REGULATORY INTELLIGENCE YEAR-END REPORT - 2022 Health Policy Tracking Service - Issue Briefs Healthcare Providers & Facilities Healthcare Workforce This Issue Brief was written by Robert White , a contributing writer, compliance attorney and member of the Oklahoma bar. 12/19/2022 Healthcare Workforce General Healthcare Worker Oversight Recent Legislation and Regulation Alaska ¢ 2021 AK H.B. 265 (NS), enacted and effective July 13, 2022, Adopts AK ST ? 08.01.085 (Telehealth) establishing requirements for the delivery of health care services via telehealth to patients in Alaska by a health care provider licensed in Alaska or a physician licensed in another state. Adopts AK ST ? 08.64.333 (Disciplinary sanctions: physician licensed in another state) authorizing the board to sanction a physician licensed in another state who provides health care services through telehealth if they violate Alaska laws for Alaska-licensed physicians; exceed the defined scope of telehealth services; or prescribe, administer, or dispense a controlled substance to an Alaska patient located in the state. ¢ 2022 AK REG TEXT 624038 (NS), published September 14, 2022, effective September 12, 2022, amends 12 AK ADC 02.940 (Effective date of renewed licenses) adding that if an application and payment for renewal of a health care professional's license is submitted but the division is unable to complete its review of the application before the expiration of the license, the license may be automatically extended for three months or until the division completes its review and either approves or denies the application, whichever occurs earlier. Arizona * 2022 AZ S.B. 1311 (NS) enacted April 25, 2022, effective July 29, 2022, adopts AZ ST ? 36-420.02 (Health care employers; workplace violence prevention plan; investigation; reporting; nondiscrimination; definitions) requiring health care employers to develop, implement and maintain a written workplace violence prevention plan by July 1, 2023. Provides processes, procedures and restrictions relating to workplace violence prevention plans, health care workers and employers. ¢ 2022 AZ H.B. 2429 (NS), enacted May 9, 2022, effective August 26, 2022, adopts AZ ST ? 32-3229.01 (Health professional wellness programs; confidentiality; definition) providing for the establishment of health professional wellness programs. Requires a health professional's participation in a health professional wellness program to be confidential and not subject to discovery, subpoena or a reporting requirement to an applicable health profession regulatory board. Provides exceptions to the confidentiality requirement and defines health professional wellness program to mean a program of evaluation, counseling, including substance abuse counseling, or another modality to address an issue related to career fatigue or wellness in a health professional who is licensed pursuant to Title 32, Chapter 13 (Medicine and Surgery), 15 (Nursing) or 17 (Osteopathic Physicians and Surgeons). ¢ 2022 AZ H.B. 2599 (NS), enacted May 27, 2022, effective September 29, 2022, amends AZ ST ? 32-4302 (Out-of-state applicants; residents; military spouses; licensure; certification; exceptions; notice) providing that prior to denying an occupational license, a regulating entity must submit the application and the reason for the denial to the Governor for review. Requires regulating entities to notify the Governor of any required time frames for approving or denying the license application and requires regulating entities, beginning July 1, 2022, to track information about the applications. California THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. 2021 CA A.B. 657 (NS), enacted September 27, 2023, effective January 1, 2023, adopts CA BUS & PROF ? 870 establishing the requirements for the Medical Board of California, the Osteopathic Medical Board of California, the Board of Registered Nursing, and the Physician Assistant Board to expedite the licensure process for an applicant who demonstrates that they intend to provide abortions within the scope of practice of their license. Colorado * 2022 CO H.B. 1257 (NS) enacted and effective April 7, 2022, amends CO ST ? 12-20-407 (Unauthorized practice of profession or occupation - penalties - exclusions) to provide that a person commits a Class 6 felony if they intentionally and fraudulently represent themselves as a licensed, certified, or registered professional or practitioner in the specified professions or occupations. * 2022 CO H.B. 1115 (NS) enacted June 7, 2022, effective August 10, 2022, requiring, on and after July 1, 2024, as a condition of license renewal, a prescriber or pharmacist to attest that they are in compliance with subsection (2)(a) of CO ST ? 12-280-403 (Prescription drug use monitoring program-- registration required), regarding registering and maintaining a user account with the program, and aware of the penalties for noncompliance with that section. ¢ 2022 CO REG TEXT 624328 (NS), published September 15, 2022, effective September 14, 2022, adopts 3 CO ADC 717-1:1.17 (Protections for Provision of Reproductive Health Care in Colorado) providing that no licensee, certificant, or registrant shall be subject to disciplinary action against a professional license or disqualified from professional licensure for obtaining, providing or assisting in the provision of reproductive health care or as a consequence of any civil or criminal judgment, discipline, or other sanction threatened or imposed under the laws of another state so long as the care provided is lawful and consistent with professional conduct and standards of care within the State of Colorado. Adopts 3 CO ADC 717-1:1.18 (Protecting Colorado's Workforce and Expanding Licensing Opportunities) prohibiting a regulator from denying a license to an applicant or from imposing disciplinary action against an individual's license based solely on a civil or criminal judgment or on professional disciplinary action against the applicant or licensee regarding the consumption, possession, cultivation, or processing of marijuana so long as the actions are lawful and consistent with professional conduct and standards of care within Colorado and did not otherwise violate Colorado law. ¢ 2022 CO REG TEXT 626891 (NS), published December 8, 2022, effective January 14, 2023, adopts 3 CO ADC 713-50:190 (Conceming Health Care Provider Disclosures to Consumers About the Potential Effects of Receiving Emergency or Nonemergency Services from An Out-Of-Network Provider) establishing requirements for health care providers to provide disclosures to consumers about the potential effects of receiving emergency or non-emergency services from an out-of-network provider. Adopts 3 CO ADC 713-50:APPENDIX A (Your Rights and Protections Against Surprise Medical Bills) to provide the surprise billing consumer disclosure that a health care provider is required to provide when a consumer has incurred a claim for emergency or nonemergency health care services from an out-of-network provider in compliance with CO ST ? 12-30-112 (Health-care providers--required disclosures--balance billing--rules-- definitions). Delaware * 2021 DE H.B. 404 (NS), enacted September 21, 2022, effective January 1, 2023, adopts DE ST TI 29 ? 8735 (Division of Professional Regulation) providing that criminal history records will only disqualify applicants for professional licensure under chapters of DE ST TI 24, Professions and Occupations, in limited circumstances with certain exceptions. Provides that conviction of a crime may be grounds for the denial of a license only if the underlying offense is one identified by the licensing board as being substantially related to the practice of the occupation or profession. Identifies certain kinds of criminal history elements that should not be considered by licensing boards and identifies factors a licensing authority should consider in determining whether a waiver should be granted. ¢ 2021 DE H.B. 334 (NS), enacted and effective October 21, 2022, amends DE ST TI 24 ? 6002 (Authorization to practice by telehealth and telemedicine) adding that a health-care provider licensed in a state that has not adopted an interstate compact applicable to the health-care provider may only provide telehealth under this chapter if the health-care provider obtains an interstate telehealth registration from the Division of Professional Regulation. Also sets forth the requirements for obtaining an interstate telehealth registration. District of Columbia 2022 DC REG TEXT 605992 (NS), published January 28, 2022, effective January 12, 2022, amends 17 DC ADC ? 4006 (Term of a License, Certificate, or Registration) authorizing the Director to extend the term of a license, certificate, or registration of a health profession if the Director determines that there is an exigent circumstance that requires an extension for the preservation of the health and safety of the public. Requires the director to issue a notice of the extension which shall not exceed ninety days. Florida ¢ 2022 FL S.B. 562 (NS), enacted June 9, 2022, effective July 1, 2022, amends FL ST ? 456.024 (Members of Armed Forces in good standing with administrative boards or the department; spouses; licensure) requiring the Department of Health and certain boards to issue a professional license, rather than a temporary professional license, to spouses of active duty members of the Armed Forces of the United States if certain requirements are met. Requires the department to waive the application fee for such license applications. Requires the department and certain boards to expedite applications for such licenses and to issue a license within 7 days after receipt of all required documentation for such application. THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. ¢ 2022 FL REG TEXT 607029 (NS), published March 29, 2022, effective April 13, 2022, adopts 64 FL ADC 64813-15.0065 (Disciplinary Action; Telehealth Registrants) establishing disciplinary action for health care professionals not licensed in Florida but who have registered as a telehealth provider. Illinois 2022 IL REG TEXT 598510 (NS), published February 14, 2022, effective January 28, 2022, adopts 68 |L ADC 1130.500 (Implicit Bias Awareness Training) requiring all specified health care professionals to complete a 1-hour course in implicit bias awareness training and establishing the requirements for the course. Amends 68 |L ADC 1130.400 (Sexual Harassment Prevention Training) clarifying that a licensee who holds multiple licensees issued by the Division may count the 1-hour sexual harassment prevention training course towards the minimum credit hours required for continuing education for each professional license without having to repeat the course for each license. lowa 2021 IA S.F. 2383 (NS), enacted June 16, 2022, effective July 1, 2022, adopts IA ST ? 272C.12A (Licensure of military spouses and veterans) requiring a licensing board, agency, or department to expedite the application for an occupational or professional license, certificate, or registration by a person who is licensed in a profession or occupation with similar scope of practice in another state and who is married to an active duty member of the military forces of the United States or is a veteran. Establishes requirements for temporary licensure. Requires a licensing board, agency, or department to adopt rules and file annual reports with the governor and general assembly on the licenses and temporary licenses issued pursuant to this section. Kansas 2021 KS H.B. 2477 (NS), enacted and effective January 21, 2022, adopts uncodified section extending the renewal deadline for any occupational or professional license, certificate, or registration issued by the Kansas Department for Aging and Disability Services (KDADS). Allows temporary licensure, certification, and registration to be issued for persons who were previously licensed, certified, or registered by KDADS as long as the person was in good standing prior to the lapse. Requires the Department to extend the deadlines for any continuing education requirements and to waive certain late fees associated with any license, certificate, or registration. 2022 ME REG TEXT 599009 (NS), published August 3, 2022, effective July 24, 2022, amends a joint rule of the Board of Licensure in Medicine, State Board of Nursing, and Board of Osteopathic Licensure regarding office-based treatment of opioid use disorder (OBOT). Eliminates gender terms, changes the term 'medical records' to 'patient records', adds a definition of 'medical emergency', and updates the definition of 'telemedicine' to 'telehealth' to comport with statutory changes. Includes the use of audio-only technology for the delivery of telehealth under certain circumstances and clarifies that telehealth shall not include the provision of health care services only through email, instant messaging, facsimile transmission, or U.S. mail or other parcel service, or in combination thereof, between a licensee and a patient in different locations with or without an intervening health care provider. Also updates the requirements for informed consent to provide an exception to obtaining informed consent prior to OBOT for a genuine medical emergency. Also requires a Clinician to obtain and document voluntary informed consent instead of obtaining written informed consent from the patient. Massachusetts 2021 MA S.B. 3075 (NS), enacted and effective August 5, 2022, amends MA ST 112 ? 1B (Acceptance of education, training or service completed by applicant as member of armed forces toward qualification requirements to receive license or certification; validity of license or certificate during active service of holder; expedited licensing of spouse of member of armed services; waiver of commonwealth's fees) updating the procedures to expedite the issuance of a license or certificate to a military spouse. Adds a timeframe of 30 days to issue the license or certificate or a temporary license or certificate, notify the applicant that their experience does not meet the requirements for licensure and specify the reasons, or notify the applicant that there is insufficient information to make the determination and specify the needed information and outstanding materials. Michigan ¢ 2021 MI S.B. 759 (NS), enacted December 23, 2021, effective December 27, 2021, amends Il ST 333.16171 (Exemptions from licensure requirement; circumstances and limitations) providing an exemption from licensure during epidemic-related staffing shortages for health professionals who hold an out-of-state license. Also clarifies the exemption for an individual appointed by the United States Olympic Committee to provide health services and an individual providing health services for an athletic team. ¢ 2021 MI H.B. 5523 (NS), enacted and effective February 16, 2022, provides that if a health care employer receives funds from the Department of Health and Human Services for health care recruitment, retention, and training, and has established a COVID-19 vaccine policy, the policy must allow for an exemption for any employee who can document that the vaccine is clinically contraindicated or against the employee's religious convictions. Requires the health care employer to respond in writing of an employee's COVID-19 vaccine exemption approval or disapproval. Also prohibits the health care employer from using an employee's vaccination status as a factor for distributing recruitment, retention, and training program funds. New Hampshire THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. 