Bill Text: HI HB1560 | 2019 | Regular Session | Introduced
Bill Title: Relating To Physician Assistants.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2019-01-28 - Referred to HLT, CPC, FIN, referral sheet 6 [HB1560 Detail]
Download: Hawaii-2019-HB1560-Introduced.html
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HOUSE OF REPRESENTATIVES |
H.B. NO. |
1560 |
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THIRTIETH LEGISLATURE, 2019 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
Relating to Physician Assistants.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
PART I
SECTION 1. Section 329-1, Hawaii Revised Statutes, is amended as follows:
1. By amending the definition of "dispense" to read:
""Dispense"
means to deliver a controlled substance to an ultimate user or research subject
by or pursuant to the lawful order of a practitioner, including the administering
of a practitioner's controlled substances, and packaging, labeling, or
compounding necessary to prepare the substance for that delivery. A controlled substance is dispensed when:
(1) It is compounded, prepared, labeled, and packaged pursuant to the lawful order of a practitioner by a licensed pharmacist acting in the usual course of the licensed pharmacist's professional practice and who is either registered individually or employed in a registered pharmacy or by a registered institutional practitioner, for delivery to the ultimate user;
(2) It is compounded, prepared, labeled and packaged for delivery to the ultimate user by a practitioner acting in the usual course of the practitioner's professional practice;
(3) It is prepared, labeled, and packaged pursuant to the lawful order of a practitioner by a registered health care professional acting as an agent of the practitioner for delivery to the ultimate user by the practitioner; or
(4) It is prepackaged by a pharmacist for use in
an emergency facility for delivery to the ultimate user by a licensed or
registered health care professional [pursuant to the order of a physician]."
2. By amending the definition of "physician assistant" to read:
""Physician
assistant" means a person licensed under section 453-5.3[, who is
registered under this chapter to administer, prescribe, or dispense a
controlled substance under the authority and supervision of a physician
registered under section 329-33, but who is not authorized to request, receive,
or sign for professional controlled substance samples]."
3. By amending the definition of "physician-patient relationship" to read:
""Physician-patient relationship" or "physician assistant-patient relationship" means the collaborative relationship between physicians or physician assistants and their patients. To establish this relationship, the treating physician, the physician assistant, or the physician's or physician assistant's designated member of the health care team, at a minimum shall:
(1) Personally
perform a face-to-face history and physical examination of the patient that is
appropriate to the specialty training and experience of the physician, physician
assistant, or the designated member of the physician's or physician
assistant's health care team, make a diagnosis and formulate a therapeutic
plan, or personally treat a specific injury or condition;
(2) Discuss
with the patient the diagnosis or treatment, including the benefits of other
treatment options; and
(3) Ensure
the availability of appropriate follow-up care."
4. By amending the definition of "practitioner" to read:
""Practitioner" means:
(1) A physician, physician assistant, dentist, veterinarian, scientific investigator, or other person licensed and registered under section 329-32 to distribute, dispense, or conduct research with respect to a controlled substance in the course of professional practice or research in this State;
(2) An advanced practice registered nurse with prescriptive authority licensed and registered under section 329-32 to prescribe and administer controlled substances in the course of professional practice in this State; and
(3) A pharmacy, hospital, or other institution licensed, registered, or otherwise permitted to distribute, dispense, conduct research with respect to or to administer a controlled substance in the course of professional practice or research in this State."
5. By repealing the definition of "supervising physician":
[""Supervising physician"
means a physician licensed to practice medicine in the State and registered
under section 329-33, who supervises a physician assistant and retains full
professional and legal responsibility for the performance of the supervised
physician assistant and the care and treatment of the patient."]
SECTION 2. Section 329-38, Hawaii Revised Statutes, is amended as follows:
1. By amending subsections (h) and (i) to read:
"(h) The effectiveness of a prescription for the purposes of this section shall be determined as follows:
(1) A prescription for a controlled substance shall be issued for a legitimate medical purpose by an individual practitioner acting in the usual course of the practitioner's professional practice. The responsibility for the proper prescribing and dispensing of controlled substances shall be upon the prescribing practitioner, but a corresponding responsibility shall rest with the pharmacist who fills the prescription. An order purporting to be a prescription issued not in the usual course of professional treatment or for legitimate and authorized research shall not be deemed a prescription within the meaning and intent of this section, and the person who knowingly fills such a purported prescription, as well as the person who issues the prescription, shall be subject to the penalties provided for violations of this chapter;
(2) A prescription may not be issued to allow an individual practitioner to obtain controlled substances for supplying the individual practitioner for the purpose of general dispensing to patients;
(3) A prescription may not be issued for "medically managed withdrawal", also known as "detoxification treatment" or "maintenance treatment", unless the prescription is for a schedule III, IV, or V narcotic drug approved by the Food and Drug Administration specifically for use in maintenance or detoxification treatment and the practitioner is in compliance with title 21 Code of Federal Regulations section 1301.28, the registration requirements of section 329-32(e), and any other federal or state regulatory standards relating to treatment qualification, security, records, and unsupervised use of drugs;
(4) A practitioner may administer or dispense directly (but not prescribe) a narcotic drug listed in any schedule to a narcotic dependent person for the purpose of maintenance or detoxification treatment if the practitioner meets both of the following conditions:
(A) The practitioner is separately registered with the Drug Enforcement Administration as a narcotic treatment program; and
(B) The practitioner is in compliance with Drug Enforcement Administration regulations regarding treatment qualifications, security, records, and unsupervised use of the drugs pursuant to this chapter;
(5) Nothing in this section shall prohibit a physician or physician assistant who is not specifically registered to conduct a narcotic treatment program from administering (but not prescribing) narcotic drugs to a person for the purpose of relieving acute withdrawal symptoms when necessary while arrangements are being made for referral for treatment. Not more than one day's medication may be administered to the person or for the person's use at one time. Such emergency treatment may be carried out for not more than three days and may not be renewed or extended;
(6) This section is not intended to impose any limitations on a physician, physician assistant, or authorized hospital staff to administer or dispense narcotic drugs in a hospital to maintain or detoxify a person as an incidental adjunct to medical or surgical treatment of conditions other than addiction, or to administer or dispense narcotic drugs to persons with intractable pain in which no relief or cure is possible or none has been found after reasonable efforts;
(7) A practitioner may administer or dispense (including prescribe) any schedule III, IV, or V narcotic drug approved by the Food and Drug Administration specifically for use in maintenance or detoxification treatment to a narcotic dependent person if the practitioner complies with the requirements of title 21 Code of Federal Regulations section 1301.28, the registration and any other requirements of section 329-32(e), and any other federal or state regulatory standards relating to treatment qualification, security, records, and unsupervised use of drugs;
(8) An individual practitioner shall not prescribe or dispense a substance included in schedule II, III, IV, or V for that individual practitioner's personal use, except in a medical emergency; and
(9) A pharmacist shall not dispense a substance included in schedule II, III, IV, or V for the pharmacist's personal use.
