South Carolina General Assembly
116th Session, 2005-2006

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H. 3784

STATUS INFORMATION

General Bill
Sponsors: Rep. White
Document Path: l:\council\bills\pt\2471sj05.doc
Companion/Similar bill(s): 881

Introduced in the House on March 16, 2005
Currently residing in the House Committee on Medical, Military, Public and Municipal Affairs

Summary: Medical Examiners Board; Medical Disciplinary Commission

HISTORY OF LEGISLATIVE ACTIONS

     Date      Body   Action Description with journal page number
-------------------------------------------------------------------------------
   3/16/2005  House   Introduced and read first time HJ-34
   3/16/2005  House   Referred to Committee on Medical, Military, Public and 
                        Municipal Affairs HJ-34

View the latest legislative information at the LPITS web site

VERSIONS OF THIS BILL

3/16/2005

(Text matches printed bills. Document has been reformatted to meet World Wide Web specifications.)

A BILL

TO AMEND ARTICLES 1 AND 3, CHAPTER 47 OF TITLE 4O, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO THE PRACTICE OF PHYSICIANS, SURGEONS, AND OSTEOPATHS, SO AS TO PROVIDE FOR THE COMPOSITION OF THE STATE BOARD OF MEDICAL EXAMINERS AND PROVIDE FOR ITS POWERS AND DUTIES; PROVIDE FOR THE MEDICAL DISCIPLINARY COMMISSION, ITS COMPOSITION, POWERS, AND DUTIES; DEFINE CERTAIN TERMS; PROVIDE THAT OSTEOPATHIC PHYSICIANS AND SURGEONS HAVE THE SAME RIGHTS AND PRIVILEGES AS PHYSICIANS AND SURGEONS OF OTHER SCHOOLS OF MEDICINE WITH RESPECT TO CERTAIN CIRCUMSTANCES; PROVIDE THE RESTRICTIONS ON PRACTICING MEDICINE AND PROVIDE FOR LICENSED AND UNLICENSED PERSONS; PROVIDE REQUIREMENTS FOR LIMITED AND TEMPORARY LICENSES; PROVIDE REQUIREMENTS FOR PERMANENT LICENSES AND EXAMINATIONS AN APPLICANT SHALL PASS; PROVIDE BOARD DISCRETION TO ISSUE A PERMANENT LICENSE TO CERTAIN THIRD YEAR RESIDENTS; PROVIDE REQUIREMENTS FOR AN ACADEMIC LICENSE; PROVIDE REQUIREMENTS FOR A SPECIAL VOLUNTEER LICENSE; PROVIDE FOR A LICENSE REGULATING THE PRACTICE OF AN EXPERT MEDICAL WITNESS; PROVIDE CRIMINAL BACKGROUND CHECKS OF NEW APPLICANTS AND LICENSEES UNDER INVESTIGATION OR IN DISCIPLINARY PROCEEDINGS; PROVIDE FOR CONTINUED PROFESSIONAL COMPETENCY OF PHYSICIANS HOLDING PERMANENT LICENSES AND RENEWAL, REINSTATEMENT, AND REACTIVATION OF CERTAIN PERMANENT LICENSES; PROVIDE THE RENEWAL PROCESS FOR CERTAIN LICENSES; PROVIDE THAT A LICENSEE SHALL NOTIFY THE BOARD REGARDING CERTAIN CHANGES AND REGARDING AN ADVERSE DISCIPLINARY ACTION AND PROVIDE EXCEPTIONS; PROVIDE THE PROCEDURE FOR REACTIVATION OF AN INACTIVE LICENSE; PROVIDE THE PROCEDURE FOR LATE RENEWAL OF A LICENSE; PROVIDE THE PROCEDURE FOR REINSTATEMENT OF A LICENSE AFTER SUSPENSION; PROVIDE THAT THE ADMINISTRATIVE LAW COURT SHALL REVIEW CERTAIN ACTIONS OF THE BOARD UPON PETITION OF THE APPLICANT OR LICENSEE; PROVIDE THAT THE DEPARTMENT OF LABOR, LICENSING AND REGULATION SHALL PROVIDE CERTAIN OPERATIONS AND ACTIVITIES TO THE BOARD; PROVIDE FOR THE FEES THE BOARD SHALL CHARGE; PROVIDE FOR RECORD KEEPING OF THE ADMINISTRATOR AND THE BOARD; PROVIDE THAT PRACTITIONERS SHALL CONDUCT THEMSELVES ACCORDING TO THE CODE OF ETHICS ADOPTED BY THE BOARD; PROVIDE THAT THE DEPARTMENT SHALL INVESTIGATE COMPLAINTS AND VIOLATIONS; THE PRESIDING OFFICER OF THE BOARD MAY ADMINISTER OATHS WHEN TAKING TESTIMONY UPON MATTERS PERTAINING TO THE BUSINESS OR DUTIES OF THE BOARD; PROVIDE THAT RESTRAINING ORDERS AND CEASE AND DESIST ORDERS MAY BE ISSUED PURSUANT TO CERTAIN CIRCUMSTANCES; PROVIDE ADDITIONAL GROUNDS FOR DISCIPLINARY ACTION AND DEFINE WHEN A LICENSEE HAS COMMITTED MISCONDUCT; PROVIDE FOR A LICENSEE WHO HAS BEEN ADJUDGED MENTALLY ILL; PROVIDE THE PROCEDURE FOR HOW THE BOARD SHALL REVOKE, SUSPEND, OR RESTRICT A LICENSE OF LIMIT OR DISCIPLINE A LICENSEE WITH THE RIGHT OF REVIEW BY THE ADMINISTRATIVE LAW COURT; PROVIDE THE PROCEDURE FOR WHEN A PERSON HAS ENGAGED IN CONDUCT WHICH SUBVERTS OR ATTEMPTS TO SUBVERT THE SECURITY OR INTEGRITY OF THE LICENSING EXAMINATION PROCESS; PROVIDE FOR DISCIPLINARY PROCEEDINGS WHEN A LICENSEE COMMITS ACTS OR OMISSIONS CAUSING THE DENIAL, CANCELLATION, REVOCATION, SUSPENSION, OR RESTRICTION OF A LICENSE TO PRACTICE IN ANOTHER STATE; PROVIDE THAT IF A LICENSEE ATTENDS A PATIENT WHILE UNDER THE INFLUENCE OF ALCOHOL OR DRUGS HE IS GUILTY OF A MISDEMEANOR; PROVIDE THAT IT IS UNPROFESSIONAL CONDUCT FOR A LICENSEE TO PRESCRIBE DRUGS TO AN INDIVIDUAL WITHOUT FIRST ESTABLISHING A PROPER PHYSICIAN-PATIENT RELATIONSHIP; PROVIDE FOR SUSPENSION OF REVOCATION OF A LICENSE PURSUANT TO CERTAIN CIRCUMSTANCES; PROVIDE FOR A PROFESSIONAL COMPETENCY, MENTAL, OR PHYSICAL EXAMINATION AND THE CONFIDENTIALITY OF THE EXAMINATION; PROVIDE THE JURISDICTION OF THE BOARD; PROVIDE FOR THE PROCEDURE FOR AN INITIAL COMPLAINT AND AN INVESTIGATION REGARDING PROFESSIONAL MISCONDUCT; PROVIDE FOR WHEN A FORMAL COMPLAINT MUST BE ISSUED, WHEN THERE MUST BE A FORMAL HEARING, THE REPORTING AND NOTIFICATION REQUIREMENTS, THE REVIEW BY THE BOARD, ACTIONS THE BOARD MAY TAKE UPON FINAL REVIEW, AND THE PROCEDURE FOR SERVICE OF NOTICE; PROVIDE FOR WHEN DISCOVERY MAY BE PERMITTED; PROVIDE THE ACTIONS A BOARD MAY TAKE UPON THE DETERMINATION THAT GROUNDS FOR DISCIPLINARY ACTION EXIST AND THE MANNER OF AND PROCEDURE FOR DISCIPLINING THE PERSON COMMITTING THE MISCONDUCT; PROVIDE THAT THE PERSON MAY HAVE TO PAY A FINE AND THE COSTS OF THE DISCIPLINARY ACTION; PROVIDE THAT A PERSON WHOSE LICENSE HAS BEEN PERMANENTLY REVOKED MUST NOT BE READMITTED TO PRACTICE IN THIS STATE; PROVIDE THAT A LICENSEE MAY RELINQUISH AN AUTHORIZATION TO PRACTICE INSTEAD OF FURTHER DISCIPLINARY PROCEEDINGS SUBJECT TO CERTAIN CONDITIONS; PROVIDE FOR FINAL ORDERS OF THE BOARD; PROVIDE THAT DISCIPLINARY ACTIONS ARE SUBJECT TO THE FREEDOM OF INFORMATION ACT; PROVIDE THAT THE BOARD MAY DENY LICENSURE ON THE SAME GROUNDS FOR WHICH THE BOARD MAY TAKE DISCIPLINARY ACTION AGAINST THE PERSON PROVIDE THAT THE BOARD MAY DENY A LICENSE BASED ON A PERSON'S CRIMINAL RECORD PURSUANT TO CERTAIN CIRCUMSTANCES; PROVIDE THAT A PERSON MAY NOT PRACTICE UNTIL FINAL ACTION IN THE DISCIPLINARY MATTER IF HE VOLUNTARILY SURRENDERS HIS AUTHORIZATION TO PRACTICE WHILE UNDER INVESTIGATION OF A VIOLATION; FINAL DECISION BY THE BOARD MAY BE REVIEWED BY THE ADMINISTRATIVE LAW COURT; PROVIDE THAT A PERSON FOUND IN VIOLATION MAY BE REQUIRED TO PAY COSTS SUBJECT TO COLLECTION AND ENFORCEMENT PROVISIONS; PROVIDE FOR THE CONFIDENTIALITY OF INFORMATION RELATED TO PROCEEDINGS AND CERTAIN COMMUNICATIONS UNTIL FILED; PROVIDE THAT THE DEPARTMENT SHALL PROVIDE WRITTEN ACKNOWLEDGEMENT OF EACH INITIAL COMPLAINT AND NOTIFY THE COMPLAINANT OF THE OUTCOME; PROVIDE A PROCEDURE FOR BREACH OF CONFIDENTIALITY; PROVIDE WHEN A LICENSEE MAY SUPERVISE ANOTHER PRACTITIONER AND THE RESPONSIBILITIES OF THE SUPERVISING PHYSICIAN; PROVIDE PENALTIES FOR UNLAWFUL PRACTICE OF MEDICINE; AND PROVIDE THAT THE DEPARTMENT, IN ADDITION TO INSTITUTING A CRIMINAL PROCEEDING, MAY INSTITUTE A CIVIL ACTION THROUGH THE ADMINISTRATIVE LAW COURT FOR INJUNCTIVE RELIEF AGAINST A PERSON OR ENTITY FOR CERTAIN VIOLATIONS AND PROVIDE A PENALTY.

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

SECTION    1.    Articles 1 and 3 of Chapter 47, Title 40 of the 1976 Code are amended to read:

"Article 1

General Provisions

Section 40-47-5.    As used in this chapter, 'physician' or 'surgeon' shall mean a doctor of medicine.

Section 40-47-10.    There is created the State Board of Medical Examiners to be composed of ten members, one of whom must be a lay member, one of whom must be a doctor of osteopathy, two of whom must be physicians or surgeons from the State-at-large, and six of whom must be physicians or surgeons representing each of six congressional districts. All members of the board must be residents of this State, and each member representing a congressional district shall reside in the district the member represents. All physician members of the board must be licensed by the board and must be practicing their profession in South Carolina.

The members of the board shall serve for terms of four years or until their successors are appointed and qualify.

The members of the board are limited to two terms. All members of the board have full voting rights.

The lay member and one physician or surgeon from the State-at-large must be appointed by the Governor, with the advice and consent of the Senate. The board shall conduct an election to nominate one physician or surgeon from the State-at-large. The election must provide for participation by all physicians or surgeons currently licensed and residing in South Carolina. To nominate the physicians or surgeons who will represent the six congressional districts the board shall conduct an election within each district. These elections must provide for participation by all licensed physicians residing in the particular district. The board shall conduct an election to nominate the doctor of osteopathy from the State-at-large, and this election must provide for participation by any physician currently licensed in South Carolina as a doctor of osteopathy. The board shall certify in writing to the Governor the results of each election. The Governor may reject any or all of the nominees upon satisfactory showing of the unfitness of those rejected. If the Governor declines to appoint any of the nominees submitted, additional nominees must be submitted in the same manner following another election. Vacancies must be filled in a like manner by appointment by the Governor, with the advice and consent of the Senate, for the unexpired portion of the term.

The Governor may remove a member of the board who is guilty of continued neglect of board duties or who is found to be incompetent, unprofessional, or dishonorable. No member may be removed without first giving the member an opportunity to refute the charges filed against the member. The member must be given a copy of the charges at the time they are filed.

Section 40-47-20.    The State Board of Medical Examiners shall meet at least twice a year at such time and place as determined by the Board. The Board shall hold elections for its officers each year. The Board may call additional meetings when necessary for the transaction of Board business. The Board shall adopt rules and regulations for its government, for the practice of medicine and for the practice of osteopathy, for judging the professional and ethical competence of physicians and surgeons including a code of medical ethics, and for the discipline of physicians and surgeons (medical and osteopathic). A majority of the Board shall constitute a quorum for the transaction of business.

Section 40-47-25.    (A)    A representative of the South Carolina Academy of Physicians' Assistants has the privilege of attendance at all meetings of the State Board of Medical Examiners (board) and must be permitted to speak to matters affecting physicians' assistants. However, this representative is not a member of the board and is not entitled to vote.

(B)    The board shall explore the possibility of administering its own examination for purposes of determining a physician's assistant's competency before issuing a temporary or permanent certificate. The board may impose an examination fee to cover the costs and expenses of administering this examination.

Section 40-47-30.    Members of the Board and persons authorized by the Board, engaged in business for the Board, shall receive for their services a per diem as determined by the Board, and travel expenses as provided by law for State boards, committees and commissions. Such compensation shall be paid from Board funds.

Section 40-47-40.    Any person shall be regarded as practicing medicine within the meaning of this article who (a) shall as a business treat, operate on or prescribe for any physical ailment of another, (b) shall engage in any branch or specialty of the healing art or (c) shall diagnose, cure, relieve in any degree or profess or attempt to diagnose, cure or relieve any human disease, ailment, defect, abnormality or complaint, whether of physical or mental origin, by attendance or advice, by prescribing, using or furnishing any drug, appliance, manipulation, adjustment or method or by any therapeutic agent whatsoever.

Section 40-47-50.    (A)    'Osteopathy' is defined as a complete school of medicine and surgery utilizing all methods of diagnosis and treatment in health and disease and placing special emphasis on the interrelationship of the musculo-skeletal system to all other body systems.

(B)    A person is eligible for examination before the board before or after completing a board-approved one-year internship if the person:

(1)    holds a diploma from an osteopathic college approved by the American Osteopathic Association;

(2)    gives evidence of completing at least three years' preprofessional education in an accredited college or university; and

(3)    has attended an osteopathic college for four full courses of lectures of at least thirty-six weeks each or any combination of these courses aggregating one hundred and forty-four weeks.

A person who successfully passes the examination is eligible for a temporary certificate to practice osteopathy which is good for one year. At the end of one year, if the person has completed a one-year internship, the person is eligible for a certificate to practice osteopathy.

(C)    Doctors of osteopathy shall use only the letters D.O. after their names when used in connection with their profession.

Section 40-47-60.    No person shall practice medicine, surgery or osteopathy within the State unless he is twenty-one years of age and has been authorized so to do pursuant to the provisions of this article. But nothing in this article shall be construed:

(1)    To prohibit service in cases of emergency or the domestic administration of family remedies;

(2)    To apply to those who practice the religious tenets of their church without pretending a knowledge of medicine or surgery if the laws, rules and regulations relating to contagious diseases and sanitary matters are not violated; or

(3)    To prohibit licensed druggists from selling, using and dispensing drugs in their places of business, respectively.