2021 NH S.B. 390 (NS), enacted and effective August 3, 2022, amends NH ST ? 310-A:1-g (Telemedicine and Telehealth Services) providing the definition for 'asynchronous interaction" and 'synchronous interaction" and updating the definition for 'telemedicine' and 'telehealth." Provides that nothing in this section limits a provider's ability to diagnoses, assess, or treat an individual patient. New Jersey ¢ 2020 NJ S.B. 4139 (NS), enacted and effective January 12, 2022, adopts uncodified sections to extend temporary emergency licensure of certain health care professionals. The temporary emergency reciprocal licensure of out-of-State health care workers in New Jersey and the temporary emergency graduate licensure for nurses, physician assistants, respiratory care therapists, pharmacists, and alcohol and drug counselors approved under certain Executive Order waivers expired on January 11, 2022. The new uncodified sections specify the provisions to extend and expand these requirements through June 30, 2022. * 2020 NJ S.B. 845 (NS), enacted January 10, 2022, effective April 10, 2022, requires health care professional licensing boards to utilize National Practitioner Data Bank. The bill requires professional and occupational licensing boards within the Division of Consumer Affairs in the Department of Law and Public Safety that regulate the practice of a health care professional to:(1) not issue an initial license or other authorization to practice a health care profession to any applicant unless the board first determines that no information exists on file in the National Practitioner Data Bank which may disqualify the applicant; and (2) utilize the continuous query function of the National Practitioner Data Bank for each person issued a license or authorization to practice a health care profession. New York 2022 NY REG TEXT 600117 (NS), published September 28, 2022, effective September 13, 2022, amends 14 NY ADC 596 (Telehealth Services) to expand the opportunity to offer telehealth services in the New York State regulated mental health system. North Dakota 2021 ND H.B. 1514 (NS), enacted November 12, 2021, effective November 15, 2021, adopts new uncodified sections, 'Limitations on disciplinary actions" in ND ST 43-12.1 (Nurse Practices Act), ND ST 43-15 (Pharmacists) and ND ST 43-17 (Physicians and Surgeons) providing that a board may not take disciplinary action against an advanced practice registered nurse, pharmacist, physician or physician assistant based solely on the prescribing or dispensing ivermectin for the off-label treatment or prevention of severe acute respiratory syndrome coronavirus 2 identified as SARS-CoV-2, or any mutation or viral fragments of SARS-CoV-2. These sections do not limit the board from taking a disciplinary action on another basis, such as unlicensed practice, inappropriate documentation, or substandard care, or any basis that would in the board's determination harm the patient. Oklahoma 2021 OK H.B. 3319 (NS), enacted and effective May 16, 2022, adopts OK ST T. 59 ? 6011 establishing the requirements for the issuance of a temporary critical need license under certain conditions for an allopathic physician, osteopathic physician, physician assistant, registered nurse, licensed practical nurse, advanced practice registered nurse, respiratory care practitioner, or perfusionist. Ohio 2021 OH H.B. 122 (NS), enacted December 22, 2021, effective March 23, 2022, adopts multiple sections to authorize various health professionals to provide telehealth services. Oregon 2022 OR H.B. 4096 (NS), enacted March 23, 2022, effective June 3, 2022, adopts uncodified Section 1 defining 'Health care practitioner' and providing requirements for a health care practitioner to practice, without compensation and in connection with a coordinating organization or other entity. 'Health care practitioner' means a person authorized in another state or United States territory to practice as a physician, physician assistant, nurse, nurse practitioner, clinical nurse specialist, dentist, dental hygienist, dental therapist, pharmacist, optometrist or naturopathic physician. Rhode Island * 2022 RI REG TEXT 606422 (NS), published January 28, 2022, effective January 26, 2022, amends 216 R! ADC 20-15-7.6 (Minimum Standards for Immunization and Communicable Disease Testing for Health Care Workers) to add an exception for the evidence of immunity requirements for Federal troops providing emergency assistance in hospitals for the duration of a COVID-19 declaration of disaster emergency. ¢ 2022 RI REG TEXT 609664 (NS), published March 12, 2022, effective March 11, 2022, adopts 216 RI ADC 20-15-9 (Requirement for Protection Against COVID-19 for Health Care Workers in Licensed Health Care Facilities) to require health care workers in licensed health care facilities to either be up to date with a SARS-CoV-2 (COVID-19) vaccine or wear an N95 mask when the prevalence rate in Rhode Island is greater than or equal to 50 cases per 100,000 people per week. South Carolina 2021 SC H.B. 4776 (NS), enacted and effective June 17, 2022, enacts the 'Medical Ethics and Diversity Act' to authorize medical practitioners, health care institutions, and health care payers not to participate in health care services that violate the practitioner's or entity's conscience and to protect these individuals and entities from civil, criminal, or administrative liability and from discrimination for THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. exercising their personal right of conscience, with exceptions; and to allow medical practitioners and health care institutions to file a complaint with the state human affairs commission for an alleged violation of the chapter. Utah 2021 UT REG TEXT 596674 (NS), published December 15, 2021, effective November 23, 2021, Adopts UT ADC R156-4 (Utah Professionals Health Program Rule) to establish the standards for participation in the Utah Professionals Health Program (UPHP). The UPHP provides an alternative to public disciplinary action for licensees who have substance use disorders Vermont 2021 VT H.B. 655 (NS), enacted May 9, 2022, effective July 1, 2023, adopts Chapter 56 (Telehealth Licensure and Registration for Out-of-State Health Care Professionals) in Title 26 (Professions and Occupations) to enact a regulatory system that would allow out-of- state health care professionals to become licensed or registered to deliver services to Vermont residents using telehealth. Virginia 2022 VA S.B. 647 (NS) and 2022 VA H.B. 939 (NS), enacted and effective April 27, 2022, amends VA ST ? 54.1-3408 (Professional use by practitioners) to allow the Commissioner of Health to authorize persons who are not authorized by law to administer or dispense drugs or devices to do so in accordance with protocols established by the Commissioner when the Board of Health has made an emergency order for the purpose of suppressing nuisances dangerous to the public health and communicable, contagious, and infectious diseases and other dangers to the public life and health for the limited purpose of administering vaccines as an approved countermeasure for such communicable, contagious, and infectious diseases. Washington 2022 WA REG TEXT 596794 (NS), published December 7, 2022, effective December 24, 2022, adopts WA ADC 246-12 (Minimum Standards for Health Equity Continuing Education Trainings for Health Care Professionals) to establish minimum standards for health equity continuing education for health professions. 'Health equity' is defined to mean all people have the same opportunities and equal access in order to attain their full health potential regardless of the color of their skin, ancestry, ethnicity, level of education, gender identity, sexual orientation, age, religion, socioeconomic status, the job they have, the neighborhood they live in, or their ability status. West Virginia 2022 WV H.B. 302 (NS), enacted September 16, 2022, effective September 13, 2022, adopts WV ST ? 16-2R-7 (Licensure action) providing that a licensed medical professional who knowingly and willfully performs, induces, or attempts to perform or induce an abortion, with the intent to violate the provisions of WV ST ?16-2R-3 (Prohibition to perform an abortion) is subject to disciplinary action by his or her applicable licensing board. If the licensing board finds that the licensed medical professional has knowingly and willfully performed, induced, or attempted to perform or induce an abortion, with the intent to violate the provisions of WV ST ? 16-2R-3 the licensing board shall revoke medical professional's license. Wisconsin 2021 WI A.B. 720 (NS), enacted March 8, 2022, effective April 2, 2022, adopts WW! ST 440.077 (Military medical personnel program) establishing the requirements for a program in which military medical personnel may temporarily perform certain skilled health services while supervised in an inpatient health care facility, outpatient health care facility, community-based residential facility, or a residential care apartment complex without having to obtain a license. Dentist and Allied Personnel Recent Legislation and Regulation Alabama 2021 AL REG TEXT 592838 (NS), published November 30, 2021, effective January 14, 2022, amends AL ADC 270-X-3-.01 (Examination Rules for Dental Hygienists) updating examination requirements. Provides that applicants must pass examinations specified by the Board of Dental Examiners. Allows designees of the board to be present during examinations. Provides that any falsification or intentional misrepresentation of application requirements, collusion, dishonesty, or use of unwarranted assistance during the examination shall automatically result in failure of the entire examination by any candidate, who may not retake the examination for one year. Reduces the number of unsuccessful attempts from 4 to 3 before a remediation program is required. Alaska 2021 AK S.B. 173 (NS) enacted August 15, 2022, effective January 1, 2023, requires the Board of Dental Examiners to establish and collect fees so that the total amount of fees collected by the Board of Dental Examiners approximately equals the total regulatory costs of the department, the board, and the Department of Health for all occupations regulated by the board. Provides that for purposes of this subsection, the regulatory costs of the Department of Health for the occupations regulated by the board include the cost of inspecting dental radiological equipment. Adopts AK ST ? 08.32.125 (Advanced practice permits) authorizing the board to issue an advanced practice permit to a licensed dental hygienist with a minimum of 4,000 documented hours of clinical experience and sets forth the authorized duties. Adopts AK ST ? 08.36.242 (License to practice as specialist required) providing that a dentist may not advertise THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. using the term 'specialist," the name of a specialty, or other phrases that suggest they are a specialist unless they have a specialist license as established. Sets forth qualifications for a specialist license and the scope of practice. Arizona * 2022 AZ S.B. 1074 (NS), enacted March 18, 2022, effective July 23, 2022, amends AZ ST ? 32-1201.01 (Definition of unprofessional conduct) clarifying that the act of prescribing, dispensing or using drugs for other than accepted dental therapeutic purposes or medically indicated supportive therapy in conjunction with managing the patient's needs is unprofessional conduct when in conjunction with the scope of practice as prescribed in AZ ST ? 32-1202 (Scope of practice; practice of dentistry). Makes technical changes. Amends AZ ST ? 32-1202 (Scope of practice; practice of dentistry) clarifying that the practice of dentistry includes the diagnosis, surgical or non-surgical treatment and performance of related adjunctive procedures for any disease, pain, deformity, deficiency, injury or physical condition of associated tissues of the oral maxillofacial complex. Adds administering botulinum toxin type A and dermal fillers to the oral maxillofacial complex for therapeutic or cosmetic purposes to the practice of dentistry. ¢ 2022 AZ S.B. 1240 (NS), enacted April 13, 2022, effective July 23, 2022, specifying that a dentist, dental therapist or dental hygienist practicing for educational purposes on behalf of a recognized dental school, dental therapy school or dental hygiene school are exempt from licensure requirements; removing the requirement of an applicant for a dental license, dental therapist or dental hygienist license to pass the Western Regional Examining Board Examination and instead requires an applicant to pass clinical examination administered by a state or regional testing agency in the United States; removing the requirement for an applicant for a dental consultant license to have passed the Arizona Dental Jurisprudence Examination; changing the expiration date for a dental professional's license or certificate and dental therapist's license to 30 days after the licensee's or certificate holder's birth month every third year instead of 30 days after their birthday; and changes the deadline to complete a renewal application with the renewal fee to every third year on or before the last day of the licensee's or certificate holder's birth month instead of their birthday. ¢ 2022 AZ REG TEXT 590798 (NS), published August 5, 2022, effective September 12, 2022, amends AZ ADC R4-11-1202 (Continuing Dental Education Compliance and Renewal Requirements) reducing the number of calendar days, from 60 to 35, in which a licensee or denturist selected for audit must provide the Board with Documentation of Attendance that shows compliance with the continuing dental education requirements. Updates the number of required continuing education credit hours and related requirements to conform with updated licensing renewal timeframes. Arkansas 2022 AK REG TEXT 623290 (NS), published September 1, 2022, effective August 31, 2022, amends 12 AK ADC 28.320 (Application for certification to administer local anesthetic agents) and 12 AK ADC 28.935 (Dental hygienist licensure by examination) allowing mannequin-based exams for dental hygienist licensure and for certification to administer local anesthetic agents. California ¢ 2022 CA REG TEXT 597619 (NS), published April 15, 2022, effective July 1, 2022, adopts 16 CA ADC ? 