Office of the Revisor of Statutes
Minnesota Session Laws - 2002, Regular Session
Key: (1) language to be deleted (2) new language
CHAPTER 361-S.F.No. 3026
An act relating to health; regulating the provision of
interstate telemedicine services; appropriating money;
amending Minnesota Statutes 2000, sections 147.081,
subdivision 1; 147.091, subdivision 1; 147.141;
proposing coding for new law in Minnesota Statutes,
chapter 147.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1. [147.032] [INTERSTATE PRACTICE OF
TELEMEDICINE.]
Subdivision 1. [REQUIREMENTS; REGISTRATION.] (a) A
physician not licensed to practice medicine in this state may
provide medical services to a patient located in this state
through interstate telemedicine if the following conditions are
met:
(1) the physician is licensed without restriction to
practice medicine in the state from which the physician provides
telemedicine services;
(2) the physician has not had a license to practice
medicine revoked or restricted in any state or jurisdiction;
(3) the physician does not open an office in this state,
does not meet with patients in this state, and does not receive
calls in this state from patients; and
(4) the physician annually registers with the board, on a
form provided by the board.
(b) To register with the board, a physician must:
(1) state the physician's intention to provide interstate
telemedicine services in this state;
(2) provide complete information on:
(i) all states and jurisdictions in which the physician is
currently licensed;
(ii) any states or jurisdictions in which the physician was
previously licensed;
(iii) any negative licensing actions taken previously
against the physician in any state or jurisdiction; and
(iv) other information requested by the board; and
(3) pay a registration fee of $75 annually and an initial
application fee of $100.
(c) A physician registered to provide interstate
telemedicine services under this section must immediately notify
the board of restrictions placed on the physician's license to
practice in any state or jurisdiction.
(d) In registering to provide interstate telemedicine
services to state residents under this section, a physician
agrees to be subject to state laws, the state judicial system,
and the board with respect to providing medical services to
state residents.
(e) For the purposes of this section, telemedicine means
the practice of medicine as defined in section 147.081,
subdivision 3, when the physician is not in the physical
presence of the patient.
Subd. 2. [EXEMPTIONS FROM REGISTRATION.] A physician who
is not licensed to practice medicine in this state, but who
holds a valid license to practice medicine in another state or
jurisdiction, and who provides interstate telemedicine services
to a patient located in this state is not subject to the
registration requirement of subdivision 1, paragraph (a), clause
(4), if:
(1) the services are provided in response to an emergency
medical condition. For the purposes of this section, an
emergency medical condition means a condition, including
emergency labor and delivery, that manifests itself by acute
symptoms of sufficient severity, including severe pain, that the
absence of immediate medical attention could reasonably be
expected to result in placing the patient's health in serious
jeopardy, serious impairment to bodily functions, or serious
dysfunction of any body organ or part;
(2) the services are provided on an irregular or infrequent
basis. For the purposes of this section, a person provides
services on an irregular or infrequent basis if the person
provides the services less than once a month or provides the
services to fewer than ten patients annually; or
(3) the physician provides interstate telemedicine services
in this state in consultation with a physician licensed in this
state and the Minnesota physician retains ultimate authority
over the diagnosis and care of the patient.
Subd. 3. [NOTIFICATION TO OTHER STATES.] The board shall
obtain confirmation of licensure from all states and
jurisdictions in which a physician registered under subdivision
1 has ever been licensed to verify statements made by the
physician and to be notified if any future adverse action is
taken against the physician's license in another state or
jurisdiction. This requirement does not replace the reporting
obligation under section 147.111.
Subd. 4. [HEALTH RECORDS.] A physician who provides
interstate telemedicine services to a patient located in this
state must comply with section 144.335 with respect to the
provision of those services.
Sec. 2. Minnesota Statutes 2000, section 147.081,
subdivision 1, is amended to read:
Subdivision 1. [UNLAWFUL PRACTICE OF MEDICINE.] It is
unlawful for any person not holding a valid license issued in
accordance with this chapter to practice medicine as defined in
subdivision 3 in this state unless:
(1) the person holds a valid license issued according to
this chapter; or
(2) the person is registered to provide interstate
telemedicine services according to section 147.032.