(4)    To apply to any act, task or function performed by an assistant to a physician certified by the Board of Medical Examiners, provided that (a) such assistant is approved and certified by the Board as one qualified by training or experience to function as an assistant to a specified physician or a specified physicians' group or professional association; and (b) such act, task or function is performed at the direction and under the supervision of such physician, or physicians' group or professional association, in accordance with rules and regulations promulgated by the Board. Provided, however, that under no circumstances will these physicians' assistants nor optometrists' assistants be allowed to make a refraction for glasses or give a contact lens fitting.

(5)    To prohibit a licensed physician from delegating tasks to unlicensed personnel in his employ and on his premises if:

a. the task is of a routine nature involving neither the special skill of a licensed person nor significant risk to the patient if improperly done;

b.    the task is performed while the physician is present on the premises and in such close proximity as to be readily available to the unlicensed person if needed;

c.    the task does not involve the verbal transmission of a physician's order or prescription to a licensed person if the licensed person requires the order or prescription to be in writing;

d.    the unlicensed person wears an appropriate badge denoting to any patient his status.

Section 40-47-65.    (1)    Amphetamine, methamphetamine, phenmetrazine, their salts and isomers, as identified in Section 44-53-210, Schedule II, hereafter referred to as "the assigned drugs", shall not be dispensed or prescribed except as provided in this section. A departure from these provisions is deemed to constitute an act of professional misconduct subject to discipline under Section 40-47-200.

(2)    A physician, medical or osteopathic, shall not dispense or prescribe the assigned drugs without taking into account the high potential for abuse of such drugs, the possibility that such drugs may lead to severe psychic or physical dependence, the possibility that the patient will obtain the drug for a nontherapeutic use or distribution to others, and the existence of extensive abuse and an illicit market for such drugs. The physician shall note on his records the purpose for which the assigned drugs are prescribed. In no event shall there be a prescription for the purpose of treating obesity.

(3)    The assigned drugs shall not be dispensed or prescribed in the treatment of a hyperkinetic child syndrome prior to the taking of a complete history and physical examination.

(4)    A sufficient history and physical examination and appropriate diagnostic studies of a patient shall be taken to establish that the condition exists prior to dispensing or prescribing the assigned drugs in the treatment of narcolepsy. The findings upon which the diagnosis of narcolepsy was made shall be entered in the patient's record.

(5)    A physician, medical or ostopathic, may apply for a written waiver of the requirements of this section by submitting a written request to the Board. The request shall include all information necessary for a comprehensive evaluation of its merit. If the physician, medical or ostopathic, requesting the waiver demonstrates to the satisfaction of the Board that a waiver would further legitimize medical purposes without undermining the purposes of this section, the Board may issue a written waiver with such terms and conditions as may be deemed appropriate.

(6)    This section shall not be construed to endorse the use of the assigned drugs in the treatment of obesity nor shall it be construed to diminish a physician's, medical or ostopathic, responsibility to comply with those standards of medical practice in the dispensing or prescribing of the assigned drugs which are not set forth in this section.

Section 40-47-70.    The practice of acupuncture shall be permitted in this State under the supervision and referral of a licensed medical doctor or dentist in facilities approved by the Department of Health and Environmental Control. No acupuncturist shall practice in this State without prior written approval of the State Board of Medical Examiners.

Section 40-47-75.    Notwithstanding the provisions of Section 40-47-70, any acupuncturist who has lawfully practiced acupuncture in this State for at least one year prior to the effective date of this section may continue to practice acupuncture without being required to secure the prior written approval of the State Board of Medical Examiners.

Section 40-47-80.    The Board shall have the power to issue temporary licenses and limited certificates to practice medicine and to practice osteopathy to any physician who meets the requirements as set by the Board. A temporary license or a limited certificate may be cancelled upon notice from the Board.

Section 40-47-90.    No person is eligible to appear before the board for examination unless the person has given evidence of preliminary and medical education as may be prescribed by the board or as defined by law.

Section 40-47-95.    The South Carolina Board of Medical Examiners shall promulgate regulations, no later than November 1, 1992, outlining qualifications for the issuance of a special class of license for physicians who are retired from active practice and wish to donate their expertise for the care and treatment of needy patients or patients in underserved areas.

Section 40-47-97.    (A)    A physician licensed in another state, territory, or other jurisdiction of the United States or of any other nation or foreign jurisdiction is exempt from the requirements of licensure in this State, if the physician:

(1)    holds an active license to practice in the other jurisdiction;

(2)    engages in the active practice of medicine in the other jurisdiction; and

(3)    is employed or designated as the team physician by an athletic team visiting the State for a specific sporting event.

(B)    A physician's practice under this section is limited to the members, coaches, and staff of the team by which the physician is employed or designated. A physician practicing in this State under the authority of this section does not have practice privileges in any licensed health care facility and is not authorized to issue orders or prescriptions or to order testing at a medical facility in this State.

Section 40-47-100.    Any person who is, and was on January 1, 1963, duly licensed by the State of South Carolina to operate a nursing home for the chronically ill and the infirm and who had immediately prior to said date continuously operated a hospital or nursing home for a period of at least seven years, and who was duly licensed by this State to practice the healing arts eighteen years prior to January 1, 1956, and who is qualified and experienced in the practice of eclectic medicine and who has a diploma certifying that he is a graduate of a recognized institution teaching eclecticism, shall be and he is hereby licensed to practice eclectic medicine in this State. Provided, that no such person shall perform major surgery.

Section 40-47-110.    Each applicant, before being allowed to take the examination, shall pay to the treasurer of the Board a fee, to be fixed by the Board at an amount which, with other available resources of the Board, will fully cover the cost of the examination, including the compensation and expenses of members of the examining board.

Section 40-47-120.    The Board, when organized, shall examine all candidates for examination, as herein provided, and shall pass upon their qualifications and fitness to practice medicine or osteopathy in this State and give each successful applicant a temporary certificate to practice medicine or osteopathy which shall be good for one year. At the end of one year, if he has also completed all of his other requirements, he shall be eligible for a permanent certificate to practice medicine or osteopathy. The osteopathic member of the Board shall participate in Board action only in relation to the examination and licensing of doctors of osteopathy.

Section 40-47-130.    For each examination the Board shall present suitable questions and testing material for thoroughly testing the knowledge and ability of the applicants in such subjects as are approved by the Board. The examinations conducted by the Board may be written or as otherwise prescribed by the Board. All applicants shall be examined by number only; neither names nor schools of practice shall be known to the examiners.

Section 40-47-140.    (A)    The board by regulation shall establish minimum standards of performance to be attained on examinations for an applicant to qualify for a license.

(B)    For FLEX examinations taken before June 1, 1985, the following standards apply:

An applicant for permanent licensure shall obtain, in one sitting, a FLEX weighted average score of at least seventy-five on the examination.

(C)    For FLEX examinations taken after June 1, 1985, the following standards apply:

An applicant for permanent licensure shall obtain a score of seventy-five or more on both Component I and Component II. An applicant shall pass both components within five years of the first taking of any component of this examination.

(D)    For the SPEX (Special Purpose) and COMVEX examinations, the following standards apply:

An applicant for permanent licensure who has not passed national boards, FLEX, SPEX, COMVEX, or been certified, recertified, or awarded a certificate of added qualifications by a specialty board recognized by the American Board of Medical Specialities or the American Osteopathic Association within ten years of the date of filing the application with this board shall pass the SPEX or COMVEX exam. A passing score on the SPEX examination is seventy-five or better. A passing score on the COMVEX examination must be established by the testing agency. This requirement is in addition to all other requirements for licensure. The SPEX or COMVEX examination requirement does not apply to a physician employed full time by the South Carolina Department of Corrections, South Carolina Department of Health and Environmental Control, State Department of Mental Health, and Department of Disabilities and Special Needs acting within the scope of his employment. A license issued to this physician is revoked immediately if he leaves the full-time employment or acts outside his scope of employment. However, the SPEX or COMVEX examination requirement applies to a physician providing services under a contract for the State and a physician providing services for which there is an expectation of payment, is payment for services, or should have been payment from a source other than the salary the physician receives from the State.

Section 40-47-150.    In case of failure at any examination, the applicant shall have the privilege of a second examination with the payment of the regular fee. In case of failure in a second examination the applicant, to be eligible, in addition to the requirements for previous examinations, must have pursued his studies for such time as the Board may approve and furnish satisfactory evidence thereof.

If the applicant has not met the Board's criteria for passing the examination after three takings, he shall not be permitted to retake the examination and any score received after three takings shall not be considered except by special permission of the Board. It shall be the responsibility of the applicant to demonstrate special or compelling circumstances in order to have a fourth taking considered. A petition for special permission shall be filed with the Board setting forth in detail the special or compelling circumstances the applicant wishes the Board to consider. These special or compelling circumstances include, but are not limited to, the following:

(1)    the applicant's successful completion of additional medical education in an American Medical Association approved medical school;

(2)    the applicant's score on the third examination and its closeness to the passing score required by the Board; or

(3)    other special or compelling factors presented by the applicant to the Board.

If an individual is granted special permission to have the results of a fourth taking of the examination considered and he still has not passed the examination as required by the Board, no further attempts at or scores from the examination shall be considered by the Board.

Section 40-47-160.    (A)    The board may grant or refuse certifications to licentiates of the National Board of Medical Examiners, the Medical Council of Canada, or of the National Board of Examiners for Osteopathic Physicians and Surgeons without further examination and may make and establish all necessary rules and regulations for the reciprocal recognition of certificates issued by other state boards having an equal standing. This section applies only to doctors of osteopathy who graduated after January 1, 1955, from a school approved by the American Osteopathic Association and who now hold unlimited license. Graduates before January 1, 1955, may make application and appear before the Board of Medical Examiners for interview, with each applicant considered for approval on the basis of his training and experience.

(B)    The State Board of Medical Examiners may not grant reciprocity or issue a limited or temporary or permanent license to a licensed physician or an intern of another state of the United States who applies for licensure after May 31, 1985, and:

(1)    whose license is currently restricted in any way or who is currently on a probationary status in that state; or

(2)    who currently has disciplinary action pending against him in that state.

Section 40-47-165.    Notwithstanding any other provisions of this chapter, if a physician has applied for or been granted a limited or temporary license in South Carolina prior to December 31, 1984, and has been sanctioned by another state, that physician's license in South Carolina must be limited, at minimum, by the same disciplinary conditions or restrictions imposed by the previous disciplining state.

Section 40-47-170.    Any action of the board relating to the granting, refusal or cancellation of a license, or any other official action of the board relating to a license or licensee hereunder, shall be subject to review by an administrative law judge as provided under Article 5 of Chapter 23 of Title 1 on the record of the board, as in certiorari, upon petition of the applicant or licensee within ten days from receipt of official notice from the board of the action of which review is sought. Service of such notice shall be conclusively presumed ten days after mailing by registered or certified mail to such applicant or licensee of such notice at such person's last known address.

Section 40-47-180.    Nothing in this article shall change or diminish practice rights of those licensed as osteopaths under Chapter 19 of Title 56 of Code of Laws of South Carolina, 1962. All persons holding a valid certificate of this State to practice osteopathy under Chapter 19 of Title 56 of Code of Laws of South Carolina, 1962 and who are actively engaged in such practice in this State on July 14, 1969 shall be issued a license to practice osteopathy as defined under this article.

Section 40-47-190.    Any practicing osteopath, physician or surgeon licensed by the State Board of Medical Examiners to practice as an osteopath, physician or surgeon, who shall attend any patient while he is under the influence of whiskey or drugs, shall be guilty of a misdemeanor and, upon conviction, shall suffer a fine of not more than two hundred dollars or be imprisoned for a period of not more than sixty days and, in addition thereto, upon conviction, the license granted to such osteopath, physician or surgeon shall be revoked and deemed null and void and he shall be disqualified from ever practicing osteopathy, medicine or surgery in this State until he shall thereafter satisfy the State Board of Medical Examiners that he is qualified to resume the practice of medicine or surgery. The provisions of this section shall be construed as being in addition to the remedies otherwise of force relating to osteopaths, physicians and surgeons who may be addicted to the use of liquor or habitually use drugs.

Section 40-47-200.    (A)    The State Board of Medical Examiners, if it has reason to believe grounds exist, may order the revocation or suspension of a license to practice medicine or osteopathy, publicly or privately reprimand the holder of a license to practice medicine or osteopathy, or take other reasonable action short of revocation or suspension, such as requiring the licensee to undertake additional professional training subject to the direction and supervision of the board or imposing restraint upon the medical or osteopathic practice of the licensee as circumstances warrant until the licensee demonstrates to the board adequate professional competence. In addition to or in lieu of action taken by the board affecting the license of a licensee, when it is established that the individual has violated this chapter or any regulation promulgated by the board, the board may require the licensee to pay a civil penalty of up to ten thousand dollars to the board and the costs of the disciplinary action. All penalties must be remitted to the State Treasurer for deposit in a special fund from which the State Board of Medical Examiners must be reimbursed for administrative costs for each case upon the approval of the Budget and Control Board. At any time the special fund exceeds twenty thousand dollars, the excess funds must be remitted to the general fund. An action of the board relating to the revocation or suspension of a license or other action either restricting a license or limiting or disciplining a licensee may not be taken until after an initial complaint of misconduct, in writing, has been filed with the board in accordance with regulations promulgated by the board. In subsequently determining whether to approve the issuance of a formal complaint in accordance with regulations promulgated by the board, the board may consult with the Attorney General's office. The Attorney General's office, after investigation, must issue a written recommendation to the board. The board may act upon this written recommendation, but no review of the potential testimony or substantive evidence by the board or a member of the board is permitted. A formal hearing must be held upon thirty days' notice to the complainant and the licensee or their counsel before a panel as provided in Section 40-47-211.

(B)    Upon receipt of the panel's report in accordance with Section 40-47-211, the board must notify the complainant and the licensee and their counsel of the time and place at which the board will consider the report for the purpose of determining its action on the report, and the notice must be given not less than ten days before the meeting. The complainant and the licensee and their counsel have the right to appear before the board at the meeting and to submit briefs and be heard in oral argument in opposition to or in support of the recommendations of the panel. The Attorney General's office has the right to appear before the board and to submit briefs and be heard in oral argument if it has participated in the hearing before the panel.

(C)    Upon consideration of the report of the panel and of the showing made to the board, the board may:

(1)    refer the matter back to the panel for further hearing;

(2)    order a further hearing before the board; or

(3)    proceed upon the certified report of the prior proceedings before the panel.

(D)    Upon its final review, the board may either dismiss the complaint or find that the licensee is guilty of misconduct meriting sanction. In either event, the board must file a final certified report of the proceedings before it with the secretary of the board and the secretary must notify the complainant and the licensee and their counsel of the board's action.

(E)    A decision by the board to revoke, suspend, or restrict a license or to limit or discipline a licensee must be by majority vote of the total membership of the board. A licensee against whom disciplinary action is taken pursuant to this article has the right to judicial review. A disciplinary action is subject to review by an administrative law judge as provided under Article 5 of Chapter 23 of Title 1 upon petition filed by the licensee with an administrative law judge and a copy of the petition served upon the secretary of the board within thirty days from the date of delivery of the board's decision to the licensee. An appeal taken to an administrative law judge as provided under Article 5 of Chapter 23 of Title 1 has precedence on the calendar of an administrative law judge, is considered an emergency appeal if the board has revoked, suspended, or restricted a license for more than six months, and should be heard not later than thirty days from the date the petition is filed. The review is limited to the record established by the board hearing. No stay or supersedeas may be granted pending appeal from a decision by the board to revoke, suspend, or restrict a license for more than six months.

