HOUSE BILL NO. 6285

June 30, 2022, Introduced by Reps. Tisdel, Posthumus, Harris and Martin and referred to the Committee on Health Policy.

"Public health code,"

by amending sections 16186, 16186a, 17011, 17119, 17213, 17317, 17511, 17611, and 20961 (MCL 333.16186, 333.16186a, 333.17011, 333.17119, 333.17213, 333.17317, 333.17511, 333.17611, and 333.20961), section 16186 as amended by 2020 PA 329, section 16186a as added by 2021 PA 25, sections 17011 and 17511 as amended by 2006 PA 398, section 17119 as added by 2016 PA 417, section 17213 as added by 2007 PA 19, section 17317 as added by 2001 PA 139, section 17611 as added by 2008 PA 524, and section 20961 as added by 1990 PA 179.

the people of the state of michigan enact:

Sec. 16186. (1) An Except as provided in subsection (5), an individual who is licensed to practice a health profession in another state or in a province of Canada, who is registered in another state, or who holds a health profession specialty field license or specialty certification from another state and who applies for licensure, registration, specialty certification, or a health profession specialty field license in this state may shall be granted an appropriate license or registration or specialty certification or health profession specialty field license upon satisfying the board or task force to which the applicant applies as to all of the following:

(a) The applicant substantially meets the requirements of this article and rules promulgated under this article for licensure, registration, specialty certification, or a health profession specialty field license.

(b) Subject to subsection (3), the applicant is licensed, registered, specialty certified, or specialty licensed in another state or is licensed in a province in Canada that maintains standards substantially equivalent to those of this state.

(c) Subject to subsection (3), if the applicant is licensed to practice a health profession in a province in Canada, the applicant completed the educational requirements in Canada or in the United States for licensure in Canada or in the United States.

(d) If the applicant is licensed to practice a health profession in a province in Canada, that the applicant will perform the professional services for which he or she bills in this state, and that any resulting request for third-party reimbursement will originate from the applicant's place of employment in this state.

(2) Before granting a license, registration, specialty certification, or a health profession specialty field license to the applicant, the board or task force to which the applicant applies may require the applicant to appear personally before it for an interview to evaluate the applicant's relevant qualifications.

(3) An applicant who is licensed in a province in Canada who meets the requirements of subsection (1)(c) and takes and passes a national examination in this country that is approved by the appropriate licensing board of this state, or who takes and passes a Canadian national examination approved by the appropriate licensing board of this state, is considered to have met the requirements of subsection (1)(b). This subsection does not apply if the department, in consultation with the appropriate licensing board, promulgates a rule disallowing the use of this subsection for an applicant licensed in a province in Canada who does not substantially meet the training or educational requirements expected of an applicant for the same health profession who received his or her education in the United States or who is not licensed in a province in Canada that maintains standards substantially equivalent to those of this state.

(4) If the department receives an application for licensure under part 187 from an individual who is licensed as a respiratory therapist in Canada, the department shall consult the international reciprocity agreement executed by the National Board for Respiratory Care and the Canadian Society of Respiratory Therapists in effect on July 1, 2004.

(5) This section does not prevent an applicant from being granted a license or registration under another provision of this article.

Sec. 16186a. (1) Notwithstanding Except as otherwise provided in subsection (2), notwithstanding any other provision of this article to the contrary, an applicant must be granted an initial license or initial registration, without examination, if the applicant meets all of the following:

(a) Demonstrates to the satisfaction of the department that he or she is 1 of the following:

(i) A member of the armed forces or the uniformed services.

(ii) A veteran.

(iii) A dependent of a member of the armed forces, a member of the uniformed services, or a veteran.

(b) Demonstrates to the satisfaction of the department that he or she holds a current license or registration in good standing in another state or country for the health profession for which the applicant is seeking licensure or registration in this state. and the department determines that the requirements for licensure or registration in the other state or country are substantially equivalent to or exceed the requirements of this article and rules promulgated by the department, in consultation with the applicable board, under this article for licensure or registration.

