternate physician, an affidavit of consent to act 29.4 as an alternate supervising physician signed by the alternate 29.5 supervising physician. 29.6 (d) Modifications requiring submission prior to the 29.7 effective date are changes to the practice setting description 29.8 which include: 29.9 (1) supervising physician change, excluding alternate 29.10 supervising physicians; or 29.11 (2) delegation of prescribing, administering, or dispensing 29.12 of legend drugs, controlled substances, or medical devices. 29.13 Sec. 20. [147A.21] [RULEMAKING AUTHORITY.] 29.14 The board shall adopt rules: 29.15 (1) setting registration fees; 29.16 (2) setting renewal fees; 29.17 (3) setting fees for locum tenens permits; 29.18 (4) setting fees for temporary registration; and 29.19 (5) establishing renewal dates. 29.20 Sec. 21. [147A.22] [LOCUM TENENS PERMIT.] 29.21 The board may grant a locum tenens permit to any applicant 29.22 who is registered in the state. The applications for locum 29.23 tenens permits shall be reviewed at the next scheduled board 29.24 meeting. The application shall include a practice setting 29.25 description. The maximum duration of a locum tenens permit is 29.26 one year. The permit may be renewed annually on a date set by 29.27 the board. 29.28 Sec. 22. [147A.24] [CONTINUING EDUCATION REQUIREMENTS.] 29.29 Subdivision 1. [AMOUNT OF EDUCATION REQUIRED.] Applicants 29.30 for registration renewal or reregistration must either attest to 29.31 and document successful completion of at least 50 contact hours 29.32 of continuing education within the two years immediately 29.33 preceding registration renewal, reregistration, or attest to and 29.34 document taking the national certifying examination required by 29.35 this chapter within the past two years. 29.36 Subd. 2. [TYPE OF EDUCATION REQUIRED.] Approved continuing 30.1 education equivalent to category 1 credit hours as defined by 30.2 the American Osteopathic Association Bureau of Professional 30.3 Education, the Royal College of Physicians and Surgeons of 30.4 Canada, the American Academy of Physician Assistants, or by 30.5 organizations that have reciprocal arrangements with the 30.6 physician recognition award program of the American Medical 30.7 Association. 30.8 Sec. 23. [147A.25] [CONTINUING EDUCATION CYCLES.] 30.9 During each two-year cycle each physician assistant shall 30.10 obtain 50 hours of continuing medical education credit with at 30.11 least two hours in the subject of infection control, including 30.12 blood borne diseases. "Infection control" means programs, 30.13 procedures, and methods to reduce the transmission of agents of 30.14 infection for the purpose of preventing or decreasing the 30.15 incidence of infectious diseases. "Blood borne diseases" means 30.16 diseases that are spread through exposure to, inoculation of, or 30.17 injection of blood, or through exposure to blood contained in 30.18 body fluids, tissue, or organs. Blood borne diseases include 30.19 infection caused by such agents as the human immunodeficiency 30.20 virus (HIV) and hepatitis B virus (HBV). Infection control 30.21 continuing education credits must be obtained from the category 30.22 1 activities. Continuing education in infection control is 30.23 required for renewal periods beginning on or after October 1, 30.24 1995. For initial continuing education periods of less than two 30.25 years, one continuing education hour in infection control is 30.26 required for each remaining full year. 30.27 Sec. 24. [147A.26] [PROCEDURES.] 30.28 The board shall establish, in writing, internal operating 30.29 procedures for receiving and investigating complaints, accepting 30.30 and processing applications, granting registrations, and 30.31 imposing enforcement actions. The written internal operating 30.32 procedures may include procedures for sharing complaint 30.33 information with government agencies in this and other states. 