| 1 | 1 | | 1.1 A bill for an act |
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| 2 | 2 | | 1.2 relating to health; amending licensing requirements for graduates of foreign medical |
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| 3 | 3 | | 1.3 schools; authorizing the commissioner of health to remedy certain violations by |
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| 4 | 4 | | 1.4 employers of limited license holders; requiring employers of limited license holders |
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| 5 | 5 | | 1.5 to carry medical malpractice insurance; requiring limited license holders to provide |
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| 6 | 6 | | 1.6 periodic certification to the medical board; amending Minnesota Statutes 2024, |
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| 7 | 7 | | 1.7 sections 144.99, subdivision 1; 147.037, by adding a subdivision. |
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| 8 | 8 | | 1.8BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: |
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| 9 | 9 | | 1.9 Section 1. Minnesota Statutes 2024, section 144.99, subdivision 1, is amended to read: |
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| 10 | 10 | | 1.10 Subdivision 1.Remedies available.The provisions of chapters 103I and 157 and sections |
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| 11 | 11 | | 1.11115.71 to 115.77; 144.12, subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), (14), |
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| 12 | 12 | | 1.12and (15); 144.1201 to 144.1204; 144.121; 144.1215; 144.1222; 144.35; 144.381 to 144.385; |
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| 13 | 13 | | 1.13144.411 to 144.417; 144.495; 144.71 to 144.74; 144.9501 to 144.9512; 144.97 to 144.98; |
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| 14 | 14 | | 1.14144.992; 147.037, subdivision 1b, paragraph (d); 326.70 to 326.785; 327.10 to 327.131; |
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| 15 | 15 | | 1.15and 327.14 to 327.28 and all rules, orders, stipulation agreements, settlements, compliance |
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| 16 | 16 | | 1.16agreements, licenses, registrations, certificates, and permits adopted or issued by the |
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| 17 | 17 | | 1.17department or under any other law now in force or later enacted for the preservation of |
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| 18 | 18 | | 1.18public health may, in addition to provisions in other statutes, be enforced under this section. |
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| 19 | 19 | | 1.19 EFFECTIVE DATE.This section is effective January 1, 2026. |
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| 20 | 20 | | 1.20 Sec. 2. Minnesota Statutes 2024, section 147.037, is amended by adding a subdivision to |
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| 21 | 21 | | 1.21read: |
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| 22 | 22 | | 1.22 Subd. 1b.Limited license.(a) The board must issue a limited license to any person who |
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| 23 | 23 | | 1.23satisfies the requirements of subdivision 1, paragraphs (a) to (c) and (e) to (g), and who: |
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| 24 | 24 | | 1Sec. 2. |
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| 25 | 25 | | REVISOR AGW/LN 25-0108812/11/24 |
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| 26 | 26 | | State of Minnesota |
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| 27 | 27 | | This Document can be made available |
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| 28 | 28 | | in alternative formats upon request |
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| 29 | 29 | | HOUSE OF REPRESENTATIVES |
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| 30 | 30 | | H. F. No. 1913 |
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| 31 | 31 | | NINETY-FOURTH SESSION |
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| 32 | 32 | | Authored by Mahamoud, Bierman, Nadeau, Reyer, Bahner and others03/05/2025 |
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| 33 | 33 | | The bill was read for the first time and referred to the Committee on Health Finance and Policy 2.1 (1) pursuant to a license or other authorization to practice, has practiced medicine, as |
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| 34 | 34 | | 2.2defined in section 147.081, subdivision 3, clauses (2) to (4), for at least 60 months in the |
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| 35 | 35 | | 2.3previous ten years outside of the United States; |
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| 36 | 36 | | 2.4 (2) submits sufficient evidence of an offer to practice within the context of a collaborative |
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| 37 | 37 | | 2.5agreement within a hospital or clinical setting where the limited license holder and physicians |
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| 38 | 38 | | 2.6work together to provide patient care; |
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| 39 | 39 | | 2.7 (3) provides services in a designated rural area or underserved urban community as |
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| 40 | 40 | | 2.8defined in section 144.1501; and |
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| 41 | 41 | | 2.9 (4) submits two letters of recommendation in support of a limited license, which must |
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| 42 | 42 | | 2.10include one letter from a physician with whom the applicant previously worked and one |
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| 43 | 43 | | 2.11letter from an administrator of the hospital or clinical setting in which the applicant previously |