1117 (Reporting Dental Relationships Between Registered Dental Hygienists in Alternative Practice and Licensed Dentists) establishing reporting requirements for registered dental hygienists in alternative practice (RDHAP) to provide documentation of a relationship with at least one licensed dentist located in California for referral, consultation, and emergency services. Requires that the dentist's license must be current, active, and not under discipline prohibiting practice. ¢ 2022 CA REG TEXT 582119 (NS), published June 3, 2022, effective July 1, 2022, amends 16 CA ADC ? 1031 (Supplemental Examinations in California Law and Ethics) deleting the requirement that a candidate pass the supplemental exam in law and ethics with a score of at least 75% and instead requiring an applicant to achieve a criterion-referenced passing score on the exam. Defines 'criterion-referenced passing score'. * 2022 CA REG TEXT 594499 (NS), published May 27, 2022, effective July 1, 2022, adopts 16 CA ADC ? 1138.1 (Unprofessional Conduct) defining additional conduct that qualifies as unprofessional conduct to include: (1) failure to provide requested documentation to the Board; (2) failure to cooperate with Board investigations; and (3) failure to report convictions and disciplinary actions against the licensee. * 2022 CA REG TEXT 599084 (NS), published September 16, 2022, effective January 1, 2023, amends 16 CA ADC ? 1016 (Continuing Education Courses and Providers) updating continuing education requirements. Requires mandatory courses of study for continuing education credit for license renewal to include a Board-approved course on the responsibilities and requirements of prescribing Schedule II opioids. Adds professional ethics as mandatory CE coursework. Provides that a BLS course taught by a provider approved by the American Safety and Health Institute (ASHI) will satisfy the mandatory requirement for certification in Basic Life Support. Adds a requirement that, at a minimum, course content for a Board-approved course on the responsibilities and requirements of prescribing Schedule II opioid drugs shall include the practices for pain management in dentistry, regulatory requirements for prescribers and dispensers, and dental office procedures for managing vulnerable or substance use disorder patients. Adds sexual harassment prevention as an example of the types of course of study in the actual delivery of dental services to the patient or the community that would be acceptable for mandatory CE credit. Adds business planning services and operations as an example of the types of courses to be considered primarily for the benefit to the licensee. Colorado THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. ¢ 2022 CO S.B. 219 (NS), enacted June 7, 2022, effective January 1, 2022, adopts CO ST ? 12-220-407.2 (Application for dental therapist license - fee - rules), CO ST ? 12-220-407.5 (Dental therapist examinations - license) and CO ST ? 12-220-508 (Practice of dental therapy supervision requirement - rules) requiring, on and after May 1, 2023, a person practicing as a dental therapist to be licensed by the Colorado dental board and outlining requirements for dental therapists including education, examination and supervision. * 2022 CO S.B. 58 (NS), enacted June 8, 2022, effective August 10, 2022, Adopts CO ST ? 12-220-507 (Dental hygienist peer health assistance program - fees - rules) creating a peer health assistance program for dental hygienists to assist dental hygienists with physical, emotional, or psychological problems that may be detrimental to the dental hygienist's ability to practice dental hygiene. * 2022 CO REG TEXT 625818 (NS), published September 30, 2022, effective October 4, 2022, adopts 3 CO ADC 709-1:1.32 (Protections for Provision of Reproductive Health Care in Colorado) providing that no licensee or applicant shall be subject to disciplinary action against a professional license or disqualified from professional licensure for providing, assisting, seeking, or obtaining reproductive health care or as a consequence of any civil or criminal judgment, discipline, or other sanction threatened or imposed under the laws of another state so long as the care provided is lawful and consistent with professional conduct and standards of care within the State of Colorado. Adopts 3 CO ADC 709-1:1.33 (Protecting Colorado's Workforce and Expanding Licensing Opportunities) prohibiting a regulator from denying a license to an applicant or from imposing disciplinary action against an individual's license based solely on a civil or criminal judgment or on professional disciplinary action against the applicant or licensee regarding the consumption, possession, cultivation, or processing of marijuana so long as the actions are lawful and consistent with professional conduct and standards of care within Colorado and did not otherwise violate Colorado law. * 2022 CO REG TEXT 629327 (NS), published and effective November 16, 2022, adopts 3 CO ADC 709-1:1.27 (Expanded Scope of Practice for Dentists Pursuant to the Governor's Executive Order D 2022 040) authorizing dentists to perform services while working in a hospital or inpatient facility as delegated by certain health care professionals. Adopts 3 CO ADC 709-1:1.28 (Expanded Scope of Practice for Dentists and Dental Hygienists in Order to Administer Vaccinations Pursuant to the Governor's Executive Order D 2022 040) authorizing dentists and dental hygienists to counsel patients and administer the COVID-19 vaccination while working in a hospital, inpatient facility or outpatient setting under certain conditions and limitations. Delaware 2021 DE S.B. 277 (NS), enacted August 30, 2022, effective November 28, 2022, amends DE ST TI 24 ? 1123 (Examinations) updating the requirements for licensure by examination. Requires an applicant to successfully pass, with a score established by the Board, a validated practical examination prepared and administered by the Board. Provides that an applicant who has failed the practical examination 3 times may not take the examination again unless the applicant can provide evidence of mitigating circumstances to the satisfaction of the Board. Amends DE ST TI 24 ? 1124 (Dentists and dental hygienist licensed in other jurisdictions) reorganizing and clarifying the required criteria to grant a license to practice dentistry or dental hygiene to an applicant licensed in another jurisdiction. Florida * 2022 FL REG TEXT 593538 (NS), published February 1, 2022, effective February 15, 2022, amends 64 FL ADC 6485-17.0011 (Change of Address) updating requirements to provide that each licensee shall provide written notification to the department of the licensee's current mailing address and place of practice. Defines 'place of practice' to mean the primary physical location where the licensee practices the profession of dentistry or dental hygiene. Amends 64 FL ADC 6485-17.003 (Patient Referrals) removing provision that allowed, under certain conditions, the referral of a patient to another health care practice in which the referring dentist or any owner, employee or agent of the referring practice or immediate family member thereof has a financial interest. ¢ 2022 FL REG TEXT 610791 (NS), published May 17, 2022, effective June 2, 2022, amends 64 FL ADC 64B5-14.004 (Continuing Education Requirement) updating continuing education requirements regarding the Medical Emergencies course for dentists to require that each biennium, all dentists who hold an active sedation permit of any level must complete a four-hour board-approved continuing education course in Medical Emergencies. Requires the Medical Emergencies course to include a hands-on airway management component and be taken through a board-approved continuing education provider. ¢ 2022 FL REG TEXT 618887 (NS), published September 7, 2022, effective September 22, 2022, Amends 64 FL ADC 64B5-2.013 (Dental Examination) and 64 FL ADC 64B5-2.0135 (Dental Hygiene Examination) removing provisions that required candidates for the dental examination and for the dental hygiene examination to assess patients in person for suitability as exam patients at a dental office or at an accredited dental program. ¢ 2022 FL REG TEXT 593540 (NS), published October 25, 2022, effective November 9, 2022, amends 64 FL ADC 64B5-13.005 (Disciplinary Guidelines) updating disciplinary guidelines for the Board of Dentistry. Amendments include adding penalty ranges for telehealth registrants. Provides that for telehealth registrants, a suspension may be accompanied by a corrective action plan that addressees the conduct which resulted in the underlying disciplinary violations. The Board may require a corrective action plan be completed prior to reinstatement of the suspended registration or the corrective action plan may follow a suspension for a definite term. Also, establishes penalty ranges for failure to comply with the parental consent requirements of FL ST ? 1014.06 (Parental consent for health care services) and for committing an act that would constitute a violation of any of the offenses listed in FL ST ? 456.074(5) (Certain health care practitioners; immediate suspension of license) or similar offense in another jurisdiction. THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. Hawaii 2021 HI S.B. 2280 (NS), enacted and effective June 17, 2022, adopts new section in 2 HI ST T. 25, Ch. 448, Dentistry, to allow dental assistants to provide auxiliary support dental services in a public health setting under the general supervision of a licensed dentist and under the direction of a licensed dental hygienist. Provides that the supervising licensed dentist shall be responsible for all delegated acts performed by the dental assistant. lowa 2022 IA REG TEXT 623418 (NS), published November 16, 2022, effective December 21, 2022, adopts IA ADC 650-11.8(153) (Dental assistant registration) establishing the requirements for dental assistant registration. Adopts IA ADC 650-11.9(272) (Registration by verification) establishing the requirements for registration by verification. Adopts |A ADC 650-20.3(153) (Dental assistants) establishing the requirements for dental assistant trainees and registered dental assistants. Louisiana * 2022 LA S.B. 324 (NS), enacted June 10, 2022, effective August 1, 2022, updating examination requirements to simply state that the applicant present satisfactory evidence of having taken and passed an examination in the theory and practice of the science of the profession given by the Joint Commission on National Dental Examinations. Removes the requirement that any national, regional, or independent third-party clinical dental licensing examination include procedures performed on human subjects as part of the assessment of restorative clinical competencies, and strikes the paragraph regarding the waiver or modification of this requirement during the specified state of emergency. ¢ 2022 LA REG TEXT 596905 (NS), amends 46 LA ADC Pt XXxiIll, ? 306 (Requirements of Applicants for Dental Licensure by Credentials) removing requirement that the holder of a license establish a practice location and actively practice dentistry in Louisiana within 1 year from the date the license is issued. ¢ 2022 LA REG TEXT 614900 (NS), published and effective September 20, 2022, amends 46 LA ADC Pt XXxIll, ? 322 (Expungement of Disciplinary Actions) allowing a dentist to apply for the expungement of advertising violations after 3 years have elapsed from the date the consent decree was executed by the Board President or order issued after a disciplinary hearing. Makes technical and conforming changes. Amends 46 LA ADC Pt XXxXiIll, ? 1607 (Exemptions) providing a continuing education exemption for dentists holding a retired volunteer dental license who work fewer than 250 hours per calendar year during the renewal period. Provides that if the dentist holding the retired volunteer dental license maintains a sedation permit, the requirements of 46 LA ADC Pt XXxXiIll, ? 1611 (H) (Continuing Education Requirements for Relicensure of Dentists) still apply. ¢ 2022 LA REG TEXT 620129 (NS), published and effective October 20, 2022, adopts 46 LA ADC Pt XXxXiIll ? 702 (General Supervision in Nursing Homes) providing the requirements for a dental hygienist to work under the general supervision of a dentist in a licensed nursing home. Specifies that a dental hygienist who meets the requirements may be referred to as a 'public health dental hygienist'. Provides that certain limitations and restrictions do not apply. Maryland * 2022 MD S.B. 611 (NS) and 2022 MD H.B. 969 (NS) enacted May 12, 2022, effective October 1, 2022, adopts MD HEALTH OCCUP ? 