| 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; modifying application and license fees; |
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| 7 | 7 | | 1.7 amending Minnesota Statutes 2024, sections 144.99, subdivision 1; 147.01, |
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| 8 | 8 | | 1.8 subdivision 7; 147.037, by adding a subdivision. |
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| 9 | 9 | | 1.9BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: |
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| 10 | 10 | | 1.10 Section 1. Minnesota Statutes 2024, section 144.99, subdivision 1, is amended to read: |
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| 11 | 11 | | 1.11 Subdivision 1.Remedies available.The provisions of chapters 103I and 157 and sections |
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| 12 | 12 | | 1.12115.71 to 115.77; 144.12, subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), (14), |
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| 13 | 13 | | 1.13and (15); 144.1201 to 144.1204; 144.121; 144.1215; 144.1222; 144.35; 144.381 to 144.385; |
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| 14 | 14 | | 1.14144.411 to 144.417; 144.495; 144.71 to 144.74; 144.9501 to 144.9512; 144.97 to 144.98; |
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| 15 | 15 | | 1.15144.992; 147.037, subdivision 1b, paragraph (d); 326.70 to 326.785; 327.10 to 327.131; |
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| 16 | 16 | | 1.16and 327.14 to 327.28 and all rules, orders, stipulation agreements, settlements, compliance |
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| 17 | 17 | | 1.17agreements, licenses, registrations, certificates, and permits adopted or issued by the |
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| 18 | 18 | | 1.18department or under any other law now in force or later enacted for the preservation of |
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| 19 | 19 | | 1.19public health may, in addition to provisions in other statutes, be enforced under this section. |
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| 20 | 20 | | 1.20 EFFECTIVE DATE.This section is effective January 1, 2026. |
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| 21 | 21 | | 1.21 Sec. 2. Minnesota Statutes 2024, section 147.01, subdivision 7, is amended to read: |
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| 22 | 22 | | 1.22 Subd. 7.Physician application and license fees.(a) The board may charge the following |
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| 23 | 23 | | 1.23nonrefundable application and license fees processed pursuant to sections 147.02, 147.03, |
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| 24 | 24 | | 1.24147.037, 147.0375, and 147.38: |
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| 25 | 25 | | 1Sec. 2. |
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| 39 | 37 | | 2.2 (2) physician annual registration renewal fee, $192; |
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| 40 | 38 | | 2.3 (3) physician endorsement to other states, $40; |
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| 41 | 39 | | 2.4 (4) physician emeritus license, $50; |
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| 42 | 40 | | 2.5 (5) physician late fee, $60; |
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| 43 | 41 | | 2.6 (6) nonrenewable 24-month limited license, $392; |
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| 44 | 42 | | 2.7 (7) initial physician license for limited license holder, $192; |
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| 45 | 43 | | 2.8 (6) (8) duplicate license fee, $20; |
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| 46 | 44 | | 2.9 (7) (9) certification letter fee, $25; |
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| 47 | 45 | | 2.10 (8) (10) education or training program approval fee, $100; |
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| 48 | 46 | | 2.11 (9) (11) report creation and generation fee, $60 per hour; |
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| 49 | 47 | | 2.12 (10) (12) examination administration fee (half day), $50; |
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| 50 | 48 | | 2.13 (11) (13) examination administration fee (full day), $80; |
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| 51 | 49 | | 2.14 (12) (14) fees developed by the Interstate Commission for determining physician |
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| 52 | 50 | | 2.15qualification to register and participate in the interstate medical licensure compact, as |
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| 53 | 51 | | 2.16established in rules authorized in and pursuant to section 147.38, not to exceed $1,000; and |
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| 54 | 52 | | 2.17 (13) (15) verification fee, $25. |
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| 55 | 53 | | 2.18 (b) The board may prorate the initial annual license fee. All licensees are required to |
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| 56 | 54 | | 2.19pay the full fee upon license renewal. The revenue generated from the fee must be deposited |
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| 57 | 55 | | 2.20in an account in the state government special revenue fund. |
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| 58 | 56 | | 2.21 Sec. 3. Minnesota Statutes 2024, section 147.037, is amended by adding a subdivision to |
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| 59 | 57 | | 2.22read: |
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| 60 | 58 | | 2.23 Subd. 1b.Limited license.(a) A limited license under this section is valid for one |
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| 61 | 59 | | 2.2424-month period and is not renewable or eligible for reapplication. The board may issue a |
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| 62 | 60 | | 2.25limited license, valid for 24 months, to any person who satisfies the requirements of |
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| 63 | 61 | | 2.26subdivision 1, paragraphs (a) to (c) and (e) to (g), and who: |
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| 64 | 62 | | 2.27 (1) pursuant to a license or other authorization to practice, has practiced medicine, as |
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| 65 | 63 | | 2.28defined in section 147.081, subdivision 3, clauses (2) to (4), for at least 60 months in the |
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| 66 | 64 | | 2.29previous 12 years outside of the United States; |
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| 67 | 65 | | 2Sec. 3. |
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| 69 | 67 | | 3.2agreement within a hospital or clinical setting where the limited license holder and physicians |
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| 70 | 68 | | 3.3work together to provide patient care; |
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| 71 | 69 | | 3.4 (3) provides services in a designated rural area or underserved urban community as |
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| 72 | 70 | | 3.5defined in section 144.1501; and |
