H*3912(Rat #0417, Act #0411 of 2008)  General Bill, By White and Bales

Similar(S 693)
 AN ACT TO AMEND SECTION 40-47-30, AS AMENDED, CODE OF LAWS OF SOUTH CAROLINA,
 1976, RELATING TO THE REQUIREMENT TO BE LICENSED TO PRACTICE MEDICINE AND TO
 SPECIFY WHAT IS NOT TO BE CONSTRUED AS PRACTICING MEDICINE, SO AS TO CLARIFY
 THAT A PHYSICIAN MAY DELEGATE CERTAIN TASKS TO AN UNLICENSED PERSON IF THE
 PHYSICIAN IS IMMEDIATELY AVAILABLE AND TO PROVIDE THAT A PHYSICIAN IS NOT
 PROHIBITED FROM PRACTICING IN CONSULTATION WITH A SOUTH CAROLINA PHYSICIAN
 CONCERNING AN OPINION FOR THE SOUTH CAROLINA PHYSICIAN'S CONSIDERATION IN
 MANAGING THE CASE AND TREATMENT OF A PATIENT IN THIS STATE; TO AMEND SECTION
 40-47-32, RELATING TO REQUIREMENTS FOR LICENSURE TO PRACTICE MEDICINE, SO AS
 TO PROVIDE THAT WHEN PROVIDING DOCUMENTATION OF RESIDENCY TRAINING FOR
 LICENSURE, A PHYSICIAN WHO GRADUATED FROM A SCHOOL OUTSIDE OF THE UNITED
 STATES OR CANADA IS ONLY REQUIRED TO HAVE BEEN ACTIVELY LICENSED FOR THE
 PRECEDING FIVE YEARS, RATHER THAN THE PRECEDING TEN YEARS, AND TO PROVIDE THAT
 SEVENTY-FIVE PERCENT OF CONTINUING MEDICAL EDUCATION MUST BE IN A BOARD
 CERTIFIED APPLICANT'S AREA OF SPECIALTY IN ORDER FOR THE APPLICANT TO OBTAIN
 LICENSURE WITHOUT HAVING TO PASS AN EXAMINATION; TO AMEND SECTION 40-47-20, AS
 AMENDED, RELATING TO THE DEFINITION OF TERMS IN THE LICENSURE AND REGULATION
 OF PHYSICIANS, INCLUDING THE DEFINITION OF THE PRACTICE OF MEDICINE, SO AS TO
 PROVIDE THAT RENDERING A DETERMINATION OF MEDICAL NECESSITY OR A DECISION
 AFFECTING THE DIAGNOSIS OR TREATMENT OF A PATIENT IS NOT, UNDER CERTAIN
 CIRCUMSTANCES, THE PRACTICE OF MEDICINE WHEN SUCH DETERMINATION OR DECISION IS
 A COVERAGE DECISION DENYING HEALTH CARE SERVICES OR COVERAGE FOR A COVERED
 BENEFIT OR APPROVING A COVERED BENEFIT; AND BY ADDING SECTION 38-59-25 SO AS
 TO FURTHER SPECIFY THOSE CIRCUMSTANCES UNDER WHICH RENDERING A DETERMINATION
 OR MAKING A DECISION DENYING OR APPROVING HEALTH CARE SERVICES OR BENEFITS IS
 NOT THE PRACTICE OF MEDICINE. - ratified title

   04/17/07  House  Introduced and read first time HJ-39
   04/17/07  House  Referred to Committee on Medical, Military,
                     Public and Municipal Affairs HJ-40
   02/27/08  House  Committee report: Favorable Medical, Military,
                     Public and Municipal Affairs HJ-8
   02/28/08         Scrivener's error corrected
   03/04/08  House  Requests for debate-Rep(s). White, Skelton,
                     Cobb-Hunter, Hart, Parks, JH Neal, Sellers,
                     Rutherford, Taylor, Whitmire, Sandifer,
                     Gambrell, Thompson, Brady, Hayes, Clyburn,
                     Hosey, Mulvaney, Umphlett, G Brown, R Brown,
                     Anderson, Owens, Limehouse, Bedingfield,
                     Mahaffey, Shoopman, Leach, Breeland, Gullick,
                     Hutson, Lowe, Crawford, Alexander, GR Smith, and
                     Govan HJ-59
   03/05/08  House  Member(s) request name added as sponsor: Bales
   03/05/08  House  Debate interrupted HJ-33
   03/05/08  House  Amended HJ-45
   03/05/08  House  Read second time HJ-52
   03/05/08  House  Roll call Yeas-65  Nays-43 HJ-52
   03/06/08  House  Read third time and sent to Senate HJ-30
   03/06/08         Scrivener's error corrected
   03/11/08  Senate Introduced and read first time SJ-6
   03/11/08  Senate Referred to Committee on Judiciary SJ-6
   03/12/08  Senate Recalled from Committee on Judiciary SJ-2
   03/12/08  Senate Committed to Committee on Medical Affairs SJ-2
   05/14/08  Senate Committee report: Favorable with amendment
                     Medical Affairs SJ-8
   05/15/08         Scrivener's error corrected
   05/28/08  Senate Special order, set for May 28, 2008 SJ-94
   06/03/08  Senate Debate interrupted SJ-61
   06/04/08  Senate Read second time SJ-311
   06/04/08  Senate Debate interrupted SJ-311
   06/05/08  Senate Committee Amendment Amended and Adopted SJ-97
   06/05/08  Senate Read third time and returned to House with
                     amendments SJ-97
   06/05/08  House  Concurred in Senate amendment and enrolled HJ-91
   06/10/08         Ratified R 417
   06/16/08         Vetoed by Governor
   06/25/08  House  Veto overridden by originating body Yeas-96  Nays-13
   06/25/08  Senate Veto overridden Yeas-34  Nays-5
   08/12/08         Copies available
   08/12/08         Effective date 06/25/08
   08/12/08         Act No. 411