Sec. 3. Minnesota Statutes 2000, section 147.091,
subdivision 1, is amended to read:
Subdivision 1. [GROUNDS LISTED.] The board may refuse to
grant a license, may refuse to grant registration to perform
interstate telemedicine services, or may impose disciplinary
action as described in section 147.141 against any physician.
The following conduct is prohibited and is grounds for
disciplinary action:
(a) Failure to demonstrate the qualifications or satisfy
the requirements for a license contained in this chapter or
rules of the board. The burden of proof shall be upon the
applicant to demonstrate such qualifications or satisfaction of
such requirements.
(b) Obtaining a license by fraud or cheating, or attempting
to subvert the licensing examination process. Conduct which
subverts or attempts to subvert the licensing examination
process includes, but is not limited to: (1) conduct which
violates the security of the examination materials, such as
removing examination materials from the examination room or
having unauthorized possession of any portion of a future,
current, or previously administered licensing examination; (2)
conduct which violates the standard of test administration, such
as communicating with another examinee during administration of
the examination, copying another examinee's answers, permitting
another examinee to copy one's answers, or possessing
unauthorized materials; or (3) impersonating an examinee or
permitting an impersonator to take the examination on one's own
behalf.
(c) Conviction, during the previous five years, of a felony
reasonably related to the practice of medicine or osteopathy.
Conviction as used in this subdivision shall include a
conviction of an offense which if committed in this state would
be deemed a felony without regard to its designation elsewhere,
or a criminal proceeding where a finding or verdict of guilt is
made or returned but the adjudication of guilt is either
withheld or not entered thereon.
(d) Revocation, suspension, restriction, limitation, or
other disciplinary action against the person's medical license
in another state or jurisdiction, failure to report to the board
that charges regarding the person's license have been brought in
another state or jurisdiction, or having been refused a license
by any other state or jurisdiction.
(e) Advertising which is false or misleading, which
violates any rule of the board, or which claims without
substantiation the positive cure of any disease, or professional
superiority to or greater skill than that possessed by another
physician.
(f) Violating a rule promulgated by the board or an order
of the board, a state, or federal law which relates to the
practice of medicine, or in part regulates the practice of
medicine including without limitation sections 148A.02, 609.344,
and 609.345, or a state or federal narcotics or controlled
substance law.
(g) Engaging in any unethical conduct; conduct likely to
deceive, defraud, or harm the public, or demonstrating a willful
or careless disregard for the health, welfare or safety of a
patient; or medical practice which is professionally
incompetent, in that it may create unnecessary danger to any
patient's life, health, or safety, in any of which cases, proof
of actual injury need not be established.
(h) Failure to supervise a physician's assistant or failure
to supervise a physician under any agreement with the board.
(i) Aiding or abetting an unlicensed person in the practice
of medicine, except that it is not a violation of this paragraph
for a physician to employ, supervise, or delegate functions to a
qualified person who may or may not be required to obtain a
license or registration to provide health services if that
person is practicing within the scope of that person's license
or registration or delegated authority.
(j) Adjudication as mentally incompetent, mentally ill or
mentally retarded, or as a chemically dependent person, a person
dangerous to the public, a sexually dangerous person, or a
person who has a sexual psychopathic personality by a court of
competent jurisdiction, within or without this state. Such
adjudication shall automatically suspend a license for the
duration thereof unless the board orders otherwise.
(k) Engaging in unprofessional conduct. Unprofessional
conduct shall include any departure from or the failure to
conform to the minimal standards of acceptable and prevailing
medical practice in which proceeding actual injury to a patient
need not be established.
(l) Inability to practice medicine with reasonable skill
and safety to patients by reason of illness, drunkenness, use of
drugs, narcotics, chemicals or any other type of material or as
a result of any mental or physical condition, including
deterioration through the aging process or loss of motor skills.
(m) Revealing a privileged communication from or relating
to a patient except when otherwise required or permitted by law.
(n) Failure by a doctor of osteopathy to identify the
school of healing in the professional use of the doctor's name
by one of the following terms: osteopathic physician and
surgeon, doctor of osteopathy, or D.O.
(o) Improper management of medical records, including
failure to maintain adequate medical records, to comply with a
patient's request made pursuant to section 144.335 or to furnish
a medical record or report required by law.
