South Carolina General Assembly
116th Session, 2005-2006

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A385, R387, S881

STATUS INFORMATION

General Bill
Sponsors: Senator Ritchie
Document Path: l:\council\bills\pt\2683sj05.doc
Companion/Similar bill(s): 3784

Introduced in the Senate on May 24, 2005
Introduced in the House on May 2, 2006
Last Amended on May 30, 2006
Passed by the General Assembly on May 31, 2006
Governor's Action: June 9, 2006, Signed

Summary: Medical Examiners Board

HISTORY OF LEGISLATIVE ACTIONS

     Date      Body   Action Description with journal page number
-------------------------------------------------------------------------------
   5/24/2005  Senate  Introduced and read first time SJ-6
   5/24/2005  Senate  Referred to Committee on Medical Affairs SJ-6
   4/25/2006  Senate  Committee report: Favorable with amendment Medical 
                        Affairs SJ-15
   4/26/2006  Senate  Amended SJ-38
   4/26/2006  Senate  Read second time SJ-38
   4/27/2006  Senate  Amended SJ-36
   4/27/2006  Senate  Read third time and sent to House SJ-36
    5/2/2006  House   Introduced and read first time HJ-15
    5/2/2006  House   Referred to Committee on Medical, Military, Public and 
                        Municipal Affairs HJ-18
   5/17/2006  House   Committee report: Favorable with amendment Medical, 
                        Military, Public and Municipal Affairs HJ-92
   5/24/2006  House   Debate adjourned until Tuesday, May 30, 2006 HJ-63
   5/30/2006  House   Requests for debate-Rep(s). White, GR Smith, Skelton, 
                        Hagood, Perry, Vaughn, Davenport, Anderson, Hayes, 
                        Cobb-Hunter, Bannister, Weeks, Sandifer, JH Neal, 
                        Haley, EH Pitts, Parks, Pinson, Clyburn, Jefferson, 
                        Toole, Agnew, Cato, Loftis, Mahaffey, and Mitchell 
                        HJ-19
   5/30/2006  House   Amended HJ-85
   5/30/2006  House   Debate interrupted HJ-99
   5/30/2006  House   Read second time HJ-103
   5/30/2006  House   Roll call Yeas-110  Nays-1 HJ-103
   5/31/2006  House   Read third time and returned to Senate with amendments 
                        HJ-77
   5/31/2006  Senate  Concurred in House amendment and enrolled SJ-301
    6/7/2006          Ratified R 387
    6/9/2006          Signed By Governor
   6/22/2006          Copies available
   6/22/2006          Effective date 06/09/06
   6/23/2006          Act No. 385

View the latest legislative information at the LPITS web site

VERSIONS OF THIS BILL

5/24/2005
4/25/2006
4/26/2006
4/27/2006
5/17/2006
5/30/2006


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

(A385, R387, S881)

AN ACT TO AMEND ARTICLES 1 AND 3, CHAPTER 47 OF TITLE 40, 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 AND PROVIDE FOR A WAIVER FOR CERTAIN EXAMINATIONS; 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; 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; PROVIDE THAT 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 INCOMPETENT; PROVIDE THE PROCEDURE FOR HOW THE BOARD SHALL REVOKE, SUSPEND, OR RESTRICT A LICENSE OR 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 PROCEDURE LEADING UP TO A HEARING; 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 FOR THE REPORTING OF THE CHANGE IN STATUS OF A LICENSE TO THE LICENSEE'S LAST KNOWN EMPLOYER; 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; PROVIDE THAT 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 THAT A FORMAL COMPLAINT AND ANSWER MUST BE MADE AVAILABLE TO THE PUBLIC EXCEPT FOR CERTAIN RECORDS; PROVIDE FOR THE CONFIDENTIALITY OF CERTAIN INFORMATION RELATED TO PROCEEDINGS; PROVIDE THAT THE DEPARTMENT SHALL TRY TO 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 THAT THE PHYSICIAN OR DENTIST RESPONSIBLE FOR SUPERVISION OF A CERTIFIED REGISTERED NURSE ANESTHETIST MUST BE IDENTIFIED ON THE ANESTHESIA RECORD BEFORE ADMINISTRATION OF ANESTHESIA; 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:

Practice of physicians, surgeons, and osteopaths

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.    (A)    Unless otherwise provided for in this chapter, Chapter 1, Title 40 applies to the profession or business regulated under this chapter. However, if there is a conflict between this chapter and Article 1, Chapter 1, Title 40, the provisions of this chapter control.