(F)    'Misconduct' which constitutes grounds for revocation, suspension, or restriction of a license or limitation on or discipline of a licensee is a satisfactory showing to the board that the holder of a license:

(1)    has used a false, fraudulent, or forged statement or document or practiced a fraudulent, deceitful, or dishonest act in connection with a licensing requirement;

(2)    has been convicted of, has pled guilty to, or has pled nolo contendere to a felony or other crime involving moral turpitude or drugs. For purposes of this item, "drugs" includes a substance whose possession, use, or distribution is governed by Section 44-53-110 through Section 44-53-580 (Narcotics and Controlled Substances) or which is listed in the current edition of the Physician's Desk Reference;

(3)    is addicted to alcohol or drugs to such a degree as to render the holder unfit to practice medicine or osteopathy;

(4)    has been convicted of the illegal or unauthorized practice of medicine or osteopathy;

(5)    has knowingly performed an act which in any way assists an unlicensed person to practice medicine or osteopathy;

(6)    has sustained a physical or mental disability which renders further practice by the holder dangerous to the public;

(7)    has violated the principles of ethics as adopted by the State Board of Medical Examiners and published in its regulations;

(8)    is guilty of engaging in dishonorable, unethical, or unprofessional conduct that is likely to deceive, defraud, or harm the public;

(9)    is guilty of the use of a false or fraudulent statement in a document connected with the practice of medicine;

(10)    is guilty of obtaining fees or assisting in obtaining fees under dishonorable, false, or fraudulent circumstances;

(11)    has intentionally violated or attempted to violate, directly or indirectly, or is assisting in or abetting the violation of or conspiring to violate the medical practice laws; or

(12)    is guilty of violating the code of medical ethics adopted by the board in accordance with Section 40-47-20 or has been found by the board to lack the ethical or professional competence to practice medicine or osteopathy.

(G)    In addition to all other remedies and actions incorporated in this chapter, the license of a medical or osteopathic physician adjudged mentally incompetent by a court of competent jurisdiction must be automatically suspended by the board until the physician is adjudged by a court of competent jurisdiction or in any other manner provided by law as being restored to mental competency.

(H)    The license of a person who is convicted of or who pleads guilty or nolo contendere to a crime stated in subsection (F) (2) immediately must be suspended temporarily pending final disposition of a disciplinary proceeding to be commenced upon the conviction or the filing of a plea of guilty or nolo contendere. A person suspended under this subsection must be reinstated immediately upon the filing of a certificate that the conviction has been reversed. The reinstatement does not terminate a disciplinary action pending against the person.

(I)    In enforcing subsections (F) (3) and (6) the board upon reasonable grounds may require a licensee or applicant to submit to a mental or physical examination by physicians designated by the board. The results of an examination are admissible in a hearing before the board, notwithstanding a claim of privilege under a contrary rule of law or statute. A person who accepts the privilege of practicing medicine in this State or who files an application for a license to practice medicine in this State is deemed to have consented to submit to a mental or physical examination and to have waived all objections to the admissibility of the results in a hearing before the board upon the grounds that the same constitutes a privileged communication. If a licensee or applicant fails to submit to an examination when properly directed to do so by the board, unless the failure was due to circumstances beyond the person's control, the board shall enter an order automatically suspending or denying the license pending compliance and further order of the board. A licensee or applicant who is prohibited from practicing medicine under this subsection must be afforded at reasonable intervals an opportunity to demonstrate to the board the ability to resume or begin the practice of medicine with reasonable skill and safety to patients.

(J)    In enforcing subsections (F)(3) and (6) the board upon reasonable grounds may obtain records relating to the mental or physical condition of a licensee or applicant including, but not limited to, psychiatric records; and these records are admissible in a hearing before the board, notwithstanding any other provision of law. A person who accepts the privilege of practicing medicine in this State or who files an application to practice medicine in this State is deemed to have consented to the board obtaining these records and to have waived all objections to the admissibility of these records in a hearing before the board upon the grounds that the same constitute a privileged communication. If a licensee or applicant refuses to sign a written consent for the board to obtain these records when properly requested by the board, unless the failure was due to circumstances beyond the person's control, the board shall enter an order automatically suspending or denying the license pending compliance and further order of the board. A licensee or applicant who is prohibited from practicing medicine under this subsection must be afforded at reasonable intervals an opportunity to demonstrate to the board the ability to resume or begin the practice of medicine with reasonable skill and safety to patients.

Section 40-47-201.    Acts or omissions by a licensee causing the denial, revocation, suspension, or restriction of a license to practice medicine in another state will support the issuance of a formal complaint and the commencement of disciplinary proceedings as described in Section 40-47-200 and, if required by law, pursuant to Section 40-47-211. This provision applies only when the disciplinary action taken in another state is based on grounds that would constitute misconduct under Section 40-47-200.

Proof of such acts or omissions may be shown by a copy of the transcript of record of the disciplinary proceedings in another state or a copy of the final order, consent order, or similar order stating the basis for the action taken.

Upon the filing of an initial complaint alleging that the licensee has been disciplined in another state, the licensee must produce for the State Board of Medical Examiners or the Medical Disciplinary Commission of the board, if required by law, copies of all transcripts, documents, and orders used, relied upon, or issued by the licensing authority in the other state. Failure to produce such items within ninety days of the board's or Medical Disciplinary Commission's request for them shall result in the suspension of the individual's license to practice medicine in this State until such time as the items have been supplied to the board or the Medical Disciplinary Commission.

The licensee may present mitigating testimony to the board or the Medical Disciplinary Commission regarding disciplinary action taken in another state or evidence that the acts or omissions committed in another state do not constitute misconduct under Section 40-47-200.

Section 40-47-202.    Any individual found by the board to have engaged in conduct which subverts or attempts to subvert the security or integrity of the medical licensing examination process may, in the discretion of the board, have his scores on the licensing examination withheld or declared invalid, be disqualified from the practice of medicine, or be subjected to the imposition of any other appropriate sanction provided by Section 40-47-200.

Conduct which subverts or attempts to subvert the security or integrity of the medical licensing examination process includes, but is not limited to:

(1)    conduct which violates the security of examination materials, including, but not limited to, the improper reproduction or reconstruction of any portion of the licensing examination; aiding in the improper reproduction or reconstruction of any portion of the licensing examination; or selling, distributing, buying, receiving, or having unauthorized possession of any portion of a future, current, or previously administered licensing examination.

(2)    conduct which violates the standard of test administration, including, but not limited to, improperly communicating with any other examinee during the administration of a licensing examination; copying answers from another examinee or permitting one's own answers to be copied by another examinee during the administration of a licensing examination; or having in one's possession during the administration of a licensing examination any books, notes, other written or printed materials, or data of any kind other than the examination materials or other materials authorized by the board.

(3)    conduct which violates the credentials process, including, but not limited to, falsifying or misrepresenting educational credentials or other information required for admission to the licensing examination, impersonating an examinee, or having an impersonator take the licensing examination in one's behalf.

Section 40-47-210.    For the purpose of any investigation or proceeding under the provisions of this article, the board or any person designated by it may administer oaths and affirmations, subpoena witnesses, take evidence, and require the production of any documents or records which the board deems relevant to the inquiry. In the case of contumacy by, or refusal to obey a subpoena issued to any person, an administrative law judge as provided under Article 5 of Chapter 23 of Title 1, may issue an order requiring the person to appear before the board or the person designated by it and produce documentary evidence and to give other evidence concerning the matter under inquiry.

Whenever the board has reason to believe that any person is violating or intends to violate any provision of this article, it may, in addition to all other remedies, order such person to immediately desist and refrain from such conduct. The board may apply to an administrative law judge as provided under Article 5 of Chapter 23 of Title 1 for an injunction restraining the person from such conduct. An administrative law judge may issue a temporary injunction ex parte, and upon notice and full hearing may issue any other order in the matter it deems proper. No bond shall be required of the board by an administrative law judge as a condition to the issuance of any injunction or order contemplated by the provisions of this section.

Section 40-47-211.    There is created the Medical Disciplinary Commission of the State Board of Medical Examiners to be composed of thirty-six members. The members of the commission must be licensed physicians practicing their profession, and five commissioners must be elected from each of the six congressional districts, and six members of the commission must be elected at large from across the State. The board shall conduct the elections, and the elections shall provide for participation by any physician currently licensed and actively practicing medicine in South Carolina and residing in the congressional district in which the election is held. At-large members must be currently licensed and actively practicing medicine in South Carolina and must reside within the State at the time of election and throughout their term. One commissioner initially elected from each district shall serve for a term of one year and until his successor is elected and qualifies, one commissioner initially elected from each district shall serve for a term of two years and until his successor is elected and qualifies, and one commissioner initially elected from each district shall serve for a term of three years and until his successor is elected and qualifies. The successors of the initial commissioners shall serve for terms of three years or until their successors are elected and qualify. The members of the commission are limited to three terms. The members appointed to the board may not simultaneously serve as a commissioner. In case of any vacancy by way of death, resignation, or otherwise, the board shall appoint a successor to serve for the unexpired term. Where justice, fairness, or other circumstances so require, the board may appoint past commissioners to hear complaints in individual cases.

The commission is empowered to investigate and hear those complaints against physicians (medical and osteopathic) filed with the board pursuant to Section 40-47-200. The hearing must be conducted in accordance with Act 176 of 1977 (Administrative Procedures Act) and with regulations promulgated by the board and must be before a panel composed of at least three commissioners designated by the board. The panel is empowered to hear the matters complained of and to make findings of fact and recommendations as to disposition of those matters to the board. The panel shall make a certified report of the proceedings before it, including its findings of fact, conclusions, and recommendations, which must be filed together with a transcript of the testimony taken and exhibits as may have been in evidence before it with the administrator of the board, and a copy of the report must be delivered to the office of general counsel and the licensee or his counsel.

Section 40-47-212.    Every communication, whether oral or written, made by or on behalf of any person, firm or corporation to the Board or any person designated by it to investigate or otherwise hear matters relating to the revocation, suspension or other restriction on a license or the limitation on or other discipline of a licensee, whether by way of complaint or testimony, shall be privileged; and no action or proceeding, civil or criminal, shall lie against any such person, firm or corporation by or on whose behalf such communication shall have been made by reason thereof, except upon proof that such communication was made with malice.

No part of this article shall be construed as prohibiting the respondent or his legal counsel from exercising the respondent's constitutional right of due process under the law, nor to prohibit the respondent from normal access to the charges and evidence filed against him as a part of due process under the law.

Section 40-47-213.    No person connected with any complaint, investigation, or other proceeding before the board, including, but not limited to, any witness, counsel, counsel's secretary, board member, board employee, court reporter, or investigator, may mention the existence of the complaint, investigation, or other proceeding, disclose any information pertaining to the complaint, investigation, or other proceeding, or discuss any testimony or other evidence in the complaint, investigation, or other proceeding, except to persons involved and having a direct interest in the complaint, investigation, or other proceeding, and then only to the extent necessary for the proper disposition of the complaint, investigation, or other proceeding. However, whenever the board receives information in any complaint, investigation, or other proceeding before it indicating a violation of state or federal law, the board may provide that information, to the extent the board considers necessary, to the appropriate state or federal law enforcement agency or regulatory body. Nothing contained in this section may be construed so as to prevent the board from making public a copy of its final order in any proceeding as authorized or required by law.

Section 40-47-230.    The Board shall keep a record of all the proceedings thereof and also a record or register of all applicants for a license, together with their ages, the time spent in the study of medicine and the names and locations of all institutions granting such applicants' degrees or certificates of lectures in medicine or surgery. Such books and register shall be prima facie evidence of all the matters therein recorded.

Section 40-47-240.    This article shall not apply to surgeons of the United States Army, Navy or public health service, practicing in the discharge of their official duties as such, nor to physicians or surgeons of other states or territories in actual consultation with a licensed physician or surgeon of this State, nor shall it be construed to apply to or to change the laws relating to dentists, trained nurses, pharmaceutists, opticians and optometrists or midwives.

Section 40-47-250.    Any practitioner of medicine or surgery or any branch or specialty thereof, within the meaning of this article, failing to comply with the requirements of this article shall not (a) be exempt from jury or military duty, (b) be permitted to collect any fees or charges for services rendered, (c) be allowed to testify as a medical or surgical expert in any court in this State, execute any certificate as a physician or surgeon, or hold any medical office or be recognized by the State or any county or municipal corporation as a physician or surgeon or (d) be entitled to enjoy any of the privileges, rights or exemptions granted to physicians or surgeons by the laws of this State.

Section 40-47-255.    The Chairman of the State Board of Medical Examiners or his designee from the board shall serve as an advisory nonvoting member of the State Board of Nursing to provide consultation on matters requested by such board. The Board of Nursing shall be required to send written notice of meetings that it wants the member representing the Board of Medical Examiners to attend at least ten days prior to the meeting date. Such member and the Board of Nursing shall meet at least twice a year, and thereafter as necessary.

Section 40-47-260.    It shall be unlawful for any person in this State to practice medicine or osteopathy, within the meaning of this article, in violation of the provisions of this article, and anyone violating any provisions thereof shall, upon conviction by any court of competent jurisdiction, be fined not more than one thousand dollars or imprisoned for a period of not more than two years, or both, in the discretion of the court. Each violation shall constitute a separate offense. The provisions of this section shall apply to any corporation, association or person aiding or abetting in any violation of this article.

Section 40-47-270.    No more than one hundred seventy doctors of osteopathy shall be issued certificates to practice within five years of July 14, 1969.

Section 40-47-5.    Unless otherwise provided for in this chapter, Article 1, Chapter 1, Title 40 applies to the profession or business regulated pursuant to this chapter. However, if there is a conflict between this chapter and Article 1, Chapter 1, Title 40, the provisions of this chapter control.

Section 40-47-10.    (A)    There is created the State Board of Medical Examiners to be composed of eleven members, two of whom must be lay members, one of whom must be a doctor of osteopathic medicine, two of whom must be physicians from the State at large, and six of whom must be physicians representing each of the six congressional districts. All members of the board must be residents of this State, and each member representing a congressional district shall reside in the district the member represents. All physician members of the board must be licensed by the board, must be without prior disciplinary action or conviction of a felony or other crime of moral turpitude, and must be practicing their profession in South Carolina. All lay members of the board must hold a baccalaureate degree or higher, may not have a conviction of a felony or other crime of moral turpitude, and must not be employed or have a member of their immediate family employed in a health or medically related field.

(1)    The members of the board shall serve for terms of four years or until their successors are appointed and qualify.

(2)    All members of the board have full voting rights.

(3)    The two lay members and one physician from the State at large must be appointed by the Governor, with the advice and consent of the Senate. The board shall conduct an election to nominate one physician from the State at large. The election must provide for participation by all physicians currently permanently licensed and residing in South Carolina. To nominate the physicians who will represent the six congressional districts the board shall conduct an election within each district. These elections must provide for participation by all permanently licensed physicians residing in the particular district. The board shall conduct an election to nominate the doctor of osteopathic medicine from the State at large, and this election must provide for participation by a physician currently permanently licensed in South Carolina as a doctor of osteopathic medicine. The board shall certify in writing to the Governor the results of each election. The Governor may reject any of the nominees upon satisfactory showing of the unfitness of those rejected. If the Governor declines to appoint any of the nominees submitted, additional nominees must be submitted in the same manner following another election. Vacancies must be filled in a like manner by appointment by the Governor, with the advice and consent of the Senate, for the unexpired portion of the term.

(4)    Vacancies which occur during the recess of the Senate may be filled by an interim appointment of the Governor in the manner provided by Section 1-3-210.

(B)    Public and lay members of boards and panels must be appointed in accordance with Section 40-1-45.

(C)    Board members and persons authorized by the board to engage in business for the board must be compensated for their services at the usual rate for mileage, subsistence, and per diem as provided by law for members of state boards, committees, and commissions and may be reimbursed for actual and necessary expenses incurred in connection with and as a result of their work as members or persons acting on behalf of the board.

