SENATE BILL No. 254
SENATE BILL No. 254
SENATE BILL No. 254
April 9, 2019, Introduced by Senator ZORN and referred to the Committee on Health Policy and Human Services.
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending sections 7333, 16221, and 16226 (MCL 333.7333,
333.16221, and 333.16226), section 7333 as amended by 2018 PA 34
and sections 16221 and 16226 as amended by 2018 PA 463, and by
adding section 7333c.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
1 Sec. 7333. (1) As used in this section, "good faith" means the
2 prescribing or dispensing of a controlled substance by a
3 practitioner licensed under section 7303 in the regular course of
4 professional treatment to or for an individual who is under
5 treatment by the practitioner for a pathology or condition other
1 than that individual's physical or psychological dependence upon or
2 addiction to a controlled substance, except as provided in this
3 article. Application of good faith to a pharmacist means the
4 dispensing of a controlled substance pursuant to a prescriber's
5 order which, in the professional judgment of the pharmacist, is
6 lawful. The pharmacist shall be guided by nationally accepted
7 professional standards including, but not limited to, all of the
8 following, in making the judgment:
9 (a) Lack of consistency in the doctor-patient relationship.
10 (b) Frequency of prescriptions for the same drug by 1
11 prescriber for larger numbers of patients.
12 (c) Quantities beyond those normally prescribed for the same
13 drug.
14 (d) Unusual dosages.
15 (e) Unusual geographic distances between patient, pharmacist,
16 and prescriber.
17 (2) Except as otherwise provided in this section, a
18 practitioner, in good faith, may dispense a controlled substance
19 included in schedule 2 upon receipt of a prescription of a
20 practitioner licensed under section 7303 on a prescription form. A
21 practitioner may issue more than 1 prescription for a controlled
22 substance included in schedule 2 on a single prescription form.
23 (3) In an emergency situation, as described in R 338.3165 of
24 the Michigan Administrative Code, a controlled substance included
25 in schedule 2 may be dispensed upon the oral prescription of a
26 practitioner if the prescribing practitioner promptly fills out a
27 prescription form and forwards the prescription form to the
1 dispensing pharmacy within 7 days after the oral prescription is
2 issued. A prescription for a controlled substance included in
3 schedule 2 must not be filled more than 90 days after the date on
4 which the prescription was issued. A pharmacist, consistent with
5 federal law and regulations on the partial filling of a controlled
6 substance included in schedule 2, may partially fill in increments
7 a prescription for a controlled substance included in schedule 2.
8 (4) A practitioner, in good faith, may dispense a controlled
9 substance included in schedule 3, 4, or 5 that is a prescription
10 drug as determined under section 503(b) of the federal food, drug,
11 and cosmetic act, 21 USC 353, or section 17708, upon receipt of a
12 prescription on a prescription form or an oral prescription of a
13 practitioner. A prescription for a controlled substance included in
14 schedule 3 or 4 must not be filled or refilled without specific
15 refill instructions noted by the prescriber. A prescription for a
16 controlled substance included in schedule 3 or 4 must not be filled
17 or refilled later than 6 months after the date of the prescription
18 or be refilled more than 5 times, unless renewed by the prescriber
19 in accordance with rules promulgated by the administrator.
20 (5) A controlled substance included in schedule 5 must not be
21 distributed or dispensed other than for a medical purpose, or in
22 any manner except in accordance with rules promulgated by the
23 administrator.
24 (6) If a prescription is required under this section, the
25 prescription must contain the quantity of the controlled substance
26 prescribed in both written and numerical terms. A prescription is
27 in compliance with this subsection if, in addition to containing
1 the quantity of the controlled substance prescribed in written
2 terms, it contains preprinted numbers representative of the
3 quantity of the controlled substance prescribed next to which is a
4 box or line the prescriber may check.
5 (7) A prescribing practitioner shall not use a prescription
6 form for a purpose other than prescribing. A prescribing
7 practitioner shall not postdate a prescription form that contains a
8 prescription for a controlled substance. A Subject to section
9 7333c, a prescriber may transmit a prescription by facsimile of a
10 printed prescription form and by electronic transmission of a
11 printed prescription form, if not prohibited by federal law. If,
12 Subject to section 7333c, if, with the patient's consent, a
13 prescription is electronically transmitted, it must be transmitted
14 directly to a pharmacy of the patient's choice by the prescriber or
15 the prescriber's authorized agent, and the data must not be
16 altered, modified, or extracted in the transmission process.
