HB-4755, As Passed House, June 19, 2003

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOUSE BILL No. 4755

 

May 27, 2003, Introduced by Rep. Vander Veen and referred to the Committee on Health Policy.

        

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                 A bill to amend 1978 PA 368, entitled                                             

                                                                                

    "Public health code,"                                                       

                                                                                

    by amending sections 16221 and 16226 (MCL 333.16221 and                     

                                                                                

    333.16226), section 16221 as amended by 2002 PA 402 and section             

                                                                                

    16226 as amended by 2002 PA 643, and by adding section 20170.               

                                                                                

                THE PEOPLE OF THE STATE OF MICHIGAN ENACT:                      

                                                                                

1       Sec. 16221.  The department may investigate activities                      

                                                                                

2   related to the practice of a health profession by a licensee, a             

                                                                                

3   registrant, or an applicant for licensure or registration.  The             

                                                                                

4   department may hold hearings, administer oaths, and order                   

                                                                                

5   relevant testimony to be taken and shall report its findings to             

                                                                                

6   the appropriate disciplinary subcommittee.  The disciplinary                

                                                                                

7   subcommittee shall proceed under section 16226 if it finds that 1           

                                                                                

8   or more of the following grounds exist:                                     

                                                                                

9       (a) A violation of general duty, consisting of negligence or                

                                                                                


                                                                                

1   failure to exercise due care, including negligent delegation to             

                                                                                

2   or supervision of employees or other individuals, whether or not            

                                                                                

3   injury results, or any conduct, practice, or condition that                 

                                                                                

4   impairs, or may impair, the ability to safely and skillfully                

                                                                                

5   practice the health profession.                                             

                                                                                

6       (b) Personal disqualifications, consisting of 1 or more of                  

                                                                                

7   the following:                                                              

                                                                                

8                                                                                (i) Incompetence.                                                                   

                                                                                

9       (ii) Subject to sections 16165 to 16170a, substance abuse as                 

                                                                                

10  defined in section 6107.                                                    

                                                                                

11      (iii) Mental or physical inability reasonably related to and                 

                                                                                

12  adversely affecting the licensee's ability to practice in a safe            

                                                                                

13  and competent manner.                                                       

                                                                                

14      (iv) Declaration of mental incompetence by a court of                        

                                                                                

15  competent jurisdiction.                                                     

                                                                                

16      (v) Conviction of a misdemeanor punishable by imprisonment                  

                                                                                

17  for a maximum term of 2 years; a misdemeanor involving the                  

                                                                                

18  illegal delivery, possession, or use of a controlled substance;             

                                                                                

19  or a felony.  A certified copy of the court record is conclusive            

                                                                                

20  evidence of the conviction.                                                 

                                                                                

21      (vi) Lack of good moral character.                                           

                                                                                

22      (vii) Conviction of a criminal offense under sections  520a                  

                                                                                

23  to 520l  520b to 520g of the Michigan penal code, 1931 PA 328,              

                                                                                

24  MCL  750.520a to 750.520l  750.520b to 750.520g.  A certified               

                                                                                

25  copy of the court record is conclusive evidence of the                      

                                                                                

26  conviction.                                                                 

                                                                                

27      (viii) Conviction of a violation of section 492a of the                       


                                                                                

1   Michigan penal code, 1931 PA 328, MCL 750.492a.  A certified copy           

                                                                                

2   of the court record is conclusive evidence of the conviction.               

                                                                                

3       (ix) Conviction of a misdemeanor or felony involving fraud in                

                                                                                

4   obtaining or attempting to obtain fees related to the practice of           

                                                                                

5   a health profession.  A certified copy of the court record is               

                                                                                

6   conclusive evidence of the conviction.                                      

                                                                                

7       (x) Final adverse administrative action by a licensure,                     

                                                                                

8   registration, disciplinary, or certification board involving the            

                                                                                

9   holder of, or an applicant for, a license or registration                   

                                                                                

10  regulated by another state or a territory of the United States,             

                                                                                

11  by the United States military, by the federal government, or by             

                                                                                

12  another country.  A certified copy of the record of the board is            

                                                                                

13  conclusive evidence of the final action.                                    

                                                                                

14      (xi) Conviction of a misdemeanor that is reasonably related                  

                                                                                

15  to or that adversely affects the licensee's ability to practice             

                                                                                

16  in a safe and competent manner.  A certified copy of the court              

                                                                                

17  record is conclusive evidence of the conviction.                            