30.34 Establishment of the operating procedures are not subject to 30.35 rulemaking procedures under chapter 14. Procedures for sharing 30.36 complaint information must be consistent with the requirements 31.1 for handling government data under chapter 13. 31.2 Sec. 25. [REPEALER.] 31.3 Minnesota Statutes 1994, sections 147.34; 147.35; and 31.4 147.36; Minnesota Rules, parts 5600.2600; 5600.2605; 5600.2610; 31.5 5600.2615; 5600.2620; 5600.2625; 5600.2630; 5600.2635; 31.6 5600.2640; 5600.2645; 5600.2650; 5600.2655; 5600.2660; 31.7 5600.2665; and 5600.2670, are repealed. 31.8 Sec. 26. [EFFECTIVE DATE.] 31.9 Sections 1 to 25 are effective on the day following final 31.10 enactment, except that sections 7; 12, subdivisions 1 and 7; and 31.11 21, are effective on July 1, 1996. All physician assistants 31.12 registered under this act shall be in compliance no later than 31.13 July 1, 1996. 31.14 ARTICLE 2 31.15 CONFORMING AMENDMENTS 31.16 Section 1. Minnesota Statutes 1994, section 116J.70, 31.17 subdivision 2a, is amended to read: 31.18 Subd. 2a. [LICENSE; EXCEPTIONS.] "Business license" or 31.19 "license" does not include the following: 31.20 (1) any occupational license or registration issued by a 31.21 licensing board listed in section 214.01 or any occupational 31.22 registration issued by the commissioner of health pursuant to 31.23 section 214.13; 31.24 (2) any license issued by a county, home rule charter city, 31.25 statutory city, township, or other political subdivision; 31.26 (3) any license required to practice the following 31.27 occupation regulated by the following sections: 31.28 (a) abstracters regulated pursuant to chapter 386; 31.29 (b) accountants regulated pursuant to chapter 326; 31.30 (c) adjusters regulated pursuant to chapter 72B; 31.31 (d) architects regulated pursuant to chapter 326; 31.32 (e) assessors regulated pursuant to chapter 270; 31.33 (f) athletic trainers regulated pursuant to chapter 148; 31.34 (g) attorneys regulated pursuant to chapter 481; 31.35 (h) auctioneers regulated pursuant to chapter 330; 31.36 (i) barbers regulated pursuant to chapter 154; 32.1 (j) beauticians regulated pursuant to chapter 155A; 32.2 (k) boiler operators regulated pursuant to chapter 183; 32.3 (l) chiropractors regulated pursuant to chapter 148; 32.4 (m) collection agencies regulated pursuant to chapter 332; 32.5 (n) cosmetologists regulated pursuant to chapter 155A; 32.6 (o) dentists, registered dental assistants, and dental 32.7 hygienists regulated pursuant to chapter 150A; 32.8 (p) detectives regulated pursuant to chapter 326; 32.9 (q) electricians regulated pursuant to chapter 326; 32.10 (r) embalmers regulated pursuant to chapter 149; 32.11 (s) engineers regulated pursuant to chapter 326; 32.12 (t) insurance brokers and salespersons regulated pursuant 32.13 to chapter 60A; 32.14 (u) certified interior designers regulated pursuant to 32.15 chapter 326; 32.16 (v) midwives regulated pursuant to chapter 148; 32.17 (w) morticians regulated pursuant to chapter 149; 32.18 (x) nursing home administrators regulated pursuant to 32.19 chapter 144A; 32.20 (y) optometrists regulated pursuant to chapter 148; 32.21 (z) osteopathic physicians regulated pursuant to chapter 32.22 147; 32.23 (aa) pharmacists regulated pursuant to chapter 151; 32.24 (bb) physical therapists regulated pursuant to chapter 148; 32.25 (cc) physician assistants regulated pursuant to chapter 32.26 147A; 32.27 (dd) physicians and surgeons regulated pursuant to chapter 32.28 147; 32.29