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| 73 | 71 | | 3.6 (4) submits two letters of recommendation in support of a limited license, which must |
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| 74 | 72 | | 3.7include one letter from a physician with whom the applicant previously worked and one |
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| 75 | 73 | | 3.8letter from an administrator of the hospital or clinical setting in which the applicant previously |
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| 76 | 74 | | 3.9worked. The letters of recommendation must attest to the applicant's good medical standing. |
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| 77 | 75 | | 3.10The board may accept alternative forms of proof that demonstrate good medical standing |
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| 78 | 76 | | 3.11where there are extenuating circumstances that prevent an applicant from providing letters. |
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| 79 | 77 | | 3.12 (b) For purposes of this subdivision, a person has satisfied the requirements of subdivision |
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| 80 | 78 | | 3.131, paragraph (e), if the person has passed steps or levels one and two of the USMLE or the |
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| 81 | 79 | | 3.14COMLEX-USA with passing scores as recommended by the USMLE program or National |
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| 82 | 80 | | 3.15Board of Osteopathic Medical Examiners within three attempts. |
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| 83 | 81 | | 3.16 (c) A person issued a limited license under this subdivision must not be required to |
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| 84 | 82 | | 3.17present evidence satisfactory to the board of the completion of one year of graduate clinical |
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| 85 | 83 | | 3.18medical training in a program accredited by a national accrediting organization approved |
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| 86 | 84 | | 3.19by the board. |
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| 87 | 85 | | 3.20 (d) An employer of a limited license holder must pay the limited license holder at least |
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| 88 | 86 | | 3.21an amount equivalent to a medical resident in a comparable field. The employer must carry |
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| 89 | 87 | | 3.22medical malpractice insurance covering a limited license holder for the duration of the |
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| 90 | 88 | | 3.23employment. The commissioner of health may issue a correction order under section 144.99, |
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| 91 | 89 | | 3.24subdivision 3, requiring an employer to comply with this paragraph. An employer must not |
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| 92 | 90 | | 3.25retaliate against or discipline an employee for raising a complaint or pursuing enforcement |
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| 93 | 91 | | 3.26relating to this paragraph. |
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| 94 | 92 | | 3.27 (e) The board may issue a full and unrestricted license to practice medicine to a person |
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| 95 | 93 | | 3.28who holds a limited license issued pursuant to paragraph (a) and who has: |
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| 96 | 94 | | 3.29 (1) held the limited license for two years and is in good standing to practice medicine |
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| 97 | 95 | | 3.30in this state; |
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| 98 | 96 | | 3.31 (2) practiced for a minimum of 1,692 hours per year for each of the previous two years; |
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| 99 | 97 | | 3Sec. 3. |
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| 117 | | - | 4.18paragraph (e), clause (2), to be eligible for a full and unrestricted license to practice medicine. |
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| 118 | | - | 4.19 (g) In addition to any other remedy provided by law, the board may, without a hearing, |
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| 119 | | - | 4.20temporarily suspend the license of a limited license holder if the board finds that the limited |
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| 120 | | - | 4.21license holder has violated a statute or rule that the board is empowered to enforce and |
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| 121 | | - | 4.22continued practice by the limited license holder would create a serious risk of harm to the |
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| 122 | | - | 4.23public. The suspension shall take effect upon written notice to the limited license holder, |
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| 123 | | - | 4.24specifying the statute or rule violated. The suspension shall remain in effect until the board |
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| 124 | | - | 4.25issues a final order in the matter after a hearing. At the time it issues the suspension notice, |
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| 125 | | - | 4.26the board shall schedule a disciplinary hearing to be held pursuant to the Administrative |
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| 126 | | - | 4.27Procedure Act. The limited license holder shall be provided with at least 20 days' notice of |
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| 127 | | - | 4.28any hearing held pursuant to this subdivision. The hearing shall be scheduled to begin no |
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| 128 | | - | 4.29later than 30 days after the issuance of the suspension order. |
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| 129 | | - | 4.30 (h) For purposes of this subdivision, "collaborative agreement" means a mutually agreed |
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| 130 | | - | 4.31upon plan for the overall working relationship and collaborative arrangement between a |
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| 131 | | - | 4.32holder of a limited license and one or more physicians licensed under this chapter that |
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| 132 | | - | 4.33designates the scope of services that can be provided to manage the care of patients. The |
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| 133 | | - | 4.34limited license holder and one of the collaborating physicians must have experience in |
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| 115 | + | 4.18paragraph (d), clause (2), to be eligible for a full and unrestricted license to practice medicine. |
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| 116 | + | 4.19The board may suspend or revoke a limited license if a majority of the board determines |
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| 117 | + | 4.20that the licensee is no longer employed as a physician in this state by an employer. The |
