Arizona 2023 Regular Session

Arizona Senate Bill SB1249 Compare Versions

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1-Senate Engrossed international medical graduates; licensure. (now: medical licensing; study committee) State of Arizona Senate Fifty-sixth Legislature First Regular Session 2023 SENATE BILL 1249 An Act amending title 32, chapter 13, article 2, Arizona Revised Statutes, by adding section 32-1440; relating to medical licensure. (TEXT OF BILL BEGINS ON NEXT PAGE)
1+REFERENCE TITLE: international medical graduates; licensure. State of Arizona Senate Fifty-sixth Legislature First Regular Session 2023 SB 1249 Introduced by Senator Shope An Act amending title 32, chapter 13, article 2, Arizona Revised Statutes, by adding sections 32-1440 and 32-1441; relating to the Arizona medical board. (TEXT OF BILL BEGINS ON NEXT PAGE)
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9-Senate Engrossed international medical graduates; licensure.
10-(now: medical licensing; study committee) State of Arizona Senate Fifty-sixth Legislature First Regular Session 2023
11-SENATE BILL 1249
9+REFERENCE TITLE: international medical graduates; licensure.
10+State of Arizona Senate Fifty-sixth Legislature First Regular Session 2023
11+SB 1249
12+Introduced by Senator Shope
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14+REFERENCE TITLE: international medical graduates; licensure.
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55-amending title 32, chapter 13, article 2, Arizona Revised Statutes, by adding section 32-1440; relating to medical licensure.
68+amending title 32, chapter 13, article 2, Arizona Revised Statutes, by adding sections 32-1440 and 32-1441; relating to the Arizona medical board.
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65- Be it enacted by the Legislature of the State of Arizona: Section 1. Title 32, chapter 13, article 2, Arizona Revised Statutes, is amended by adding section 32-1440, to read: START_STATUTE32-1440. International medical graduates; provisional licensure; disciplinary actions; revocation; definitions A. Notwithstanding any other law, the board shall grant a provisional license to engage in the practice of medicine in this state to any international medical graduate who has an offer for employment as a physician at any health care provider that operates in this state and who meets the requirements for licensure prescribed in section 32-1422 and section 32-1423, paragraphs 1 and 2. B. The board may discipline a licensee or revoke a provisional license granted pursuant to this section based on clear and compelling evidence after an investigation conducted pursuant to section 32-1451. A provisional licensee may appeal the revocation of the provisional license to the superior court in Maricopa county pursuant to title 12, chapter 7, article 6 within one hundred twenty days after the decision of the board revoking the provisional license. The court shall reinstate the provisional license if the court finds that the board's actions did not meet the standards prescribed in this subsection. C. A provisional license shall automatically be converted into a full license to practice medicine in this state after three years unless the board DISCIPLINES the licensee in that three-year period of the provisional license. D. This section does not require the board to license an international medical graduate who does not provide all of the following: 1. Evidence of substantially similar medical training as that required by this state. 2. Evidence of satisfactory passage of exams. 3. A complete license application. 4. Payment of all required licensing fees. E. The board may require an applicant international medical graduate to submit any necessary supporting application materials so that the board may properly evaluate the applicant for licensure. F. The board may require an applicant international medical graduate, at the applicant's expense, to submit medical education information through the educational commission for foreign medical graduates or another third-party records service. G. for the purposes of this section: 1. "Health care provider": (a) Means an individual, entity, corporation, person or organization, whether for-profit or nonprofit, that furnishes, bills for or is paid for health care procedures or service delivery in the normal course of business. (b) Includes health systems, hospitals, hospital-based facilities, freestanding emergency facilities and urgent care clinics. 2. "International medical graduate" means an individual who meets all of the following requirements: (a) Is a citizen of the United States. (b) Has been granted a medical doctorate or a substantially similar degree by an international medical program of good standing. (c) Has completed a residency or substantially similar postgraduate medical training in the country where the individual was granted a medical doctorate or a substantially similar degree by an international medical program in good standing. (d) Possesses basic fluency in the English language. 3. "International medical program" means any medical school, residency program, medical internship program or entity that provides physicians with a medical education or training outside of the United States and that is substantially similar to that required to practice as a physician in this state. 