(dd)(ee) plumbers regulated pursuant to chapter 326; 32.30 (ee)(ff) podiatrists regulated pursuant to chapter 153; 32.31 (ff)(gg) practical nurses regulated pursuant to chapter 32.32 148; 32.33 (gg)(hh) professional fund raisers regulated pursuant to 32.34 chapter 309; 32.35 (hh)(ii) psychologists regulated pursuant to chapter 148; 32.36 (ii)(jj) real estate brokers, salespersons, and others 33.1 regulated pursuant to chapters 82 and 83; 33.2 (jj)(kk) registered nurses regulated pursuant to chapter 33.3 148; 33.4 (kk)(ll) securities brokers, dealers, agents, and 33.5 investment advisers regulated pursuant to chapter 80A; 33.6 (ll)(mm) steamfitters regulated pursuant to chapter 326; 33.7 (mm)(nn) teachers and supervisory and support personnel 33.8 regulated pursuant to chapter 125; 33.9 (nn)(oo) veterinarians regulated pursuant to chapter 156; 33.10 (oo)(pp) water conditioning contractors and installers 33.11 regulated pursuant to chapter 326; 33.12 (pp)(qq) water well contractors regulated pursuant to 33.13 chapter 156A; 33.14 (qq)(rr) water and waste treatment operators regulated 33.15 pursuant to chapter 115; 33.16 (rr)(ss) motor carriers regulated pursuant to chapter 221; 33.17 (ss)(tt) professional corporations regulated pursuant to 33.18 chapter 319A; 33.19 (tt)(uu) real estate appraisers regulated pursuant to 33.20 chapter 82B; 33.21 (uu)(vv) residential building contractors, residential 33.22 remodelers, residential roofers, manufactured home installers, 33.23 and specialty contractors regulated pursuant to chapter 326; 33.24 (4) any driver's license required pursuant to chapter 171; 33.25 (5) any aircraft license required pursuant to chapter 360; 33.26 (6) any watercraft license required pursuant to chapter 33.27 86B; 33.28 (7) any license, permit, registration, certification, or 33.29 other approval pertaining to a regulatory or management program 33.30 related to the protection, conservation, or use of or 33.31 interference with the resources of land, air, or water, which is 33.32 required to be obtained from a state agency or instrumentality; 33.33 and 33.34 (8) any pollution control rule or standard established by 33.35 the pollution control agency or any health rule or standard 33.36 established by the commissioner of health or any licensing rule 34.1 or standard established by the commissioner of human services. 34.2 Sec. 2. Minnesota Statutes 1994, section 136A.1356, 34.3 subdivision 1, is amended to read: 34.4 Subdivision 1. [DEFINITIONS.] For purposes of this 34.5 section, the following definitions apply: 34.6 (a) "Designated rural area" has the definition developed in 34.7 rule by the higher education coordinating board. 34.8 (b) "Midlevel practitioner" means a nurse practitioner, 34.9 nurse-midwife, nurse anesthetist, advanced clinical nurse 34.10 specialist, or physician assistant. 34.11 (c) "Nurse-midwife" means a registered nurse who has 34.12 graduated from a program of study designed to prepare registered 34.13 nurses for advance practice as nurse-midwives. 34.14 (d) "Nurse practitioner" means a registered nurse who has 34.15 graduated from a program of study designed to prepare registered 34.16 nurses for advance practice as nurse practitioners. 34.17 (e) "Physician assistant" means a person meeting the34.18 definition in Minnesota Rules, part 5600.2600, subpart34.19 11registered under chapter 147A. 34.20 Sec. 3. Minnesota Statutes 1994, section 144.335, 34.21 subdivision 1, is amended to read: 34.22 Subdivision 1. [DEFINITIONS.] For the purposes of this 34.23 section, the following terms have the meanings given them: 34.24 (a) "Patient" means a natural person who has received 34.25 health care services from a provider for treatment or 34.26 examination of a medical, psychiatric, or mental condition, the 34.27 surviving spouse and parents of a deceased patient, or a person 34.28 the patient designates in writing as a representative. Except 34.29 for minors who have received health care services pursuant to 34.30 sections 144.341 to 144.347, in the case of a minor, patient 34.31 includes a parent or guardian, or a person acting as a parent or 34.32 guardian in the absence of a parent or guardian. 