(B)    Unless there is a conflict with other articles of this chapter, Article 1, Chapter 47, Title 40 applies to all programs administered through the State Board of Medical Examiners.

Section 40-47-10.    (A)(1)    There is created the State Board of Medical Examiners to be composed of twelve members, three 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, each representing one 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 this State. All lay members of the board must hold a baccalaureate degree or higher, must not have been convicted of a felony or a 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.

(2)    The members of the board shall serve for terms of four years or until their successors are appointed and qualify. Members of the board may only serve three consecutive terms.

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

(4)    The one lay member and one physician from the State at large must be appointed by the Governor, with the advice and consent of the Senate. Two lay members must be appointed by the Governor, with the advice and consent of the Senate, one upon the recommendation of the President Pro Tempore of the Senate and one upon the recommendation of the Speaker of the House of Representatives.

(5)    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 any physician currently permanently licensed in this State 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 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 the same manner of the original appointment for the unexpired portion of the term.

(6)    Vacancies that occur when the General Assembly is not in session 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. The Governor may remove members from the board for absenteeism, as well as for other grounds provided for in Section 1-3-240.

(H)    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 of the State Board of Medical Examiners, or the chairman's designee, 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.

(I)    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 under 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 any 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;

(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. Five physician commissioners must be appointed from each of the six congressional districts and must reside in the district, which they are appointed to represent, and six physician members of the commission must be appointed from the State at large. At-large members must be currently licensed and actively practicing medicine in this State and must reside within the State at the time of appointment and throughout their terms. One physician commissioner initially appointed from each congressional district shall serve a term of one year and until a successor is appointed and qualified. One physician commissioner initially appointed from each congressional district shall serve a term of two years and until a successor is appointed and qualified. One physician commissioner initially appointed from each congressional district shall serve a term of three years and until a successor is appointed and qualified. The successors of the initial physician commissioners shall serve terms of three years or until their successors are appointed and qualified. The members of the commission are limited to three consecutive terms. A member of the board may not simultaneously serve as a commissioner. In case of a vacancy by way of death, resignation, or otherwise, the board shall appoint a successor to serve for the unexpired portion of the term. Where justice, fairness, or other circumstances so require, the board may appoint past commissioners to hear complaints in individual cases.

(B)    All lay commissioners must hold a baccalaureate degree or higher, must not have been convicted 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. Two lay commissioners must be appointed by the Governor from each of the six congressional districts, with the advice and consent of the Senate. Each lay commissioner must be a registered voter and reside in the congressional district he represents throughout his term. Each lay commissioner initially appointed from each district shall serve for a term of three years and until his successor is appointed and qualified. Vacancies must be filled in the manner of the original appointment for the remainder of the unexpired portion of the term. The Governor may appoint a lay commissioner to serve a full term; however, a lay commissioner may not serve more than three consecutive terms.

(C)    The commission is empowered to hear those formal complaints filed against practitioners authorized to practice under this chapter, unless otherwise provided in this chapter. These hearings must be conducted in accordance with the 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 recommend findings of fact and conclusions of law to the board. The panel shall submit a certified report of its proceedings, including its findings of fact, conclusions of law, and mitigating and aggravating circumstances, for consideration by the board in rendering a final decision and shall file this report with the department.

(D)    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)    'Administrative hearing officer' means a physician designated by the board or director.

(3)    '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.

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

(5)    '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.

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

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

(8)    '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 approved by the board for evaluating continuing competency in a specialized area of practice.

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

(10)    '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.

(11)    '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.

(12)    '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.

(13)    'Delegated medical acts' means additional acts delegated by a physician or dentist to a physician assistant, respiratory care practitioner, anesthesiologist's assistant, or other practitioner authorized by law 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 must be performed under the supervision of a physician or dentist who must be readily or immediately available for consultation in accordance with the applicable scope of professional practice.

(14)    'Delegated medical acts to the APRN' means additional acts delegated by a physician or dentist to the Advanced Practice Registered Nurse (NP, CNM, or CNS) which may include formulating a medical diagnosis and initiating, continuing, and modifying therapies, including prescribing drug therapy, under approved written protocols as provided in Section 40-33-34 and Section 40-47-195. Delegated medical acts to the APRN (NP, CNM, or CNS) must be agreed to jointly by both the Board of Nursing and the Board of Medical Examiners. Delegated medical acts to the APRN (NP, CNM, or CNS) must be performed under the general supervision of a physician or dentist who must be readily available for consultation.

