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Indicates Matter Stricken
Indicates New Matter
Indicates Matter Stricken
Indicates New Matter
AS PASSED BY THE SENATE
June 5, 2008
H. 3912
S. Printed 6/5/08--S.
Read the first time March 11, 2008.
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 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 A PHYSICIAN WHO GRADUATED FROM A SCHOOL OUTSIDE OF THE UNITED STATES OR CANADA AND WHO HAS BEEN LICENSED FOR FIVE YEARS, RATHER THAN TEN YEARS, IN ANOTHER STATE, THE PHYSICIAN IS ONLY REQUIRED TO DOCUMENT ONE YEAR OF POST GRADUATE RESIDENCY TRAINING AND TO REVISE THE TIME WITHIN WHICH CERTAIN SPECIALTY EDUCATION REQUIREMENTS MUST BE UNDERTAKEN IN ORDER TO BE SUBSTITUTED FOR REQUIRED EXAMINATIONS; AND TO AMEND SECTION 40-47-35, RELATING TO LICENSURE AS AN EXPERT MEDICAL WITNESS, SO AS TO PROVIDE THAT RATHER THAN THE BOARD OF MEDICAL EXAMINERS LICENSING A PHYSICIAN AS AN EXPERT WITNESS, A PHYSICIAN WHO TESTIFIES IN A PROCEEDING IN THIS STATE IS DEEMED TO HAVE SUBMITTED TO THE JURISDICTION OF THE BOARD AND TO PROVIDE NOTICE AND INVESTIGATION PROCEDURES FOR COMPLAINTS RECEIVED.
Amend Title To Conform
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. Section 40-47-30(A)(5)(c) of the 1976 Code, as 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 readily immediately available to the unlicensed person if needed;"
SECTION 2. Section 40-47-30(A) of the 1976 Code, as 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."
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 ten the preceding five years or more without significant disciplinary action, the applicant is need only required to document one year of postgraduate residency training approved by the board; or"
SECTION 4. Section 40-47-32(D)(11) of the 1976 Code, as added by Act 385 of 2006, is amended to read:
"(11) maintenance of certification by a specialty board recognized by the American Board of Medical Specialties, the American Osteopathic Association, or another organization approved by the board, as evidenced by having acquired 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, and the specialty board of the applicant during the three years preceding the date of application. 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."
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."
SECTION 6. Section 40-47-20(36)(f) of the 1976 Code, as 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;"
SECTION 7. Chapter 59, Title 38 of the 1976 Code is amended by adding:
"Section 38-59-25. A determination of medical necessity or 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 willfully 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 attorneys' fees and the costs of defending the case. "
SECTION 8. This act takes effect upon approval by the Governor.
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