------------------------------------------------------------------------------------------ ¦ REFERENCE TITLE: allopathic board of medical examiners ¦ ------------------------------------------------------------------------------------------ ¦ ¦ ¦ ¦ ¦ ¦ ¦ State of Arizona ¦ ¦ House of Representatives ¦ ¦ Forty-fifth Legislature ¦ ¦ First Regular Session ¦ ¦ 2001 ¦ ------------------------------------------------------------------------------------------ ¦ HB 2412 ¦ ------------------------------------------------------------------------------------------ ¦ Introduced by ¦ ¦ Representatives Huppenthal, Hatch-Miller, Johnson, Allen, Senators Gerard, Brown: ¦ ¦ Representatives Cannell, Loredo ¦ ------------------------------------------------------------------------------------------
AN ACT
AMENDING SECTIONS 32-1401,32-1403.01, 32-1405, 32-1431 AND 32-1451, ARIZONA REVISED STATUTES; RELATING TO THE ALLOPATHIC BOARD OF MEDICAL EXAMINERS.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Section 32-1401, Arizona Revised Statutes, is amended to read:
32-1401. Definitions
In this chapter, unless the context otherwise requires:
1. "Active license" means a valid and existing license to practice medicine.
2. "Adequate records" means legible medical records containing, at a minimum, sufficient information to identify the patient, support the diagnosis, justify the treatment, accurately document the results, indicate advice and cautionary warnings provided to the patient and provide sufficient information for another practitioner to assume continuity of the patient's care at any point in the course of treatment.
3. "Advisory letter" means a nondisciplinary letter to notify a licensee that while there is insufficient evidence to support disciplinary action the board believes that continuation of the activities that led to the investigation may result in further board action against the licensee.
4. "Approved hospital internship, residency or clinical fellowship program" means a program at a hospital that at the time the training occurred was legally incorporated and that had a program that was approved for internship, fellowship or residency training by the accreditation council for graduate medical education, the association of American medical colleges, the royal college of physicians and surgeons of Canada or any similar body in the United States or Canada approved by the board whose function is that of approving hospitals for internship, fellowship or residency training.
5. "Approved school of medicine" means any school or college offering a course of
study which, upon THAT, ON successful completion, results in the degree of
doctor of medicine and whose course of study has been approved or accredited by an
educational or professional association, recognized by the board, including the
association of American medical colleges, the association of Canadian medical colleges or
the American medical association.
6. "Board" means the allopathic board of medical examiners of the state of Arizona.
7. "Completed application" means that the applicant has supplied all required fees, information and correspondence requested by the board on forms and in a manner acceptable to the board.
8. "Direct supervision" means that a physician, physician assistant licensed pursuant to chapter 25 of this title or nurse practitioner certified pursuant to chapter 15 of this title is within the same room or office suite as the medical assistant in order to be available for consultation regarding those tasks the medical assistant performs pursuant to section 32-1456.
9. "Dispense" means the delivery by a doctor of medicine of a prescription drug or device to a patient, except for samples packaged for individual use by licensed manufacturers or repackagers of drugs, and includes the prescribing, administering, packaging, labeling and security necessary to prepare and safeguard the drug or device for delivery.
10. "Doctor of medicine" means a natural person holding a license, registration or permit to practice medicine pursuant to this chapter.
11. "Full-time faculty member" means a physician employed full time as a faculty member while holding the academic position of assistant professor or a higher position at an approved school of medicine.
12. "Health care institution" means any facility as defined in section 36-401, any
person authorized to transact disability insurance, as defined in title 20, chapter 6,
article 4 or 5, any person who is issued a certificate of authority pursuant to title 20,
chapter 4, article 9 or any other partnership, association or corporation which
THAT provides health care to consumers.
13. "Immediate family" means the spouse, natural or adopted children, father, mother, brothers and sisters of the doctor and the natural or adopted children, father, mother, brothers and sisters of the doctor's spouse.
14. "Joint board" means the joint board on the regulation of physician assistants established pursuant to chapter 25 of this title.
15. "Letter of reprimand" means a disciplinary letter that is issued by the board and that informs the physician that the physician's conduct violates state or federal law and may require the board to monitor the physician.
