HB-5078, As Passed House, November 30, 2004                                 

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                              SUBSTITUTE FOR                                    

                                                                                

                           HOUSE BILL NO. 5078                                  

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                 A bill to amend 1978 PA 368, entitled                                             

                                                                                

    "Public health code,"                                                       

                                                                                

    by amending sections 17001 and 17501 (MCL 333.17001 and                     

                                                                                

    333.17501), section 17001 as amended by 1990 PA 248 and section             

                                                                                

    17501 as amended by 1990 PA 247, and by adding sections 17018 and           

                                                                                

    17518.                                                                      

                                                                                

                THE PEOPLE OF THE STATE OF MICHIGAN ENACT:                      

                                                                                

1       Sec. 17001.  (1) As used in this part:                                      

                                                                                

2       (a) "Academic institution" means either of the following:                   

                                                                                

3                                                                                (i) A medical school approved by the board.                                         

                                                                                

4       (ii) A hospital licensed under article 17 that meets all of                  

                                                                                

5   the following requirements:                                                 

                                                                                

6       (A) Was the sole sponsor or a co-sponsor, if each other                     

                                                                                

7   co-sponsor is either a medical school approved by the board or a            

                                                                                

8   hospital owned by the federal government and directly operated by           

                                                                                


                                                                                

1   the United States department of veterans' affairs, of not less              

                                                                                

2   than 4 postgraduate education residency programs approved by the            

                                                                                

3   board under section 17031(1) for not less than the 3 years                  

                                                                                

4   immediately preceding the date of an application for a limited              

                                                                                

5   license under section 16182(2)(c) or an application for a full              

                                                                                

6   license under section 17031(2), provided that at least 1 of the             

                                                                                

7   residency programs is in the specialty area of medical practice,            

                                                                                

8   or in a specialty area that includes the subspecialty of medical            

                                                                                

9   practice, in which the applicant for a limited license proposes             

                                                                                

10  to practice or in which the applicant for a full license has                

                                                                                

11  practiced for the hospital.                                                 

                                                                                

12      (B) Has spent not less than $2,000,000.00 for medical                       

                                                                                

13  education during each of the 3 years immediately preceding the              

                                                                                

14  date of an application for a limited license under                          

                                                                                

15  section 16182(2)(c) or an application for a full license under              

                                                                                

16  section 17031(2).  As used in this subparagraph, "medical                   

                                                                                

17  education" means the education of physicians and candidates for             

                                                                                

18  degrees or licenses to become physicians, including, but not                

                                                                                

19  limited to, physician staff, residents, interns, and medical                

                                                                                

20  students.                                                                   

                                                                                

21      (b) "Electrodiagnostic studies" means the testing of                        

                                                                                

22  neuromuscular functions utilizing nerve conduction tests and                

                                                                                

23  needle electromyography.  It does not include the use of surface            

                                                                                

24  electromyography.                                                           

                                                                                

25      (c)  (b)  "Medical care services" means those services within               

                                                                                

26  the scope of practice of physicians licensed by the board, except           

                                                                                

27  those services that the board determines shall not be delegated             


                                                                                

1   by a physician without endangering the health and safety of                 

                                                                                

2   patients as provided for in section 17048(3).                               

                                                                                

3       (d)  (c)  "Physician" means an individual licensed under this               

                                                                                

4   article to engage in the practice of medicine.                              

                                                                                

5       (e)  (d)  "Practice of medicine" means the diagnosis,                       

                                                                                

6   treatment, prevention, cure, or relieving of a human disease,               

                                                                                

7   ailment, defect, complaint, or other physical or mental                     

                                                                                

8   condition, by attendance, advice, device, diagnostic test, or               

                                                                                

9   other means, or offering, undertaking, attempting to do, or                 

                                                                                

10  holding oneself out as able to do, any of these acts.                       

