1.1 A bill for an act
1.2 relating to health; amending licensing requirements for graduates of foreign medical
1.3 schools; authorizing the commissioner of health to remedy certain violations by
1.4 employers of limited license holders; requiring employers of limited license holders
1.5 to carry medical malpractice insurance; requiring limited license holders to provide
1.6 periodic certification to the medical board; amending Minnesota Statutes 2024,
1.7 sections 144.99, subdivision 1; 147.037, by adding a subdivision.
1.8BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.9 Section 1. Minnesota Statutes 2024, section 144.99, subdivision 1, is amended to read:
1.10 Subdivision 1.Remedies available.The provisions of chapters 103I and 157 and sections
1.11115.71 to 115.77; 144.12, subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), (14),
1.12and (15); 144.1201 to 144.1204; 144.121; 144.1215; 144.1222; 144.35; 144.381 to 144.385;
1.13144.411 to 144.417; 144.495; 144.71 to 144.74; 144.9501 to 144.9512; 144.97 to 144.98;
1.14144.992; 147.037, subdivision 1b, paragraph (d); 326.70 to 326.785; 327.10 to 327.131;
1.15and 327.14 to 327.28 and all rules, orders, stipulation agreements, settlements, compliance
1.16agreements, licenses, registrations, certificates, and permits adopted or issued by the
1.17department or under any other law now in force or later enacted for the preservation of
1.18public health may, in addition to provisions in other statutes, be enforced under this section.
1.19 EFFECTIVE DATE.This section is effective January 1, 2026.
1.20 Sec. 2. Minnesota Statutes 2024, section 147.037, is amended by adding a subdivision to
1.21read:
1.22 Subd. 1b.Limited license.(a) The board must issue a limited license to any person who
1.23satisfies the requirements of subdivision 1, paragraphs (a) to (c) and (e) to (g), and who:
1Sec. 2.
25-01088 as introduced12/11/24 REVISOR AGW/LN
SENATE
STATE OF MINNESOTA
S.F. No. 509NINETY-FOURTH SESSION
(SENATE AUTHORS: MANN, Klein, Lieske and Abeler)
OFFICIAL STATUSD-PGDATE
Introduction and first reading01/23/2025
Referred to Health and Human Services 2.1 (1) pursuant to a license or other authorization to practice, has practiced medicine, as
2.2defined in section 147.081, subdivision 3, clauses (2) to (4), for at least 60 months in the
2.3previous ten years outside of the United States;
2.4 (2) submits sufficient evidence of an offer to practice within the context of a collaborative
2.5agreement within a hospital or clinical setting where the limited license holder and physicians
2.6work together to provide patient care;
2.7 (3) provides services in a designated rural area or underserved urban community as
2.8defined in section 144.1501; and
2.9 (4) submits two letters of recommendation in support of a limited license, which must
2.10include one letter from a physician with whom the applicant previously worked and one
2.11letter from an administrator of the hospital or clinical setting in which the applicant previously
2.12worked. The letters of recommendation must attest to the applicant's good medical standing.
2.13 (b) For purposes of this subdivision, a person has satisfied the requirements of subdivision
2.141, paragraph (e), if the person has passed steps or levels one and two of the USMLE or the
2.15COMLEX-USA with passing scores as recommended by the USMLE program or National
2.16Board of Osteopathic Medical Examiners within three attempts.
2.17 (c) A person issued a limited license under this subdivision must not be required to
2.18present evidence satisfactory to the board of the completion of one year of graduate clinical
2.19medical training in a program accredited by a national accrediting organization approved
2.20by the board.
2.21 (d) An employer of a limited license holder must pay the limited license holder at least
2.22an amount equivalent to a medical resident in a comparable field. The employer must carry
2.23medical malpractice insurance covering a limited license holder for the duration of the
2.24employment. The commissioner of health may issue a correction order under section 144.99,
2.25subdivision 3, requiring an employer to comply with this paragraph. An employer must not
2.26retaliate against or discipline an employee for raising a complaint or pursuing enforcement
2.27relating to this paragraph.