(i) Prescriptions for controlled substances shall be issued only as follows:
(1) All prescriptions for controlled substances shall originate from within the State and be dated as of, and signed on, the day when the prescriptions were issued and shall contain:
(A) The first and last name and address of the patient; and
(B) The drug name, strength, dosage form, quantity prescribed, and directions for use. Where a prescription is for gamma hydroxybutyric acid, methadone, or buprenorphine, the practitioner shall record as part of the directions for use, the medical need of the patient for the prescription.
Except for electronic prescriptions, controlled substance prescriptions shall be no larger than eight and one-half inches by eleven inches and no smaller than three inches by four inches. A practitioner may sign a prescription in the same manner as the practitioner would sign a check or legal document (e.g., J.H. Smith or John H. Smith) and shall use both words and figures (e.g., alphabetically and numerically as indications of quantity, such as five (5)), to indicate the amount of controlled substance to be dispensed. Where an oral order or electronic prescription is not permitted, prescriptions shall be written with ink or indelible pencil or typed, shall be manually signed by the practitioner, and shall include the name, address, telephone number, and registration number of the practitioner. The prescriptions may be prepared by a secretary or agent for the signature of the practitioner, but the prescribing practitioner shall be responsible in case the prescription does not conform in all essential respects to this chapter and any rules adopted pursuant to this chapter. In receiving an oral prescription from a practitioner, a pharmacist shall promptly reduce the oral prescription to writing, which shall include the following information: the drug name, strength, dosage form, quantity prescribed in figures only, and directions for use; the date the oral prescription was received; the full name, Drug Enforcement Administration registration number, and oral code number of the practitioner; and the name and address of the person for whom the controlled substance was prescribed or the name of the owner of the animal for which the controlled substance was prescribed.
A corresponding liability shall rest upon a pharmacist who fills a prescription not prepared in the form prescribed by this section. A pharmacist may add a patient's missing address or change a patient's address on all controlled substance prescriptions after verifying the patient's identification and noting the identification number on the back of the prescription document on file. The pharmacist shall not make changes to the patient's name, the controlled substance being prescribed, the quantity of the prescription, the practitioner's Drug Enforcement Administration number, the practitioner's name, the practitioner's electronic signature, or the practitioner's signature;
(2) An intern, resident, or foreign-trained
physician, or a [physician] United States-trained physician or
physician assistant on the staff of a Department of Veterans Affairs
facility or other facility serving veterans, exempted from registration under
this chapter, shall include on all prescriptions issued by the [physician:]
appropriate health care professional:
(A) The registration number of the hospital or other institution; and
(B) The special internal code number assigned to the physician or physician assistant by the hospital or other institution in lieu of the registration number of the practitioner required by this section.
The hospital or other institution shall forward a copy of this special internal code number list to the department as often as necessary to update the department with any additions or deletions. Failure to comply with this paragraph shall result in the suspension of that facility's privilege to fill controlled substance prescriptions at pharmacies outside of the hospital or other institution. Each written prescription shall have the name of the physician or physician assistant stamped, typed, or hand-printed on it, as well as the signature of the physician or physician assistant;
(3) An official exempted from registration shall include on all prescriptions issued by the official:
(A) The official's branch of service or agency (e.g., "U.S. Army" or "Public Health Service"); and
(B) The official's service identification number, in lieu of the registration number of the practitioner required by this section. The service identification number for a Public Health Service employee shall be the employee's social security or other government issued identification number.
Each prescription shall have the name of the officer stamped, typed, or handprinted on it, as well as the signature of the officer; and
(4) A physician assistant [registered] licensed
to prescribe controlled substances [under the authorization of a supervising
physician] shall include the federal Drug Enforcement Administration registration
number of the physician assistant on all controlled substance prescriptions
issued[:
(A) The Drug Enforcement Administration
registration number of the supervising physician; and
(B) The Drug Enforcement Administration
registration number of the physician assistant].
Each written
controlled substance prescription issued shall include the printed, stamped,
typed, or hand-printed name, address, and phone number of [both the
supervising physician and] the physician assistant, and shall be
signed by the physician assistant. [The
medical record of each written controlled substance prescription issued by a
physician assistant shall be reviewed and initialed by the physician
assistant's supervising physician within seven working days.]"
2. By amending subsection (l) to read:
"(l) A prescription for a schedule II controlled substance may be transmitted by the practitioner or the practitioner's agent to a pharmacy by facsimile equipment; provided that the original written, signed prescription is presented to the pharmacist for review prior to the actual dispensing of the controlled substance, except as noted in subsections (m), (n), and (o). The original prescription shall be maintained in accordance with section 329-36. A prescription for a schedule III, IV, or V controlled substance may be transmitted by the practitioner or the practitioner's agent to a pharmacy by facsimile; provided that:
(1) The information shall be communicated only between the prescribing practitioner or the prescriber's authorized agent and the pharmacy of the patient's choice. The original prescription shall be maintained by the practitioner in accordance with section 329-36;
(2) The information shall be communicated in a retrievable, recognizable format acceptable to the intended recipient and shall include the physician's or physician assistant's oral code designation and the name of the recipient pharmacy;
(3) No electronic system, software, or other intervening mechanism or party shall alter the practitioner's prescription, order entry, selection, or intended selection without the practitioner's approval on a per prescription per order basis. Facsimile prescription information shall not be altered by any system, software, or other intervening mechanism or party prior to receipt by the intended pharmacy;
(4) The prescription information processing system shall provide for confidentiality safeguards required by federal or state law; and
(5) Prescribing practitioners and pharmacists shall exercise prudent and professional judgment regarding the accuracy, validity, and authenticity of any facsimile prescription information. The facsimile shall serve as the original written prescription for purposes of this section and shall be maintained in accordance with section 329-36."
