GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2015
H 3
HOUSE BILL 543
Committee Substitute Favorable 4/15/15
Committee Substitute #2 Favorable 4/21/15
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Short Title: Amend Laws Pertaining to NC Medical Board. |
(Public) |
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Sponsors: |
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Referred to: |
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April 6, 2015
A BILL TO BE ENTITLED
AN ACT amending laws pertaining to the north carolina medical board.
The General Assembly of North Carolina enacts:
SECTION 1. G.S. 90‑2(b) reads as rewritten:
"(b) No member shall serve more than two complete consecutive
three‑year terms, terms in a lifetime, except that each
member shall serve until a successor is chosen and qualifies."
SECTION 2. G.S. 90‑3(b) reads as rewritten:
"(b) To be considered qualified for a physician position or the physician assistant or nurse practitioner position on the Board, an applicant shall meet each of the following criteria:
…
(10) Have not served more than 72 months as a member of the Board."
SECTION 3. G.S. 90‑3(c) reads as rewritten:
"(c) The review panel Review Panel shall
recommend at least two qualified nominees for each open position on the Board.
If the Governor chooses not to appoint either of the recommended nominees, the
Review Panel shall recommend at least two new qualified nominees."
SECTION 4. G.S. 90‑3 is amended by adding new subsections to read:
"(f) Notwithstanding any provision of G.S. 90‑16, the Board may provide confidential and nonpublic licensing and investigative information in its possession to the Review Panel.
(g) All applications, records, papers, files, reports, and all investigative and licensing information received by the Review Panel from the Board and other documents received or gathered by the Review Panel, its members, employees, agents, and consultants as a result of soliciting, receiving, and reviewing applications and making recommendations as required in this section shall not be considered public records within the meaning of Chapter 132 of the General Statutes. All such information shall be privileged, confidential, and not subject to discovery, subpoena, or other means of legal compulsion for release to any person other than the Review Panel, the Board, and their employees, agents, or consultants, except as provided in this section. The Review Panel shall publish on its Internet Web site the names and practice addresses of all applicants within 10 days after the application deadline. The Review Panel shall publish on its Internet Web site the names and practice addresses of the nominees recommended to the Governor within 10 days after notifying the Governor of those recommendations and not less than 30 days prior to the expiration of the open position on the Board.
(h) The Review Panel is a public body within the meaning of Article 33C of Chapter 143 of the General Statutes. In addition to the provisions contained in Article 33C of Chapter 143 of the General Statutes permitting a public body to conduct business in a closed session, the Review Panel shall meet in closed session to review applications; interview applicants; review and discuss information received from the Board; and discuss, debate, and vote on recommendations to the Governor."
SECTION 5. G.S. 90‑5.2(7) reads as rewritten:
"(7) An A current, active e‑mail
address or facsimile number address, which shall not be made
available to the public and shall considered a public record within the
meaning of Chapter 132 of the General Statutes. This information may be
used or made available by the Board for the purpose of expediting the
dissemination of disseminating or soliciting information about a affecting
public health emergency.or the practice of medicine."
SECTION 6. G.S. 90‑5.2(a1) reads as rewritten:
"(a1) The Board shall make e‑mail addresses and
facsimile numbers reported pursuant to G.S. 90‑5.2(a)(7)
available to the Department of Health and Human Services for use in the North
Carolina Controlled Substance Reporting System established by Article 5E of
this Chapter."
SECTION 7. G.S. 90‑8.1 reads as rewritten:
"§ 90‑8.1. Rules governing applicants for licensure.
(a) The North Carolina Medical Board is empowered to adopt rules that prescribe additional qualifications for an applicant, including education and examination requirements and application procedures.
(b) The Board shall not deny an application for licensure based solely on the applicant's failure to become board certified."
SECTION 8. G.S. 90‑13.1(a) reads as rewritten:
"(a) Each applicant for a license to practice
medicine and surgery in this State under either G.S. 90‑9.1 or G.S. 90‑9.2
shall pay to the North Carolina Medical Board an application fee of three four
hundred fifty dollars ($350.00).($400.00)."
SECTION 9. G.S. 90‑13.2 reads as rewritten:
"§ 90‑13.2. Registration every year with Board.
(a) Every person licensed to practice medicine by the North Carolina Medical Board shall register annually with the Board within 30 days of the person's birthday.
(b) A person who registers with the Board shall report
to the Board the person's name and office and residence address and any other
information required by the Board, and shall pay an annual registration fee of one
hundred seventy‑five two hundred fifty dollars ($175.00), ($250.00),
except those who have a limited license to practice in a medical education
and training program approved by the Board for the purpose of education or training
shall pay a registration fee of one hundred twenty‑five dollars ($125.00),
($125.00) and those who have a retired limited volunteer license
pursuant to G.S. 90‑12.1B shall pay an annual registration fee of
twenty‑five dollars ($25.00), and those who have or a limited
volunteer license pursuant to G.S. 90‑12.1A shall pay no annual
registration fee. However, licensees who have a limited license to practice for
the purpose of education and training under G.S. 90‑12.01 shall not
be required to pay more than one annual registration fee for each year of
training.