(A411, R417, H3912)

AN ACT TO AMEND SECTION 40-47-30, AS AMENDED, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO THE REQUIREMENT TO BE LICENSED TO PRACTICE MEDICINE AND TO SPECIFY WHAT IS NOT TO BE CONSTRUED AS PRACTICING MEDICINE, SO AS TO CLARIFY THAT A PHYSICIAN MAY DELEGATE CERTAIN TASKS TO AN UNLICENSED PERSON IF THE PHYSICIAN IS IMMEDIATELY AVAILABLE AND TO PROVIDE THAT A PHYSICIAN IS NOT PROHIBITED FROM PRACTICING IN CONSULTATION WITH A SOUTH CAROLINA PHYSICIAN CONCERNING AN OPINION FOR THE SOUTH CAROLINA PHYSICIAN'S CONSIDERATION IN MANAGING THE CASE AND TREATMENT OF A PATIENT IN THIS STATE; TO AMEND SECTION 40-47-32, RELATING TO REQUIREMENTS FOR LICENSURE TO PRACTICE MEDICINE, SO AS TO PROVIDE THAT WHEN PROVIDING DOCUMENTATION OF RESIDENCY TRAINING FOR LICENSURE, A PHYSICIAN WHO GRADUATED FROM A SCHOOL OUTSIDE OF THE UNITED STATES OR CANADA IS ONLY REQUIRED TO HAVE BEEN ACTIVELY LICENSED FOR THE PRECEDING FIVE YEARS, RATHER THAN THE PRECEDING TEN YEARS, AND TO PROVIDE THAT SEVENTY-FIVE PERCENT OF CONTINUING MEDICAL EDUCATION MUST BE IN A BOARD CERTIFIED APPLICANT'S AREA OF SPECIALTY IN ORDER FOR THE APPLICANT TO OBTAIN LICENSURE WITHOUT HAVING TO PASS AN EXAMINATION; TO AMEND SECTION 40-47-20, AS AMENDED, RELATING TO THE DEFINITION OF TERMS IN THE LICENSURE AND REGULATION OF PHYSICIANS, INCLUDING THE DEFINITION OF THE PRACTICE OF MEDICINE, SO AS TO PROVIDE THAT RENDERING A DETERMINATION OF MEDICAL NECESSITY OR A DECISION AFFECTING THE DIAGNOSIS OR TREATMENT OF A PATIENT IS NOT, UNDER CERTAIN CIRCUMSTANCES, THE PRACTICE OF MEDICINE WHEN SUCH DETERMINATION OR DECISION IS A COVERAGE DECISION DENYING HEALTH CARE SERVICES OR COVERAGE FOR A COVERED BENEFIT OR APPROVING A COVERED BENEFIT; AND BY ADDING SECTION 38-59-25 SO AS TO FURTHER SPECIFY THOSE CIRCUMSTANCES UNDER WHICH RENDERING A DETERMINATION OR MAKING A DECISION DENYING OR APPROVING HEALTH CARE SERVICES OR BENEFITS IS NOT THE PRACTICE OF MEDICINE.

Be it enacted by the General Assembly of the State of South Carolina:

Activity excepted from licensure

SECTION    1.    Section 40-47-30(A)(5)(c) of the 1976 Code, as last amended by Act 385 of 2006, is further amended to read:

"(c)    the task is performed while the physician is present on the premises and in such close proximity as to be immediately available to the unlicensed person if needed;"

Activity excepted from licensure

SECTION    2.    Section 40-47-30(A) of the 1976 Code, as last amended by Act 385 of 2006, is further amended by adding at the end:

"(10)    prohibit a physician from practicing in actual consultation with a physician licensed in this State concerning an opinion for the South Carolina physician's consideration in managing the care or treatment of a patient in this State."

