HB-4325, As Passed Senate, December 6, 2005

SENATE SUBSTITUTE FOR

HOUSE BILL NO. 4325

     A bill to amend 1978 PA 368, entitled

"Public health code,"

by amending sections 17001 and 17501 (MCL 333.17001 and 333.17501),

section 17001 as amended by 1990 PA 248 and section 17501 as

amended by 1990 PA 247, and by adding sections 17018 and 17518.

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

     Sec. 17001. (1) As used in this part:

     (a) "Academic institution" means either of the following:

     (i) A medical school approved by the board.

     (ii) A hospital licensed under article 17 that meets all of the

following requirements:

     (A) Was the sole sponsor or a co-sponsor, if each other co-

sponsor is either a medical school approved by the board or a

hospital owned by the federal government and directly operated by

the United States department of veterans' affairs, of not less than

4 postgraduate education residency programs approved by the board

under section 17031(1) for not less than the 3 years immediately

preceding the date of an application for a limited license under

section 16182(2)(c) or an application for a full license under

section 17031(2), provided that at least 1 of the residency

programs is in the specialty area of medical practice, or in a

specialty area that includes the subspecialty of medical practice,

in which the applicant for a limited license proposes to practice

or in which the applicant for a full license has practiced for the

hospital.

     (B) Has spent not less than $2,000,000.00 for medical

education during each of the 3 years immediately preceding the date

of an application for a limited license under section 16182(2)(c)

or an application for a full license under section 17031(2). As

used in this subparagraph, "medical education" means the education

of physicians and candidates for degrees or licenses to become

physicians, including, but not limited to, physician staff,

residents, interns, and medical students.

(b) "Electrodiagnostic studies" means the testing of

neuromuscular functions utilizing nerve conduction tests and needle

electromyography. It does not include the use of surface

electromyography.

(c)  (b)  "Medical care services" means those services within

the scope of practice of physicians licensed by the board, except

those services that the board determines shall not be delegated by

a physician without endangering the health and safety of patients

as provided for in section 17048(3).

(d)  (c)  "Physician" means an individual licensed under this

article to engage in the practice of medicine.

(e)  (d)  "Practice of medicine" means the diagnosis,

treatment, prevention, cure, or relieving of a human disease,

ailment, defect, complaint, or other physical or mental condition,

by attendance, advice, device, diagnostic test, or other means, or

offering, undertaking, attempting to do, or holding oneself out as

able to do, any of these acts.

(f)  (e)  "Practice as a physician's assistant" means the

practice of medicine or osteopathic medicine and surgery performed

under the supervision of a physician or physicians licensed under

this part or part 175.

(g)  (f)  "Supervision" means that term as defined in section

16109, except that it also includes the existence of a

predetermined plan for emergency situations, including, but not

limited to, the designation of a physician to supervise a

physician's assistant in the absence of the primary supervising

physician.

(h)  (g)  "Task force" means the joint task force created in

sections 17025 and 17525.

     (2) In addition to the definitions in this part, article 1

contains definitions and principles of construction applicable to

all articles in this code and part 161 contains definitions

applicable to this part.

Sec. 17018. (1) Except as otherwise provided under this

section, only an individual who is licensed as a physician shall

House Bill No. 4325 as amended November 9, 2005

perform needle electromyography or interpret nerve conduction

tests. A physician shall not delegate the interpretation of nerve

conduction tests to another individual unless that individual is

licensed under this article to engage in the practice of medicine

or osteopathic medicine and surgery. A physician shall not delegate

the performance of needle electromyography to another individual

unless that individual is licensed under this article to engage in

the practice of medicine or osteopathic medicine and surgery or

that individual is otherwise authorized under this section.

     (2) In accordance with section 16215, a physician may delegate

the performance of nerve conduction tests to a licensed or

unlicensed individual who is otherwise qualified by education,

training, or experience if those tests are conducted under the

direct supervision of a physician.

     (3) A physical therapist who is licensed under this article

and certified by the American board of physical therapy specialties

as an electrophysiologic clinical specialist on the effective date

of this section may perform electrodiagnostic studies that are to

be interpreted by a physician if he or she has been performing

electrodiagnostic studies in this state on a consistent basis

within the 5 years immediately preceding the effective date of this

section. <<A physical therapist who is licensed under this article but is

not certified by the American board of physical therapy specialties as an electrophysiologic clinical specialist on the effective date of this section and who has been performing electrodiagnostic studies in this state on a consistent basis since before May 1, 2001 may continue to perform electrodiagnostic studies that are to be interpreted by a physician as long as he or she becomes certified by the American board of physical therapy specialties as an electrophysiologic clinical specialist by December 31, 2007. As used in this subsection, "consistent basis" means at a minimum an annual average of 10 electrodiagnostic studies each month.>>

     (4) A podiatrist who is licensed under this article and has

successfully completed additional training in the performance and

interpretation of electrodiagnostic studies that is satisfactory to

his or her respective board may conduct electrodiagnostic studies

that are within his or her scope of practice.