PART II
SECTION 3. Chapter 453, Hawaii Revised Statutes, is amended by adding six new sections to part I to be appropriately designated and to read as follows:
"§453- Definitions. As used in this chapter, unless the context requires otherwise:
"Advanced
directives" means a document that includes but is not limited to orders to
not resuscitate, physician orders for life-sustaining treatment, organ and
tissue donation, durable power of attorney for health care, health care power
of attorney, and living wills.
"Collaborating
physician" means a physician or medical facility licensed in the State who
has entered into a practice agreement with a physician assistant pursuant to
this chapter.
"Distant
site" means the location of the physician or physician assistant
delivering services through telemedicine at the time the services are provided.
"Durable
medical equipment" means but is not limited to air-fluidized beds and other
support surfaces, blood sugar
monitors, blood sugar test
strips, canes, commode chairs, continuous
passive motion machines, continuous positive airway pressure devices and
accessories, crutches, enteral
nutrition supplies and equipment, glucose
control solutions, hospital beds, hyperbaric
oxygen therapy, infusion
pumps and supplies, lancet
devices and lancets, nebulizers
and nebulizer medications, oxygen
equipment and related accessories, patient lifts, suction pumps, traction equipment,
walkers, wheelchairs,
and scooters.
"Hawaii
medical board" or "board" means the state board whose duty it
shall be to examine all applicants for a license to practice medicine or
surgery.
"Legend
drug" or "prescription drug" means any drug that is approved by
the United States Food and Drug Administration and that is required by federal
or state law to be dispensed to the public only by prescription of a licensed
physician, physician assistant, or other licensed provider.
"National
Commission on Certification of Physician Assistants" means the United
States' certifying organization for physician assistants.
"Originating
site" means the location where the patient is present, whether or not accompanied
by a health care provider, at the time services are provided by a physician or physician
assistant through telemedicine; provided that the location includes but is not
limited to a physician's office, a hospital, a health care facility, a hospice
facility, a nursing home, an ambulatory facility, a patient's home, and any
other non-medical environment including pharmacies, school-based health
centers, university-based health centers, or the work locations of the patient.
"Osteopathic
medicine" means the utilization of full methods of diagnosis and treatment
in physical health, mental health, and disease, including the prescribing and administering
any drugs or biologicals, operative surgery, obstetrics, or radiological or other
electromagnetic emissions, while placing special emphasis on the interrelation
of the neuro-musculoskeletal system to all other body systems and the amelioration
of disturbed structure-function relationships by the clinical application of
the osteopathic diagnosis and therapeutic skills for the maintenance of health
and treatment of disease.
"Optimal
team practice" means physician assistants' ability to consult with a
physician or other qualified medical professional, as indicated by the patient's
condition and the standard of care, and in accordance with the physician assistant's
training, experience, and current competencies.
"Physician
assistant" means a healthcare professional who meets qualifications and is
licensed to practice medicine pursuant to this chapter.
"Practice
agreement" means a written agreement between a collaborating physician or
medical facility and a physician
assistant.
"Radiologist"
means a doctor of medicine or a doctor of osteopathy certified in radiology by
the American Board of Radiology or the American Board of Osteopathy.
"Telemedicine"
means the use of telecommunications services, as that term is defined in
sections 269-1, and includes but is not limited to voice, real-time video
conferencing-based communication, secure interactive and non-interactive
web-based communication, and secure asynchronous information exchange to
transmit patient medical information, such as diagnostic-quality digital images
and laboratory results for medical interpretation and diagnosis, for the
purposes of delivering enhanced health care services and information while a
patient is at an originating site and the physician or physician assistant is evaluating
a patient at a distant site or treating a patient separated by distance from
the physician or physician assistants.
"Telemedicine" shall include "telehealth".
§453- Physician assistant; scope of practice. (a) A physician assistant may provide any legal medical service for which the physician assistant is prepared by education, training, and experience, and is competent to perform.
(b) A physician assistant
shall:
(1) Take full responsibility for the patient
care they provide;
(2) Be included in other relevant areas of law,
including but not limited to:
(A) Laws that grant patient-provider immunity from testifying about confidential information;
(B) Mandates to report child and elder abuse and certain types of injuries, such as wounds from firearms;
(C) Provisions allowing the formation of professional corporations by related healthcare professionals; and
(D) Mandates that promote health wellness and practice standards; provided that laws that govern specific medical technology shall be authorized for use by appropriately trained physician assistants; and
(3) Subscribe to the concept of optimal team practice and collaborate with, consult with, and refer to physicians and other members of the health care team at the practice level as indicated by the patient's condition and the standard of care; provided that optimal team practice is applicable to all physician assistants, regardless of specialty or experience.
(c) A physician assistant
may:
(1) Exercise autonomy in medical decision-making;
(2) Obtain informed consent;
(3) Provide services in healthcare facilities
or programs including but not limited to physicians' offices, hospitals,
hospice facilities, nursing homes, ambulatory facilities, assisted living
facilities, medical clinics, behavioral or mental facilities, medical
organizations, health care centers, and school-based or college-based services;
(4) Supervise, delegate and assign therapeutic and diagnostic measures to licensed or unlicensed personnel;
(5) Certify the health or disability of a
patient as required by any local, state, or federal program; and
(6) Authenticate any document with their signature, certification, stamp, verification, affidavit, or endorsement if it may be so authenticated by the signature, certification, stamp, verification, affidavit, or endorsement of a physician.
(d) Medical and surgical services provided by a
physician assistant include but are not limited to:
(1) Obtaining and performing comprehensive health histories and physical examinations;
(2) Evaluating, diagnosing, managing, and providing medical treatment;
(3) Ordering, performing, and interpreting diagnostic studies and therapeutic procedures;
(4) Educating patients on health promotion and disease prevention;
(5) Providing consultation upon request; and
(6) Writing medical orders.
§453-
Physician assistant; disasters;
emergency field response; volunteering.
A physician assistant shall be allowed to provide medical care in
disaster and emergency situations that occur outside of their place of
employment. This exemption
shall include a physician assistant who is a federal employee or licensed
in another state. A physician assistant
shall be granted immunity pursuant to section 663-1.5 to the same extent as other
health professionals. A physician
assistant who is volunteering without compensation or remuneration shall be
permitted to provide medical care as indicated by the patient's condition and
the standard of care, and in accordance with the physician assistant's education,
training, and experience. State law
shall not require a specific relationship between a physician assistant,
physician, or any other entity in order for a physician assistant to volunteer
in any situation pursuant to this section.
