Rhode Island 2025 Regular Session

Rhode Island House Bill H5108 Compare Versions

Only one version of the bill is available at this time.

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5	5	2025 -- H 5108
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7	7	LC000280
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9	9	S T A T E O F R H O D E I S L A N D
10	10	IN GENERAL ASSEMBLY
11	11	JANUARY SESSION, A.D. 2025
12	12	____________
13	13
14	14	A N A C T
15	15	RELATING TO BUSINESSES AND PROFESSIONS -- BOARD OF MEDICAL LICENSURE
16	16	AND DISCIPLINE
17	17	Introduced By: Representatives Solomon, Casimiro, Cruz, McNamara, J. Lombardi,
18	18	Ackerman, Cortvriend, Biah, McGaw, and Marszalkowski
19	19	Date Introduced: January 22, 2025
20	20	Referred To: House Corporations
21	21
22	22
23	23	It is enacted by the General Assembly as follows:
24	24	SECTION 1. Sections 5-37-1 and 5-37-16 of the General Laws in Chapter 5-37 entitled 1
25	25	"Board of Medical Licensure and Discipline" are hereby amended to read as follows: 2
26	26	5-37-1. Definitions. 3
27	27	As used in this chapter: 4
28	28	(1) “Board” means the Rhode Island board of medical licensure and discipline or any 5
29	29	committee or subcommittee thereof. 6
30	30	(2) “Chief administrative officer” means the administrator of the Rhode Island board of 7
31	31	medical licensure and discipline. 8
32	32	(3) “Department” means the Rhode Island department of health. 9
33	33	(4) “Director” means the director of the Rhode Island department of health. 10
34	34	(5) "ECFMG" means the Educational Commission for Foreign Medical Graduates. 11
35	35	(5)(6) “Healthcare facility” means any institutional health-service provider licensed 12
36	36	pursuant to the provisions of chapter 17 of title 23. 13
37	37	(6)(7) “Health-maintenance organization” means a public or private organization licensed 14
38	38	pursuant to the provisions of chapter 17 of title 23 or chapter 41 of title 27. 15
39	39	(8) "Internationally-trained physician" means a physician who has received a degree of 16
40	40	doctor of medicine or its equivalent from a legally chartered medical school outside the United 17
41	41	States recognized by the World Health Organization, who has been licensed or otherwise 18
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45	45	authorized to practice medicine in a country other than the United States, and who has practiced 1
46	46	medicine for at least one year 2
47	47	(7)(9) “Limited registrant” means a person holding a limited-registration certificate 3
48	48	pursuant to the provisions of this chapter. 4
49	49	(8)(10) “Medical malpractice” or “malpractice” means any tort, or breach of contract, 5
50	50	based on health care or professional services rendered or that should have been rendered, by a 6
51	51	physician, dentist, hospital, clinic, health-maintenance organization, or professional service 7
52	52	corporation providing healthcare services and organized under chapter 5.1 of title 7, to a patient or 8
53	53	the rendering of medically unnecessary services except at the informed request of the patient. 9
54	54	(9)(11) “Medical-practice group” means a single legal entity formed primarily for the 10
55	55	purpose of being a physician group practice in any organizational form recognized by the state in 11
56	56	which the group practice achieves its legal status, including, but not limited to, a partnership, 12
57	57	professional corporation, limited-liability company, limited-liability partnership, foundation, not-13
58	58	for-profit corporation, faculty practice plan, or similar association. 14
59	59	(10)(12) “Medical record” means a record of a patient’s medical information and treatment 15
60	60	history maintained by physicians and other medical personnel, which includes, but is not limited 16
61	61	to, information related to medical diagnosis, immunizations, allergies, x-rays, copies of laboratory 17
62	62	reports, records of prescriptions, and other technical information used in assessing the patient’s 18
63	63	health condition, whether such information is maintained in a paper or electronic format. 19
64	64	(11)(13) “Nonprofit medical-services corporation” or “nonprofit hospital-service 20
65	65	corporation” means any corporation organized pursuant to chapter 19 or chapter 20 of title 27 for 21
66	66	the purpose of establishing, maintaining, and operating a nonprofit medical-service plan. 22
67	67	(14) "Participating healthcare facility" means a federally-qualified health center, 23
68	68	community health center, hospital, or other healthcare facility approved by the board that provides 24
69	69	an assessment and evaluation program designed to develop, assess, and evaluate an internationally-25
70	70	trained physician's non-clinical skills, according to criteria developed or approved by the board; 26
71	71	provided, however, that the participating healthcare facility provides medical care in a Rhode Island 27
72	72	physician shortage area. 28
73	73	(12)(15)(i) “Peer-review board” means any committee of a state or local professional 29
74	74	association or society including a hospital association, or a committee of any licensed healthcare 30
75	75	facility, or the medical staff thereof, or any committee of a medical-care foundation or health-31
76	76	maintenance organization, or any committee of a professional-service corporation or nonprofit 32
77	77	corporation employing twenty (20) or more practicing professionals, organized for the purpose of 33
