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| PRIOR PRINTER'S NO. 275 | PRINTER'S NO. 2059 |
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| THE GENERAL ASSEMBLY OF PENNSYLVANIA |
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| HOUSE BILL |
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| INTRODUCED BY SCAVELLO, SIPTROTH, PEIFER, BAKER, BEYER, DONATUCCI, GEORGE, HELM, HENNESSEY, KILLION, KIRKLAND, KORTZ, KOTIK, MILLER, MILNE, MOUL, O'NEILL, PASHINSKI, PICKETT, READSHAW, REICHLEY, VULAKOVICH, WATSON, YOUNGBLOOD AND ROHRER, FEBRUARY 5, 2009 |
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| AS REPORTED FROM COMMITTEE ON PROFESSIONAL LICENSURE, HOUSE OF REPRESENTATIVES, AS AMENDED, JUNE 9, 2009 |
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| AN ACT |
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1 | Amending the act of March 2, 1956 (1955 P.L.1206, No.375), | <-- |
2 | entitled, as reenacted and amended, "An act relating to and |
3 | defining the practice of podiatry; conferring powers and |
4 | imposing duties on the State Board of Podiatry Examiners and |
5 | the Department of State; requiring licensure; providing for |
6 | the granting, cancellation, suspension and revocation of |
7 | licenses; preserving the rights of existing licenses; |
8 | providing for the promulgation of rules and regulations; |
9 | transfer of jurisdiction and records to the board; regulation |
10 | of schools of chiropody and podiatry; reciprocity; and |
11 | providing penalties, and remedies," further providing for |
12 | definitions, for exclusive jurisdiction of the board, for |
13 | reporting of multiple licensure and for practice by |
14 | unregistered persons; providing for prosthetists, orthotists, |
15 | orthotic fitters and pedorthists; further providing for |
16 | penalties, for refusal to grant, suspension and revocation, |
17 | for reinstatement of license, certificate or registration, |
18 | for display of license and certificate and for injunction or |
19 | other process; and providing for expungement. |
20 | Amending the act of December 20, 1985 (P.L.457, No.112), | <-- |
21 | entitled "An act relating to the right to practice medicine |
22 | and surgery and the right to practice medically related acts; |
23 | reestablishing the State Board of Medical Education and |
24 | Licensure as the State Board of Medicine and providing for |
25 | its composition, powers and duties; providing for the |
26 | issuance of licenses and certificates and the suspension and |
27 | revocation of licenses and certificates; providing penalties; |
28 | and making repeals," adding definitions; and providing for |
29 | licensure of prosthetists, orthotists, pedorthists and |
30 | orthotic fitters. |
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1 | The General Assembly of the Commonwealth of Pennsylvania |
2 | hereby enacts as follows: |
3 | Section 1. Section 2 of the act of March 2, 1956 (1955 P.L. | <-- |
4 | 1206, No. 375), known as the Podiatry Practice Act, reenacted |
5 | and amended August 24, 1963 (P.L.1199, No.505) and amended Dec. |
6 | 20, 1985 (P.L.384, No.107), is amended by adding subsections to |
7 | read: |
8 | Section 2. Definitions.--The following words or phrases, |
9 | unless the context clearly indicates otherwise, shall have the |
10 | meanings ascribed to them in this section: |
11 | * * * |
12 | (d) "Custom-fabricated device" shall mean a prosthesis, |
13 | orthosis or pedorthic device that is fabricated to original |
14 | measurements or a mold for use by a patient in accordance with a |
15 | prescription and which requires substantial clinical and |
16 | technical judgment in its design and fitting. |
17 | (e) "Custom-fitted device" shall mean a prefabricated |
18 | prosthesis, orthosis or pedorthic device that is sized or |
19 | modified for use by the patient in accordance with a |
20 | prescription and which requires substantial clinical judgment |
21 | and substantive alteration for appropriate use. |
22 | (f) "Orthotic fitter" shall mean an individual who is |
23 | licensed to practice orthotics, pursuant to a licensed |
24 | physician's written prescription, whose scope of practice is |
25 | limited to fitting: |
26 | (1) Prefabricated cervical orthoses not requiring more than |
27 | minor modification. |
28 | (2) Pressure gradient hose. |
29 | (3) Trusses. |
30 | (4) Custom-molded therapeutic footwear. |
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1 | (5) Custom-molded foot orthoses. |
2 | (6) Prefabricated spinal orthoses, except for those used in |
3 | the treatment of scoliosis, rigid body jackets made of |
4 | thermoformable materials, and "halo" devices. |
5 | (7) Prefabricated orthoses of the upper and lower |
6 | extremities. |
7 | (g) "Orthotics" shall mean evaluating, measuring, designing, |
8 | fabricating, assembling, fitting, adjusting or servicing an |
9 | orthosis for the correction or alleviation of neuromuscular or |
10 | musculoskeletal dysfunction, disease, injury or deformity, as |
11 | provided in this act. |
12 | (h) "Orthotist" shall mean an individual other than an |
13 | orthotic fitter licensed under this act to practice orthotics. |
14 | (i) "Over-the-counter" shall mean a prefabricated, mass- |
15 | produced item that is prepackaged and requires no professional |
16 | advice or judgment in either size selection or use, including |
17 | fabric or elastic supports, corsets, generic arch supports and |
18 | elastic hose. |
19 | (j) "Pedorthic device" shall mean therapeutic shoes, shoe |
20 | modifications made for therapeutic purposes, partial foot |
21 | prostheses, foot orthoses and below-the-knee pedorthic |
22 | modalities. Pedorthic devices do not include nontherapeutic, |
23 | accommodative inlays and nontherapeutic accommodative footwear, |
24 | regardless of method of manufacture; unmodified, nontherapeutic |
25 | over-the-counter shoes; or prefabricated unmodified and/or |
26 | unmodifiable foot care and foot wear products, accommodative |
27 | means designed with a primary goal of conforming to the |
28 | individual's anatomy, and therapeutic devices are devices that |
29 | address a medical condition, while nontherapeutic devices are |
