2019 -- S 0681

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LC001869

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2019

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A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS - PENALTIES

     Introduced By: Senator Joshua Miller

     Date Introduced: March 21, 2019

     Referred To: Senate Health & Human Services

     (Dept. of Health)

It is enacted by the General Assembly as follows:

     SECTION 1. Section 5-25-14 of the General Laws in Chapter 5-25 entitled "Veterinary

Practice" is hereby amended to read as follows:

     5-25-14. Grounds for refusal to issue, refusal to renew, revoke, or suspend a license.

     The division has the power to deny, revoke, or suspend, or assess administrative

monetary penalties against any license issued under this chapter or otherwise discipline a licensee

upon proof of the following (administrative monetary penalties may not exceed one thousand five

hundred dollars ($1,500) per charge or count):

     (1) Conviction of a crime involving moral turpitude; conviction of a felony; and

conviction of a crime arising out of the practice of veterinary medicine;

     (2) Addiction to narcotics, habitual drunkenness, or rendering professional services to a

patient while the veterinarian is intoxicated or incapacitated by the use of drugs;

     (3) Knowingly placing the health of a client at serious risk without maintaining proper

precautions;

     (4) Fraud or misrepresentation in any phase of procuring or renewing a license;

     (5) Unprofessional conduct, which includes the matters set forth in the section or other

matters as further defined in regulations of the division;

     (6) Advertising designed to mislead the public;

     (7) Representing certain procedures are performed with greater authority or expertise;

     (8) Fraud or misrepresentation of treatment procedures or statements regarding the ability

to treat;

     (9) Fee splitting or kickbacks of any kind, except where services are provided jointly;

     (10) Failure to maintain acceptable sanitation standards;

     (11) Malpractice, gross negligence, or wanton disregard of accepted professional

standards;

     (12) Adjudication of mental incompetence;

     (13) Lack of fitness to practice by reason of mental or physical impairment or otherwise;

or

     (14) Any other grounds to deny, revoke or suspend a license as provided for in the rules

and regulations.

     SECTION 2. Section 5-29-33 of the General Laws in Chapter 5-29 entitled "Podiatrists"

is hereby amended to read as follows:

     5-29-33. Sanctions.

     If the accused is found guilty of unprofessional conduct as specified in § 5-29-32, the

director, at the direction of the board, shall impose one or more of the following conditions:

     (1) Administer a reprimand;

     (2) Suspend, limit or restrict his or her license or limited registration to practice podiatry;

     (3) Require him or her to serve a period of probation subject to certain conditions and

requirements including, where appropriate, sanctions or restitution;

     (4) Revoke indefinitely his or her license or limited registration to practice podiatry;

     (5) Require him or her to submit to the care, counseling, or treatment of a physician or

program acceptable to the board;

     (6) Require him or her to participate in a program of continuing podiatric education in the

area or areas in which he or she has been judged deficient;

     (7) Require him or her to practice under the direction of a podiatrist in a public

institution, public or private health care program, or private practice for a period of time specified

by the board;

     (8) Assess against the podiatrist the administrative costs of the proceedings instituted

against the podiatrist; provided, that assessment does not exceed ten thousand dollars ($10,000);

or

     (9) Assess administrative monetary penalties against any podiatrist who fails to comply

with any provision of this chapter or rule, regulation, order, license, or approval issued by the

director; provided, that the administrative monetary penalties do not exceed one thousand five

hundred dollars ($1,500) per charge or count; and

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     (9)(10) Any other conditions or restrictions deemed appropriate under the circumstances.

     SECTION 3. Section 5-31.1-17 of the General Laws in Chapter 5-31.1 entitled "Dentists

and Dental Hygienists" is hereby amended to read as follows:

     5-31.1-17. Sanctions.

