Bill Text: AZ SB1159 | 2024 | Fifty-sixth Legislature 2nd Regular | Engrossed
Bill Title: Dentists; restricted permits; continuing education
Spectrum: Partisan Bill (Republican 1-0)
Status: (Engrossed) 2024-04-01 - House Committee of the Whole action: Retained on the Calendar [SB1159 Detail]
Download: Arizona-2024-SB1159-Engrossed.html
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Senate Engrossed
technical correction; home health agencies |
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(now: dentists; restricted permits; continuing education)
State of Arizona Senate Fifty-sixth Legislature Second Regular Session 2024
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SENATE BILL 1159 |
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An Act
amending sections 32-1201, 32-1231, 32-1232, 32-1237, 32-1238 and 32-1239, Arizona Revised Statutes; relating to dentistry.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Section 32-1201, Arizona Revised Statutes, is amended to read:
32-1201. Definitions
In this chapter, unless the context otherwise requires:
1. "Affiliated practice dental hygienist" means any licensed dental hygienist who is able, pursuant to section 32-1289.01, to initiate treatment based on the dental hygienist's assessment of a patient's needs according to the terms of a written affiliated practice agreement with a dentist, to treat the patient without the presence of a dentist and to maintain a provider-patient relationship.
2. "Auxiliary personnel" means all dental assistants, dental technicians, dental x-ray technicians and other persons employed by dentists or firms and businesses providing dental services to dentists.
3. "Board" means the state board of dental examiners.
4. "Business entity" means a business organization that has an ownership that includes any persons who are not licensed or certified to provide dental services in this state, that offers to the public professional services regulated by the board and that is established pursuant to the laws of any state or foreign country.
5. "Dental assistant" means any person who acts as an assistant to a dentist, dental therapist or dental hygienist by rendering personal services to a patient that involve close proximity to the patient while the patient is under treatment or observation or undergoing diagnostic procedures.
6. "Dental hygienist" means any person who is licensed and engaged in the general practice of dental hygiene and all related and associated duties, including educational, clinical and therapeutic dental hygiene procedures.
7. "Dental incompetence" means lacking in sufficient dentistry knowledge or skills, or both, in that field of dentistry in which the dentist, dental therapist, denturist or dental hygienist concerned engages, to a degree likely to endanger the health of that person's patients.
8. "Dental laboratory technician" means any person, other than a licensed dentist, who, pursuant to a written work order of a dentist, fabricates artificial teeth, prosthetic appliances or other mechanical and artificial contrivances designed to correct or alleviate injuries or defects, both developmental and acquired, disorders or deficiencies of the human oral cavity, teeth, investing tissues, maxilla or mandible or adjacent associated structures.
9. "Dental therapist" means any person who is licensed and engaged in the general practice of dental therapy and all related and associated duties, including educational, clinical and therapeutic dental therapy procedures.
10. "Dental x-ray laboratory technician" means any person, other than a licensed dentist, who, pursuant to a written work order of a dentist, performs dental and maxillofacial radiography, including cephalometrics, panoramic and maxillofacial tomography and other dental related nonfluoroscopic diagnostic imaging modalities.
11. "Dentistry", "dentist" and "dental" mean the general practice of dentistry and all specialties or restricted practices of dentistry.
12. "Denturist" means a person practicing denture technology pursuant to article 5 of this chapter.
13. "Disciplinary action" means regulatory sanctions that are imposed by the board in combination with, or as an alternative to, revocation or suspension of a license and that may include:
(a) Imposition of an administrative penalty in an amount not to exceed two thousand dollars $2,000 for each violation of this chapter or rules adopted under this chapter.
(b) Imposition of restrictions on the scope of practice.
(c) Imposition of peer review and professional education requirements.
(d) Imposition of censure or probation requirements best adapted to protect the public welfare, which may include a requirement for restitution to the patient resulting from violations of this chapter or rules adopted under this chapter.
14. "Irregularities in billing" means submitting any claim, bill or government assistance claim to any patient, responsible party or third-party payor for dental services rendered that is materially false with the intent to receive unearned income as evidenced by any of the following:
(a) Charges for services not rendered.