16. "Medical assistant" means an unlicensed person who meets the requirements of
section 32-1456, has completed an education program approved by the board, assists in a
medical practice under the supervision of a doctor of medicine, physician assistant or
nurse practitioner and performs delegated procedures commensurate with the assistant's
education and training but does not diagnose, interpret, design or modify established
treatment programs or perform any functions which THAT would violate any
statute applicable to the practice of medicine.
17. "Medical peer review" means:
(a) The participation by a doctor of medicine in the review and evaluation of the medical management of a patient and the use of resources for patient care.
(b) Activities relating to a health care institution's decision to grant or continue privileges to practice at that institution.
18. "Medically incompetent" means a person who the board determines is incompetent based on a variety of factors including:
(a) A lack of sufficient medical knowledge or skills, or both, to a degree likely to endanger the health of patients.
(b) When considered with other indications of medical incompetence, failing to obtain a scaled score of at least seventy-five per cent on the written special purpose licensing examination administered by the board.
19. "Medicine" means allopathic medicine as practiced by the recipient of a degree of doctor of medicine.
20. "Physician" means a doctor of medicine licensed pursuant to this chapter.
21. "Practice of medicine" means the diagnosis, the treatment or the correction of or the attempt or the holding of oneself out as being able to diagnose, treat or correct any and all human diseases, injuries, ailments, infirmities, deformities, physical or mental, real or imaginary, by any means, methods, devices or instrumentalities, except as the same may be among the acts or persons not affected by this chapter. The practice of medicine includes the practice of medicine alone or the practice of surgery alone, or both.
22. "Special purpose licensing examination" means an examination developed by the national board of medical examiners on behalf of the federation of state medical boards for use by state licensing boards to test the basic medical competence of physicians who are applying for licensure and who have been in practice for a considerable period of time in another jurisdiction and to determine the competence of a physician under investigation by a state licensing board.
23. "Teaching hospital's accredited graduate medical education program" means that the hospital is incorporated and has an internship, fellowship or residency training program that is accredited by the accreditation council for graduate medical education, the American medical association, the association of American medical colleges, the royal college of physicians and surgeons of Canada or a similar body in the United States or Canada approved by the board whose function is that of approving hospitals for internship, fellowship or residency training.
24. "Teaching license" means a valid license to practice medicine as a full-time faculty member of an approved school of medicine or a teaching hospital's accredited graduate medical education program.
25. "Unprofessional conduct" includes the following, whether occurring in this state or elsewhere:
(a) Violating any federal or state laws or rules and regulations applicable to the practice of medicine.
(b) Intentionally disclosing a professional secret or intentionally disclosing a privileged communication except as either act may otherwise be required by law.
(c) False, fraudulent, deceptive or misleading advertising by a doctor of medicine or the doctor's staff, employer or representative.
(d) Committing a felony, whether or not involving moral turpitude, or a misdemeanor involving moral turpitude. In either case, conviction by any court of competent jurisdiction or a plea of no contest is conclusive evidence of the commission.
(e) Failing or refusing to maintain adequate records on a patient.
(f) Habitual intemperance in the use of alcohol or habitual substance abuse.
(g) Using controlled substances except if prescribed by another physician for use during a prescribed course of treatment.
(h) Prescribing or dispensing controlled substances to members of the physician's immediate family.
(i) Prescribing, dispensing or administering schedule II controlled substances as defined in section 36-2513 including amphetamines and similar schedule II sympathomimetic drugs in the treatment of exogenous obesity for a period in excess of thirty days in any one year, or the non-therapeutic use of injectable amphetamines.
(j) Prescribing, dispensing or administering any controlled substance or prescription-only drug for other than accepted therapeutic purposes.
(k) Signing a blank, undated or predated prescription form.
(l) Conduct that the board determines is gross malpractice, repeated malpractice or any malpractice resulting in the death of a patient.
(m) Representing that a manifestly incurable disease or infirmity can be permanently cured, or that any disease, ailment or infirmity can be cured by a secret method, procedure, treatment, medicine or device, if such is not the fact.