     If the accused is found guilty of unprofessional conduct as defined in § 5-31.1-10, the

director, at the direction of the board, shall impose one or more of the following conditions:

     (1) Administer a reprimand;

     (2) Suspend, limit, or restrict his or her license or limited registration to practice dentistry

or license to practice dental hygiene or license to practice DAANCE-certified maxillofacial

surgery assisting;

     (3) Require him or her to serve a period of probation subject to certain conditions and

requirements including, where appropriate, sanctions or restitution;

     (4) Revoke, indefinitely, his or her license or limited registration to practice dentistry or

license to practice dental hygiene or license to practice DAANCE-certified maxillofacial surgery

assisting;

     (5) Require him or her to submit to the care, counseling, or treatment of a physician or

program acceptable to the board;

     (6) Require him or her to participate in a program of continuing dental, dental hygiene, or

DAANCE-certified maxillofacial surgery assisting education the area or areas in which he or she

has been judged deficient;

     (7) Require him or her to practice under the direction of a dentist in a public institution,

public or private health care program, or private practice for a period of time specified by the

board;

     (8) Assess against the dentist, dental hygienist or DAANCE-certified maxillofacial

surgery assistant the administrative costs of the proceedings instituted against the dentist, dental

hygienist or DAANCE-certified maxillofacial surgery assisting under this chapter; provided, that

the assessment does not exceed ten thousand dollars ($10,000); or

     (9) Assess administrative monetary penalties against any dentist who fails to comply with

any provision of this chapter or rule, regulation, order, license, or approval issued by the director;

provided, that the administrative monetary penalties do not exceed one thousand five hundred

dollars ($1,500) per charge or count; and

     (9)(10) Any other condition, conditions, or restrictions deemed appropriate under the

circumstances.

     SECTION 4. Section 5-35.1-18 of the General Laws in Chapter 5-35.1 entitled

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"Optometrists" is hereby amended to read as follows:

     5-35.1-18. Refusal, suspension or revocation of license for unprofessional conduct.

     In addition to any and all other remedies provided in this chapter, the director may, after

notice and hearing in the director's discretion, refuse to grant, refuse to renew, suspend, assess

administrative monetary penalties against, or revoke any license provided for in this chapter to

any person who is guilty of unprofessional conduct or conduct of a character likely to deceive or

defraud the public, or for any fraud or deception committed in obtaining a license. Administrative

monetary penalties may not exceed one thousand five hundred dollars ($1,500) per charge or

count. "Unprofessional conduct" is defined as including, but is not limited to:

     (1) Conviction of one or more of the offenses set forth in § 23-17-37;

     (2) Knowingly placing the health of a patient at serious risk without maintaining proper

precautions;

     (3) Advertising by means of false or deceptive statements;

     (4) The use of drugs or alcohol to an extent that impairs the person's ability to properly

engage in the profession;

     (5) Use of any false or fraudulent statement in any document connected with his or her

practice;

     (6) Obtaining of any fee by fraud or willful misrepresentation of any kind whether from a

patient or insurance plan;

     (7) Knowingly performing any act which in any way aids or assists an unlicensed person

to practice in violation of this chapter;

     (8) Violating or attempting to violate, directly or indirectly, or assisting in, or abetting,

the violation of, or conspiring to violate, any of the provisions of this chapter or regulations

previously or hereafter issued pursuant to this chapter;

     (9) Incompetence;

     (10) Repeated acts of gross misconduct;

     (11) An optometrist providing services to a person who is making a claim as a result of a

personal injury, who charges or collects from the person any amount in excess of the

reimbursement to the optometrist by the insurer as a condition of providing or continuing to

provide services or treatment;

     (12) Failure to conform to acceptable and prevailing community standard of optometric

practice;

     (13) Advertising by written or spoken words of a character tending to deceive or mislead

the public;

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     (14) Practicing his or her profession under any oral or written contract, arrangement or

understanding where anyone, not licensed to practice optometry in this state shares, directly or

indirectly, in any fees received by that licensed optometrist;

     (15) Grave and repeated misuse of any ocular pharmaceutical agent; or

     (16) The use of any agent or procedure in the course of optometric practice by an

optometrist not properly authorized under this chapter.

     SECTION 5. Section 5-37-6.3 of the General Laws in Chapter 5-37 entitled "Board of

Medical Licensure and Discipline" is hereby amended to read as follows:

     5-37-6.3. Sanctions.