                                                                                

11      (f)  (e)  "Practice as a physician's assistant" means the                   

                                                                                

12  practice of medicine or osteopathic medicine and surgery                    

                                                                                

13  performed under the supervision of a physician or physicians                

                                                                                

14  licensed under this part or part 175.                                       

                                                                                

15      (g)  (f)  "Supervision" means that term as defined in section               

                                                                                

16  16109, except that it also includes the existence of a                      

                                                                                

17  predetermined plan for emergency situations, including, but not             

                                                                                

18  limited to, the designation of a physician to supervise a                   

                                                                                

19  physician's assistant in the absence of the primary supervising             

                                                                                

20  physician.                                                                  

                                                                                

21      (h)  (g)  "Task force" means the joint task force created in                

                                                                                

22  sections 17025 and 17525.                                                   

                                                                                

23      (2) In addition to the definitions in this part, article 1                  

                                                                                

24  contains definitions and principles of construction applicable to           

                                                                                

25  all articles in this code and part 161 contains definitions                 

                                                                                

26  applicable to this part.                                                    

                                                                                

27      Sec. 17018.  (1) Except as otherwise provided under this                    


                                                                                

1   section, only an individual who is licensed as a physician and              

                                                                                

2   who has successfully completed additional training in the                   

                                                                                

3   performance and interpretation of electrodiagnostic studies that            

                                                                                

4   is satisfactory to the board shall perform needle                           

                                                                                

5   electromyography or interpret nerve conduction tests.  A                    

                                                                                

6   physician shall not delegate the interpretation of nerve                    

                                                                                

7   conduction tests to another individual unless that individual is            

                                                                                

8   licensed under this article to engage in the practice of medicine           

                                                                                

9   or osteopathic medicine and surgery and has successfully                    

                                                                                

10  completed the additional training as described in this                      

                                                                                

11  subsection.  A physician shall not delegate the performance of              

                                                                                

12  needle electromyography to another individual unless that                   

                                                                                

13  individual is licensed under this article to engage in the                  

                                                                                

14  practice of medicine or osteopathic medicine and surgery and has            

                                                                                

15  successfully completed the additional training as described in              

                                                                                

16  this subsection or that individual is otherwise authorized under            

                                                                                

17  subsection (3).                                                             

                                                                                

18      (2) In accordance with section 16215, a physician may                       

                                                                                

19  delegate the performance of nerve conduction tests to a licensed            

                                                                                

20  or unlicensed individual who is otherwise qualified by education,           

                                                                                

21  training, or experience if those tests are conducted under the              

                                                                                

22  direct supervision of a physician.                                          

                                                                                

23      (3) A physical therapist who is licensed under this article                 

                                                                                

24  and certified by the American board of physical therapy                     

                                                                                

25  specialties as an electrophysiologic clinical specialist on the             

                                                                                

26  effective date of this section may perform electrodiagnostic                

                                                                                

27  studies that are to be interpreted by a physician if he or she              


                                                                                

1   has been performing electrodiagnostic studies in this state on a            

                                                                                

2   consistent basis within the 5 years immediately preceding the               

                                                                                

3   effective date of this section.                                             

                                                                                

4       (4) A podiatrist who is licensed under this article and has                 

                                                                                

5   successfully completed additional training in the performance and           

                                                                                

6   interpretation of electrodiagnostic studies that is satisfactory            

                                                                                

7   to his or her respective board may conduct electrodiagnostic                

                                                                                

8   studies.                                                                    

                                                                                

9       Sec. 17501.  (1) As used in this part:                                      

                                                                                

10      (a) "Electrodiagnostic studies" means the testing of                        

                                                                                

11  neuromuscular functions utilizing nerve conduction tests and                

                                                                                

12  needle electromyography.  It does not include the use of surface            

                                                                                

13  electromyography.                                                           

                                                                                

14      (b)  (a)  "Medical care services" means those services within               

                                                                                

15  the scope of practice of physicians licensed and approved by the            

                                                                                

16  board, except those services that the board determines shall not            

                                                                                

17  be delegated by a physician without endangering the health and              

                                                                                

18  safety of patients as provided for in section 17548(3).                     