Foreign-trained physician license requirement

SECTION    3.    Section 40-47-32(B)(2)(a)(ii) of the 1976 Code, as added by Act 385 of 2006, is amended to read:

"(ii)    document a minimum of three years of progressive postgraduate medical residency training in the United States approved by the Accreditation Council for Graduate Medical Education (ACGME), American Osteopathic Association (AOA), or postgraduate training in Canada approved by the Royal College of Physicians and Surgeons, except that if an applicant has been actively licensed in another state for the preceding five years or more without significant disciplinary action, the applicant need only document one year of postgraduate residency training approved by the board; or"

Exception to examination for licensure

SECTION    4.    Section 40-47-32(D)(11) of the 1976 Code, as added by Act 385 of 2006, is amended to read:

"(11)    one hundred fifty hours of Category I continuing medical education in the three years preceding the date of the application by an applicant who is currently certified by a specialty board recognized by the American Board of Medical Specialties, the American Osteopathic Association, or other organization approved by the board, which certification is not time limited and does not require recertification by examination. Such Category I continuing medical education must be approved by the American Medical Association or American Osteopathic Association, or other national organization approved by the board, as appropriate. Seventy-five percent of these hours must be related to the applicant's area of specialty. This is the only exception to the ten year requirement of this subsection that does not require an examination or reexamination."

Residency training requirements for foreign-trained physicians

SECTION    5.    Section 40-47-32(G)(2) of the 1976 Code, as added by Act 385 of 2006, is amended to read:

"(2)    Graduates of medical schools located outside the United States or Canada shall document a minimum of three years of progressive postgraduate medical residency training approved by the board, except that these graduates who have completed at least two and one-half years of progressive postgraduate medical residency training in the program in which they are currently enrolled may be issued a license upon certification from the program of their good standing and expected satisfactory completion. These graduates who have been actively licensed in another state for the preceding five years or more without significant disciplinary action need only document one year of postgraduate residency training approved by the board. A foreign graduate may satisfy the three year postgraduate training requirement with at least one year of approved training in combination with certification by a specialty board recognized by the ABMS, AOA, or another national organization approved by the board."

Definition of "Practice of Medicine"

SECTION    6.    Section 40-47-20(36)(f) of the 1976 Code, as last amended by Act 385 of 2006, is further amended to read:

"(f)    rendering a determination of medical necessity or a decision affecting the diagnosis and/or treatment of a patient is the practice of medicine subject to all of the powers provided to the Board of Medical Examiners, except as provided in Section 38-59-25;"

Exception from the practice of medicine

SECTION    7.    Chapter 59, Title 38 of the 1976 Code is amended by adding:

"Section 38-59-25.    A determination of medical necessity of a decision affecting the diagnosis and/or treatment of a patient is not the practice of medicine, provided:

(A)    it is a coverage decision denying health care services by an insurer that is based on a finding that the provision of a particular service is included or excluded as a covered benefit under the terms and conditions of the health care service plan contract; or

(B)    it is a coverage decision approving a covered benefit for health care services that provides for the diagnosis, treatment, cure, or relief of a health condition, illness, injury, or disease; or

(C)    it is a coverage decision denying coverage for a covered benefit for a health care service that provides diagnosis, treatment, cure, or relief of a health condition, illness, injury, or disease excluding, except where otherwise provided for by law, experimental, investigational, or cosmetic purposes, if the denial is issued by a licensed physician who has not wilfully and knowingly, or with reckless disregard or gross negligence, or with the intent solely to delay payment of the claim in bad faith, ignored nationally recognized protocols or standards of medical care in rendering such a decision. A good faith request for records or additional information is not a delay for purposes of this section. A person providing medical necessity review services for a health insurer or health maintenance organization who is subject to an inquiry regarding whether the person has been practicing medicine pursuant to this section has the right to remove the case to the Administrative Law Court upon petition of the person. If the Administrative Law Court determines that a complaint is filed, pursuant to this section, to harass or intimidate a person or is otherwise not based on a good faith belief that the provisions of this section are being violated, the defendant is entitled to an award of attorney's fees and the costs of defending the case."

Time effective

SECTION    8.    This act takes effect upon approval by the Governor.

Ratified the 10th day of June, 2008.

Vetoed by the Governor -- 6/16/08.

Veto overridden by House -- 6/25/08.

Veto overridden by Senate -- 6/25/08.