30 | devices that do not address a medical condition. |
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1 | (k) "Pedorthics" shall mean shall mean evaluating, treatment |
2 | planning, patient managing, measuring, designing, fabricating, |
3 | assembling, fitting, adjusting or servicing necessary to |
4 | accomplish the application of a pedorthic device for the |
5 | prevention or amelioration of painful and/or disabling |
6 | conditions related to the lower extremities. |
7 | (l) "Pedorthist" shall mean an individual licensed under |
8 | this act to practice pedorthics. |
9 | (m) "Podiatrist" shall mean an individual licensed by the |
10 | board under this act. |
11 | (n) "Prefabricated orthosis" shall mean a brace or support |
12 | designed to provide for alignment, correction or prevention of |
13 | neuromuscular or musculoskeletal dysfunction, disease, injury or |
14 | deformity. The term does not include fabric or elastic support, |
15 | corsets, arch supports, low-temperature plastic splints, |
16 | trusses, elastic hose, canes, crutches, soft cervical collars, |
17 | dental appliances or other similar devices carried in stock and |
18 | sold as over-the-counter items by a drug store, department |
19 | store, corset shop or surgical supply facility. |
20 | (o) "Prosthesis" shall mean a custom-designed, custom- |
21 | fabricated, custom-fitted or custom-modified device to replace |
22 | an absent external limb for purposes of restoring physiological |
23 | function or cosmesis. The term does not include artificial eyes, |
24 | ears, fingers or toes, dental appliances, cosmetic devices such |
25 | as artificial breasts, eyelashes or wigs or other devices that |
26 | do not have a significant impact on the musculoskeletal |
27 | functions of the body. |
28 | (p) "Prosthetics" shall mean evaluating, measuring, |
29 | designing, fabricating, assembling, fitting, adjusting or |
30 | servicing a prosthesis. |
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1 | (q) "Prosthetist" shall mean an individual licensed under |
2 | this act to practice prosthetics. |
3 | (r) "Expungement" shall mean the removal of a disciplinary |
4 | record, accomplished by: |
5 | (1) Permanently sealing the affected record from public |
6 | access. |
7 | (2) Deeming the proceedings to which the affected record |
8 | refers as not having occurred. |
9 | (3) Except with respect to any subsequent application for |
10 | expungement, affording the affected party the right to represent |
11 | that no record exists regarding the subject matter of the |
12 | affected record. |
13 | (s) "NCCA" shall mean the National Commission for Certifying |
14 | Agencies. |
15 | (t) "NOCA" shall mean the National Organization for |
16 | Competency Assurance. |
17 | Section 2. Sections 5, 9.2 and 12 of the act, amended or |
18 | added December 20, 1985 (P.L.384, No.107), are amended to read: |
19 | Section 5. Exclusive Jurisdiction of Board.--From and after |
20 | the effective date of this act, the board shall exercise |
21 | exclusive jurisdiction over all persons licensed, or to be |
22 | licensed, and registered to practice podiatric medicine, |
23 | prosthetics, orthotics, pedorthics or orthotic fitting in this |
24 | Commonwealth. |
25 | Section 9.2. Reporting of Multiple Licensure.--Any licensed |
26 | podiatrist, prosthetist, orthotist, pedorthist or orthotic |
27 | fitter of this Commonwealth who is also licensed to practice |
28 | podiatric medicine, prosthetics, orthotics, pedorthics, orthotic |
29 | fitting or surgery in any other state, territory or country |
30 | shall report this information to the board on the biennial |
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1 | registration application. Any disciplinary action taken in other |
2 | states shall be reported to the board on the biennial |
3 | registration application or within ninety days of final |
4 | disposition, whichever is sooner. Multiple licensure shall be |
5 | noted by the board on the podiatrist's record, and such state, |
6 | territory or country shall be notified by the board of any |
7 | disciplinary actions taken against said podiatrist in this |
8 | Commonwealth. |
9 | Section 12. Practice by Unregistered Persons.--Any person |
10 | who is not a licensed, and registered as a podiatrist, |
11 | prosthetist, orthotist, pedorthist or orthotic fitter shall not |
12 | practice podiatric medicine, prosthetics, orthotics, pedorthics |
13 | or orthotic fitting nor in any written or printed circular or in |
14 | any business card, letterhead or sign or otherwise assume the |
15 | title "Chiropodist," "Podiatrist," "Prosthetist," "Orthotist," |
16 | "Pedorthist," "Orthotic Fitter," "DSC," "DPM," "Doctor of |
17 | Podiatric Medicine," "Foot Specialist," "Foot Correctionist," |
18 | "Pedopractor" nor any other title, name or description implying |
19 | or calculated to lead to the belief that he is qualified to |
20 | practice podiatric medicine. |
21 | Section 3. The act is amended by adding a section to read: |
22 | Section 12.1. Prosthetists, orthotists, pedorthists and |
23 | orthotic fitters.--(a) To qualify for licensure to practice |
24 | prosthetics, orthotics, orthotic fitting or pedorthics, an |
25 | applicant shall: |
26 | (1) Be of good moral character. |
27 | (2) Possess a high school diploma or its equivalent. |
28 | (3) Complete the amount of formal training which shall |
29 | include any hours of classroom education and clinical practice |
30 | established and approved by a prosthetic, orthotic and pedorthic |
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1 | credentialing organization recognized by NOCA and accredited by |
2 | NCCA. |
3 | (4) Complete a qualified work experience program or |
4 | internship in prosthetics, orthotics or pedorthics in accordance |
5 | with any standards, guidelines or procedures established and |
6 | approved by the board. |
7 | (5) Pass all examinations that are required for |
8 | certification by a prosthetic, orthotic or pedorthic |
9 | credentialing organization recognized by NOCA and accredited by |
10 | NCCA. |
11 | (6) Have fulfilled all educational and training requirements |
12 | consistent with those required for certification by a |
