1.1                          A bill for an act 
  1.2             relating to professions; modifying certain licensing 
  1.3             and registration requirements for physicians, 
  1.4             acupuncturists, and physical therapists; amending 
  1.5             Minnesota Statutes 1996, sections 147.02, subdivision 
  1.6             1; 147.03, subdivision 1; 147.037, subdivision 1; 
  1.7             147B.02, subdivision 9; and 148.71. 
  1.8   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.9      Section 1.  Minnesota Statutes 1996, section 147.02, 
  1.10  subdivision 1, is amended to read: 
  1.11     Subdivision 1.  [UNITED STATES OR CANADIAN MEDICAL SCHOOL 
  1.12  GRADUATES.] The board shall issue a license to practice medicine 
  1.13  to a person who meets the requirements in paragraphs (a) to (h). 
  1.14     (a) An applicant for a license shall file a written 
  1.15  application on forms provided by the board, showing to the 
  1.16  board's satisfaction that the applicant is of good moral 
  1.17  character and satisfies the requirements of this section.  
  1.18     (b) The applicant shall present evidence satisfactory to 
  1.19  the board of being a graduate of a medical or osteopathic school 
  1.20  located in the United States, its territories or Canada, and 
  1.21  approved by the board based upon its faculty, curriculum, 
  1.22  facilities, accreditation by a recognized national accrediting 
  1.23  organization approved by the board, and other relevant data, or 
  1.24  is currently enrolled in the final year of study at the school.  
  1.25     (c) The applicant must have passed an examination as 
  1.26  described in paragraph (1) or (2). 
  2.1      (1) The applicant must have passed a comprehensive 
  2.2   examination for initial licensure prepared and graded by the 
  2.3   National Board of Medical Examiners or the Federation of State 
  2.4   Medical Boards.  The board shall by rule determine what 
  2.5   constitutes a passing score in the examination.  
  2.6      (2) The applicant taking the United States Medical 
  2.7   Licensing Examination (USMLE) must have passed steps one, two, 
  2.8   and three within a seven-year period.  This seven-year period 
  2.9   begins when the applicant first passes either step one or two, 
  2.10  as applicable.  Applicants actively enrolled in or graduated 
  2.11  from accredited MD/PhD, MD/JD, MD/MBA, or MD/MPH dual degree 
  2.12  programs or osteopathic equivalents must have passed each of 
  2.13  steps one, two, and three within three attempts in seven years 
  2.14  plus the time taken to obtain the non-MD degree or ten years, 
  2.15  whichever occurs first.  The applicant must pass each of steps 
  2.16  one, two, and three with passing scores as recommended by the 
  2.17  USMLE program within three attempts.  The applicant taking 
  2.18  combinations of Federation of State Medical Boards, National 
  2.19  Board of Medical Examiners, and USMLE may be accepted only if 
  2.20  the combination is approved by the board as comparable to 
  2.21  existing comparable examination sequences and all examinations 
  2.22  are completed prior to the year 2000.  
  2.23     (d) The applicant shall present evidence satisfactory to 
  2.24  the board of the completion of one year of graduate, clinical 
  2.25  medical training in a program accredited by a national 
  2.26  accrediting organization approved by the board or other graduate 
  2.27  training approved in advance by the board as meeting standards 
  2.28  similar to those of a national accrediting organization.  
  2.29     (e) The applicant shall make arrangements with the 
  2.30  executive director to appear in person before the board or its 
  2.31  designated representative to show that the applicant satisfies 
  2.32  the requirements of this section.  The board may establish as 
  2.33  internal operating procedures the procedures or requirements for 
  2.34  the applicant's personal presentation.  