4-318.1 establishing the requirements for the board to order the summary suspension of a license if the board determines there is a substantial likelihood that a licensee poses a risk of harm to the public health, safety, or welfare. * 2022 MD H.B. 968 (NS), enacted May 16, 2022, effective October 1, 2022, establishing the qualifications for a certificate to be an expanded function dental assistant. Minnesota 2022 MN REG TEXT 580173 (NS), published February 7, 2022, effective February 14, 2022, Revises MN ADC 3100, Dentists, Hygienists, and Assistants. Updates definitions. Provides standard license options for dentists, dental therapists, dental hygienists, and licensed dental assistants. Updates educational and examination requirements for licensure by credentials. Adds terms and renewal of license for resident dental therapist and resident dental hygienist. Adds requirements for emeritus active and inactive, guest license, and guest-volunteer licenses. Updates the requirements for professional development, including the removal of the self-assessment examination, changes to the treatment of CPR course/certification, and adding a deadline for extenuating circumstances. Updates conduct unbecoming a licensee. Updates compensation for patient referral to allow a dentist to give a gift to a patient or provide credit for dental services. Eliminates the naming of all the specialty examining boards and instead lists the specialty areas and adds dental anesthesiology, oral medicine, and orofacial pain to the specialty areas. Clarifies rules for licensed dental assistants, including the type of education required for designated procedures and renaming the limited license permit as the limited radiology registration. Makes housekeeping changes throughout the rules for clarity, including terms and renewal of license or registration; reinstatement of a license; administration of nitrous oxide, general anesthesia, and sedation; advertising dental fees and services; assistants without a license; dental hygienists; and record keeping. Repeals obsolete, unnecessary, or duplicative rules. Missouri THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. ¢ 2022 MO REG TEXT 611981 (NS), published August 1, 2022, effective September 30, 2022, amends 20 MO ADC 2110-2.120 (Dental Assistants) to update terminology and to clarify and expand the duties that can be delegated to an Expanded Function Dental Assistant (EFDA). ¢ 2022 MO REG TEXT 617749 (NS), published October 17, 2022, effective November 30, 2022, amends 20 MO ADC 2110-2.050 (Licensure by Examination-Dental Hygienists) specifying the clinical examinations that will be accepted effective January 1, 2023, and authorizing manikin-based clinical exams for dental hygiene licensure. Montana * 2022 MT REG TEXT 598479 (NS), published January 14, 2022, effective January 15, 2022 amends MT ADC 24.138.504 (Approved Clinical Exam Criteria for Dentists and Dental Hygienists) to allow graduates through 2022 to utilize a manikin-based examination. ¢ 2022 MT REG TEXT 613411 (NS), published August 5, 2022, effective August 6, 2022, Amends IMT ADC 24.138.402 (Fee Schedule) to reduce certain credentialing and renewal fees. Amends MT ADC 24.138.504 (Approved Clinical Exam Criteria for Dentists and Dental Hygienists) to allow for the continued use of manikin or simulated patient-based testing in components of the clinical practical exam. New Hampshire 2022 NH REG TEXT 609558 (NS), published March 10, 2022, effective February 8, 2022, amends NH ADC Den 403.07 (Categories of Credit) providing that a licensee shall receive credit for up to 100% of the required CEUs by participating in audio-visual or online webinars, instead of 40% credit. New Jersey ¢ 2022 NJ REG TEXT 539593 (NS), published and effective January 3, 2022, to update the requirements for a dental hygienist scope of practice in school settings; to specify a list and the standards for equipment and supplies that general anesthesia permit holders must have to deal with emergency situations; adds additional requirements for a licensee who administers general anesthesia; and requires offices in which parenteral conscious sedation is conducted to be inspected every 5 years instead of every 6 years. ¢ 2022 NJ REG TEXT 578910 (NS), published and effective January 18, 2022, adopts NJ ADC 13:30-9 (Telemedicine and Telehealth) to establish the requirements for telemedicine and telehealth for a dentist or dental hygienist. New Mexico 2021 NM REG TEXT 593790 (NS), published November 30, 2021, effective December 5, 2021, adopts NM ADC 16.5.1.30 (Criminal Offenders Employment Act) specifying a list of convictions that are disqualifying criminal convictions. Provides that the board shall not consider a criminal conviction as part of an application for licensure and shall not deny, suspend or revoke a license on the sole basis of a criminal conviction unless the conviction in question is one of the specified disqualifying criminal convictions. Provides that nothing in this rule prevents the board from denying an application or disciplining a licensee on the basis of an individual's conduct to the extent that such conduct violated the Dental Health Care Act, regardless of whether the individual was convicted of a crime for such conduct or whether the crime for which the individual was convicted is listed as one of the disqualifying criminal convictions. Provides that the board shall not use, distribute, disseminate, or admit into evidence at an adjudicatory proceeding certain specified criminal records. North Carolina ¢ 2022 NC REG TEXT 607676 (NS), published August 1, 2022, effective July 1, 2022, amends 21 NC ADC 16C.01071 (Licensure) providing that all persons desiring to practice dental hygiene in North Carolina shall pass Board approved written and clinical examinations, as set forth in 21 NC ADC 16C.0303 (Board Approved Examinations), before receiving a license. Amends 21 NC ADC 16G.0103 (Procedures Prohibited) updating the list of items that a dentist shall not delegate to a dental hygienist to allow the administration of local anesthetics by certified dental hygienists under the direct supervision of a North Carolina licensed dentist. Amends 21 NC ADC 16G.0109 (Dental Hygienist Certification to Administer Local Anesthetics) to update the requirements for a dental hygienist to apply for certification to administer local anesthetics. Amends 21 NC ADC 16G.0109 (Dental Hygienist Certification to Administer Local Anesthetics) to update the requirements for a dental hygienist to apply for certification to administer local anesthetics. * 2022 NC REG TEXT 614690 (NS), published November 1, 2022, effective October 1, 2022, adopts 21 NC ADC 16!.0206 (Continuing Education On Substance Abuse And Mental Health) requiring dental hygienists to complete one clock hour of continuing education on substance abuse and mental health every two calendar years. Adopts 21 NC ADC 16R.0206 (Continuing Education On Substance Abuse And Mental Health) requiring dentists to complete one clock hour of continuing education on substance abuse and mental health every two calendar years. North Dakota 2022 ND REG TEXT 608247 (NS), published and effective July 1, 2022, amends multiple sections in ND ADC 20 (State Board of Dental Examiners) to update the licensing requirements for dentists, dental assistants and dental hygienists in North Dakota. The changes include adding and updating definitions; updating the requirements for advertising; updating the anesthesia and sedation permit requirements; and updating the continuing education requirements for dentists. Also updates, the duties, and requirements for registration and continuing education for dental assistants and dental hygienists. THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. Oklahoma 2021 OK S.B. 1432 (NS), enacted May 2, 2022, effective November 1, 2022, removing the Central Regional Dental Testing Service (CRDTS) from the list of acceptable exam entities. Allows for manikins in addition to live patients for certain exam components. Provides that every licensee or permit holder shall have an official address and email address listed with the Board and shall update the address within 30 calendar days of moving. Provides that official notification of any action of the Board adverse to a licensee or permit holder including but not limited to notification of license or permit cancellation due to nonrenewal, notice of a formal complaint, or a decision of the hearing panel or board, shall be served to the licensee or permit holder by registered mail at the official address, in person, to the licensee's or permit holder's attorney, by agreement of the individual, by a process server, or by an Investigator of the Board. Provides that a special volunteer license may be issued for any live patient training approved by the Board. Updates the list of acts or occurrences considered grounds for penalties. Clarifies that the malpractice liability requirement does not apply to dentists practicing or residing in another state or country, who will not practice within Oklahoma during the license renewal year. Provides that a dentist that is residing but not practicing in Oklahoma but wishes to maintain an active license may sign an affidavit stating that the dentist is not practicing dentistry, listing the specific dates during which the dentist will not practice Oregon 2022 OR REG TEXT 611014 (NS), published June 21, 2022, effective July 1, 2022, Adopts and amends multiple sections in OR ADC 181 (Oregon Board of Dentistry) to establish the requirements for dental therapy and issuance of dental therapist licenses due to the passage of 2021 OR H.B. 2528 (NS). Pennsylvania 2022 PA REG TEXT 570025 (NS), published and effective November 5, 2022, amends 49 PA ADC ? 33.3 (Fees) striking the current fee schedule and providing a new schedule of fees charged by the State Board of Dentistry. Tennessee 2021 TN S.B. 1827 (NS), enacted April 14, 2022, effective July 1, 2022, amends TN ST ? 63-5-107 (Licenses; unlawful practice) providing that 'live, interactive webinar' means an internet-based broadcast in which viewers may interact with a presenter in real time. Provides that a live interactive webinar is considered to be in-person continuing education; and not considered remote attendance of an online or web-based course. Texas ¢ 2022 TX REG TEXT 609439 (NS) published May 27, 2022, effective June 2, 2022, adopts 22 TX ADC ? 108.16 (Teledentistry) to establish the standards of practice for teledentistry as provided in 2021 TX H.B. 2056 (NS). * 2022 TX REG TEXT 609438 (NS), published May 27, 2022, effective June 2, 2022, amends 22 TX ADC ? 108.7 (Minimum Standard of Care, General) to update the requirements regarding the limited physical evaluation of dental patients. Provides that each dentist shall perform and review a limited physical examination when a reasonable and prudent dentist would do so under the same or similar circumstances. At a minimum, a limited physical examination should be performed and reviewed annually. Requires, at a minimum, a medical history should be reviewed and updated annually Washington 2022 WA REG TEXT 593661 (NS), published January 19, 2022, effective January 28, 2022, amends VWA ADC 246-817-230 (Dentist retired active status) to require sixty-three hours of continuing education every three years instead of twenty-one hours every year with renewal for a licensed dentist with a retired active status. West Virginia * 2022 WV REG TEXT 586082 (NS), published May 6, 2022, effective July 1, 2022, adopts WV ADC ? 5-16 (Teledentistry) to establish the requirements for teledentistry. * 2022 WV REG TEXT 620854 (NS), published October 28, 2022, effective December 1, 2022, Amends WV ADC ? 5-9 (Application Procedures for Licensure or Certificate) clarifying that each applicant shall submit evidence of graduation with a diploma from an approved dental college, school or dental department of a university; and a transcript is required and must be sent to the Board's office. Removes requirements allowing Board discretion to consider an applicant who is a graduate of an international dental college, school or dental department of a university as being equivalent to programs accredited by the Commission on Dental Accreditation. Also removes requirements regarding moral character reference letters. Wisconsin ¢ 2021 WI S.B. 392 (NS), enacted April 15, 2022, effective April 17, 2022, adopts VV! ST 447.035 (Certification; expanded function dental auxiliaries) and amends WV! ST 447.04 (Licensure; certification) to establish the requirements for the certification and practice of expanded function dental auxiliaries. THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. -10- ¢ 2022 WI REG TEXT 560915 (NS), published January 31, 2022, effective February 1, 2022, adopts WI ADC ? DE 2.035 (Application procedure for service members, former service members, and their spouses) to establish the requirements for reciprocal licensure as a dentist or a dental hygienist for service members, former service members, and their spouses. Wyoming 2022 WY REG TEXT 594372 (NS), published January 26, 2022, effective January 14, 2022, amends multiple sections in WY ADC 034.0001 (Dental Examiners, Board of) to update the requirements for the Dental Examiners Board Practice Act. Updates include changing the license expiration date from an annual renewal to a biennial renewal; updating examination requirements; updating requirements for teledentistry; updating the requirements for licensing by endorsement; updating the continuing education requirements; updating the anesthesia administration and sedation permit procedures; updating the fees; and making multiple other clarifying and conforming changes. Nursing Recent Legislation and Regulation Alabama 2022 AL REG TEXT 615942 (NS), published July 29, 2022, effective September 12, 2022, amends AL ADC 610-X-4-.08 (Renewal of License) updating the requirements for continuing education. Requires, for the first license renewal, 4 contact hours of Board-provided continuing education related to statutory and administrative frameworks for nursing regulation, scope of practice, and standards of practice and 1 contact hour for each calendar month remaining in the earning period up to a maximum of 24 contact hours including the 4 hours of Board-provided continuing education referenced in the section. Alaska ¢ 2022 AK REG TEXT 612828 (NS), published April 22, 2022, effective April 21, 2022, amends 12 AK ADC 44.305 (License by endorsement) updating application requirements related to employment history to require an applicant to include attestation of 320 hours of nursing-related employment in the five years immediately before the date of application. Also changes requirements for the reference letter from the applicant's past employer to require verification that the applicant has been employed in a nursing capacity for at least 320 hours within the last five years before application, instead of the past two years. Removes requirement for the applicant to submit proof of completion of a course of study approved by the board if the applicant has not worked within the preceding five years. ¢ 2022 AK REG TEXT 604392 (NS), published May 14, 2022, effective June 12, 2022, adopts 12 AK ADC 44.312 (Temporary military courtesy licenses or certification to practice as a certified nurse aide, licensed practical nurse, registered nurse, or advanced practice registered nurse) establishing temporary courtesy licenses or certification for an active duty military member or spouse of an active duty military member of the armed forces of the United States. * 2022 AK REG TEXT 609632 (NS), published July 21, 2022, effective August 19, 2022, amends 12 AK ADC 44.290 (Application for examination) providing the application requirements for a practical nurse applicant who has completed the United States Army Practical Nurse Program or Air Force Basic Medical Technician Corpsman Program (BMTCP) 4N051 (5 Skill Level) and who is on active duty or has been discharged for not more than five years from the date of application. Amends 12 AK ADC 44.305 (License by endorsement) updating the application for licensure by endorsement requirements to allow the United States Army Practical Nurse Program, or Air Force Basic Medical Technician Corpsman Program (BMTCP) 4N051 (5 Skill Level) as options for the successful completion of a recognized nursing education program requirement. * 2022 AL REG TEXT 615943 (NS), published July 29, 2022, effective September 12, 2022, amends AL ADC 610-X-4-.16 (Special Circumstances) updating requirements pertaining to applicants who are the eligible spouse of a service member or other qualified individual. Provides that temporary permits or approvals will be valid for 365 days, instead of 180 days. Provides that official documentation of the qualified service member or other qualified individual's relocation to the state may be used to substantiate eligibility. ¢ 2022 AL REG TEXT 615945 (NS), published July 29, 2022, effective August 12, 2022, amends AL ADC 610-X-10-.02 (Continuing Education General Standards) updating requirements to provide access to a wider breadth of continuing education content. Removes language referring to 'the mandatory class" and instead specifies that the Board-provided continuing education related to statutory and administrative frameworks for nursing regulation, scope of practice, and standards of practice described in AL ADC 610-X-4-.08 (Renewal of License) is required for each licensed nurse for the first license renewal period and may be viewed by any licensed nurse at any time. A licensed nurse may receive continuing education credit for completing any of the required courses once each renewal period. ¢ 2022 AL REG TEXT 615941 (NS), published July 29, 2022, effective September 12, 2022, amends AL ADC 610-X-4-.02 (Qualifications Of Applicants For Licensure) establishing a pathway to licensure as an LPN by education equivalency. Provides that students in prelicensure registered nurse programs who have fulfilled the requirements of a practical nursing program may be eligible to apply for the NCLEX-PN for licensure as a practical nurse by education equivalency, at the discretion of the Board. Requires that the student must successfully complete an ABN-approved course on LPN scope of practice prior to receiving approval to sit for the NCLEX- PN. THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. -11- Colorado ¢ 2022 CO S.B. 226 (NS), enacted and effective May 18, 2022, amends CO ST ? 