13 | prosthetic, orthotic and pedorthic credentialing organization |
14 | recognized by the NOCA and accredited by the NCCA. |
15 | (7) Paid a fee as established by the board by regulation. |
16 | (8) Not be addicted to alcohol, narcotics or other habit- |
17 | forming drugs. |
18 | (9) Not been convicted of a felony under the act of April |
19 | 14, 1972 (P.L.233, No.64), known as "The Controlled Substance, |
20 | Drug, Device and Cosmetic Act," or of an offense under the laws |
21 | of another jurisdiction which, if committed in this |
22 | Commonwealth, would be a felony under "The Controlled Substance, |
23 | Drug, Device and Cosmetic Act," unless the following apply: |
24 | (i) Ten years have elapsed from the date of conviction. |
25 | (ii) The applicant satisfactorily demonstrates to the board |
26 | that the applicant has made significant progress in personal |
27 | rehabilitation since the conviction and the licensure of the |
28 | applicant is not expected to create a substantial risk of harm |
29 | to the health and safety of the applicant's clients or the |
30 | public or a substantial risk of further criminal violations. |
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1 | (iii) The applicant otherwise satisfies the qualifications |
2 | required under this act. |
3 | The term "convicted" shall include a judgment, an admission of |
4 | guilt or a plea of nolo contendere. |
5 | (b) A license issued pursuant to this section shall be valid |
6 | for two years and may be renewed biennially with the board as |
7 | provided in subsection (j). A license and a temporary practice |
8 | permit are not transferable. |
9 | (c) Prior to administering the first treatment, a |
10 | prosthetist, orthotist, orthotics fitter or pedorthist shall do |
11 | all of the following: |
12 | (1) Ensure the patient has secured a written referral for |
13 | treatment using prosthetics, orthotics or pedorthics from a |
14 | physician or podiatrist. A referral under this paragraph shall |
15 | place conditions and restrictions on the course of treatment if |
16 | required as a matter of sound medical practice. |
17 | (2) Ensure the patient has undergone a medical diagnostic |
18 | examination or has had the results of a recently performed |
19 | medical diagnostic examination reviewed by a physician or |
20 | podiatrist. |
21 | (3) Keep a copy of the referral and the results of the |
22 | medical diagnostic examination in the patient's file. |
23 | (d) Nothing in this section shall prohibit students enrolled |
24 | in a prosthetics, orthotics, orthotics fitter or pedorthics |
25 | educational program from performing prosthetics, orthotics or |
26 | pedorthics in the course of their instruction, provided a |
27 | physician or podiatrist is readily available for consultations |
28 | and that a prosthetist, orthotist or pedorthist, respectively, |
29 | is on site and responsible for the direct supervision of |
30 | students. |
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1 | (e) Nothing in this section shall prohibit faculty teaching |
2 | in a prosthetic, orthotic, orthotics fitter or pedorthic |
3 | educational program or guest lecturers from performing |
4 | prosthetics, orthotics or pedorthics in the course of student |
5 | instruction or during professional development seminars, |
6 | provided the individuals are licensed as a prosthetist, |
7 | orthotist or pedorthist in this Commonwealth or another |
8 | jurisdiction recognized by the Commonwealth and obtain temporary |
9 | licensure in this Commonwealth. |
10 | (f) Nothing in this section shall be construed to prevent: |
11 | (1) An occupational therapist licensed by the Commonwealth |
12 | from engaging in the practice in which the occupational |
13 | therapist is licensed. |
14 | (2) A physical therapist licensed by the Commonwealth from |
15 | engaging in the practice in which the physical therapist is |
16 | licensed. |
17 | (3) A physician licensed by the Commonwealth from engaging |
18 | in the practice in which the physician is licensed. |
19 | (4) A podiatrist licensed by the Commonwealth from engaging |
20 | in the practice in which the podiatrist is licensed. |
21 | (5) The practice of prosthetics, orthotics or pedorthics by |
22 | an individual who is employed by the Federal Government while in |
23 | the discharge of the employee's official duties. |
24 | (g) Commencing two years after the effective date of this |
25 | section, individuals shall not practice or hold themselves out |
26 | as being able to practice prosthetics, orthotics, orthotics |
27 | fitter or pedorthics in this Commonwealth unless the individuals |
28 | are licensed in accordance with this section. |
29 | (h) Within two years after the effective date of this |
30 | section, individuals holding a national certification as a |
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1 | prosthetist, orthotist or a prosthetist/orthotist in accordance |
2 | with this section may apply for and shall be granted prosthetic |
3 | or orthotic licensure under this section upon payment of the |
4 | required fee. Beginning two years after the effective date of |
5 | this section, applicants for licensure as a prosthetist or an |
6 | orthotist shall meet the requirements of this section. |
7 | (i) The board may issue a temporary practice permit to an |
8 | applicant in order to permit the applicant to practice |
9 | prosthetics, orthotics, orthotics fitter or pedorthics under |
10 | this section during the six-month period immediately preceding |
11 | completion of the applicant's education program. The temporary |
12 | practice permit shall be nonrenewable and expire on the earlier |
13 | of six months from the date of issuance, or the date the |
14 | applicant fails any board required licensing examination. |
15 | (j) To renew a license, a licensee must: |
16 | (1) File a renewal application with the board. |
17 | (2) Pay a fee established by regulation of the board. |
18 | (3) For prosthestists and orthotists, provide certification |
19 | of successful completion of a minimum of twenty-four hours of |
20 | continuing education during the immediately preceding two years. |
21 | For orthotic fitters and pedorthists, provide certification of |
