Kansas Amends The Healing Arts Statute

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The Kansas legislature amended the Healing Arts Statute in 2015. The statutory amendments are designed to address certain failings of the previous statutory provisions. Furthermore, the amended sections align statutory regulations with the reality of the practice of medicine today.  The amendments impose more severe criminal punishments for practicing medicine without a license as well as augments the rules governing unprofessional conduct exposing a practitioner to potential licensing discipline.  Kansas professional licensing attorney Danielle Sanger counsels practitioners of the healing arts in Kansas to become well versed in the changes in the law and to be wary of conduct potentially subjecting oneself to discipline.

The statutory amendments cover a wide range of conduct. At the outset, the definition of healing arts was expanded to include medical treatment with the purpose of “alteration or enhancement of a condition or appearance.”  Additionally, the criminal penalty for practicing a healing art without a license—be it suspended, revoked, or otherwise—was increased from a Class B misdemeanor to a Level 10, non-person felony. This crime carries the potential for imprisonment of up to 6 months and probation for at least 12 months. The statute also authorized a more severe civil penalty of $1,000 per day for practicing without a license. The costs of prosecution may be included in addition to the daily fine. The Board of Healing Arts is permitted to seek an injunction against any person found to be practicing medicine without a license as well.

Significantly, the statutory amendments introduced new grounds for disciplinary action. The amendments added two criminal dispositions to the list of criminal dispositions presumptively mandating discipline. A conviction by either a special or a general court martial irrespective of a conviction of a Class A misdemeanor or felony or a similar crime in another jurisdiction will now warrant discipline. The amendment created the presumption of revocation following the conviction of a felony or like offense in another jurisdiction and for a conviction at a general court martial. The Board may decline to revoke if the Board determines by 2/3 vote that the practitioner is not a danger to anyone and that the person has been rehabilitated so as to not violate the public trust.

The statutory amendments also reflect the growing need to monitor health care professionals who are suffering an inability to competently practice a healing art. The amendments alter the language of the previous statute. Ostensibly in an effort to maintain the public trust, the previous safeguards afforded to the professions have been omitted. The statute now reads the “licensee’s ability … is impaired” by illness or drugs.  The previous statutory language referred to the licensee’s inability to practice. All documents obtained through an investigation shall remain confidential and will not be released to anyone for any purpose other than by use for the Board.

The amendments expanded upon the definition of professional incompetence. Interfering with a Board investigation is now included within that definition. Acts considered obstructing or interfering are

  1. falsifying or concealing a material fact;
  2. knowingly making or causing to be made any false or misleading statement or writing; or
  3. other acts or conduct likely to deceive or defraud the Board.

Furthermore, the newly passed statute has revised certain aspects of disciplinary procedure for licensees. The amendment expands the professional designations subject to discipline from merely licensees to include registrants, certificate holders, and permit holders. These additional professional designations may receive the benefit of a professional development plan in lieu of discipline. All of these professions are also subject to the Board of Healing Art’s subpoena power. This power was expanded to have the authority to compel production of evidence if the person previously failed to comply with a subpoena. The person subpoenaed may contest the subpoena but must first rely on the administrative remedy of appealing to the Board prior to appealing the ruling to the district court. Importantly, every person practicing a healing art is now obligated to report a violation of the law related to practicing the healing arts to the Board of which they have knowledge.

Consult An Experienced Professional Licensing Attorney For More Information

 Kansas Professional License Defense Lawyer Danielle Sanger is a dedicated advocate for all practitioners of the healing arts. She will vigorously and zealously fight to protect your livelihood. Call Attorney Sanger today at 785-979-4353 for your free consultation.

 

Recently Enacted Statute Permits Collaborative Practice Arrangements

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A recently enacted bill allows medical school graduates to practice medicine in collaboration with supervising physicians. The statute, known as Section 334.036, permits assistant physicians to practice medicine in rural or underserved locations in Missouri. The law facilitates delivery of health care services to citizens who have little or no opportunity to avail themselves of quality health care while providing aspiring physicians with a forum for practical skill development. The law delineates the practices an assisting physician may undertake as well as identifies the ethical responsibilities of the assisting physician and supervising physician. Missouri professional licensing attorney Danielle Sanger advises that physicians who agree to supervise a student physician under a collaborative practice arrangement must familiarize themselves with the requisite ethical standards to avoid potential pitfalls.

An assistant physician may practice medicine only in compliance with strict adherence to established guidelines. An assistant physician must be licensed in Missouri. An applicant must have graduated from medical school and be a citizen of the United State or a legal alien. Moreover, the applicant must have successfully completed Steps 1 and 2 of the United States Medical Licensing Examination within two years of applying to become an assistant physician.  However, the applicant is ineligible if applying to be an assistant physician more than three  years after graduation. A person is also eligible to apply if the postgraduate residency has not been completed but has passed Step 2. Moreover, the applicant must be fluent in English.