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

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

(17)    '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.

(18)    'Final decision' means an order of the board that concludes a license application proceeding or formal disciplinary proceeding.

(19)    'Formal complaint' means a formal written complaint charging misconduct by a respondent in violation of this chapter, Chapter 1 of Title 40, or any other provision of law.

(20)    'Immediately available' for the purpose of supervising unlicensed personnel means being located within the office and ready for immediate utilization when needed.

(21)    '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.

(22)    '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.

(23) 'Independent credentials verification organization' means an entity approved by the board to provide primary source verification of an applicant's identity, medical education, postgraduate training, examination history, disciplinary history, and other core information required for licensure in this State.

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

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

(26)    '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.

(27)    '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.

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

(29)    '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.

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

(31)    '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.

(32)    '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.

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

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

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

(36)    'Practice of Medicine' means:

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

(b)    offering or undertaking to prescribe, order, give, or administer any drug or medicine for the use of any other 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 any 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 this 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 such physician or his or her agent;

(f)    rendering a determination of medical necessity or a decision affecting the diagnosis and/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 such a 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.

(37)    '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 this State, except as provided by law for persons licensed in another state or jurisdiction.

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

(39)    '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.

(40)    '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.

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

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

(43)    '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 the equivalent of three full-time NPs, CNMs, or CNSs 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 the Board of Medical Examiners shall review the application to determine if adequate supervision exists.

(44)    '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.

(45)    '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.

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

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

(48)    '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 may consider any actions taken by the original board or conduct considered relevant to the applicant's fitness for licensure to practice in this State.

(49)    '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.

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

(51)    '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.

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

(53)    '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 any provision of the code of ethics adopted by the board or a specialty.

(54)    '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 any suspension subsequently imposed to include this time.

(55)    '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 hereunder 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 United States Medical Licensing Examination (USMLE) or the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) examination sequence, or graduated from a college accredited by the Liaison Committee on Medical Education (LCME) or the American Osteopathic Association (AOA), Commission on Osteopathic College Accreditation (COCA), or successfully completed post-graduate training from the American Council for Graduate Medical Education (ACGME) approved or AOA-approved programs, or obtained American Board of Medical Specialties (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 this 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 pharmacists from selling, using, and dispensing drugs in their places of business;

(4)    allow under any circumstances, physicians' 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 delegated directly to unlicensed personnel by the physician and not through another licensed practitioner;

(b)    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;

(c)    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;

(d)    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

(e)    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 any legally qualified licensee of another state who is employed by the United States government or any department, bureau, division, or agency of the United States government, while in the discharge of official duties;

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

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

(9)    prohibit the practice of any legally qualified licensee of another state involved in the transport of patients to medical facilities or the lawful procurement of organs or other body parts for medical use.

(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 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.

(C)    Nothing in this chapter may be construed to authorize a physician to delegate the performance of radiological services in violation of Chapter 74 of Title 44.

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 the Department of Health and Environmental Control. 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 a 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 in which the applicant has been offered a position in a medical residency training program accredited by the American Council for Graduate Medical Education or American Osteopathic Association 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)    An applicant for a limited license for medical residency training who is a graduate of a medical school located outside the United States or Canada may be considered on an individual basis. Such 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, or both. The board may waive this requirement if the applicant has a full-time academic faculty appointment at the rank of assistant professor or greater in a medical school in this State accredited by the American Council for Graduate Medical Education or the American Osteopathic Association. 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 or the American Osteopathic Association or another organization approved by the board.

(D)    A physician in a medical residency training program in this State may apply for a permanent license at least ninety days before his or her limited license expires. No part of a limited license application may be applied to an application for a permanent license. Each application must be filed separately.

(E)    A new application for a limited license for employment with a state agency may not be authorized after January 1, 2001. A current holder of a limited license for employment with a state agency may renew his or her limited license 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 the limited license holder has 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 must 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)    An emergency limited license may be issued to a physician actively licensed in another state who is in good standing in accordance with Section 40-47-160(B) and whose place of established practice has been the subject of an emergency disaster declaration by an appropriate federal or state authority. An emergency limited license is valid for one year and may be renewed upon approval of the board. This license must be limited to practice in this State while associated with a licensed physician in this State who holds an unrestricted, permanent license or while employed by a licensed healthcare facility in this State. The applicant must submit the following items:

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

(2)    such documentation as may be acceptable to the board under the circumstances to demonstrate eligibility for the limited license, including documentation of an existing license in good standing authorizing professional practice in the state which is subject to the emergency disaster declaration.