(n) Refusing to divulge to the board upon ON demand the means, method,
procedure, modality of treatment or medicine used in the treatment of a disease, injury,
ailment or infirmity.
(o) Action THAT IS taken against a doctor of medicine by another licensing or
regulatory jurisdiction due to that doctor's mental or physical inability to engage
safely in the practice of medicine, his THE DOCTOR'S medical incompetence or
for unprofessional conduct as defined by that jurisdiction and which THAT
corresponds directly or indirectly to an act of unprofessional conduct prescribed by
this paragraph. The action taken may include refusing, denying, revoking or suspending a
license by that jurisdiction or a surrendering of a license to that jurisdiction,
otherwise limiting, restricting or monitoring a licensee by that jurisdiction or placing
a licensee on probation by that jurisdiction.
(p) Sanctions imposed by an agency of the federal government, including restricting, suspending, limiting or removing a person from the practice of medicine or restricting that person's ability to obtain financial remuneration.
(q) Any conduct or practice which THAT is or might be harmful or
dangerous to the health of the patient or the public.
(r) Violating a formal order, probation, consent agreement or stipulation issued or entered into by the board or its executive director under the provisions of this chapter.
(s) Violating or attempting to violate, directly or indirectly, or assisting in or abetting the violation of or conspiring to violate any provision of this chapter.
(t) Knowingly making any false or fraudulent statement, written or oral, in connection with the practice of medicine or if applying for privileges or renewing an application for privileges at a health care institution.
(u) Charging a fee for services not rendered or dividing a professional fee for
patient referrals among health care providers or health care institutions or between
these providers and institutions or a contractual arrangement which THAT has
the same effect.
(v) Obtaining a fee by fraud, deceit or misrepresentation.
(w) Charging or collecting a clearly excessive fee. In determining if a fee is
clearly excessive, THE BOARD SHALL CONSIDER the fee or range of fees customarily
charged in the state for similar services shall be considered by the board, in light
of modifying factors, such as the time required, the complexity of the service and
the skill requisite to perform the service properly. This subdivision does not apply if
there is a clear written contract for a fixed fee between the physician and the patient
which THAT has been entered into prior to BEFORE the provision of
service.
(x) Fetal experiments conducted in violation of section 36-2302.
(y) The use of experimental forms of diagnosis and treatment without adequate informed patient consent, and without conforming to generally accepted experimental criteria, including protocols, detailed records, periodic analysis of results and periodic review by a medical peer review committee as approved by the federal food and drug administration or its successor agency.
(z) Sexual intimacies with a patient.
(z) ENGAGING IN SEXUAL MISCONDUCT WITH A CURRENT PATIENT OR WITH A FORMER PATIENT WITHIN ONE YEAR AFTER THE TERMINATION OF TREATMENT IF THE CURRENT OR FORMER PATIENT IS NOT THE LICENSEE'S SPOUSE OR DOMESTIC PARTNER. FOR THE PURPOSES OF THIS SUBDIVISION, "SEXUAL MISCONDUCT" INCLUDES:
(i) ENGAGING IN OR SOLICITING SEXUAL RELATIONSHIPS, WHETHER CONSENSUAL OR NONCONSENSUAL.
(ii) MAKING SEXUAL ADVANCES, REQUESTING SEXUAL FAVORS OR ENGAGING IN ANY OTHER VERBAL CONDUCT OR PHYSICAL CONTACT OF A SEXUAL NATURE WITH A PATIENT.
(iii) INTENTIONALLY VIEWING A COMPLETELY OR PARTIALLY DISROBED PATIENT IN THE COURSE OF TREATMENT IF THE VIEWING IS NOT RELATED TO PATIENT DIAGNOSIS OR TREATMENT UNDER CURRENT PRACTICE STANDARDS.
(aa) Procuring or attempting to procure a license to practice medicine or a license renewal by fraud, by misrepresentation or by knowingly taking advantage of the mistake of another person or an agency.
(bb) Representing or holding oneself out as being a medical specialist when such is not the fact.
(cc) Maintaining a professional connection with or lending one's name to enhance or continue the activities of an illegal practitioner of medicine.