  2.35     (f) The applicant shall pay a fee established by the board 
  2.36  by rule.  The fee may not be refunded.  Upon application or 
  3.1   notice of license renewal, the board must provide notice to the 
  3.2   applicant and to the person whose license is scheduled to be 
  3.3   issued or renewed of any additional fees, surcharges, or other 
  3.4   costs which the person is obligated to pay as a condition of 
  3.5   licensure.  The notice must: 
  3.6      (1) state the dollar amount of the additional costs; 
  3.7      (2) clearly identify to the applicant the payment schedule 
  3.8   of additional costs; and 
  3.9      (3) advise the applicant of the right to apply to be 
  3.10  excused from the surcharge if a waiver is granted under section 
  3.11  256.9657, subdivision 1b, or relinquish the license to practice 
  3.12  medicine in lieu of future payment if applicable.  
  3.13     (g) The applicant must not be under license suspension or 
  3.14  revocation by the licensing board of the state or jurisdiction 
  3.15  in which the conduct that caused the suspension or revocation 
  3.16  occurred.  
  3.17     (h) The applicant must not have engaged in conduct 
  3.18  warranting disciplinary action against a licensee, or have been 
  3.19  subject to disciplinary action other than as specified in 
  3.20  paragraph (g).  If the applicant does not satisfy the 
  3.21  requirements stated in this paragraph, the board may issue a 
  3.22  license only on the applicant's showing that the public will be 
  3.23  protected through issuance of a license with conditions and 
  3.24  limitations the board considers appropriate. 
  3.25     Sec. 2.  Minnesota Statutes 1996, section 147.03, 
  3.26  subdivision 1, is amended to read: 
  3.27     Subdivision 1.  [ENDORSEMENT; RECIPROCITY.] (a) The board 
  3.28  may issue a license to practice medicine to any person who 
  3.29  satisfies the requirements in paragraphs (b) to (f).  
  3.30     (b) The applicant shall satisfy all the requirements 
  3.31  established in section 147.02, subdivision 1, paragraphs (a), 
  3.32  (b), (d), (e), and (f).  
  3.33     (c) The applicant shall: 
  3.34     (1) ~~within ten years prior to application~~ have passed an 
  3.35  examination prepared and graded by the Federation of State 
  3.36  Medical Boards, the National Board of Medical Examiners, the 
  4.1   United States Medical Licensing Examination program in 
  4.2   accordance with section 147.02, subdivision 1, paragraph (c), 
  4.3   clause (2), the National Board of Osteopathic Examiners, or the 
  4.4   Medical Council of Canada; ~~or~~ and 
  4.5      (2) have a current license from the equivalent licensing 
  4.6   agency in another state or Canada and, if the examination in 
  4.7   clause (1) was passed more than ten years ago, either: 
  4.8      (i) pass the Special Purpose Examination of the Federation 
  4.9   of State Medical Boards with a score of 75 or better within 
  4.10  three attempts; or 
  4.11     (ii) have a current certification by a specialty board of 
  4.12  the American Board of Medical Specialties, of the American 
  4.13  Osteopathic Association Bureau of Professional Education, or of 
  4.14  the Royal College of Physicians and Surgeons of Canada. 
  4.15     (d) The applicant shall pay a fee established by the board 
  4.16  by rule.  The fee may not be refunded.  
  4.17     (e) The applicant must not be under license suspension or 
  4.18  revocation by the licensing board of the state or jurisdiction 
  4.19  in which the conduct that caused the suspension or revocation 
  4.20  occurred. 
  4.21     (f) The applicant must not have engaged in conduct 
  4.22  warranting disciplinary action against a licensee, or have been 
  4.23  subject to disciplinary action other than as specified in 
  4.24  paragraph (e).  If an applicant does not satisfy the 
  4.25  requirements stated in this paragraph, the board may issue a 
  4.26  license only on the applicant's showing that the public will be 
  4.27  protected through issuance of a license with conditions or 
  4.28  limitations the board considers appropriate. 
  4.29     Sec. 3.  Minnesota Statutes 1996, section 147.037, 
  4.30  subdivision 1, is amended to read: 
  4.31     Subdivision 1.  [REQUIREMENTS.] The board shall issue a 
  4.32  license to practice medicine to any person who satisfies the 
  4.33  requirements in paragraphs (a) to (g). 