4. "Physician" means an individual who has obtained a medical doctorate or a substantially similar degree and who has completed a residency program or substantially similar postgraduate medical training. END_STATUTE Sec. 2. Study committee on physician shortages; membership; duties; report; delayed repeal A. The study committee on physician shortages is established consisting of the following members: 1. One member of the majority party in the senate who is appointed by the president of the senate and who serves as cochairperson of the study committee. 2. One member of the minority party in the senate who is appointed by the president of the senate. 3. One member of the majority party in the house of representatives who is appointed by the speaker of the house of representatives and who serves as cochairperson of the study committee. 4. One member of the minority party in the house of representatives who is appointed by the speaker of the house of representatives. 5. The director of the department of health services or the director's designee. 6. A representative from a statewide association that primarily represents physicians and that engages in health care policy who is appointed by the president of the senate. 7. Two representatives from two different organizations that represent hospitals in this state, one of whom is appointed by the president of the senate and one of whom is appointed by the speaker of the house of representatives. 8. A representative of a public university with a medical school in this state who is appointed by the president of the senate. 9. A representative of a private university with a medical school in this state who is appointed by the speaker of the house of representatives. 10. One resident physician practicing in this state who attended medical school outside the United States and who is appointed by the speaker of the house of representatives. 11. One licensed practicing primary care physician who practices in a county with a population of less than one hundred thousand persons and who is appointed by the president of the senate. 12. Two representatives from nonprofit advocacy organizations that engage in health care policy and have an interest in addressing the physician shortage. These members shall be appointed by the speaker of the house of representatives. 13. A representative from a tribal government that is facing a physician shortage who is appointed by the president of the senate. 14. A representative from this state's immigrant or refugee community that understands the skills immigrants and refugees bring to this country and the barriers those individuals face to use their training. This member shall be appointed by the speaker of the house of representatives. 15. An Arizona licensed physician who was previously licensed in a foreign country and then enrolled in a residency program in the United States in order to be licensed in this state. This member shall be appointed by the president of the senate. 16. The executive director of the Arizona medical board or the executive director's designee. 17. One representative of an organization that seeks to eliminate employment barriers and advance the skills for immigrant professionals. This member shall be appointed by the president of the senate. B. The study committee shall research and make recommendations for addressing the physician shortage in this state, with a particular emphasis on how to encourage more physicians to practice in rural areas and low-income communities and in primary care practice. The study committee shall review current policies and practices on the licensing of international medical graduates and foreign-licensed physicians to determine how to reduce barriers to entry into medical practice in this state. The study committee shall prioritize increasing health care access in rural areas and low-income communities while maintaining public health and safety when making its recommendations. C. The study committee shall consult with the following national organizations to solicit their input on any preliminary recommendations: 1. The federation of state medical boards. 2. The accreditation council for graduate medical education. 3. The educational commission for foreign medical graduates. D. The study committee shall meet as frequently as the cochairpersons deem necessary and may hold hearings and take testimony from stakeholders in fulfilling its responsibilities. All study committee hearings shall be open to the public. E. Study committee members are not eligible to receive compensation, but members are eligible for reimbursement of expenses under title 38, chapter 4, article 2, Arizona Revised Statutes. F. On or before December 1, 2024, the study committee shall submit a report regarding its findings and recommendations to the governor, the president of the senate and the speaker of the house of representatives and shall provide a copy of this report to the secretary of state. G. This section is repealed from and after December 31, 2024. Sec. 3. Effective date Section 32-1440, Arizona Revised Statutes, as added by this act, is effective from and after December 31, 2023.
