ACT Act 929 of 2015 codified in A.C.A. §
17-95-901 -917
I.
Definitions.
A. ""Graduate registered physician" means an
individual who:
1. Is a resident of Arkansas
who has graduated from an accredited allopathic medical school or osteopathic
medical school and is not currently enrolled in an accredited graduate medical
education training program; or
2.
Is a citizen of the United States or a legal resident alien who has graduated
from an accredited Arkansas allopathic medical school medical school or
Arkansas osteopathic medical school and is not currently enrolled in an
accredited graduate medical education training program.
3. The graduate registered physician is a
dependent medical practitioner who:
4. Only provides healthcare services under
the supervision of a physician; and
5. Works under a physician-drafted protocol
approved by the Arkansas State Medical Board, which describes how the graduate
registered physician and the physician will work together and practice
guidelines required by the supervising physician;
B. "Medical school" means an accredited
allopathic medical school or osteopathic medical school;
C. "Resident of Arkansas" means a natural
person who provides evidence deemed sufficient to the Arkansas State Medical
Board that the person uses an Arkansas residence address for federal or state
tax purposes;
1. 'supervising physician"
means a physician who is board eligible in his or her specialty and licensed
under the Arkansas Medical Practices Act, §
17-95-201 et seq., §
17-95-301 etseq., and §
17-95-401 et seq., who has agreed
to practice in consultation with a graduate registered physician and;
and
D. 'supervision"
means overseeing the activities of and accepting responsibility for the medical
services rendered by a graduate registered physician.
1. Supervision of each graduate registered
physician by a physician or physicians shall be continuous.
II.
Qualifications
for licensure.
A. Except as otherwise
provided in this subchapter, an individual shall be licensed by the Arkansas
State Medical Board before the individual may practice as a graduate registered
physician.
B. The board may grant a
license as a graduate registered physician to an applicant who:
1. Submits an application on forms approved
by the board; The application and licensing fees shall be the same amount as
those paid by regular physicians;
2. Has successfully completed Step 1 and Step
2 of the United States Medical Licensing Examination, Comprehensive Osteopathic
Medical Licensing Examination, or the equivalent of both steps of an Arkansas
State Medical Board-approved medically licensing examination within the
two-year period immediately preceding application for licensure as a graduate
registered physician, but not more than two (2) years after graduation from a
medical school, an allopathic medical college, or an osteopathic medical
college; All graduates must have already passed Step 1 and Step 2 of the United
States Medical Licensing Examination, Comprehensive Osteopathic Medical
Licensing Examination, as well as the COMLEX Cognitive Evaluation and
Performance Evaluation prior to graduating from Medical School. Any individual
applying for graduate registered physician will be held to the same standards
as outlined in Board Regulations 3 and 14 with regard to the number of pass
attempts for each step.
3. Has not
completed an accredited postgraduate residency but has successfully completed
Step 2 of the United States Medical Licensing Examination or the equivalent of
Step 2 from a board accredited medically licensing examination within the
two-year period immediately preceding application for licensure as graduate
registered physician;
4. Has no
licensure, certification, or registration under current discipline, revocation,
suspension, or probation for cause resulting from the applicant's medical
practice, unless the board considers the conditions and agrees to
licensure;
5. Enters into a
physician-drafted protocol within six (6) months of initial
licensure;
6. Submits to the board
any other information that the board deems necessary to evaluate the
applicant's qualifications.
C. Individuals applying to practice as
graduate registered physicians shall be subject to criminal background checks
as outlined in
17-95-306.
D. Registered graduate physician applicant
must obtain supervising physician who is in good standing pursuant to Section
VI.D below and appear before the Board for approval prior to
practicing.
E. The license will
expire the day the physician enters residency.
III.
Renewal.
A. Upon notification from the Arkansas State
Medical Board, an individual who holds a license as a graduate registered
physician in this state shall renew the license by:
1. The renewal fees shall be the same amount
as those of regular physicians;
2.
Completing the appropriate renewal forms;
3. Submitting verification of actual practice
under a physician-drafted protocol during the immediately preceding licensure
period; and
4. Meeting other
requirements set by the board.
B. The Arkansas State Medical Board shall
determine the renewal period.
C. An
individual who holds a license as a graduate registered physician in this state
cannot renew his or her license more than two times after the initial license
has been granted.
IV.
Scope of authority.
A. A
graduate registered physician
1. May provide
healthcare services with physician supervision.
2. The supervising physician shall be
identified on all prescriptions and orders.
3. A graduate registered physician may
perform those duties and responsibilities, including the prescribing, ordering,
and administering of drugs and medical devices that are delegated by his or her
supervising physician.
B.
A graduate registered physician shall be considered the agent of his or her
supervising physician in the performance of all practice-related activities,
including but not limited to, the ordering of diagnostic, therapeutic, and
other medical services.
C. A
graduate registered physician may perform healthcare services in a setting
authorized by the supervising physician in accordance with any applicable
facility policy.
V.
Prescriptive authority.
A. A
physician who is supervising a graduate registered physician may
1. Delegate prescriptive authority to a
graduate registered physician to include prescribing, ordering, and
administering Schedules III-V controlled substances as described in the Uniform
Controlled Substances Act, §§
5-64-101 -
5-64-510, and 21 C.F.R. Part
1300,
all legend drugs, and all nonscheduled prescription medications and medical
devices.