34.33 (b) "Provider" means (1) any person who furnishes health 34.34 care services and is licensed to furnish the services pursuant 34.35 to chapter 147, 148, 148B, 150A, 151, or 153; (2) a home care 34.36 provider licensed under section 144A.46; (3) a health care 35.1 facility licensed pursuant to this chapter or chapter 144A; (4) 35.2 a physician assistant registered under chapter 147A; and (4)(5) 35.3 an unlicensed mental health practitioner regulated pursuant to 35.4 sections 148B.60 to 148B.71. 35.5 (c) "Individually identifiable form" means a form in which 35.6 the patient is or can be identified as the subject of the health 35.7 records. 35.8 Sec. 4. Minnesota Statutes 1994, section 148B.60, 35.9 subdivision 3, is amended to read: 35.10 Subd. 3. [UNLICENSED MENTAL HEALTH PRACTITIONER OR 35.11 PRACTITIONER.] "Unlicensed mental health practitioner" or 35.12 "practitioner" means a person who provides or purports to 35.13 provide, for remuneration, mental health services as defined in 35.14 subdivision 4. It does not include persons licensed by the 35.15 board of medical practice under chapter 147 or registered by the 35.16 board of medical practice under chapter 147A; the board of 35.17 nursing under sections 148.171 to 148.285; the board of 35.18 psychology under sections 148.88 to 148.98; the board of social 35.19 work under sections 148B.18 to 148B.28; the board of marriage 35.20 and family therapy under sections 148B.29 to 148B.39; or another 35.21 licensing board if the person is practicing within the scope of 35.22 the license; or members of the clergy who are providing pastoral 35.23 services in the context of performing and fulfilling the 35.24 salaried duties and obligations required of a member of the 35.25 clergy by a religious congregation. For the purposes of 35.26 complaint investigation or disciplinary action relating to an 35.27 individual practitioner, the term includes: 35.28 (1) hospital and nursing home social workers exempt from 35.29 licensure by the board of social work under section 148B.28, 35.30 subdivision 6, including hospital and nursing home social 35.31 workers acting within the scope of their employment by the 35.32 hospital or nursing home; 35.33 (2) persons employed by a program licensed by the 35.34 commissioner of human services who are acting as mental health 35.35 practitioners within the scope of their employment; 35.36 (3) persons employed by a program licensed by the 36.1 commissioner of human services who are providing chemical 36.2 dependency counseling services; persons who are providing 36.3 chemical dependency counseling services in private practice; and 36.4 (4) clergy who are providing mental health services that 36.5 are equivalent to those defined in subdivision 4. 36.6 Sec. 5. Minnesota Statutes 1994, section 151.01, 36.7 subdivision 23, is amended to read: 36.8 Subd. 23. [PRACTITIONER.] "Practitioner" means a licensed 36.9 doctor of medicine, licensed doctor of osteopathy duly licensed 36.10 to practice medicine, licensed doctor of dentistry, licensed 36.11 doctor of optometry, licensed podiatrist, or licensed 36.12 veterinarian. For purposes of sections 151.15, subdivision 4, 36.13 151.37, subdivision 2, paragraph (b), and 151.461, 36.14 "practitioner" also means a physician assistant authorized to 36.15 prescribe, dispense, and administer under section 147.34chapter 36.16 147A, or an advanced practice nurse authorized to prescribe, 36.17 dispense, and administer under section 148.235. 36.18 Sec. 6. Minnesota Statutes 1994, section 151.37, 36.19 subdivision 2a, is amended to read: 36.20 Subd. 2a. A supervising physician may delegate to a 36.21 physician assistant who is registered with the board of medical 36.22 practice and certified by the National Commission on 36.23 Certification of Physician Assistants and who is under the 36.24 supervising physician's supervision, the authority to prescribe, 36.25 dispense, and administer legend drugs and medical devices, 36.26 subject to the requirements in section 147.34chapter 147A and 36.27 other requirements established by the commissioner of health36.28 board of medical practice in rules. 