Reference is to Printer's Date 2/15/18-H.
Amend the bill, as and if amended, by deleting all after the enacting words and inserting:
/ SECTION 1. Chapter 51, Title 40 of the 1976 Code is amended by adding:
"Section 40-51-67.
(A)(1) A licensed podiatrist seeking a
permit from the Board of Medical Examiners to independently
engage in ankle surgery procedures as provided in Section
40-51-65(B) must:
(a)
be a graduate, on or after July 1, 2006, of a three-year
residency program in podiatric medicine and surgery that is
accredited by the Council on Podiatric Medical Education, or its
successor organization, at the time of graduation; and
(b)
either be:
(i)
board certified in reconstructive
rearfoot ankle surgery by the American Board of Podiatric
Surgery, or its successor organization; or
(ii)
board qualified, but not board certified, in
reconstructive rearfoot ankle surgery by the American Board of
Podiatric Surgery, or its successor organization, and able to
document that he has completed training and experience in
midfoot, rearfoot and ankle procedures. This training and
experience, and the documentation of it, all must be
satisfactory to the board in its discretion.
(2)
The Board of Medical Examiners shall issue no permit
enabling a licensed podiatrist to independently engage in the
surgical treatment of the ankle unless:
(a)
a licensee submits an application on forms provided by the
Board of Medical Examiners and pays a registration fee set by
the board by promulgation of regulation; and
(b)
the Board of Medical Examiners is satisfied that the
applicant is in compliance with all requirements of this
subsection, as appropriate.
(B)(1) There is created
a Joint Podiatric Surgery Advisory Committee as a committee to
the Board of Medical Examiners which consists of five members
with experience regarding podiatry or orthopedic surgery.
(2)
The committee is comprised of:
(a)
three orthopedic surgeons selected by the Board of Medical
Examiners; and
(b)
two podiatrists selected by the Board of Podiatry
Examiners.
(3)
Members of the committee may not be compensated for their
service on the board and may not receive mileage, per diem, and
subsistence as otherwise authorized by law for members of state
boards, committees, and commissions.
(4)
The committee shall meet at least once annually and at
other times as may be necessary. Three members, at least one of
whom must be a podiatrist, constitute a quorum for all meetings.
At its initial meeting, and at the beginning of each year
thereafter, the committee shall elect from its membership a
chairman to serve for a one-year term.
(5)
The committee shall assist and advise the Board of Medical
Examiners in evaluating an applicant's training and experience
in midfoot, rearfoot and ankle procedures for purposes of
determining whether to permit the applicant to independently
engage in ankle surgery procedures pursuant to subsection
(A)(1).
(C) The Board of
Medical Examiners shall investigate allegations of practices
violating the provisions of this section concerning permits to
enable licensed podiatrists to independently engage in the
surgical treatment of the ankle. The Board of Medical Examiners
may issue subpoenas, examine witnesses, and administer oaths in
connection with an investigation or related hearings. The Board
of Medical Examiners may suspend a permit issued pursuant to
this section pending an investigation. Upon a finding of a
violation, the Board of Medical Examiners may revoke a permit,
assess a fine not to exceed five hundred dollars for each
violation, or both, provided, however, the board may not make
such a finding without first having provided the permit holder a
hearing after having provided thirty days' notice of the hearing
to the permit holder. For allegations of the performance of
unauthorized surgical treatment of an ankle in violation of
Section 40-51-65(B), the Board of Medical Examiners also may
seek restraining orders and cease and desist orders from the
Administrative Law Court.
(D) The Board of
Medical Examiners shall promulgate regulations to implement the
provisions this section. These regulations must include, but are
not limited to, the number and types of procedures required for
an applicant's training or experience to be deemed acceptable
for purposes of issuing a permit pursuant to subsection (A)(1).