§453- Physician
assistant; continuing medical education requirements. (a)
To be eligible for license renewal, a physician assistant must provide
evidence of completion of a minimum of forty continuing medical education
credits during the renewal period.
(b) Recertification by the National Commission on
Certification of Physician Assistants is not required for license renewal.
§453- Physician
assistant; controlled substances. A physician assistant may prescribe, order,
administer, and dispense legend drugs and schedule II, III, IV, or V controlled
substances consistent with the physician assistant's scope of practice;
provided that:
(1) The physician
assistant shall have an active federal Drug Enforcement Administration
registration number that is valid for the handling of that controlled substance
and that is on file with the board;
(2) A physician assistant
registered to prescribe controlled substances shall include the federal Drug
Enforcement Administration registration number of the physician assistant on all
controlled substance prescriptions;
(3) Each written controlled substance prescription issued by the physician
assistant shall include the printed, stamped, typed, or hand-printed name,
address, and phone number of the physician assistant and shall be signed by the
physician assistant; and
(4) All prescriptions shall
comply with applicable state and federal laws.
§453-
Physician assistant; non-discrimination. (a)
Notwithstanding any provision to the contrary a physician assistant
shall be included in any state program that provides for educational loan
repayment for medical personnel.
(b) A physician assistant shall be reimbursed by any
insurer licensed in this State at the same rate as physicians, nurse practitioners,
and advanced practice registered nurses.
Reimbursements shall be paid directly to the physician assistant or the
employer of the physician assistant."
SECTION 4. Section 453-1, Hawaii Revised Statutes, is amended to read as follows:
"§453-1 Practice of medicine defined.
(a) For the purposes of
this chapter the practice of medicine by a physician, a physician assistant,
or an osteopathic physician includes the use of drugs and medicines, water,
electricity, hypnotism, osteopathic medicine, or any means or method, or any
agent, either tangible or intangible, for the treatment of disease in the human
subject; provided that when a duly licensed physician or osteopathic physician
pronounces a person affected with any disease hopeless and beyond recovery and
gives a written certificate to that effect to the person affected or the
person's attendant nothing herein shall forbid any person from giving or
furnishing any remedial agent or measure when so requested by or on behalf of
the affected person.
(b)
Collaboration among physicians and physician assistants shall be
continuous, but shall not be construed to require the physical presence of the
physician at the time and place that services are rendered or that a physician
is liable for any care rendered by a physician assistant. Collaborating physicians shall be considered
a resource that strengthens the physician-physician assistant team approach to
patient care.
(c)
A practice or facility may establish terms of an agreement of
collaboration to define the manner and degree of collaboration that is
appropriate in rendering patient care at the practice or facility level.
(d)
This section shall not amend or repeal the law respecting the treatment
of those affected with Hansen's disease.
[For purposes of this chapter,
"osteopathic medicine" means the utilization of full methods of
diagnosis and treatment in physical and mental health and disease, including
the prescribing and administration of drugs and biologicals of all kinds,
operative surgery, obstetrics, radiological, and other electromagnetic
emissions, and placing special emphasis on the interrelation of the
neuro-musculoskeletal system to all other body systems, and the amelioration of
disturbed structure-function relationships by the clinical application of the
osteopathic diagnosis and therapeutic skills for the maintenance of health and
treatment of disease.]"
SECTION 5. Section 453-1.3, Hawaii Revised Statutes, is amended to read as follows:
"§453-1.3 Practice of telehealth. (a) Subject to section
453-2(b), nothing in this section shall preclude any physician or physician
assistant acting within the scope of the physician's or physician
assistant's license to practice from practicing telehealth as defined in
this section.
(b) [Telehealth]
Telemedicine services shall include a documented patient evaluation,
including history and a discussion of physical symptoms adequate to establish a
diagnosis and to identify underlying conditions or contraindications to the
treatment recommended or provided.
(c)
Treatment recommendations made via [telehealth,] telemedicine,
including issuing a prescription via electronic means, shall be held to the
same standards of appropriate practice as those in traditional
physician-patient or physician assistant-patient settings that do not include a face-to-face
visit but in which prescribing is appropriate, including on-call telephone
encounters and encounters for which a follow-up visit is arranged. Issuing a prescription based solely on an
online questionnaire is not treatment for the purposes of this section and does
not constitute an acceptable standard of care.
For the purposes of prescribing opiates or any other schedule II
drugs or certifying a patient for the medical use of cannabis, a
physician-patient or physician assistant-patient relationship shall only
be established after an in-person consultation between the prescribing
physician or physician assistant and the patient.
(d)
All medical reports resulting from telehealth services are part of a
patient's health record and shall be made available to the patient. Patient medical records shall be maintained
in compliance with all applicable state and federal requirements including
privacy requirements.
(e)
A physician or physician assistant shall not use [telehealth]
telemedicine to establish a physician-patient relationship or
physician assistant-patient with a patient in this State without a license
to practice medicine in Hawaii.
(f)
A physician-patient or physician assistant-patient relationship may
be established via [telehealth] telemedicine if the patient is
referred to the [telehealth] telemedicine provider by another
health care provider who has conducted an in-person consultation and has
provided all pertinent patient information to the telehealth provider. Once a provider-patient relationship is
established, a patient [or], physician, or physician assistant
licensed in this State may use [telehealth] telemedicine for any
purpose, including consultation with a medical provider licensed in another
state, authorized by this section or as otherwise provided by law.
(g)
The physician-patient or physician assistant-patient relationship
prerequisite under this section shall not apply to [telehealth] telemedicine
consultations for emergency department services.
(h)
Reimbursement for behavioral health services provided through [telehealth]
telemedicine shall be equivalent to reimbursement for the same services
provided via face-to-face contact between a health care provider and a patient.
(i)
Services provided by [telehealth] telemedicine pursuant to
this chapter shall be consistent with all federal and state privacy, security,
and confidentiality laws.
[(j)
For the purposes of this section:
"Distant site" means the
location of the physician delivering services through telehealth at the time
the services are provided.
"Originating site"
means the location where the patient is located, whether accompanied or not by
a health care provider, at the time services are provided by a physician
through telehealth, including but not limited to a physician's office,
hospital, health care facility, a patient's home, and other non-medical
environments such as school-based health centers, university-based health
centers, or the work location of a patient.