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| 118 | + | 4.21licensee must be granted an opportunity to be heard prior to the board's determination. |
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| 119 | + | 4.22 (g) In addition to any other remedy provided by law, the board may, without a hearing, |
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| 120 | + | 4.23temporarily suspend the license of a limited license holder if the board finds that the limited |
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| 121 | + | 4.24license holder has violated a statute or rule which the board is empowered to enforce and |
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| 122 | + | 4.25continued practice by the limited license holder would create a serious risk of harm to the |
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| 123 | + | 4.26public. The suspension shall take effect upon written notice to the limited license holder, |
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| 124 | + | 4.27specifying the statute or rule violated. The suspension shall remain in effect until the board |
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| 125 | + | 4.28issues a final order in the matter after a hearing. At the time it issues the suspension notice, |
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| 126 | + | 4.29the board shall schedule a disciplinary hearing to be held pursuant to the Administrative |
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| 127 | + | 4.30Procedure Act. The limited license holder shall be provided with at least 20 days' notice of |
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| 128 | + | 4.31any hearing held pursuant to this subdivision. The hearing shall be scheduled to begin no |
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| 129 | + | 4.32later than 30 days after the issuance of the suspension order. |
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| 130 | + | 4.33 (h) For purposes of this subdivision, "collaborative agreement" means a mutually agreed |
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| 131 | + | 4.34upon plan for the overall working relationship and collaborative arrangement between a |
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| 135 | | - | S0509-3 3rd EngrossmentSF509 REVISOR AGW 5.1providing care to patients with the same or similar medical conditions. Under the |
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| 136 | | - | 5.2collaborative agreement, the limited license holder must shadow the collaborating physician |
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| 137 | | - | 5.3for four weeks, after which time the limited license holder must staff all patient encounters |
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| 138 | | - | 5.4with the collaborating physician for an additional four weeks. After that time, the |
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| 139 | | - | 5.5collaborating physician has discretion to allow the limited license holder to see patients |
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| 140 | | - | 5.6independently and will require the limited license holder to present patients at their discretion. |
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| 141 | | - | 5.7However, the limited license holder must be supervised by the collaborating physician for |
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| 142 | | - | 5.8a minimum of two hours per week. A limited license holder may practice medicine without |
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| 143 | | - | 5.9a collaborating physician physically present, but the limited license holder and collaborating |
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| 144 | | - | 5.10physicians must be able to easily contact each other by radio, telephone, or other |
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| 145 | | - | 5.11telecommunication device while the limited license holder practices medicine. The limited |
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| 146 | | - | 5.12license holder must have one-on-one practice reviews with each collaborating physician, |
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| 147 | | - | 5.13provided in person or through eye-to-eye electronic media while maintaining visual contact, |
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| 148 | | - | 5.14for at least two hours per week. |
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| 149 | | - | 5.15 (i) At least one collaborating physician must submit a letter to the board, after the limited |
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| 150 | | - | 5.16license holder has practiced under the license for 12 months, attesting to the following: |
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| 151 | | - | 5.17 (1) that the limited license holder has a basic understanding of federal and state laws |
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| 152 | | - | 5.18regarding the provision of health care, including but not limited to: |
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| 153 | | - | 5.19 (i) medical licensing obligations and standards; and |
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| 154 | | - | 5.20 (ii) the Health Insurance Portability and Accountability Act, Public Law 104-191; |
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| 155 | | - | 5.21 (2) that the limited license holder has a basic understanding of documentation standards; |
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| 156 | | - | 5.22 (3) that the limited license holder has a thorough understanding of which medications |
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| 157 | | - | 5.23are available and unavailable in the United States; |
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| 158 | | - | 5.24 (4) that the limited license holder has a thorough understanding of American medical |
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| 159 | | - | 5.25standards of care; |
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| 160 | | - | 5.26 (5) that the limited license holder has demonstrated mastery of each of the following: |
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| 161 | | - | 5.27 (i) gathering a history and performing a physical exam; |
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| 162 | | - | 5.28 (ii) developing and prioritizing a differential diagnosis following a clinical encounter |
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| 163 | | - | 5.29and selecting a working diagnosis; |
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| 164 | | - | 5.30 (iii) recommending and interpreting common diagnostic and screening tests; |
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| 165 | | - | 5.31 (iv) entering and discussing orders and prescriptions; |
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| 166 | | - | 5.32 (v) providing an oral presentation of a clinical encounter; |
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| 133 | + | S0509-2 2nd EngrossmentSF509 REVISOR AGW 5.1holder of a limited license and one or more physicians licensed under this chapter that |