  4.34     (a) The applicant shall satisfy all the requirements 
  4.35  established in section 147.02, subdivision 1, paragraphs (a), 
  4.36  (e), (f), (g), and (h).  
  5.1      (b) The applicant shall present evidence satisfactory to 
  5.2   the board that the applicant is a graduate of a medical or 
  5.3   osteopathic school approved by the board as equivalent to 
  5.4   accredited United States or Canadian schools based upon its 
  5.5   faculty, curriculum, facilities, accreditation, or other 
  5.6   relevant data.  
  5.7      (c) The applicant shall present evidence satisfactory to 
  5.8   the board that the applicant has been awarded a certificate by 
  5.9   the educational council for foreign medical graduates, and the 
  5.10  applicant has a working ability in the English language 
  5.11  sufficient to communicate with patients and physicians and to 
  5.12  engage in the practice of medicine.  
  5.13     (d) The applicant shall present evidence satisfactory to 
  5.14  the board of the completion of two years of graduate, clinical 
  5.15  medical training in a program located in the United States, its 
  5.16  territories, or Canada and accredited by a national accrediting 
  5.17  organization approved by the board.  This requirement does not 
  5.18  apply: 
  5.19     (1) to an applicant who is admitted as a permanent 
  5.20  immigrant to the United States on or before October 1, 1991, as 
  5.21  a person of exceptional ability in the sciences according to 
  5.22  Code of Federal Regulations, title 20, section 656.22(d); 
  5.23     (2) to an applicant holding a valid license to practice 
  5.24  medicine in another country and issued a permanent immigrant 
  5.25  visa after October 1, 1991, as a person of extraordinary ability 
  5.26  ~~or as an outstanding professor or researcher~~ according to Code 
  5.27  of Federal Regulations, title 8, section 204.5(h), provided that 
  5.28  a person under clause (1) or (2) is admitted pursuant to rules 
  5.29  of the United States Department of Labor; ~~or meeting standards~~ 
  5.30  ~~similar to those of a national accrediting organization;~~ or 
  5.31     (3) to an applicant who is licensed in another state, has 
  5.32  practiced five years without disciplinary action in the United 
  5.33  States, its territories, or Canada, has completed one year of 
  5.34  the graduate, clinical medical training required by this 
  5.35  paragraph, and has passed the Special Purpose Examination of the 
  5.36  Federation of State Medical Boards within three attempts in the 
  6.1   24 months before licensing. 
  6.2      (e) The applicant must:  
  6.3      (1) ~~within ten years prior to application~~ have passed an 
  6.4   examination prepared and graded by the Federation of State 
  6.5   Medical Boards, the United States Medical Licensing Examination 
  6.6   program in accordance with section 147.02, subdivision 1, 
  6.7   paragraph (c), clause (2), or the Medical Council of Canada; ~~or~~ 
  6.8   and 
  6.9      (2) have a current license from the equivalent licensing 
  6.10  agency in another state or Canada~~;~~ and, if the examination in 
  6.11  clause (1) was passed more than ten years ago, either: 
  6.12     (i) pass the Special Purpose Examination of the Federation 
  6.13  of State Medical Boards with a score of 75 or better within 
  6.14  three attempts; or 
  6.15     (ii) have a current certification by a specialty board of 
  6.16  the American Board of Medical Specialties, of the American 
  6.17  Osteopathic Association Bureau of Professional Education, of the 
  6.18  Royal College of Physicians and Surgeons of Canada, or of the 
  6.19  College of Family Physicians of Canada. 
  6.20     (f) The applicant must not be under license suspension or 
  6.21  revocation by the licensing board of the state or jurisdiction 
  6.22  in which the conduct that caused the suspension or revocation 
  6.23  occurred.  
