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Regular Session, 2014
SENATE BILL NO. 619
BY SENATOR HEITMEIER
HEALTH SERVICES. Transfers the powers, duties, and functions relative to regulating
pain management clinics from the Department of Health and Hospitals to the Louisiana State
Board of Medical Examiners. (1/1/15)
AN ACT1
To amend and reenact R.S. 40:2198.12(A), the introductory paragraph of (B)(1) and2
(B)(1)(f), (D), and 2198.13 and to enact R.S. 40:2198.12(B)(1)(h) through (j), and3
2198.14 through 2198.20, relative to pain management clinics; to transfer the powers4
and duties for the regulation of pain management clinics from the Department of5
Health and Hospitals to the Louisiana State Board of Medical Examiners; to provide6
licensure authority and powers to the Louisiana State Board of Medical Examiners7
to regulate and license pain management clinics; to provide for criminal penalties for8
operating a pain management clinic without a license; to provide relative to scope9
of practice prohibitions; to provide an effective date; and to provide for related10
matters.11
Be it enacted by the Legislature of Louisiana:12
Section 1. R.S. 40:2198.12(A), the introductory paragraph of (B)(1) and (B)(1)(f),13
(D), and 2198.13 are hereby amended and reenacted and R.S. 40:2198.12(B)(1)(h) through14
(j) and 2198.14 through 2198.20 are hereby enacted to read as follows:15
§2198.12. Licensure of pain management clinics; rules and regulations16
A. Except as provided in Subsection D of this Section, all pain management17 SB NO. 619
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clinics shall be owned and operated by a physician certified in the subspecialty of1
pain management by a member board of the American Boards of Medical2
Specialties, the American Osteopathic Association, and such other entities as the3
board may approve. All pain management clinics shall be licensed by the4
department board.5
B.(1) The department board shall prescribe and publish minimum standards,6
rules, and regulations as necessary to effectuate the provisions of this Section. Such7
rules and regulations shall include but not be limited to all of the following:8
* * *9
(f) Reimbursement policies, procedures, and requirements, including but not10
limited to the requirement to accept payment from third party payors.11
* * *12
(h) The submission of periodic reports to the board.13
(i) Utilization of a disclosure form developed by the board.14
(j) Accessing the Prescription Monitoring Program information on a15
regular basis.16
* * *17
D.(1) The following shall apply to pain management clinics operating on or18
before June 15, 2005, pursuant to an occupational license or certificate of operation19
which has not been suspended or revoked:20
(1)(a) The pain management clinic shall not be owned, either in whole or in21
part, by or have any contractual relationship, whether through employment or by22
independent contract, with a physician who during the course of his practice has been23
denied the privilege of prescribing, dispensing, administering, supplying, or selling24
any controlled dangerous substance and who has, during the course of his practice25
had board action taken against his medical license as a result of dependency on drugs26
or alcohol.27
(2)(b) The pain management clinic shall be operated by a medical director28
who shall be a physician. The medical director shall be responsible for29 SB NO. 619
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compliance with all applicable laws and rules.1
(3)(c) The pain management clinic shall not be owned in whole or in part by2
a person who has been convicted of or who has pled guilty or nolo contendere to an3
offense that constitutes a felony.4
(4)(d) The pain management clinic shall not be owned in whole or in part by5
a person who has been convicted of or who has pled guilty or nolo contendere to an6
offense that constitutes a misdemeanor, the facts of which relate to the distribution7
or illegal prescription of any narcotic.8
(5)(e) The pain management clinic shall operate as an urgent care facility,9
offering primary or acute health services in addition to caring for those with chronic10
pain and shall have held itself out to the public as such.11
(6)(f) The pain management clinic shall implement policies and procedures12
that are consistent with all pain management regulations issued by the State Board13
of Medical Examiners.14
(7)(g) A pain management clinic which is exempted from the requirement of15
being owned and operated by a physician certified in the subspeciality of pain16
management may relocate and continue to be exempted from the requirement of17
being owned and operated by a physician certified in the subspeciality of pain18
management if the new location is in the same parish in which the original clinic was19
located.20
(8)(h) All pain management clinics shall submit to the department board all21
relevant documentation proving valid operation before June 15, 2005, including but22
not limited to occupational licenses or certificates of operation issued by local23
authorities.24
(2) A pain management clinic that is not licensed by or has not made an25
application to the department for licensure under this Part on or before August26
1, 2014, shall not be licensed under the exemption to Subsection A of this27
Section as provided for in this Subsection.28
* * *29 SB NO. 619
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§2198.13. Annual fee; use of proceeds1