78	78	furnishing medical service, or any staff committee or consultant of a hospital-service or medical-34
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82	82	service corporation, the function of which, or one of the functions of which, is to evaluate and 1
83	83	improve the quality of health care rendered by providers of healthcare services or to determine that 2
84	84	healthcare services rendered were professionally indicated or were performed in compliance with 3
85	85	the applicable standard of care or that the cost of health care rendered was considered reasonable 4
86	86	by the providers of professional healthcare services in the area and shall include a committee 5
87	87	functioning as a utilization-review committee under the provisions of 42 U.S.C. § 1395 et seq. 6
88	88	(Medicare law) or as a professional-standards review organization or statewide professional-7
89	89	standards review council under the provisions of 42 U.S.C. § 1301 et seq. (professional-standards 8
90	90	review organizations) or a similar committee or a committee of similar purpose, to evaluate or 9
91	91	review the diagnosis or treatment of the performance or rendition of medical or hospital services 10
92	92	that are performed under public medical programs of either state or federal design. 11
93	93	(ii) “Peer-review board” also means the board of trustees or board of directors of a state or 12
94	94	local professional association or society, a licensed healthcare facility, a medical-care foundation, 13
95	95	a health-maintenance organization, and a hospital-service or medical-service corporation only 14
96	96	when such board of trustees or board of directors is reviewing the proceedings, records, or 15
97	97	recommendations of a peer-review board of the above enumerated organizations. 16
98	98	(13)(16) “Person” means any individual, partnership, firm, corporation, association, trust 17
99	99	or estate, state or political subdivision, or instrumentality of a state. 18
100	100	(14)(17) “Physician” means a person with a license to practice allopathic or osteopathic 19
101	101	medicine in this state under the provisions of this chapter. 20
102	102	(15)(18) “Practice of medicine” includes the practice of allopathic and osteopathic 21
103	103	medicine. Any person is regarded as practicing medicine within the meaning of this chapter who 22
104	104	holds himself or herself out as being able to diagnose, treat, operate, or prescribe for any person ill 23
105	105	or alleged to be ill with disease, pain, injury, deformity, or abnormal physical or mental condition, 24
106	106	or who either professes to heal, offer, or undertake, by any means or method, to diagnose, treat, 25
107	107	operate, or prescribe for any person for disease, pain, injury, deformity, or physical or mental 26
108	108	condition. In addition, one who attaches the title, M.D., physician, surgeon, D.O., osteopathic 27
109	109	physician, and surgeon, or any other similar word or words or abbreviation to his or her name 28
110	110	indicating that he or she is engaged in the treatment or diagnosis of the diseases, injuries, or 29
111	111	conditions of persons, shall be held to be engaged in the practice of medicine. 30
112	112	(19) "Rhode Island physician shortage area" means a geographic region or population in 31
113	113	the state experiencing a shortage of physicians, especially primary care physicians or psychiatrists, 32
114	114	relative to population and need, as determined by the board. 33
115	115	(20) "USMLE" means United States Medical Licensure and Exam which consists of three 34
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119	119	(3) steps: 1
120	120	(i) Step 1 of the USMLE requires an assessment of the examinee’s understanding of and 2
121	121	ability to apply important concepts of the basic sciences to the practice of medicine, with special 3
122	122	emphasis on principles and mechanisms underlying health disease, and modes of therapy; 4
123	123	(ii) Step 2 of the USMLE requires an assessment of the examinee’s ability to apply 5
124	124	knowledge, skills, and understanding of clinical science essentials for the provision of patient care 6
125	125	under supervision, with an emphasis on health promotion and disease prevention; 7
126	126	(iii) Step 3 of the USMLE requires an assessment of the examinee’s ability to apply medical 8
127	127	knowledge and understanding of biomedical and clinical science essential for the unsupervised 9
128	128	practice of medicine, with the emphasis on patient management in ambulatory settings. 10
129	129	5-37-16. Limited registrations. 11
130	130	(a) An applicant for limited registration under this chapter who furnishes the board with 12
131	131	satisfactory proof that the applicant is eighteen (18) years of age or older and of good moral 13
132	132	character; that the applicant has graduated from a legally chartered medical school or school of 14
133	133	osteopathic medicine having power to grant degrees in allopathic or osteopathic medicine; and that 15
134	134	the applicant has been appointed an intern, resident, fellow, or medical officer in a hospital or other 16
135	135	institution maintained by the state, or by a city or town, or in a hospital or clinic that is incorporated 17
136	136	under the laws of this state, or in a clinic that is affiliated with a hospital licensed by the department 18