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| 44 | 44 | | 2.12worked. The letters of recommendation must attest to the applicant's good medical standing. |
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| 45 | 45 | | 2.13 (b) For purposes of this subdivision, a person has satisfied the requirements of subdivision |
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| 46 | 46 | | 2.141, paragraph (e), if the person has passed steps or levels one and two of the USMLE or the |
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| 47 | 47 | | 2.15COMLEX-USA with passing scores as recommended by the USMLE program or National |
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| 48 | 48 | | 2.16Board of Osteopathic Medical Examiners within three attempts. |
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| 49 | 49 | | 2.17 (c) A person issued a limited license under this subdivision must not be required to |
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| 50 | 50 | | 2.18present evidence satisfactory to the board of the completion of one year of graduate clinical |
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| 51 | 51 | | 2.19medical training in a program accredited by a national accrediting organization approved |
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| 52 | 52 | | 2.20by the board. |
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| 53 | 53 | | 2.21 (d) An employer of a limited license holder must pay the limited license holder at least |
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| 54 | 54 | | 2.22an amount equivalent to a medical resident in a comparable field. The employer must carry |
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| 55 | 55 | | 2.23medical malpractice insurance covering a limited license holder for the duration of the |
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| 56 | 56 | | 2.24employment. The commissioner of health may issue a correction order under section 144.99, |
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| 57 | 57 | | 2.25subdivision 3, requiring an employer to comply with this paragraph. An employer must not |
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| 58 | 58 | | 2.26retaliate against or discipline an employee for raising a complaint or pursuing enforcement |
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| 59 | 59 | | 2.27relating to this paragraph. |
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| 60 | 60 | | 2.28 (e) The board must issue a full and unrestricted license to practice medicine to a person |
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| 61 | 61 | | 2.29who holds a limited license issued pursuant to paragraph (a) and who has: |
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| 62 | 62 | | 2.30 (1) held the limited license for two years and is in good standing to practice medicine |
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| 63 | 63 | | 2.31in this state; |
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| 64 | 64 | | 2.32 (2) practiced for a minimum of 1,692 hours per year for each of the previous two years; |
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| 65 | 65 | | 2Sec. 2. |
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| 66 | 66 | | REVISOR AGW/LN 25-0108812/11/24 3.1 (3) submitted a letter of recommendation in support of a full and unrestricted license |
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| 67 | 67 | | 3.2containing all attestations required under paragraph (h) from any physician who participated |
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| 68 | 68 | | 3.3in the collaborative agreement; and |
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| 69 | 69 | | 3.4 (4) has passed steps or levels one, two, and three of the USMLE or COMLEX-USA |
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| 70 | 70 | | 3.5with passing scores as recommended by the USMLE program or National Board of |
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| 71 | 71 | | 3.6Osteopathic Medical Examiners within three attempts. |
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| 72 | 72 | | 3.7 (f) A limited license holder must submit to the board, every six months or upon request, |
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| 73 | 73 | | 3.8a statement certifying whether the person is still employed as a physician in this state and |
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| 74 | 74 | | 3.9whether the person has been subjected to professional discipline as a result of the person's |
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| 75 | 75 | | 3.10practice. The board may suspend or revoke a limited license if a majority of the board |
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| 76 | 76 | | 3.11determines that the licensee is no longer employed as a physician in this state by an employer. |
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| 77 | 77 | | 3.12The licensee must be granted an opportunity to be heard prior to the board's determination. |
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| 78 | 78 | | 3.13A licensee may change employers during the duration of the limited license if the licensee |
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| 79 | 79 | | 3.14has another offer of employment. In the event that a change of employment occurs, the |
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| 80 | 80 | | 3.15licensee must still work the number of hours required under paragraph (d), clause (2), to be |
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| 81 | 81 | | 3.16eligible for a full and unrestricted license to practice medicine. |
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| 82 | 82 | | 3.17 (g) For purposes of this subdivision, "collaborative agreement" means a mutually agreed |