17 (8) Notwithstanding subsections (1) to (5), a class B dealer
18 may acquire a limited permit only for the purpose of buying,
19 possessing, and administering a commercially prepared, premixed
20 solution of sodium pentobarbital to perform euthanasia on injured,
21 sick, homeless, or unwanted domestic pets and other animals, if the
22 class B dealer does all of the following:
23 (a) Applies to the administrator for a permit in accordance
24 with rules promulgated under this part. The application must
25 contain the name of the individual in charge of the day-to-day
26 operations of the class B dealer's facilities and the name of the
27 individual responsible for designating employees who will be
1 performing euthanasia on animals pursuant to this act.
2 (b) Complies with the rules promulgated by the administrator
3 for the storage, handling, and use of a commercially prepared,
4 premixed solution of sodium pentobarbital to perform euthanasia on
5 animals. The class B dealer shall maintain a record of use and
6 shall make the record available for inspection by the department of
7 licensing and regulatory affairs, the department of agriculture and
8 rural development, and the United States Department of Agriculture.
9 (c) Subject to subdivision (d), certifies that the class B
10 dealer or an employee of the class B dealer has received, and can
11 document completion of, a minimum of 16 hours of training,
12 including at least 12 hours of content training and at least 4
13 hours of practical training, in the use of a commercially prepared,
14 premixed solution of sodium pentobarbital and an animal
15 tranquilizer to perform euthanasia on animals from a training
16 program approved by the state veterinarian, in consultation with
17 the Michigan board of veterinary medicine, and given by a licensed
18 veterinarian pursuant to rules promulgated by the administrator.
19 The training described in this subdivision shall comply with the
20 American Veterinary Medical Association's guidelines for the
21 euthanasia of animals.
22 (d) Until December 31, 2021, ensures that the class B dealer
23 or an employee of the class B dealer who received, and can document
24 the completion of, the 8 hours of training required immediately
25 before the effective date of the 2018 amendatory act that amended
26 this section May 22, 2018 only administers a commercially prepared,
27 premixed solution of sodium pentobarbital to perform euthanasia on
1 the animals described in this subsection. Beginning January 1,
2 2022, the individuals described in this subdivision must have
3 received, and be able to document the completion of, the training
4 described in subdivision (c) to administer a commercially prepared,
5 premixed solution of sodium pentobarbital or an animal tranquilizer
6 to perform euthanasia on the animals described in this subsection.
7 (e) Certifies that only an individual described in subdivision
8 (c) or (d) or an individual otherwise permitted to use a controlled
9 substance pursuant to this article will administer the commercially
10 prepared, premixed solution of sodium pentobarbital or an animal
11 tranquilizer according to written procedures established by the
12 class B dealer.
13 (f) Beginning January 1, 2022, certifies that the individual
14 in charge of the day-to-day operations of the class B dealer's
15 facilities has received, and can document the completion of, the
16 training described in subdivision (c).
17 (g) Complies with all state and federal laws, rules, and
18 regulations regarding the acquisition, use, and security of
19 controlled substances.
20 (9) Notwithstanding subsections (1) to (5), an animal control
21 shelter or animal protection shelter registered with the department
22 of agriculture and rural development pursuant to 1969 PA 287, MCL
23 287.331 to 287.340, may acquire a limited permit only for the
24 purpose of buying, possessing, and administering a commercially
25 prepared, premixed solution of sodium pentobarbital, or an animal
26 tranquilizer, to use exclusively as an adjunct in the process of
27 performing euthanasia on injured, sick, homeless, or unwanted
1 domestic pets and other animals, if the animal control shelter or
2 animal protection shelter does all of the following:
3 (a) Applies to the administrator for a permit in accordance
4 with rules promulgated under this part. The application must
5 contain the name of the individual in charge of the day-to-day
6 operations of the animal control shelter or animal protection
7 shelter and the name of the individual responsible for designating
8 employees who will be performing euthanasia on animals pursuant to
9 this act.
10 (b) Complies with the rules promulgated by the administrator
11 for the storage, handling, and use of a commercially prepared,
12 premixed solution of sodium pentobarbital or an animal tranquilizer
13 to perform euthanasia on animals. The animal control shelter or
14 animal protection shelter shall maintain a record of use and make
15 the record available for inspection by the department of licensing
16 and regulatory affairs and the department of agriculture and rural
17 development.
18 (c) Subject to subdivision (d), certifies that an employee of
19 the animal control shelter or animal protection shelter has
20 received, and can document completion of, a minimum of 16 hours of
21 training, including at least 12 hours of content training and at
22 least 4 hours of practical training, in the use of a commercially
23 prepared, premixed solution of sodium pentobarbital and an animal
24 tranquilizer to perform euthanasia on animals from a training
25 program approved by the state veterinarian, in consultation with
26 the Michigan board of veterinary medicine, and given by a licensed
27 veterinarian pursuant to rules promulgated by the administrator.