There shall be an annual license fee to be set by the department board not to2
exceed one thousand dollars for any license issued in accordance with the provisions3
of this Part. Monies collected for annual fees shall be used for the investigation and4
enforcement of the provisions of this Part.5
§2198.14. Powers and duties of the board6
A. In the administration of this Part, the board shall have all of the7
authority, powers, protections, and immunities conferred upon it by the8
Louisiana Medical Practice Act. In addition, the board shall have authority to:9
(1) Adopt rules and regulations in accordance with the Administrative10
Procedure Act for the purpose of administering the provisions of this Part and11
administer and enforce all rules and regulations promulgated by the12
department pursuant to this Part until modified, superseded, or repealed by the13
board.14
(2) Approve, refuse to issue or renew, restrict, place on probation,15
suspend, or revoke a license.16
(3) Conduct administrative hearings on the refusal to issue, renew,17
suspend, or revoke a license.18
(4) Conduct inspections, surveys, and investigations of pain management19
clinics and their records to ensure compliance with this Part.20
(5) Have all other powers necessary and proper for the performance of21
its duties and the administration of this Part.22
(6) Issue a subpoena for any medical information, testimony, records,23
data, reports, or other documents or information relative to a pain management24
clinic or a facility operating as a pain management clinic without a license.25
B.(1) Nothing in this Part shall limit the authority of a health care26
provider, licensed by a licensing authority of this state, from engaging in the27
scope of practice conferred by such license under Louisiana law.28
(2) Nothing in this Part shall authorize an individual, other than a29 SB NO. 619
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physician licensed by the board, to own or operate a pain management clinic1
nor prohibit the board from conducting an investigation or taking action2
against the owner or operator of a pain management clinic suspected of3
operating without a license issued by the board, except as set forth in R.S.4
40:2198.12(D).5
§2198.15. Causes for nonissuance, suspension, and revocation; administrative6
costs and fines7
A. In accordance with the Administrative Procedure Act, the board may8
refuse to issue or renew, restrict, suspend, or revoke a license held or applied9
for under this Part for any of the following causes, including but not limited to:10
(1) Failing to meet the qualifications prescribed by this Part.11
(2) Fraud, deceit, or perjury in obtaining a license issued under this Part.12
(3) Action against the license of a physician operating a pain13
management clinic or working in association with a pain management clinic by14
the board for violation of the board's pain management rules or for any15
violation of R.S. 37:1285(A), which would render the physician ineligible under16
this Part to own, operate, be employed by or contracted to a pain management17
clinic.18
(4) Owning or operating an unlicensed pain management clinic or19
performing any act which in any way assists a person to operate an unlicensed20
pain management clinic, or having a professional connection with or lending21
one's name to an illegal practitioner.22
(5) Violation of any rules, regulations, or orders of the board, or any23
provisions of this Part.24
B.(1) As part of a decision or order, the board may require a license25
holder or an applicant to pay all costs of the board proceedings, including but26
not limited to investigator, stenographer and attorney fees, witness fees and27
expenses, and the per diem and expenses of the members of the board's hearing28
panel and to pay a fine not to exceed five thousand dollars.29 SB NO. 619
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(2) If for any reason the costs or fines imposed by the board under this1
Section are not paid within the time specified by the board, the board may2
recover costs and reasonable attorney fees associated with their collection.3
(3) The board may authorize any member of the board or the board's4
executive director to sign an affidavit, petition, or other legal process, including5
but not limited to a petition in any court of competent jurisdiction for a money6
judgment for any and all costs and fines payable pursuant to a final decision or7
order of the board.8
§2198.16. Adjudication; publication of action; judicial review; security9
A. Proceedings for the refusal to issue or renew, restriction, probation,10
suspension, or revocation of a pain management clinic license shall be11
conducted by the board in accordance with its rules, regulations, and12
procedures and in compliance with the Administrative Procedure Act.13
B. Any final decision or order issued by the board shall constitute a14
public record.15
C. A party aggrieved by a final decision or order of the board resulting16
from an administrative adjudication may file a petition for judicial review,17
pursuant to R.S. 49:964.18
D. Judicial review of a final decision or order of the board, or a19
preliminary, procedural, or intermediate decision, ruling, order, or action of the20
board shall be subject to and governed by the requirements and procedures set21
forth in R.S. 37:1285 (F) through (I).22
E. A party seeking judicial review of a decision or order of the board23