(b) Any treatment date that does not accurately reflect the date when the service and procedures were actually completed.
(c) Any description of a dental service or procedure that does not accurately reflect the actual work completed.
(d) Any charge for a service or procedure that cannot be clinically justified or determined to be necessary.
(e) Any statement that is material to the claim and that the licensee knows is false or misleading.
(f) An abrogation of the copayment provisions of a dental insurance contract by a waiver of all or a part of the copayment from the patient if this results in an excessive or fraudulent charge to a third party or if the waiver is used as an enticement to receive dental services from that provider. This subdivision does not interfere with a contractual relationship between a third-party payor and a licensee or business entity registered with the board.
(g) Any other practice in billing that results in excessive or fraudulent charges to the patient.
15. "Letter of concern" means an advisory letter to notify a licensee or a registered business entity that, while the evidence does not warrant disciplinary action, the board believes that the licensee or registered business entity should modify or eliminate certain practices and that continuation of the activities that led to the information being submitted to the board may result in board action against the practitioner's license or the business entity's registration. A letter of concern is not a disciplinary action. A letter of concern is a public document and may be used in a future disciplinary action.
16. "Licensed" means licensed pursuant to this chapter.
17. "Place of practice" means each physical location at which a person who is licensed pursuant to this chapter performs services subject to this chapter.
18. "Primary mailing address" means the address on file with the board and to which official board correspondence, notices or documents are delivered in a manner determined by the board.
19. "Qualified anesthesia provider" means any of the following:
(a) A licensee who holds a permit to administer anesthesia and sedation from the board pursuant to section 32-1207.
(b) A physician who has completed residency training in anesthesiology, who is licensed pursuant to chapter 13 or 17 of this title and who is registered with the Arizona medical board or the Arizona board of osteopathic examiners in medicine and surgery to administer anesthesia in dental offices and dental clinics pursuant to section 32-1403 or 32-1803.
(c) A certified registered nurse anesthetist who has a national board certification in anesthesiology, who is licensed pursuant to chapter 15 of this title and who is registered with the Arizona state board of nursing to administer anesthesia in dental offices and dental clinics pursuant to section 32-1606.
20. "Recognized continuing dental education" means continuing dental education as prescribed by the board in rule.
20. 21. "Recognized dental hygiene school" means a school that has a dental hygiene program with a minimum two academic year curriculum, or the equivalent of four semesters, and that is approved by the board and accredited by the American dental association commission on dental accreditation.
21. 22. "Recognized dental school" means a dental school that is accredited by the American dental association commission on dental accreditation.
22. 23. "Recognized dental therapy school" means a school that is accredited or that has received initial accreditation by the American dental association commission on dental accreditation.
23. 24. "Recognized denturist school" means a denturist school that maintains standards of entrance, study and graduation and that is accredited by the United States department of education or the council on higher education accreditation.
24. 25. "Supervised personnel" means all dental hygienists, dental assistants, dental laboratory technicians, dental therapists, denturists, dental x-ray laboratory technicians and other persons supervised by licensed dentists.
25. 26. "Teledentistry" means the use of data transmitted through interactive audio, video or data communications for the purposes of examination, diagnosis, treatment planning, consultation and directing the delivery of treatment by dentists and dental providers in settings permissible under this chapter or specified in rules adopted by the board.
Sec. 2. Section 32-1231, Arizona Revised Statutes, is amended to read:
32-1231. Persons not required to be licensed
This chapter does not prohibit:
1. A dentist, dental therapist or dental hygienist who is officially employed in the service of the United States from practicing dentistry in the dentist's, dental therapist's or dental hygienist's official capacity, within the scope of that person's authority, on persons who are enlisted in, directly connected with or under the immediate control of some branch of service of the United States.
2. A person, whether or not licensed by this state, from practicing dental therapy either:
(a) In the discharge of official duties on behalf of the United States government, including the United States department of veterans affairs, the United States public health service and the Indian health service.
(b) While employed by tribal health programs authorized pursuant to Public Law 93-638 or urban Indian health programs.
3. An intern or student of dentistry, dental therapy or dental hygiene from operating in the clinical departments or laboratories of a recognized dental school, recognized dental therapy school, recognized dental hygiene school or hospital under the supervision of a dentist.