1 The training described in this subdivision must comply with the
2 American Veterinary Medical Association's guidelines for the
3 euthanasia of animals.
4 (d) Until December 31, 2021, ensures that an employee of the
5 animal control shelter or animal protection shelter who received,
6 and can document the completion of, the training required
7 immediately before the effective date of the 2018 amendatory act
8 that amended this section May 22, 2018 only administers a
9 commercially prepared solution of xylazine hydrochloride or a
10 commercially prepared, premixed solution of sodium pentobarbital to
11 perform euthanasia on the animals described in this subsection in
12 accordance with his or her training. Beginning January 1, 2022, the
13 employee described in this subdivision must have received, and be
14 able to document the completion of, the training described in
15 subdivision (c) to administer a commercially prepared, premixed
16 solution of sodium pentobarbital or an animal tranquilizer to
17 perform euthanasia on the animals described in this subsection.
18 (e) Certifies that only an individual described in subdivision
19 (c) or (d) or an individual otherwise permitted to use a controlled
20 substance pursuant to this article will administer a commercially
21 prepared, premixed solution of sodium pentobarbital or an animal
22 tranquilizer according to written procedures established by the
23 animal control shelter or animal protection shelter.
24 (f) Beginning January 1, 2022, certifies that the individual
25 in charge of the day-to-day operations of the animal control
26 shelter or animal protection shelter has received, and can document
27 the completion of, the training described in subdivision (c).
1 (g) Complies with all state and federal laws and regulations
2 regarding the acquisition, use, and security of controlled
3 substances.
4 (10) The application described in subsection (8) or (9) must
5 include the names and addresses of all individuals employed by the
6 animal control shelter or animal protection shelter or class B
7 dealer who have been trained as described in subsection (8)(c),
8 (d), and (f) or (9)(c), (d), and (f) and the name of the
9 veterinarian who trained them. The list of names and addresses must
10 be updated every 6 months.
11 (11) If an animal control shelter or animal protection shelter
12 or class B dealer issued a permit pursuant to subsection (8) or (9)
13 does not have in its employ an individual trained as described in
14 subsection (8)(c) or (d) and (8)(f), or (9)(c) or (d) and (9)(f),
15 the animal control shelter or animal protection shelter or class B
16 dealer shall immediately notify the administrator and shall cease
17 to administer a commercially prepared, premixed solution of sodium
18 pentobarbital or an animal tranquilizer for the purposes described
19 in subsection (8) or (9) until the administrator is notified that 1
20 of the following has occurred:
21 (a) An individual trained as described in subsection (8)(c),
22 (d), or (f) or (9)(c), (d), or (f) has been hired by the animal
23 control shelter or animal protection shelter or class B dealer.
24 (b) An individual employed by the animal control shelter or
25 animal protection shelter or class B dealer has been trained as
26 described in subsection (8)(c) or (f) or (9)(c) or (f).
27 (12) A veterinarian, including a veterinarian who trains
1 individuals as described in subsection (8)(c), (d), or (f), or
2 (9)(c), (d), or (f), is not civilly or criminally liable for the
3 use of a commercially prepared, premixed solution of sodium
4 pentobarbital or an animal tranquilizer by an animal control
5 shelter or animal protection shelter or a class B dealer, unless
6 the veterinarian is employed by or under contract with the animal
7 control shelter or animal protection shelter or class B dealer and
8 the terms of the veterinarian's employment or the contract require
9 the veterinarian to be responsible for the use or administration of
10 the commercially prepared, premixed solution of sodium
11 pentobarbital or animal tranquilizer.
12 (13) A person shall not knowingly use or permit the use of a
13 commercially prepared, premixed solution of sodium pentobarbital or
14 an animal tranquilizer in violation of this section.
15 (14) This section does not require that a veterinarian be
16 employed by or under contract with an animal control shelter or
17 animal protection shelter or class B dealer to obtain, possess, or
18 administer a commercially prepared, premixed solution of sodium
19 pentobarbital or an animal tranquilizer pursuant to this section.
20 (15) Notwithstanding subsections (1) to (5), an animal control
21 shelter registered with the department of agriculture and rural
22 development pursuant to 1969 PA 287, MCL 287.331 to 287.340, may
23 acquire a limited permit only for the purpose of buying,
24 possessing, and administering an animal tranquilizer to sedate or
25 immobilize an animal running at large that is dangerous or
26 difficult to capture, if the animal control shelter does all of the
27 following:
1 (a) Applies to the administrator for a permit in accordance
2 with the rules promulgated under this part. The application must
3 contain the name of the individual in charge of the day-to-day
4 operations of the animal control shelter and the name of the
5 individual responsible for designating employees who will be
6 administering an animal tranquilizer pursuant to this act.