2. All prescriptions and
orders issued by a graduate registered physician also shall identify his or her
supervising physician.
B.
A graduate registered physician's level of prescriptive authority shall not
exceed the authority of the supervising physician.
C. A graduate registered physician who
prescribes controlled substances shall register with the Drug Enforcement
Administration as part of the Drug Enforcement Administration's Mid-Level
Practitioner Registry, C.F.R. Part 1300, 58 FR
31171-
31175, and the Controlled
Substances Act, 21 30 U.S.C.
§
801 et seq.
VI.
Supervision.
A. Supervision of a graduate registered
physician shall be continuous and require the physical presence of the
supervising physician at the place that the services are rendered.
B. Each team of physicians and graduate
registered physicians has an obligation to ensure that:
1. The graduate registered physician's scope
of practice is identified;
2. The
delegation of a medical task is appropriate to the graduate registered
physician's level of competence;
3.
The relationship and access to the supervising physician is defined;
and
4. A process of evaluation of
the graduate registered physician's performance is
established.
C. The
graduate registered physician and supervising physician may designate backup
physicians who agree to supervise the graduate registered physician during the
absence of the supervising physician.
D. A physician who desires to supervise a
graduate registered physician shall:
1. Be
licensed in this state and must have an unencumbered license, and have no
disciplinary action by the Arkansas State Medical Board;
2. Notify the Arkansas State Medical Board of
his or her intent to supervise a graduate registered physician;
3. Submit a statement to the board that he or
she will exercise supervision over the graduate registered physician in
accordance with rules adopted by the board; and
4. Limit supervision to no more than two (2)
graduate registered physicians per supervising
physician.
VII.
Notification of intent to practice.
A. Before initiating practice, a graduate
registered physician licensed in this state must submit on forms approved by
the Arkansas State Medical Board notification of an intent to
practice.
B. The notification shall
include:
1. The name, business address, email
address, and telephone number of the supervising physician; and
2. The name, business address, and telephone
number of the graduate registered physician.
C. A graduate registered physician shall
notify the board of any changes or additions in supervising physicians within
ten (10) calendar days. If a graduate registered physician leaves their current
employment, their license would become ""Inactive.""
VIII.
Exclusions of limitations of
employment
This chapter shall not be construed to limit the employment
arrangement of a graduate registered physician licensed under this
subchapter.
IX.
Violation.
Following the exercise of due process, the Arkansas State
Medical Board may discipline a graduate registered physician who;
A. Fraudulently or deceptively obtains or
attempts to obtain a license;
B.
Fraudulently or deceptively uses a license;
C. Violates any provision of this subchapter
or any rules adopted by the board pertaining to this chapter;
D. Is convicted of a felony:
E. Is a habitual user of intoxicants or drugs
to the extent that he or she is unable to safely perform as a graduate
registered physician;
F. Has been
adjudicated as mentally incompetent or has a mental condition that renders him
or her unable to safely perform as a graduate registered physician;
or
G. Has committed an act of moral
turpitude.
X.
Disciplinary authority.
Upon finding that a graduate registered physician has committed
an offense described in §
17-95-910, the Arkansas State
Medical Board may:
A. Refuse to grant
a license;
B. Administer a public
or private reprimand;
C. Revoke,
suspend, limit, or otherwise restrict a license;
D. Require a graduate registered physician to
submit to the care, counseling, or treatment of a physician or physicians
designated by the board;
E. Suspend
enforcement of its finding and place the graduate registered physician on
probation with right to vacate the probationary order for noncompliance;
or
F. Restore or reissue, at its
discretion, a license and impose any disciplinary or corrective measure that
may have been imposed previously.
XI.
Title and practice
protection
An individual who is not licensed under this subchapter is
guilty of a Class A misdemeanor and is subject to penalties applicable to the
unlicensed practice of medicine if he or she:
A. Holds himself or herself out as a graduate
registered physician; or
B. Uses
any combination or abbreviation of the term "graduate registered physician" to
indicate or imply that he or she is a graduate registered physician.
XII.
Identification
requirements.
A graduate registered physician licensed under this subchapter
shall keep his or her license available for inspection at his or her primary
place of business, and when engaged in professional activities, a graduate
registered physician shall wear a name tag identifying himself or herself as a
graduate registered physician, and immediately below the licensure of degree,
information, in equal size or larger lettering.
XIII.
Rule-making authority.
The Arkansas State Medical Board shall promulgate rules that
are reasonable and necessary to implement this subchapter.
XIV.
"Good Samaritan"
provision.
A graduate registered physician shall be subject to the ""Good
Samaritan" provisions embodied in §
17-95-101.
XV.
Patient care orders.
A. Patient care orders generated by a
graduate registered physician shall be construed as having the same medical,
health, and legal force and effect as if the orders were generated by his or
her supervising physician, provided that the supervising physician's name is
identified in the patient care order.
B. The orders shall be complied with and
carried out as if the orders had been issued by the graduate registered
physician's supervising physician.
XVI.
Medical malpractice -
Professional and legal liability for actions.
A graduate registered physician shall be covered under the
provisions regarding medical malpractice and legal liability as such applies to
his or her supervising physician as embodied in §§ 16-114-20 -
16-114-203 and §§
416-114-205 -
16-114-209.
History: Adopted December 3, 2015. Effective
February 10, 2016.