Rep. Norm Thurston — Voting Record

Bill

Number

S.B. 217 First Substitute (2018GS)

Sponsor

Sen. Hillyard, L.

Final action

Governor Signed 3/22/2018

Outcome

Became law — signed by Gov. Gary R. Herbert

Summary

What it does

• This bill:
• unless the test reflects certain nationally recognized standards, prohibits the following from requiring that a physician take a cognitive exam at a certain age:
• a health care facility for purposes of employment, privileges, or reimbursement;
• a managed care organization or other third party for purposes of reimbursement; and
• the Division of Occupational and Professional Licensing for purposes of licensing; and
• makes technical and conforming changes.

Every vote on this bill

Bill text

PHYSICIAN TESTING AMENDMENTS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Lyle W. Hillyard
House Sponsor: 
Keven J. Stratton
LONG TITLE
General Description:
This bill enacts language related to certain age-based physician testing. 
Highlighted Provisions:
This bill:
▸ unless the test reflects certain nationally recognized standards, prohibits the
following from requiring that a physician take a cognitive exam at a certain age:
• a health care facility for purposes of employment, privileges, or reimbursement;
• a managed care organization or other third party for purposes of reimbursement;
and
• the Division of Occupational and Professional Licensing for purposes of
licensing; and
▸ makes technical and conforming changes. 
Money Appropriated in this Bill:
None
Other Special Clauses:
This bill provides a special effective date.
Utah Code Sections Affected:
AMENDS:
58-67-302
, as last amended by Laws of Utah 2012, Chapters 162 and 225
58-67-302.5
, as last amended by Laws of Utah 2011, Chapter 214
58-68-302
, as last amended by Laws of Utah 2012, Chapters 162 and 225
ENACTS:
26-21-30
, Utah Code Annotated 1953
31A-45-305
, Utah Code Annotated 1953
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
26-21-30
 is enacted to read:
 26-21-30.
Prohibition on certain age-based physician testing.
A health care facility may not require for purposes of employment, privileges, or
reimbursement, that a physician, as defined in Section 
58-67-102
, take a cognitive test when
the physician reaches a specified age, unless the test reflects nationally recognized standards
adopted by the American Medical Association for testing whether an older physician remains
able to provide safe and effective care for patients.
Section 2. Section 
31A-45-305
 is enacted to read:
 31A-45-305.
Prohibition on certain age-based physician testing.
A managed care organization or other third party may not require for purposes of
reimbursement that a physician, as defined in Section 
58-67-102
, take a cognitive test when the
physician reaches a specified age, unless the test reflects nationally recognized standards
adopted by the American Medical Association for testing whether an older physician remains
able to provide safe and effective care for patients.
Section 3. Section 
58-67-302
 is amended to read:
58-67-302.
Qualifications for licensure.
(1) An applicant for licensure as a physician and surgeon, except as set forth in
Subsection (2), shall:
(a) submit an application in a form prescribed by the division, which may include:
(i) submissions by the applicant of information maintained by practitioner data banks,
as designated by division rule, with respect to the applicant;
(ii) a record of professional liability claims made against the applicant and settlements
paid by or on behalf of the applicant; and
(iii) authorization to use a record coordination and verification service approved by the
division in collaboration with the board;
(b) pay a fee determined by the department under Section 
63J-1-504
;
(c) be of good moral character;
(d) provide satisfactory documentation of having successfully completed a program of
professional education preparing an individual as a physician and surgeon, as evidenced by:
(i) having received an earned degree of doctor of medicine from an LCME accredited
medical school or college; or
(ii) if the applicant graduated from a medical school or college located outside the
United States or its territories, submitting a current certification by the Educational
Commission for Foreign Medical Graduates or any successor organization approved by the
division in collaboration with the board;
(e) satisfy the division and board that the applicant:
(i) has successfully completed 24 months of progressive resident training in a program
approved by the ACGME, the Royal College of Physicians and Surgeons, the College of
Family Physicians of Canada, or any similar body in the United States or Canada approved by
the division in collaboration with the board; or
(ii) (A) has successfully completed 12 months of resident training in an ACGME
approved program after receiving a degree of doctor of medicine as required under Subsection
(1)(d);
(B) has been accepted in and is successfully participating in progressive resident
training in an ACGME approved program within Utah, in the applicant's second or third year
of postgraduate training; and
(C) has agreed to surrender to the division the applicant's license as a physician and
surgeon without any proceedings under Title 63G, Chapter 4, Administrative Procedures Act,
and has agreed the applicant's license as a physician and surgeon will be automatically revoked
by the division if the applicant fails to continue in good standing in an ACGME approved
progressive resident training program within the state;
(f) pass the licensing examination sequence required by division rule made in