12-255-115 (Volunteer nurse licensure) removing the limitation that prohibits a nurse who holds a volunteer nursing license from accepting compensation for nursing tasks that are performed while in possession of the license. * 2022 CO REG TEXT 627085 (NS), published October 20, 2022, effective October 19, 2022, adopts 3 CO ADC 716-1:1.33 (Protections for Provision of Reproductive Health Care in Colorado) providing that no licensee or applicant shall be subject to disciplinary action against a professional license or disqualified from professional licensure for providing, assisting, seeking, or obtaining reproductive health care or as a consequence of any civil or criminal judgment, discipline, or other sanction threatened or imposed under the laws of another state so long as the care provided is lawful and consistent with professional conduct and standards of care within the State of Colorado. Adopts 3 CO ADC 716-1:1.34 (Protecting Colorado's Workforce and Expanding Licensing Opportunities) prohibiting a regulator from denying a license to an applicant or from imposing disciplinary action against an individual's license based solely on a civil or criminal judgment or on professional disciplinary action against the applicant or licensee regarding the consumption, possession, cultivation, or processing of marijuana so long as the actions are lawful and consistent with professional conduct and standards of care within Colorado and did not otherwise violate Colorado law. Delaware * 2021 DE S.B. 283 (NS), enacted and effective September 8, 2022, amends DE ST TI 24 ? 1713 (Powers and duties of the Board) and DE ST TI 24 ? 1906 (Delaware Board of Nursing--Powers and duties) requiring medical and nursing professionals who work in adult gerontology to complete one hour of continuing education in each reporting period on the topic of diagnosis, treatment, and care of patients with Alzheimer's disease or other dementias. Also makes technical corrections. ¢ 2022 DE REG TEXT 595223 (NS), published February 1, 2022, effective February 11, 2022, amends 24 DE ADC 1900-6.0 (Requirements and Procedures for Licensure) updating the requirements and the procedure for a nurse to be placed on inactive status by the Board. * 2022 DE REG TEXT 615996 (NS) published October 1, 2022, effective October 11, 2022, amends 24 DE ADC 1900-6.0 (Requirements and Procedures for Licensure) requiring applications to be completed online and removing notarization requirements. Amends 24 DE ADC 1900-7.0 (Standards of Nursing Practice) adding that the scope of practice decision tree should be used to determine if a task or procedure is within the scope of the nurse. If all conditions are met, the procedure is within the scope of the nurse. Also provides a website address to the decision tree. Amends 24 DE ADC 1900-10.0 (Disciplinary Proceedings) defining practicing advanced practice, professional or practical nursing in Delaware without an active Delaware license or temporary permit or a privilege to practice under the Nurse Licensure Compact as unprofessional conduct. District of Columbia 2022 DC REG TEXT 614858 (NS), published and effective September 2, 2022, amends 17 DC ADC ? 5404 (National Examination) updating the requirements for applicants to take and pass the National Council Licensure Examination for Registered Nurses (NCLEX- RN). Provides a time limit for any person who fails to take or pass the NCLEX-RN more than 5 years after completing their relevant nursing education or meeting the licensure requirements as a foreign-educated applicant. Amends 17 DC ADC ? 5405 (Licensure by Endorsement) updating requirements by removing the provisions governing the application process and including substantive requirements pertaining to the education and national examination. Amends 17 DC ADC ? 5407 (Reactivation of an Inactive License) updating the requirements for reactivation of a license and clarifying that evidence of sufficient current competency and fitness for reactivation may be established through completion of relevant continuing education, re-entry program, or continuous practice pursuant to a license in good standing in another state. Amends 17 DC ADC ? 5410 (Approved Continuing Education) updating requirements for continuing education credits and clarifying criteria for a continuing education program to qualify for board approval. Amends 17 DC ADC ? 5414 (Scope of Practice) updating the activities included in the practice of registered nursing. Also provides that a registered nurse may accept or perform an activity, intervention, or role that is not within the traditional nursing training or responsibility if certain criteria are met and requires a registered nurse to ensure that a client or patient is fully informed of their role and responsibility as a registered nurse. Florida 2022 FL REG TEXT 606218 (NS), published March 29, 2022, effective April 10, 2022, amends 64 FL ADC 64B9-3.014 (Graduates from International or Non-NCSBN Jurisdictions) requiring an applicant who passed the examination more than five years prior to the application but was not issued a license to take a remedial course prior to licensure. Hawaii ¢ 2021 HI S.B. 2274 (NS), enacted June 17, 2022, effective July 1, 2022, amends HI ST ? 457-9.5 (Center for nursing fee) increasing the center for nursing fee, from $40 to $60, that each nurse is required to pay upon the issuance of a new license and at each license renewal period. THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. -12- ¢ 2021 HI H.B. 1758 (NS), enacted and effective June 27, 2022, amends HI ST ? 457-7 (Registered nurses; qualifications; licenses; fees; title; existing licensed nurses; verification of licenses; eligibility) providing for licensure by endorsement for a registered nurse with a valid, unencumbered license form a territory or foreign country. ¢ 2022 HI REG TEXT 622756 (NS), published August 31, 2022, effective August 11, 2022, adopts new Subchapter 4, Temporary Permits, in Title 16, Chapter 89, establishing the requirements for out-of-state nurses to temporarily practice in Hawaii. Provides that the temporary permit is valid for 90 days. lowa ¢ 2021 IA H.F. 2169 (NS), enacted June 13, 2022, effective July 1, 2022, adopts IA ST ? 155A.33B (Registered nurses - vaccinations and immunizations) authorizing a registered nurse to assist in the administration of immunizations and vaccinations under a pharmacist's order without obtaining a registration from the board. ¢ 2022 IA REG TEXT 608122 (NS), published May 18, 2022, effective June 22, 2022, adopts |A ADC 655-7.9(152) (Standards of practice for telehealth) establishing the licensing requirements and standards of practice for advanced registered nurse practitioners (ARNPs) who provide health care services through telehealth. ¢ 2022 IA REG TEXT 608121 (NS), published May 18, 2022, effective June 22, 2022, adopts IA ADC 655-6.4(152) (Telehealth) establishing the licensing requirements and minimum standards of practice for registered nurses (RNs) and licensed practical nurses (LPNs) who provide health care services through telehealth. Kansas * 2022 KS REG TEXT 606704 (NS), published February 3, 2022, effective January 26, 2022, amends KS ADC 60-3-101 (Licensure) updating the requirements for licensure by examination and licensure by endorsement pursuant to KS ST 65-1115 (Licensure of professional nurses; qualifications of applicants; examination; refresher course; renewal license; title and abbreviation; temporary permit; exempt license) and KS ST 65-1116 (Licensure of practical nurses; qualifications of applicants; examination; refresher course; renewal license; title and abbreviation; temporary permit; exempt license). Updates examination requirements. Requires verification of a current Kansas license to be provided to other state boards upon the applicant's request and payment of the fee. Adds requirements for licensure for endorsement pursuant to KS ST 48-3406 (Expedited state licensure procedure if licensed, registered or certified in another state for military servicemembers or military spouses) and requirements for temporary emergency license. ¢ 2022 KS REG TEXT 602919 (NS), published April 21, 2022, effective May 6, 2022, to update terminology to use 'applicant' instead of 'candidate" and updates the examination requirements. Requires verification of a current Kansas license to be provided to other state boards upon the applicant's request and payment of the required fee. Defines 'active practice" and 'similar scope of practice" for purposes of licensure for endorsement pursuant to KS ST 48-3406 (Expedited state licensure procedure if licensed, registered or certified in another state for military service members, military spouses or individuals who have established or intend to establish residency in this state; temporary emergency licenses; reports by licensing bodies). Establishes requirements for temporary emergency licensure. Kentucky * 2022 KY S.B. 10 (NS), enacted and effective April 7, 2022, amends KY ST ? 314.041 (Registered nurse license; jurisprudence examination; use of 'R.N.A." by provisional licensee; use of 'R.N."; special license; reinstatement; limited license) providing for issuance of a temporary work permit and licensure by endorsement for a registered nurse in good standing in another state or territory or who is a graduate of a foreign nursing school. Amends KY ST ? 314.101 (Excepted activities and practices; work permits; withdrawal of temporary work permits) clarifying that the practice of any currently licensed nurse in good standing in another state may be recognized as having a temporary work permit in Kentucky. Removes requirement that an emergency declared by the President of the United States or the Governor of Kentucky exist. Provides that any currently licensed nurse in good standing in another state who is practicing nursing in Kentucky must be subject to the jurisdiction of the Board. Removes language limiting the practice of any currently licensed nurse of another state that is not a member of the Nurse Licensure Compact. * 2022 KY REG TEXT 609067 (NS), published June 1, 2022, effective May 10, 2022, adopts 201 KY ADC 20:480E (Licensure of graduates of foreign nursing schools) to amend 201 KY ADC 20:480 (Licensure of graduates of foreign nursing schools) updating the requirements for applicants who are graduates of foreign nursing schools and the requirements for English Language Proficiency examinations. ¢ 2022 KY REG TEXT 611341 (NS), published October 1, 2022, effective August 25, 2022, amends 201 KY ADC 20:110 (Licensure by endorsement) clarifying that to be eligible for licensure by endorsement, an applicant must have completed requirements found equivalent to a state program of nursing. Clarifies that an applicant must submit a new application and fee after 1 year if the requirements for licensure have not been met. Clarifies that the applicant must meet all the continuing education course learning requirements in 201 KY ADC 20:215(Section 5) (Continuing competency requirements)) that are required for the applicant's licensure. Louisiana 2022 LA REG TEXT 609931 (NS), published March 24, 2022, effective March 23, 2022, rescinds emergency rule 46 LA ADC Pt XLVII, ? 3327 (Licensure by Endorsement) which allowed RNs and APRNs with a current, active, unencumbered, unrestricted out-of- THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. -13- state license working under the emergency proclamation to continue working for a 90-day transition period following the expiration of the Covid-19 public health emergency. 2022 ME REG TEXT 608565 (NS), published June 15, 2022, effective June 13, 2022, adopts ME ADC 02-380 Ch. 13, Criminal History Record Information, establishing the requirements for fingerprint-based background checks for all applicants to the Board of Nursing for initial licensure or licensure by endorsement, including applications for multistate licensure. Maryland ¢ 2022 MD H.B. 1208 (NS), enacted May 29, 2022, effective June 1, 2022, amends MD HEALTH OCCUP ? 8-312 (Expiration, renewal of license) requiring the renewal application form to include the workforce data information required by MD HEALTH OCCUP ? 