(H)    A temporary license may be issued to an applicant who has met all requirements for the issuance of a permanent license, except such 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.

(I)    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.    (A)    To obtain a permanent license to practice medicine in this State an applicant shall comply with the requirements of this section.

(B)(1)    An applicant shall document to the satisfaction of the board graduation from a:

(a)    medical school located in the United States or Canada that is accredited by the Liaison Committee on Medical Education 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;

(c)    medical school located outside the United States or Canada.

(2)    An applicant who graduated from a medical school located outside of the United States shall:

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

(ii)    document a minimum of three years of progressive postgraduate medical residency training in the United States approved by the Accreditation Council for Graduate Medical Education (ACGME), American Osteopathic Association (AOA), or postgraduate training in Canada approved by the Royal College of Physicians and Surgeons, except that if an applicant has been licensed in another state for ten years or more, the applicant is only required to document one year of postgraduate residency training approved by the board; or

(b)(i)    document successful completion of a Fifth Pathway program; and

(ii)    complete a minimum of three years progressive postgraduate medical residency training in the United States approved by the ACGME or 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 another organization approved by the board;

(c)    notwithstanding the provisions of this subsection, the board may waive the ECFMG or Fifth Pathway requirement if the applicant is to have a full-time academic faculty appointment at the rank of assistant professor or greater at a medical school in this State.

(C)    An applicant shall document to the satisfaction of the board successful completion of:

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

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

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

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

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

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

(7)    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 another organization approved by the board; or

(8)    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 may be accepted only if taken before 1999.

(D)    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 filing a completed application to the board one of the following:

(1)    National Board of Medical Examiners examination;

(2)    National Board of Osteopathic Medical Examiners examination;

(3)    FLEX;

(4)    USMLE;

(5)    MCCQE;

(6)    SPEX;

(7)    COMVEX;

(8)    COMLEX-USA;

(9)    ECFMG;

(10)    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 another organization approved by the board; or

(11)    maintenance of certification by a specialty board recognized by the American Board of Medical Specialties, the American Osteopathic Association, or another organization approved by the board, as evidenced by having acquired one hundred fifty hours of Category I continuing medical education 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.

(E)    The additional examination required pursuant to subsection (D) 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 is immediately 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 the individual has 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)    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 licensure:

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

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

(b)    FLEX examinations taken before June 1, 1985, were administered in three days and the days were referred to as Day 1, Day 2, and Day 3. In case of failure, the results of the first three takings of each day must be considered by the board, and the board may consider the results from a fourth taking of any day; however, the applicant has the burden of presenting 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 for an applicant who currently holds a certification, recertification, or a certificate of added qualification by a specialty board recognized by the ABMS, AOA, or another organization approved by the board.

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

(a)    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.

(b)    FLEX examinations taken after June 1, 1985, were administered as Component I and Component II. In case of failure, the results of the first three takings of each component must be considered by the board. The board may consider the results from a fourth taking of any component; however, the applicant has the burden of presenting 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 I or Component II, except that a subsequent taking may be considered by the board for an applicant who currently holds a certification, recertification, or a certificate of added qualification by a specialty board recognized by the ABMS, AOA, or another organization approved by the board.

(3)    For the United States Medical Licensing Examination or the Comprehensive Osteopathic Medical Licensing Examination, or the Medical Council of Canada Qualifying Examination, 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 must be considered by the board. The board may consider the results from a fourth taking of any step; however, the applicant has the burden of presenting 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 for an applicant who currently holds a certification, recertification, or a certificate of added qualification by a specialty board recognized by the ABMS, AOA, or another organization approved by the board.

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

(1)    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.

(2)    Graduates of medical schools located outside the United States or Canada shall document a minimum of three years of progressive postgraduate medical residency training approved by the board, except that these graduates who have completed at least two and one-half years of progressive postgraduate medical residency training in the program in which they are currently enrolled may be issued a license upon certification from the program of their good standing and expected satisfactory completion. These graduates who have been 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. A foreign graduate may satisfy the three year postgraduate training requirement with at least one year of approved training in combination with certification by a specialty board recognized by the ABMS, AOA, or another organization approved by the board.