collaboration with the board;
(g) be able to read, write, speak, understand, and be understood in the English language
and demonstrate proficiency to the satisfaction of the board if requested by the board;
(h) meet with the board and representatives of the division, if requested, for the
purpose of evaluating the applicant's qualifications for licensure;
(i) designate:
(i) a contact person for access to medical records in accordance with the federal Health
Insurance Portability and Accountability Act; and
(ii) an alternate contact person for access to medical records, in the event the original
contact person is unable or unwilling to serve as the contact person for access to medical
records; and
(j) establish a method for notifying patients of the identity and location of the contact
person and alternate contact person, if the applicant will practice in a location with no other
persons licensed under this chapter.
(2) An applicant for licensure as a physician and surgeon by endorsement who is
currently licensed to practice medicine in any state other than Utah, a district or territory of the
United States, or Canada shall:
(a) be currently licensed with a full unrestricted license in good standing in any state,
district, or territory of the United States, or Canada;
(b) have been actively engaged in the legal practice of medicine in any state, district, or
territory of the United States, or Canada for not less than 6,000 hours during the five years
immediately preceding the date of application for licensure in Utah;
(c) comply with the requirements for licensure under Subsections (1)(a) through (d),
(1)(e)(i), and (1)(g) through (j);
(d) have passed the licensing examination sequence required in Subsection (1)(f) or
another medical licensing examination sequence in another state, district or territory of the
United States, or Canada that the division in collaboration with the board by rulemaking
determines is equivalent to its own required examination;
(e) not have any investigation or action pending against any health care license of the
applicant, not have a health care license that was suspended or revoked in any state, district or
territory of the United States, or Canada, and not have surrendered a health care license in lieu
of a disciplinary action, unless:
(i) the license was subsequently reinstated as a full unrestricted license in good
standing; or
(ii) the division in collaboration with the board determines to its satisfaction, after full
disclosure by the applicant, that:
(A) the conduct has been corrected, monitored, and resolved; or
(B) a mitigating circumstance exists that prevents its resolution, and the division in
collaboration with the board is satisfied that, but for the mitigating circumstance, the license
would be reinstated;
(f) submit to a records review, a practice history review, and comprehensive
assessments, if requested by the division in collaboration with the board; and
(g) produce satisfactory evidence that the applicant meets the requirements of this
Subsection (2) to the satisfaction of the division in collaboration with the board.
(3) An applicant for licensure by endorsement may engage in the practice of medicine
under a temporary license while the applicant's application for licensure is being processed by
the division, provided:
(a) the applicant submits a complete application required for temporary licensure to the
division;
(b) the applicant submits a written document to the division from:
(i) a health care facility licensed under Title 26, Chapter 21, Health Care Facility
Licensing and Inspection Act, stating that the applicant is practicing under the:
(A) invitation of the health care facility; and
(B) the general supervision of a physician practicing at the facility; or
(ii) two individuals licensed under this chapter, whose license is in good standing and
who practice in the same clinical location, both stating that:
(A) the applicant is practicing under the invitation and general supervision of the
individual; and
(B) the applicant will practice at the same clinical location as the individual;
(c) the applicant submits a signed certification to the division that the applicant meets
the requirements of Subsection (2);
(d) the applicant does not engage in the practice of medicine until the division has
issued a temporary license;
(e) the temporary license is only issued for and may not be extended or renewed
beyond the duration of one year from issuance; and
(f) the temporary license expires immediately and prior to the expiration of one year
from issuance, upon notification from the division that the applicant's application for licensure
by endorsement is denied.
(4) The division shall issue a temporary license under Subsection (3) within 15
business days after the applicant satisfies the requirements of Subsection (3).
(5) The division may not require 
 the following requirements for licensure: 
(a)
 a post-residency board certification [
as a requirement for licensure.
]
; or
(b) a cognitive test when the physician reaches a specified age, unless the test reflects
nationally recognized standards adopted by the American Medical Association for testing
whether an older physician remains able to provide safe and effective care for patients.
Section 4. Section 
58-67-302.5
 is amended to read:
58-67-302.5.
Licensing of graduates of foreign medical schools.
(1) Notwithstanding any other provision of law to the contrary, an individual enrolled
in a medical school outside the United States, its territories, the District of Columbia, or
Canada is eligible for licensure as a physician and surgeon in this state if the individual has