(c) A physician who is not actively engaged
in the practice of medicine in North Carolina and who does not wish to register
the license may direct the Board to place the license on inactive status.
(d) A physician who is not actively engaged in the practice of medicine in North Carolina and who does not wish to register the license may direct the Board to place the license on inactive status.
(e) A physician who fails to register as required by this section shall pay an additional fee of fifty dollars ($50.00) to the Board. The license of any physician who fails to register and who remains unregistered for a period of 30 days after certified notice of the failure is automatically inactive. The Board shall retain jurisdiction over the holder of the inactive license.
(f) Except as provided in G.S. 90‑12.1B, a person whose license is inactive shall not practice medicine in North Carolina nor be required to pay the annual registration fee.
(g) Upon payment of all accumulated fees and penalties, the license of the physician may be reinstated, subject to the Board requiring the physician to appear before the Board for an interview and to comply with other licensing requirements. The penalty may not exceed the maximum fee for a license under G.S. 90‑13.1.
(h) The Board shall not deny a licensee's annual registration based solely on the licensee's failure to become board certified."
SECTION 10. G.S. 90‑14(n) reads as rewritten:
"(n) Notwithstanding subsection (m) of this
section, if the licensee has retained counsel and the Board has not made a
nonpublic determination to initiate disciplinary proceedings, counsel, the
Board may serve to both the licensee and the licensee's counsel orders
to produce, orders to appear, or submit to assessment,
examination, or orders following a hearing, or provide notice that the
Board will not be taking any further action against a licensee to both the
licensee and the licensee's counsel.licensee."
SECTION 11. G.S. 90‑14.2 is amended by adding a new subsection to read:
"(c) Once charges have been issued, the parties may engage in discovery as provided in G.S. 1A‑1, the North Carolina Rules of Civil Procedure. Additionally, pursuant to any written request by the respondent or respondent's counsel, the Board shall provide information obtained during an investigation, except for the following:
(1) Information that is subject to attorney‑client privilege or is attorney work product.
(2) Information that would identify an anonymous complainant.
(3) Information generated during an investigation that will not be offered into evidence by the Board and is related to:
a. Advice, opinions, or recommendations of the Board staff, consultants, or agents.
b. Deliberations by the Board and its committees during an investigation."
SECTION 12. G.S. 90‑14.13(a1)(1) reads as rewritten:
"(a1) A hospital is not required to report:
(1) The suspension or limitation of a physician's
privileges for failure to timely complete medical records unless the suspension
or limitation is the third within the calendar year for failure to timely
complete medical records. Upon reporting the third suspension or limitation,
the hospital shall also report the previous two suspensions or limitations.records."
SECTION 13. Article 1D of Chapter 90 of the General Statutes is renamed as follows:
"Article 1D.
"Peer Review."Health Program for
Medical Professionals."
SECTION 14. G.S. 90‑21.22 reads as rewritten:
"§ 90‑21.22.
Peer review agreements.Health program for medical professionals.
(a) The North Carolina Medical Board may, under
rules adopted by the Board in compliance with Chapter 150B of the General
Statutes, (Board) may enter into agreements with the North Carolina
Medical Society and its local medical society components, and with (Society),
the North Carolina Academy of Physician Assistants (Academy), and the
North Carolina Physicians Health Program (Program) for the purpose purposes
of conducting peer review activities. Peer review activities to be
covered by such agreements shall include investigation, review, and evaluation
of records, reports, complaints, litigation and other information about the
practices and practice patterns of physicians licensed by the Board, and of
physician assistants approved by the Board, and shall include programs for
impaired physicians and impaired physician assistants. Agreements between the
Academy and the Board shall be limited to programs for impaired physicians and
physician assistants and shall not include any other peer review activities.identifying,
reviewing, and evaluating the ability of licensees of the Board who have
been referred to the Program to function in their professional capacity and to
coordinate regimens for treatment and rehabilitation. The agreement
shall include guidelines for all items outlined below:
(1) The assessment, referral, monitoring, support, and education of licensees of the Board by reason of a physical or mental illness, a substance use disorder, or professional sexual misconduct.
(2) Procedures for the Board to refer licensees to the Program.
(3) Criteria for the Program to report licensees to the Board.
(4) A procedure by which licensees may obtain review of recommendations by the Program regarding assessment or treatment.