(D)    The board annually shall elect from among its members a chairman, vice-chairman, secretary, and other officers as the board determines necessary. The board may adopt rules and regulations reasonably necessary for the performance of its duties and the governance of its operations and proceedings, for the practice of medicine, for judging the professional and ethical competence of physicians including a code of medical ethics, and for the discipline of persons licensed or otherwise authorized to practice pursuant to this chapter.

(E)    The board shall meet at least four times a year and at other times upon the call of the chair or a majority of the board.

(F)    A majority of the members of the board constitutes a quorum; however, if there is a vacancy on the board, a majority of the members serving constitutes a quorum.

(G)    A board member is required to attend meetings or to provide proper notice and justification of inability to do so. Unexcused absences from meetings may result in removal from the board as provided for in Section 1-3-240.

(H)    The Governor may remove a member of the board pursuant to Section 1-3-240. Vacancies on the board must be filled for the unexpired portion of the term in the manner of the original appointment or election.

(I)    The chairman of the State Board of Medical Examiners, or the chairman's designee, shall serve as an advisory nonvoting member of the State Board of Nursing to provide consultation on matters requested by the State Board of Nursing. The Board of Nursing shall send written notice at least ten days before meetings that the Board of Nursing wants the chairman or designee of the State Board of Medical Examiners to attend. The chairman of the State Board of Medical Examiners, or the chairman's designee, and the State Board of Nursing shall meet at least twice a year and more often as necessary.

(J)    In addition to the powers and duties enumerated in Section 40-1-70, the board may:

(1)    publish advisory opinions and position statements relating to practice procedures or policies authorized or acquiesced to by any agency, facility, institution, or other organization that employs persons authorized to practice pursuant to this chapter to comply with acceptable standards of practice;

(2)    develop minimum standards for continued competency of licensees continuing in or returning to practice;

(3)    adopt rules governing the proceedings of the board and may promulgate regulations for the practice of medicine and as necessary to carry out the provisions of this chapter;

(4)    conduct hearings concerning alleged violations of this chapter;

(5)    use minimum standards as a basis for evaluating safe and effective medical practice;

(6)    license and renew the authorizations to practice of qualified applicants;

(7)    approve temporary licenses, limited licenses, and other authorizations to practice in its discretion as it considers in the public interest;

(8)    join organizations that develop and regulate the national medical licensure examinations and promote the improvement of the practice of medicine for the protection of the public;

(9)    collect information the board considers necessary, including social security numbers or alien identification numbers, in order to report disciplinary actions to national databanks of disciplinary information as otherwise required by law;

(10)    establish guidelines to assist employers of licensees when errors in practice can be handled through corrective action in the employment setting; and

(11)    establish an initial fee schedule in regulations.

Section 40-47-11.    (A)    There is created the Medical Disciplinary Commission of the State Board of Medical Examiners to be composed of thirty-six physician members appointed by the board and twelve lay members appointed by the Governor. The physician members of the commission must be licensed physicians practicing their profession, and they must be without prior disciplinary action or conviction of a felony or other crime of moral turpitude. All lay members of the board must hold a baccalaureate degree or higher, may not have a conviction of a felony or other crime of moral turpitude, and must not be employed or have a member of their immediate family employed in a health or medically related field. Five physician commissioners must be appointed from each of the six congressional districts in which they reside, and six physician members of the commission must be appointed at large from across the State. At-large members must be currently licensed and actively practicing medicine in South Carolina and must reside within the State at the time of appointment and throughout their term. One physician commissioner initially appointed from each district shall serve for a term of one year and until a successor is appointed and qualified. One physician commissioner initially appointed from each district shall serve for a term of two years and until a successor is appointed and qualified. One physician commissioner initially appointed from each district shall serve for a term of three years and until a successor is appointed and qualified. The successors of the initial physician commissioners shall serve for terms of three years or until their successors are appointed and qualified. The members of the commission are limited to three consecutive terms. Members appointed to the board may not serve simultaneously as commissioners. In case of a vacancy by way of death, resignation, or otherwise, the board shall appoint a successor to serve for the unexpired term. Where justice, fairness, or other circumstances so require, the board may appoint past commissioners to hear complaints in individual cases.

(B)    The commission is empowered to hear those formal complaints filed against practitioners authorized to practice pursuant to this chapter, unless otherwise provided in this chapter. The hearing must be conducted in accordance with Act 176 of 1977, Administrative Procedures Act, and with regulations promulgated by the board and must be before a panel composed of not more than three physician commissioners and one lay commissioner. The panel is empowered to hear the matters complained of and to make recommendations as to findings of fact and conclusions of law to the board. The panel shall make a certified report of the proceedings before it, including its findings of fact, conclusions of law, and mitigating and aggravating circumstances for consideration by the board in rendering a final decision, and file the report with the department.

(C)    The physician members of the commission may serve as expert reviewers and witnesses in investigations and proceedings pursuant to this chapter. A physician commissioner who serves as an expert reviewer or witness in an investigation or proceeding may not serve on the hearing panel for that particular matter or related matters.

Section 40-47-20.    In addition to the definitions provided in Section 40-1-20, as used in this chapter unless the context indicates otherwise:

(1)    'Active license' means the status of an authorization to practice that has been renewed for the current period and authorizes the licensee to practice in this State.

(2)    'Adverse disciplinary action' means a final decision by a United States or foreign licensing jurisdiction, a peer review group, a health care institution, a professional or medical society or association, or a court, which action was not resolved completely in the licensee's favor.

(3)    'Agreed to jointly' means the agreement by the Board of Nursing and Board of Medical Examiners on delegated medical acts which nurses perform and which are promulgated by the Board of Nursing in regulation.

(4)    'Approved written protocols' means specific statements developed collaboratively by the physician or the medical staff and the advanced practice registered nurse (NP, CNM, or CNS) that establish physician delegation for medical aspects of care, including the prescription of medications.

(5)    'Approved written scope of practice guidelines' means specific statements developed by a physician or the medical staff and a physician assistant that establishes physician delegation for medical aspects of care, including the prescription of medications.

(6)    'Board' means the State Board of Medical Examiners for South Carolina.

(7)    'Board-approved credentialing organization' means an organization that offers a certification examination in a specialty area of practice, establishes scope and standards of practice statements, and provides a mechanism for evaluating continuing competency in a specialized area of practice which has been approved by the board.

(8)    'Business days' means every day except Saturdays, Sundays, and legal holidays.

(9)    'Cancellation' means the withdrawal or invalidation of an authorization to practice that was issued to an ineligible person either in error or based upon a false, fraudulent, or deceptive representation in the application process.

(10)    'Certification' means approval by an established body, other than the board, but recognized by the board, that recognizes the unique, minimal requirements of specialized areas of practice. Certification requires completion of a recognized formal program of study and specialty board examination, if the specialty board exists, and certification of competence in practice by the certifying agency.

(11)    'Criminal history' means a federal, state, or local criminal history of conviction or a pending charge or indictment of a crime, whether a misdemeanor or a felony, that bears upon a person's fitness or suitability for an authorization to practice with responsibility for the safety and well-being of others.

(12)    'Delegated medical acts' means additional acts delegated by a physician or dentist to a physician assistant, advanced practice registered nurse as defined in Title 40 of Chapter 33, respiratory care practitioner, anesthesiologist's assistant, or other practitioner authorized by law and may include, but is not limited to, formulating a medical diagnosis and initiating, continuing, and modifying therapies, including prescribing drug therapy, under approved written scope of practice guidelines or approved written protocols as provided by law in accordance with the applicable scope of professional practice. Delegated medical acts to advanced practice registered nurses must be agreed to jointly by both the Board of Nursing and the Board of Medical Examiners. Delegated medical acts must be performed under the general supervision of a physician or dentist who must be readily or immediately available for consultation in accordance with the applicable scope of professional practice.

(13)    'DHEC' means S.C. Department of Health and Environmental Control.

(14)    'Dentist' means a dentist licensed by the South Carolina Board of Dentistry.

(15)    'Disciplinary action' means a final decision and sanction imposed at the conclusion of a disciplinary proceeding.

(16)    'Entity' means a sole proprietorship, partnership, limited liability partnership, limited liability corporation, association, joint venture, cooperative, company, corporation, or other public or private legal entity authorized by law.

(17)    'Final decision' means an order of the board that concludes a license application proceeding or formal disciplinary proceeding.     (18)    'Formal complaint' means a formal written complaint charging misconduct by a respondent in violation of this chapter, Chapter 1 of Title 40, or other provision of law.

(19)    'Inactive license' means the official temporary retirement of a person's authorization to practice upon the person's notice to the board that the person does not wish to practice.

(20)    'Incompetence' means the failure of a licensee to demonstrate and apply the knowledge, skill, and care that is ordinarily possessed and exercised by other practitioners of the same licensure status and required by the generally accepted standards of the profession. Charges of incompetence may be based upon a single act of incompetence or upon a course of conduct or series of acts or omissions that extend over a period of time and that, taken as a whole, demonstrate incompetence. It is not necessary to show that actual harm resulted from the act or omission or series of acts or omissions if the conduct is such that harm could have resulted to the patient or to the public from the act or omission or series of acts or omissions.

(21)    'Initial complaint' means a brief statement which alleges misconduct on the part of a licensee.

(22)    'Initial licensure' means the first authorization to practice issued to a person by a licensing authority in this State or any other state.

(23)    'Lapsed license' means an authorization to practice that no longer authorizes practice in this State due to the person's failure to renew the authorization within the renewal period.

(24)    'Letter of caution or concern' means a written caution or warning about past or future conduct issued when it is determined that no misconduct has been committed. The issuance of a letter of caution or concern is not a form of discipline and does not constitute a finding of misconduct. The fact that a letter of caution or concern has been issued must not be considered in a subsequent disciplinary proceeding against a person authorized to practice unless the caution or warning contained in the letter of caution or concern is relevant to the misconduct alleged in the proceedings.

(25)    'License' means a current document authorizing a person to practice.

(26)    'Licensed in good standing' means that one's authorization to practice has not been revoked and there are no restrictions or limitations currently in effect. Public reprimands issued less than five years from the date an application is received by the board are considered restrictions upon practice.

(27)    'Limited license' means a current time-limited and practice-limited document that authorizes practice at the level for which one is seeking licensure.

(28)    'Misconduct' means violation of any of the provisions of this chapter or regulations promulgated by the board pursuant to this chapter or violation of any of the principles of ethics as adopted by the board or incompetence or unprofessional conduct.

(29)    'Osteopathic medicine' means a complete school of medicine and surgery utilizing all methods of diagnosis and treatment in health and disease and placing special emphasis on the interrelationship of the musculo-skeletal system to all other body systems.

(30)    'Pending disciplinary action' means an action or proceeding initiated by a formal complaint.

(31)    'Person' means a natural person, male or female.

(32)    'Physician' means a doctor of medicine or doctor of osteopathic medicine licensed by the South Carolina Board of Medical Examiners.

(33)    'Practice of Medicine' means:

(a)    advertising, holding out to the public or represent in any manner that one is authorized to practice medicine in this State;

(b)    offering or undertaking to prescribe, order, give, or administer a drug or medicine for the use of another person;

(c)    offering or undertaking to prevent or to diagnose, correct, or treat, in any manner, or by any means, methods, or devices, disease, illness, pain, wound, fracture, infirmity, defect or abnormal physical or mental condition of a person, including the management or pregnancy and parturition;

(d)    offering or undertaking to perform a surgical operation upon a person;

(e)    rendering a written or otherwise documented medical opinion concerning the diagnosis or treatment of a patient or the actual rendering of treatment to a patient within a state by a physician located outside the state as a result of transmission of individual patient data by electronic or other means from within a state to the physician or his or her agent;

(f)    rendering a determination of medical necessity or a decision affecting the diagnosis or treatment of a patient;

(g)    using the designation Doctor, Doctor of Medicine, Doctor of Osteopathic Medicine, Physician, Surgeon, Physician and Surgeon, Dr., M.D., D.O., or any combination of these in the conduct of any occupation or profession pertaining to the prevention, diagnosis, or treatment of human disease or condition unless the designation additionally contains the description of another branch of the healing arts for which one holds a valid license in this State that is applicable to the clinical setting; and

(h)    testifying as a physician in an administrative, civil, or criminal proceeding in this State by expressing an expert medical opinion.

(34)    'Practitioner' means a person who has been issued an authorization to practice in this State. The term does not include persons who have not been issued a license, registration, certification, or other authorization to practice in South Carolina, except as provided by law for persons licensed in another state or jurisdiction.

(35)    'Presiding officer' means the chairman of the hearing panel or designee. When no chair of the hearing panel has been designated, the term includes the chairman or vice-chairman of the board or designee. A person designated to act on behalf of the chairman of the board or a hearing panel must not have been involved with the investigation or prosecution of the particular matter.

(36)    'Private reprimand' means a statement by the board that misconduct was committed by a person authorized to practice which has been declared confidential and which is not subject to disclosure as a public document.

(37)    'Probation' means the issuance of an authorization to practice conditioned upon compliance with terms and conditions imposed by a licensing board in this State or another state. The holder of the authorization to practice on probation may petition the board for reinstatement to full, unrestricted practice upon compliance with all terms and conditions imposed by the board.

(38)    'Public reprimand' means a publicly available statement of the board that misconduct was committed by a person authorized to practice.

(39)    'Reactivation' means the restoration to active status of an authorization from inactive status.

(40)    'Readily available' means the physician must be in near proximity and is able to be contacted either in person or by telecommunications or other electronic means to provide consultation and advice to the practitioner performing delegated medical acts. When application is made for more than three NP's, CNM's, or CNS's, to practice with one physician, or when a NP, CNM, or CNS is performing delegated medical acts in a practice site greater than forty-five miles from the physician, the Board of Nursing and Board of Medical Examiners shall each review the application to determine if adequate supervision exists.

(41)    'Reinstatement' means an action of the board in a disciplinary matter that authorizes the resumption of practice upon any terms or conditions ordered or agreed to by the board.

(42)    'Relinquish' means to permanently cancel or invalidate an authorization instead of disciplinary proceedings or final decision by the board. A person whose authorization to practice has been relinquished to the board is permanently ineligible for a license or other authorization of any kind from the board. Relinquishment is irrevocable, an admission of any or all of the allegations of misconduct, and reported and treated as a permanent revocation.

(43)    'Respondent' means a person charged with responding in a disciplinary or other administrative action.

(44)    'Revocation' means the permanent cancellation or withdrawal of an authorization issued by the board. A person whose authorization has been revoked permanently by the board is permanently ineligible for an authorization of any kind from the board.

(45)    'Significant disciplinary action' means a public decision in a disciplinary matter that involves substantial issues of professional or ethical competence or qualification to practice. The board, in its discretion, may consider actions taken by the original board or conduct relevant to the applicant's fitness for licensure to practice in this State.

(46)    'State Identification Bureau' means an authorized governmental agency responsible for receiving and screening the results of criminal history records checks in this State or another state.

(47)    'Supervision' means the process of critically observing, directing, and evaluating another person's performance, unless otherwise provided by law.

(48)    'Suspension' means the temporary withdrawal of authorization to practice for either a definite or indefinite period of time ordered by the board. The holder of a suspended authorization to practice may petition the board for reinstatement to practice upon compliance with all terms and conditions imposed by the board.

(49)    'Temporary license' means a current, time-limited document that authorizes practice at the level for which one is seeking licensure.

(50)    'Unprofessional conduct' means acts or behavior that fail to meet the minimally acceptable standard expected of similarly situated professionals including, but not limited to, conduct that may be harmful to the health, safety, and welfare of the public, conduct that may reflect negatively on one's fitness to practice, or conduct that may violate a provision of the code of ethics adopted by the board or a specialty.

(51)    'Voluntary surrender' means forgoing the authorization to practice by the subject of an initial or formal complaint pending further order of the board. It anticipates other formal action by the board and allows a suspension subsequently imposed to include this time.

(52)    'Volunteer license' means authorization of a retired practitioner to provide medical services to others through an identified charitable organization without remuneration.