     (5) A chiropractor who is licensed under this article and has

successfully completed additional training in the performance and

interpretation of electrodiagnostic studies that is satisfactory to

his or her respective board may conduct nerve conduction tests that

are within his or her scope of practice.

     (6) This section does not require new or additional third

party reimbursement or mandated worker's compensation benefits for

services rendered by an individual authorized to conduct

electrodiagnostic studies under this section.

     Sec. 17501. (1) As used in this part:

(a) "Electrodiagnostic studies" means the testing of

neuromuscular functions utilizing nerve conduction tests and needle

electromyography. It does not include the use of surface

electromyography.

(b)  (a)  "Medical care services" means those services within

the scope of practice of physicians licensed and approved by the

board, except those services that the board determines shall not be

delegated by a physician without endangering the health and safety

of patients as provided for in section 17548(3).

(c)  (b)  "Physician" means an individual licensed under this

article to engage in the practice of osteopathic medicine and

surgery.

(d)  (c)  "Practice of osteopathic medicine and surgery" means

a separate, complete, and independent school of medicine and

surgery utilizing full methods of diagnosis and treatment in

physical and mental health and disease, including the prescription

and administration of drugs and biologicals, operative surgery,

obstetrics, radiological and other electromagnetic emissions, and

placing special emphasis on the interrelationship of the

musculoskeletal system to other body systems.

(e)  (d)  "Practice as a physician's assistant" means the

practice of osteopathic medicine performed under the supervision of

a physician licensed under this part or part 170.

(f)  (e)  "Supervision" has the meaning ascribed to it in

section 16109 except that it includes the existence of a

predetermined plan for emergency situations, including, but not

limited to, the designation of a physician to supervise a

physician's assistant in the absence of the primary supervising

physician.

(g)  (f)  "Task force" means the joint task force created in

sections 17025 and 17525.

     (2) In addition to the definitions in this part, article 1

contains general definitions and principles of construction

applicable to all articles in the code and part 161 contains

definitions applicable to this part.

Sec. 17518. (1) Except as otherwise provided in this section,

only an individual who is licensed as a physician shall perform

needle electromyography or interpret nerve conduction tests. A

physician shall not delegate the interpretation of nerve conduction

studies to another individual unless that individual is licensed

under this article to engage in the practice of medicine or

osteopathic medicine and surgery. A physician shall not delegate

the performance of needle electromyography to another individual

unless that individual is licensed under this article to engage in

House Bill No. 4325 (S-1) as amended November 29, 2005

the practice of medicine or osteopathic medicine and surgery or

that individual is otherwise authorized under this section.

     (2) In accordance with section 16215, a physician may delegate

the performance of nerve conduction tests to a licensed or

unlicensed individual who is otherwise qualified by education,

training, or experience if those tests are conducted under the

direct supervision of a physician.

     (3) A physical therapist who is licensed under this article

and certified by the American board of physical therapy specialties

as an electrophysiologic clinical specialist on the effective date

of this section may perform electrodiagnostic studies that are to

be interpreted by a physician if he or she has been performing

electrodiagnostic studies in this state on a consistent basis

within the 5 years immediately preceding the effective date of this

section.  [A physical therapist who is licensed under this article but is

not certified by the American board of physical therapy specialties as an electrophysiologic clinical specialist on the effective date of this section and who has been performing electrodiagnostic studies in this state on a consistent basis since before May 1, 2001 may continue to perform electrodiagnostic studies that are to be interpreted by a physician as long as he or she becomes certified by the American board of physical therapy specialties as an electrophysiologic clinical specialist by December 31, 2007.  As used in this subsection, "consistent basis" means at a minimum an annual average of 10 electrodiagnostic studies each month.]

     (4) A podiatrist who is licensed under this article and has

successfully completed additional training in the performance and

interpretation of electrodiagnostic studies that is satisfactory to

his or her respective board may conduct electrodiagnostic studies

that are within his or her scope of practice.

     (5) A chiropractor who is licensed under this article and has

successfully completed additional training in the performance and

interpretation of electrodiagnostic studies that is satisfactory to

his or her respective board may conduct nerve conduction tests that

are within his or her scope of practice.

     (6) This section does not require new or additional third

party reimbursement or mandated worker's compensation benefits for

services rendered by an individual authorized to conduct

electrodiagnostic studies under this section.