4. An unlicensed person from performing for a licensed dentist merely mechanical work on inert matter not within the oral cavity in the construction, making, alteration or repairing of any artificial dental substitute or any dental restorative or corrective appliance, if the casts or impressions for that work have been furnished by a licensed dentist and the work is directly supervised by the dentist for whom done or under a written authorization signed by the dentist, but the burden of proving that written authorization or direct supervision is on the person charged with having violated this provision.
5. A clinician who is not licensed in this state from giving demonstrations, before bona fide dental societies, study clubs and groups of professional students, that are free to the persons on whom made.
6. The state director of dental public health from performing the director's administrative duties as prescribed by law.
7. A dentist or dental hygienist to whom a restricted permit has been issued from practicing dentistry or dental hygiene in this state as provided in sections 32-1237 and 32-1292.
8. A dentist, dental therapist or dental hygienist from practicing for educational purposes on behalf of a recognized dental school, recognized dental therapy school or recognized dental hygiene school.
9. A dentist who holds an active and unrestricted license in another state, territory or possession of the United States from practicing for educational purposes in connection with recognized continuing dental education. A dentist who practices under this paragraph:
(a) May not receive compensation for dental services provided in connection with recognized continuing dental education.
(b) Is subject to the jurisdiction and discipline of the board to the same extent as dentists who are licensed in this state.
(c) May not provide any dental care or services in this state to a person whose primary residence is an emergency shelter as defined in section 46-241, an institution that provides a temporary residence for individuals intended to be institutionalized or a public or private place that is not designed for, or ordinarily used as a regular sleeping accommodation for, human beings. This subdivision does not preclude a dentist who practices under this paragraph from providing dental care or services to a person who is participating in a long-term recovery or rehabilitative program.
(d) Shall file a restricted permit application on a form approved by the board with the recognized continuing dental education before providing any dental care or services in this state. The provider of the recognized continuing dental education shall retain the dentist's restricted permit application for a period of at least five years.
Sec. 3. Section 32-1232, Arizona Revised Statutes, is amended to read:
32-1232. Qualifications of applicant; application; fee; fingerprint clearance card; exception
A. An applicant for licensure shall meet the requirements of section 32-1233 and shall hold a diploma conferring a degree of doctor of dental medicine or doctor of dental surgery from a recognized dental school.
C. The board may deny an application for a license, for license renewal or for a restricted permit if the applicant:
1. Has committed any act that would be cause for censure, probation or suspension or revocation of a license under this chapter.
2. While unlicensed, committed or aided and abetted the commission of any act for which a license is required by this chapter.
3. Knowingly made any false statement in the application.
4. Has had a license to practice dentistry revoked by a dental regulatory board in another jurisdiction in the United States for an act that occurred in that jurisdiction and that constitutes unprofessional conduct pursuant to this chapter.
5. Is currently under suspension or restriction by a dental regulatory board in another jurisdiction in the United States for an act that occurred in that jurisdiction and that constitutes unprofessional conduct pursuant to this chapter.
6. Has surrendered, relinquished or given up a license to practice dentistry in lieu of disciplinary action by a dental regulatory board in another jurisdiction in the United States for an act that occurred in that jurisdiction and that constitutes unprofessional conduct pursuant to this chapter.
D. The board shall suspend an application for a license, for license renewal or for a restricted permit if the applicant is currently under investigation by a dental regulatory board in another jurisdiction. The board shall not issue or deny a license to the applicant until the investigation is resolved.
Sec. 4. Section 32-1237, Arizona Revised Statutes, is amended to read:
32-1237. Restricted permit
A. A person may apply for a restricted permit if the applicant demonstrates to the board's satisfaction that the applicant:
1. Has a pending contract with a recognized charitable dental clinic or organization OR WILL BE PRACTICING FOR EDUCATIONAL PURPOSES IN CONNECTION WITH AND WHILE ENROLLED IN RECOGNIZED CONTINUING DENTAL EDUCATION that offers dental services without compensation or at a rate that only reimburses the clinic for dental supplies and overhead costs and the applicant will receive no compensation for dental services provided at the clinic or organization OR IN CONNECTION WITH THE RECOGNIZED CONTINUING dental EDUCATION.