  6.24     (g) The applicant must not have engaged in conduct 
  6.25  warranting disciplinary action against a licensee, or have been 
  6.26  subject to disciplinary action other than as specified in 
  6.27  paragraph (f).  If an applicant does not satisfy the 
  6.28  requirements stated in this paragraph, the board may issue a 
  6.29  license only on the applicant's showing that the public will be 
  6.30  protected through issuance of a license with conditions or 
  6.31  limitations the board considers appropriate. 
  6.32     Sec. 4.  Minnesota Statutes 1996, section 147B.02, 
  6.33  subdivision 9, is amended to read: 
  6.34     Subd. 9.  [RENEWAL.] (a) To renew a license an applicant 
  6.35  must: 
  6.36     (1) annually, or as determined by the board, complete a 
  7.1   renewal application on a form provided by the board; 
  7.2      (2) submit the renewal fee; 
  7.3      (3) provide evidence annually of one hour of continuing 
  7.4   education in the subject of infection control, including blood 
  7.5   borne pathogen diseases; 
  7.6      (4) provide documentation of current and active NCCA 
  7.7   certification; or 
  7.8      (5) if licensed under subdivision 5 or 6, meet ~~one-half the~~ 
  7.9   ~~then current~~ the same NCCA professional development activity 
  7.10  requirements as those licensed under subdivision 7. 
  7.11     (b) An applicant shall submit any additional information 
  7.12  requested by the board to clarify information presented in the 
  7.13  renewal application.  The information must be submitted within 
  7.14  30 days after the board's request, or the renewal request is 
  7.15  nullified. 
  7.16     Sec. 5.  Minnesota Statutes 1996, section 148.71, is 
  7.17  amended to read: 
  7.18     148.71 [REGISTRATION.] 
  7.19     Subdivision 1.  [QUALIFIED APPLICANT.] The state board of 
  7.20  medical practice or its designee shall register as a physical 
  7.21  therapist and shall furnish a certificate of registration to 
  7.22  each applicant who successfully passes an examination provided 
  7.23  for in sections 148.65 to 148.78 for registration as a physical 
  7.24  therapist and who is otherwise qualified as required herein. 
  7.25     Subd. 2.  [TEMPORARY ~~PERMIT~~ REGISTRATION.] ~~(a)~~ The board or 
  7.26  its designee may, upon payment of a nonrefundable fee set by the 
  7.27  board, issue ~~a~~ temporary ~~permit~~ registration to practice 
  7.28  physical therapy under supervision to a physical therapist who:  
  7.29  (1) is a graduate of an approved school of physical therapy or, 
  7.30  if foreign trained, has completed equivalent physical therapy 
  7.31  schooling and successfully completed traineeship as described in 
  7.32  subdivision 3; and ~~qualified for admission to~~ (2) has been 
  7.33  accepted to sit for the registration examination ~~for~~ 
  7.34  ~~registration as a physical therapist~~ or is awaiting examination 
  7.35  results.  ~~A~~ Temporary ~~permit~~ registration to practice physical 
  7.36  therapy under supervision may be issued only once and cannot be 
  8.1   renewed.  It expires ~~90 days after the next examination for~~ 
  8.2   ~~registration given by the board~~ in six months or ~~on the date on~~ 
  8.3   ~~which the board, after examination of the applicant, grants or~~ 
  8.4   ~~denies the applicant a registration to practice,~~ upon receipt of 
  8.5   examination results for those awaiting examination results, 
  8.6   whichever occurs first.  ~~A temporary permit expires on the first~~ 
  8.7   ~~day the board begins its next examination for registration after~~ 
  8.8   ~~the permit is issued if the holder does not submit to~~ 
  8.9   ~~examination on that date.~~  The holder of ~~a~~ temporary ~~permit~~ 
  8.10  registration to practice physical therapy under supervision may 
  8.11  practice physical therapy as defined in section 148.65 if the 
  8.12  entire practice is under the supervision of a person holding a 
  8.13  valid registration to practice physical therapy in this state.  
  8.14  The supervision shall be direct, immediate, and on 
  8.15  premises.  Temporary registration may not be issued to a 
  8.16  foreign-trained applicant who has been issued a temporary permit 
  8.17  for longer than six months in any other state. 