78+ Be it enacted by the Legislature of the State of Arizona: Section 1. Title 32, chapter 13, article 2, Arizona Revised Statutes, is amended by adding sections 32-1440 and 32-1441, to read: START_STATUTE32-1440. International medical graduates; provisional licensure; disciplinary actions; revocation; definitions A. Notwithstanding any other law, the board shall grant a provisional license to engage in the practice of medicine in this state to any international medical graduate who has an offer for employment as a physician at any health care provider that operates in this state, whose federal immigration status allows the international medical graduate to practice as a physician in the United States and who meets the requirements for licensure prescribed in section 32-1422 and section 32-1423, paragraphs 1 and 2. B. The board may discipline a licensee or revoke a provisional license granted pursuant to this section based on clear and compelling evidence after an investigation conducted pursuant to section 32-1451. A provisional licensee may appeal the revocation of the provisional license to the superior court in Maricopa county pursuant to title 12, chapter 7, article 6 within one hundred twenty days after the decision of the board revoking the provisional license. The court shall reinstate the provisional license if the court finds that the board's actions did not meet the standards prescribed in this subsection. C. A provisional license shall automatically be converted into a full license to practice medicine in this state after three years unless the board DISCIPLINES the licensee in that three-year period of the provisional license. D. This section does not require the board to license an international medical graduate who does not provide all of the following: 1. Evidence of substantially similar medical training as that required by this state. 2. Evidence of satisfactory passage of exams. 3. Documentation of legal status to work in the United States. 4. A complete license application. 5. Payment of all required licensing fees. E. The board may require an applicant international medical graduate to submit any necessary supporting application materials so that the board may properly evaluate the applicant for licensure. F. The board may require an applicant international medical graduate, at the applicant's expense, to submit medical education information through the educational commission for foreign medical graduates or another third-party records service. G. for the purposes of this section: 1. "Health care provider": (a) Means an individual, entity, corporation, person or organization, whether for-profit or nonprofit, that furnishes, bills for or is paid for health care procedures or service delivery in the normal course of business. (b) Includes health systems, hospitals, hospital-based facilities, freestanding emergency facilities and urgent care clinics. 2. "International medical graduate" means an individual who meets all of the following requirements: (a) Has been granted a medical doctorate or a substantially similar degree by an international medical program of good standing. (b) Is in good standing with the medical licensing or regulatory institution of the individual's resident country. (c) Has completed a residency or substantially similar postgraduate medical training in the individual's resident country and has practiced as a medical professional performing the duties of a physician in the individual's resident country for at least two years. (d) Possesses basic fluency in the English language. 3. "International medical program" means any medical school, residency program, medical internship program or entity that provides physicians with a medical education or training outside of the United States and that is substantially similar to that required to practice as a physician in this state. 4. "Physician" means an individual who has obtained a medical doctorate or a substantially similar degree and who has completed a residency program or substantially similar postgraduate medical training. END_STATUTE START_STATUTE32-1441. International medical graduates; licensure; countries; requirements; definitions A. Notwithstanding any other law, the board shall grant a license to engage in the practice of medicine in this state to an international medical graduate who meets the requirements of this section and who is licensed to practice in any of the following: 1. Australia. 2. Hong Kong. 3. Ireland. 4. Israel. 5. New Zealand. 6. Singapore. 7. South Africa. 8. Switzerland. 9. The United Kingdom. 10. Canada. B. The board may add additional countries to the list prescribed in subsection A of this section. C. The board may grant a license under this section only to an international medical graduate who is an international medical program graduate, whose federal immigration status allows the person to work as a physician in the United States and who meets the requirements for licensure prescribed in section 32-1422 and section 32-1423, paragraphs 1 and 2. D. An international medical graduate who is licensed to practice in a country listed in subsection A of this section or added pursuant to subsection B of this section may engage in the practice of medicine in this state without additional training or residency requirements if the person meets the requirements of this section. E. An international medical graduate whose license in a country listed in subsection A of this section or added pursuant to subsection B of this section has expired or lapsed within the previous five years but who meets all other requirements of this section may also be granted a license under this section. Such applicants must have been in good standing with the medical licensing or regulatory institution of the licensing country at the time the license expired or lapsed. F. For the purposes of this section: 1. "International medical graduate" has the same meaning prescribed in section 32-1440. 2. "International medical program" has the same meaning prescribed in section 32-1440. 3. "Physician" has the same meaning prescribed in section 32-1440. END_STATUTE Sec. 2. Effective date This act is effective from and after December 31, 2023.
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6780 Be it enacted by the Legislature of the State of Arizona:
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69-Section 1. Title 32, chapter 13, article 2, Arizona Revised Statutes, is amended by adding section 32-1440, to read:
82+Section 1. Title 32, chapter 13, article 2, Arizona Revised Statutes, is amended by adding sections 32-1440 and 32-1441, to read:
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7184 START_STATUTE32-1440. International medical graduates; provisional licensure; disciplinary actions; revocation; definitions
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73-A. Notwithstanding any other law, the board shall grant a provisional license to engage in the practice of medicine in this state to any international medical graduate who has an offer for employment as a physician at any health care provider that operates in this state and who meets the requirements for licensure prescribed in section 32-1422 and section 32-1423, paragraphs 1 and 2.