2. Has a license to practice dentistry issued by another state or territory of the United States or the District of Columbia.
3. Has been actively engaged in one or more of the following for AT LEAST three years immediately preceding the application:
(a) The practice of dentistry.
(b) An approved dental residency training program.
(c) Postgraduate training deemed by the board equivalent to an approved dental residency training program.
4. Is competent and proficient to practice dentistry.
5. Meets the requirements of section 32-1232, subsection A, other than the requirement to meet section 32-1233.
B. For the purposes of meeting the requirements of subsection A of this section, the provider of the recognized continuing dental education, before the commencement of the recognized continuing dental education, shall notify the board of the restricted permit applicants the provider has accepted that meet the requirements of section 32-1231, paragraph 9. The board shall acknowledge receipt of the notification within five business days.
Sec. 5. Section 32-1238, Arizona Revised Statutes, is amended to read:
32-1238. Issuance of restricted permit
a. tHE BOARD SHALL ISSUE A RESTRICTED PERMIT WITHIN THIRTY DAYS AFTER THE DATE THE BOARD RECEIVES A COMPLETE APPLICATION that meets the requirements of section 32-1232, subsection B FROM AN APPLICANT THAT MEETS THE REQUIREMENTS OF SECTION 32-1237.
b. A restricted permit may be issued by the board without examination or payment of fee for a period not to exceed one year or until June 30th, whichever is lesser, and shall automatically expire at that time. The board may, in its discretion and pursuant to rules or regulations not inconsistent with this chapter, renew such restricted permit for periods not to exceed one year.
C. FOR THE PURPOSEs OF THIS SECTION, THE ACKNOWLEDGMENT FROM THE BOARD PURSUANT TO SECTION 32-1237, subsection B SERVEs AS THE ISSUANCE OF A RESTRICTED PERMIT TO AN APPLICANT who WILL BE PRACTICING FOR EDUCATIONAL PURPOSES IN CONNECTION WITH AND WHILE ENROLLED IN RECOGNIZED CONTINUING DENTAL EDUCATION.
Sec. 6. Section 32-1239, Arizona Revised Statutes, is amended to read:
32-1239. Practice under restricted permit
A person to whom a restricted permit is issued shall be entitled to may practice dentistry only in the course of his THE PERSON'S employment by a recognized charitable dental clinic or organization OR FOR EDUCATIONAL PURPOSES IN CONNECTION WITH AND WHILE ENROLLED IN RECOGNIZED CONTINUING DENTAL EDUCATION as approved by the board. , on the following conditions:
1. He tHE PERSON shall file a copy of his THE PERSON'S employment contract OR CONFIRMATION OF ENROLLMENT WITH RECOGNIZED CONTINUING DENTAL EDUCATION with the board, and such THE contract OR CONFIRMATION shall contain the following provisions:
(a) 1. That the applicant understands and acknowledges that if his THE APPLICANT'S employment by the charitable dental clinic or organization OR ENROLLMENT IN THE recognized continuing dental EDUCATION is terminated prior to BEFORE the expiration of his THE APPLICANT'S restricted permit, his THE APPLICANT'S restricted permit will be automatically revoked and he THE APPLICANT will voluntarily surrender the permit to the board and will no longer be eligible to practice unless or until he THE APPLICANT has satisfied the requirements of section 32-1237 or has successfully passed the examination as provided in this article.
(b) 2. He shall THE person must be either:
(a) Employed by a dental clinic or organization that is organized and operated for charitable purposes offering dental services without compensation. The term "employed" as used in this subdivision shall include includes the performance of dental services without compensation.
(b) ENROLLED IN A RECOGNIZED CONTINUING DENTAL EDUCATION and providing charitable dental services, for which the person MAY NOT RECEIVE ANY COMPENSATION, in connection with recognized continuing dental education with an organization that is exempt from taxation pursuant to section 501(c)(3) of the internal revenue code.
(c) 3. He shall be The person is subject to all the provisions of this chapter applicable to licensed dentists and to the jurisdiction and discipline of the board for all dental care and services provided under the restricted permit.