8-205 (Additional powers and duties of Board). ¢ 2022 MD REG TEXT 607613 (NS), published February 11, 2022, effective January 4, 2022, amends iD ADC 10.27.01.03 (Licensure Exceptions) to allow a registered nurse or licensed practical nurse who holds a current active license in another state or jurisdiction to provide nursing care for 30 days or until June 29, 2022, whichever is later. Also allows a nursing graduate to practice as specified when an application for a license is pending before the Board and certain circumstances regarding the NCLEX examination exist. Provides that a nursing graduate shall cease practice as a nursing graduate no later than 120 days after the application is submitted to the Board or immediately upon failure of the NCLEX examination. Amends MD ADC 10.27.01.17 (Reinstatement) to allow the Board to issue a temporary license to a former licensee who meets certain requirements. Provides that the temporary license is effective until the earlier of 90 days after the date of issue or the date the Board issues an active license. * 2022 MD REG TEXT 626181 (NS), published October 7, 2022, effective September 7, 2022, amends MD ADC 10.27.01.03 (Licensure Exceptions) providing that beginning July 1, 2022, a nursing graduate may practice as specified when an application for a license is pending before the Board and certain circumstances regarding the NCLEX examination exist. Provides that a nursing graduate shall cease practice as a nursing graduate no later than 120 days after the application is submitted to the Board or immediately upon failure of the NCLEX examination. Amends MD ADC 10.27.01.17 (Reinstatement) providing that beginning July 1, 2022, the Board may issue a temporary license to a former licensee who meets certain requirements. Provides that the temporary license is effective until the earlier of 90 days after the date of issue or the date the Board issues an active license. Michigan 2022 MI REG TEXT 602920 (NS), published June 15, 2022, effective May 24, 2022, updating the requirements for an applicant to take the NCLEX-RN examination; updating the requirements for licensure by endorsement from another state and adding the requirements for reciprocity from Canada; and updating the requirements for a registered professional nurse who has let their license lapse in Michigan and is not currently licensed in another state or Canadian province and the requirements for a registered professional nurse who has let their license lapse in Michigan and holds a current and valid license in good standing in another state or Canadian province. Also authorizes sanctions when relicensure is granted, and it is determined that a sanction has been imposed by another state, the United States military, the federal government, or another country. New Hampshire ¢ 2022 NH REG TEXT 604332 (NS), published January 15, 2022, effective December 3, 2021, adopts NH ADC NUR 302.015 (Restricted Licensure Pending Criminal Records Check) establishing the requirements for a nursing applicant who meets all other qualifications to be issued a restricted, single-state license pending receipt of the results of the criminal records check. * 2022 NH REG TEXT 611609 (NS), published April 7, 2022, effective February 28, 2022, amends NH ADC NUH 4071 (Renewal and Reinstatement) to update renewal and reinstatement requirements for nursing licenses. The current rules require applicants for renewal or reinstatement to meet certain 'active in practice' requirements and, if those requirements cannot be met, to participate in a re-entry program approved by the Board. The amendments limit the 'active in practice' requirements to those who have not held a license for more than 5 years, to increase the number of nursing professionals who are eligible to have a license reinstated in New Hampshire. New Jersey 2022 NJ REG TEXT 543632 (NS), published and effective January 18, 2022, amends NJ ADC 13:37-2.3 (Application requirements; graduates of foreign nursing programs) providing that a graduate of a foreign registered professional nursing program who has not taken courses in medical, surgical, pediatric, obstetric, or psychiatric nursing shall complete a course in the area(s) of deficiency offered by a registered professional nursing program accredited by the Board. New Mexico 2021 NM REG TEXT 591719 (NS), published November 30, 2021, effective December 30, 2021, adopts NM ADC 16.12.12 (Discipline and Application Denials) to establish procedures for disciplinary and application proceedings conducted by the Board as well as the substantive grounds for disciplinary action and application denials by the Board. New York THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. -14- 2022 NY REG TEXT 6250714 (NS), published September 28, 2022, effective September 13, 2022, amends 8 NY ADC 64.7 (Administration of immunizations, emergency treatment of anaphylaxis, tuberculosis tests, human immunodeficiency virus (HIV) tests, opioid related overdose treatments, hepatitis C tests and screening for syphilis, gonorrhea, COVID-19, influenza and/or chlamydia infections pursuant to non-patient specific orders and protocols) adding a new section to permit registered professional nurses (RNs) to administer COVID-19 or influenza tests pursuant to a non-patient specific order issued by a licensed physician or a certified nurse practitioner. Nevada 2022 NV REG TEXT 607731 (NS), published and effective June 13, 2022, adopts uncodified section in NV ADC 632 (Nursing) establishing the requirements for a licensed nurse to delegate nursing care to certain other persons and supervise such other persons in the provision of such care. New York 2021 NY A.B. 1264 (NS), introduced January 8, 2022, provides for the award of scholarships and loan forgiveness for nurses on the same terms as physicians. Ohio 2022 OH REG TEXT 5963271 (NS), published January 11, 2022, effective February 1, 2022, to clarify the criminal records check requirements; and updating the requirements for providing evidence of possessing a working knowledge of the English language. Oklahoma 2022 OK REG TEXT 630609 (NS), published December 1, 2022, effective November 7, 2022, amends OK ADC 485:10-11-4 (Licensure or certification of individuals with criminal history) to update the list of felony convictions disqualifying individuals from retaining or becoming licensed in Oklahoma. Adds a list of felony convictions that disqualify an individual from retaining licensure or becoming licensed as a nurse or retaining certification or becoming certified as an AUA in Oklahoma if a conviction or plea of guilty or nolo contendere for which less than five years has elapsed since the date of the conviction, plea, or release from incarceration, whichever is later. Oregon * 2022 OR REG TEXT 613147 (NS), published April 25, 2022, effective May 1, amends OR ADC 851-031-0040 (Nurses Not Licensed in Oregon Hired to Meet a Temporary Staffing Shortage) to change length of time of licensure exemptions from 60 days to 90 days plus one 30-day extension. * 2022 OR REG TEXT 605966 (NS), published July 26, 2022, effective August 1, 2022, amends OR ADC 851-045-0060 (Scope of Practice Standards for Registered Nurses) striking language related to an RN delegating the performance of a nursing procedure to an unregulated assistive person (UAP). Clarifies that an RN who is employed by a public or private school, or by an education service district or a local public health authority to provide nursing services at a public or private school, may accept an order from a physician licensed to practice medicine in another state or territory of the United States if the order is related to the care or treatment of a student who has been enrolled at the school for not more than 90 days. Pennsylvania ¢ 2022 PA REG TEXT 575887 (NS), published and effective March 26, 2022, amends and adopts multiple sections in 49 PA ADC ? 21 (State Board of Nursing) to update the requirements regarding child abuse recognition and reporting. Requires nurse applicants and volunteer licensees to submit proof of completion of approved training in child abuse recognition and reporting. Requires approved continuing education in child abuse recognition and reporting for license renewals. Updates the definitions and mandatory requirements in Subchapter E. Child Abuse Reporting Requirements. * 2021 PA H.B. 889 (NS), enacted June 10, 2022, effective August 9, 2022, amends PA ST 63 P.S. ? 215 (Examinations and certificates) to allow graduates of nursing programs or dietetics-nutrition education programs in countries outside of the United States to sit for the RN licensure examination, without first being licensed, registered or duly recognized in their home country. Oklahoma 2022 OK REG TEXT 605232 (NS), published January 18, 2022, effective October 28, 2021, adopts OK ADC 485:10-23-2 (Continuing qualifications waiver for licensure/certification reinstatement) waiving certain continuing qualification requirements for licensure reinstatement of a temporary license or certification for Registered Nurses, Licensed Practical Nurses and Advanced Unlicensed Assistants through September 14, 2022, or until superseded by another rule. Adopts OK ADC 485:10-23-3 (Temporary licensure waiver for individuals holding a license issued by any state) waving certain listed requirements to allow any individual who, upon application, holds an unencumbered nursing license issued by any state, meeting of qualifications for the practice of nursing to be issued a temporary nursing license at the same level of licensure held in the other state. Texas THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. -15- ¢ 2021 TX REG TEXT 593265 (NS), published December 24, 2021 effective December 26, 2021, adopts 26 TX ADC ? 556.100 (Nurse Aide Transition from Temporary Status) establishing the process for individuals who have been trained as nurse aides and have been completing nurse aide tasks under a waiver to become certified as nurse aides. ¢ 2022 TX REG TEXT 603883 (NS), published March 11, 2022, effective March 15, 2022, amends 22 TX ADC ? 217.5 (Temporary License and Endorsement) removing the requirement for proof of a military spouse's residency in Texas in the provisions for out-of- state licensure of a military spouse. ¢ 2022 TX REG TEXT 622243 (NS), published October 7, 2022, effective October 13, 2022, amends 22 TX ADC ? 217.5 (Temporary License and Endorsement) to update the educational requirements for endorsement applicants who graduated from an out-of-state nursing education program. ¢ 2022 TX REG TEXT 622241 (NS), published October 14, 2022, effective October 18, 2022, amends 22 TX ADC ? 213.28 (Licensure of Individuals with Criminal History) updating the requirements and the Disciplinary Guidelines for Criminal Conduct table to provide that in accordance with Texas Occupations Code Chapter 108, Subchapter B, the Board is required to deny or revoke, as applicable, the license of an individual who: (A) is required to register as a sex offender under the Code of Criminal Procedure Chapter 62; (B) has been previously convicted of or placed on deferred adjudication community supervision for the commission of a felony offense involving the use or threat of force; or (C) has been previously convicted of or placed on deferred adjudication community supervision for the commission of an offense: (i) under the Texas Penal Code ?? 22.011, 22.02, 22.021, or 22.04 or an offense under the laws of another state or federal law that is equivalent to an offense under one of these sections; (ii) committed when the individual held a license as a health care professional in Texas or another state and in the course of providing services within the scope of the individual's license; and (iii) in which the victim of the offense was a patient of the individual. Provides that an individual's eligibility for reapplication or reinstatement of licensure will be governed by the Texas Occupations Code Chapter 108, Subchapter B. Vermont 2021 VT H.B. 472 (NS), introduced January 7, 2022, proposes to create the Vermont Nursing Scholarship Program for nursing students who commit to working as a nurse in Vermont for at least one year for each year of scholarship awarded. The Program would replace an existing nursing loan and loan repayment program. Virginia * 2022 VA S.B. 169 (NS), enacted April 7, 2022, effective July 1, 2022, amends VA ST ? 54.1-2972 (When person deemed medically and legally dead; determination of death; nurses', licensed practical nurses', or physician assistants' authority to pronounce death under certain circumstances) to extend to licensed practical nurses the authority to pronounce the death of a patient in hospice, provided that certain conditions are met. ¢ 2022 VA H.B. 286 (NS), enacted April 7, 2022, effective July 1, 2022, amends VA ST ? 54.1-2972 (Filing death certificates; medical certification; investigation by Office of the Chief Medical Examiner) to define autonomous nurse practitioners and allow them to declare death and determine cause of death. Allows nurse practitioners who are not autonomous nurse practitioners to pronounce the death of a patient in certain circumstances; and eliminates the requirement for a valid Do Not Resuscitate Order for the deceased patient for declaration of death by a registered nurse, physician assistant, or nurse practitioner who is not an autonomous nurse practitioner. Washington * 2022 WA REG TEXT 600186 (NS), published August 3, 2022, effective December 1, 2022, amends WA ADC 246-840-990 (Fees and renewal cycle) to increase certain application and renewal fees for RNs, LPNs and ARNPs. ¢ 2021 WAH.B. 1124 (NS), enacted March 11, 2022, effective June 9, 2022, amends WA ST 18.79.260 (Registered nurse--Activities allowed--Delegation of tasks) to update the requirements for the registered nurse delegator when delegating insulin injections. Also provides that the delegation of nursing care tasks only to registered or certified nursing assistants under WA ST 18.88A (Nursing Assistants) or to home care aides certified under WA ST 18.88B (Long?Term Care Workers) may include glucose monitoring and testing. Effective July 1, 2022, removes 'osteopathic physician assistant' from the list of professionals that may provide general direction to a registered nurse. ¢ 2022 WA REG TEXT 559815 (NS), published October 5, 2022, effective September 9, 2022, amends WA ADC 246-840-930 (Criteria for delegation) requiring a nursing assistant or home care aide to complete the basic caregiver training in accordance with dates established by the department of social and health services. Amends WA ADC 246-841-405 (Nursing assistant delegation) providing that nursing assistants who were working or hired during the COVID-19 public health emergency must complete basic caregiver training by dates established by the department of social and health services. West Virginia ¢ 2022 WV S.B. 518 (NS), enacted March 28, 2022, effective March 12, 2022, amends and reenacts multiple sections in WV ST ? 30-7 (Registered Professional Nurses) updating the board membership; updating the board's powers; updating licensure requirements; updating the requirements for temporary permits; providing license requirements for license renewal; reconstituting the nursing shortage study commission; and removing outdated provisions. THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. -16- ¢ 2022 WV REG TEXT 590643 (NS), published May 6, 2022, effective May 3, 2022, adopts WV ADC ? 