7 (b) Complies with the rules promulgated by the administrator
8 for the storage, handling, and use of an animal tranquilizer. The
9 animal control shelter shall maintain a record of use and shall
10 make the record available for inspection by the department of
11 licensing and regulatory affairs and the department of agriculture
12 and rural development.
13 (c) Subject to subdivision (d), certifies that an employee of
14 the animal control shelter has received, and can document
15 completion of, both of the following in the following order:
16 (i) The training described in subsection (9)(c).
17 (ii) A minimum of 16 hours of training, including at least 12
18 hours of content training and at least 4 hours of practical
19 training, in the use of animal tranquilizers to sedate or
20 immobilize the animals described in this subsection from a training
21 program approved by the state veterinarian, in consultation with
22 the Michigan board of veterinary medicine, and given by a licensed
23 veterinarian pursuant to rules promulgated by the administrator.
24 (d) Until December 31, 2021, ensures that an employee of the
25 animal control shelter who received, and can document the
26 completion of, the training required immediately before the
27 effective date of the 2018 amendatory act that amended this section
1 May 22, 2018 only administers a commercially prepared solution of
2 xylazine hydrochloride to sedate or immobilize the animals
3 described in this subsection. Beginning January 1, 2022, the
4 employee described in this subdivision must have received, and be
5 able to document the completion of, the training described in
6 subdivision (c) to administer an animal tranquilizer to perform
7 euthanasia on the animals described in this subsection.
8 (e) Certifies that only an individual described in subdivision
9 (c) or (d) or an individual otherwise permitted to use a controlled
10 substance pursuant to this article will administer an animal
11 tranquilizer according to written procedures established by the
12 animal control shelter.
13 (f) Beginning January 1, 2022, certifies that the individual
14 in charge of the day-to-day operations of the animal control
15 shelter has received, and can document the completion of, the
16 training described in subdivision (c).
17 (g) Complies with all state and federal laws, rules, and
18 regulations regarding the acquisition, use, and security of
19 controlled substances.
20 (16) The application described in subsection (15) must include
21 the names and business addresses of all individuals employed by the
22 animal control shelter who have been trained as described in
23 subsection (15)(c), (d), and (f) and must include documented proof
24 of the training. The list of names and business addresses must be
25 updated every 6 months.
26 (17) If an animal control shelter issued a permit pursuant to
27 subsection (15) does not have in its employ an individual trained
1 as described in subsection (15)(c) , or (d) and (15)(f), the animal
2 control shelter shall immediately notify the administrator and
3 shall cease to administer an animal tranquilizer for the purposes
4 described in subsection (15) until the administrator is notified
5 that 1 of the following has occurred:
6 (a) An individual trained as described in subsection (15)(c),
7 (d), or (f) has been hired by the animal control shelter.
8 (b) An individual employed by the animal control shelter has
9 been trained as described in subsection (15)(c) or (f).
10 (18) A veterinarian, including a veterinarian who trains
11 individuals as described in subsection (15)(c), (d), or (f), is not
12 civilly or criminally liable for the use of an animal tranquilizer
13 by an animal control shelter unless the veterinarian is employed by
14 or under contract with the animal control shelter and the terms of
15 the veterinarian's employment or the contract require the
16 veterinarian to be responsible for the use or administration of an
17 animal tranquilizer.
18 (19) As used in this section:
19 (a) "Animal tranquilizer" means a commercially prepared
20 solution of xylazine hydrochloride, a commercially prepared
21 solution of ketamine, or a commercially prepared compound
22 containing tiletamine and zolazepam.
23 (b) "Class B dealer" means a class B dealer licensed by the
24 United States Department of Agriculture pursuant to the animal
25 welfare act, 7 USC 2131 to 2159 and the department of agriculture
26 and rural development pursuant to 1969 PA 224, MCL 287.381 to
27 287.395.
1 Sec. 7333c. (1) Except as otherwise provided in this section,
2 beginning January 1, 2021, a prescription for a controlled
3 substance that is an opioid or a benzodiazepine must be transmitted
4 electronically to a pharmacy in a manner that complies with section
5 17754. An electronically transmitted prescription must include the
6 information described in section 17754 and must be transmitted
7 directly to a pharmacy of the patient's choice by the prescriber or
8 the prescriber's authorized agent.