86+A. Notwithstanding any other law, the board shall grant a provisional license to engage in the practice of medicine in this state to any international medical graduate who has an offer for employment as a physician at any health care provider that operates in this state, whose federal immigration status allows the international medical graduate to practice as a physician in the United States and who meets the requirements for licensure prescribed in section 32-1422 and section 32-1423, paragraphs 1 and 2.
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7588 B. The board may discipline a licensee or revoke a provisional license granted pursuant to this section based on clear and compelling evidence after an investigation conducted pursuant to section 32-1451. A provisional licensee may appeal the revocation of the provisional license to the superior court in Maricopa county pursuant to title 12, chapter 7, article 6 within one hundred twenty days after the decision of the board revoking the provisional license. The court shall reinstate the provisional license if the court finds that the board's actions did not meet the standards prescribed in this subsection.
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7790 C. A provisional license shall automatically be converted into a full license to practice medicine in this state after three years unless the board DISCIPLINES the licensee in that three-year period of the provisional license.
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7992 D. This section does not require the board to license an international medical graduate who does not provide all of the following:
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8194 1. Evidence of substantially similar medical training as that required by this state.
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8396 2. Evidence of satisfactory passage of exams.
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85-3. A complete license application.
98+3. Documentation of legal status to work in the United States.
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87-4. Payment of all required licensing fees.
100+4. A complete license application.
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102+5. Payment of all required licensing fees.
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89104 E. The board may require an applicant international medical graduate to submit any necessary supporting application materials so that the board may properly evaluate the applicant for licensure.
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91106 F. The board may require an applicant international medical graduate, at the applicant's expense, to submit medical education information through the educational commission for foreign medical graduates or another third-party records service.
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97112 (a) Means an individual, entity, corporation, person or organization, whether for-profit or nonprofit, that furnishes, bills for or is paid for health care procedures or service delivery in the normal course of business.
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99114 (b) Includes health systems, hospitals, hospital-based facilities, freestanding emergency facilities and urgent care clinics.
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101116 2. "International medical graduate" means an individual who meets all of the following requirements:
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103-(a) Is a citizen of the United States.
118+(a) Has been granted a medical doctorate or a substantially similar degree by an international medical program of good standing.
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105-(b) Has been granted a medical doctorate or a substantially similar degree by an international medical program of good standing.
120+(b) Is in good standing with the medical licensing or regulatory institution of the individual's resident country.
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107-(c) Has completed a residency or substantially similar postgraduate medical training in the country where the individual was granted a medical doctorate or a substantially similar degree by an international medical program in good standing.
122+(c) Has completed a residency or substantially similar postgraduate medical training in the individual's resident country and has practiced as a medical professional performing the duties of a physician in the individual's resident country for at least two years.
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109124 (d) Possesses basic fluency in the English language.
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111126 3. "International medical program" means any medical school, residency program, medical internship program or entity that provides physicians with a medical education or training outside of the United States and that is substantially similar to that required to practice as a physician in this state.
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113128 4. "Physician" means an individual who has obtained a medical doctorate or a substantially similar degree and who has completed a residency program or substantially similar postgraduate medical training. END_STATUTE
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115-Sec. 2. Study committee on physician shortages; membership; duties; report; delayed repeal
130+START_STATUTE32-1441. International medical graduates; licensure; countries; requirements; definitions
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117-A. The study committee on physician shortages is established consisting of the following members:
132+A. Notwithstanding any other law, the board shall grant a license to engage in the practice of medicine in this state to an international medical graduate who meets the requirements of this section and who is licensed to practice in any of the following:
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119-1. One member of the majority party in the senate who is appointed by the president of the senate and who serves as cochairperson of the study committee.
134+1. Australia.
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121-2. One member of the minority party in the senate who is appointed by the president of the senate.
136+2. Hong Kong.
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123-3. One member of the majority party in the house of representatives who is appointed by the speaker of the house of representatives and who serves as cochairperson of the study committee.
138+3. Ireland.
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125-4. One member of the minority party in the house of representatives who is appointed by the speaker of the house of representatives.
140+4. Israel.
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127-5. The director of the department of health services or the director's designee.
142+5. New Zealand.