(p) Fee splitting, including without limitation:
(1) paying, offering to pay, receiving, or agreeing to
receive, a commission, rebate, or remuneration, directly or
indirectly, primarily for the referral of patients or the
prescription of drugs or devices;
(2) dividing fees with another physician or a professional
corporation, unless the division is in proportion to the
services provided and the responsibility assumed by each
professional and the physician has disclosed the terms of the
division;
(3) referring a patient to any health care provider as
defined in section 144.335 in which the referring physician has
a significant financial interest unless the physician has
disclosed the physician's own financial interest; and
(4) dispensing for profit any drug or device, unless the
physician has disclosed the physician's own profit interest.
The physician must make the disclosures required in this clause
in advance and in writing to the patient and must include in the
disclosure a statement that the patient is free to choose a
different health care provider. This clause does not apply to
the distribution of revenues from a partnership, group practice,
nonprofit corporation, or professional corporation to its
partners, shareholders, members, or employees if the revenues
consist only of fees for services performed by the physician or
under a physician's direct supervision, or to the division or
distribution of prepaid or capitated health care premiums, or
fee-for-service withhold amounts paid under contracts
established under other state law.
(q) Engaging in abusive or fraudulent billing practices,
including violations of the federal Medicare and Medicaid laws
or state medical assistance laws.
(r) Becoming addicted or habituated to a drug or intoxicant.
(s) Prescribing a drug or device for other than medically
accepted therapeutic or experimental or investigative purposes
authorized by a state or federal agency or referring a patient
to any health care provider as defined in section 144.335 for
services or tests not medically indicated at the time of
referral.
(t) Engaging in conduct with a patient which is sexual or
may reasonably be interpreted by the patient as sexual, or in
any verbal behavior which is seductive or sexually demeaning to
a patient.
(u) Failure to make reports as required by section 147.111
or to cooperate with an investigation of the board as required
by section 147.131.
(v) Knowingly providing false or misleading information
that is directly related to the care of that patient unless done
for an accepted therapeutic purpose such as the administration
of a placebo.
(w) Aiding suicide or aiding attempted suicide in violation
of section 609.215 as established by any of the following:
(1) a copy of the record of criminal conviction or plea of
guilty for a felony in violation of section 609.215, subdivision
1 or 2;
(2) a copy of the record of a judgment of contempt of court
for violating an injunction issued under section 609.215,
subdivision 4;
(3) a copy of the record of a judgment assessing damages
under section 609.215, subdivision 5; or
(4) a finding by the board that the person violated section
609.215, subdivision 1 or 2. The board shall investigate any
complaint of a violation of section 609.215, subdivision 1 or 2.
(x) Practice of a board-regulated profession under lapsed
or nonrenewed credentials.
(y) Failure to repay a state or federally secured student
loan in accordance with the provisions of the loan.
(z) Providing interstate telemedicine services other than
according to section 147.032.
Sec. 4. Minnesota Statutes 2000, section 147.141, is
amended to read:
147.141 [FORMS OF DISCIPLINARY ACTION.]
When the board finds that a licensed physician or a
physician registered under section 147.032 has violated a
provision or provisions of sections 147.01 to 147.22, it may do
one or more of the following:
(1) revoke the license;
(2) suspend the license;
(3) revoke or suspend registration to perform interstate
telemedicine;
(4) impose limitations or conditions on the physician's
practice of medicine, including the limitation of scope of
practice to designated field specialties; the imposition of
retraining or rehabilitation requirements; the requirement of
practice under supervision; or the conditioning of continued
practice on demonstration of knowledge or skills by appropriate
examination or other review of skill and competence;
(4) (5) impose a civil penalty not exceeding $10,000 for
each separate violation, the amount of the civil penalty to be
fixed so as to deprive the physician of any economic advantage
gained by reason of the violation charged or to reimburse the
board for the cost of the investigation and proceeding;
(5) (6) order the physician to provide unremunerated
professional service under supervision at a designated public
hospital, clinic, or other health care institution; or
(6) (7) censure or reprimand the licensed physician.
Sec. 5. [APPROPRIATION.]
$4,000 is appropriated in fiscal year 2003 from the state
government special revenue fund to the board of medical practice
to implement the telemedicine registration requirements under
Minnesota Statutes, section 147.032.
Presented to the governor May 6, 2002
Signed by the governor May 8, 2002, 11:30 a.m.
Official Publication of the State of Minnesota
Revisor of Statutes