"Telehealth" means the use of
telecommunications as that term is defined in section 269-1, to
encompass four modalities: store and
forward technologies, remote monitoring, live consultation, and mobile health;
and which shall include but not be limited to real-time video conferencing-based communication, secure interactive
and non-interactive
web-based communication, and secure asynchronous information exchange,
to transmit patient medical information, including diagnostic-quality digital
images and laboratory results for medical interpretation and diagnosis, for the
purposes of: delivering enhanced health
care services and information while a patient is at an originating site and the
physician is at a distant site; establishing
a physician-patient relationship; evaluating a patient; or treating a patient.]"
SECTION 6. Section 453-1.5, Hawaii Revised Statutes, is amended to read as follows:
"§453-1.5 Pain management guidelines. The Hawaii medical board may establish guidelines for physicians or osteopathic physicians or physician assistants with respect to patients' pain management. The guidelines shall apply to all patients with severe acute pain or severe chronic pain, regardless of the patient's prior or current chemical dependency or addiction, and may include standards and procedures for chemically dependent individuals."
SECTION 7. Section 453-2, Hawaii Revised Statutes, is amended as follows:
1. By amending the title to read:
"§453-2 License required for physicians;
exceptions."
2. By
amending subsection (b) to read:
"(b)
Nothing herein shall:
(1) Apply
to so-called Christian Scientists; provided that the Christian Scientists
practice the religious tenets of their church without pretending a knowledge of
medicine or surgery;
(2) Prohibit
service in the case of emergency or the domestic administration of family
remedies;
(3) Apply
to any commissioned medical officer in the United States armed forces or public
health service engaged in the discharge of one's official duty, including
a commissioned medical officer employed by the United States Department of
Defense, while providing direct telehealth support or services to neighbor
island beneficiaries within a Hawaii National Guard armory on the island of
Kauai, Hawaii, Molokai, or Maui; provided that the commissioned medical officer
employed by the United States Department of Defense is credentialed by Tripler
Army Medical Center;
(4) Apply to any practitioner of medicine and surgery from another state when in actual consultation, including in-person, mail, electronic, telephonic, fiber-optic, or other telehealth consultation with a licensed physician or osteopathic physician of this State, if the physician or osteopathic physician from another state at the time of consultation is licensed to practice in the state in which the physician or osteopathic physician resides; provided that:
(A) The
physician or osteopathic physician from another state shall not open an office,
or appoint a place to meet patients in this State, or receive calls within the
limits of the State for the provision of care for a patient who is located in
this State;
(B) The
licensed physician or osteopathic physician of this State retains control and
remains responsible for the provision of care for the patient who is located in
this State; and
(C) The
laws and rules relating to contagious diseases are not violated;
(5) Prohibit
services rendered by any person certified under part II of this chapter to
provide emergency medical services, or any physician assistant, when the
services are rendered under the direction and control of a physician or
osteopathic physician licensed in this State except for final refraction
resulting in a prescription for spectacles, contact lenses, or visual training
as performed by an oculist or optometrist duly licensed by the State. The direction and control shall not be
construed in every case to require the personal presence of the supervising and
controlling physician or osteopathic physician.
Any physician or osteopathic physician who employs or directs a person
certified under part II of this chapter to provide emergency medical services,
or a physician assistant, shall retain full professional and personal
responsibility for any act that constitutes the practice of medicine when
performed by the certified person or physician assistant;
(6) Prohibit
automated external defibrillation by:
(A) Any
first responder personnel certified by the department of health to provide
automated external defibrillation when it is rendered under the medical
oversight of a physician or osteopathic physician licensed in this State; or
(B) Any
person acting in accordance with section 663‑1.5(e); or
(7) Prohibit
a radiologist duly licensed to practice medicine and provide radiology services
in another state from using [telehealth] telemedicine while
located in this State to provide radiology services to a patient who is located
in the state in which the radiologist is licensed. [For the purposes of this paragraph:
"Distant site"
means the location of the radiologist delivering services through telehealth at
the time the services are provided.
"Originating
site" means the location where the patient is located, whether accompanied
or not by a health care provider, at the time services are provided by a
radiologist through telehealth, including but not limited to a radiologist's or
health care provider's office, hospital, health care facility, a patient's
home, and other non-medical environments such as school-based health centers,
university-based health centers, or the work location of a patient.
"Radiologist" means a
doctor of medicine or a doctor of osteopathy certified in radiology by the
American Board of Radiology or the American Board of Osteopathy.
"Telehealth" means
the use of telecomunications, as that term is defined in section 269-1, to encompass four
modalities: store and forward
technologies, remote monitoring, live consultation, and mobile health; and
which shall include but not be limited to real-time video conferencing-based communication, secure
interactive and non-interactive web-based communication, and secure
asynchronous information exchange, to transmit patient medical information,
including diagnostic-quality digital images and laboratory results for medical interpretation
and diagnosis, for the purpose of delivering enhanced health care services and information
while a patient is at an originating site and the radiologist is at a
distant site. Standard telephone
contacts, facsimile transmissions, or e-mail texts, in combination or by
themselves, do not constitute a telehealth service for the purposes of this
paragraph.]"
SECTION 8. Section 453-3.2, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:
"(a)
The board may issue an educational teaching license to a physician [or],
osteopathic physician, or physician assistant who is not licensed in
this State and who is invited by the chief of service of a clinical department
of a hospital to provide and promote professional education for students,
interns, residents, fellows, doctors of medicine, [and] doctors of
osteopathic medicine, and physician assistants in this State. In no case shall an educational teaching
license issued hereunder be valid for more than a period of twelve months from
the date of issuance of the license."
SECTION 9. Section 453-3.5, Hawaii Revised Statutes, is amended by amending subsections (a) and (b) to read as follows:
"(a)
The board may issue a limited and temporary license to a physician [or],
osteopathic physician, or physician assistant to maintain patient
services for the purpose of substituting for another physician [or],
osteopathic physician, or physician assistant licensed in this State to
enable specialized training at an out-of-state fully accredited medical
teaching institution; provided that the out-of-state physician [or],
osteopathic physician, or physician assistant:
(1) Is
board certified by the American Board of Medical Specialties [or],
Bureau of Osteopathic Specialties, or National Commission on Certification
of Physician Assistants in the subspecialty in which the Hawaii physician [or],
osteopathic physician, or physician assistant is seeking training;
(2) Is
a member of the teaching faculty of the accredited medical teaching institution;
(3) Has
an unrestricted license in another state;
(4) Has
been invited by the chief of a clinical department of a hospital; and
(5) Has
been examined and approved by the hospital's credential process.