36.29 Sec. 7. Minnesota Statutes 1994, section 214.23, 36.30 subdivision 1, is amended to read: 36.31 Subdivision 1. [COMMISSIONER OF HEALTH.] The board shall 36.32 enter into a contract with the commissioner to perform the 36.33 functions in subdivisions 2 and 3. The contract shall provide 36.34 that: 36.35 (1) unless requested to do otherwise by a regulated person, 36.36 a board shall refer all regulated persons infected with HIV or 37.1 HBV to the commissioner; 37.2 (2) the commissioner may choose to refer any regulated 37.3 person who is infected with HIV or HBV as well as all 37.4 information related thereto to the person's board at any time 37.5 for any reason, including but not limited to: the degree of 37.6 cooperation and compliance by the regulated person; the 37.7 inability to secure information or the medical records of the 37.8 regulated person; or when the facts may present other possible 37.9 violations of the regulated persons practices act. Upon request 37.10 of the regulated person who is infected with HIV or HBV the 37.11 commissioner shall refer the regulated person and all 37.12 information related thereto to the person's board. Once the 37.13 commissioner has referred a regulated person to a board, the 37.14 board may not thereafter submit it to the commissioner to 37.15 establish a monitoring plan unless the commissioner of health 37.16 consents in writing; 37.17 (3) a board shall not take action on grounds relating 37.18 solely to the HIV or HBV status of a regulated person until 37.19 after referral by the commissioner; and 37.20 (4) notwithstanding sections 13.39 and 13.41 and chapters 37.21 147, 147A, 148, 150A, 153, and 214, a board shall forward to the 37.22 commissioner any information on a regulated person who is 37.23 infected with HIV or HBV that the department of health requests. 37.24 Sec. 8. Minnesota Statutes 1994, section 604A.01, 37.25 subdivision 2, is amended to read: 37.26 Subd. 2. [GENERAL IMMUNITY FROM LIABILITY.] (a) A person 37.27 who, without compensation or the expectation of compensation, 37.28 renders emergency care, advice, or assistance at the scene of an 37.29 emergency or during transit to a location where professional 37.30 medical care can be rendered, is not liable for any civil 37.31 damages as a result of acts or omissions by that person in 37.32 rendering the emergency care, advice, or assistance, unless the 37.33 person acts in a willful and wanton or reckless manner in 37.34 providing the care, advice, or assistance. This subdivision 37.35 does not apply to a person rendering emergency care, advice, or 37.36 assistance during the course of regular employment, and 38.1 receiving compensation or expecting to receive compensation for 38.2 rendering the care, advice, or assistance. 38.3 (b) For the purposes of this section, the scene of an 38.4 emergency is an area outside the confines of a hospital or other 38.5 institution that has hospital facilities, or an office of a 38.6 person licensed to practice one or more of the healing arts 38.7 under chapter 147, 147A, 148, 150A, or 153. The scene of an 38.8 emergency includes areas threatened by or exposed to spillage, 38.9 seepage, fire, explosion, or other release of hazardous 38.10 materials, and includes ski areas and trails. 38.11 (c) For the purposes of this section, "person" includes a 38.12 public or private nonprofit volunteer firefighter, volunteer 38.13 police officer, volunteer ambulance attendant, volunteer first 38.14 provider of emergency medical services, volunteer ski patroller, 38.15 and any partnership, corporation, association, or other entity. 38.16 (d) For the purposes of this section, "compensation" does 38.17 not include payments, reimbursement for expenses, or pension 38.18 benefits paid to members of volunteer organizations. 38.19 Sec. 9. [EFFECTIVE DATE.] 38.20 Sections 1 to 8 are effective on the day following final 38.21 enactment.