                                                                                

19      (c)  (b)  "Physician" means an individual licensed under this               

                                                                                

20  article to engage in the practice of osteopathic medicine and               

                                                                                

21  surgery.                                                                    

                                                                                

22      (d)  (c)  "Practice of osteopathic medicine and surgery"                    

                                                                                

23  means a separate, complete, and independent school of medicine              

                                                                                

24  and surgery utilizing full methods of diagnosis and treatment in            

                                                                                

25  physical and mental health and disease, including the                       

                                                                                

26  prescription and administration of drugs and biologicals,                   

                                                                                

27  operative surgery, obstetrics, radiological and other                       


                                                                                

1   electromagnetic emissions, and placing special emphasis on the              

                                                                                

2   interrelationship of the musculoskeletal system to other body               

                                                                                

3   systems.                                                                    

                                                                                

4       (e)  (d)  "Practice as a physician's assistant" means the                   

                                                                                

5   practice of osteopathic medicine performed under the supervision            

                                                                                

6   of a physician licensed under this part or part 170.                        

                                                                                

7       (f)  (e)  "Supervision" has the meaning ascribed to it in                   

                                                                                

8   section 16109 except that it includes the existence of a                    

                                                                                

9   predetermined plan for emergency situations, including, but not             

                                                                                

10  limited to, the designation of a physician to supervise a                   

                                                                                

11  physician's assistant in the absence of the primary supervising             

                                                                                

12  physician.                                                                  

                                                                                

13      (g)  (f)  "Task force" means the joint task force created in                

                                                                                

14  sections 17025 and 17525.                                                   

                                                                                

15      (2) In addition to the definitions in this part, article 1                  

                                                                                

16  contains general definitions and principles of construction                 

                                                                                

17  applicable to all articles in the code and part 161 contains                

                                                                                

18  definitions applicable to this part.                                        

                                                                                

19      Sec. 17518.  (1) Except as otherwise provided in this                       

                                                                                

20  section, only an individual who is licensed as a physician and              

                                                                                

21  who has successfully completed additional training in the                   

                                                                                

22  performance and interpretation of electrodiagnostic studies that            

                                                                                

23  is satisfactory to the board shall perform needle                           

                                                                                

24  electromyography or interpret nerve conduction tests.  A                    

                                                                                

25  physician shall not delegate the interpretation of nerve                    

                                                                                

26  conduction studies to another individual unless that individual             

                                                                                

27  is licensed under this article to engage in the practice of                 


                                                                                

1   medicine or osteopathic medicine and surgery and has successfully           

                                                                                

2   completed the additional training as described in this                      

                                                                                

3   subsection.  A physician shall not delegate the performance of              

                                                                                

4   needle electromyography to another individual unless that                   

                                                                                

5   individual is licensed under this article to engage in the                  

                                                                                

6   practice of medicine or osteopathic medicine and surgery and has            

                                                                                

7   successfully completed the additional training as described in              

                                                                                

8   this subsection or that individual is otherwise authorized under            

                                                                                

9   subsection (3).                                                             

                                                                                

10      (2) In accordance with section 16215, a physician may                       

                                                                                

11  delegate the performance of nerve conduction tests to a licensed            

                                                                                

12  or unlicensed individual who is otherwise qualified by education,           

                                                                                

13  training, or experience if those tests are conducted under the              

                                                                                

14  direct supervision of a physician.                                          

                                                                                

15      (3) A physical therapist who is licensed under this article                 

                                                                                

16  and certified by the American board of physical therapy                     

                                                                                

17  specialties as an electrophysiologic clinical specialist on the             

                                                                                

18  effective date of this section may perform electrodiagnostic                

                                                                                

19  studies that are to be interpreted by a physician if he or she              

                                                                                

20  has been performing electrodiagnostic studies in this state on a            

                                                                                

21  consistent basis within the 5 years immediately preceding the               

                                                                                

22  effective date of this section.                                             

                                                                                

23      (4) A podiatrist who is licensed under this article and has                 

                                                                                

24  successfully completed additional training in the performance and           

                                                                                

25  interpretation of electrodiagnostic studies that is satisfactory            

                                                                                

26  to his or her respective board may conduct electrodiagnostic                

                                                                                

27  studies.