19-16 (Telehealth Practice; Requirements; Definitions) to establish the procedures for the practice of telehealth by a registered nurse or advanced practice registered nurse. Wisconsin 2022 WI REG TEXT 573192 (NS), enacted March 28, 2022, effective April 1, 2022, adopts WI ADC ? N 2.23 (Reciprocal credentials for service members, former service members, and their spouses) providing that a reciprocal multistate or single state license shall be granted to a service member, former service member, or the spouse of a service member or former service member who the board determines meets all of the requirements under VV! ST 440.09 (Reciprocal credentials for service members, former service members, and their spouses). Provides that the board may request verification necessary to make a determination as to service member or former service member status under this subsection. Pharmacist Recent Legislation and Regulation Alabama * 2022 AL REG TEXT 613486 (NS), published July 29, 2022, effective September 12, 2022, amends AL ADC 680-X-2-.16 (Practical Training Programs Standards) updating requirements for interns/externs. Provides that the intern/extern permit expires on December 31 of odd numbered years and the initial permit fee and renewal fee is fifty dollars ($50). Requires the applicant to consent to and be subject to a Board approved criminal background check. Removes certain requirements related to the practical training externship/ internship report and affidavits. * 2022 AL REG TEXT 621043 (NS), published September 30, 2022, effective November 14, 2022, amends AL ADC 680-X-2-.36 (Continuing Education for Pharmacists) requiring pharmacists with only 1 full calendar year of licensure to complete 15 hours of continuing education for their first renewal and 3 of those hours must be live continuing education. Provides that licensees with less than 1 full calendar year do not have to complete continuing education as part of their first renewal. ¢ 2022 AL REG TEXT 623558 (NS), published October 31, 2022, effective December 15, 2022, amends AL ADC 680-X-2-.22 (Code of Professional Conduct) adding further provisions relating to the safe practice of pharmacy. Requires a pharmacy to provide an environment that allows for the proper exercise of professional judgment and skill by pharmacists and prohibits an environment that may cause a deterioration of the quality of professional services, or that require unethical conduct. Alaska ¢ 2021 AK H.B. 145 (NS), enacted June 30, 2022, effective September 28, 2022, amends AK ST ? 08.80.168 (Administration of vaccines and related emergency medications) authorizing a pharmacist to 'prescribe' a vaccine in addition to administering a vaccine. Adds a new subsection to allow a pharmacy technician to administer a vaccine or related emergency medication if they have been authorized by the Board of Pharmacy to do so and if they are under the direct supervision of a licensed pharmacist. Adopts AK ST ? 08.86.337 allowing a pharmacist to provide patient care services for a disease or condition with an existing diagnosis under an agreement made with and approved by a practitioner. Limits patient care services that pharmacists can provide and allows pharmacists to be compensated for providing these services. * 2022 AK REG TEXT 606712 (NS), published June 14, 2022, effective July 7, 2022, adopts 12 AK ADC 52.105 (Temporary military courtesy license) establishing an expedited licensing pathway to obtain a temporary military courtesy license for an active duty military member or spouse of an active duty military member of the armed forces of the United States to practice as a pharmacist, pharmacy intern, or pharmacy technician. Amends 12 AK ADC 52.300 (License renewal) updating language to be all inclusive of pharmacy license and registration types. Clarifies that licenses must be renewed biennially on or before a date set by the department and renewal applications must be on a form provided by the department. Adds that all renewal applications will be administratively processed and will not require board review unless the executive administrator has reason to believe that renewing the license poses an immediate threat to public health or safety. Arizona 2022 AZ S.B. 1374 (NS), enacted July 6, 2022, effective September 24, 2022, amends AZ ST ? 32-1974 (Pharmacists; administration of immunizations, vaccines and emergency medications; certification; reporting requirements; advisory committee; definition) updating requirements to allow pharmacists to order and administer immunizations or vaccines recommended by the U.S. Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) for children at least six years old, rather than just for adults. Allows pharmacists to administer immunizations or vaccines to a person who is at least three years old with a prescription order or under a collaborative practice agreement. Provides additional requirements for a pharmacist who administers an immunization, vaccine or emergency medication, including requiring a pharmacist to: a) report information to the Arizona State Immunization Information System (ASIIS); b) notify the Vaccine Adverse Event Reporting System in accordance with ACIP recommendations; c) provide vaccine information materials to those requesting immunizations or vaccines; d) provide educational materials to a person's parent or guardian about the importance of pediatric preventive health care visits as recommended by the American Academy of Pediatrics for person's under 18 years old; and e) follow standing operating procedures adopted by the pharmacy or institution where THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. -17- the immunization, vaccine or emergency medication is administered that are based upon the vaccine administration protocols and immunization practices published in the CDC's MMWR. California * 2022 CA REG TEXT 592546 (NS), published January 28, 2022, effective April 1, 2022, amends 16 CA ADC ? 1704 (Providing Addresses) to require that each applicant and person holding a certificate, license, permit, registration, or exemption to practice, who has an electronic mail (email) address, provide the board with the email address and maintain a current email address, if any. Additionally, requires the individual to notify the board of any change in their email address within 30 days of the change. * 2022 CA REG TEXT 596026 (NS), published February 4, 2022, effective January 25, 2022, amends 16 CA ADC ? 1746.4 (Pharmacists Initiating and Administering Vaccines) removing the 14-day mandatory reporting requirement to each patient's PCP of any vaccine administration and instead requiring reporting to the patient's PCP only if requested by the patient. ¢ 2021 CA A.B. 852 (NS), enacted September 25, 2022, effective January 1, 2023, amends CA BUS & PROF ? 688 (Electronic data transmission prescriptions; prescriptions for controlled substances; transfer or forward of prescriptions; transmission failure; valid prescriptions; administrative sanctions; liability; services to inmates) prohibiting a pharmacy, pharmacist, or other practitioner authorized to dispense or furnish a prescription from refusing to dispense or fumish an electronic prescription solely because the prescription was not submitted via, or is not compatible with, their proprietary software. Also authorizes a pharmacy, pharmacist, or other authorized practitioner to decline to dispense or furnish an electronic prescription submitted via software that fails to meet any one of specified criteria. Establishes additional exceptions to the requirement that health care practitioners issue a prescription as an electronic data transmission prescription and makes specified exceptions to the requirement for a pharmacy to immediately transfer an electronic prescription to an alternative pharmacy upon request of the patient, including if the action would result in a violation of any state or federal law. ¢ 2021 CAA.B. 2194 (NS) enacted September 30, 2022, effective January 1, 2023, amends operative on January 1, 2024, CA BUS & PROF ? 4231 (Renewal certificates; proof of successful completion of courses), to require pharmacists, as part of the 30 hours of mandatory continuing education, to submit proof of completion of at least one hour of participation in a cultural competency course, as defined, for license renewal. Colorado * 2022 CO REG TEXT 625813 (NS), published September 30, 2022, effective September 29, 2022, adopts 3 CO ADC 719-1:32.00.00 (Protections for Provision of Reproductive Health Care In Colorado) providing that no licensee or applicant shall be subject to disciplinary action against a professional license or disqualified from professional licensure for providing, assisting, seeking, or obtaining reproductive health care or as a consequence of any civil or criminal judgment, discipline, or other sanction threatened or imposed under the laws of another state so long as the care provided is lawful and consistent with professional conduct and standards of care within the State of Colorado. Adopts 3 CO ADC 719-1:33.00.00 (Protecting Colorado's Workforce and Expanding Licensing Opportunities) prohibiting a regulator from denying a license to an applicant or from imposing disciplinary action against an individual's license based solely on a civil or criminal judgment or on professional disciplinary action against the applicant or licensee regarding the consumption, possession, cultivation, or processing of marijuana so long as the actions are lawful and consistent with professional conduct and standards of care within Colorado and did not otherwise violate Colorado law. ¢ 2022 CO REG TEXT 622179 (NS), published October 20, 2022, effective November 30, 2022, adopts 3 CO ADC 719-1:32.00.00 (Protections for Provision of Reproductive Health Care In Colorado) providing that no licensee or applicant shall be subject to disciplinary action against a professional license or disqualified from professional licensure for providing, assisting, seeking, or obtaining reproductive health care or as a consequence of any civil or criminal judgment, discipline, or other sanction threatened or imposed under the laws of another state so long as the care provided is lawful and consistent with professional conduct and standards of care within the State of Colorado. Adopts 3 CO ADC 719-1:33.00.00 (Protecting Colorado's Workforce and Expanding Licensing Opportunities) prohibiting a regulator from denying a license to an applicant or from imposing disciplinary action against an individual's license based solely on a civil or criminal judgment or on professional disciplinary action against the applicant or licensee regarding the consumption, possession, cultivation, or processing of marijuana so long as the actions are lawful and consistent with professional conduct and standards of care within Colorado and did not otherwise violate Colorado law. Delaware ¢ 2021 DE H.B. 399 (NS), enacted and effective October 3, 2022, Adopts DE ST Tl 24 ? 2525 (Testing, screening, and treatment of health conditions) establishing the requirements for a pharmacist to order, test, screen, and treat certain specified health conditions. * 2022 DE REG TEXT 611240 (NS), published July1, 2022, effective July 11, 2022, amends 24 DE ADC 2500-14.0 (Administration of Injectable Medications, Biologicals and Adult Immunizations) providing that certified pharmacy technicians may only administer adult immunizations pursuant to the training, administration and documentation requirements set forth in 24 DE ADC 2500-19.0 (Technicians: Qualifications, Training, and Duties), subsection 19.2.3. Also clarifies the CPR certification requirements providing that CPR certification must be obtained through a CPR course for health care providers and the course must have a hands-on, skills check component. Florida THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. -18- 2022 FL REG TEXT 621863 (NS) published October 4, 2022, effective October 19, 2022, amends 64 FL ADC 64B16-26.103 (Continuing Education Credits; Renewal) requiring an additional 2 hours of continuing education in the area of vaccine administration for registered pharmacy technicians that maintain an immunization certification. Illinois 2021 IL H.B. 4430 (NS), enacted June 10, 2022, effective January 1, 2023, adopts IL ST CH 225 ? 85/43.5 (HIV prophylaxis) establishing the requirements for pharmacists to provide patients with prophylaxis drugs for human immunodeficiency virus pre- exposure prophylaxis or post-exposure prophylaxis. lowa ¢ 2021 IA REG TEXT 590591 (NS), published December 15, 2021, effective January 19, 2022, rescinds |A ADC 657-39.8(155A) (Statewide protocol-naloxone) and adopts IA ADC 657-39.8(155A) (Medications administered via prescriptions) authorizing pharmacists to administer vaccines and medication via patient-specific prescriptions and requiring reporting of serious complications from the administration of vaccines or medication ¢ 2022 IA REG TEXT 611494 (NS), published July 27, 2022, effective August 31, 2022, amends IA ADC 657-3.21(155A) (Delegation of functions) clarifying that an lowa-licensed supervising pharmacist may delegate any technical or nontechnical functions in the operation of the pharmacy, except those prohibited in |A ADC 657-3.23(155A) (Functions a pharmacy technician shall not perform), to an appropriately trained and lowa-registered pharmacy technician. Removes on-site supervision requirement. Establishes the requirements for a supervising pharmacist to delegate technical functions relating to prescription processing to a certified pharmacy technician who is performing the delegated functions at a location that is not a licensed pharmacy. Kansas 2021 KS S.B. 200 (NS), enacted April 18, 2022, effective April 28, 2022, adopts new section, effective July 1, 2022, allowing a pharmacist to initiate therapy within the framework of a statewide protocol for influenza, streptococcal pharyngitis, or urinary tract infection. Provides requirements for the statewide protocol established by the collaborative drug therapy management advisory committee. Allows the Board to deny an application or renewal or revoke or suspend the license of a pharmacist upon finding that the pharmacist has violated these provisions or failed to practice within the framework of statewide protocols. Kentucky ¢ 2022 KY REG TEXT 592722 (NS), published January 1, 2022, effective December 15, 2021, amends 201 KY ADC 2:050 (License and permits; fees) increasing the annual renewal of a pharmacist license fee and the delinquent renewal penalty for a pharmacist license to $95 up from $70. * 2022 KY REG TEXT 595647 (NS), published February 1, 2022, effective February 3, 2022, amends 201 KY ADC 2:030 (License transfer) to update the requirements for licensure by reciprocity. Updates the list of information that must be provided, including actions against prior licenses and other disciplinary