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| 83 | 83 | | 3.18upon plan for the overall working relationship and collaborative arrangement between a |
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| 84 | 84 | | 3.19holder of a limited license and one or more physicians licensed under this chapter that |
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| 85 | 85 | | 3.20designates the scope of services that can be provided to manage the care of patients. The |
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| 86 | 86 | | 3.21limited license holder and one of the collaborating physicians must have experience in |
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| 87 | 87 | | 3.22providing care to patients with the same or similar medical conditions. A limited license |
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| 88 | 88 | | 3.23holder may practice medicine without a collaborating physician physically present, but the |
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| 89 | 89 | | 3.24limited license holder and collaborating physicians must be able to easily contact each other |
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| 90 | 90 | | 3.25by radio, telephone, or other telecommunication device while the limited license holder |
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| 91 | 91 | | 3.26practices medicine. The limited license holder must have one-on-one practice reviews with |
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| 92 | 92 | | 3.27each collaborating physician, provided in person or through eye-to-eye electronic media |
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| 93 | 93 | | 3.28while maintaining visual contact, for at least two hours per week. |
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| 94 | 94 | | 3.29 (h) At least one collaborating physician must submit a letter to the board, after the limited |
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| 95 | 95 | | 3.30license holder has practiced under the license for 12 months, attesting to the following: |
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| 96 | 96 | | 3.31 (1) that the limited license holder has a basic understanding of federal and state laws |
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| 97 | 97 | | 3.32regarding the provision of health care, including but not limited to: |
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| 98 | 98 | | 3.33 (i) medical licensing obligations and standards; and |
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| 99 | 99 | | 3.34 (ii) the Health Insurance Portability and Accountability Act, Public Law 104-191; |
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| 100 | 100 | | 3Sec. 2. |
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| 101 | 101 | | REVISOR AGW/LN 25-0108812/11/24 4.1 (2) that the limited license holder has a basic understanding of documentation standards; |
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| 102 | 102 | | 4.2 (3) that the limited license holder has a thorough understanding of which medications |
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| 103 | 103 | | 4.3are available and unavailable in the United States; |
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| 104 | 104 | | 4.4 (4) that the limited license holder has a thorough understanding of American medical |
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| 105 | 105 | | 4.5standards of care; |
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| 106 | 106 | | 4.6 (5) that the limited license holder has demonstrated mastery of each of the following: |
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| 107 | 107 | | 4.7 (i) gathering a history and performing a physical exam; |
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| 108 | 108 | | 4.8 (ii) developing and prioritizing a differential diagnosis following a clinical encounter |
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| 109 | 109 | | 4.9and selecting a working diagnosis; |
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| 110 | 110 | | 4.10 (iii) recommending and interpreting common diagnostic and screening tests; |
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| 111 | 111 | | 4.11 (iv) entering and discussing orders and prescriptions; |
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| 112 | 112 | | 4.12 (v) providing an oral presentation of a clinical encounter; |
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| 113 | 113 | | 4.13 (vi) giving a patient handover to transition care responsibly; |
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| 114 | 114 | | 4.14 (vii) recognizing a patient requiring urgent care and initiating an evaluation; and |
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| 115 | 115 | | 4.15 (viii) obtaining informed consent for tests, procedures, and treatments; and |
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| 116 | 116 | | 4.16 (6) that the limited license holder is providing appropriate medical care. |
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| 117 | 117 | | 4.17 (i) The board must not grant a license under this section unless the applicant possesses |
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| 118 | 118 | | 4.18federal immigration status that allows the applicant to practice as a physician in the United |
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| 119 | 119 | | 4.19States. |
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| 120 | 120 | | 4.20 EFFECTIVE DATE.This section is effective January 1, 2026. |
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| 121 | 121 | | 4Sec. 2. |
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| 122 | 122 | | REVISOR AGW/LN 25-0108812/11/24 |
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