The assistant physician is limited in practice. The assistant physician’s medical practice is limited to primary care in rural or underserved areas or as part of a pilot project area. The assistant physician may self-identify as an assistant physician but is permitted to use the terms “doctor” or “doc.”  The assistant may administer medical treatment in an emergency situation; however, the practice of medicine is prohibited unless the assistant physician is a signatory to a collaborative practice arrangement with a supervising physician. The assistant physician may prescribe narcotics listed in Schedules III, IV, and V of Section 195.017 once they properly obtain a certificate to prescribe drugs and have appropriate registrations filed with the Federal Drug Administration as well as the Missouri bureau of dangerous drugs. The assistant may only prescribe medications listed in Schedule II if the medication contains hydrocodone and the prescription is limited to a five-day course. Moreover, the assistant physician may not prescribe medication for personal use or to members of their families.

A collaborative practice arrangement must be executed between assistant physician and supervising physician. To be valid, the collaborative practice agreement must be in writing and contain agreed-upon protocols or “standing orders for the delivery of medical services.”  In addition, the collaborative practice agreement can give the assistant physician authority to administer treatment and write prescriptions, consistent with statutory limitations, provided that the care administered is consistent with the assistant physician’s skills, training, and experience. The arrangement must include a provision indicating that a notice shall be displayed in the physician’s office including a list of prescriptions the assistant physician may prescribe and a notice that the patient may be seen by an assistant physician. The notice must include a statement that the patient has the right to be examined by a physician and not the assistant.

The collaborating physician has many obligations when undertaking the role of supervising physician.  The supervising physician must review a minimum of 10 percent of the assistant physician’s charts every 14 days. Additionally, the collaborating physician must review a minimum of 20 percent of the assistant’s charts in which prescriptions were written.  Moreover, the collaborating physician must document a one-month time frame during which the assistant practices exclusively with the collaborating physician before the assistant can see patients alone.  Additionally, the assistant must practice with the collaborating physician for 120 hours in a four-month period before the assistant is permitted to prescribe medications.

Attention To Detail Will Prevent Disciplinary Action

The assistant physician is practicing medicine on the license of the collaborating physician. Any ethical transgressions committed by the assistant may be attributed to the collaborating physician. Contact Missouri Professional Licensing Attorney Danielle Sanger at 785-979-4353 to schedule a no-obligation consultation to discuss disciplinary issues you face as a result of a collaborative practice arrangement.

Physician Assistants In Kansas Must Be Aware Of New Regulations

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On January 11, 2016, amendments to the regulations governing physician assistants in Kansas became effective. Generally speaking, the new regulations permit greater flexibility to physician assistants in some aspects while placing greater responsibility on the attending physician. The goal of the amendments is better patient care. Being aware of the changes is vitally important to both the physician and the physician’s assistant. Failing to follow the new changes may jeopardize your physician assistant’s license. Kansas professional licensing attorney Danielle Sanger stakes her reputation on fighting for licensees who are facing the specter of discipline.

The new amendments to the regulations governing physician assistants introduce a series of definitions for terms of art currently used in the profession to describe the relationship between a physician’s assistant and the supervising physician. For instance, the amendments define “supervision” as overseeing delegated medical care to the physician’s assistant. A substitute supervising physician is defined as the physician who agrees to take a supervisory role of the physician’s assistant when the primary supervising physician is unavailable. The phrase “different practice location” is a place where medical treatment is dispensed to patients where the supervising physician or substitute supervising physician practices less than 20% of the time. A medical care facility is exempted from this definition. “Direct supervision” is defined in the amendments as the supervising or substitute supervising physician being physically present and able to take over immediate care of the patient if so required. This is in contrast to the situation when the supervising physician is communicating with the physician’s assistant telephonically or via electronic communication.  That method of supervision is defined as “off-site supervision.” However, “indirect supervision” means that the supervising physician or substitute supervising physician can be on site to take over care of the patient in 15 minutes or less.

The amendments to the regulations define the limits on the scope of a physician assistant’s practice. The regulations allow a physician assistant to administer medical treatment to a patient when the supervising physician or substitute supervising physician authorizes and coordinates such treatment when the supervisor is physically present.  The physician assistant is also allowed to treat a patient when authorized and coordinated with the supervisor through “verbal or electronic communication.” The physician assistant may also render care to a patient consistent with the active practice request form which is required to be filed with the Kansas Board of Healing Arts. Lastly, the physician assistant may medically treat a patient in an emergency situation.

The physician assistant must file an active practice request form with the Kansas Board of Healing Arts. The physician assistant must disclose a significant amount of information on the active practice request form. Information such as identifying supervising and substitute supervising physicians, a disclosure of the nature of the medical services to be provided, and whether the supervising physicians will be present at the same location as the physician assistant. If not, the physician assistant must state that they have practiced at least 80 hours under the direct supervision of the supervising physician. The physician assistant and the supervising physician must also file a written agreement with the active practice request form. The agreement must contain a list of services the physician assistant may and may not perform. A list of prescription drugs the physician assistant is authorized to dispense must also be included in the agreement.  The practice request form must also memorialize the physician’s and substitute physician’s consent to be available for communication with the physician assistant during business hours.  It is important to note that the active request form must be filed with the Kansas Board of Healing Arts on or before July 1, 2016.

For More Information, Contact the Sanger Law Office Now

Keeping current in your field of practice is vital to satisfying the ethical standards of a physician assistant. It is critical, therefore, that you read and understand your obligations as a physician assistant. Kansas Professional Licensing Attorney Danielle Sanger advises physician assistants and other medical arts practitioners. Call Attorney Sanger today at 785-979-4353 for your no-obligation consultation.