(dd) Failing to furnish information in a timely manner to the board or its investigators or representatives if legally requested by the board.
(ee) Failing to allow properly authorized board personnel on demand to examine and have access to documents, reports and records maintained by the physician that relate to his medical practice or medically related activities.
(ff) Knowingly failing to disclose to a patient on a form that is prescribed by the
board and that is dated and signed by the patient or guardian acknowledging that the
patient or guardian has read and understands that the doctor has a direct financial
interest in a separate diagnostic or treatment agency or in non-routine goods or services
which THAT the patient is being prescribed and if the prescribed treatment,
goods or services are available on a competitive basis. This subdivision does not apply
to a referral by one doctor of medicine to another doctor of medicine within a group of
doctors of medicine practicing together.
(gg) Using chelation therapy in the treatment of arteriosclerosis or as any other form of therapy, with the exception of treatment of heavy metal poisoning, without:
(i) Adequate informed patient consent.
(ii) Conforming to generally accepted experimental criteria, including protocols, detailed records, periodic analysis of results and periodic review by a medical peer review committee.
(iii) Approval by the federal food and drug administration or its successor agency.
(hh) Prescribing, dispensing or administering anabolic-androgenic steroids to a person for other than therapeutic purposes.
(ii) Lack of or inappropriate direction, collaboration or direct supervision of a medical assistant or a licensed, certified or registered health care provider employed by, supervised by or assigned to the physician.
(jj) Knowingly making a false or misleading statement to the board or on a form required by the board or in a written correspondence, including attachments, with the board.
(kk) Failing to dispense drugs and devices in compliance with article 6 of this chapter.
(ll) Conduct that the board determines is gross negligence, repeated negligence or negligence resulting in harm to or the death of a patient.
(mm) The representation by a doctor of medicine or his THE DOCTOR'S
staff, employer or representative that the doctor is boarded or board certified if
this is not true or the standing is not current or without supplying the full name of the
specific agency, organization or entity granting this standing.
(nn) Refusing to submit to a body fluid examination as required by the board pursuant to section 32-1452 or pursuant to a board investigation into a doctor of medicine's alleged substance abuse.
(oo) Failing to report in writing to the board or the joint board any evidence that a doctor of medicine or a physician assistant is or may be medically incompetent, guilty of unprofessional conduct or mentally or physically unable to safely practice medicine or as a physician assistant.
(pp) The failure of a physician who is the chief executive officer, the medical director or the medical chief of staff of a health care institution to report in writing to the board that the hospital privileges of a doctor of medicine have been denied, revoked, suspended, supervised or limited because of actions by the doctor that appear to show that the doctor is or may be medically incompetent, is or may be guilty of unprofessional conduct or is or may be unable to engage safely in the practice of medicine.
(qq) Representing oneself to be a current member of the board, its staff or a board medical consultant if this is not true.
(rr) Failing to make patient medical records in the physician's possession promptly available to a physician assistant, a nurse practitioner, a person licensed pursuant to this chapter or a podiatrist, chiropractor, naturopathic physician, osteopathic physician or homeopathic physician licensed under chapter 7, 8, 14, 17 or 29 of this title on receipt of proper authorization to do so from the patient, a minor patient's parent, the patient's legal guardian or the patient's authorized representative or failing to comply with title 12, chapter 13, article 7.1.
(ss) Prescribing, dispensing or furnishing a prescription medication or a prescription-only device as defined in section 32-1901 to a person unless the licensee first conducts a physical examination of that person or has previously established a doctor-patient relationship. This subdivision does not apply to:
(i) A physician who provides temporary patient supervision on behalf of the
patient's regular treating physician LICENSED HEALTH CARE PROFESSIONAL.
(ii) Emergency medical situations as defined in section 41-1831.
Sec. 2. Section 32-1403.01, Arizona Revised Statutes, is amended to read:
32-1403.01. Licensees; profiles; required information; review; malpractice information; civil penalty
A. Beginning on January 1, 2001, the allopathic board of medical examiners shall make available to the public a profile of each licensee. The board shall make this information available through an internet web site and, if requested, in writing. The profile shall contain the following information:
1. A description of any criminal conviction within the last five years. For purposes of this paragraph, a licensee is deemed to be convicted of a crime if the licensee pled guilty or was found guilty by a court of competent jurisdiction.