9 (2) If a prescriber cannot meet the requirements of subsection
10 (1), the prescriber may apply to the department of licensing and
11 regulatory affairs for a waiver. The department of licensing and
12 regulatory affairs shall grant the prescriber a waiver if that
13 department determines that the prescriber cannot meet the
14 requirements of subsection (1) due to an economic hardship, a
15 technological limitation that is not reasonably within the control
16 of the prescriber, or another exceptional circumstance. A
17 prescriber who is granted a waiver under this subsection shall
18 notify the department of licensing and regulatory affairs in
19 writing if he or she is subsequently able to meet the requirements
20 of subsection (1). A waiver that is granted under this subsection
21 is valid for a period not to exceed 1 year and is renewable.
22 (3) This section does not apply under any of the following
23 circumstances:
24 (a) If the prescription is issued by a prescriber who is a
25 veterinarian.
26 (b) If the prescription is issued under a circumstance in
27 which electronic transmission is not available due to a temporary
1 technological or electrical failure.
2 (c) If the prescription is issued by a prescriber who has
3 received a waiver under subsection (2).
4 (d) If the prescription is issued by a prescriber who
5 reasonably believes that electronically transmitting the
6 prescription would make it impractical for the patient who is the
7 subject of the prescription to fill the prescription in a timely
8 manner and that the delay would adversely affect the patient's
9 medical condition.
10 (e) If the prescription is orally prescribed under section
11 7333(3) or (4).
12 (f) If the prescription is issued by a prescriber to be
13 dispensed outside of this state.
14 (g) If the prescription is issued by a prescriber who is
15 located outside of this state to be dispensed by a pharmacy located
16 inside of this state.
17 (h) If the prescription is issued and dispensed in the same
18 health care facility and the individual for whom the prescription
19 is issued uses the drug exclusively in the health care facility. As
20 used in this subdivision, "health care facility" includes, but is
21 not limited to, a hospital, hospice, or another long-term care
22 facility that provides rehabilitative, restorative, or ongoing
23 skilled nursing care to an individual who is in need of assistance
24 with activities of daily living.
25 (i) If the prescription contains content that is not supported
26 by the National Council for Prescription Drug Programs
27 Prescriber/Pharmacist Interface SCRIPT Standard.
1 (j) If the prescription is for a drug for which the Food and
2 Drug Administration requires the prescription to contain content
3 that cannot be transmitted electronically.
4 (k) If the prescription is issued under circumstances in which
5 the prescriber is not required to include on the prescription a
6 name of a patient for whom the prescription is issued.
7 (l) If the prescription is issued by a prescriber who is
8 prescribing the drug under a research protocol.
9 (m) If the prescription is for a drug that is administered to
10 the individual for whom the drug is prescribed in a hospital,
11 nursing home, hospice, dialysis treatment clinic, freestanding
12 surgical outpatient facility, or assisted living residence.
13 (4) A pharmacist who receives a prescription for a controlled
14 substance described in this section that was not transmitted
15 electronically to the pharmacy may dispense the prescription as
16 provided in section 7333 without determining whether an exception
17 under subsection (3) applies.
18 (5) As used in this section, "electronically transmitted
19 prescription" means that term as defined in section 17703.
20 Sec. 16221. Subject to section 16221b, the department shall
21 investigate any allegation that 1 or more of the grounds for
22 disciplinary subcommittee action under this section exist, and may
23 investigate activities related to the practice of a health
24 profession by a licensee, a registrant, or an applicant for
25 licensure or registration. The department may hold hearings,
26 administer oaths, and order the taking of relevant testimony. After
27 its investigation, the department shall provide a copy of the
1 administrative complaint to the appropriate disciplinary
2 subcommittee. The disciplinary subcommittee shall proceed under
3 section 16226 if it finds that 1 or more of the following grounds
4 exist:
5 (a) Except as otherwise specifically provided in this section,
6 a violation of general duty, consisting of negligence or failure to
7 exercise due care, including negligent delegation to or supervision
8 of employees or other individuals, whether or not injury results,
9 or any conduct, practice, or condition that impairs, or may impair,
10 the ability to safely and skillfully engage in the practice of the
11 health profession.
12 (b) Personal disqualifications, consisting of 1 or more of the
13 following:
14 (i) Incompetence.
15 (ii) Subject to sections 16165 to 16170a, substance use
16 disorder as defined in section 100d of the mental health code, 1974
17 PA 258, MCL 330.1100d.
18 (iii) Mental or physical inability reasonably related to and
19 adversely affecting the licensee's or registrant's ability to
20 practice in a safe and competent manner.
21 (iv) Declaration of mental incompetence by a court of
22 competent jurisdiction.