(c) Demonstrates to the satisfaction of the department that he or she is competent in the health profession for which he or she is seeking licensure or registration, as demonstrated by the applicant's training or experience or by another method prescribed by the department, in consultation with the applicable board.

(d) He or she complies with section 16174(3) so that a criminal history check is conducted in the manner prescribed in that section.Satisfies the requirements of section 16174.

(2) This section does not prevent the department from granting a temporary license or registration to a dependent under section 16181.

(3) (2) As used in this section, "dependent" and "veteran" mean those terms as defined in section 16303.

Sec. 17011. (1) An individual shall not engage in the practice of medicine or practice as a physician's assistant unless licensed or otherwise authorized by this article. An individual shall not engage in teaching or research that requires the practice of medicine unless the individual is licensed or otherwise authorized by this article.

(2) Notwithstanding section 16145 or rules promulgated under that section, the board may grant a license to an individual who meets the requirements of section 16186 or 17031(2) or shall grant a license to an individual who meets the requirements of section 16186 after reviewing the applicant's record of practice, experience, and credentials and determining that the applicant is competent to practice medicine.

(3) For individuals applying for licensure under section 16186, the board shall not impose requirements on graduates of medical schools located outside the United States or Canada that exceed the requirements imposed on graduates of medical schools located in the United States or Canada.

(4) Notwithstanding section 16145 or rules promulgated under that section, the board may shall grant a license in accordance with section 16186 after determining that each of the following conditions is satisfied:

(a) The applicant has disclosed that a sanction is in force against him or her as described in section 16174(2)(b) and considering the reasons for the sanction and the applicant's record of practice, experience, credentials, and competence to engage in the practice of medicine, that sanction should not prevent the applicant from being granted a license in this state.

(b) The sanction imposed by the other state is not permanent.

(d) If the applicant was required by the state that imposed the sanction to participate in and complete a probationary period or treatment plan as a condition of the continuation of his or her licensure, the applicant did not complete the probationary period or treatment plan because the applicant ceased engaging in the practice of medicine in that state.

(e) As a condition of licensure under this subsection, the applicant voluntarily agrees to complete a probationary period or treatment plan, the terms of which are no less stringent than those imposed by the state that imposed the sanction.

(5) Except as otherwise provided in this subsection, the following words, titles, or letters or a combination thereof, with or without qualifying words or phrases, are restricted in use only to those individuals authorized under this part to use the terms and in a way prescribed in this part: "doctor of medicine", "m.d.", "physician's assistant", and "p.a.". Notwithstanding section 16261, an individual who was specially trained at an institution of higher education in this state to assist a physician in the field of orthopedics and, upon completion of training, received a 2-year associate of science degree as an orthopedic physician's assistant before January 1, 1977 may use the title "orthopedic physician's assistant" whether or not the individual is licensed under this part.

Sec. 17119. (1) The board may shall grant a license under this part to an individual who is licensed as a midwife in another state at the time of application if the applicant provides evidence satisfactory to the board and the department that all of the following are met:

(a) Subject to subsection (2), the applicant meets the requirements described in section 17115(1) and (2).

(b) There are no pending disciplinary proceedings against the applicant before a similar licensing agency of this or any other state or country.

(c) If sanctions have been imposed against the applicant by a similar licensing agency of this or any other state or country based upon grounds that are substantially similar to those under this article, as determined by the board, the sanctions are not in force at the time of the application.

(2) If an applicant is licensed as a midwife in a state that does not require completion of an educational program or pathway equivalent to section 17115(1)(a) for licensure, the department may determine that the applicant has met the requirements of subsection (1)(a) if he or she meets all of the following:

(a) The requirements of this part and rules promulgated under this part for licensure, except section 17115(1)(a).

(b) The requirements of section 17115(2), regardless of the date he or she obtained the credential of certified professional midwife described in section 17115(1)(b).

(3) The board may make an independent inquiry to determine whether an applicant meets the requirements described in subsection (1)(b) and (c).