2. A description of any charges within the last five years to which the licensee pled no contest.
3. The number of pending complaints and final board disciplinary and nondisciplinary actions, including dismissals, within the last five years. Information concerning pending complaints shall contain the following statement:
Pending complaints represent unproven allegations. On investigation, many complaints are found to be without merit and are dismissed.
4. All medical malpractice court judgments and all medical malpractice
arbitration awards in which a payment was awarded to a complaining party within the
last five years. Information concerning malpractice actions shall also contain the
following statement:
The settlement of a medical malpractice action may occur for a variety of reasons that do not necessarily reflect negatively on the professional competence or conduct of the doctor. A payment in settlement of a medical malpractice action does not create a presumption that medical malpractice occurred.
5. The name and location of the licensee's medical school and the date of graduation.
6. The name and location of the institution from which the licensee received graduate medical education and the date that education was completed.
7. The licensee's primary practice location.
B. Each licensee shall submit the information required pursuant to subsection A each year as directed by the board. An applicant for licensure shall submit this information at the time of application. The applicant and licensee shall submit the information on a form prescribed by the board. A licensee shall submit immediately any changes in information required pursuant to subsection A, paragraphs 1, 2 and 4. The board shall update immediately its internet web site to reflect changes in information relating to subsection A, paragraphs 1 through 4. The board shall update the internet web site information at least annually.
C. The board shall provide each licensee with a copy of the licensee's profile and give the licensee reasonable time to correct the profile before it is available to the public.
D. It is an act of unprofessional conduct for a licensee to provide erroneous
information required by PURSUANT TO this section. In addition to other
disciplinary action, the board may impose a civil penalty of not more than one thousand
dollars for each erroneous statement.
Sec. 3. Section 32-1405, Arizona Revised Statutes, is amended to read:
32-1405. Executive director; compensation; duties; appeal to the board
A. The board shall appoint an executive director who shall serve at the pleasure of the board. The executive director shall not be a board member, except that the board may authorize the executive director to represent the board and to vote on behalf of the board at meetings of the federation of state medical boards of the United States.
B. The executive director is eligible to receive compensation set by the board within the range determined under section 38-611.
C. The executive director or the executive director's designee shall:
1. Employ, evaluate, dismiss, discipline and direct professional, clerical, technical, investigative and administrative personnel necessary to carry on the work of the board.
2. Set compensation for board employees within the range determined under section 38-611.
3. As directed by the board, prepare and submit recommendations for amendments to the medical practice act for consideration by the legislature.
4. Appoint and employ medical consultants and agents necessary to conduct investigations, gather information and perform those duties the executive director determines are necessary and appropriate to enforce this chapter.
5. Issue licenses, registrations and permits to applicants who meet the requirements of this chapter.
6. Manage the board's offices.
7. Prepare minutes, records, reports, registries, directories, books and newsletters and record all board transactions and orders.
8. Collect all monies due and payable to the board.
9. Pay all bills for authorized expenditures of the board and its staff.
10. Prepare an annual budget.
11. Submit a copy of the budget each year to the governor, the speaker of the house of representatives and the president of the senate.
12. Initiate an investigation if evidence appears to demonstrate that a physician may be engaged in unprofessional conduct or may be medically incompetent or mentally or physically unable to safely practice medicine.
13. Issue subpoenas if necessary to compel the attendance and testimony of witnesses and the production of books, records, documents and other evidence.
14. Provide assistance to the attorney general in preparing and sign and execute disciplinary orders, rehabilitative orders and notices of hearings as directed by the board.
15. Enter into contracts for goods and services pursuant to title 41, chapter 23 that are necessary to carry out board policies and directives.
16. Execute board directives.
17. Manage and supervise the operation of the joint board on the regulation of physician assistants.
18. Issue certificates to physician assistant applicants who meet the requirements of chapter 25 of this title.
19. Represent the board with the federal government, other states or jurisdictions of the United States, this state, political subdivisions of this state, the news media and the public.