22 | successful completion of a minimum of thirteen hours of |
23 | continuing education during the immediately preceding two years. |
24 | Certification of continuing education credit hours submitted by |
25 | the prosthetist, orthotist, orthotic fitter or pedorthist shall |
26 | be properly signed as being correct and true. No credit may be |
27 | given for courses in office management or practice building. The |
28 | board may waive all or part of the continuing education |
29 | requirement to a licensee who shows to the satisfaction of the |
30 | board that the licensee was unable to complete the requirement |
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1 | due to illness, emergency or hardship. |
2 | (k) The Department of Education shall approve any |
3 | prosthetics, orthotics, orthotics fitter or pedorthics |
4 | educational program that meets the relevant and appropriate |
5 | requirements of 22 Pa. Code (relating to education) and 24 |
6 | Pa.C.S. Ch. 65 (relating to private colleges, universities and |
7 | seminaries) and that meets or exceeds the standards required for |
8 | prosthetics, orthotics, orthotics fitter or pedorthics programs |
9 | established by an accrediting agency recognized by the United |
10 | States Department of Education. |
11 | (l) An individual licensed to practice prosthetics, |
12 | orthotics, orthotic fitting or pedorthics in this Commonwealth |
13 | shall maintain a level of professional liability insurance |
14 | coverage in the minimum amount of one million dollars |
15 | ($1,000,000) per occurrence or claims made. Failure to maintain |
16 | insurance coverage as required shall subject the licensee to |
17 | disciplinary proceedings. The board shall accept from a licensee |
18 | as satisfactory evidence of insurance coverage any of the |
19 | following: |
20 | (i) self-insurance; |
21 | (ii) personally purchased liability insurance; or |
22 | (iii) professional liability insurance coverage provided by |
23 | the individual licensee's employer or similar insurance coverage |
24 | acceptable to the board. |
25 | (m) An applicant under this section shall provide proof that |
26 | the applicant has obtained professional liability insurance in |
27 | accordance with subsection (l). It is sufficient if the |
28 | applicant files with the application a copy of a letter from the |
29 | applicant's professional liability insurance carrier indicating |
30 | the applicant will be covered against professional liability in |
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1 | the required amounts effective upon the issuance of the |
2 | applicant's license to practice prosthetics, orthotics, orthotic |
3 | fitting or pedorthics in this Commonwealth. Upon issuance of the |
4 | license, the licensee has thirty days to submit to the board the |
5 | certificate of insurance or a copy of the policy declaration |
6 | page. |
7 | (n) The board may issue a license to practice prosthetics, |
8 | orthotics, orthotic fitting or pedorthics in this Commonwealth |
9 | without examination to an applicant holding a license to |
10 | practice prosthetics, orthotics, orthotic fitting or pedorthics |
11 | from another state who submits proof satisfactory to the board |
12 | the applicant: |
13 | (1) Is of good moral character. |
14 | (2) Meets requirements for national certification. |
15 | (3) Holds a license to practice prosthetics, orthotics, |
16 | orthotic fitting or pedorthics that is in good standing from |
17 | another state. |
18 | (4) Has, at a minimum, been actively engaged in the practice |
19 | of prosthetics, orthotics, orthotic fitting or pedorthics for |
20 | five of the last seven years immediately preceding the filing of |
21 | the application for licensure by endorsement with the board. |
22 | (5) Has submitted an application accompanied by the |
23 | application fee. |
24 | (6) Has not been convicted of a felony under "The Controlled |
25 | Substance, Drug, Device and Cosmetic Act" or an offense under |
26 | the laws of another jurisdiction, which, if committed in this |
27 | Commonwealth, would be a felony under "The Controlled Substance, |
28 | Drug, Device and Cosmetic Act," unless: |
29 | (i) Ten years have elapsed from the date of conviction. |
30 | (ii) The applicant satisfactorily demonstrates to the board |
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1 | that the applicant has made significant progress in personal |
2 | rehabilitation since the conviction such that licensure of the |
3 | applicant should not be expected to create a substantial risk of |
4 | harm to the health and safety of the applicant's clients or the |
5 | public or a substantial risk of further criminal violation. |
6 | (iii) The applicant otherwise satisfies the qualifications |
7 | contained in or authorized by this act. |
8 | As used in this paragraph, the term "convicted" includes a |
9 | judgment, an admission of guilt or a plea of nolo contendere. |
10 | Section 4. Sections 13, 16, 16.2, 18 and 19 of the act, |
11 | amended or added December 20, 1985 (P.L.384, No.107), are |
12 | amended to read: |
13 | Section 13. Penalties.--(a) Any person violating any of the |
14 | provisions of this act, or any rule or regulation of the board, |
15 | shall be guilty of a misdemeanor, and, upon conviction thereof, |
16 | shall be sentenced to pay a fine of not more than one thousand |
17 | dollars ($1,000), or undergo imprisonment for not more than six |
18 | months for the first violation. On the second and each |
19 | subsequent conviction, he shall be sentenced to pay a fine of |
20 | not more than two thousand dollars ($2,000), or undergo |
21 | imprisonment for not less than six months nor more than one year |
22 | in jail, or both. |
23 | (b) In addition to any other civil remedy or criminal |
24 | penalty provided for in this act, the board, by a vote of the |
25 | majority of the maximum number of the authorized membership of |
26 | the board as provided by law, or by a vote of the majority of |
27 | the duly qualified and confirmed membership or a minimum of four |
28 | members, whichever is greater, may levy a civil penalty of up to |
29 | [one thousand dollars ($1,000)] ten thousand dollars ($10,000) |