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| 134 | + | 5.2designates the scope of services that can be provided to manage the care of patients. The |
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| 135 | + | 5.3limited license holder and one of the collaborating physicians must have experience in |
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| 136 | + | 5.4providing care to patients with the same or similar medical conditions. Under the |
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| 137 | + | 5.5collaborative agreement, the limited license holder must shadow the collaborating physician |
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| 138 | + | 5.6for four weeks, after which time the limited license holder must staff all patient encounters |
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| 139 | + | 5.7with the collaborating physician. After that time, the collaborating physician has discretion |
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| 140 | + | 5.8to allow the limited license holder to see patients independently and will require the limited |
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| 141 | + | 5.9license holder to present patients at their discretion. However, the limited license holder |
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| 142 | + | 5.10must be supervised by the collaborating physician for a minimum of two hours per week. |
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| 143 | + | 5.11A limited license holder may practice medicine without a collaborating physician physically |
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| 144 | + | 5.12present, but the limited license holder and collaborating physicians must be able to easily |
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| 145 | + | 5.13contact each other by radio, telephone, or other telecommunication device while the limited |
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| 146 | + | 5.14license holder practices medicine. The limited license holder must have one-on-one practice |
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| 147 | + | 5.15reviews with each collaborating physician, provided in person or through eye-to-eye |
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| 148 | + | 5.16electronic media while maintaining visual contact, for at least two hours per week. |
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| 149 | + | 5.17 (i) At least one collaborating physician must submit a letter to the board, after the limited |
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| 150 | + | 5.18license holder has practiced under the license for 12 months, attesting to the following: |
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| 151 | + | 5.19 (1) that the limited license holder has a basic understanding of federal and state laws |
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| 152 | + | 5.20regarding the provision of health care, including but not limited to: |
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| 153 | + | 5.21 (i) medical licensing obligations and standards; and |
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| 154 | + | 5.22 (ii) the Health Insurance Portability and Accountability Act, Public Law 104-191; |
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| 155 | + | 5.23 (2) that the limited license holder has a basic understanding of documentation standards; |
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| 156 | + | 5.24 (3) that the limited license holder has a thorough understanding of which medications |
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| 157 | + | 5.25are available and unavailable in the United States; |
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| 158 | + | 5.26 (4) that the limited license holder has a thorough understanding of American medical |
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| 159 | + | 5.27standards of care; |
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| 160 | + | 5.28 (5) that the limited license holder has demonstrated mastery of each of the following: |
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| 161 | + | 5.29 (i) gathering a history and performing a physical exam; |
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| 162 | + | 5.30 (ii) developing and prioritizing a differential diagnosis following a clinical encounter |
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| 163 | + | 5.31and selecting a working diagnosis; |
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| 164 | + | 5.32 (iii) recommending and interpreting common diagnostic and screening tests; |
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| 168 | | - | S0509-3 3rd EngrossmentSF509 REVISOR AGW 6.1 (vi) giving a patient handover to transition care responsibly; |
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| 169 | | - | 6.2 (vii) recognizing a patient requiring urgent care and initiating an evaluation; and |
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| 170 | | - | 6.3 (viii) obtaining informed consent for tests, procedures, and treatments; and |
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| 171 | | - | 6.4 (6) that the limited license holder is providing appropriate medical care. |
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| 172 | | - | 6.5 (j) The board must not grant a license under this section unless the applicant possesses |
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| 173 | | - | 6.6federal immigration status that allows the applicant to practice as a physician in the United |
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| 174 | | - | 6.7States. |
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| 175 | | - | 6.8 EFFECTIVE DATE.This section is effective January 1, 2026. |
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| 166 | + | S0509-2 2nd EngrossmentSF509 REVISOR AGW 6.1 (iv) entering and discussing orders and prescriptions; |
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| 167 | + | 6.2 (v) providing an oral presentation of a clinical encounter; |
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| 168 | + | 6.3 (vi) giving a patient handover to transition care responsibly; |
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| 169 | + | 6.4 (vii) recognizing a patient requiring urgent care and initiating an evaluation; and |
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| 170 | + | 6.5 (viii) obtaining informed consent for tests, procedures, and treatments; and |
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| 171 | + | 6.6 (6) that the limited license holder is providing appropriate medical care. |
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| 172 | + | 6.7 (j) The board must not grant a license under this section unless the applicant possesses |
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| 173 | + | 6.8federal immigration status that allows the applicant to practice as a physician in the United |
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| 174 | + | 6.9States. |
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| 175 | + | 6.10 EFFECTIVE DATE.This section is effective January 1, 2026. |
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