                                                                                

18      (c) Prohibited acts, consisting of 1 or more of the                         

                                                                                

19  following:                                                                  

                                                                                

20                                                                               (i) Fraud or deceit in obtaining or renewing a license or                           

                                                                                

21  registration.                                                               

                                                                                

22      (ii) Permitting the license or registration to be used by an                 

                                                                                

23  unauthorized person.                                                        

                                                                                

24      (iii) Practice outside the scope of a license.                               

                                                                                

25      (iv) Obtaining, possessing, or attempting to obtain or                       

                                                                                

26  possess a controlled substance as defined in section 7104 or a              

                                                                                

27  drug as defined in section 7105 without lawful authority; or                


                                                                                

1   selling, prescribing, giving away, or administering drugs for               

                                                                                

2   other than lawful diagnostic or therapeutic purposes.                       

                                                                                

3       (d) Unethical business practices, consisting of 1 or more of                

                                                                                

4   the following:                                                              

                                                                                

5                                                                                (i) False or misleading advertising.                                                

                                                                                

6       (ii) Dividing fees for referral of patients or accepting                     

                                                                                

7   kickbacks on medical or surgical services, appliances, or                   

                                                                                

8   medications purchased by or in behalf of patients.                          

                                                                                

9       (iii) Fraud or deceit in obtaining or attempting to obtain                   

                                                                                

10  third party reimbursement.                                                  

                                                                                

11      (e) Unprofessional conduct, consisting of 1 or more of the                  

                                                                                

12  following:                                                                  

                                                                                

13                                                                               (i) Misrepresentation to a consumer or patient or in                                

                                                                                

14  obtaining or attempting to obtain third party reimbursement in              

                                                                                

15  the course of professional practice.                                        

                                                                                

16      (ii) Betrayal of a professional confidence.                                  

                                                                                

17      (iii) Promotion for personal gain of an unnecessary drug,                    

                                                                                

18  device, treatment, procedure, or service.                                   

                                                                                

19      (iv) Either of the following:                                                

                                                                                

20      (A) A requirement by a licensee other than a physician that                 

                                                                                

21  an individual purchase or secure a drug, device, treatment,                 

                                                                                

22  procedure, or service from another person, place, facility, or              

                                                                                

23  business in which the licensee has a financial interest.                    

                                                                                

24      (B) A referral by a physician for a designated health service               

                                                                                

25  that violates section 1877 of part D of title XVIII of the social           

                                                                                

26  security act, 42 U.S.C. 1395nn, or a regulation promulgated under           

                                                                                

27  that section.  Section 1877 of part D of title XVIII of the                 


                                                                                

1   social security act, 42 U.S.C. 1395nn, and the regulations                  

                                                                                

2   promulgated under that section, as they exist on  the effective             

                                                                                

3   date of the amendatory act that added this sentence  June 3,                

                                                                                

4   2002, are incorporated by reference for purposes of this                    

                                                                                

5   subparagraph.  A disciplinary subcommittee shall apply                      

                                                                                

6   section 1877 of part D of title XVIII of the social security act,           

                                                                                

7   42 U.S.C. 1395nn, and the regulations promulgated under that                

                                                                                

8   section regardless of the source of payment for the designated              

                                                                                

9   health service referred and rendered.  If section 1877 of part D            

                                                                                

10  of title XVIII of the social security act, 42 U.S.C. 1395nn, or a           

                                                                                

11  regulation promulgated under that section is revised after  the             

                                                                                

12  effective date of the amendatory act that added this sentence               

                                                                                

13  June 3, 2002, the department shall officially take notice of the            

                                                                                

14  revision.  Within 30 days after taking notice of the revision,              

                                                                                

15  the department shall decide whether or not the revision pertains            

                                                                                

16  to referral by physicians for designated health services and                

                                                                                

17  continues to protect the public from inappropriate referrals by             

                                                                                

18  physicians.  If the department decides that the revision does               

                                                                                

19  both of those things, the department may promulgate rules to                

                                                                                

20  incorporate the revision by reference.  If the department does              

                                                                                

21  promulgate rules to incorporate the revision by reference, the              

                                                                                

22  department shall not make any changes to the revision.  As used             

                                                                                

23  in this subparagraph, "designated health service" means that term           

                                                                                

24  as defined in section 1877 of part D of title XVIII of the social           

                                                                                

25  security act, 42 U.S.C. 1395nn, and the regulations promulgated             

                                                                                

26  under that section and "physician" means that term as defined in            

                                                                                

27  sections 17001 and 17501.                                                   


                                                                                

1       (v) For a physician who makes referrals pursuant to section                 

                                                                                

2   1877 of part D of title XVIII of the social security act, 42                

                                                                                