20. On behalf of the board, enter into stipulated agreements with persons under the jurisdiction of either the board or the joint board on the regulation of physician assistants for the treatment, rehabilitation and monitoring of chemical substance abuse or misuse.
21. Review all complaints filed pursuant to section 32-1451. If delegated by the
board, the executive director may also dismiss complaints that do not involve medical
incompetence IF THE INFORMATION PROVIDED DOES NOT MERIT ACTION AGAINST THE
LICENSEE.
22. If delegated by the board, directly refer cases to a formal hearing if
evidence warrants suspension or revocation.
23. If delegated by the board, close cases resolved through mediation.
24. If delegated by the board, issue advisory letters.
25. If delegated by the board, enter into a consent agreement if there is evidence of danger to the public health and safety.
26. If delegated by the board, grant uncontested requests for inactive status and cancellation of a license pursuant to sections 32-1431 and 32-1433.
27. If delegated by the board, refer cases to the board for a formal interview.
28. Perform all other administrative, licensing or regulatory duties required by the board.
D. Medical consultants and agents appointed pursuant to subsection C, paragraph 4 of this section are eligible to receive compensation determined by the executive director in an amount not to exceed two hundred dollars for each day of service.
E. A person who is aggrieved by an action taken by the executive director may request the board to review that action by filing with the board a written request within thirty days after that person is notified of the executive director's action by personal delivery or certified mail to that person's last known residence or place of business. At the next regular board meeting, the board shall review the executive director's action. On review, the board shall approve, modify or reject the executive director's action.
Sec. 4. Section 32-1431, Arizona Revised Statutes, is amended to read:
32-1431. Inactive license; application; practice prohibitions
A. A person holding a current active license to practice medicine in this state may request an inactive license from the board IF BOTH OF THE FOLLOWING ARE TRUE:
1. THE LICENSEE IS NOT PRESENTLY UNDER INVESTIGATION BY THE BOARD.
2. THE BOARD HAS NOT COMMENCED ANY DISCIPLINARY PROCEEDING AGAINST THE LICENSEE.
B. The board shall MAY grant an inactive license and waive the renewal
fees and requirements for continuing medical education specified by section 32-1434 if
the licensee provides evidence to the board's satisfaction that the licensee has totally
retired from the practice of medicine in this state and any state, territory and district
of the United States or any foreign country and has paid all of the fees required by this
chapter prior to BEFORE the request. The board may grant pro bono registration
pursuant to section 32-1429, subsection C to a physician who holds an inactive license
under this section.
C. During any period in which a medical doctor holds an inactive license, that person shall not engage in the practice of medicine or continue to hold or maintain a drug enforcement administration controlled substances registration certificate, except as permitted by a pro bono registration pursuant to section 32-1429, subsection C. Any person who engages in the practice of medicine while on inactive license status is considered to be a person who practices medicine without a license or without being exempt from licensure as provided in this chapter.
D. The board may convert an inactive license to an active license if the applicant pays the renewal fee and presents evidence satisfactory to the board that the applicant possesses the medical knowledge and is physically and mentally able to safely engage in the practice of medicine. The board may require any combination of physical examination, psychiatric or psychological evaluation or successful passage of the special purpose licensing examination or interview it finds necessary to assist it in determining the ability of a physician holding an inactive license to return to the active practice of medicine.
Sec. 5. Section 32-1451, Arizona Revised Statutes, is amended to read:
32-1451. Grounds for disciplinary action; duty to report; immunity; proceedings; board action; notice requirements
A. The board on its own motion may investigate any evidence that appears to show that a doctor of medicine is or may be medically incompetent, is or may be guilty of unprofessional conduct or is or may be mentally or physically unable safely to engage in the practice of medicine. On written request of a complainant the board shall review a complaint that has been administratively closed by the executive director and take any action it deems appropriate. Any person may, and a doctor of medicine, the Arizona medical association, a component county society of that association and any health care institution shall, report to the board any information that appears to show that a doctor of medicine is or may be medically incompetent, is or may be guilty of unprofessional conduct or is or may be mentally or physically unable safely to engage in the practice of medicine. The board or the executive director shall notify the doctor as to the content of the complaint as soon as reasonable. Any person or entity that reports or provides information to the board in good faith is not subject to an action for civil damages. If requested, the board shall not disclose the name of a person who supplies information regarding a licensee's drug or alcohol impairment. It is an act of unprofessional conduct for any doctor of medicine to fail to report as required by this section. The board shall report any health care institution that fails to report as required by this section to that institution's licensing agency.