The
limited and temporary license issued under this section shall expire upon notification
of the board by the Hawaii-licensed physician [or], osteopathic
physician, or physician assistant that the physician [or],
osteopathic physician, or physician assistant has resumed the physician's
[or], osteopathic physician's, or physician assistant's practice
in this State. Licenses and extensions
of licenses issued under this section to an individual shall not be valid for
more than nine months during any consecutive twenty-four month period.
(b)
The chief of the clinical department in which the out-of-state physician
[or], osteopathic physician, or physician assistant will
practice shall submit a letter to the board that shall include, without
limitation, the following:
(1) Identification
and documentation of unrestricted license for the applicant for the specialty
training license;
(2) A
statement that the hospital is sponsoring the applicant, and shall be
responsible for monitoring the individual physician [or],
osteopathic physician, or physician assistant during the period of the
temporary license;
(3) Verification
of the start and end dates for the requested temporary license; and
(4) Verification
that the chief of the clinical department is a licensed physician [or],
osteopathic physician, or physician assistant of this State."
SECTION 10. Section 453-5, Hawaii Revised Statutes, is amended to read as follows:
"§453-5 Hawaii medical
board; appointment, removal, qualifications. (a)
For the purpose of carrying out this chapter, the governor shall appoint
a Hawaii medical board whose duty it shall be to examine all applicants for
license to practice medicine or surgery.
[As used in this chapter, "board" means the Hawaii medical
board.
The
board shall consist of eleven persons, seven of whom shall be physicians or
surgeons licensed under the laws of the State, two of whom shall be osteopathic
physicians licensed under the laws of the State, and two of whom shall be lay
members appointed from the public at large.
Of the nine members who are physicians, surgeons, or osteopathic
physicians, at least five shall be appointed from the city and county of
Honolulu and at least one shall be appointed from each of the other counties. Medical societies in the various counties may
conduct elections periodically but no less frequently than every two years to
determine nominees for the board to be submitted to the governor. In making appointments, the governor may
consider recommendations submitted by the medical societies and the public at
large. Each member shall serve until a
successor is appointed and qualified.]
(b) The board shall consist of thirteen persons
including:
(1) Seven physicians or surgeons;
(2) Two osteopathic physicians;
(3) Two physician assistants; and
(4) Two lay members appointed from the public
at large;
provided that all members under paragraphs (1), (2),
and (3) shall be licensed under this chapter.
(c) Of the nine members of the board who are
physicians, surgeons, or osteopathic physicians, no fewer than:
(1) Five shall be appointed who reside in the
city and county of Honolulu;
(2) One shall be appointed who resides in the counties of Hawaii, Kauai, and Maui, respectively; and
(3) Two shall have experience with physician assistant practice regardless of their residence.
(d) Medical societies in the counties of Hawaii,
Kauai, and Maui, and in the city and county of Honolulu, may conduct periodic
elections no less than every two years to determine nominees to the board, to
be submitted to the governor. In making appointments,
the governor shall consider recommendations submitted by the medical societies
and the public. Each member shall serve
until a qualified successor is appointed.
[(b)] (e) The department shall employ, not subject to
chapter 76, an executive secretary to administer the board's activities and an
employee to administer the medical inquiry and conciliation panels established
under chapter 671. The employee
responsible for administration of the medical inquiry and conciliation panels
shall have no duties in administration of the board's activities."
SECTION 11. Section 453-5.3, Hawaii Revised Statutes, is amended to read as follows:
"§453-5.3 Physician assistant; licensure required.
(a) The Hawaii medical board
shall require each person practicing medicine [under the supervision of a
physician or osteopathic physician], other than a person licensed under
section 453-3, to be licensed as a physician assistant. A person who is trained to do only a very
limited number of diagnostic or therapeutic procedures under the direction of a
physician or osteopathic physician shall not be deemed a practitioner of
medicine or osteopathy and therefore does not require licensure under this
section.
(b)
The board shall establish medical educational and training standards
with which a person applying for licensure as a physician assistant shall
comply. The standards shall be at least
equal to recognized national education and training standards for physician
assistants.
(c)
Upon satisfactory proof of compliance with the required medical
educational and training standards, the board may grant state licensure [to
a person who has been granted certification based] upon passage of a
national certifying examination [and who holds a current certificate from
the] administered by a national certifying entity approved by the
board.
[(d)
The board shall approve temporary licensure of an applicant under this
section. The applicant shall have graduated from a board approved training
program within twelve months of the date of application and never taken a
national certifying examination approved by the board but otherwise meets the
requirements of this section. The
applicant shall file a complete application with the board and pay all required
fees. If the applicant fails to apply
for, or to take, the first examination scheduled by the board following the
issuance of the temporary license, fails to pass the examination, or fails to
receive licensure, all privileges under this section shall automatically cease
upon written notification sent to the applicant by the board. A temporary license shall be issued only once
to each person.
(e)
Prior to practicing under temporary licensure, holders of temporary
licenses shall notify the board in writing of any and all supervising physicians
or osteopathic physicians under whom they will be performing services.
(f)
The board shall establish the degree of supervision required by the
supervising physician or osteopathic physician when a physician assistant
performs a service within the practice of medicine. A physician or osteopathic physician who does
not supervise a physician assistant's services at the degree required by the
board shall be deemed to have engaged in professional misconduct.
(g)] (d) Any license of a physician assistant may be
denied, not renewed, revoked, limited, or suspended under section 453-8.
[(h)] (e) The board shall establish the application
procedure, medical educational and training standards, examination requirement,
if any, [and degrees of supervision] by rule.
[(i)] (f) Every person holding a license under this
section shall apply for renewal with the board no later than January 31 of each
even-numbered year and pay a renewal fee.
Failure to apply for renewal shall constitute a [forfeiture] lapse
of the license that may only be restored upon written application for
restoration and payment to the board of a restoration fee. Proof of the initial certification by the
National Commission on Certification of Physician Assistants shall not be required
for license renewal. Proof of continuing
medical education shall be required for license renewal.
(g)
A category of inactive licensure shall be available for a physician
assistant who is not actively practicing in the State; provided that the physician
assistant's inactive practice is unrelated to disciplinary action or impairment
issues. Notification to reactivate a
license that has been inactive for no more than two years shall require only
written notification to the board.