  8.18     ~~(b) A physical therapist from another state who is licensed~~ 
  8.19  ~~or otherwise registered in good standing as a physical therapist~~ 
  8.20  ~~by that state and meets the requirements for registration under~~ 
  8.21  ~~section 148.72 does not require supervision to practice physical~~ 
  8.22  ~~therapy while holding a temporary permit in this state.  The~~ 
  8.23  ~~temporary permit remains valid only until the meeting of the~~ 
  8.24  ~~board at which the application for registration is considered.~~ 
  8.25     Subd. 2a.  [TEMPORARY PERMIT.] The board or its designee 
  8.26  may issue a temporary permit to practice as a physical therapist 
  8.27  eligible for registration under this chapter only if the 
  8.28  application for registration is complete, all requirements have 
  8.29  been met, and a nonrefundable fee set by the board has been 
  8.30  paid.  The permit remains valid only until the meeting of the 
  8.31  board at which a decision is made on the application for 
  8.32  registration. 
  8.33     Subd. 3.  [FOREIGN-TRAINED PHYSICAL THERAPISTS; ~~TEMPORARY~~ 
  8.34  TRAINING PERMITS.] (a) The board of medical practice or its 
  8.35  designee may issue a ~~temporary~~ training permit to a 
  8.36  foreign-trained physical therapist who: 
  9.1      (1) is enrolled in a supervised physical therapy 
  9.2   traineeship that meets the requirements under paragraph (b); 
  9.3      (2) has completed a physical therapy education program 
  9.4   equivalent to that under section 148.705 and Minnesota Rules, 
  9.5   part 5601.0800, subpart 2; 
  9.6      (3) has achieved a score of at least 550 on the test of 
  9.7   English as a foreign language or a score of at least 85 on the 
  9.8   Minnesota battery test; and 
  9.9      (4) has paid a nonrefundable fee set by the board. 
  9.10     A foreign-trained physical therapist must have the 
  9.11  ~~temporary~~ training permit before beginning a traineeship. 
  9.12     (b) A supervised physical therapy traineeship must: 
  9.13     (1) be at least six months; 
  9.14     (2) be at a board-approved facility; 
  9.15     (3) provide a broad base of clinical experience to the 
  9.16  foreign-trained physical therapist including a variety of 
  9.17  physical agents, therapeutic exercises, evaluation procedures, 
  9.18  and patient diagnoses; 
  9.19     (4) be supervised by a physical therapist who has at least 
  9.20  three years of clinical experience and is registered under 
  9.21  subdivision 1; and 
  9.22     (5) be approved by the board before the foreign-trained 
  9.23  physical therapist begins the traineeship. 
  9.24     (c) A ~~temporary~~ training permit is effective on the first 
  9.25  day of a traineeship and expires 90 days after the ~~next~~ 
  9.26  ~~examination for registration given by the board following~~ 
  9.27  ~~successful completion of the traineeship or on the date on which~~ 
  9.28  ~~the board, after examination of the applicant, grants or denies~~ 
  9.29  ~~the applicant a registration to practice, whichever occurs first~~ 
  9.30  traineeship ends. 
  9.31     (d) A foreign-trained physical therapist must successfully 
  9.32  complete a traineeship to be registered as a physical therapist 
  9.33  under subdivision 1.  The traineeship may be waived for a 
  9.34  foreign-trained physical therapist who is licensed or otherwise 
  9.35  registered in good standing in another state and has 
  9.36  successfully practiced physical therapy in that state under the 
 10.1   supervision of a licensed or registered physical therapist for 
 10.2   at least six months at a facility that meets the requirements 
 10.3   under paragraph (b), clauses (2) and (3). 
 10.4      (e) A ~~temporary~~ training permit will not be issued to a 
 10.5   foreign-trained applicant who has been issued a temporary permit 
 10.6   for longer than six months in any other state.