HB-4755, As Passed Senate, March 9, 2004                                    

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                          SENATE SUBSTITUTE FOR                                 

                                                                                

                           HOUSE BILL NO. 4755                                  

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                 A bill to amend 1978 PA 368, entitled                                             

                                                                                

    "Public health code,"                                                       

                                                                                

    by amending sections 16221 and 16226 (MCL 333.16221 and                     

                                                                                

    333.16226), as amended by 2003 PA 234, 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 520b to                

                                                                                

23  520g of the Michigan penal code, 1931 PA 328, MCL 750.520b to               

                                                                                

24  750.520g.  A certified copy of the court record is conclusive               

                                                                                

25  evidence of the conviction.                                                 

                                                                                

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

                                                                                

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


                                                                                

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

                                                                                

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

                                                                                

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

                                                                                

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

                                                                                

5   conclusive evidence of the conviction.                                      

                                                                                

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

                                                                                

7   registration, disciplinary, or certification board involving the            

                                                                                

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

                                                                                

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

                                                                                

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

                                                                                

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

                                                                                

12  conclusive evidence of the final action.                                    

                                                                                

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

                                                                                

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

                                                                                

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

                                                                                

16  record is conclusive evidence of the conviction.                            

                                                                                

17      (xii) Conviction of a violation of section 430 of the                        

                                                                                

18  Michigan penal code, 1931 PA 328, MCL 750.430.  A certified copy            

                                                                                

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

                                                                                

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

                                                                                

21  following:                                                                  

                                                                                

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

                                                                                

23  registration.                                                               

                                                                                

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

                                                                                

25  unauthorized person.                                                        

                                                                                

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

                                                                                

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


                                                                                

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

                                                                                

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

                                                                                

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

                                                                                

4   other than lawful diagnostic or therapeutic purposes.                       

                                                                                

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

                                                                                

6   the following:                                                              

                                                                                

7                                                                                (i) False or misleading advertising.                                                

                                                                                

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

                                                                                

9   kickbacks on medical or surgical services, appliances, or                   

                                                                                

10  medications purchased by or in behalf of patients.                          

                                                                                

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

                                                                                

12  third party reimbursement.                                                  

                                                                                

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

                                                                                

14  following:                                                                  

                                                                                

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

                                                                                

16  obtaining or attempting to obtain third party reimbursement in              

                                                                                

17  the course of professional practice.                                        

                                                                                

18      (ii) Betrayal of a professional confidence.                                  

                                                                                

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

                                                                                

20  device, treatment, procedure, or service.                                   

                                                                                

21      (iv) Either of the following:                                                

                                                                                

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

                                                                                

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

                                                                                

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

                                                                                

25  business in which the licensee has a financial interest.                    

                                                                                

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

                                                                                

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


                                                                                

1   security act, 42  U.S.C.  USC 1395nn, or a regulation promulgated           

                                                                                

2   under that section.  Section 1877 of part D of title XVIII of the           

                                                                                

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

                                                                                

4   promulgated under that section, as they exist on June 3, 2002,              

                                                                                

5   are incorporated by reference for purposes of this subparagraph.            

                                                                                

6   A disciplinary subcommittee shall apply section 1877 of part D of           

                                                                                

7   title XVIII of the social security act, 42  U.S.C.  USC 1395nn,             

                                                                                

8   and the regulations promulgated under that section regardless of            

                                                                                

9   the source of payment for the designated health service referred            

                                                                                

10  and rendered.  If section 1877 of part D of title XVIII of the              

                                                                                

11  social security act, 42  U.S.C.  USC 1395nn, or a regulation                

                                                                                

12  promulgated under that section is revised after June 3, 2002, the           

                                                                                

13  department shall officially take notice of the revision.  Within            

                                                                                

14  30 days after taking notice of the revision, the department shall           

                                                                                

15  decide whether or not the revision pertains to referral by                  

                                                                                

16  physicians for designated health services and continues to                  

                                                                                

17  protect the public from inappropriate referrals by physicians.              

                                                                                

18  If the department decides that the revision does both of those              

                                                                                

19  things, the department may promulgate rules to incorporate the              

                                                                                

20  revision by reference.  If the department does promulgate rules             

                                                                                

21  to incorporate the revision by reference, the department shall              

                                                                                

22  not make any changes to the revision.  As used in this                      

                                                                                

23  subparagraph, "designated health service" means that term as                

                                                                                

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

                                                                                

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

                                                                                

26  promulgated under that section and "physician" means that term as           

                                                                                

27  defined in 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.  USC 1395nn, or a regulation promulgated under that                 

                                                                                

4   section, refusing to accept a reasonable proportion of patients             

                                                                                

5   eligible for medicaid and refusing to accept payment from                   

                                                                                

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

                                                                                

7   procedure, or service for which the physician refers the                    

                                                                                

8   individual and in which the physician has a financial interest.             