30 | on any current licensee who violates any provision of this act |
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1 | or on any person who practices podiatric medicine without being |
2 | properly licensed to do so under this act. The board shall levy |
3 | this penalty only after affording the accused party the |
4 | opportunity for a hearing, as provided in Title 2 of the |
5 | Pennsylvania Consolidated Statutes (relating to administrative |
6 | law and procedure). |
7 | (c) As part of its sanction, the board may assess the costs |
8 | of investigation underlying a disciplinary action against a |
9 | respondent found in violation of the disciplinary provisions |
10 | administered by the board in a disciplinary proceeding pending |
11 | before the board for final determination. The cost of |
12 | investigation shall not include any associated legal fees or any |
13 | cost of prosecution. |
14 | Section 16. Refusal to Grant, Suspension and Revocation.-- |
15 | (a) The board may refuse to grant and may suspend or revoke or |
16 | cancel a license or a registration for the following reasons: |
17 | (1) The practice of fraud or deceit in obtaining or |
18 | attempting to obtain a license or in obtaining admission to a |
19 | school of podiatric medicine or surgery. |
20 | (2) Pleading guilty or nolo contendere to, or being found |
21 | guilty, or receiving probation without verdict, disposition in |
22 | lieu of trial, or an Accelerated Rehabilitative Disposition in |
23 | the disposition of felony charges or an offense in connection |
24 | with the practice of podiatric medicine or involving moral |
25 | turpitude by a court of competent jurisdiction, or a jury. |
26 | (3) Gross incompetency, gross immorality, negligence or |
27 | misconduct in carrying on of such profession. |
28 | (4) Violation of any of the provisions of this act, or the |
29 | rules and regulations of the board. |
30 | (5) Loaning, borrowing or using the registration or license |
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1 | to practice podiatry of another, or knowingly aiding or abetting |
2 | in any way the granting of an improper license or registration. |
3 | (6) That said applicant or licensee is addicted to alcohol |
4 | or drugs or has been convicted of a felonious act prohibited by |
5 | the act of April 14, 1972 (P.L.233, No.64), known as "The |
6 | Controlled Substance, Drug, Device and Cosmetic Act," or |
7 | convicted of a felony relating to a controlled substance in a |
8 | court of law of the United States or any other state, territory |
9 | or country, or if he or she is or shall become mentally |
10 | incompetent. An applicant's statement on the application |
11 | declaring the absence of a conviction shall be deemed |
12 | satisfactory evidence of the absence of a conviction unless the |
13 | board has some evidence to the contrary. In enforcing this |
14 | paragraph, the board shall, upon probable cause, have authority |
15 | to compel a podiatrist to submit to a mental or physical |
16 | examination by a physician or a psychologist approved by the |
17 | board. Failure of a podiatrist to submit to such examination |
18 | when directed by the board, unless such failure is due to |
19 | circumstances beyond his or her control, shall constitute an |
20 | admission of the allegations against him or her, consequent upon |
21 | which a default and final order may be entered without the |
22 | taking of testimony or presentation of evidence. A podiatrist |
23 | affected under this paragraph shall at reasonable intervals be |
24 | afforded an opportunity to demonstrate that he or she can resume |
25 | a competent practice of podiatry with reasonable skill and |
26 | safety to patients. |
27 | (7) Knowingly making substantial misrepresentations. |
28 | (8) Unethical conduct or misleading, fraudulent or unethical |
29 | advertising. |
30 | (9) Soliciting patronage other than by legitimate |
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1 | advertisement, or paying a commission or agreeing to pay a |
2 | commission to any person or persons for soliciting or for |
3 | business secured, or paying any gratuity to any person with |
4 | intent to have such person aid in securing business, or like |
5 | unprofessional conduct. |
6 | (10) Having a license to practice podiatric medicine, |
7 | prosthetics, orthotics, pedorthics or orthotic fitting |
8 | suspended, revoked or refused or receiving other disciplinary |
9 | action by the proper podiatry, prosthetics, orthotics, |
10 | pedorthics or orthotic fitting licensing authority of another |
11 | state, territory or country. |
12 | (11) Acting in such a manner as to present an immediate and |
13 | clear danger to the public health or safety. |
14 | (12) Failing to provide information, documents or records |
15 | requested by the board, or a representative of the board, in |
16 | connection with the investigation or prosecution of a |
17 | disciplinary matter under this act. |
18 | (b) When the board finds that the license of any person may |
19 | be refused, revoked or suspended under the terms of subsection |
20 | (a), the board may: |
21 | (1) Deny the application for a license. |
22 | (2) Administer a public reprimand. |
23 | (3) Revoke, suspend, limit or otherwise restrict a license |
24 | as determined by the board. |
25 | (4) Require a licensee to submit to the care, counseling or |
26 | treatment of a physician or a psychologist designated by the |
27 | board. |
28 | (5) Suspend enforcement of its finding thereof and place a |
29 | licensee on probation with the right to vacate the probationary |
30 | order for noncompliance. |
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1 | (6) Restore or reissue, in its discretion, a suspended |
2 | license to practice podiatric medicine and impose any |
3 | disciplinary or corrective measure which it might originally |
4 | have imposed. |
5 | Section 16.2. Reinstatement of License, Certificate or |
6 | Registration.--Unless ordered to do so by Commonwealth Court or |
7 | an appeal therefrom, the board shall not reinstate the license, |
8 | certificate or registration of a person to practice podiatric |
9 | medicine, prosthetics, orthotics, pedorthics or orthotic fitting |