B. The chief executive officer, the medical director or the medical chief of staff of a health care institution shall inform the board if the privileges of a doctor to practice in that health care institution are denied, revoked, suspended or limited because of actions by the doctor that appear to show that the doctor is or may be medically incompetent, is or may be guilty of unprofessional conduct or is or may be mentally or physically unable to safely engage in the practice of medicine, along with a general statement of the reasons, including patient chart numbers, that led the health care institution to take the action. The chief executive officer, the medical director or the medical chief of staff of a health care institution shall inform the board if a doctor under investigation resigns or if a doctor resigns in lieu of disciplinary action by the health care institution. Notification shall include a general statement of the reasons for the resignation, including patient chart numbers. The board shall inform all appropriate health care institutions in this state as defined in section 36-401 and the Arizona health care cost containment system ADMINISTRATION of a resignation, denial, revocation, suspension or limitation, and the general reason for that action, without divulging the name of the reporting health care institution. A person who reports information in good faith pursuant to this subsection is not subject to civil liability.
C. The board or, if delegated by the board, the executive director shall require any combination of mental, physical or oral or written medical competency examinations and conduct necessary investigations including investigational interviews between representatives of the board and the doctor to fully inform itself with respect to any information filed with the board under subsection A of this section. These examinations may include biological fluid testing. The board or, if delegated by the board, the executive director may require the doctor, at the doctor's expense, to undergo assessment by a board approved rehabilitative, retraining or assessment program.
D. If the board finds, based on the information it receives under subsections A and
B of this section, that the public health, safety or welfare imperatively requires
emergency action, and incorporates a finding to that effect in its order, the board may
RESTRICT, LIMIT OR order a summary suspension of a license pending proceedings for
revocation or other action. If the board takes this action PURSUANT TO THIS
SUBSECTION it shall also serve the licensee with a written notice that states the
charges and that the licensee is entitled to a formal hearing before the board or an
administrative law judge within sixty days.
E. If, after completing its investigation, the board finds that the information provided pursuant to subsection A of this section is not of sufficient seriousness to merit disciplinary action against the license of the doctor, the board or a board committee may take either of the following actions:
1. Dismiss if, in the opinion of the board, the information is without merit.
2. File an advisory letter. The licensee may file a written response with the board within thirty days after receiving the advisory letter.
F. If the board finds that it can take rehabilitative or disciplinary action without the presence of the doctor at a formal interview it may enter into a consent agreement with the doctor to limit or restrict the doctor's practice or to rehabilitate the doctor, protect the public and ensure the doctor's ability to safely engage in the practice of medicine. The board may also require the doctor to successfully complete a board approved rehabilitative, retraining or assessment program.
G. If after completing its investigation the board believes that the information is or may be true, it may request a formal interview with the doctor. If the doctor refuses the invitation or accepts and the results indicate that grounds may exist for revocation or suspension of the doctor's license for more than twelve months, the board shall issue a formal complaint and order that a hearing be held pursuant to title 41, chapter 6, article 10. If after completing a formal interview the board finds that the protection of the public requires emergency action, it may order a summary suspension of the license pending formal revocation proceedings or other action authorized by this section. If after completing the formal interview the board finds the information provided under subsection A of this section is not of sufficient seriousness to merit suspension for more than twelve months or revocation of the license, it may take the following actions:
1. Dismiss if, in the opinion of the board, the information is without merit.
2. File an advisory letter. The licensee may file a written response with the board within thirty days after the licensee receives the advisory letter.
3. File a letter of reprimand.
4. Issue a decree of censure. A decree of censure is an official action against the doctor's license and may include a requirement for restitution of fees to a patient resulting from violations of this chapter or rules adopted under this chapter.