[(j)] (h) A license that has
been forfeited [for one renewal term] shall be automatically terminated
and cannot be restored. A new
application for licensure shall be required.
(i) A licensed physician assistant authorized to
practice in the State shall conspicuously display on the licensee's clothing a
nameplate identifying the physician assistant as a "Physician
Assistant-Certified", which shall be worn at the licensee's customary
place of employment.
(j) A licensed physician assistant shall place at
the location of employment a conspicuous sign at least five inches by eight inches
in size informing the public that documents verifying the licensed physician
assistant's education and a copy of the current collaborative plan are on file
with the board or employer, and shall be made available for inspection upon request."
SECTION 12. Section 453-5.5, Hawaii Revised Statutes, is amended to read as follows:
"[[]§453-5.5[]] Physician assistant; authority to sign
documents. Any physician assistant
who holds a current, valid[, and permanent] license to practice medicine
pursuant to this chapter[, and who is under the supervision of a licensed
physician or osteopathic physician,] shall have the authority to sign the
following documents:
(1) Certification of psychiatric medical condition of the parents of a child applicant for aid from the temporary assistance for needy families program;
(2) Evaluation forms for Hansen's disease patients;
(3) Orders for physical therapy and plans of care;
(4) Pharmacist orders to assist in monitoring and management of anticoagulation anemia and atrial fibrillation;
(5) Orders for speech therapy and plans of care;
(6) Applications for bracelets indicating compassionate care only;
(7) Admissions applications for foster homes;
(8) Dietary consultations
forms; [and]
(9) Medicaid
application forms for nursing care facility admission[.];
(10) Prescriptions for hospice care;
(11) Prescriptions for schedule II through V drugs, including legend drugs;
(12) Handicapped parking permits;
(13) Workers' compensation claim forms;
(14) No fault insurance claim forms;
(15) Prescriptions for diabetic shoes and other diabetic devices;
(16) Durable medical equipment;
(17) Physician order for life-sustaining treatment;
(18) Federal Jones Act claim forms;
(19) Advanced directives; and
(20) Death certificates."
SECTION 13. Section 453-6, Hawaii Revised Statutes, is amended by amending subsections (d) and (e) to read as follows:
"(d)
Failure to renew, pay the renewal fee, and, in the case of audited physicians,
osteopathic physicians, or surgeons, provide documentation of compliance shall
constitute a [forfeiture] lapse of license, which may be restored
only upon the submission of written application therefor, payment to the board
of a restoration fee, and, in the case of audited physicians, osteopathic
physicians, [and] surgeons, and physician assistants
documentation of compliance.
(e)
A license that has [been forfeited] lapsed for one renewal
term shall be automatically terminated and cannot be restored[, and a]. A new application for licensure shall be
required."
SECTION 14. Section 453-7.5, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:
"(a)
The department of commerce and consumer affairs shall review each complaint,
inquiry, and information, as applicable, received under sections 92-17, 329-44,
453-8.7, 663-1.7, and 671-5. The
department shall investigate the complaint, inquiry, or information if it
appears that the physician [or], osteopathic physician, or physician
assistant who is the subject of the complaint, inquiry, or information has
violated this chapter. If the department
determines that the physician [or], osteopathic physician, or
physician assistant has violated this chapter, the department shall present
the results of its investigation to the Hawaii medical board for appropriate
disciplinary proceedings."
SECTION 15. Section 453-8, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:
"(a) In addition to any other actions authorized by law, any license to practice medicine and surgery may be revoked, limited, or suspended by the board at any time in a proceeding before the board, or may be denied, for any cause authorized by law, including but not limited to the following:
(1) Procuring, or aiding or abetting in procuring, a criminal abortion;
(2) Employing any person to solicit patients for one's self;
(3) Engaging in false, fraudulent, or deceptive advertising, including but not limited to:
(A) Making excessive claims of expertise in one or more medical specialty fields;
(B) Assuring a permanent cure for an incurable disease; or
(C) Making any untruthful and improbable statement in advertising one's medical or surgical practice or business;
(4) Being habituated to the excessive use of drugs or alcohol; or being addicted to, dependent on, or a habitual user of a narcotic, barbiturate, amphetamine, hallucinogen, or other drug having similar effects;
(5) Practicing medicine while the ability to practice is impaired by alcohol, drugs, physical disability, or mental instability;
(6) Procuring a license through fraud, misrepresentation, or deceit, or knowingly permitting an unlicensed person to perform activities requiring a license;
(7) Professional misconduct, hazardous negligence causing bodily injury to another, or manifest incapacity in the practice of medicine or surgery;
(8) Incompetence or multiple instances of negligence, including but not limited to the consistent use of medical service, which is inappropriate or unnecessary;
(9) Conduct or practice contrary to recognized standards of ethics of the medical profession as adopted by the Hawaii Medical Association, the American Medical Association, the Hawaii Association of Osteopathic Physicians and Surgeons, or the American Osteopathic Association;
(10) Violation of the conditions or limitations upon which a limited or temporary license is issued;
(11) Revocation, suspension, or other disciplinary action by another state or federal agency of a license, certificate, or medical privilege;
(12) Conviction, whether by nolo contendere or otherwise, of a penal offense substantially related to the qualifications, functions, or duties of a physician or osteopathic physician, notwithstanding any statutory provision to the contrary;
(13) Violation of chapter 329, the uniform controlled substances act, or any rule adopted thereunder except as provided in section 329-122;
(14) Failure to report
to the board, in writing, any disciplinary decision issued against the licensee
or the applicant in another jurisdiction within thirty days after the
disciplinary decision is issued; [or]
(15) Submitting to or
filing with the board any notice, statement, or other document required under
this chapter, which is false or untrue or contains any material misstatement or
omission of fact[.];
(16) Conviction of a crime involving moral
turpitude, a felony, or a crime arising out of the practice of medicine,
including advertising of medical business that is intended to or has a tendency
to deceive the public;
(17) Abandonment of a patient;
(18) Promotion of the sale of drugs, devices,
appliances, or goods or services provided for a patient in a manner that
exploits the patient for the financial gain of the medical practitioner;
(19) Immoral conduct of a medical practitioner in
the practice of medicine;
(20) Wilfully making and filing false reports or
records;
(21) Wilful omission to file or record, or wilfully
impeding or obstructing a filing or recording, or inducing another person to
omit to file or record medical or other reports as required by law;
(22) Accepting payments from a clinical or
bioanalytical laboratory in return for ordering individual tests or test series
for patients;
(23) Practicing with an unlicensed physician or physician
assistant or aiding or abetting any unlicensed person in the practice of
medicine;
(24) Offering, undertaking or agreeing to cure
or treat a disease by a secret method, procedure, treatment, or medicine;
(25) Professional or mental incompetence;
(26) Surrender, revocation, suspension,
limitation of privilege based on:
(A) Quality of care provided;
(B) Any other disciplinary action against a
license or authorization to practice in another state or jurisdiction; or
(C) Membership with any medical staff or in any medical professional association or society while under disciplinary investigation by any authority or body for acts or conduct similar to acts or conduct that would constitute grounds for action pursuant to this chapter;
(27) Any adverse judgment, settlement, or award arising
from a medical liability claim related to acts or conduct that would constitute
grounds for action as stated in this chapter;
(28) Failure to furnish the board, the
administrator, investigator, or representatives information legally requested
by the board;
(29) Medical malpractice;
(30) Sexual contact between a medical
practitioner and patient during the existence of the practitioner-patient
relationship; or
(31) Providing services to a person who is making a claim as a result of a personal injury, and who charges or collects from the person any amount in excess of the reimbursement to the practitioner by the insurer as a condition of providing or continuing to provide services or treatment."