(5) Periodic reporting of statistical information by the Program to the Board, the Society, and the Academy.
(6) Maintaining the confidentiality of nonpublic information.
(b) Peer review agreements shall include
provisions for the society and for the Academy to receive relevant information
from the Board and other sources, conduct the investigation and review in an
expeditious manner, provide assurance of confidentiality of nonpublic
information and of the review process, make reports of investigations and
evaluations to the Board, and to do other related activities for promoting a
coordinated and effective peer review process. Peer review agreements shall
include provisions assuring due process.
(c) Each society which enters a peer review
agreement with the Board shall establish and maintain a program for impaired
physicians licensed by the Board. The Academy, after entering a peer review
agreement with the Board, shall either enter an agreement with the North
Carolina Medical Society for the inclusion of physician assistants in the Society's
program for impaired physicians, or shall establish and maintain the Academy's
own program for impaired physician assistants. The purpose of the programs
shall be to identify, review, and evaluate the ability of those physicians and
physician assistants to function in their professional capacity and to provide
programs for treatment and rehabilitation. The North Carolina Physicians
Health Program (Program) is an independent organization for medical
professionals that provides screening, referral, monitoring,
educational, and support services. The Board Board,
Society, and the Academy may provide funds for the administration of impaired
physician and impaired physician assistant programs and shall adopt rules with
provisions for definitions of impairment; guidelines for program elements;
procedures for receipt and use of information of suspected impairment;
procedures for intervention and referral; monitoring treatment, rehabilitation,
post‑treatment support and performance; reports of individual cases to
the Board; periodic reporting of statistical information; assurance of
confidentiality of nonpublic information and of the review process.the
Program.
(d) Upon investigation and review of a physician
licensed by the Board, or a physician assistant approved by the Board, or upon
receipt of a complaint or other information, a society which enters a peer
review agreement with the Board, or the Academy if it has a peer review
agreement with the Board, as appropriate, The Program shall report
immediately to the Board detailed information about any physician or
physician assistant licensed or approved by the Board if:licensee of the
Board who meets any of the following criteria:
(1) The physician or physician assistant constitutes
The licensee constitutes an imminent danger to the public or to
himself patient care by reason of impairment, mental illness,
physical illness, the commission of substance use disorder, professional
sexual boundary violations, misconduct, or any other reason;reason.
(2) The physician or physician assistant The
licensee refuses to cooperate with the program, refuses to submit to
treatment, or is still impaired after treatment and exhibits professional
incompetence; orsubmit to an assessment as ordered by the Board, has
entered into a monitoring contract and fails to comply with the terms of the
Program's monitoring contract, or is still unsafe to practice medicine after
treatment.
(3) It reasonably appears that there are
other grounds for disciplinary action.
(e) Any confidential patient information and
other nonpublic information acquired, created, or used in good faith by the
Academy or a society Program pursuant to this section shall
remain confidential and shall not be subject to discovery or subpoena in a
civil case. is privileged, confidential, and not subject to discovery,
subpoena, or other means of legal compulsion for release to any person other
than to the Board, the Program, or their employees or consultants. No
person participating in good faith in the peer review or impaired physician
or impaired physician assistant programs of this section Program shall
be required in a civil case to disclose the fact of participation in the
Program or any information acquired or opinions, recommendations, or
evaluations acquired or developed solely in the course of participating in any
agreements the Program pursuant to this section.
(f) Peer review activities Activities conducted
in good faith pursuant to any the agreement under authorized
by subsection (a) of this section shall not be grounds for civil action
under the laws of this State and are deemed to be State directed and
sanctioned and shall constitute State action for the purposes of application of
antitrust laws.State.
(g) Upon the written request of a licensee, the Program shall provide the licensee and the licensee's legal counsel with a copy of a written assessment of the licensee prepared as part of the licensee's participation in the Program. In addition, the licensee shall be entitled to a copy of any written assessment created by a treatment provider or facility at the recommendation of the Program, to the extent permitted by State and federal laws and regulations. Any information furnished to a licensee pursuant to this subsection shall be inadmissible in evidence and shall not be subject to discovery in any civil proceeding. However, this subsection shall not be construed to make information, documents, or records otherwise available for discovery or use in a civil action immune from discovery or use in a civil action merely because the information, documents, or records were included as part of the Program's assessment of the licensee or were the subject of information furnished to the licensee pursuant to this subsection. For purposes of this subsection, a civil action or proceeding shall not include administrative actions or proceedings conducted in accordance with Article 1 of Chapter 90 and Chapter 150B of the General Statutes.
(h) The Board has authority to adopt, amend, or repeal rules as may be necessary to carry out and enforce the provisions of this section."
SECTION 15. G.S. 90‑16(d) is repealed.
SECTION 16. This act becomes effective October 1, 2015.