23 (v) Conviction of a misdemeanor punishable by imprisonment for
24 a maximum term of 2 years; conviction of a misdemeanor involving
25 the illegal delivery, possession, or use of a controlled substance;
26 or conviction of any felony other than a felony listed or described
27 in another subparagraph of this subdivision. A certified copy of
1 the court record is conclusive evidence of the conviction.
2 (vi) Lack of good moral character.
3 (vii) Conviction of a criminal offense under section 520e or
4 520g of the Michigan penal code, 1931 PA 328, MCL 750.520e and
5 750.520g. A certified copy of the court record is conclusive
6 evidence of the conviction.
7 (viii) Conviction of a violation of section 492a of the
8 Michigan penal code, 1931 PA 328, MCL 750.492a. A certified copy of
9 the court record is conclusive evidence of the conviction.
10 (ix) Conviction of a misdemeanor or felony involving fraud in
11 obtaining or attempting to obtain fees related to the practice of a
12 health profession. A certified copy of the court record is
13 conclusive evidence of the conviction.
14 (x) Final adverse administrative action by a licensure,
15 registration, disciplinary, or certification board involving the
16 holder of, or an applicant for, a license or registration regulated
17 by another state or a territory of the United States, by the United
18 States military, by the federal government, or by another country.
19 A certified copy of the record of the board is conclusive evidence
20 of the final action.
21 (xi) Conviction of a misdemeanor that is reasonably related to
22 or that adversely affects the licensee's or registrant's ability to
23 practice in a safe and competent manner. A certified copy of the
24 court record is conclusive evidence of the conviction.
25 (xii) Conviction of a violation of section 430 of the Michigan
26 penal code, 1931 PA 328, MCL 750.430. A certified copy of the court
27 record is conclusive evidence of the conviction.
1 (xiii) Conviction of a criminal offense under section 83, 84,
2 316, 317, 321, 520b, 520c, 520d, or 520f of the Michigan penal
3 code, 1931 PA 328, MCL 750.83, 750.84, 750.316, 750.317, 750.321,
4 750.520b, 750.520c, 750.520d, and 750.520f. A certified copy of the
5 court record is conclusive evidence of the conviction.
6 (xiv) Conviction of a violation of section 136 or 136a of the
7 Michigan penal code, 1931 PA 328, MCL 750.136 and 750.136a. A
8 certified copy of the court record is conclusive evidence of the
9 conviction.
10 (c) Prohibited acts, consisting of 1 or more of the following:
11 (i) Fraud or deceit in obtaining or renewing a license or
12 registration.
13 (ii) Permitting a license or registration to be used by an
14 unauthorized person.
15 (iii) Practice outside the scope of a license.
16 (iv) Obtaining, possessing, or attempting to obtain or possess
17 a controlled substance as defined in section 7104 or a drug as
18 defined in section 7105 without lawful authority; or selling,
19 prescribing, giving away, or administering drugs for other than
20 lawful diagnostic or therapeutic purposes.
21 (d) Except as otherwise specifically provided in this section,
22 unethical business practices, consisting of 1 or more of the
23 following:
24 (i) False or misleading advertising.
25 (ii) Dividing fees for referral of patients or accepting
26 kickbacks on medical or surgical services, appliances, or
27 medications purchased by or in behalf of patients.
1 (iii) Fraud or deceit in obtaining or attempting to obtain
2 third party reimbursement.
3 (e) Except as otherwise specifically provided in this section,
4 unprofessional conduct, consisting of 1 or more of the following:
5 (i) Misrepresentation to a consumer or patient or in obtaining
6 or attempting to obtain third party reimbursement in the course of
7 professional practice.
8 (ii) Betrayal of a professional confidence.
9 (iii) Promotion for personal gain of an unnecessary drug,
10 device, treatment, procedure, or service.
11 (iv) Either of the following:
12 (A) A requirement by a licensee other than a physician or a
13 registrant that an individual purchase or secure a drug, device,
14 treatment, procedure, or service from another person, place,
15 facility, or business in which the licensee or registrant has a
16 financial interest.
17 (B) A referral by a physician for a designated health service
18 that violates 42 USC 1395nn or a regulation promulgated under that
19 section. For purposes of this subdivision, 42 USC 1395nn and the
20 regulations promulgated under that section as they exist on June 3,
21 2002 are incorporated by reference. A disciplinary subcommittee
22 shall apply 42 USC 1395nn and the regulations promulgated under
23 that section regardless of the source of payment for the designated
24 health service referred and rendered. If 42 USC 1395nn or a
25 regulation promulgated under that section is revised after June 3,
26 2002, the department shall officially take notice of the revision.