3   U.S.C. 1395nn, or a regulation promulgated under that section,              

                                                                                

4   refusing to accept a reasonable proportion of patients eligible             

                                                                                

5   for medicaid and refusing to accept payment from medicaid or                

                                                                                

6   medicare as payment in full for a treatment, procedure, or                  

                                                                                

7   service for which the physician refers the individual and in                

                                                                                

8   which the physician has a financial interest.  A physician who              

                                                                                

9   owns all or part of a facility in which he or she provides                  

                                                                                

10  surgical services is not subject to this subparagraph if a                  

                                                                                

11  referred surgical procedure he or she performs in the facility is           

                                                                                

12  not reimbursed at a minimum of the appropriate medicaid or                  

                                                                                

13  medicare outpatient fee schedule, including the combined                    

                                                                                

14  technical and professional components.                                      

                                                                                

15      (f) Beginning  1 year after the effective date of this act                  

                                                                                

16  June 3, 2003, the department of consumer and industry services              

                                                                                

17  shall prepare the first of 3 annual reports on the effect of this           

                                                                                

18  amendatory act on access to care for the uninsured and medicaid             

                                                                                

19  patients.  The department shall report on the number of referrals           

                                                                                

20  by licensees of uninsured and medicaid patients to purchase or              

                                                                                

21  secure a drug, device, treatment, procedure, or service from                

                                                                                

22  another person, place, facility, or business in which the                   

                                                                                

23  licensee has a financial interest.                                          

                                                                                

24      (g) Failure to report a change of name or mailing address                   

                                                                                

25  within 30 days after the change occurs.                                     

                                                                                

26      (h) A violation, or aiding or abetting in a violation, of                   

                                                                                

27  this article or of a rule promulgated under this article.                   


                                                                                

1       (i) Failure to comply with a subpoena issued pursuant to this               

                                                                                

2   part, failure to respond to a complaint issued under this article           

                                                                                

3   or article 7, failure to appear at a compliance conference or an            

                                                                                

4   administrative hearing, or failure to report under section 16222            

                                                                                

5   or 16223.                                                                   

                                                                                

6       (j) Failure to pay an installment of an assessment levied                   

                                                                                

7   pursuant to the insurance code of 1956, 1956 PA 218, MCL 500.100            

                                                                                

8   to 500.8302, within 60 days after notice by the appropriate                 

                                                                                

9   board.                                                                      

                                                                                

10      (k) A violation of section 17013 or 17513.                                  

                                                                                

11                                                                               (l) Failure to meet 1 or more of the requirements for                               

                                                                                

12  licensure or registration under section 16174.                              

                                                                                

13      (m) A violation of section 17015 or 17515.                                  

                                                                                

14      (n) A violation of section 17016 or 17516.                                  

                                                                                

15      (o) Failure to comply with section 9206(3).                                 

                                                                                

16      (p) A violation of section 5654 or 5655.                                    

                                                                                

17      (q) A violation of section 16274.                                           

                                                                                

18      (r) A violation of section 17020 or 17520.                                  

                                                                                

19      (s) A violation of the medical records access act.                          

                                                                                

20      Sec. 16226.  (1) After finding the existence of 1 or more of                

                                                                                

21  the grounds for disciplinary subcommittee action listed in                  

                                                                                

22  section 16221, a disciplinary subcommittee shall impose 1 or more           

                                                                                

23  of the following sanctions for each violation:                              

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

24  Violations of Section 16221               Sanctions                         

                                                                                

                                                                                


                                                                                

1   Subdivision (a), (b)(ii),       Probation, limitation, denial,               

                                                                                

2   (b)(iv), (b)(vi), or            suspension, revocation,                      

                                                                                

3   (b)(vii)                        restitution, community service,              

                                                                                

4                                   or fine.                                    

                                                                                

5   Subdivision (b)(viii)           Revocation or denial.                         

                                                                                

                                                                                

                                                                                

6   Subdivision (b)(i),             Limitation, suspension,                     

                                                                                

7   (b)(iii), (b)(v),               revocation, denial,                           

                                                                                

8   (b)(ix), (b)(x),                probation, restitution,                      

                                                                                

9   or (b)(xi)                      community service, or fine.                  

                                                                                

                                                                                

                                                                                

10  Subdivision (c)(i)              Denial, revocation, suspension,             

                                                                                

11                                  probation, limitation, community            

                                                                                

12                                  service, or fine.                           

                                                                                

                                                                                

                                                                                

13  Subdivision (c)(ii)             Denial, suspension, revocation,              

                                                                                

14                                  restitution, community service,             

                                                                                

15                                  or fine.                                    