(3)    The board may accept 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.

(4)    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 or the American Osteopathic Association or postgraduate training in Canada approved by the Royal College of Physicians and Surgeons.

(H)    An applicant may be denied licensure if the individual has committed acts or omissions that are grounds for disciplinary action as provided for 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.

(I)    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.

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

(K)    An applicant shall file a completed application, with required supporting documentation, on forms provided by the department. Primary source verification of an applicant's identity, medical education, postgraduate training, examination history, disciplinary history, and other core information required for licensure in this State must be provided through an independent credentials verification organization approved by the board.

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

(M)    The board must not issue a permanent 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 40-47-33.    (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.

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

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

Section 40-47-34.    (A)    The board shall waive all application fees, examination fees, and annual reregistration fees for an applicant who applies for a special volunteer license and who otherwise meets permanent licensure requirements if the applicant 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 this State. To be eligible for the waiver of these fees, an applicant shall acknowledge that there is no expectation of payment or compensation for any medical services rendered, or compensation or payment to the applicant, 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 the Department of Health and Environmental Control.

(B)    A special volunteer license may be issued to a qualified applicant upon approval by the board. Practice must be limited to each specific site and practice setting approved by the board. There must 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 specific proposed practice location;

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

(4)    documentation that the applicant shall only 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 shall review the proposed supervisory relationship to ensure that the physician supervisor is competent to supervise the special volunteer licensee. Factors the board shall consider include, but are not 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 this State. An approved supervising physician physically must be on the premises whenever a special volunteer licensee is practicing medicine;

(6)    documentation and acknowledgement that the applicant may not receive payment or compensation, either direct or indirect, or have any expectation of payment or compensation for medical services rendered, and 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 a physician holding a permanent license must be demonstrated in the following manner:

(1)    For renewal of a permanent license initially issued during a biennial renewal period, compliance with all educational, examination, and other requirements for the issuance of a permanent license is 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 following options during the renewal period is required:

(a)    forty hours of Category I continuing medical education sponsored by the American Medical Association, American Osteopathic Association, or another organization approved by the board as having acceptable standards for courses it sponsors, at least thirty hours of which must be 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 another 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 or Comprehensive Osteopathic Medical Variable Purpose Examination; or

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

(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 is required:

(a)    forty hours of Category I continuing medical education sponsored by the American Medical Association, American Osteopathic Association, or another organization approved by the board as having acceptable standards for courses it sponsors, at least thirty hours of which must be 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 another 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 or Comprehensive Osteopathic Medical Variable Purpose Examination; or

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

(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 is required:

(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 another 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 or Comprehensive Osteopathic Medical Variable Purpose Examination; or

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

(5)    For reinstatement or reactivation of a lapsed or an 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 is sufficient.

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 issuance or renewal of an active license.

(B)    A licensee shall complete the renewal form and submit the form 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 to timely renew the license, the license is deemed 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 any change of residential address, office address, or office telephone number.

(D)    A licensee shall notify the board within thirty days of any 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 arrest, or a court, including indictment. Confidential information received from a licensee or 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 evidence of rehabilitation that is satisfactory to the board. The board may require the licensee to personally appear in support of a petition for reinstatement or it may proceed upon information filed in the disciplinary matter or thereafter.

Section 40-47-45.    A final action of the board relating to the granting, refusal, or cancellation of a license is subject to review by the Administrative Law Court as provided pursuant to 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 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 the 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 maintain a record of each formal complaint and of all final decisions on complaints, which must be retained permanently as part of the records of the board.

Section 40-47-70.    A practitioner shall conduct himself or herself 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 any and all 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 that 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 engaged in misconduct.

(B)    'Misconduct' that constitutes grounds for disciplinary action is a showing to the board by the preponderance of 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 that in any way assists an unlicensed person to practice;

(8)    sustained a physical or mental impairment that renders further practice by the licensee dangerous to the public or that 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, or both, with physicians, hospital personnel, patients, family members, or others that interferes with patient care or could reasonably be expected to adversely impact the quality of care rendered to a patient. This behavior may include, but is not 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 any adverse disciplinary action by another United States or foreign licensing jurisdiction, a peer review body, a health care institution, by any professional or medical society or association, a board-approved credentialing organization, a governmental agency, a law enforcement agency, including arrest, or a court, including indictment, for acts or conduct similar to acts or conduct that would constitute grounds for disciplinary action as provided for 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 a patient or by a lawfully designated representative of a 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 witness in an administrative, civil, or criminal proceeding in this State.