shall furnish security in accordance with R.S. 37:1285.3.24
§2198.17. Investigations and complaints; confidentiality of records25
A. The board, through its duly authorized agents, shall inspect at regular26
intervals as may be deemed necessary by the board, and without prior notice,27
all pain management clinics subject to the provisions of this Part. The board28
shall also develop and facilitate coordination with other authorized local, state,29 SB NO. 619
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and federal agencies making inspections of such facilities.1
B. The board, through its duly authorized agents, shall investigate all2
complaints against any pain management clinic as defined in this Part. This3
shall include investigating complaints regarding a facility or clinic operating as4
a pain management clinic without a license.5
C. Notwithstanding any law to the contrary, all information, records,6
accounts, books, photographs, copies, memoranda, or data concerning the7
fitness of any individual to receive or continue to hold a pain management clinic8
license, in the custody or control of the board, shall be deemed nonpublic,9
confidential, and privileged information and restricted to the exclusive use of10
the board, its members, officers, investigators, agents, and representatives in11
carrying out the provisions of this Part.12
§2198.18. Injunctive and other relief13
A. The board may cause to issue in any court of competent jurisdiction14
a writ of injunction enjoining any person from operating a pain management15
clinic that is not licensed under this Part. The injunction shall not be subject to16
being released upon bond. The trial of the proceeding by injunction shall be17
summary and by the judge without a jury. The failure of the board to seek an18
injunction shall not constitute a waiver nor confer upon any person violating19
this Part a right to engage in such conduct.20
B. In the suit for an injunction, the board may demand of the defendant21
a penalty of not more than five thousand dollars, as well as reasonable attorney22
fees and court costs. The judgment for penalty, reasonable attorney fees, and23
costs may be rendered in the same judgment as the injunction.24
C. In lieu of or in addition to the other remedies provided in this Section,25
the board may report violations of this Part to the attorney general, an26
appropriate district attorney, or other appropriate law enforcement officer, who27
may in his discretion cause appropriate criminal proceedings to be brought.28
§2198.19. Criminal penalties29 SB NO. 619
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A. It shall be unlawful for any person to own or operate a pain1
management clinic without a license issued by the board.2
B. Whosoever owns or operates an unlicensed pain management clinic3
shall be fined not more than five hundred dollars for each offense or imprisoned4
for not more than five months, or both. Each day that a pain management clinic5
operates without a license shall constitute a separate offense.6
§2198.20. Prohibition on limiting the practice of health care providers7
Nothing in this Part is intended to limit the practice of health care8
providers who are licensed by the state of Louisiana and who are acting within9
their scope of practice under Louisiana law. The board shall be specifically10
prohibited from promulgating any rule, adopting any policy, or issuing any11
advisory opinion that limits a licensed health care provider's scope of practice12
contrary to that authorized by the legislature or applicable licensing board13
regulating the licensed health care provider, if authorized by law.14
Section 2. Upon the transfer accomplished by this Act, any pending or unfinished15
business of the Department of Health and Hospitals related to the licensure or regulation of16
any pain management clinic shall become the business of and be completed by the Louisiana17
State Board of Medical Examiners; provided, that any legal proceeding to which the18
Department of Health and Hospitals is or may be made a party as a result of the19
administration of this Part that is pending before any court on the effective date of transfer20
shall be continued in the name of the Department of Health and Hospitals. 21
Section 3. All documents, records or rights of action heretofore possessed, controlled22
or used by the Department of Health and Hospitals in the exercise of the functions hereby23
transferred shall be transferred to the Louisiana State Board of Medical Examiners.24
Section 4. Any reference in this Part or in any related rules or documents to the25
Department of Health and Hospitals shall be deemed to refer to the Louisiana State Board26
of Medical Examiners, and any administrative rules and regulations promulgated by the27
Department of Health and Hospitals pursuant to this Part, which are in effect on the day28
preceding the effective date of this Act, shall be considered valid and shall continue in force29 SB NO. 619
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and effect and be enforceable by the Louisiana State Board of Medical Examiners until and1
unless modified, superseded, or repealed by the Louisiana State Board of Medical2
Examiners.3
Section 5. This Act shall become effective on January 1, 2015.4
The original instrument and the following digest, which constitutes no part
of the legislative instrument, were prepared by Christopher D. Adams.
