1.1                          A bill for an act 
  1.2             relating to health occupations; establishing 
  1.3             requirements for orthopedic physician assistant 
  1.4             practice; protecting certain titles; establishing a 
  1.5             ground for disciplinary action for physician 
  1.6             assistants; amending Minnesota Statutes 1998, sections 
  1.7             147A.01, by adding subdivisions; 147A.03, subdivisions 
  1.8             3 and 4, and by adding a subdivision; and 147A.13, 
  1.9             subdivision 1; proposing coding for new law in 
  1.10            Minnesota Statutes, chapter 147A. 
  1.11  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.12     Section 1.  Minnesota Statutes 1998, section 147A.01, is 
  1.13  amended by adding a subdivision to read: 
  1.14     Subd. 16a.  [ORTHOPEDIC PHYSICIAN.] "Orthopedic physician" 
  1.15  means a person currently licensed in good standing as a 
  1.16  physician or osteopath under chapter 147 who specializes in 
  1.17  orthopedic medicine or orthopedic surgery. 
  1.18     Sec. 2.  Minnesota Statutes 1998, section 147A.01, is 
  1.19  amended by adding a subdivision to read: 
  1.20     Subd. 16b.  [ORTHOPEDIC PHYSICIAN ASSISTANT.] "Orthopedic 
  1.21  physician assistant" means an individual who engages in 
  1.22  orthopedic physician assistant practice and who satisfies the 
  1.23  requirements of section 147A.095 for engaging in such practice. 
  1.24     Sec. 3.  Minnesota Statutes 1998, section 147A.01, is 
  1.25  amended by adding a subdivision to read: 
  1.26     Subd. 16c.  [ORTHOPEDIC PHYSICIAN ASSISTANT 
  1.27  PRACTICE.] "Orthopedic physician assistant practice" means the 
  1.28  provision of services within the specialty of orthopedic 
  2.1   medicine and orthopedic surgery under the supervision of an 
  2.2   orthopedic physician.  Such services include, but are not 
  2.3   limited to, assisting with the application and execution of 
  2.4   orthopedic and orthopedic surgical procedures; the application 
  2.5   of casts, splints, traction, and other orthopedic devices and 
  2.6   equipment; and cast and splint changes. 
  2.7      Sec. 4.  Minnesota Statutes 1998, section 147A.03, is 
  2.8   amended by adding a subdivision to read: 
  2.9      Subd. 1a.  [PROTECTED TITLES; ORTHOPEDIC PHYSICIAN 
  2.10  ASSISTANTS.] No individual may use the title "Orthopedic 
  2.11  Physician Assistant," "Orthopedic PA," or "OPA" in connection 
  2.12  with the individual's name, or any other words, letters, 
  2.13  abbreviations, or insignia indicating or implying that the 
  2.14  individual is authorized to engage in orthopedic physician 
  2.15  assistant practice, unless the individual is so authorized by 
  2.16  satisfying the requirements of section 147A.095 for engaging in 
  2.17  such practice. 
  2.18     Sec. 5.  Minnesota Statutes 1998, section 147A.03, 
  2.19  subdivision 3, is amended to read: 
  2.20     Subd. 3.  [IDENTIFICATION OF REGISTERED PRACTITIONERS.] 
  2.21  Physician assistants and orthopedic physician assistants in 
  2.22  Minnesota shall wear name tags which identify them as physician 
  2.23  assistants or orthopedic physician assistants. 
  2.24     Sec. 6.  Minnesota Statutes 1998, section 147A.03, 
  2.25  subdivision 4, is amended to read: 
  2.26     Subd. 4.  [SANCTIONS.] Individuals who hold themselves out 
  2.27  as physician assistants by or through any of the titles provided 
  2.28  in subdivision 1 without prior registration shall be subject to 
  2.29  sanctions or actions against continuing the activity according 
  2.30  to section 214.11, or other authority.  Individuals who hold 
  2.31  themselves out as orthopedic physician assistants by or through 
  2.32  any of the titles provided in subdivision 1a without satisfying 
  2.33  the requirements of section 147A.095 shall be subject to 
  2.34  sanctions or actions against continuing the activity according 
  2.35  to section 214.11 or other authority. 