Section 40-47-25.    Osteopathic physicians and surgeons licensed pursuant to this chapter shall have the same rights and privileges as physicians and surgeons of other schools of medicine with respect to the treatment of cases, hospital privileges, and the holding of health offices or offices of public institutions. Physicians and surgeons licensed pursuant to this chapter must be licensed to practice medicine in all its branches regardless of whether the physician holds an M.D. or D.O. degree and has passed the USMLE or COMLEX-USA examination sequence, or graduated from a college accredited by the Liaison Committee on Medical Education (LCME) or the AOA Commission on Osteopathic College Accreditation (COCA), or successfully completed post-graduate training from ACGME- or AOA-approved programs, or obtained ABMS or AOA board certification, or on the basis of his or her race, color, creed, religion, sex, or national origin.

Section 40-47-30.    (A)    A person may not practice medicine in the State unless the person is twenty-one years of age and has been authorized to do so pursuant to the provisions of this article. Nothing in this article may be construed to:

(1)    prohibit service in cases of emergency or the domestic administration of family remedies;

(2)    apply to those who practice the religious tenets of their church without pretending a knowledge of medicine if the laws, rules, and regulations relating to contagious diseases and sanitary matters are not violated;

(3)    prohibit licensed druggists from selling, using, and dispensing drugs in their places of business, respectively;

(4)    allow under any circumstances, physician assistants or optometrists' assistants to make a refraction for glasses or give a contact lens fitting;

(5)    prohibit a licensed physician from delegating tasks to unlicensed personnel in the physician's employ and on the premises if:

(a)    the task is of a routine nature involving neither the special skill of a licensed person nor significant risk to the patient if improperly done;

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

(c)    the task does not involve the verbal transmission of a physician's order or prescription to a licensed person if the licensed person requires the order or prescription to be in writing; and

(d)    the unlicensed person wears an appropriate badge denoting to a patient the person's status. The unlicensed person shall wear a clearly legible identification badge or other adornment at least one inch by three inches in size bearing the person's first name at a minimum and staff position. The identification badge must be worn in a manner so that it is clearly visible to patients at all times;

(6)    prohibit the practice of a legally qualified licensee of another state who is employed by the United States Government or any department, bureau, division, or agency thereof, while in the discharge of official duties;

(7)    prohibit students while engaged in training in a medical school approved by the board; or

(8)    prohibit those practicing dentistry, nursing, optometry, podiatry, psychology, or another of the healing arts in accordance with state law.

(B)(1)    A physician licensed in another state, territory, or other jurisdiction of the United States or of any other nation or foreign jurisdiction is exempt from the requirements of licensure in this State, if the physician:

(a) holds an active license to practice in the other jurisdiction;

(b)    engages in the active practice of medicine in the other jurisdiction; and

(c)    is employed or designated as the team physician by an athletic team visiting the State for a specific sporting event.

(2)    A physician's practice pursuant to this section is limited to the members, coaches, and staff of the team by which the physician is employed or designated. A physician practicing in this State pursuant to this section does not have practice privileges in a licensed health care facility and is not authorized to issue orders or prescriptions or to order testing at a medical facility in this State.

Section 40-47-31.    (A)    Limited licenses may be issued for postgraduate medical residency training or for employment with a state agency, as approved by the board. A limited license entitles the licensee to apply for individual controlled substance registration through DHEC. Each limited license is valid for one year or part of one year. Renewal may be considered upon approval of the board. A special limited license also may be issued to a physician licensed in another state for up to fourteen days not more than four times per year in order to authorize practice under supervision for training involving direct patient care or to explore potential employment relationships.

(B)    Applicants for a limited license for medical residency training who are graduates of an approved medical school located in the United States or Canada must complete and submit an application and the appropriate application fee. A completed application must include the following:

(1)    a copy of a contract where the applicant has been offered a position in a medical residency training program or a fellowship or a letter from the institution stating the applicant has been recommended for a medical residency training program or a fellowship. The recommendation letter must be addressed and mailed directly to the board office from the institution;

(2)    a certification of medical education form approved by the board to be completed by the dean, the president, or the registrar of the applicant's medical school or as approved by the board;

(3)    a supervising physician form approved by the board to be completed by the chairman or residency director of the training program;

(4)    letters of recommendation from licensed physicians recommending the applicant for a limited license in this State; and

(5)    verification of licensure in other states, if applicable.

(C)    Applicants for limited license for medical residency training who are graduates of medical schools located outside the United States or Canada may be considered on an individual basis. These applicants shall complete and submit an application and the appropriate application fee. In addition to all other requirements, a completed application must include a copy of a current or permanent Educational Commission for Foreign Medical Graduates (ECFMG) certificate or documentation of successful completion of a Fifth Pathway program. This requirement may be waived, in the board's discretion, if the applicant has a full-time academic faculty appointment at the rank of assistant professor or greater in a medical school in South Carolina accredited by American Council for Graduate Medical Education (ACGME) or American Osteopathic Association (AOA). This requirement also may be waived if the applicant:

(1)    has been licensed for five years or more without significant disciplinary action; and

(2)    holds current certification by a specialty board recognized by the American Board of Medical Specialties, the American Osteopathic Association, or other organization approved by the board.

(D)    Physicians in medical residency training programs in South Carolina may apply for a permanent license at least ninety days before their limited license expires. No parts of a limited license application may be applied to an application for a permanent license. Each application is filed separately.

(E)    No new applications for a limited license for employment with a state agency are authorized after January 1, 2001. Current holders of a limited license for employment with a state agency may be renewed if no change of agency has occurred. A change in agency may be approved upon presentation to the board of a copy of a contract in which they have been offered a position within the South Carolina Department of Corrections, the South Carolina Department of Health and Environmental Control, the South Carolina Department of Mental Health, or the South Carolina Department of Disabilities and Special Needs.

(F)    A special limited license may be issued to a physician licensed in another state to authorize practice under supervision for training involving direct patient care or to explore potential employment relationships. The applicant shall submit the following items:

(1)    a completed application and payment of applicable fees; and

(2)    a documentation from the supervising physician relating the purpose and dates requested.

(G)    A temporary license may be issued to an applicant who has met all requirements for the issuance of a permanent license, except final verifications as may be required. A temporary license is valid for three months or more, if approved by the board. Renewal may be considered upon approval of the board.

(H)    The board may not issue a limited or temporary license to a licensed physician of another state of the United States:

(1)    whose license is currently revoked, suspended, restricted in any way, or on probationary status in that state; or

(2)    who currently has disciplinary action pending in any state.

Section 40-47-32.    Requirements for a permanent license to practice medicine in South Carolina include the following educational, examination, postgraduate medical residency training and other requirements:

(1)    With respect to the educational requirements for licensure, applicants must document to the satisfaction of the board graduation from a:

(a)    medical school located in the United States or Canada which is accredited by the Liaison Committee on Medical Education (LCME) or other accrediting body approved by the board;

(b)    school of osteopathic medicine located in the United States or Canada accredited by the Commission on Osteopathic College Accreditation or other accrediting body approved by the board; or

(c)    medical school located outside the United States or Canada. These graduates shall:

(i)(A)    possess a permanent Standard Certificate from the Education Commission on Foreign Medical Graduates (ECFMG); and

(B)    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 graduates who have been licensed in another state for ten years or more need only document one year of postgraduate residency training approved by the board; or

(ii)(A)    document successful completion of a Fifth Pathway Program; and

(B)    completion of a minimum of three years progressive postgraduate medical residency training in the United States approved by the ACGME, AOA, or postgraduate training in Canada approved by the Royal College of Physicians and Surgeons or be board eligible or board certified by a specialty board recognized by the American Board of Medical Specialties (ABMS), the AOA, or other organization approved by the board.

Notwithstanding other provisions, the ECFMG or Fifth Pathway requirement may be waived at the discretion of the board if the applicant is to have full-time academic faculty appointment at the rank of Assistant Professor or greater at a medical school in South Carolina.

(2)    With respect to the examination requirements for licensure, applicants shall document to the satisfaction of the board successful completion of:

(a)    all parts of the National Board of Medical Examiners Examination in approved sequence;

(b)    all parts of the National Board of Osteopathic Medical Examiners Examination in approved sequence;

(c)    the Federation Licensing Exam (FLEX) based on standards established by the board;

(d)    the United States Medical Licensing Examination (USMLE) based on standards established by the board;

(e)    the Medical Council of Canada Qualifying Examination (MCCQE) Examination in approved sequence;

(f)    the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA);

(g)    a written state examination of another state medical, osteopathic, or composite board prior to 1976, and current certification by a specialty board recognized by the American Board of Medical Specialties, the American Osteopathic Association, or other organization approved by the board; or

(h)    combinations of the FLEX, National Board of Medical Examiners, and USMLE acceptable to the Composite Committee of the USMLE and approved by the board. These combinations are accepted only if taken prior to 1999.

(3)    In addition to meeting all other licensure requirements, an applicant shall pass the Special Purpose Examination (SPEX) or the Composite Osteopathic Variable-Purpose Examination (COMVEX), unless the applicant can document within ten years of the date of the filing of a completed application to the board one of the following:

(a)    National Board of Medical Examiners examination;

(b)    National Board of Osteopathic Medical Examiners examination;

(c)    FLEX;

(d)    USMLE;

(e)    MCCQE;

(f)    SPEX;

(g)    COMVEX;

(h)    COMLEX-USA;

(i)    ECFMG;

(j)    certification, recertification, or a certificate of added qualification examination by a specialty board recognized by either the American Board of Medical Specialties (ABMS), the American Osteopathic Association (AOA), or other organization approved by the board; or

(k)    maintenance of certification by a specialty board recognized by either the American Board of Medical Specialties (ABMS), the American Osteopathic Association (AOA), or other organization approved by the board, as evidenced by having acquired one hundred fifty hours of Category I continuing medical education approved by the American Medical Association or American Osteopathic Association, as appropriate, and the specialty board of the applicant during the three years preceding the date of application.

(4)    The additional examination requirement set forth in item (3) must be waived if the applicant is to practice in a position within the South Carolina Department of Corrections, South Carolina Department of Health and Environmental Control, South Carolina Department of Mental Health, or the South Carolina Department of Disabilities and Special Needs. A license issued pursuant to this waiver immediately is invalid if the individual leaves that position or acts outside the scope of employment within the department. A change in agency may be approved upon presentation to the board of a copy of a contract in which they have been offered a position within the South Carolina Department of Corrections, the South Carolina Department of Health and Environmental Control, the South Carolina Department of Mental Health, or the South Carolina Department of Disabilities and Special Needs.

(5)    In addition to the following standards, the board shall establish minimum standards of performance to be attained on examinations for an applicant to qualify for a license:

(a)    For FLEX examinations taken before June 1, 1985, the following standards apply:

(i)    An applicant for permanent licensure shall obtain, in one sitting, a FLEX weighted average score of at least seventy-five on the examination.

(ii)    FLEX examinations taken before June 1, 1985, were administered in three days and each day was referred to as Day 1, Day 2, and Day 3. In case of failure, the results of the first three takings of each day will be considered by the board. The board has discretion whether to consider the results from a fourth taking of any day. It is the burden of the applicant to present special and compelling circumstances why a result from a fourth taking should be considered. These circumstances may include, but are not limited to, the applicant's additional medical education or training, the applicant's score on the third taking or other special or compelling circumstances. Under no circumstances may the board consider results received after the fourth taking of Day 1, Day 2, or Day 3, except that a subsequent taking may be considered by the board, in its discretion, for an applicant who holds a current certification, recertification, or a certificate of added qualification by a specialty board recognized by the ABMS, AOA, or other organization approved by the board.

(b)    For FLEX examinations taken after June 1, 1985, the following standards apply:

(i)    An applicant for permanent licensure shall obtain a score of seventy-five or more on both Component I and Component II. An applicant shall pass both components within five years of the first taking of a component of this examination.

(ii)    FLEX examinations taken after June 1, 1985, were administered as Component 1 and Component 2. In case of failure, the results of the first three takings of each component will be considered by the board. The board has discretion whether to consider the results from a fourth taking of any component. It is the burden of the applicant to present special and compelling circumstances why a result from a fourth taking should be considered. These circumstances may include, but are not limited to, the applicant's additional medical education or training, the applicant's score on the third taking or other special or compelling circumstances. Under no circumstances may the board consider results received after the fourth taking of Component 1 or Component 2, except that a subsequent taking may be considered by the board, in its discretion, for an applicant who holds a current certification, recertification, or a certificate of added qualification by a specialty board recognized by the ABMS, AOA, or other organization approved by the board.

(c)    For the United States Medical Licensing Examination (USMLE), the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA), or the Medical Council of Canada Qualifying Examination (MCCQE), the applicant shall pass all steps within ten years of passing the first taken step. The results of the first three takings of each step examination will be considered by the board. The board has discretion whether to consider the results from a fourth taking of any step. It is the burden of the applicant to present special and compelling circumstances why a result from a fourth taking should be considered. These circumstances may include, but are not limited to, the applicant's additional medical education or training, the applicant's score on the third taking or other special or compelling circumstances. Under no circumstances may the board consider results received after the fourth taking of any step, except that a subsequent taking may be considered by the board, in its discretion, for applicants who currently hold certification, recertification, or a certificate of added qualification by a specialty board recognized by the ABMS, AOA, or other organization approved by the board.

(6)    With respect to postgraduate medical residency training requirements, the following standards apply:

(a)    Graduates of approved medical or osteopathic schools located in the United States or Canada shall document the successful completion of a minimum of one year of postgraduate medical residency training approved by the board.

(b)    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 licensed in another state for five years or more without significant disciplinary action need only document one year of postgraduate residency training approved by the board.

(c)    The board has the discretion of accepting a full-time academic appointment at the rank of Assistant Professor or greater in a medical or osteopathic school in the United States as a substitute for and instead of postgraduate medical residency training. Each year of this academic appointment may be credited as one year of postgraduate medical residency training for purposes of the board's postgraduate training requirements.

(d)    For purposes of satisfying postgraduate medical residency training requirements, the board may accept postgraduate training in the United States approved by the Accreditation Council on Graduate Medical Education and the American Osteopathic Association, or postgraduate training in Canada approved by the Royal College of Physicians and Surgeons.

(7)    An applicant may be denied licensure if the individual has committed acts or omissions which are grounds for disciplinary action as set forth in Section 40-47-110. The board or department immediately may cancel an authorization that was issued based on false, fraudulent, or misleading information provided by an applicant.

(8)    The board may grant or refuse licensure to licentiates of the National Board of Medical Examiners, the Medical Council of Canada or of the National Board of Osteopathic Medical Examiners without further examination and may make and establish all necessary rules and regulations for the endorsement of licensure issued by other state boards having substantially equivalent requirements.

(9)    An applicant for a permanent license shall document compliance with applicable continued competency requirements.

(10)    An applicant shall file a completed application, with required supporting documentation, on forms provided by the department.

(11)    A nonrefundable permanent license application fee must be submitted with the application. Applications will not be processed without the required fee.

(12)    The board may not issue a permanent license to a licensed physician of another state of the United States:

(a)    whose license currently is revoked, suspended, restricted in any way, or on probationary status in that state; or

(b)    who has current disciplinary action pending in any state.

Section 40-47-33.    (A)    The issuance of an academic license is initiated by a written request from the dean of the medical school outlining the candidate's credentials, proposed role at the academic institution, and the reasons for requesting an exception to the usual course of permanent licensure. The candidate shall meet the following requirements:

(1)    the individual must have the rank of Assistant Professor or higher;

(2)    the individual must have established academic credentials and a compelling reason to be invited by the dean;

(3)    the academic license may be used only in the educational setting or in a training program associated with the medical school; and

(4)    use of the academic license is limited to the designated practice site only. It is not for independent practice or 'moonlighting' situations.

(B)    Because an academic license is issued at the dean's request for his accommodation, the dean is professionally responsible pursuant to Section 40-47-110(B)(5) for the academic licensee's compliance with the limitations of practice under an academic license.