(C)    In addition to all 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 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 serving, except that the board may delegate to the chairman or vice chairman of the board the authority to issue orders to temporarily suspend licenses or to seek from the Administrative Law Court an order temporarily suspending or restricting a license pending final decision by the board, as follows:

(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 hearing officer. The fact of suspension or restriction of a license, and the fact of any subsequent related action, is public information under the Freedom of Information Act after issuance of an order by the chairman or vice chairman, unless a review by the administrative hearing officer has been timely requested in writing. Filing a written request for a review by the administrative hearing officer does not stay the temporary suspension and no stay may be issued; however, the fact of the issuance of the temporary suspension order must not be made public until the time for requesting a review has passed or the administrative hearing officer issues an order after a review hearing. Upon proper written request, a review hearing must be held by the administrative hearing officer within three business days of the filing of the request for review, unless otherwise agreed by the parties. If the issuance of the temporary suspension order is not sustained by the administrative hearing officer, the matter must remain confidential and must not be made public, except to the extent the board considers it relevant to the final decision of the board; or

(2)    the Department of Labor, Licensing and Regulation, acting through the Office of General Counsel or its designee, at the direction of the chairman or vice chairman of the board, 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 three business days of the filing of the petition, unless otherwise agreed by the parties. 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 considers it relevant to the final decision of the board. The fact of suspension or restriction of a license, and the fact of 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 that subverts or attempts to subvert the security or integrity of the licensing examination process, the board 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 any other appropriate sanction provided by Section 40-47-120.

(2)    Conduct that subverts or attempts to subvert the security or integrity of the medical licensing examination process includes, but is not limited to, conduct that 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 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; 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, which would constitute misconduct in this State, support the issuance of a formal complaint and the commencement of disciplinary proceedings.

(B)    Proof of acts or omissions in another state may be shown by a copy of the transcript of record of the disciplinary proceedings in that 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 provide 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 provide these items within ninety days of a 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 or imprisoned not more than one year. In addition, upon conviction, the license or authorization granted to the person must be suspended and the person must be disqualified from practicing in this State until he satisfies the board that he is qualified to resume practice. 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 and document an appropriate history and physical examination, make a diagnosis, and formulate a therapeutic plan;

(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)    Notwithstanding subsection (A), a licensee may prescribe for a patient whom the licensee has not personally examined under certain circumstances including, but not limited to, writing 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 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 the administrative hearing officer. Filing a written request for a review by the administrative hearing officer does not stay the time directed in which to submit to a professional competency, 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 three business days of receipt of the request, unless otherwise agreed by the parties. 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 hearing officer. 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 hearing officer'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 or mental or physical condition of a licensee or applicant including, but not limited to, psychiatric records, which are admissible in a hearing before the board, notwithstanding any other 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 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.

(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 professional competency or 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 hearing officer. The fact of automatic suspension or denial of a license pending compliance and further order of the board is public information under the Freedom of Information Act. A review hearing and decision of an administrative hearing officer 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 fact of suspension or denial of a license by the administrative hearing officer is public information under the 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.    (A)    An initial complaint may be made by any 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. Except as provided in Section 40-47-190, 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, or 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.

(B)    Before authorization of a formal complaint, the department shall provide an opportunity for the respondent to have an informal conference concerning the alleged misconduct with representatives of the department, including a physician designated by the board. The respondent may be represented by counsel at the conference, and the department shall so inform the respondent. Communications during the informal conference must be confidential. The parties shall maintain the confidentiality of the informal conference and shall not rely on, or introduce as evidence in any proceedings, any oral or written communications having occurred during the informal conference, unless such communications are obtained by means other than the informal conference. An agreement reached by the respondent and department must be documented in writing and signed by the respondent and the department and may provide for formal or informal disposition of the allegations, with or without admitting and denying misconduct. An agreement is not final until it has been submitted to and approved by the board. An agreement marked private must be placed in the respondent's file within the department and maintained as confidential pursuant to Section 40-47-190(F).

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 the notice and formal complaint are mailed. The notice mailed to the respondent must 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)(1)    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.

(2)    If the panel finds that the charges in the formal complaint are not supported by the evidence or do not merit taking 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.