27 Within 30 days after taking notice of the revision, the department
1 shall decide whether or not the revision pertains to referral by
2 physicians for designated health services and continues to protect
3 the public from inappropriate referrals by physicians. If the
4 department decides that the revision does both of those things, the
5 department may promulgate rules to incorporate the revision by
6 reference. If the department does promulgate rules to incorporate
7 the revision by reference, the department shall not make any
8 changes to the revision. As used in this sub-subparagraph,
9 "designated health service" means that term as defined in 42 USC
10 1395nn and the regulations promulgated under that section and
11 "physician" means that term as defined in sections 17001 and 17501.
12 (v) For a physician who makes referrals under 42 USC 1395nn or
13 a regulation promulgated under that section, refusing to accept a
14 reasonable proportion of patients eligible for Medicaid and
15 refusing to accept payment from Medicaid or Medicare as payment in
16 full for a treatment, procedure, or service for which the physician
17 refers the individual and in which the physician has a financial
18 interest. A physician who owns all or part of a facility in which
19 he or she provides surgical services is not subject to this
20 subparagraph if a referred surgical procedure he or she performs in
21 the facility is not reimbursed at a minimum of the appropriate
22 Medicaid or Medicare outpatient fee schedule, including the
23 combined technical and professional components.
24 (vi) Any conduct by a health professional with a patient while
25 he or she is acting within the health profession for which he or
26 she is licensed or registered, including conduct initiated by a
27 patient or to which the patient consents, that is sexual or may
1 reasonably be interpreted as sexual, including, but not limited to,
2 sexual intercourse, kissing in a sexual manner, or touching of a
3 body part for any purpose other than appropriate examination,
4 treatment, or comfort.
5 (vii) Offering to provide practice-related services, such as
6 drugs, in exchange for sexual favors.
7 (viii) A violation of section 16655(4) by a dental therapist.
8 (f) Failure to notify under section 16222(3) or (4).
9 (g) Failure to report a change of name or mailing address as
10 required in section 16192.
11 (h) A violation, or aiding or abetting in a violation, of this
12 article or of a rule promulgated under this article.
13 (i) Failure to comply with a subpoena issued pursuant to this
14 part, failure to respond to a complaint issued under this article,
15 article 7, or article 8, failure to appear at a compliance
16 conference or an administrative hearing, or failure to report under
17 section 16222(1) or 16223.
18 (j) Failure to pay an installment of an assessment levied
19 under the insurance code of 1956, 1956 PA 218, MCL 500.100 to
20 500.8302, within 60 days after notice by the appropriate board.
21 (k) A violation of section 17013 or 17513.
22 (l) Failure to meet 1 or more of the requirements for
23 licensure or registration under section 16174.
24 (m) A violation of section 17015, 17015a, 17017, 17515, or
25 17517.
26 (n) A violation of section 17016 or 17516.
27 (o) Failure to comply with section 9206(3).
1 (p) A violation of section 5654 or 5655.
2 (q) A violation of section 16274.
3 (r) A violation of section 17020 or 17520.
4 (s) A violation of the medical records access act, 2004 PA 47,
5 MCL 333.26261 to 333.26271.
6 (t) A violation of section 17764(2).
7 (u) Failure to comply with the terms of a practice agreement
8 described in section 17047(2)(a) or (b), 17547(2)(a) or (b), or
9 18047(2)(a) or (b).
10 (v) A violation of section 7303a(2).
11 (w) A violation of section 7303a(4) or (5).
12 (x) A violation of section 7303b.
13 (y) A violation of section 7333c.
14 Sec. 16226. (1) After finding the existence of 1 or more of
15 the grounds for disciplinary subcommittee action listed in section
16 16221, a disciplinary subcommittee shall impose 1 or more of the
17 following sanctions for each violation:
18
nbsp;Violations of Section 16221
nbsp;Sanctions
19
Subdivision (a), (b)(i),
Probation, limitation, denial,
20
(b)(ii), (b)(iii), (b)(iv),
suspension, revocation,
21
(b)(v), (b)(vi), (b)(vii),
permanent revocation,
22
(b)(ix), (b)(x), (b)(xi),
restitution, or fine.
23
or (b)(xii)
24
25
Subdivision (b)(viii)
Revocation, permanent revocation,
26
or denial.
27
1
Subdivision (b)(xiii)
Permanent revocation
2
for a violation described in
3
subsection (5); otherwise,
4
probation, limitation, denial,
5
suspension, revocation,
6
restitution, or fine.
7
8
Subdivision (b)(xiv)
Permanent revocation.
9
10
Subdivision (c)(i)
Denial, revocation, suspension,
11
probation, limitation, or fine.
12
13
Subdivision (c)(ii)
Denial, suspension, revocation,
14
restitution, or fine.
