SB-0235, As Passed Senate, June 16, 2011

 

 

 

 

 

 

 

 

 

 

 

SUBSTITUTE FOR

 

SENATE BILL NO. 235

 

 

 

 

 

 

 

 

 

 

     A bill to amend 1978 PA 368, entitled

 

"Public health code,"

 

by amending section 16221 (MCL 333.16221), as amended by 2004 PA

 

214.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 16221. The department may investigate activities related

 

to the practice of a health profession by a licensee, a registrant,

 

or an applicant for licensure or registration. The department may

 

hold hearings, administer oaths, and order relevant testimony to be

 

taken and shall report its findings to the appropriate disciplinary

 

subcommittee. The disciplinary subcommittee shall proceed under

 

section 16226 if it finds that 1 or more of the following grounds

 

exist:

 

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

 

failure to exercise due care, including negligent delegation to or


 

supervision of employees or other individuals, whether or not

 

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

 

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

 

practice the health profession.

 

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

 

following:

 

     (i) Incompetence.

 

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

 

defined in section 6107.

 

     (iii) Mental or physical inability reasonably related to and

 

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

 

and competent manner.

 

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

 

jurisdiction.

 

     (v) Conviction of a misdemeanor punishable by imprisonment for

 

a maximum term of 2 years; a misdemeanor involving the illegal

 

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

 

felony. A certified copy of the court record is conclusive evidence

 

of the conviction.

 

     (vi) Lack of good moral character.

 

     (vii) Conviction of a criminal offense under sections 520b to

 

520g section 520e or 520g of the Michigan penal code, 1931 PA 328,

 

MCL 750.520b to 750.520g 750.520e and 750.520g. A certified copy of

 

the court record is conclusive evidence of the conviction.

 

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

 

penal code, 1931 PA 328, MCL 750.492a. A certified copy of the

 

court record is conclusive evidence of the conviction.


 

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

 

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

 

health profession. A certified copy of the court record is

 

conclusive evidence of the conviction.

 

     (x) Final adverse administrative action by a licensure,

 

registration, disciplinary, or certification board involving the

 

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

 

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

 

States military, by the federal government, or by another country.

 

A certified copy of the record of the board is conclusive evidence

 

of the final action.

 

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

 

or that adversely affects the licensee's ability to practice in a

 

safe and competent manner. A certified copy of the court record is

 

conclusive evidence of the conviction.

 

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

 

penal code, 1931 PA 328, MCL 750.430. A certified copy of the court

 

record is conclusive evidence of the conviction.

 

     (xiii) Conviction of a criminal offense under section 520b,

 

520c, 520d, or 520f of the Michigan penal code, 1931 PA 328, MCL

 

750.520b, 750.520c, 750.520d, and 750.520f. A certified copy of the

 

court record is conclusive evidence of the conviction.

 

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

 

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

 

registration.

 

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

 

unauthorized person.


 

     (iii) Practice outside the scope of a license.

 

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

 

a controlled substance as defined in section 7104 or a drug as

 

defined in section 7105 without lawful authority; or selling,

 

prescribing, giving away, or administering drugs for other than

 

lawful diagnostic or therapeutic purposes.

 

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

 

the following:

 

     (i) False or misleading advertising.

 

     (ii) Dividing fees for referral of patients or accepting

 

kickbacks on medical or surgical services, appliances, or

 

medications purchased by or in behalf of patients.

 

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

 

party reimbursement.

 

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

 

following:

 

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

 

or attempting to obtain third party reimbursement in the course of

 

professional practice.

 

     (ii) Betrayal of a professional confidence.

 

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

 

device, treatment, procedure, or service.

 

     (iv) Either of the following:

 

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

 

individual purchase or secure a drug, device, treatment, procedure,

 

or service from another person, place, facility, or business in

 

which the licensee has a financial interest.


 

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

 

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

 

security act, 42 USC 1395nn , or a regulation promulgated under

 

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

 

security act, For purposes of this subparagraph, 42 USC 1395nn ,

 

and the regulations promulgated under that section , as they exist

 

on June 3, 2002 , are incorporated by reference. for purposes of

 

this subparagraph. A disciplinary subcommittee shall apply section

 

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

 

1395nn , and the regulations promulgated under that section

 

regardless of the source of payment for the designated health

 

service referred and rendered. If section 1877 of part D of title

 

XVIII of the social security act, 42 USC 1395nn , or a regulation

 

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

 

department shall officially take notice of the revision. Within 30

 

days after taking notice of the revision, the department shall

 

decide whether or not the revision pertains to referral by

 

physicians for designated health services and continues to protect

 

the public from inappropriate referrals by physicians. If the

 

department decides that the revision does both of those things, the

 

department may promulgate rules to incorporate the revision by

 

reference. If the department does promulgate rules to incorporate

 

the revision by reference, the department shall not make any

 

changes to the revision. As used in this subparagraph, "designated

 

health service" means that term as defined in section 1877 of part

 

D of title XVIII of the social security act, 42 USC 1395nn , and

 

the regulations promulgated under that section and "physician"


 

means that term as defined in sections 17001 and 17501.

 

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

 

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

 

1395nn , or a regulation promulgated under that section, refusing

 

to accept a reasonable proportion of patients eligible for medicaid

 

and refusing to accept payment from medicaid or medicare as payment

 

in full for a treatment, procedure, or service for which the

 

physician refers the individual and in which the physician has a

 

financial interest. A physician who owns all or part of a facility

 

in which he or she provides surgical services is not subject to

 

this subparagraph if a referred surgical procedure he or she

 

performs in the facility is not reimbursed at a minimum of the

 

appropriate medicaid or medicare outpatient fee schedule, including

 

the combined technical and professional components.

 

     (f) Beginning June 3, 2003, the department of consumer and

 

industry services shall prepare the first of 3 annual reports on

 

the effect of this amendatory act 2002 PA 402 on access to care for

 

the uninsured and medicaid patients. The department shall report on

 

the number of referrals by licensees of uninsured and medicaid

 

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

 

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

 

business in which the licensee has a financial interest.

 

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

 

within 30 days after the change occurs.

 

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

 

article or of a rule promulgated under this article.

 

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


 

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

 

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

 

administrative hearing, or failure to report under section 16222 or

 

16223.

 

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

 

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

 

500.8302, within 60 days after notice by the appropriate board.

 

     (k) A violation of section 17013 or 17513.

 

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

 

or registration under section 16174.

 

     (m) A violation of section 17015 or 17515.

 

     (n) A violation of section 17016 or 17516.

 

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

 

     (p) A violation of section 5654 or 5655.

 

     (q) A violation of section 16274.

 

     (r) A violation of section 17020 or 17520.

 

     (s) A violation of the medical records access act, 2004 PA 47,

 

MCL 333.26261 to 333.26271.

 

     (t) A violation of section 17764(2).

 

     Enacting section 1. This amendatory act does not take effect

 

unless all of the following bills of the 96th Legislature are

 

enacted into law:

 

     (a) House Bill No. 4411.

 

     (b) House Bill No. 4412.