Section 40-47-34.    (A)    The board shall waive application fees, examination fees and annual re-registration fees for any physician who applies for a special volunteer license and who otherwise meets permanent licensure requirements if the physician documents, to the satisfaction of the board, that practice is to be exclusively and totally devoted to providing medical care to the needy and indigent in South Carolina. To be eligible for the waiver of these fees, a physician shall acknowledge that there must be no expectation of payment or compensation for medical services rendered, or compensation or payment to the physician, either direct or indirect, monetary or in-kind, for the provision of medical services. A special volunteer license entitles the licensee to apply for individual controlled substance registration through DHEC.

(B)    A special volunteer license may be issued, in the board's discretion, to qualified applicants upon approval by the board. Practice will be limited to each specific site and practice setting approved by the board. There will be no licensure or other fees associated with a special volunteer license.

(C)    Requirements for a special volunteer license are as follows:

(1)    satisfactory completion of a special volunteer license application, including documentation of medical or osteopathic school graduation and practice history;

(2)    documentation of a specific proposed practice location;

(3)    documentation that applicant previously has been issued an unrestricted license to practice medicine in South Carolina or another state of the United States or Canada and that applicant has never been the subject of any significant disciplinary action in any jurisdiction;

(4)    documentation that the applicant only shall practice under the supervision of a supervising physician approved by the board. In order to ensure that public health, safety, and welfare are protected, the board will review the proposed supervisory relationship to ensure that the physician supervisor is competent to supervise the special volunteer licensee. Factors the board shall consider will include, but not be limited to, the training and practice experience of the supervising physician, the current nature and extent of the supervising physician's practice, the existence of any recent demonstration of the supervising physician's clinical competency and the number of special volunteer licensees the physician proposes to supervise;

(5)    documentation of the name of the supervising physician and that the physician has agreed to accept this supervisory responsibility. Supervising physicians shall possess an active, unrestricted permanent license to practice medicine in South Carolina. An approved supervising physician physically must be on the premises whenever a special volunteer licensee is practicing medicine; and

(6)    documentation and acknowledgement that the applicant may not receive payment or compensation, either direct or indirect, or have an expectation of payment or compensation for medical services rendered. Moreover, the supervising physician may not receive compensation or payment as the result of the special volunteer licensee's provision of medical services.

Section 40-47-35.    (A)    The board may issue a license to a physician licensed in good standing in another state who has been engaged to testify as an expert medical witness in an administrative, civil, or criminal proceeding in this State. The license only shall authorize practice in this State as an expert medical witness in a particular proceeding in this State. This license must be valid for the duration of the particular proceeding for which it is issued. This license must authorize only practice in this State that is related directly to the particular proceeding for which it is issued. A separate license must be obtained for each proceeding in which the applicant is engaged to testify as an expert medical witness in this State. The applicant shall submit the following items:

(1)    a completed application and payment of applicable fees; and

(2)    satisfactory documentation of the applicant's engagement as an expert witness in a particular proceeding in this State.

(B)    The board may waive any part or all of a fee for this license for a physician to testify as an expert witness on behalf of a state, county, or municipal agency or office.

Section 40-47-36.    (A)    In addition to other requirements established by law and for the purpose of determining an applicant's eligibility for an authorization to practice, the department may require a criminal history background check of each applicant for an authorization to practice pursuant to this chapter. Each applicant may be required to furnish a full set of fingerprints and additional information required to enable a criminal history background check to be conducted by the State Law Enforcement Division or the State Identification Bureau of another state and the Federal Bureau of Investigation, if no disqualifying record is identified at the state level. Costs of conducting a criminal history background check must be borne by the applicant. The department shall keep information received pursuant to this section confidential, except that information relied upon in denying an authorization to practice may be disclosed as may be necessary to support the administrative action.

(B)    In an investigation or disciplinary proceeding concerning a licensee, the department may require a criminal history background check of a licensee. A licensee may be required to furnish a full set of fingerprints and additional information required to enable a criminal history background check to be conducted by the State Law Enforcement Division or the State Identification Bureau of another state and the Federal Bureau of Investigation, if no pertinent information is identified at the state level. Costs of conducting a criminal history background check must be borne by the department and may be recovered as administrative costs associated with an investigation or hearing pursuant to this chapter, unless ordered by the board as a cost in a disciplinary proceeding. The department shall keep information received pursuant to this section confidential, except that information relied upon in an administrative action may be disclosed as may be necessary to support the administrative action.

Section 40-47-40.    The continued professional competency of physicians holding a permanent license must be assured in the following manner:

(1)    for renewal of a permanent license initially issued during a biennial renewal period, compliance with educational, examination, and other requirements for the issuance of a permanent license must be sufficient for the first renewal period following initial licensure;

(2)    for renewal of an active permanent license biennially, documented evidence of at least one of the following options during the renewal period:

(a)    forty hours of Category I continuing medical education sponsored by the American Medical Association, American Osteopathic Association, or other organization approved by the board as having acceptable standards for courses it sponsors, at least thirty hours of which are related directly to the licensee's practice area;

(b)    certification of added qualifications or recertification after examination by a national specialty board recognized by the American Board of Medical Specialties or American Osteopathic Association or other approved specialty board certification;

(c)    completion of a residency program or fellowship in medicine in the United States or Canada approved by the Accreditation Council on Graduate Medical Education or American Osteopathic Association;

(d)    passage of the Special Purpose Examination (SPEX) or Comprehensive Osteopathic Medical Variable Purpose Examination (COMVEX); or

(e)    successful completion of a clinical skills assessment program approved by the board, such as the Institute for Physician Evaluation (IPE) or the Center for Personalized Education for Physicians (CPEP);

(3)    for reinstatement or reactivation of a permanent license from lapsed or inactive status of less than four years, documented evidence of at least one of the following options within the preceding two years:

(a)    forty hours of Category I continuing medical education sponsored by the American Medical Association, American Osteopathic Association, or other organization approved by the board as having acceptable standards for courses it sponsors, at least thirty hours of which are directly related to the licensee's practice area;

(b)    certification of added qualifications or recertification after examination by a national specialty board recognized by the American Board of Medical Specialties or American Osteopathic Association or other approved specialty board certification;

(c)    completion of a residency program or fellowship in medicine in the United States or Canada approved by the Accreditation Council on Graduate Medical Education or American Osteopathic Association;

(d)    passage of the Special Purpose Examination (SPEX) or Comprehensive Osteopathic Medical Variable Purpose Examination (COMVEX); or

(e)    successful completion of a clinical skills assessment program approved by the board, such as the Institute for Physician Evaluation (IPE) or the Center for Personalized Education for Physicians (CPEP);

(4)    for reinstatement or reactivation of a permanent license from lapsed or inactive status of four years or more, documented evidence of at least one of the following options within the preceding two years:

(a)    certification of added qualifications or recertification after examination by a national specialty board recognized by the American Board of Medical Specialties or American Osteopathic Association or other approved specialty board certification;

(b)    completion of a residency program or fellowship in medicine in the United States or Canada approved by the Accreditation Council on Graduate Medical Education or American Osteopathic Association;

(c)    passage of the Special Purpose Examination (SPEX) or Comprehensive Osteopathic Medical Variable Purpose Examination (COMVEX); or

(d)    successful completion of a clinical skills assessment program approved by the board, such as the Institute for Physician Evaluation (IPE) or the Center for Personalized Education for Physicians (CPEP);

(5)    for reinstatement or reactivation from lapsed or inactive status of a permanent license of a licensee who has been in active practice in another state, compliance with any of the requirements of this section within the preceding two years must be accepted.

Section 40-47-41.    (A)    A license issued pursuant to this chapter may be renewed biennially or as otherwise provided by the board and department. A person who has not demonstrated continuing medical competence, as required by this chapter, is not eligible for renewal or issuance of an active license.

(B)    A licensee shall complete the renewal form and submit it to the board with the renewal fee. Upon receipt of the application and the fee, the department shall verify the accuracy of the application and renew the license for the applicable period. If a licensee fails timely to renew the license, the license is considered lapsed at the close of the renewal period, and the licensee may not practice in this State until the licensee is reinstated to practice. The board may reinstate the licensee on payment of a reinstatement fee, the current renewal fee, and demonstration of continued competency satisfactory to the board. The board may deny reinstatement or take other action based on evidence of misconduct.

(C)    A licensee shall notify the board in writing within fifteen business days of a change of residential address, office address, or office telephone number.

(D)    A licensee shall notify the board within thirty days of an adverse disciplinary action by another United States or foreign licensing jurisdiction, a peer review group, a health care institution, a professional or medical society or association, a governmental agency, a law enforcement agency, including an arrest, or a court, including an indictment. Confidential information received from other sources must continue to be maintained as confidential, except to the extent necessary for the proper disposition of the matter. Notification is not required in the case of:

(1)    a nondisciplinary resignation by the licensee from a health care facility; however, a resignation occurring after an incident or occurrence which could result in the revocation or suspension of or other limitation upon the licensee's privileges must be reported;

(2)    a minor disciplinary action regarding the licensee's privileges in a health care facility when the action taken does not involve the revocation or suspension of or other limitation upon the licensee's privileges to practice there;

(3)    a disciplinary action resulting from the licensee's failure to meet recordkeeping standards in a health care institution;

(4)    a disciplinary action resulting from the licensee's failure to attend meetings of a health care institution; or

(5)    other disciplinary actions as defined by the board in regulation.

Section 40-47-42.    A person with an inactive license to practice medicine in this State who wishes to resume active practice shall submit an application for reactivation including:

(1)    a completed application form approved by the board;

(2)    the applicable reactivation fee;

(3)    documented evidence of compliance with applicable continued competency requirements;

(4)    written verification of licensure and disciplinary history in all states in which a license has ever been issued; and

(5)    a practice history, including any malpractice suits and judgments.

Section 40-47-43.    A person submitting an application for renewal within one year after the expiration of the previous authorization period shall:

(1)    submit a completed application on a form provided by the board;

(2)    pay a renewal fee;

(3)    pay a late fee of one hundred dollars for any part of each month during which the license was lapsed;

(4)    provide evidence of compliance with applicable continued competency requirements; and

(5)    provide a statement under oath relating any practice activity following the expiration of the previous renewal period. If unauthorized practice occurred following the expiration of the previous renewal period, a penalty of one thousand dollars must be imposed for any portion of each month in which unauthorized practice occurred. The penalty must be paid in full before the license may be renewed by the department unless otherwise provided by the board.

Section 40-47-44.    In addition to compliance with all of the terms and conditions for reinstatement of a licensee required in a final order of the board, the licensee shall provide documented evidence of compliance with all other requirements for reactivation or renewal of authorization to practice before authorization may be issued. It is the licensee's responsibility to present clear and convincing proof of rehabilitation that is satisfactory to the board. The board, in its discretion, may require the licensee to appear personally in support of a petition for reinstatement or it may proceed upon information filed in the disciplinary matter or afterward.

Section 40-47-45.    A final action of the board relating to the granting, refusal, or cancellation of a license must be subject to review by the Administrative Law Court as provided pursuant to Article 5, Chapter 23 of Title 1 on the record of the board, as in certiorari, upon petition of the applicant or licensee within thirty days from receipt of official notice from the board of the action of which review is sought. Service of this notice conclusively must be presumed ten days after mailing by registered or certified mail to an applicant or licensee of the notice at the person's last known address. Motions for continuance and for other interlocutory relief are not subject to review by the Administrative Law Court until a final decision has been issued by the board.

Section 40-47-50.    (A)    The Department of Labor, Licensing and Regulation shall provide all administrative, fiscal, investigative, inspectional, clerical, secretarial, and license renewal operations and activities of the board in accordance with Section 40-1-50.

(B)    Initial fees must be established by the board in statute or regulation and must serve as the basis for necessary adjustments in accordance with Section 40-1-50 to ensure that they are sufficient, but not excessive, to cover expenses, including the total of the direct and indirect costs to the State for the operations of the board.

(C)    The administrator shall keep a record of each formal complaint and of all final decisions, which must be retained permanently as part of the records of the board.

Section 40-47-70.    Practitioners shall conduct themselves in accordance with the applicable codes of ethics adopted by the board in regulation.

Section 40-47-80.    The department shall investigate complaints and violations as provided in Section 40-1-80.

Section 40-47-90.    In addition to the powers and duties enumerated in Section 40-1-90, the presiding officer of the board may administer oaths when taking testimony upon matters pertaining to the business or duties of the board.

Section 40-47-100.    Restraining orders and cease and desist orders may be issued in accordance with Section 40-1-100.

Section 40-47-110.    (A)    In addition to the grounds provided in Section 40-1-110, upon finding misconduct which constitutes one or more of the grounds for disciplinary action, the board may cancel, fine, suspend, revoke, issue a public reprimand or a private reprimand, or restrict, including probation or other reasonable action such as requiring additional education or training or limitation on practice, the authorization to practice of a person who has committed misconduct.

(B)    'Misconduct' which constitutes grounds for disciplinary action is a showing to the board by the preponderance of the evidence that a licensee has:

(1)    used a false, fraudulent, or forged statement or document or practiced a fraudulent, deceitful, or dishonest act in connection with a licensing requirement;

(2)    been convicted of, has pled guilty to, or has pled nolo contendere to a felony or other crime involving moral turpitude or drugs. For purposes of this item, 'drugs' includes a substance whose possession, use, or distribution is governed by Article 3, Chapter 53 of Title 44, Narcotics and Controlled Substances, or which is listed in the current edition of the Physician's Desk Reference;

(3)    violated a federal, state, or local law involving alcohol or drugs or committed an act involving a crime of moral turpitude. The board may receive evidence to reach an independent conclusion as to the commission of the violation; however, the determination may be used only in making the administrative decision;

(4)    engaged in the habitual or excessive use or abuse of drugs, alcohol, or other substances that impair ability;

(5)    attempted to practice when judgment or physical ability is impaired by alcohol, drugs, or other substances;

(6)    been convicted of or sanctioned for illegal or unauthorized practice;

(7)    knowingly performed an act which in any way assists an unlicensed person to practice;

(8)    sustained a physical or mental impairment which renders further practice by the licensee dangerous to the public or which may interfere with the licensee's ability to competently and safely perform the essential functions of practice;

(9)    engaged in dishonorable, unethical, or unprofessional conduct that is likely either to deceive, defraud, or harm the public;         (10)    used a false or fraudulent statement in a document connected with the licensee's practice;

(11)    obtained fees or assisted in obtaining fees under dishonorable, false, or fraudulent circumstances;

(12)    intentionally violated or attempted to violate, directly or indirectly, or is assisting in or abetting the violation of or conspiring to violate the medical practice laws;

(13)    violated the code of medical ethics adopted by the board or has been found by the board to lack the ethical or professional competence to practice;

(14)    violated a provision of this chapter or a regulation or order of the board;

(15)    failed to cooperate with an investigation or other proceeding of the board;

(16)    failed to comply with an order, subpoena, or directive of the board or department;

(17)    failed to prepare or maintain an adequate patient record of care provided;

(18)    engaged in disruptive behavior or interaction with physicians, hospital personnel, patients, family members, or others that interferes with patient care or reasonably could be expected to impact adversely the quality of care rendered to a patient. This behavior may include but not be limited to inappropriate sexual behavior;

(19)    engaged in behavior that exploits the physician-patient relationship in a sexual way. This behavior is nondiagnostic and nontherapeutic, may be written, verbal, or physical and may include expressions of thoughts and feelings or gestures that are sexual or that reasonably may be construed by a patient as sexual. This behavior includes sexual contact with patient surrogates or key third parties;

(20)    failed to appear before the board after receiving a formal notice to appear;

(21)    signed a blank prescription form;

(22)    failed to report to the board an adverse disciplinary action by another United States or foreign licensing jurisdiction , a peer review body, a health care institution, a professional or medical society or association, a board-approved credentialing organization, a governmental agency, a law enforcement agency including an arrest, or a court including an indictment for acts or conduct similar to acts or conduct that would constitute grounds for action as defined in this section;

(23)    failed to provide pertinent and necessary medical records to another physician or patient in a timely fashion when lawfully requested to do so by the subject patient or by a lawfully designated representative of the subject patient;

(24)    improperly managed medical records, including failure to maintain timely, legible, accurate, and complete medical records; or

(25)    provided false, deceptive, or misleading testimony as an expert medical witness in an administrative, civil, or criminal proceeding in this State.