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

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

(5)    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)    When 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 on the report, the notice must be given not less than thirty days before the meeting. The respondent and the Office of General Counsel 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 panel's report 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, the board 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)    When 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.

(I)    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 any 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 is not permitted in a medical disciplinary proceeding except as provided in this chapter. Within twenty days of an answer being filed, 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. Except as provided in Section 40-47-190, 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 must be en 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 any 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 are not required to be made available to the requesting party by the opposing party unless not otherwise available.

(D)    Depositions are only 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 upon a showing of good cause. The presiding officer may place restrictions or conditions on the manner, time, and place of an authorized deposition. Depositions must be completed not later than fifteen days before a scheduled hearing. 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 to by all participating parties. The admissibility of a deposition de bene esse or portion of the deposition must be determined by the presiding officer or board not less than five days prior to the time it is to be offered into evidence.

(F)    Prehearing 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. Any 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 any other provision of this section, the Office of General Counsel, or its designee, shall provide the respondent with exculpatory evidence relevant to the formal charges.

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

(I)    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. If 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.

(J)    Disputes concerning depositions and the disclosure or exchange of information must be determined by the panel or presiding officer. Review of these decisions are not subject to an interlocutory appeal and 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 40-47-119.    (A)    Before the hearing the parties shall exchange:

(1)    a final list of witnesses the party reasonably expects to testify at the hearing;

(2)    a final list of all exhibits expected to be offered at the hearing, including a written report or summary from each expert witness expected to testify;

(3)    a final list of all facts that the party intends to request be judicially noticed and the information supporting the judicial notice of the facts requested.

(B)    A witness list or exhibit not exchanged before the hearing may be excluded from admission into evidence. The prehearing exchange may be amended upon motion and for good cause shown, unless the amendment would substantially prejudice any other party in the presentation of its case.

(C)(1)    If at least twenty days written notice of the intention to offer the following documents is given to every party, accompanied by a copy of the document, the name of the author or maker of the document or other person who can establish its admissibility in evidence, a party may offer in evidence, without foundation or other proof:

(a)    documents including, but not limited to, photographs, maps, drawings, blue prints, weather reports, business records, and communications;

(b)    documents prepared by hospitals, doctors, dentists, registered nurses, and other health care providers; bills for drugs and medical appliances; property damages bills or estimates, if itemized, setting forth the charges for labor and materials; and reports of earnings and lost time prepared by an employer;

(c)    the deposition of a witness;

(d)    the written opinion of an expert, or the deposition of the expert if the expert's qualifications, the subject of the expert testimony, the basis of the expert's opinions and conclusions, and the expert's opinions are also submitted at least twenty days before the hearing;

(e)    any other document not specifically covered by any of the foregoing provisions which is otherwise admissible under the rules of evidence.

(2)    Upon ten days notice to the proponent of the document and all other parties, any other party may subpoena the author, maker, or other person identified by the proponent who can establish the admissibility in evidence of a document admissible under this rule at that party's expense and examine the author or maker as if under cross-examination. If the properly subpoenaed author, maker, or other person identified by the proponent who can establish the admissibility of the document in evidence fails to appear at the hearing, or is beyond the jurisdiction of the subpoena and fails to appear at the hearing, the document is not admissible unless otherwise provided by the rules of evidence.

(3)    Except as provided in this chapter, the established rules of evidence as provided in S.C. Code Ann. Section1-23-330 (1976) must be followed. The presiding officer may require the submitting party to identify the portions of voluminous records or depositions that are relevant and material.

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 engaged in misconduct.

(B)    Upon ordering suspension, an action may be stayed upon terms and conditions as the board 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 shall surrender within fifteen days after the effective date of the revocation 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 is 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 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 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)    The fact of restriction of a licensee's right to practice and subsequent related action is public information under the Freedom of Information Act. Orders to cease and desist issued against unlicensed persons are public information under the Freedom of Information Act.

(H)    If a person's license is suspended, reissued, or reinstated by the board for any reason, the board shall report that action to the licensee's last known employer and, if applicable, to any place where the person has been granted privileges to practice.

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 board may credit the time that an authorization has been surrendered toward any 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 are not 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)(1)    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 mention the existence of the complaint investigation, or other proceeding, or disclose any information tending to identify the initial complainant or any witness or discuss testimony or other evidence in the complaint, investigation, or proceeding, except as otherwise provided in this section.