  2.36     Sec. 7.  [147A.095] [ORTHOPEDIC PHYSICIAN ASSISTANTS.] 
  3.1      Subdivision 1.  [QUALIFICATIONS FOR ORTHOPEDIC PHYSICIAN 
  3.2   ASSISTANT PRACTICE.] No individual may engage in orthopedic 
  3.3   physician assistant practice unless the individual has: 
  3.4      (1) successfully completed the examination of the national 
  3.5   board for certification of orthopedic physician assistants and 
  3.6   provided evidence to the board, in a form specified by the 
  3.7   board, of successful completion of the examination; 
  3.8      (2) graduated from an orthopedic physician assistant 
  3.9   training program approved by the board and provided evidence to 
  3.10  the board, in a form specified by the board, of graduation from 
  3.11  an approved program; and 
  3.12     (3) provided evidence, at a time and in a form specified by 
  3.13  the board, of maintaining current certification from the 
  3.14  national board for certification of orthopedic physician 
  3.15  assistants. 
  3.16     Subd. 2.  [OTHER REQUIREMENTS.] An orthopedic physician 
  3.17  assistant shall only provide services and care that are 
  3.18  commensurate with the orthopedic physician assistant's 
  3.19  education, training, and experience and that are provided under 
  3.20  the supervision of an orthopedic physician. 
  3.21     Sec. 8.  Minnesota Statutes 1998, section 147A.13, 
  3.22  subdivision 1, is amended to read: 
  3.23     Subdivision 1.  [GROUNDS LISTED.] The board may refuse to 
  3.24  grant registration or may impose disciplinary action as 
  3.25  described in this subdivision against any physician assistant.  
  3.26  The following conduct is prohibited and is grounds for 
  3.27  disciplinary action: 
  3.28     (1) failure to demonstrate the qualifications or satisfy 
  3.29  the requirements for registration contained in this chapter or 
  3.30  rules of the board.  The burden of proof shall be upon the 
  3.31  applicant to demonstrate such qualifications or satisfaction of 
  3.32  such requirements; 
  3.33     (2) obtaining registration by fraud or cheating, or 
  3.34  attempting to subvert the examination process.  Conduct which 
  3.35  subverts or attempts to subvert the examination process 
  3.36  includes, but is not limited to: 
  4.1      (i) conduct which violates the security of the examination 
  4.2   materials, such as removing examination materials from the 
  4.3   examination room or having unauthorized possession of any 
  4.4   portion of a future, current, or previously administered 
  4.5   licensing examination; 
  4.6      (ii) conduct which violates the standard of test 
  4.7   administration, such as communicating with another examinee 
  4.8   during administration of the examination, copying another 
  4.9   examinee's answers, permitting another examinee to copy one's 
  4.10  answers, or possessing unauthorized materials; and 
  4.11     (iii) impersonating an examinee or permitting an 
  4.12  impersonator to take the examination on one's own behalf; 
  4.13     (3) conviction, during the previous five years, of a felony 
  4.14  reasonably related to the practice of physician assistant.  
  4.15  Conviction as used in this subdivision includes a conviction of 
  4.16  an offense which if committed in this state would be deemed a 
  4.17  felony without regard to its designation elsewhere, or a 
  4.18  criminal proceeding where a finding or verdict of guilt is made 
  4.19  or returned but the adjudication of guilt is either withheld or 
  4.20  not entered; 
  4.21     (4) revocation, suspension, restriction, limitation, or 
  4.22  other disciplinary action against the person's physician 
  4.23  assistant credentials in another state or jurisdiction, failure 
  4.24  to report to the board that charges regarding the person's 
  4.25  credentials have been brought in another state or jurisdiction, 
  4.26  or having been refused registration by any other state or 
  4.27  jurisdiction; 
  4.28     (5) advertising which is false or misleading, violates any 
  4.29  rule of the board, or claims without substantiation the positive 
  4.30  cure of any disease or professional superiority to or greater 
  4.31  skill than that possessed by another physician assistant; 
  4.32     (6) violating a rule adopted by the board or an order of 
  4.33  the board, a state, or federal law which relates to the practice 
  4.34  of a physician assistant, or in part regulates the practice of a 
  4.35  physician assistant, including without limitation sections 
  4.36  148A.02, 609.344, and 609.345, or a state or federal narcotics 
  5.1   or controlled substance law; 
  5.2      (7) engaging in any unethical conduct; conduct likely to 
  5.3   deceive, defraud, or harm the public, or demonstrating a willful 
  5.4   or careless disregard for the health, welfare, or safety of a 
  5.5   patient; or practice which is professionally incompetent, in 