15
16
Subdivision (c)(iii)
Probation, denial, suspension,
17
revocation, restitution, or fine.
18
19
Subdivision (c)(iv)
Fine, probation, denial,
20
or (d)(iii)
suspension, revocation, permanent
21
revocation, or restitution.
22
23
Subdivision (d)(i)
Reprimand, fine, probation,
24
or (d)(ii)
denial, or restitution.
25
26
Subdivision (e)(i),
Reprimand, fine, probation,
27
(e)(iii), (e)(iv), (e)(v),
limitation, suspension,
1
(h), or (s)
revocation, permanent revocation,
2
denial, or restitution.
3
4
Subdivision (e)(ii)
Reprimand, probation, suspension,
5
or (i)(i)
revocation, permanent
6
revocation, restitution,
7
denial, or fine.
8
9
Subdivision (e)(vi),
Probation, suspension, revocation,
10
(e)(vii), or (e)(viii)
limitation, denial,
11
restitution, or fine.
12
13
Subdivision (f)
Reprimand, denial, limitation,
14
probation, or fine.
15
16
Subdivision (g)
Reprimand or fine.
17
18
Subdivision (j)
Suspension or fine.
19
20
Subdivision (k), (p),
Reprimand, probation, suspension,
21
or (r)
revocation, permanent revocation,
22
or fine.
23
24
Subdivision (l)
Reprimand, denial, or
25
limitation.
26
27
Subdivision (m) or (o)
Denial, revocation, restitution,
1
probation, suspension,
2
limitation, reprimand, or fine.
3
4
Subdivision (n)
Revocation or denial.
5
6
Subdivision (q)
Revocation.
7
8
Subdivision (t)
Revocation, permanent revocation,
9
fine, or restitution.
10
11
Subdivision (u)
Denial, revocation, probation,
12
suspension, limitation, reprimand,
13
or fine.
14
15
Subdivision (v) or (x)
Probation, limitation, denial,
16
fine, suspension, revocation, or
17
permanent revocation.
18
19
Subdivision (w)
Denial, fine, reprimand,
20
probation, limitation,
21
suspension, revocation, or
22
permanent revocation.
23
Subdivision (y)
Subject to subsection (7), fine.
24 (2) Determination of sanctions for violations under this
25 section shall be made by a disciplinary subcommittee. If, during
26 judicial review, the court of appeals determines that a final
27 decision or order of a disciplinary subcommittee prejudices
1 substantial rights of the petitioner for 1 or more of the grounds
2 listed in section 106 of the administrative procedures act of 1969,
3 1969 PA 306, MCL 24.306, and holds that the final decision or order
4 is unlawful and is to be set aside, the court shall state on the
5 record the reasons for the holding and may remand the case to the
6 disciplinary subcommittee for further consideration.
7 (3) A disciplinary subcommittee may impose a fine in an amount
8 that does not exceed $250,000.00 for a violation of section
9 16221(a) or (b). A disciplinary subcommittee shall impose a fine of
10 at least $25,000.00 if the violation of section 16221(a) or (b)
11 results in the death of 1 or more patients.
12 (4) A disciplinary subcommittee may require a licensee or
13 registrant or an applicant for licensure or registration who has
14 violated this article, article 7, or article 8 or a rule
15 promulgated under this article, article 7, or article 8 to
16 satisfactorily complete an educational program, a training program,
17 or a treatment program, a mental, physical, or professional
18 competence examination, or a combination of those programs and
19 examinations.
20 (5) A disciplinary subcommittee shall impose the sanction of
21 permanent revocation for a violation of section 16221(b)(xiii) if
22 the violation occurred while the licensee or registrant was acting
23 within the health profession for which he or she was licensed or
24 registered.
25 (6) Except as otherwise provided in subsection (5) and this
26 subsection, a disciplinary subcommittee shall not impose the
27 sanction of permanent revocation under this section without a
1 finding that the licensee or registrant engaged in a pattern of
2 intentional acts of fraud or deceit resulting in personal financial
3 gain to the licensee or registrant and harm to the health of
4 patients under the licensee's or registrant's care. This subsection
5 does not apply if a disciplinary subcommittee finds that a licensee
6 or registrant has violated section 16221(b)(xiv).
7 (7) A disciplinary subcommittee shall impose a fine of $250.00
8 for each violation of section 16221(y). However, the aggregate fine
9 that a disciplinary subcommittee imposes on a licensee or
10 registrant for multiple violation of section 16221(y) must not
11 exceed $5,000.00 in 1 calendar year.
00575'19 * 28=1"1=1" Final Page" " " Final Page" " " EMR