DIGEST
Heitmeier (SB 619)
Present law provides for the regulation of pain management clinics by the Department of
Health and Hospitals.
Proposed law transfers the regulation of pain management clinics from the department to the
Louisiana State Board of Medical Examiners (the board).
Present law provides that certain pain management clinics operating on or before June 15,
2005, may be licensed by Department of Health and Hospitals if their license has not been
suspended or revoked.
Present law provides the following qualifiers:
(1)The pain management clinic shall not be owned, either in whole or in part, by or
have any contractual relationship, whether through employment or by independent
contract, with a physician who during the course of his practice has been denied the
privilege of prescribing, dispensing, administering, supplying, or selling any
controlled dangerous substance and who has, during the course of his practice had
board action taken against his medical license as a result of dependency on drugs or
alcohol.
(2)The pain management clinic shall be operated by a medical director who shall be a
physician.
(3)The pain management clinic shall not be owned in whole or in part by a person who
has been convicted of or who has pled guilty or nolo contendere to an offense that
constitutes a felony.
(4)The pain management clinic shall not be owned in whole or in part by a person who
has been convicted of or who has pled guilty or nolo contendere to an offense that
constitutes a misdemeanor, the facts of which relate to the distribution or illegal
prescription of any narcotic.
(5)The pain management clinic shall operate as an urgent care facility, offering primary
or acute health services in addition to caring for those with chronic pain and shall
have held itself out to the public as such.
(6)The pain management clinic shall implement policies and procedures that are
consistent with all pain management regulations issued by the State Board of
Medical Examiners.
(7)A pain management clinic which is exempted from the requirement of being owned
and operated by a physician certified in the subspeciality of pain management may
relocate and continue to be exempted from the requirement of being owned and SB NO. 619
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operated by a physician certified in the subspeciality of pain management if the new
location is in the same parish in which the original clinic was located.
(8)All pain management clinics shall submit to the department all relevant
documentation proving valid operation before June 15, 2005, including but not
limited to occupational licenses or certificates of operation issued by local
authorities.
Proposed law amends the present law to provide the present law exemption for licensure
shall not apply to a pain management clinic that is not licensed by or has not made an
application to the Department of Health and Hospitals for licensure on or before August 1,
2014.
Proposed law provides the causes for nonissuance, restriction, probation, suspension,
revocation of a pain management clinic license and provides for adjudication, publication
of action, judicial review, and a posting of a required security.
Proposed law provides that nothing in the proposed law shall limit the authority of a health
care provider, licensed by a licensing authority of this state, from engaging in the scope of
practice conferred by such license under present law.
Proposed law provides nothing in proposed law shall authorize an individual, other than a
physician licensed by the board, to own or operate a pain management clinic nor prohibit the
board from conducting an investigation or taking action against the owner or operator of a
pain management clinic suspected of operating without a license issued by the board, except
as set forth in present law.
Proposed law provides injunctive relief powers to the Louisiana State Board of Medical
Examiners.
Proposed law provides criminal penalties for any person owning or operating a pain
management clinic without a license. Proposed penalties are a fine of not more than $500
for each offense, or imprisonment for not more than five months, or both. Each day the pain
management clinic operates without a license is a separate offense.
Proposed law provides nothing in the proposed law is intended to limit the practice of health
care providers who are licensed by the state of Louisiana and who are acting within their
scope of practice under present law. Further, the board shall be specifically prohibited from
promulgating any rule, adopting any policy, or issuing any advisory opinion that limits a
licensed health care provider's scope of practice contrary to that authorized by the legislature
or applicable licensing board regulating the licensed health care provider, if authorized by
present law.
Effective January 1, 2015.
(Amends R.S. 40:2198.12(A), (B)(1)(intro para) and (B)(1)(f), (D), and 2198.13; adds R.S.
40:2198.12(B)(1)(h) through (j), and 2198.14 through 2198.20)
Summary of Amendments Adopted by Senate
Committee Amendments Proposed by Senate Committee on Health and Welfare to
the original bill
1. Clarifies the proposed law does not limit that the authority of a health care
provider, licensed by a licensing authority of this state, from engaging in the
scope of practice conferred by such license under present law.
2. Clarifies who may own or operate a pain management clinic. SB NO. 619
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3. Prohibits LSBME from limiting the scope of practice of health care providers
licensed by another licensing board when such scope of practice is provided
to such health provider by Louisiana law.
4. Makes technical amendments.