satisfied the following requirements:
(a) meets all the requirements of Subsection 
58-67-302
(1), except for Subsection
58-67-302
(1)(d);
(b) has studied medicine in a medical school located outside the United States which is
recognized by an organization approved by the division;
(c) has completed all of the formal requirements of the foreign medical school except
internship or social service;
(d) has attained a passing score on the educational commission for foreign medical
graduates examination or other qualifying examinations such as the United States Medical
Licensing Exam parts I and II, which are approved by the division or a medical school
approved by the division;
(e) has satisfactorily completed one calendar year of supervised clinical training under
the direction of a United States medical education setting accredited by the liaison committee
for graduate medical education and approved by the division;
(f) has completed the postgraduate hospital training required by Subsection
58-67-302
(1)(e)(i); and
(g) has passed the examination required by the division of all applicants for licensure.
(2) Satisfaction of the requirements of Subsection (1) is in lieu of:
(a) the completion of any foreign internship or social service requirements; and
(b) the certification required by Subsection 
58-67-302
(1)(d).
(3) Individuals who satisfy the requirements of Subsections (1)(a) through (f) shall be
eligible for admission to graduate medical education programs within the state, including
internships and residencies, which are accredited by the liaison committee for graduate medical
education.
(4) A document issued by a medical school located outside the United States shall be
considered the equivalent of a degree of doctor of medicine for the purpose of licensure as a
physician and surgeon in this state if:
(a) the foreign medical school is recognized by an organization approved by the
division;
(b) the document granted by the foreign medical school is issued after the completion
of all formal requirements of the medical school except internship or social service; and
(c) the foreign medical school certifies that the person to whom the document was
issued has satisfactorily completed the requirements of Subsection (1)(c).
(5) The division may not require as a requirement for licensure a cognitive test when
the physician reaches a specified age, unless the test reflects nationally recognized standards
adopted by the American Medical Association for testing whether an older physician remains
able to provide safe and effective care for patients. 
[
(5)
] 
(6)
 The provisions for licensure under this section shall be known as the "fifth
pathway program."
Section 5. Section 
58-68-302
 is amended to read:
58-68-302.
Qualifications for licensure.
(1) An applicant for licensure as an osteopathic physician and surgeon, except as set
forth in Subsection (2), shall:
(a) submit an application in a form prescribed by the division, which may include:
(i) submissions by the applicant of information maintained by practitioner data banks,
as designated by division rule, with respect to the applicant;
(ii) a record of professional liability claims made against the applicant and settlements
paid by or on behalf of the applicant; and
(iii) authorization to use a record coordination and verification service approved by the
division in collaboration with the board;
(b) pay a fee determined by the department under Section 
63J-1-504
;
(c) be of good moral character;
(d) provide satisfactory documentation of having successfully completed a program of
professional education preparing an individual as an osteopathic physician and surgeon, as
evidenced by:
(i) having received an earned degree of doctor of osteopathic medicine from an AOA
approved medical school or college; or
(ii) submitting a current certification by the Educational Commission for Foreign
Medical Graduates or any successor organization approved by the division in collaboration
with the board, if the applicant is graduated from an osteopathic medical school or college
located outside of the United States or its territories which at the time of the applicant's
graduation, met criteria for accreditation by the AOA;
(e) satisfy the division and board that the applicant:
(i) has successfully completed 24 months of progressive resident training in an
ACGME or AOA approved program after receiving a degree of doctor of osteopathic medicine
required under Subsection (1)(d); or
(ii) (A) has successfully completed 12 months of resident training in an ACGME or
AOA approved program after receiving a degree of doctor of osteopathic medicine as required
under Subsection (1)(d);
(B) has been accepted in and is successfully participating in progressive resident
training in an ACGME or AOA approved program within Utah, in the applicant's second or
third year of postgraduate training; and
(C) has agreed to surrender to the division the applicant's license as an osteopathic
physician and surgeon without any proceedings under Title 63G, Chapter 4, Administrative
Procedures Act, and has agreed the applicant's license as an osteopathic physician and surgeon
will be automatically revoked by the division if the applicant fails to continue in good standing
in an ACGME or AOA approved progressive resident training program within the state;
(f) pass the licensing examination sequence required by division rule, as made in
collaboration with the board;
(g) be able to read, write, speak, understand, and be understood in the English language
and demonstrate proficiency to the satisfaction of the board, if requested by the board;