SECTION 16. Section 453-8.1, Hawaii Revised Statutes, is amended to read as follows:
"§453-8.1 Voluntary limitation of license.
A physician, osteopathic physician, [or] surgeon, or physician
assistant may request, in writing, that the board limit the individual's
license to practice. The board may grant
the request and may impose conditions on the limited license. The board shall determine whether and when the
limitation shall be removed."
SECTION 17. Section 453-8.2, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:
"(a)
In addition to any other actions authorized by law, in disciplining a
licensee in a proceeding held in conformity with chapter 91, the board may
impose one or more of the following sanctions:
(1) Place
the licensee on probation, including conditions of probation as requiring
observation of the licensee by an appropriate group or society of licensed
physicians, osteopathic physicians, [or] surgeons, or physician
assistants;
(2) Suspend
the license;
(3) Revoke
the license;
(4) Limit
the license by restricting the fields of practice in which the licensee may
engage;
(5) Fine
the licensee, including assessment against the licensee of the costs of the
disciplinary proceedings. Any fine
imposed by the board after a hearing in accordance with chapter 91 shall be not
less than $500 and not more than $5,000 for each violation, exclusive of the
costs of the disciplinary proceedings;
(6) Require
further education or training, or require proof of performance competency; or
(7) Censure or reprimand."
SECTION 18. Section 453-8.7, Hawaii Revised Statutes, is amended to read as follows:
"§453-8.7 Reporting requirements.
(a) Every physician [or],
osteopathic physician, surgeon, or physician assistant licensed pursuant
to this chapter who does not possess professional liability insurance shall
report any settlement or arbitration award of a claim or action for damages for
death or personal injury caused by negligence, error, or omission in practice,
or the unauthorized rendering of professional services. The report shall be submitted to the
department of commerce and consumer affairs within thirty days after any
written settlement agreement has been reduced to writing and signed by all the
parties thereto or thirty days after service of the arbitration award on the
parties.
(b)
Failure of a physician [or], osteopathic physician,
surgeon, or physician assistant to comply with the provisions of this
section is an offense punishable by a fine of not less than $100 for the first
offense, $250 to $500 for the second offense, and $500 to $1,000 for subsequent
offenses.
(c)
The clerks of the respective courts of this State shall report to the
department any judgment or other determination of the court[, which] that
adjudges or finds that a physician [or], osteopathic physician,
surgeon, or physician assistant is liable criminally or civilly for any
death or personal injury caused by the physician's [or],
osteopathic physician's, surgeon's, or physician assistant's
professional negligence, error, or omission in the practice of the physician's [or],
osteopathic physician's, surgeon's, or physician assistant's profession,
or rendering of unauthorized professional services. The report shall be submitted to the
department within ten days after the judgment is entered by the court.
(d) The department shall prescribe forms for the submission of reports as required by this section."
SECTION 19. Section 453-10, Hawaii Revised Statutes, is amended to read as follows:
"§453-10 Witnesses in such proceeding.
In any proceeding the board may subpoena, administer oaths to, and
examine witnesses on any relevant matter in the proceeding. The board may subpoena physicians,
osteopathic physicians, [or] surgeons, or physician assistants as
specialists, on the recommendation of the appropriate specialist society. The board may order a mental, physical, or
medical competency examination to determine the capacity or ability of a
licensee to continue to practice medicine or surgery and order appropriate
specialist societies to conduct examinations.
The person whose license is sought in the proceeding to be revoked,
limited, or suspended shall be entitled to require the board or any member
thereof to subpoena and to administer oaths to any witness who may be able to
present evidence relevant in the proceeding, and shall be entitled to examine
any witness in the proceeding. The
circuit court of the circuit in which the proceeding is held may enforce by
proper proceeding the attendance and
SECTION 20. Section 453-14, Hawaii Revised Statutes, is amended by amending its title to read as follows:
"§453-14 Duty of physician, osteopathic physician, surgeon, physician assistant, hospital, clinic, etc., to report wounds."
SECTION 21. Section 453-5.4, Hawaii Revised Statutes, is repealed.
["§453-5.4 Physician assistant advisory committee.
There shall be a physician assistant advisory committee under the Hawaii
medical board consisting solely of persons licensed under section 453-5.3. The committee shall review all complaints and
requests relating to physician assistants, and review and recommend revisions
of the physician assistant regulations.
The chairperson of the committee shall
be the representative for the committee members to the Hawaii medical board for
the purpose of providing input to the board from the physician assistant's
perspective on issues and concerns, including complaints and requests,
regarding physician assistants. The
chairperson shall not be a member of the Hawaii medical board to avoid conflict
of interests."]
PART III
SECTION 22. This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.
SECTION 23. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 24. This Act shall take effect upon its approval; provided that the amendment made to section 329-38, Hawaii Revised Statutes, by this Act shall not be repealed when that section is reenacted on June 30, 2023, by section 6 of Act 66, Session Laws of Hawaii 2017.
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Report Title:
Physician Assistants; Hawaii Medical Board; Telehealth; Telemedicine
Description:
Expands the scope of practice of licensed physician assistants in the State.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.