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129-6. A representative from a statewide association that primarily represents physicians and that engages in health care policy who is appointed by the president of the senate.
144+6. Singapore.
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131-7. Two representatives from two different organizations that represent hospitals in this state, one of whom is appointed by the president of the senate and one of whom is appointed by the speaker of the house of representatives.
146+7. South Africa.
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133-8. A representative of a public university with a medical school in this state who is appointed by the president of the senate.
148+8. Switzerland.
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135-9. A representative of a private university with a medical school in this state who is appointed by the speaker of the house of representatives.
150+9. The United Kingdom.
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137-10. One resident physician practicing in this state who attended medical school outside the United States and who is appointed by the speaker of the house of representatives.
152+10. Canada.
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139-11. One licensed practicing primary care physician who practices in a county with a population of less than one hundred thousand persons and who is appointed by the president of the senate.
154+B. The board may add additional countries to the list prescribed in subsection A of this section.
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141-12. Two representatives from nonprofit advocacy organizations that engage in health care policy and have an interest in addressing the physician shortage. These members shall be appointed by the speaker of the house of representatives.
156+C. The board may grant a license under this section only to an international medical graduate who is an international medical program graduate, whose federal immigration status allows the person to work as a physician in the United States and who meets the requirements for licensure prescribed in section 32-1422 and section 32-1423, paragraphs 1 and 2.
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143-13. A representative from a tribal government that is facing a physician shortage who is appointed by the president of the senate.
158+D. An international medical graduate who is licensed to practice in a country listed in subsection A of this section or added pursuant to subsection B of this section may engage in the practice of medicine in this state without additional training or residency requirements if the person meets the requirements of this section.
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145-14. A representative from this state's immigrant or refugee community that understands the skills immigrants and refugees bring to this country and the barriers those individuals face to use their training. This member shall be appointed by the speaker of the house of representatives.
160+E. An international medical graduate whose license in a country listed in subsection A of this section or added pursuant to subsection B of this section has expired or lapsed within the previous five years but who meets all other requirements of this section may also be granted a license under this section. Such applicants must have been in good standing with the medical licensing or regulatory institution of the licensing country at the time the license expired or lapsed.
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147-15. An Arizona licensed physician who was previously licensed in a foreign country and then enrolled in a residency program in the United States in order to be licensed in this state. This member shall be appointed by the president of the senate.
162+F. For the purposes of this section:
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149-16. The executive director of the Arizona medical board or the executive director's designee.
164+1. "International medical graduate" has the same meaning prescribed in section 32-1440.
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151-17. One representative of an organization that seeks to eliminate employment barriers and advance the skills for immigrant professionals. This member shall be appointed by the president of the senate.
166+2. "International medical program" has the same meaning prescribed in section 32-1440.
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153-B. The study committee shall research and make recommendations for addressing the physician shortage in this state, with a particular emphasis on how to encourage more physicians to practice in rural areas and low-income communities and in primary care practice. The study committee shall review current policies and practices on the licensing of international medical graduates and foreign-licensed physicians to determine how to reduce barriers to entry into medical practice in this state. The study committee shall prioritize increasing health care access in rural areas and low-income communities while maintaining public health and safety when making its recommendations.
168+3. "Physician" has the same meaning prescribed in section 32-1440. END_STATUTE
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155-C. The study committee shall consult with the following national organizations to solicit their input on any preliminary recommendations:
170+Sec. 2. Effective date
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157-1. The federation of state medical boards.
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159-2. The accreditation council for graduate medical education.
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161-3. The educational commission for foreign medical graduates.
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163-D. The study committee shall meet as frequently as the cochairpersons deem necessary and may hold hearings and take testimony from stakeholders in fulfilling its responsibilities. All study committee hearings shall be open to the public.
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165-E. Study committee members are not eligible to receive compensation, but members are eligible for reimbursement of expenses under title 38, chapter 4, article 2, Arizona Revised Statutes.
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167-F. On or before December 1, 2024, the study committee shall submit a report regarding its findings and recommendations to the governor, the president of the senate and the speaker of the house of representatives and shall provide a copy of this report to the secretary of state.
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169-G. This section is repealed from and after December 31, 2024.
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171-Sec. 3. Effective date
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173-Section 32-1440, Arizona Revised Statutes, as added by this act, is effective from and after December 31, 2023.
172+This act is effective from and after December 31, 2023.