(2)    Information may be disclosed to persons involved and having a direct interest in the complaint, investigation, or other proceeding to the extent necessary for the proper disposition of the complaint, investigation, or other proceeding. The name of the initial complainant must be provided to the licensee who is the subject of the complaint, investigation, or proceeding unless the board, hearing officer, or panel determines there is good cause to withhold that information.

(3)    When the board receives information in any complaint, investigation, or other proceeding 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. The department may provide any information it considers necessary or appropriate to a substance abuse treatment program facility or monitoring program approved by the board, and this information must continue to be kept confidential and privileged from disclosure, except as provided by law.

(B)    When a formal complaint is made regarding allegations of misconduct, the formal complaint and an answer must be available for public inspection and copying ten days after the answer is filed or if no answer is filed, ten days after the expiration of the time to answer. Once the formal complaint becomes available for public inspection and copying, subsequent records and proceedings relating to the misconduct allegations must be open to the public except as otherwise provided in this section.

(1)    Patient records and identities must remain confidential unless the patient or legal representative of the patient consents in writing to the release of the records.

(2)    If allegations of incapacity of a licensee due to physical or mental causes are raised in the complaint or answer, all records, information, and proceedings relating to those allegations of incapacity must remain confidential. Any order relating to the licensee's authorization to practice must be made public; however, the order must not disclose the nature of the incapacity.

(C)    Once a proceeding becomes public as provided in this section, there is a presumption that any hearing, other proceeding, or record must remain public unless a party to the proceeding makes a showing on the record before the board, hearing officer, or panel that closure of the hearing or the record, in whole or in part, is essential to protect patients, witnesses, or the respondent from unreasonable disclosure of personal or confidential information. Public notice must be given of the request or motion to close any portion of a hearing or record, and the board, hearing officer, or panel shall provide an opportunity for a person opposing the closure to be heard prior to the decision on closure being made.

(D)    Subject to the right of public access and utilizing the procedure regarding closure described in this section, a witness in a proceeding or a patient whose care is at issue in a proceeding may petition the board, hearing officer, or panel for an order to close the hearing or record, in whole or part, to protect the witness or patient from unreasonable disclosure of personal or confidential information; however, the identity of a minor or sexual battery victim must remain confidential without a motion being made.

(E)    Upon a finding on the record that the health or safety or the personal privacy of a witness or patient would be put at risk unreasonably by the public disclosure of identifying information or of other personal information, the board, hearing officer, or panel may issue an order to protect the witness or patient from the harm shown to be probable from public disclosure.

(F)    Information that has been declared confidential or personal pursuant to this chapter or another 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.

(G)    Except as provided in this section, the identity of confidential informants or other witnesses who do not testify must be kept confidential and must not be disclosed to other parties, entities, or persons, and all information contained in confidential investigative files is privileged from disclosure for any reason whatsoever.

(H)(1)    The department shall make reasonable efforts to provide written acknowledgment of every initial complaint and 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.

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

(J)    Every communication, oral or written, to the board, department, staff, counsel, expert reviewers or witnesses, or any other 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 such communications are immune from liability.

(K)    Nothing in this chapter may be construed as prohibiting the respondent or the respondent's counsel from exercising the respondent's right of due process under the law or as prohibiting the respondent from access to the evidence relevant to the formal charges, documents to be presented at the hearing, and statements of witnesses who will be called at the hearing.

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 shall 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 to the APRN (NP, CNM, or CNS) or other practitioners are performed 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)    nature and complexity of the delegated medical acts being performed;

(3)    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 the practitioner, and prior board approval must be received for this practice; and

(4)    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 the number of practitioners prescribed by law, 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.

Section 40-47-197.    The physician or dentist 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 any section, subsection, paragraph, subparagraph, sentence, clause, phrase, or word of this act is for any reason held to be unconstitutional or invalid, such holding shall not affect the constitutionality or validity of the remaining portions of this act, the General Assembly hereby declaring that it would have passed this act, and each and every section, subsection, paragraph, subparagraph, sentence, clause, phrase, and word thereof, irrespective of the fact that any one or more other sections, subsections, paragraphs, subparagraphs, sentences, clauses, phrases, or words hereof may be declared to be unconstitutional, invalid, or otherwise ineffective."

Time effective

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

Ratified the 7th day of June, 2006.

Approved the 9th day of June, 2006.

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This web page was last updated on Friday, December 4, 2009 at 3:33 P.M.