2.28 (e) The board must issue a full and unrestricted license to practice medicine to a person
2.29who holds a limited license issued pursuant to paragraph (a) and who has:
2.30 (1) held the limited license for two years and is in good standing to practice medicine
2.31in this state;
2.32 (2) practiced for a minimum of 1,692 hours per year for each of the previous two years;
2Sec. 2.
25-01088 as introduced12/11/24 REVISOR AGW/LN 3.1 (3) submitted a letter of recommendation in support of a full and unrestricted license
3.2containing all attestations required under paragraph (h) from any physician who participated
3.3in the collaborative agreement; and
3.4 (4) has passed steps or levels one, two, and three of the USMLE or COMLEX-USA
3.5with passing scores as recommended by the USMLE program or National Board of
3.6Osteopathic Medical Examiners within three attempts.
3.7 (f) A limited license holder must submit to the board, every six months or upon request,
3.8a statement certifying whether the person is still employed as a physician in this state and
3.9whether the person has been subjected to professional discipline as a result of the person's
3.10practice. The board may suspend or revoke a limited license if a majority of the board
3.11determines that the licensee is no longer employed as a physician in this state by an employer.
3.12The licensee must be granted an opportunity to be heard prior to the board's determination.
3.13A licensee may change employers during the duration of the limited license if the licensee
3.14has another offer of employment. In the event that a change of employment occurs, the
3.15licensee must still work the number of hours required under paragraph (d), clause (2), to be
3.16eligible for a full and unrestricted license to practice medicine.
3.17 (g) For purposes of this subdivision, "collaborative agreement" means a mutually agreed
3.18upon plan for the overall working relationship and collaborative arrangement between a
3.19holder of a limited license and one or more physicians licensed under this chapter that
3.20designates the scope of services that can be provided to manage the care of patients. The
3.21limited license holder and one of the collaborating physicians must have experience in
3.22providing care to patients with the same or similar medical conditions. A limited license
3.23holder may practice medicine without a collaborating physician physically present, but the
3.24limited license holder and collaborating physicians must be able to easily contact each other
3.25by radio, telephone, or other telecommunication device while the limited license holder
3.26practices medicine. The limited license holder must have one-on-one practice reviews with
3.27each collaborating physician, provided in person or through eye-to-eye electronic media
3.28while maintaining visual contact, for at least two hours per week.
3.29 (h) At least one collaborating physician must submit a letter to the board, after the limited
3.30license holder has practiced under the license for 12 months, attesting to the following:
3.31 (1) that the limited license holder has a basic understanding of federal and state laws
3.32regarding the provision of health care, including but not limited to:
3.33 (i) medical licensing obligations and standards; and
3.34 (ii) the Health Insurance Portability and Accountability Act, Public Law 104-191;
3Sec. 2.
25-01088 as introduced12/11/24 REVISOR AGW/LN 4.1 (2) that the limited license holder has a basic understanding of documentation standards;
4.2 (3) that the limited license holder has a thorough understanding of which medications
4.3are available and unavailable in the United States;
4.4 (4) that the limited license holder has a thorough understanding of American medical
4.5standards of care;
4.6 (5) that the limited license holder has demonstrated mastery of each of the following:
4.7 (i) gathering a history and performing a physical exam;
4.8 (ii) developing and prioritizing a differential diagnosis following a clinical encounter
4.9and selecting a working diagnosis;
4.10 (iii) recommending and interpreting common diagnostic and screening tests;
4.11 (iv) entering and discussing orders and prescriptions;
4.12 (v) providing an oral presentation of a clinical encounter;
4.13 (vi) giving a patient handover to transition care responsibly;
4.14 (vii) recognizing a patient requiring urgent care and initiating an evaluation; and
4.15 (viii) obtaining informed consent for tests, procedures, and treatments; and
4.16 (6) that the limited license holder is providing appropriate medical care.
4.17 (i) The board must not grant a license under this section unless the applicant possesses
4.18federal immigration status that allows the applicant to practice as a physician in the United
4.19States.
4.20 EFFECTIVE DATE.This section is effective January 1, 2026.
4Sec. 2.
25-01088 as introduced12/11/24 REVISOR AGW/LN