10 | pursuant to this act which has been revoked. Any person whose |
11 | license, certificate or registration has been revoked may apply |
12 | for reinstatement after a period of at least five years but must |
13 | meet all of the licensing qualifications of this act for the |
14 | license applied for, including the examination requirement, if |
15 | he or she desires to practice at any time after such revocation. |
16 | Section 18. Display of License and Certificate.--Every |
17 | holder of a license or certificate of registration shall display |
18 | the same in a conspicuous place wherein such person shall |
19 | practice podiatric medicine, prosthetics, orthotics, pedorthics |
20 | or orthotic fitting. |
21 | Section 19. Injunction or Other Process.--It shall be |
22 | unlawful for any person to practice or attempt to offer to |
23 | practice podiatric medicine, prosthetics, orthotics, pedorthics |
24 | or orthotic fitting as defined in this act, without having at |
25 | the time of so doing a valid, unexpired, unrevoked and |
26 | unsuspended license issued under this act. The unlawful practice |
27 | of podiatric medicine, prosthetics, orthotics, pedorthics or |
28 | orthotic fitting, as defined in this act may be enjoined by the |
29 | courts on petition of the board or the Commissioner of |
30 | Professional and Occupational Affairs. In any such proceeding, |
|
1 | it shall not be necessary to show that any person is |
2 | individually injured by the actions complained of. If it is |
3 | found that the respondent has engaged in the unlawful practice |
4 | of podiatric medicine, prosthetics, orthotics, pedorthics or |
5 | orthotic fitting, the court shall enjoin him or her from so |
6 | practicing unless and until he or she has been duly licensed. |
7 | Procedure in such cases shall be the same as in any other |
8 | injunction suit. The remedy by injunction hereby given is in |
9 | addition to any other civil or criminal prosecution and |
10 | punishment. |
11 | Section 5. The act is amended by adding a section to read: |
12 | Section 23. Expungement.--To expunge a disciplinary record |
13 | of a certificate holder, registrant or licensee subject to the |
14 | following conditions: |
15 | (1) The certificate holder, registrant or licensee shall |
16 | make written application to the board for expungement no earlier |
17 | than four years from the effective date of the disciplinary |
18 | record. |
19 | (2) The disciplinary record shall be the only disciplinary |
20 | record the certificate holder, registrant or licensee has with |
21 | the board. |
22 | (3) The certificate holder, registrant or licensee shall |
23 | have no disciplinary record previously expunged. |
24 | (4) The disciplinary record shall have involved either the |
25 | imposition of a civil penalty against the certificate holder, |
26 | registrant or licensee for a violation under authority of |
27 | section 5(a) of the act of July 2, 1993 (P.L.345, No.48), |
28 | entitled "An act empowering the General Counsel or his designee |
29 | to issue subpoenas for certain licensing board activities; |
30 | providing for hearing examiners in the Bureau of Professional |
|
1 | and Occupational Affairs; providing additional powers to the |
2 | Commissioner of Professional and Occupational Affairs; and |
3 | further providing for civil penalties and license suspension", |
4 | or the imposition of discipline against the certificate holder, |
5 | registrant or licensee for a violation that, at the time of |
6 | application for expungement, would be prosecuted under authority |
7 | of section 5(a) of the act of July 2, 1993 (P.L.345, No.48). |
8 | Section 6. This act shall take effect in 60 days. |
9 | Section 1. Section 2 of the act of December 20, 1985 | <-- |
10 | (P.L.457, No.112), known as the Medical Practice Act of 1985, is |
11 | amended by adding definitions to read: |
12 | Section 2. Definitions. |
13 | The following words and phrases when used in this act shall |
14 | have the meanings given to them in this section unless the |
15 | context clearly indicates otherwise: |
16 | * * * |
17 | "Accommodative." Designed with a primary goal of conforming |
18 | to an individual's anatomy. |
19 | * * * |
20 | "Custom-fabricated device." A prosthesis, orthosis or |
21 | pedorthic device that is fabricated to original measurements or |
22 | a mold for use by a patient in accordance with a prescription or |
23 | work order and which requires substantial clinical and technical |
24 | judgment in its design and fitting. |
25 | "Custom-fitted device." A prefabricated prosthesis, orthosis |
26 | or pedorthic device that is sized or modified for use by the |
27 | patient in accordance with a prescription or work order and |
28 | which requires substantial clinical judgment and substantive |
29 | alteration for appropriate use. |
30 | * * * |
|
1 | "NCCA." The National Commission for Certifying Agencies or |
2 | its successor. |
3 | "NOCA." The National Organization for Competency Assurance |
4 | or its successor. |
5 | "Nontherapeutic devices." Devices that do not address a |
6 | medical condition. |
7 | "Orthotic fitter." An individual who is licensed under this |
8 | act to practice orthotics pursuant to a written prescription of |
9 | a physician, podiatrist, certified registered nurse practitioner |
10 | or physician assistant or pursuant to a work order. |
11 | "Orthotics." Evaluating, measuring, designing, fabricating, |
12 | assembling, fitting, adjusting or servicing an orthosis for the |
13 | correction or alleviation of neuromuscular or musculoskeletal |
14 | dysfunction, disease, injury or deformity, as provided in this |
15 | act. |
16 | "Orthotist." An individual other than an orthotic fitter |
17 | licensed under this act to practice orthotics pursuant to a |
18 | written prescription of a physician, podiatrist, certified |
19 | registered nurse practitioner or physician assistant or pursuant |
20 | to a work order. |
21 | "Over-the-counter prostheses, orthoses and pedorthic |
22 | devices." Prefabricated, mass-produced items that are |
23 | prepackaged and require no professional advice or judgment in |
24 | either size selection or use, including fabric or elastic |