(C)    In addition to other remedies and actions incorporated in this chapter, a licensee who is adjudged mentally incompetent by a court of competent jurisdiction automatically must be suspended by the board until the licensee is adjudged by a court of competent jurisdiction or in another manner provided by law as being restored to mental competency. The automatic suspension of a license pursuant to this section is public information under the South Carolina Freedom of Information Act.

(D)    A decision by the board to revoke, suspend, or restrict a license or to limit or discipline a licensee must be by majority vote of the board members, except that the board may delegate to the chairman or vice-chairman of the board the authority to issue orders to suspend temporarily licenses or to seek from the Administrative Law Court an order temporarily suspending or restricting a license pending final decision by the board, as provided below:

(1)    When the chairman or vice-chairman of the board determines that public health, safety, or welfare imperatively requires emergency action and incorporates a finding to that effect in an order, a temporary suspension order may be issued without a prior hearing being afforded to the licensee, in which event the licensee may request by the close of the next business day after receipt of the order a review by the Administrative Law Court. Filing of a written request for a review by the Administrative Law Court does not stay the temporary suspension and no stay may be issued; however, the issuance of the temporary suspension order must not be made public until the time for requesting a review has passed or the administrative law judge issues an order after a review hearing. Upon proper written request, a review hearing must be held by the Administrative Law Court within seventy-two hours of the filing of the request for review. If the issuance of the temporary suspension order is not sustained by the administrative law judge, the matter shall remain confidential and must not be made public, except to the extent the board may consider it relevant to the final decision of the board.

(2)    Alternately, the board or the Department of Labor, Licensing and Regulation, acting through the Office of General Counsel or its designee, may petition the Administrative Law Court for an order temporarily suspending or restricting a license pending final decision by the board. A hearing must be held by the Administrative Law Court within seventy-two hours of the filing of the petition. If an order temporarily suspending or restricting a license is not issued by the administrative law judge, the matter must remain confidential and must not be made public, except to the extent the board may consider it relevant to the final decision of the board. The suspension or restriction of a license, and any subsequent related action, is public information under the Freedom of Information Act after issuance of an order by the Administrative Law Court.

(E)    Motions for continuance and for other interlocutory relief are not subject to review by the Administrative Law Court until a final decision has been issued by the board. A licensee against whom disciplinary action is taken in a final decision pursuant to this article has the right to review by the Administrative Law Court as provided in Section 40-1-160. If the board has revoked, suspended, or restricted a license in any manner for six months or more, including probation conditions, an appeal taken to the Administrative Law Court as provided in Section 40-1-160 has precedence on the court's calendar, is considered an emergency appeal, and should be heard not later than thirty days from the date the petition is filed. The review is limited to the record established by the board hearing. No stay or supersedeas may be granted by the administrative law judge or a reviewing court pending appeal from a final decision by the board to revoke, suspend, or restrict a license for six months or more.

(F)(1)    If a person is found by the board to have engaged in conduct which subverts or attempts to subvert the security or integrity of the licensing examination process, the board, in its discretion, may have the scores on the licensing examination withheld or declared invalid. The individual may be disqualified from practice or be subjected to the imposition of another appropriate sanction provided by Section 40-47-120.

(2)    Conduct which subverts or attempts to subvert the security or integrity of the medical licensing examination process includes, but is not limited to conduct which violates the:

(a)    security of examination materials, including, but not limited to, the improper reproduction or reconstruction of any portion of the licensing examination aiding in the improper reproduction or reconstruction of any portion of the licensing examination; or selling, distributing, buying, receiving, or having unauthorized possession of any portion of a future, current, or previously administered licensing examination;

(b)    standard of test administration, including, but not limited to, improperly communicating with another examinee during the administration of a licensing examination; copying answers from another examinee or permitting one's own answers to be copied by another examinee during the administration of a licensing examination; or having in one's possession during the administration of a licensing examination books, notes, other written or printed materials, or data of any kind other than the examination materials or other materials authorized by the board; and

(c)    credentials process, including, but not limited to, falsifying or misrepresenting educational credentials or other information required for admission to the licensing examination, impersonating an examinee, or having an impersonator take the licensing examination in one's behalf.

Section 40-47-111.    (A)    Acts or omissions by a licensee causing the denial, cancellation, revocation, suspension, or restriction of a license to practice in another state supports the issuance of a formal complaint and the commencement of disciplinary proceedings. This section applies only if the disciplinary action taken in another state is based on grounds that would constitute misconduct in this State.

(B)    Proof of these acts or omissions may be shown by a copy of the transcript of record of the disciplinary proceedings in another state or a copy of the final order, consent order, or similar order stating the basis for the action taken.

(C)    Upon the filing of an application or an initial complaint alleging that the applicant or licensee has been disciplined in another state, the applicant or licensee must produce to the department copies of all transcripts, documents, and orders used, relied upon, or issued by the licensing authority in the other state. Failure to produce these items within ninety days of written request results in the denial of the individual's application or suspension of the individual's authorization to practice in this State until these items have been provided to the department and until further order of the board.

(D)    The applicant or licensee may present mitigating testimony to the board or hearing officer or hearing panel regarding disciplinary action taken in another state or evidence that the acts or omissions committed in another state do not constitute misconduct in this State.

Section 40-47-112.    A person licensed or otherwise authorized by the Board of Medical Examiners who attends a patient while under the influence of alcohol or drugs is guilty of a misdemeanor and, upon conviction, may be fined not more than ten thousand dollars and be imprisoned for a period of not more than one year, in the discretion of the court. In addition, upon conviction, the license granted to the person must be suspended and the person must be disqualified from practicing in this State until he satisfies the State Board of Medical Examiners that he is qualified to resume the practice of medicine. The provisions of this section are in addition to the remedies otherwise relating to physicians who may be addicted to the use of alcohol or drugs.

Section 40-47-113.    (A)    It is unprofessional conduct for a licensee initially to prescribe drugs to an individual without first establishing a proper physician-patient relationship. A proper relationship, at a minimum, requires that the licensee make an informed medical judgment based on the circumstances of the situation and on the licensee's training and experience and that the licensee:

(1)    personally perform an appropriate history and physical examination, make a diagnosis, and formulate a therapeutic plan. This process must be documented appropriately;

(2)    discuss with the patient the diagnosis and the evidence for it, and the risks and benefits of various treatment options; and

(3)    ensure the availability of the licensee or coverage for the patient for appropriate follow-up care.

(B)    Prescribing for a patient whom the licensee has not personally examined may be suitable under certain circumstances. These may include, but not be limited to, admission orders for a newly hospitalized patient, prescribing for a patient of another licensee for whom the prescriber is taking call, prescribing for a patient examined by a licensed advanced practice registered nurse, a physician assistant or other physician extender authorized by law and supervised by the physician, or continuing medication on a short-term basis for a new patient prior to the patient's first appointment.

(C)    prescribing drugs to individuals the licensee has never personally examined based solely on answers to a set of questions is inappropriate and unprofessional.

Section 40-47-114.    (A)    If the board finds that probable cause exists that a licensee or applicant may be professionally incompetent, addicted to alcohol or drugs, or may have sustained a physical or mental disability that may render practice by the licensee or applicant dangerous to the public or is otherwise practicing in a manner dangerous to the public, the board, without a formal complaint or opportunity for hearing, may require a licensee or applicant to submit to a professional competency, mental, or physical examination by authorized practitioners designated by the board. The results of an examination are admissible in a hearing before the board, notwithstanding a claim of privilege under a contrary rule of law. A person who accepts the privilege of engaging in licensed practice in this State pursuant to this chapter, or who files an application for a license to practice pursuant to this chapter, is considered to have consented to submit to a professional competency, mental, or physical examination and to have waived all objections to the admissibility of the results in a hearing before the board upon the grounds that this constitutes a privileged communication. If a licensee or applicant fails to submit to an examination when properly directed to do so by the board, unless the failure was due to circumstances beyond the person's control, the board shall enter an order automatically suspending or denying the license pending compliance and further order of the board. A licensee or applicant who is required to submit to a professional competency, mental, or physical examination may request by the close of the next business day after receipt of the requirement a review by Administrative Law Court. Filing of a written request for a review by the Administrative Law Court does not stay the time directed in which to submit to a mental or physical examination, and no stay may be issued, except as provided in this section. Upon proper written request, a review hearing must be conducted within seventy-two hours of receipt of the request. Failure to provide a review hearing within the prescribed time stays the time required to submit to a professional competency, mental, or physical examination until a decision is issued by the administrative law judge. The review hearing for purposes of this section must be limited to the issues of whether the person is a licensee or applicant, whether reasonable grounds exist to require a professional competency, mental, or physical examination, and whether the licensee or applicant has been informed that failure to submit to an examination will result in the entry of an order automatically suspending or denying the license pending compliance and further order of the board. The administrative law judge's decision is not subject to appeal. A licensee or applicant who is prohibited from practicing pursuant to this subsection must be afforded at reasonable intervals an opportunity to demonstrate to the board the ability to resume or begin the practice with reasonable skill and safety.

(B)    The board upon probable cause may obtain records relating to the professional competency, mental, or physical condition of a licensee or applicant including, but not limited to, psychiatric records; and these records are admissible in a hearing before the board, notwithstanding another provision of law. A person who accepts the privilege of engaging in licensed practice in this State pursuant to this chapter, or who files an application to practice pursuant to this chapter, is considered to have consented to the board obtaining these records and to have waived all objections to the admissibility of these records in a hearing before the board upon the grounds that this constitutes a privileged communication. If a licensee or applicant refuses to sign a written consent for the board to obtain these records when properly requested by the board, unless the failure was due to circumstances beyond the person's control, the board shall enter an order automatically suspending or denying the license pending compliance and further order of the board. A licensee or applicant who is prohibited from practicing pursuant to this subsection must be afforded at reasonable intervals an opportunity to demonstrate to the board the ability to resume or begin the practice of medicine with reasonable skill and safety.

(C)    An order requiring a licensee or applicant to submit to a professional competency, mental, or physical examination or an order requiring the submission of records relating to the mental or physical condition of a licensee or applicant is confidential and must not be disclosed, except to the extent necessary for the proper disposition of the matter before the board or Administrative Law Court. The automatic suspension or denial of a license pending compliance and further order of the board is public information under the South Carolina Freedom of Information Act. A review hearing and decision of an administrative law judge are confidential, unless an order automatically suspending or denying a license pending compliance and further order of the board has been issued, in which case the suspension or denial of a license by the administrative law judge is public information under the South Carolina Freedom of Information Act.

Section 40-47-115.    The board has jurisdiction over the actions committed or omitted by current and former licensees as provided in Section 40-1-115.

Section 40-47-116.    An initial complaint may be made by a person or the administrator of the board or director of the department based upon information considered reliable. The initial complaint must be dated, signed by the person making the complaint or the administrator or director when appropriate, and must identify the subject of the complaint and contain a brief summary of the nature of the complaint. Initial complaints must be filed with the director, or his designee, who may cause an investigation to be made into the allegation of professional misconduct. If the initial complaint on its face does not demonstrate an allegation of misconduct pursuant to this chapter, an investigation may not ensue. If the initial complaint does not demonstrate an allegation of misconduct pursuant to this chapter after investigation, the initial complaint may be dismissed. The department shall notify in writing the person initially complaining of the reason for dismissing the initial complaint. The identity of the person making the initial complaint must remain privileged and confidential and must not be disclosed for use in any administrative or judicial proceeding of any kind. If a formal complaint is authorized, the identity of the initial complainant must continue to remain privileged and confidential, and must not be disclosed during the conduct of formal proceedings, upon administrative or judicial review, nor at any time after that for use in any administrative or judicial proceeding of any kind, unless the initial complainant testifies as a witness in the formal proceedings.

Section 40-47-117.    (A)    A formal complaint must be issued by the Office of General Counsel after investigation upon a finding by one or more physicians designated by the board that probable cause exists to believe that professional misconduct may have been committed. Formal complaints must be captioned 'In the Matter of (name of respondent)', and signed by an attorney assigned or designated by the Office of General Counsel. The department shall cause to be sent to the respondent or counsel, if any, by certified mail a formal complaint setting forth in summary fashion the alleged misconduct together with a notice requiring that the respondent file with the department an answer to the formal complaint and to serve a copy of the answer upon the attorney assigned or designated by the Office of General Counsel within thirty days after mailing of the notice and formal complaint. The notice mailed to the respondent further shall state that if the respondent fails to answer, judgment by default may be taken against the respondent. The answer must be signed by the respondent or counsel or by both and may be verified. If no answer has been filed by the respondent or counsel after thirty calendar days from the date of receipt by the respondent of the notice and formal complaint and no extension has been granted, the allegations of the formal complaint must be considered admitted, and the board may proceed and render a default judgment against the respondent.

(B)    After the respondent's answer has been filed, or the time within which the respondent was required to file the answer has expired, a formal hearing into the matter must be held by a panel of one lay member and not more than three physician members of the Medical Disciplinary Commission, none of which may reside or have a major part of their practice in the same county as the respondent. If the facts are not in dispute, the matter may be presented directly to the board for final decision without need for a panel hearing. The Office of General Counsel or its designee shall prepare and present the matter before the panel and board, as appropriate. Hearings must be held by the panel or board upon thirty days notice to the Office of General Counsel and the respondent or counsel.

(1)    If the panel finds that the charges in the formal complaint are not supported by the evidence or do not merit the taking of a disciplinary action, the panel shall make a certified report of the proceedings before it, including its findings of fact and conclusions of law, and shall file the report with the department.

(2)    If the panel finds and determines that the respondent is guilty of misconduct, it shall make a certified report of the proceedings before it, including its recommendation as to findings of fact, conclusions of law, and mitigating and aggravating circumstance for consideration by the board, and shall file the report together with a transcript of the testimony taken and any exhibits as may have been in evidence before it, with the department. The panel may not recommend to the board whether a sanction should or should not be imposed.

(3)    A copy of the panel's report must be served upon the Office of General Counsel and the respondent or counsel.

(4)    In the event of a tie vote by the panel, the matter must be presented to the board for final decision upon separate reports submitted by each side of the tie vote.

(C)    Whenever the panel has filed its report, the department shall notify the respondent or counsel, if any, of the time and place at which the board will consider the report for the purpose of determining its action, the notice to be given not less than thirty days before the meeting. The respondent and the Office of General Counsel shall have the right to appear before the board and to submit briefs and be heard in oral argument in opposition to or in support of the recommendations of the panel.

(D)    Upon consideration of the report of the panel and of the showing made to the board, the board may:

(1)    refer the matter back to a panel for hearing;

(2)    order a further hearing before the board; or

(3)    proceed upon the certified report of the prior proceedings before the panel.

(E)    Upon its final review, the board either may dismiss the complaint or find that the respondent is guilty of misconduct. If the formal complaint is dismissed, the department shall notify the respondent or counsel, if any, and the Office of General Counsel.

(F)    If the board determines that the respondent is guilty of misconduct meriting sanction, it shall issue a final order including its findings of fact, conclusions of law, and decision of sanction, and shall file the report, with the department, which promptly shall serve the respondent or counsel, if any, and the Office of General Counsel with a copy of the board's final order.

(G)    Service of notices conclusively must be presumed thirty days after mailing by first class or certified mail to the respondent to the last address provided to the board by the respondent.