     If the accused is found guilty of unprofessional conduct as described in § 5-37-6.2, the

director, at the direction of the board, shall impose one or more of the following conditions:

     (1) Administer a reprimand;

     (2) Suspend or limit or restrict his or her license or limited registration to practice

medicine;

     (3) Require him or her to serve a period of probation subject to certain conditions and

requirements including, where appropriate, sanctions or restitution;

     (4) Revoke indefinitely his or her license or limited registration to practice medicine;

     (5) Require him or her to submit to the care, counseling, or treatment of a physician or

program acceptable to the board;

     (6) Require him or her to participate in a program of continuing medical education in the

area or areas in which he or she has been judged deficient;

     (7) Require him or her to practice under the direction of a physician in a public

institution, public or private health care program, or private practice for a period of time specified

by the board;

     (8) Assess against the physician the administrative costs of the proceedings instituted

against the physician under this chapter; provided, that this assessment does not exceed ten

thousand dollars ($10,000) fifty thousand dollars ($50,000);

     (9) Assess administrative monetary penalties against any physician who fails to comply

with any provision of this chapter or rule, regulation, order, license, or approval issued by the

director; provided, that the administrative monetary penalties do not exceed five thousand dollars

($5,000) per charge or count; and

     (9)(10) Any other conditions or restrictions deemed appropriate under the circumstances.

     SECTION 6. Section 5-54-12 of the General Laws in Chapter 5-54 entitled "Physician

Assistants" is hereby amended to read as follows:

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     5-54-12. Grounds for refusal to renew, suspension or revocation of certificates.

     The director may, after notice and a hearing refuse to grant, refuse to renew, assess

monetary penalties against, suspend, or revoke any certificate of licensure or discipline any

registrant upon proof that the person is guilty of unprofessional conduct as defined in § 5-54-2.

Administrative monetary penalties may not exceed two thousand five hundred dollars ($2,500)

per charge or count.

     SECTION 7. Section 23-13-9 of the General Laws in Chapter 23-13 entitled "Maternal

and Child Health Services for Children with Special Health Care Needs" is hereby amended to

read as follows:

     23-13-9. Licensing and regulation of midwives -- Penalty for violations.

     The state director of health is authorized and directed to make rules for the regulation of

the practice of midwifery and for the licensing of midwives, including regulations that require the

payment of an initial application fee equal to that fee that is imposed upon applicants for licensure

as nurse practitioners and a renewal fee also equivalent to that for nurse practitioners. The rules

regarding the regulation of the practice of midwifery shall authorize a licensed, certified nurse-

midwife (CNM) or a licensed, certified midwife (CM) to prescribe medications that might be

reasonably required by his or her patients; provided however, that a licensed, certified nurse-

midwife (CNM) or a licensed, certified midwife (CM) shall prescribe any of those medications as

authorized by the director of health. The provisions of this section relating to prescription

authority by certified nurse-midwives and certified midwives shall be overseen by the department

of health as defined in the department's rules and regulations for licensing of midwives (R23-

13MID). No person not a licensed midwife or a physician, registered under the provisions of

chapter 37 of title 5, shall practice midwifery, or shall make a practice of attending women in

childbirth for hire, or use the name or title of midwife. Any person who violates the provisions of

this section, or who violates any of the rules of the department of health made in pursuance of this

section, shall be fined not more than one hundred dollars ($100), or imprisoned not more than six

(6) months, or both, and the director of health may refuse to grant, refuse to renew, revoke

suspend, assess administrative monetary provisions against, or the license issued to any person

when, in the opinion of the director of health, that person is guilty of unprofessional conduct.

Administrative monetary penalties may not exceed one thousand five hundred dollars ($1,500)

per charge or count.

     SECTION 8. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO BUSINESSES AND PROFESSIONS - PENALTIES

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     This act would enhance the ability of the director of the board of medical licensure and

discipline, the director of the board of dentists and dental hygienists, the director of the board of

podiatrists, the director of the board of physician assistants, the director of the board of

optometrists, the division of the board of veterinary practice, and the state director of health

overseeing the practice of midwifery, to assess administrative monetary penalties, in addition to

their ability to suspend, revoke or refuse to renew the license of any licensed professional within

their department who is found guilty of unprofessional conduct.

     This act would take effect upon passage.

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LC001869

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