Sec. 17213. (1) Notwithstanding section 16145 or section 16174(1)(c) or rules promulgated pursuant to under either of those sections, the board may grant a license to an applicant applying for initial licensure as a registered professional nurse who is a graduate of a nurse education program that is located outside of the United States if he or she meets the requirements of section 16174 and satisfies each of the following:

(a) Provides verification that the nurse education program from which he or she graduated is substantially equivalent to the nursing education programs in this state that are approved by the board.

(b) Has passed the requisite examination for licensure as a registered professional nurse, as approved by the board.

(2) Notwithstanding section 16145 or section 16174(1)(c) or rules promulgated pursuant to under either of those sections, the board may shall grant a license to an applicant applying for licensure as a registered professional nurse who is licensed in another state or, until January 1, 2012, is licensed in a province of Canada and who is a graduate of a nurse education program located outside of the United States and Canada if he or she meets the requirements of subsection (1) and provides verification of licensure or registration in each state, country, jurisdiction, territory, and province in which he or she is currently licensed or registered or has been licensed or registered. If the applicant seeking licensure under this subsection has, for at least 5 years immediately preceding the application, maintained an active license or registration in another state with no disciplinary sanctions, then the applicant does not have to provide the verification required under subsection (1)(a).

Sec. 17317. Subject to section 16186, the department may issue shall grant a nursing home administrator's license, without examination, to an individual who holds a current license as a nursing home administrator from another state if the applicant passes an examination approved by the department and the board which that tests the individual's knowledge of law relating to practice in Michigan.this state.

Sec. 17511. (1) A person An individual shall not engage in the practice of osteopathic medicine and surgery or practice as a physician's assistant unless licensed or otherwise authorized by this article.

(2) Notwithstanding section 16145 or rules promulgated under that section, the board may shall grant a license in accordance with section 16186 after determining that each of the following conditions is satisfied:

(a) The applicant has disclosed that a sanction is in force against him or her as described in section 16174(2)(b) and considering the reasons for the sanction and the applicant's record of practice, experience, credentials, and competence to engage in the practice of osteopathic medicine and surgery, that sanction should not prevent the applicant from being granted a license in this state.

(b) The sanction imposed by the other state is not permanent.

(3) Except as otherwise provided in this subsection, the following words, titles, or letters or a combination thereof, with or without qualifying words or phrases, are restricted in use only to those persons individuals authorized under this part to use the terms and in a way prescribed in this part: "osteopath", "osteopathy", "osteopathic practitioner", "doctor of osteopathy", "diplomate in osteopathy", "d.o.", "physician's assistant", and "p.a.". Notwithstanding section 16261, a person an individual who was specially trained at an institution of higher education in this state to assist a physician in the field of orthopedics and, upon completion of training, received a 2-year associate of science degree as an orthopedic physician's assistant before January 1, 1977 may use the title "orthopedic physician's assistant" whether or not the individual is licensed under this part.

Sec. 17611. The department may issue shall grant a license by endorsement to an applicant from another state that has licensure requirements substantially equivalent to this part, as determined by the board.

Sec. 20961. (1) The Except as otherwise provided in subsection (2), the department may grant a license under this part to a person who that is licensed in another state at the time of application if the applicant provides evidence satisfactory to the department as to all of the following:

(a) The applicant meets the requirements of this part and rules promulgated by the department for licensure.

(b) There are no pending disciplinary proceedings against the applicant before a similar licensing agency of this or any other state or country.

(c) If sanctions have been imposed against the applicant by a similar licensing agency of this or any other state or country based upon grounds that are substantially similar to those set forth in section 20165 or 20958, as determined by the department, the sanctions are not in force at the time of the application.

(d) The other state maintains licensure standards equivalent to or more stringent than those of this state.

(2) The department shall grant a license under this part to an applicant who is licensed in another state at the time of application and provides evidence satisfactory to the department as to all of the requirements described in subsection (1), if the applicant is applying for a license as a medical first responder, emergency medical technician, emergency medical technician specialist, paramedic, or emergency medical services instructor-coordinator.

(3) (2) The department may make an independent inquiry to determine whether an applicant under this section meets the requirements described in subsection (1)(b) and (c).