                                                                                

                                                                                

                                                                                

16  Subdivision (c)(iii)            Probation, denial, suspension,               

                                                                                

17                                  revocation, restitution,                    

                                                                                

18                                  community service, or fine.                 

                                                                                

                                                                                

                                                                                

19  Subdivision (c)(iv) or                                                       

                                                                                

20  (d)(iii)                        Fine, probation, denial,                     

                                                                                

21                                  suspension, revocation, community           

                                                                                

22                                  service, or restitution.                    


                                                                                

                                                                                

                                                                                

1   Subdivision (d)(i)              Reprimand, fine, probation,                 

                                                                                

2   or (d)(ii)                      community service, denial,                   

                                                                                

3                                   or restitution.                             

                                                                                

4   Subdivision (e)(i)              Reprimand, fine, probation,                 

                                                                                

5                                   limitation, suspension, community           

                                                                                

6                                   service, denial, or restitution.            

                                                                                

                                                                                

                                                                                

7   Subdivision (e)(ii)             Reprimand, probation,                        

                                                                                

8   or (i)                          suspension, restitution,                    

                                                                                

9                                   community service, denial, or               

                                                                                

10                                  fine.                                       

                                                                                

                                                                                

                                                                                

11  Subdivision (e)(iii),           Reprimand, fine, probation,                  

                                                                                

12  (e)(iv), or (e)(v)              suspension, revocation,                      

                                                                                

13                                  limitation, community service,              

                                                                                

14                                  denial, or restitution.                     

                                                                                

                                                                                

                                                                                

15  Subdivision (g)                 Reprimand or fine.                          

                                                                                

                                                                                

                                                                                

16  Subdivision (h) or (s)          Reprimand, probation, denial,               

                                                                                

17                                  suspension, revocation,                     

                                                                                

18                                  limitation, restitution,                    

                                                                                

19                                  community service, or fine.                 

                                                                                

                                                                                

                                                                                

20  Subdivision (j)                 Suspension or fine.                         

                                                                                

                                                                                


                                                                                

1   Subdivision (k), (p), or                                                    

                                                                                

2   (r)                             Reprimand or fine.                          

                                                                                

                                                                                

                                                                                

3   Subdivision (l)                 Reprimand, denial, or                       

                                                                                

4                                   limitation.                                 

                                                                                

5   Subdivision (m) or (o)          Denial, revocation, restitution,            

                                                                                

6                                   probation, suspension,                      

                                                                                

7                                   limitation, reprimand, or fine.             

                                                                                

                                                                                

                                                                                

8   Subdivision (n)                 Revocation or denial.                       

                                                                                

                                                                                

                                                                                

9   Subdivision (q)                 Revocation.                                 

                                                                                

10      (2) Determination of sanctions for violations under this                    

                                                                                

11  section shall be made by a disciplinary subcommittee.  If, during           

                                                                                

12  judicial review, the court of appeals determines that a final               

                                                                                

13  decision or order of a disciplinary subcommittee prejudices                 

                                                                                

14  substantial rights of the petitioner for 1 or more of the grounds           

                                                                                

15  listed in section 106 of the administrative procedures act of               

                                                                                

16  1969, 1969 PA 306, MCL 24.306, and holds that the final decision            

                                                                                

17  or order is unlawful and is to be set aside, the court shall                

                                                                                

18  state on the record the reasons for the holding and may remand              

                                                                                

19  the case to the disciplinary subcommittee for further                       

                                                                                

20  consideration.                                                              

                                                                                

21      (3) A disciplinary subcommittee may impose a fine of up to,                 

                                                                                

22  but not exceeding, $250,000.00 for a violation of                           

                                                                                

23  section 16221(a) or (b).                                                    

                                                                                

24      (4) A disciplinary subcommittee may require a licensee or                   


                                                                                

1   registrant or an applicant for licensure or registration who has            

                                                                                

2   violated this article or article 7 or a rule promulgated under              

                                                                                

3   this article or article 7 to satisfactorily complete an                     

                                                                                

4   educational program, a training program, or a treatment program,            

                                                                                

5   a mental, physical, or professional competence examination, or a            

                                                                                

6   combination of those programs and examinations.                             

                                                                                

7       Sec. 20170.  A health facility or agency shall comply with                  

                                                                                

8   the medical records access act.                                             

                                                                                

9       Enacting section 1.  This amendatory act does not take                      

                                                                                

10  effect unless Senate Bill No. _____ or House Bill No. 4706                  

                                                                                

11  (request no. 02043'03) of the 92nd Legislature is enacted into              

                                                                                

12  law.