In identifying the required number and types of procedures, the
Board of Medical Examiners shall seek the advice and assistance
of the Joint Podiatric Surgery Advisory Committee and shall
consider nationally recognized standards for accredited
residency programs in podiatric medicine and surgery for
midfoot, rearfoot, and ankle procedures. The Board of Medical
Examiners may not issue permits pursuant to subsection (A)(1)
before the effective date of any regulations adopted pursuant to
this section.
(E) The Board of
Medical Examiners issuance of a permit to a licensed podiatrist
to independently engage in the surgical treatment of the ankle
may not be construed to obligate a hospital or outpatient
surgical facility to grant him privileges to perform such
procedures at the hospital or outpatient surgical
facility."
SECTION 2. Section 40-51-20 of the 1976 Code is amended to read:
"Section 40-51-20.
For the purposes of this chapter:
(1) 'Podiatry'
shall mean the diagnosis, medical and surgical treatment limited
to ailments of the human foot, except the administration of an
anaesthetic other than local 'Ankle' means the
distal metaphysis and epiphysis of the tibia and fibula, the
articular cartilage of the distal tibia and distal fibula, the
ligaments that connect the distal metaphysis and epiphysis of
the tibia and fibula and the talus, and the portions of skin,
subcutaneous tissue, fascia, muscles, tendons and nerves at or
below the level of the myotendinous junction of the triceps
surae.
(2) 'Diagnosis'
shall mean means to ascertain a disease
or ailment by symptoms and findings and does not confer the
right to use X-ray other than for diagnosis.
(3) 'Medical treatment'
shall mean means the application or
prescribing of any therapeutic agent or remedy for the relief of
foot ailments, except the medical treatment of
any a systemic disease causing
manifestations in the foot.
(4)
'Podiatric ankle surgery' or 'surgical treatment of the
ankle' means surgical treatment of the ankle, including the
surgical treatment of the anatomical structures of the ankle, as
well as the administration and prescription of drugs incidental
to the ankle, and the surgical treatment of manifestations of
systemic diseases as they appear on the ankle, excluding:
(a)
placement of any intramedullary nail into the
tibia regardless of entry point;
(b)
placement of external fixator half pins in to
the tibia;
(c)
amputation of the leg or foot above the level of
the transmetatarsal;
(d)
total ankle replacement;
(e)
surgical fixation of pilon fractures, tibial
shaft fractures, calcaneus and talus fractures, and ankle
fractures;
(f)
Osteochondral Autograft Transfer System (OATS)
to the Talus (autograft and allograft); and
(g)
tibial osteotomy.
(5)
'Podiatry' means the diagnosis, medical and surgical
treatment limited to ailments of the human foot, except the
administration of an anaesthetic other than local.
(46) 'Surgical
treatment' shall mean means the use of
any a cutting or invasive
instrument to treat a disease, ailment, deformity or condition
of the foot, but shall not confer the right to amputate the foot
or toes."
SECTION 3. Section 40-51-65 of the 1976 Code is amended to read:
"Section 40-51-65.
(A) It is unlawful for
any a person to practice podiatric
medicine in this State without obtaining first a license from
the board Board of Podiatry
Examiners.
(B) The board
shall conduct an examination of any an
applicant who submits satisfactory evidence that he has:
(a1) received
four years of high school training;
(b2) completed
at least three years of pre-podiatry training at a recognized
college; and
(c3) received
a diploma or certificate of graduation from a recognized college
of podiatric medicine which has been accredited by the Council
on Podiatric Medical Education.
(C) A
licensed podiatrist may not independently engage in the surgical
treatment of the ankle, including the surgical treatment of the
anatomical structures of the ankle, as well as the
administration and prescription of drugs incidental to the
ankle, and the surgical treatment of manifestations of systemic
diseases as they appear on the ankle, until he obtains a permit
from the Board of Medical Examiners after meeting the
requirements of Section 40-51-67."
SECTION 4. This act takes effect upon approval by the Governor. /
Renumber sections to conform.
Amend title to conform.