5. Fix a period and terms of probation best adapted to protect the public health and safety and rehabilitate or educate the doctor concerned. Probation may include temporary suspension for not to exceed twelve months, restriction of the doctor's license to practice medicine, a requirement for restitution of fees to a patient or education or rehabilitation at the licensee's own expense. If a licensee fails to comply with the terms of probation the board shall serve the licensee with a written notice that states that the licensee is subject to a formal hearing based on the information considered by the board at the formal interview and any other acts or conduct alleged to be in violation of this chapter or rules adopted by the board pursuant to this chapter including noncompliance with the term of probation, a consent agreement or a stipulated agreement.
6. Enter into an agreement with the doctor to restrict or limit the doctor's practice or medical activities in order to rehabilitate, retrain or assess the doctor, protect the public and ensure the physician's ability to safely engage in the practice of medicine.
H. If the board finds that the information provided in subsection A or G of this section warrants suspension or revocation of a license issued under this chapter, it shall initiate formal proceedings pursuant to title 41, chapter 6, article 10.
I. In a formal interview pursuant to subsection G of this section or in a hearing pursuant to subsection H of this section, the board in addition to any other action may impose a civil penalty in the amount of not less than three hundred dollars nor more than ten thousand dollars for each violation of this chapter or a rule adopted under this chapter.
J. An advisory letter is a public document.
K. Any doctor of medicine who after a formal hearing is found by the board to be guilty of unprofessional conduct, to be mentally or physically unable safely to engage in the practice of medicine or to be medically incompetent is subject to censure, probation as provided in this section, suspension of license or revocation of license or any combination of these, including a stay of action, and for a period of time or permanently and under conditions as the board deems appropriate for the protection of the public health and safety and just in the circumstance. The board may charge the costs of formal hearings to the licensee who it finds to be in violation of this chapter.
L. If the board acts to modify any doctor of medicine's prescription writing privileges the board shall immediately notify the state board of pharmacy of the modification.
M. If the board, during the course of any investigation, determines that a criminal violation may have occurred involving the delivery of health care, it shall make the evidence of violations available to the appropriate criminal justice agency for its consideration.
N. If the board's chairperson determines that a backlog of complaints exists the chairperson may divide the board into two six member review committees. Each of these committees shall select a chairperson. Four members constitute a quorum for each committee. The committees shall review complaints not dismissed by the executive director and may take the following actions:
1. Dismiss the complaint if a committee determines that it is without merit.
2. Issue an advisory letter. The licensee may file a written response with the board within thirty days after the licensee receives the advisory letter.
3. Refer the matter for further review by the full board.
3. CONDUCT A FORMAL INTERVIEW PURSUANT TO SUBSECTION G OF THIS SECTION AND TAKE ANY OF THE ACTIONS THAT THE FULL BOARD MAY TAKE AFTER IT CONDUCTS A FORMAL INTERVIEW.
4. REFER THE MATTER FOR FURTHER REVIEW BY THE FULL BOARD.
O. PURSUANT TO SECTIONS 35-146 AND 35-147, THE BOARD SHALL DEPOSIT all
monies collected from civil penalties paid pursuant to this chapter shall be
deposited in the state general fund.
P. Notice of a complaint and hearing is effective by a true copy of it being sent by certified mail to the doctor's last known address of record in the board's files. Notice of the complaint and hearing is complete on the date of its deposit in the mail. The board shall begin a formal hearing within one hundred twenty days of that date.
Q. A physician who submits an independent medical examination pursuant to an order by a court or the industrial commission is not subject to a complaint for unprofessional conduct unless a complaint is made or referred by a court or the industrial commission to the board. For purposes of this subsection, "independent medical examination" means a professional analysis of medical status based on a person's past and present physical and psychiatric history and conducted by a licensee or group of licensees on a contract basis for a court or for the industrial commission.
R. The board may accept the surrender of an active license from a person who admits in writing to any of the following:
1. Being unable to safely engage in the practice of medicine.
2. Having committed an act of unprofessional conduct.
3. Having violated this chapter or a board rule.