(H)    Unless and until otherwise ordered by the board, proceedings and documents relating to formal complaints and hearings and to proceedings must be private, unless the respondent shall in writing request that they be public. In no case will the identity of the initial complainant be disclosed, unless the initial complainant testifies as a witness in the formal proceedings, nor shall the investigative file be disclosed under any circumstance.

(I)    Wherever provision is made for the service of any notice, order, report, or other paper or copy of these upon any person in connection with any proceeding, service may be made upon counsel of record for the person, either personally or by first class or certified mail.

(J)    Service of notice upon a respondent who cannot be found at the last known address provided by the respondent may be made by leaving with the director, or his designee, a copy of the notice and accompanying documents along with proof of attempted service at the last known address. The board may set aside and reopen a proceeding upon satisfactory showing by the respondent of good cause as to why the respondent did not receive service of the notice.

Section 40-47-118.    (A)    Discovery must not be permitted in a medical disciplinary proceeding except as provided in this chapter. Within twenty days of the filing of an answer, the Office of General Counsel or its designee and the respondent or counsel shall exchange the names and addresses of all persons known to have knowledge of the relevant facts. The name and address of the initial complainant or a confidential informant must not be exchanged unless the person is expected to testify in the proceeding. The Office of General Counsel or its designee or the respondent or counsel may withhold information only with permission of the presiding officer, who shall authorize withholding of the information only for good cause shown, taking into consideration the materiality of the information possessed by the witness and the position the witness occupies in relation to the respondent. The presiding officer's review of the withholding request is to be in camera, but the party making the request shall advise the opposing party of the request without disclosing the subject of the request. The presiding officer shall set a date for the exchange of the names and addresses of all witnesses the parties intend to call at the hearing.

(B)    The Office of General Counsel or its designee and respondent or counsel shall exchange:

(1)    notwithstanding Section 40-47-190, evidence relevant to the formal charges, documents to be presented at the hearing and statements of witnesses who will be called at the hearing, except evidence privileged pursuant to other state law. For purposes of this item, a witness statement is a written statement signed or otherwise adopted or approved by the person making it, or a stenographic, mechanical, electrical, or other recording, or a transcription of these, which is a substantially verbatim recital of an oral statement by the person making it and contemporaneously recorded; and

(2)    other material only upon good cause shown to the presiding officer of the panel.

(C)    Copies of transcripts of testimony taken by a court reporter pursuant to this section may be obtained by the parties from the court reporter at the expense of the requesting party and need not be made available to the requesting party by the opposing party unless not otherwise available.

(D)    Depositions only must be allowed if agreed upon by the Office of General Counsel or its designee and the respondent or counsel, or if the presiding officer grants permission to do so based on a showing of good cause. The presiding officer may place restrictions or conditions on the manner, time, and place of an authorized deposition. A deposition request filed less than fifteen days before a scheduled hearing must not be granted absent a showing of exceptional circumstances.

(E)    A party may take the deposition de bene esse of a supporting witness who will be unavailable to testify at hearing without order of the presiding officer and as a matter of right under due process of law. Other parties must be notified and afforded the opportunity to participate in the deposition de bene esse upon not less than ten days notice, unless sooner ordered by the presiding officer or agreed by the participating parties. The admissibility of a deposition de bene esse or portion of the deposition must be determined by the presiding officer or board at the time it is offered into evidence.

(F)    Pre-hearing motions must be made to the presiding officer in writing and must state the grounds for relief and the relief sought. Motions pertaining to the hearing must be filed not later than ten days before the hearing date, unless otherwise ordered by the presiding officer. A party may file a written response to the motion within five days unless the time is extended or shortened by the presiding officer.

(G)    Notwithstanding another provision of this section, the Office of General Counsel or its designee shall provide respondent with exculpatory evidence relevant to the formal charges.

(H)    Both parties have a continuing duty to supplement information required to be exchanged pursuant to this section.

(I)    Depositions must be completed not later than fifteen days before a scheduled hearing.

(J)    If a party fails to disclose timely a witness's name and address, statements by the witness, or other evidence required to be disclosed or exchanged pursuant to this section, the panel or presiding officer may grant a continuance of the hearing, preclude the party from calling the witness or introducing the document, or take other action as may be appropriate. In the event the Office of General Counsel or its designee has not disclosed timely exculpatory material, the panel or presiding officer may require the matter to be disclosed and grant a continuance, or take other action as may be appropriate.

(K)    Disputes concerning depositions and the disclosure or exchange of information must be determined by the panel or presiding officer. Review of these decisions must not be subject to an interlocutory appeal; instead, these decisions must be challenged by filing objections to the panel's report within fifteen days from the service of the report. Failure to file objections to the panel report constitutes acceptance of the ruling on the issue.

Section 40-47-120.    (A)    Upon determination by the board that one or more of the grounds for disciplinary action exists, the board may cancel, fine, suspend, revoke, issue a public reprimand or a private reprimand, or restrict, including probation or other reasonable action such as requiring additional education or training, or limitation on practice, the authorization to practice of a person who has committed misconduct.

(B)    Upon ordering suspension, an action may be stayed upon terms and conditions as the board, in its discretion, considers appropriate, including, but not limited to, probation, payment of a fine, or other reasonable action, such as requiring additional education and training or limitation on practice.

(C)    The board may require the licensee to pay a fine of up to twenty-five thousand dollars and the costs of the disciplinary action. Fines are payable immediately upon the effective date of discipline unless otherwise provided by the board. Interest accrues after fines are due at the maximum rate allowed by law. No licensee against whom a fine is levied is eligible for reinstatement until the fine has been paid in full. Fines must be deposited in a special fund established for the department to defray the administrative costs associated with investigations and hearings pursuant to this chapter.

(D)    A person whose authorization to practice has been permanently revoked never may be readmitted to practice in this State. A person whose authorization to practice has been revoked, within fifteen days after the effective date of the revocation, shall surrender the wall certificate and wallet card to the board administrator. The wall certificate and wallet card must be destroyed by the board administrator.

(E)    A licensee may relinquish an authorization to practice instead of further disciplinary proceedings, subject to acceptance by the board chairman as being in the public interest. This action must be taken in writing on a form approved by the board. This action must be irrevocable by the licensee upon signature by the licensee. Relinquishment must be given the same effect as a revocation of an authorization to practice and must be considered a public action under the South Carolina Freedom of Information Act.

(F)    Final orders of the board in a disciplinary proceeding must be issued upon approval of the board. Final orders must be kept on file in the board's office and must be distributed as public orders of the board, except those designated as private reprimands or dismissals. Final orders, except those orders designated as private reprimands or dismissals, must be filed promptly with the Federation of State Boards of Medical Examiners and other national databases as required by law. A final order of the board, including those designated as private reprimands or dismissals, must be provided to the respondent.

(G)    Restriction of a licensee's right to practice and subsequent related action is public information under the South Carolina Freedom of Information Act. Orders to cease and desist issued against unlicensed persons are public information under the South Carolina Freedom of Information Act.

Section 40-47-130.    As provided in Section 40-1-130, the board may deny licensure to an applicant based on the same grounds for which the board may take disciplinary action against a licensee.

Section 40-47-140.    A license may be denied based on a person's prior criminal record only as provided in Section 40-1-140.

Section 40-47-150.    A licensee under investigation for a violation of this chapter or a regulation promulgated pursuant to this chapter voluntarily may surrender the license to practice in accordance with and subject to the provisions of Section 40-1-150. A person whose license is voluntarily surrendered may not practice or represent oneself to be authorized to practice until the board takes final action in the pending disciplinary matter. The voluntary surrender of the license is subject to public disclosure in accordance with Chapter 4 of Title 30. The time that an authorization has been surrendered may be credited, in the board's discretion, toward a period of suspension or other restriction of practice.

Section 40-47-160.    A respondent aggrieved by a final decision of the board may seek review of the decision to the Administrative Law Court in accordance with Section 40-1-160. Motions for continuance and for other interlocutory relief must not be subject to review by the Administrative Law Court until a final decision has been issued by the board.

Section 40-47-170.    A person found in violation of this chapter or regulations promulgated pursuant to this chapter may be required to pay costs associated with the investigation and prosecution of the case, including appeals, in accordance with Section 40-1-170.

Section 40-47-180.    Costs and fines imposed pursuant to this chapter must be paid in accordance with and are subject to the collection and enforcement provisions of Section 40-1-180. No person against whom a fine is levied is eligible for the issuance or reinstatement of an authorization to practice until the fine has been paid in full.

Section 40-47-190.    (A)    A person connected with any complaint, investigation, or other proceeding before the board including, but not limited to, a witness, counsel, counsel's staff, board member, board employee, court reporter, or investigator may not disclose information tending to identify the initial complainant or a witness or discuss testimony or other evidence in the complaint, investigation, or proceeding, except to persons directly involved, and except as necessary for the proper disposition of the complaint, investigation, or other proceeding, or as necessary to allow the administrator or designee to confirm the existence and status of a formal complaint or proceeding against the licensee. Provided, however, a formal proceeding before the board may be made public upon written request of the respondent. Persons attending proceedings or taking part in a matter must be advised of this provision upon the commencement of the matter. Records and correspondence held by members of the board at the conclusion of their respective terms of office must be screened carefully by them. They shall deliver essential records and correspondence to the administrator for filing with the permanent records of the board and destroy nonessential records having no permanent or continuing effect.

(B)    Every communication, oral or written, to the board, department, staff, counsel, expert reviewers or witnesses, or another person acting on behalf of the board or department during the investigation, hearing, or adjudication of the disciplinary matters including, but not limited to, investigative reports concerning interviews and issues under investigation, correspondence, summaries, incident reports, computer printouts, and documents created during peer review proceedings are privileged from disclosure. Those persons and entities making these communications are immune from liability.

(C)    Information that has been declared confidential or personal pursuant to this chapter or other applicable law must not be disclosed, except to the extent necessary for the proper disposition of the matter before the board, and is protected in the same manner as provided in Section 40-71-20, or as otherwise provided by law.

(D)    Except as provided in subsection (E), the identity of the initial complainant and confidential informant or other witness who does not testify must be kept confidential and must not be disclosed to other parties, entities, or persons, and information contained in confidential investigative files is privileged from disclosure for any reason whatsoever.

(E)    Whenever the department receives information indicating a violation of state or federal law, the department may provide that information, to the extent the department considers necessary, to the appropriate state or federal law enforcement or regulatory body, including licensing authorities in other states. The department may provide information it considers necessary or appropriate to a substance abuse treatment program facility or monitoring program approved by the board, which information shall continue to be kept confidential and privileged from disclosure, except as provided by law.

(F)(1)    The department shall provide written acknowledgment of every initial complaint, if the initial complainant is known, and notify the initial complainant in writing of the disposition of the matter. Although entitled to notice, an initial complainant is not a party to the proceeding and is not entitled to appeal or otherwise seek review of the dismissal or other disposition of the matter.

(2)    For every unauthorized disclosure of confidential or personal information by a person in violation of this chapter, the department may issue an administrative citation and may assess an administrative penalty of up to five hundred dollars per violation, not to exceed a total of ten thousand dollars per matter. Upon disclosure of confidential or personal information in violation of this chapter, the department may refuse to provide further information to the violator.

(3)    An entity or individual assessed administrative penalties may appeal those penalties to the board within ten days of receipt of the citation. If an appeal is filed, the department shall schedule a hearing before the board, which shall make a determination in the matter. If no appeal is filed, the citation is considered a final order and the administrative penalties must be paid within thirty days of receipt of the citation or other written demand.

(G)    No information in investigative files or disciplinary proceedings is required to be expunged pursuant to another provision of state law.

Section 40-47-195.    (A)    A licensee who supervises another practitioner shall hold a permanent, active, unrestricted authorization to practice in this State and be currently engaged in the active practice of their respective profession, or alternately, hold an active unrestricted academic license to practice medicine in this State.

(B)    Pursuant to this chapter, only licensed physicians may supervise another practitioner who performs delegated medical acts in accordance with the practitioner's applicable scope of professional practice authorized by state law. It is the supervising physician's responsibility to ensure that delegated medical acts are performed by another practitioner under approved written scope of practice guidelines or approved written protocol in accordance with the applicable scope of professional practice authorized by state law. A copy of approved written scope of practice guidelines or approved written protocol, dated and signed by the supervising physician and the practitioner, must be provided to the board by the supervising physician within seventy-two hours of request by a representative of the department or board.

(C)    In evaluating a written guideline or protocol, the board and supervising physician shall consider the:

(1)    training and experience of the supervising physician;

(2)    training and experience of the supervised practitioner;

(3)    nature and complexity of the delegated medical acts being performed;

(4)    geographic proximity of the supervising physician to the supervised practitioner. When the supervising physician is to be more than forty-five miles from the supervised practitioner, special consideration must be given to the manner in which the physician intends to monitor, and prior board approval must be received for this practice; and

(5)    number of other practitioners the physician supervises. Reference must be given to the number of supervised practitioners, as prescribed by law. When the supervising physician assumes responsibility for more than three other practitioners, special consideration must be given to the manner in which the physician intends to monitor, and prior board approval must be received for such practice.

(D)    The physician responsible for the supervision of a certified registered nurse anesthetist (CRNA) must be identified on the anesthesia record before administration of anesthesia.

Section 40-47-200.    A person who practices or offers to practice medicine in this State in violation of this chapter or who knowingly submits false information for the purpose of obtaining a license is guilty of a misdemeanor and, upon conviction, must be imprisoned not more than one year or fined not more than fifty thousand dollars. Each violation constitutes a separate offense. The provisions of this chapter apply to a person or entity aiding and abetting in a violation of this chapter.

Section 40-47-210.    The department, in addition to instituting a criminal proceeding, may institute a civil action through the Administrative Law Court for injunctive relief against a person or entity violating this chapter, a regulation promulgated pursuant to this chapter, or an order of the board. For each violation the administrative law judge may impose a fine of not more than ten thousand dollars.

Section 40-47-220.    If a provision of this chapter or the application of a provision of this chapter to a person or circumstance is held invalid, the invalidity does not affect other provisions or applications of this statute which can be given effect without the invalid provision or application, and to this end the provisions of this chapter are severable."

Article 3

Reregistration Of Persons Licensed To

Practice Medicine Or Osteopathy

Section 40-47-410.    All persons authorized to practice medicine or osteopathy in this State shall by the first of July of each year apply to the State Board of Medical Examiners for a reregistration certificate which shall be furnished by the Board after payment of a fee to be set by the Board.

Section 40-47-420.    By May first of each year the Board shall mail to every registered physician an application for reregistration addressed to the last address of such physician on file with the Board. The failure to receive such application shall not excuse failure to reregister. The application shall contain proper spaces for insertion by the applicant of the information required by the Board and such instructions as may be required to properly complete the application form.

Section 40-47-430.    Any licensed physician who fails to comply with the reregistration provisions of this article shall pay to the Board a penalty of ten dollars for each month of default. If nonregistration continues for more than six months, the Board may place a physician's license on an inactive status.

Section 40-47-440.    Prior to any resumption of the practice of medicine or osteopathy in this State, a physician with an inactive license must notify the Board in writing that he desires to resume practice. The Board may require such information as it deems necessary to be currently advised of the past and present activities of such physician and a hearing may be required if unsatisfactory information is received by the Board. If nonregistration continues for more than six months and the physician is practicing in the State, the penalty shall thereafter be five dollars per day. The Board shall issue an order requiring payment of the penalties, and upon the failure of the physician to remit within thirty days, the Attorney General shall institute an action on behalf of the Board to recover such penalties, which for good cause shown, may be compromised at the sole discretion of the Board. Wilful refusal to comply with this section will subject the person concerned to the provisions of Sections 40-47-250 and 40-47-260.

Section 40-47-450.    During each year the Board shall publish and mail to every registered physician in the State a directory of all physicians reregistered. The publication shall contain the Medical Practice Laws of South Carolina. A physician who changes the address of his usual place of practice shall notify the Board within thirty days thereafter.

SECTION    2.    This act takes effect upon approval by the Governor.

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