25 | supports, corsets, generic arch supports and elastic hose. |
26 | "Pedorthic device." Includes therapeutic shoes, shoe |
27 | modifications made for therapeutic purposes, partial foot |
28 | prostheses, foot orthoses and below-the-knee pedorthic |
29 | modalities. The term does not include nontherapeutic, |
30 | accommodative inlays and nontherapeutic accommodative footwear, |
|
1 | regardless of method of manufacture; unmodified, nontherapeutic |
2 | over-the-counter shoes; or prefabricated unmodified or |
3 | unmodifiable foot care and footwear products. |
4 | "Pedorthics." Evaluating, measuring, designing, fabricating, |
5 | assembling, fitting, adjusting or servicing necessary to |
6 | accomplish the application of a pedorthic device for the |
7 | prevention or amelioration of painful or disabling conditions |
8 | related to the lower extremities. |
9 | "Pedorthist." An individual licensed under this act to |
10 | practice pedorthics pursuant to a written prescription of a |
11 | physician, podiatrist, certified registered nurse practitioner |
12 | or physician assistant or pursuant to a work order. |
13 | "Podiatrist." An individual licensed under the act of March |
14 | 2, 1956 (1955 P.L.1206, No.375), known as the Podiatry Practice |
15 | Act, to practice podiatry. |
16 | * * * |
17 | "Prefabricated orthosis." A brace or support designed to |
18 | provide for alignment, correction or prevention of neuromuscular |
19 | or musculoskeletal dysfunction, disease, injury or deformity. |
20 | The term does not include fabric or elastic support, corsets, |
21 | arch supports, low-temperature plastic splints, trusses, elastic |
22 | hose, canes, crutches, soft cervical collars, dental appliances |
23 | or other similar devices carried in stock and sold as over-the- |
24 | counter items by a drug store, department store, corset shop or |
25 | surgical supply facility. |
26 | * * * |
27 | "Prosthesis." A custom-designed, custom-fabricated, custom- |
28 | fitted or custom-modified device to replace an absent external |
29 | limb for purposes of restoring physiological function or |
30 | cosmesis. The term does not include artificial eyes, ears, |
|
1 | fingers or toes, dental appliances, cosmetic devices, such as |
2 | artificial breasts, eyelashes or wigs, or other devices that do |
3 | not have a significant impact on the musculoskeletal functions |
4 | of the body. |
5 | "Prosthetics." Evaluating, measuring, designing, |
6 | fabricating, assembling, fitting, adjusting or servicing a |
7 | prosthesis. |
8 | "Prosthetist." An individual licensed under this act to |
9 | practice prosthetics pursuant to a written prescription of a |
10 | physician, podiatrist, certified registered nurse practitioner |
11 | or physician assistant or pursuant to a work order. |
12 | * * * |
13 | "Therapeutic devices." Devices that address a medical |
14 | condition. |
15 | * * * |
16 | Section 2. The act is amended by adding a section to read: |
17 | Section 13.4. Prosthetists, orthotists, pedorthists and |
18 | orthotic fitters. |
19 | (a) Licensure qualifications.--To qualify for licensure to |
20 | practice prosthetics, orthotics, pedorthics or orthotic fitting, |
21 | an applicant shall: |
22 | (1) Be of good moral character. |
23 | (2) Possess a high school diploma or its equivalent. |
24 | (3) Have fulfilled all educational and training required |
25 | for certification by a prosthetic, orthotic, pedorthic and |
26 | orthotic fitting credentialing organization recognized by |
27 | NOCA and accredited by NCCA and any additional requirements |
28 | as required by the board. |
29 | (4) Pass all examinations that are required for |
30 | certification by a prosthetic, orthotic, pedorthic or |
|
1 | orthotic fitting credentialing organization recognized by |
2 | NOCA and accredited by NCCA. |
3 | (5) Submit an application and fee as prescribed by the |
4 | board by regulation. |
5 | (6) Not be addicted to alcohol, narcotics or other |
6 | habit-forming drugs. |
7 | (7) Not been convicted of a felony under the act of |
8 | April 14, 1972 (P.L.233, No.64), known as The Controlled |
9 | Substance, Drug, Device and Cosmetic Act, or of an offense |
10 | under the laws of another jurisdiction which, if committed in |
11 | this Commonwealth, would be a felony under The Controlled |
12 | Substance, Drug, Device and Cosmetic Act, unless the |
13 | following apply: |
14 | (i) Ten years have elapsed from the date of |
15 | conviction. |
16 | (ii) The applicant satisfactorily demonstrates to |
17 | the board that the applicant has made significant |
18 | progress in personal rehabilitation since the conviction |
19 | and the licensure of the applicant is not expected to |
20 | create a substantial risk of harm to the health and |
21 | safety of the applicant's clients or the public or a |
22 | substantial risk of further criminal violations. |
23 | (iii) The applicant otherwise satisfies the |
24 | qualifications required under this act. |
25 | (b) Term of license.--A license issued pursuant to this |
26 | section shall be valid for two years and may be renewed |
27 | biennially with the board as provided in subsection (g). |
28 | (c) Treatment requirements.--Prior to administering the |
29 | first treatment, a prosthetist, orthotist, pedorthist or |
30 | orthotics fitter shall do all of the following: |
|
1 | (1) Ensure the patient has secured a prescription or |
2 | work order for treatment using prosthetics, orthotics, |
3 | pedorthics or orthotic fitting from a physician, podiatrist, |
4 | certified registered nurse practitioner or physician |
5 | assistant. A prescription or work order under this paragraph |
6 | shall place conditions and restrictions on the course of |
7 | treatment if required as a matter of sound medical practice. |
8 | (2) Ensure the patient has undergone a medical |
9 | diagnostic examination or has had the results of a recently |
10 | performed medical diagnostic examination reviewed by a |
11 | physician, podiatrist, certified registered nurse |
12 | practitioner or physician assistant. |
13 | (3) Keep a copy of the prescription or work order and, |
14 | if provided, the results of the medical diagnostic |
15 | examination in the patient's file. |