  5.6   that it may create unnecessary danger to any patient's life, 
  5.7   health, or safety, in any of which cases, proof of actual injury 
  5.8   need not be established; 
  5.9      (8) failure to adhere to the provisions of the 
  5.10  physician-physician assistant agreement; 
  5.11     (9) engaging in the practice of medicine beyond that 
  5.12  allowed by the physician-physician assistant agreement, 
  5.13  including the delegation form or the addendum to the delegation 
  5.14  form, or aiding or abetting an unlicensed person in the practice 
  5.15  of medicine; 
  5.16     (10) adjudication as mentally incompetent, mentally ill or 
  5.17  mentally retarded, or as a chemically dependent person, a person 
  5.18  dangerous to the public, a sexually dangerous person, or a 
  5.19  person who has a sexual psychopathic personality by a court of 
  5.20  competent jurisdiction, within or without this state.  Such 
  5.21  adjudication shall automatically suspend a registration for its 
  5.22  duration unless the board orders otherwise; 
  5.23     (11) engaging in unprofessional conduct.  Unprofessional 
  5.24  conduct includes any departure from or the failure to conform to 
  5.25  the minimal standards of acceptable and prevailing practice in 
  5.26  which proceeding actual injury to a patient need not be 
  5.27  established; 
  5.28     (12) inability to practice with reasonable skill and safety 
  5.29  to patients by reason of illness, drunkenness, use of drugs, 
  5.30  narcotics, chemicals, or any other type of material, or as a 
  5.31  result of any mental or physical condition, including 
  5.32  deterioration through the aging process or loss of motor skills; 
  5.33     (13) revealing a privileged communication from or relating 
  5.34  to a patient except when otherwise required or permitted by law; 
  5.35     (14) any use of the title "Physician," "Doctor," or "Dr."; 
  5.36     (15) improper management of medical records, including 
  6.1   failure to maintain adequate medical records, to comply with a 
  6.2   patient's request made pursuant to section 144.335, or to 
  6.3   furnish a medical record or report required by law; 
  6.4      (16) engaging in abusive or fraudulent billing practices, 
  6.5   including violations of the federal Medicare and Medicaid laws 
  6.6   or state medical assistance laws; 
  6.7      (17) becoming addicted or habituated to a drug or 
  6.8   intoxicant; 
  6.9      (18) prescribing a drug or device for other than medically 
  6.10  accepted therapeutic, experimental, or investigative purposes 
  6.11  authorized by a state or federal agency or referring a patient 
  6.12  to any health care provider as defined in section 144.335 for 
  6.13  services or tests not medically indicated at the time of 
  6.14  referral; 
  6.15     (19) engaging in conduct with a patient which is sexual or 
  6.16  may reasonably be interpreted by the patient as sexual, or in 
  6.17  any verbal behavior which is seductive or sexually demeaning to 
  6.18  a patient; 
  6.19     (20) failure to make reports as required by section 147A.14 
  6.20  or to cooperate with an investigation of the board as required 
  6.21  by section 147A.15, subdivision 3; 
  6.22     (21) knowingly providing false or misleading information 
  6.23  that is directly related to the care of that patient unless done 
  6.24  for an accepted therapeutic purpose such as the administration 
  6.25  of a placebo; 
  6.26     (22) aiding suicide or aiding attempted suicide in 
  6.27  violation of section 609.215 as established by any of the 
  6.28  following: 
  6.29     (i) a copy of the record of criminal conviction or plea of 
  6.30  guilty for a felony in violation of section 609.215, subdivision 
  6.31  1 or 2; 
  6.32     (ii) a copy of the record of a judgment of contempt of 
  6.33  court for violating an injunction issued under section 609.215, 
  6.34  subdivision 4; 
  6.35     (iii) a copy of the record of a judgment assessing damages 
  6.36  under section 609.215, subdivision 5; or 
  7.1      (iv) a finding by the board that the person violated 
  7.2   section 609.215, subdivision 1 or 2.  The board shall 
  7.3   investigate any complaint of a violation of section 609.215, 
  7.4   subdivision 1 or 2; ~~or~~ 
  7.5      (23) failure to maintain annually reviewed and updated 
  7.6   physician-physician assistant agreements, internal protocols, or 
  7.7   prescribing delegation forms for each physician-physician 
  7.8   assistant practice relationship, or failure to provide copies of 
  7.9   such documents upon request by the board; or 
  7.10     (24) engaging in orthopedic physician assistant practice or 
  7.11  use of a title protected under section 147A.03, subdivision 1a, 
  7.12  without satisfying the requirements for engaging in orthopedic 
  7.13  physician assistant practice in section 147A.095.