                                                                                

9   A physician who owns all or part of a facility in which he or she           

                                                                                

10  provides surgical services is not subject to this subparagraph if           

                                                                                

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

                                                                                

12  is 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 June 3, 2003, the department of consumer and                  

                                                                                

16  industry services shall prepare the first of 3 annual reports on            

                                                                                

17  the effect of this amendatory act on access to care for the                 

                                                                                

18  uninsured and medicaid patients.  The department shall report on            

                                                                                

19  the number of referrals by licensees of uninsured and medicaid              

                                                                                

20  patients to purchase or secure a drug, device, treatment,                   

                                                                                

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

                                                                                

22  business in which the licensee has a financial interest.                    

                                                                                

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

                                                                                

24  within 30 days after the change occurs.                                     

                                                                                

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

                                                                                

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

                                                                                

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


                                                                                

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

                                                                                

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

                                                                                

3   administrative hearing, or failure to report under section 16222            

                                                                                

4   or 16223.                                                                   

                                                                                

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

                                                                                

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

                                                                                

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

                                                                                

8   board.                                                                      

                                                                                

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

                                                                                

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

                                                                                

11  licensure or registration under section 16174.                              

                                                                                

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

                                                                                

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

                                                                                

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

                                                                                

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

                                                                                

16      (q) A violation of section 16274.                                           

                                                                                

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

                                                                                

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

                                                                                

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

                                                                                

20  the grounds for disciplinary subcommittee action listed in                  

                                                                                

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

                                                                                

22  of the following sanctions for each violation:                              

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

23  Violations of Section 16221               Sanctions                         

                                                                                

                                                                                

                                                                                

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


                                                                                

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

                                                                                

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

                                                                                

3                                   or fine.                                    

                                                                                

                                                                                

                                                                                

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

                                                                                

                                                                                

                                                                                

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

                                                                                

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

                                                                                

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

                                                                                

8   (b)(xi), or (b)(xii)            community service, or fine.                   

                                                                                

                                                                                

                                                                                

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

                                                                                

10                                  probation, limitation, community            

                                                                                

11                                  service, or fine.                           

                                                                                

                                                                                

                                                                                

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

                                                                                

13                                  restitution, community service,             

                                                                                

14                                  or fine.                                    

                                                                                

                                                                                

                                                                                

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

                                                                                

16                                  revocation, restitution,                    

                                                                                

17                                  community service, or fine.                 

                                                                                

                                                                                

                                                                                

18  Subdivision (c)(iv) or                                                       

                                                                                

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

                                                                                

20                                  suspension, revocation, community           

                                                                                

21                                  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.                         

                                                                                

                                                                                

                                                                                

21  Subdivision (k), (p),           Reprimand or fine.                          


                                                                                

1   or (r)                                                                      

                                                                                

                                                                                

                                                                                

2   Subdivision (l)                 Reprimand, denial, or                       

                                                                                

3                                   limitation.                                 

                                                                                

                                                                                

                                                                                

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

                                                                                

5                                   probation, suspension,                      

                                                                                

6                                   limitation, reprimand, or fine.             

                                                                                

                                                                                

                                                                                

7   Subdivision (n)                 Revocation or denial.                       

                                                                                

                                                                                

                                                                                

8   Subdivision (q)                 Revocation.                                 

                                                                                

9       (2) Determination of sanctions for violations under this                    

                                                                                

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

                                                                                

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

                                                                                

12  decision or order of a disciplinary subcommittee prejudices                 

                                                                                

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

                                                                                

14  listed in section 106 of the administrative procedures act of               

                                                                                

15  1969, 1969 PA 306, MCL 24.306, and holds that the final decision            

                                                                                

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

                                                                                

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

                                                                                

18  the case to the disciplinary subcommittee for further                       

                                                                                

19  consideration.                                                              

                                                                                

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

                                                                                

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

                                                                                

22  section 16221(a) or (b).                                                    

                                                                                

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

                                                                                

24  registrant or an applicant for licensure or registration who has            


                                                                                

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

                                                                                

2   this article or article 7 to satisfactorily complete an                     

                                                                                

3   educational program, a training program, or a treatment program,            

                                                                                

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

                                                                                

5   combination of those programs and examinations.                             

                                                                                

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

                                                                                

7   the medical records access act.                                             

                                                                                

8       Enacting section 1.  This amendatory act does not take                      

                                                                                

9   effect unless House Bill No. 4706 of the 92nd Legislature is                

                                                                                

10  enacted into law.