137	137	of health, or in an outpatient clinic operated by the state, may, upon the payment as set forth in § 19
138	138	23-1-54, be registered by the board as a hospital medical officer for any time that the board may 20
139	139	prescribe. This limited registration shall entitle the applicant to practice medicine in the hospital or 21
140	140	other institution designated on his or her certificate of limited registration, or outside this hospital 22
141	141	or other institution for the treatment, under the supervision of one of its medical officers who is a 23
142	142	licensed physician, of persons accepted by it as patients, or in any hospital, institution, clinic, or 24
143	143	program affiliated for training purposes with the hospital, institution, or clinic designated on this 25
144	144	certificate, which affiliation is approved by the board, and in any case under regulations established 26
145	145	by the hospital, institution, or clinic; provided, that each hospital, institution, or clinic annually 27
146	146	submits to the board a list of affiliated hospitals, institutions, clinics, or programs providing training 28
147	147	programs that comply with the terms of this section. Limited registration under this section may be 29
148	148	revoked at any time by the board. 30
149	149	(b) Notwithstanding the other provisions of subsection (a) of this section, an 31
150	150	internationally-trained physician who has been licensed or otherwise authorized to practice 32
151	151	medicine in a country other than the United States shall be eligible to apply for a limited license to 33
152	152	practice medicine for a renewable one-year term after satisfying the criteria in subsection (c) of this 34
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156	156	section; provided, however, that such limited registration shall provide a pathway for the issuance 1
157	157	of a full unrestricted license to practice medicine in accordance with, and upon satisfaction of, the 2
158	158	criteria in subsection (f) of this section. 3
159	159	(c) The board shall issue a limited license to an applicant if the participating facility and 4
160	160	the applicant submit evidence acceptable to the board that the applicant: 5
161	161	(1) Is an internationally-trained physician; 6
162	162	(2) Has a valid certificate issued by the Educational Commission for Foreign Medical 7
163	163	Graduates or other credential evaluation service approved by the board; provided, however, that 8
164	164	the board may waive such certification at its discretion where the applicant is unable to obtain the 9
165	165	required documentation from a non-cooperating country; 10
166	166	(3) Has achieved a passing score on both of Steps 1 and 2 (Clinical Knowledge) of the 11
167	167	United States Medical Licensing Examination; 12
168	168	(4) Has entered into an agreement with the participating healthcare facility providing that 13
169	169	the facility shall develop, assess and evaluate the applicant's familiarity with nonclinical skills 14
170	170	standards appropriate for medical practice in Rhode Island, according to the assessment and 15
171	171	evaluation criteria developed or approved by the board; 16
172	172	(5) Will enter a full-time employment relationship with that participating healthcare facility 17
173	173	after the board issues a limited license pursuant to this subsection; and 18
174	174	(6) Has satisfied other criteria that the board may require for issuance of a restricted license 19
175	175	pursuant to this section. 20
176	176	(d) The one-year limited license may be renewed once, for a total two (2) year term of 21
177	177	limited registration. 22
178	178	(e) To be eligible for a renewable two (2) year restricted license to practice medicine only 23
179	179	in a Rhode Island physician shortage area designated by the board, an internationally trained 24
180	180	physician shall provide the board with proof of the following: 25
181	181	(1) Successful completion of the participating facility’s assessment and evaluation 26
182	182	program; 27
183	183	(2) A passing score on Step 3 of the USMLE; and 28
184	184	(3) The license shall authorize the holder to practice independently in a primary care 29
185	185	specialty, psychiatry, or other specialty approved by the board. 30
186	186	(f) After a minimum of two (2) years of restricted practice, the internationally trained 31
187	187	physician shall be eligible to apply for a full, unrestricted license to practice medicine. 32
188	188	(b)(g) The director may promulgate any rules and regulations that he or she the director 33
189	189	deems necessary to carry out the provisions of this chapter. 34
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193	193	SECTION 2. This act shall take effect upon passage. 1
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200	200	EXPLANATION
201	201	BY THE LEGISLATIVE COUNCIL
202	202	OF
203	203	A N A C T
204	204	RELATING TO BUSINESSES AND PROFESSIONS -- BOARD OF MEDICAL LICENSURE
205	205	AND DISCIPLINE
206	206	***
207	207	This act would allow internationally trained physicians to practice at healthcare facilities 1
208	208	in rural and underserved communities and would provide a mentorship alternative to the residency 2
209	209	requirement. This act would also create pathways to licensure and allow them to apply for a full, 3
210	210	unrestricted license to practice medicine. 4
211	211	This act would take effect upon passage. 5
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