(h) meet with the board and representatives of the division, if requested for the purpose
of evaluating the applicant's qualifications for licensure;
(i) designate:
(i) a contact person for access to medical records in accordance with the federal Health
Insurance Portability and Accountability Act; and
(ii) an alternate contact person for access to medical records, in the event the original
contact person is unable or unwilling to serve as the contact person for access to medical
records; and
(j) establish a method for notifying patients of the identity and location of the contact
person and alternate contact person, if the applicant will practice in a location with no other
persons licensed under this chapter.
(2) An applicant for licensure as an osteopathic physician and surgeon by endorsement
who is currently licensed to practice osteopathic medicine in any state other than Utah, a
district or territory of the United States, or Canada shall:
(a) be currently licensed with a full unrestricted license in good standing in any state,
district or territory of the United States, or Canada;
(b) have been actively engaged in the legal practice of osteopathic medicine in any
state, district or territory of the United States, or Canada for not less than 6,000 hours during
the five years immediately preceding the day on which the applicant applied for licensure in
Utah;
(c) comply with the requirements for licensure under Subsections (1)(a) through (d),
(1)(e)(i), and (1)(g) through (j);
(d) have passed the licensing examination sequence required in Subsection (1)(f) or
another medical licensing examination sequence in another state, district or territory of the
United States, or Canada that the division in collaboration with the board by rulemaking
determines is equivalent to its own required examination;
(e) not have any investigation or action pending against any health care license of the
applicant, not have a health care license that was suspended or revoked in any state, district or
territory of the United States, or Canada, and not have surrendered a health care license in lieu
of a disciplinary action, unless:
(i) the license was subsequently reinstated as a full unrestricted license in good
standing; or
(ii) the division in collaboration with the board determines, after full disclosure by the
applicant, that:
(A) the conduct has been corrected, monitored, and resolved; or
(B) a mitigating circumstance exists that prevents its resolution, and the division in
collaboration with the board is satisfied that, but for the mitigating circumstance, the license
would be reinstated;
(f) submit to a records review, a practice review history, and physical and
psychological assessments, if requested by the division in collaboration with the board; and
(g) produce evidence that the applicant meets the requirements of this Subsection (2) to
the satisfaction of the division in collaboration with the board.
(3) An applicant for licensure by endorsement may engage in the practice of medicine
under a temporary license while the applicant's application for licensure is being processed by
the division, provided:
(a) the applicant submits a complete application required for temporary licensure to the
division;
(b) the applicant submits a written document to the division from:
(i) a health care facility licensed under Title 26, Chapter 21, Health Care Facility
Licensing and Inspection Act, stating that the applicant is practicing under the:
(A) invitation of the health care facility; and
(B) the general supervision of a physician practicing at the health care facility; or
(ii) two individuals licensed under this chapter, whose license is in good standing and
who practice in the same clinical location, both stating that:
(A) the applicant is practicing under the invitation and general supervision of the
individual; and
(B) the applicant will practice at the same clinical location as the individual;
(c) the applicant submits a signed certification to the division that the applicant meets
the requirements of Subsection (2);
(d) the applicant does not engage in the practice of medicine until the division has
issued a temporary license;
(e) the temporary license is only issued for and may not be extended or renewed
beyond the duration of one year from issuance; and
(f) the temporary license expires immediately and prior to the expiration of one year
from issuance, upon notification from the division that the applicant's application for licensure
by endorsement is denied.
(4) The division shall issue a temporary license under Subsection (3) within 15
business days after the applicant satisfies the requirements of Subsection (3).
(5) The division may not require 
 the following as a requirement for licensure: 
(a)
 a post-residency board certification [
as a requirement for licensure.
]
; or
(b) a cognitive test when the physician reaches a specified age, unless the test reflects
nationally recognized standards adopted by the American Medical Association for testing
whether an older physician remains able to provide safe and effective care for patients. 
Section 6. 
Contingent effective date.
(1) Except as provided in Subsection (2), this bill takes effect when the Division of
Occupational and Professional Licensing certifies to the Health and Human Services Interim
Committee that the American Medical Association has adopted standards for testing whether
an older physician remains able to provide safe and effective care for patients.
(2) If the certification described in Subsection (1) does not occur before September 1,
2018, this bill takes effect on September 1, 2018.