16 | (d) Exceptions.-- |
17 | (1) Nothing in this section shall prohibit students |
18 | enrolled in a prosthetics, orthotics, pedorthics or orthotics |
19 | fitter educational program from performing prosthetics, |
20 | orthotics, pedorthics or orthotic fitting in the course of |
21 | their instruction, provided that a physician or podiatrist is |
22 | readily available for consultations and that a prosthetist, |
23 | orthotist, pedorthist or orthotic fitter, respectively, is on |
24 | site and responsible for the direct supervision of students. |
25 | (2) Nothing in this section shall prohibit an individual |
26 | from engaging in the practice for which that individual is |
27 | licensed or certified to practice or to act within the scope |
28 | of that license or certification held in this Commonwealth. |
29 | Nothing in this act shall prohibit an individual who is |
30 | employed by the Federal Government from engaging in the |
|
1 | practice of a prosthetist, orthotist, pedorthist or orthotic |
2 | fitter while in the discharge of the employee's official |
3 | duties. |
4 | (3) Nothing in this section shall prohibit the sale of |
5 | over-the-counter prostheses, orthoses or pedorthic devices. |
6 | (4) Nothing in this section shall prohibit a |
7 | representative of a medical device manufacturer registered |
8 | with the United States Food and Drug Administration from |
9 | measuring, fitting and adjusting orthoses when the |
10 | representative is supervised by a physician or other licensed |
11 | health care professional. |
12 | (e) License requirement effective.--Commencing two years |
13 | after the effective date of this section, individuals shall not |
14 | practice or hold themselves out as being able to practice |
15 | prosthetics, orthotics, pedorthics or orthotic fitting in this |
16 | Commonwealth unless the individuals are licensed in accordance |
17 | with this section. |
18 | (f) License without examination.--Within two years after the |
19 | effective date of this section, an individual may be granted a |
20 | prosthetic, orthotic, pedorthotic or orthotic fitting license by |
21 | the board if the individual: |
22 | (1) Complies with subsection (a)(1), (2), (5), (6) and |
23 | (7); and |
24 | (2) Complies with one of the following: |
25 | (i) Holds a national certification as a prosthetist, |
26 | orthotist, pedorthist or orthotic fitter. |
27 | (ii) Has been in active, continuous practice for the |
28 | three years immediately preceding the effective date of |
29 | this section. |
30 | (g) License renewal.--To renew a license, a licensee must: |
|
1 | (1) File a renewal application with the board. |
2 | (2) Pay a fee established by regulation by the board. |
3 | (3) Complete continuing education as required by the |
4 | board. The following apply: |
5 | (i) Certification of continuing education credit |
6 | hours submitted by the prosthetist, orthotist, pedorthist |
7 | or orthotic fitter shall be verified as being correct and |
8 | true. |
9 | (ii) No credit may be given for courses in office |
10 | management or practice building. |
11 | (iii) The board may waive all or part of the |
12 | continuing education requirements to a licensee who shows |
13 | to the satisfaction of the board that the licensee was |
14 | unable to complete the requirement due to illness, |
15 | emergency or hardship. |
16 | (h) Orthotic fitter scope of practice.--The scope of |
17 | practice of an orthotic fitter is limited to measuring, fitting, |
18 | dispensing and adjusting prefabricated devices not requiring |
19 | more than minor modification of: |
20 | (1) Cervical soft foam collars. |
21 | (2) Thoraco-lumbo-sacral orthoses. |
22 | (3) Lumbo-sacral orthoses. |
23 | (4) Knee orthoses. |
24 | (5) Ankle foot orthoses. |
25 | (6) Foot orthoses. |
26 | (7) Elbow orthoses. |
27 | (8) Shoulder orthoses. |
28 | (9) Abdominal and pelvic: |
29 | (i) Trusses. |
30 | (ii) Flexible supports. |
|
1 | (iii) Maternity supports. |
2 | (10) Compression devices: |
3 | (i) Lymphedema garments. |
4 | (ii) Compression garments. |
5 | (iii) Burn garments. |
6 | (11) Breast prosthesis and ancillary supplies. |
7 | (i) Liability insurance coverage.--An individual licensed to |
8 | practice prosthetics, orthotics, pedorthics or orthotic fitting |
9 | in this Commonwealth shall maintain a level of professional |
10 | liability insurance coverage in the minimum amount of $1,000,000 |
11 | per occurrence or claims made and shall verify to the board the |
12 | required coverage. Failure to maintain insurance coverage as |
13 | required shall subject the licensee to disciplinary proceedings. |
14 | The licensee must provide proof of coverage to the board upon |
15 | request. The board shall accept from a licensee as satisfactory |
16 | evidence of insurance coverage any of the following: |
17 | (1) Personally purchased liability insurance. |
18 | (2) Professional liability insurance coverage provided |
19 | by the individual licensee's employer or similar insurance |
20 | coverage acceptable to the board. |
21 | (j) Practice by unregistered persons.–-Any person who is not |
22 | licensed as a prosthetist, orthotist, pedorthist or orthotic |
23 | fitter shall not practice prosthetics, orthotics, pedorthics or |
24 | orthotic fitting nor in any written or printed circular or in |
25 | any business card, letterhead or sign or otherwise assume the |
26 | title "Prosthetist," "Orthotist," "Pedorthist" or "Orthotic |
27 | Fitter" nor any other title, abbreviation, name or description |
28 | implying or calculated to lead to the belief that he is |
29 | qualified to practice prosthetics, orthotics, pedorthics or |
30 | orthotic fitting. |
|
1 | Section 3. The board shall promulgate regulations to |
2 | implement the amendment or addition of sections 2 and 13.4 of |
3 | the act within 18 months of the effective date of this section. |
4 | The amendment or addition of sections 2 and 13.4 of the act |
5 | shall not be enforceable by the State Board of Medicine until |
6 | the publication of final regulations under this section or 24 |
7 | months following the effective date of this section, whichever |
8 | occurs first. |
9 | Section 4. This act shall take effect immediately. |
|