actions, conditions or impairments that affect the ability to practice pharmacy, and applications for licensure that have been denied. * 2022 KY REG TEXT 621102 (NS), published August 1, 2022, effective June 27, 2022, adopts 201 KY ADC 2:413E (Ordering and administering vaccinations) establishing the requirements for a pharmacist to prescribe and administer vaccinations to individuals age 3 and up. Establishes the requirements for pharmacy technicians and pharmacist interns to administer vaccinations to individuals age 3 and older. ¢ 2022 KY REG TEXT 623041 (NS), published September 1, 2022, effective August 8, 2022, updating the procedures for a pharmacist or pharmacists to initiate the dispensing of noncontrolled medications, over-the-counter medications, or other professional services. Removes pharmacist education and training requirements related to prescriber-approved protocols. Removes the list of conditions that Board-authorized protocols may be established for. ¢ 2022 KY REG TEXT 613798 (NS), published October 1, 2022, effective August 25, 2022, amends 201 KY ADC 2:020 (Examination) updating the requirements for examination for licensure, including limits on the number of attempts and requiring additional training for unsuccessful attempts. Clarifies an applicant must submit a fee. Updates material that is incorporated by reference and provides a Web site where the material may be inspected, copied, or obtained. Maryland * 2022 MD REG TEXT 607615 (NS), published February 11, 2022, effective January 1, 2022, amends MD ADC 10.34.13.04 (Waiver) to temporarily waive the continuing education requirements for a pharmacist who holds a license that expires between January 1, 2021, and June 30, 2022, and meets the other stated requirements. This provision is effective January 1, 2022, and is repealed on the earlier of June 30, 2022, or the end of the federal COVID-19 Public Health Emergency. Amends IMD ADC 10.34.15.01 (Requirements) to temporarily waive certain requirements for licensure as a pharmacist by reciprocity. The Board's authority to grant this waiver is effective January 1, 2022, and is repealed on the earlier of June 30, 2022, or the end of the federal COVID-19 Public Health Emergency. THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. -19- ¢ 2022 MD REG TEXT 607628 (NS), published June 3, 2022, effective June 13, 2022, adopts WD ADC 10.34.41.04 (Training Program Requirements) requiring a pharmacist to successfully complete a Board-approved training program for the administration of injectable maintenance medications prior to administering injectable maintenance medications unless the pharmacist has undergone the training as part of a formal education program. Also authorizes a pharmacy student in a Pharmacy Experiential Program or a registered pharmacy intern who has successfully completed the specified Board-approved certification course to administer a maintenance injectable medication under the direct supervision of a qualified licensed pharmacist. Mississippi 2022 MS REG TEXT 626972 (NS), published October 17, 2022, effective October 13, 2022, repeals 30 MS ADC Pt. 3002, Chapter 4, Penalties, and replaces with new 30 MS ADC Pt. 3002, R. 4.1 (Uniform Penalty Policy) providing that any penalty imposed by Board pursuant to a violation of any statute, rule or regulation within the jurisdiction of the Board shall be not less than the minimum nor more than the maximum penalty allowed by Mississippi Code. Missouri ¢ 2022 MO H.B. 2162 (NS), enacted June 16, 2022, effective August 28, 2022, Amends iO ST 195.206 (Opioid antagonist, sale and dispensing of by pharmacists, possession of--administration of, contacting emergency personnel-- immunity from liability, when) adding a definition of 'Addiction mitigation medication' and authorizing a licensed pharmacist to sell and dispense an addiction mitigation medication under a physician protocol or a statewide standing order. Provides immunity. Allows any person to possess an addiction mitigation medication. ¢ 2022 MO REG TEXT 617755 (NS), published October 17, 2022, effective November 30, 2022, amends 20 MO ADC 2220-7.030 (Pharmacist Licensure by Examination) updating language, incorporating current application procedures from the National Association of Boards of Pharmacy, and clarifying requirements and restrictions for taking and passing the required licensure examinations. Requires a completed state and federal criminal history background check. Updates the 1500 hours of pharmacy practice experience and the requirements for experience earned in another state. Requires applicants to pass both the NAPLEX and MPJE exams within 2 years of submitting their application for licensure by examination to the board. Provides that the board or its designee must approve any applicant who fails the NAPLEX or MPJE 3, rather than 2, consecutive times prior to retest. Specifies that applicants who fail the NAPLEX 5 times shall not be declared eligible to retake the NAPLEX, and applicants who fail the MPJE 5 times shall not be declared eligible to retake the MPJE unless otherwise approved by the board for extenuating circumstances. « 2022 MO REG TEXT 617754 (NS), published October 17, 2022, effective November 30, 2022, amends 20 MO ADC 2220-7.010 (General Licensing Rules) updating terms and the general requirements for licensing. Provides that a pharmacist license is invalid if the applicant fails to submit or make available via the National Association of Boards of Pharmacy all information required to complete the application within 90 days, rather than 6 months, after the application is received by the board, with the exception of NAPLEX or MPJE examination scores. Updates the requirements to issue a duplicate license, certificate, or registration. Requires payment of the duplicate license fee and return of the most recent license, registration, or certificate, or an attestation under penalty of perjury that the license, certificate, or registration has been lost, stolen, or destroyed. Nevada 2022 NV REG TEXT 601193 (NS), published and effective September 28, 2022, amends NV ADC 639.330 (Registration and reregistration: Continuing education required; submission of proof) to eliminate the requirement that not less than 15 of the 30 continuing education units required per biennium be units in accredited programs. Requires all continuing education units to be obtained through a course or program for continuing education provided by certain schools or governmental entities or accredited by the Accreditation Council for Pharmacy Education. New Hampshire 2021 NH S.B. 229 (NS), enacted June 24, 2022, effective September 22, 2022, amends NH ST ? 318:16-b (Pharmacist Administration of Vaccines) to include certified pharmacy technicians in the requirements to administer vaccines. Provides that the required training shall include hands-on injection technique and the recognition and treatment of emergency reactions to vaccinations. Requires the pharmacist, pharmacy intern, licensed advanced pharmacy technician, or certified pharmacy technician to have a current certificate in basic cardiopulmonary resuscitation and review the vaccine registry or other vaccination records before administering the vaccination. New Mexico ¢ 2021 NM REG TEXT 593799 (NS), published and effective November 30, 2021, amends NIM ADC 16.19.4.8 (Defining Gross Immorality) providing that gross immorality shall constitute a felony conviction of a crime involving a disqualifying criminal conviction. Defines convictions and specifies a list of convictions that are disqualifying criminal convictions. Provides that unless otherwise specified by law, the board shall not consider a criminal conviction as part of an application for licensure unless the conviction in question is one of the specified disqualifying criminal convictions. Provides that nothing in this section prevents the board from denying an application or disciplining a licensee on the basis of the licensee or applicant's conduct to the extent that such conduct violated certain specified acts, regardless of whether the individual was convicted of a crime for such conduct or whether the crime for which the individual was convicted is listed as one of the disqualifying criminal convictions in this rule. Provides that the board shall not use, distribute, disseminate, or admit into evidence at an adjudicatory proceeding certain specified criminal records. THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. -20- ¢ 2022 NM REG TEXT 616379 (NS), published and effective September 13, 2022, amends NM ADC 16.19.4.9 (Defining Unprofessional or Dishonorable Conduct) clarifying that the dispensing of naloxone or other opioid antagonist as authorized in NM ST ? 24-23-1 (Authority to possess, store, distribute, dispense, prescribe and administer opioid antagonists; release from liability; rulemaking) is not unprofessional or dishonorable conduct by a pharmacist. Amends NIV ADC 16.19.4.12 (Impaired Pharmacist) clarifying that when an impaired licensee who has been reported to the board successfully completes a board/committee approved treatment program, that licensee must appear before the board as a condition of consideration for reinstatement. New Jersey 2021 NJ REG TEXT 583317 (NS), published and effective March 7, 2022, amends NJ ADC 13:3974.21 (Procedures for authorized prescriber ordered or government sponsored immunizations performed by pharmacists, pharmacy interns, or pharmacy externs) updating the requirements to allow pharmacy interns and pharmacy externs to administer injectable medications and vaccinations under the direct supervision of a pharmacist. Amends NJ ADC 13:3974.21A (Requirements for pharmacists, pharmacy interns, and pharmacy externs to administer influenza vaccine to patients under 18 years of age) updating the requirements to allow pharmacy interns and pharmacy externs to administer influenza vaccine to patients under 18 years of age. Also provides that for a patient who is under 10, but is at least 7, a licensed pharmacist, registered pharmacy intern, or pharmacy extern may administer the influenza vaccine only pursuant to a prescription by an authorized prescriber. New York 2022 NY REG TEXT 605774 (NS), published January 26, 2022, effective January 31, 2022, amends 8 NY ADC 63.9 (Immunizations and emergency treatment of anaphylaxis pursuant to patient specific and non-patient specific orders and protocols) updating the list of immunizations a pharmacist may administer to patients 18 or older to include hepatitis A, hepatitis B, human papillomavirus, measles, mumps, rubella, and varicella. Also provides additional requirements to administer other immunizations recommended by the advisory committee on immunization practices of the Centers for Disease Control and prevention for patients 18 or older, pursuant to a patient specific or a non-patient specific order. North Carolina * 2022 NC REG TEXT 607677 (NS), published August 1, 2022, effective July 1, 2022, adopts 21 NC ADC 46.1820 (Code of Ethics) providing that all pharmacists must comply with the American Pharmacist Association Code of Ethics, which is incorporated by reference. Provides any contrary conduct is unprofessional conduct. * 2022 NC REG TEXT 607678 (NS) published August 1, 2022, effective July 1, 2022, adopts 21 NC ADC 46.2514 (Administration of Long-Acting Injectables) establishing standards for training, recordkeeping and other requirements necessary for a pharmacist to administer long-acting injectables. « 2022 NC REG TEXT 608819 (NS), published August 1, 2022, effective July 1, 2022, adopts 21 NC ADC 32U.0102 (Administration of Long-Acting Injectables) providing that pharmacists may administer long-acting injectables in accordance with 21 NC ADC 46.2514 (Administration of Long-Acting Injectables). North Dakota 2021 ND REG TEXT 586091 (NS), published and effective January 1, 2022, to allow for a provisional license for military members in addition to military spouses; to add improper marketing to the list of items considered unprofessional conduct; and to establish the requirements for limited prescriptive authority for immunizations for authorized pharmacists. Ohio 2022 OH REG TEXT 604207 (NS), published April 26, 2022, effective April 25, 2022, adopts OH ADC 4729-3-01 (Disqualifying offenses) defining 'disqualifying offense' and providing that the board of pharmacy shall issue a resolution providing the list of specific criminal offenses for which a conviction, judicial finding of guilt, or plea of guilty may disqualify an individual from obtaining an initial license or registration issued by the board. Oklahoma 2022 OK REG TEXT 600563 (NS), published September 1, 2022, effective September 11, 2022, amends OK ADC 535:10-3-4 (Uniform pharmacy continuing education) providing that webinars are considered live CE if the pharmacist can ask questions and get answers from the presenter(s) or the moderator during the webinar. Allows the Board to require up to 3 hours of CE on a specific topic and requires the Board to give adequate notice for specific CE requirements. Amends OK ADC 535:10-11-3 (D.Ph. administering of immunization requirements) removing requirement that a D.PH administer immunizations on the order of a prescribing licensed practitioner. Requires the Board to maintain a register of those pharmacists who have been approved to administer immunizations. Amends OK ADC 535:10-11-6 (Records) requiring immunization records to include the prescribing licensed practitioner or pharmacist. Oregon 2022 OR REG TEXT 613177 (NS), published June 15, 2022, effective June 16, 2022, amends OR ADC 855-019-0300 (Duties of a Pharmacist-in-Charge) clarifying that a pharmacy must, at all times have one Pharmacist-in-Charge (PIC) who is normally present in the pharmacy on a regular basis instead of employed on a regular basis. Provides that a Pharmacy Prescription Locker in OR ADC THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. -24- 855-143 (Pharmacy Prescription Locker) does not count towards PIC limitation. Provides that if a discrepancy is noted on a board inspection, the PIC must submit a plan of correction within 15 days of receiving a deficiency notice; or 30 days of receiving a non- compliance notice. Pennsylvania ¢ 2021 PA H.B. 2679 (NS), enacted and effective July 11, 2022, amends PA ST 63 P.S. ? 390-9.2 (Authority to administer injectable medications, biologicals and immunizations) to lower the minimum child's age for injectable or needle-free delivery methods from 9 to 5. Adds a physician, physician assistant and certified registered nurse practitioner as professionals that may supervise a pharmacy intern administering injectable medications, biologicals and immunizations. Provides that a pharmacist or pharmacy intern who administers an influenza or COVID-19 immunization to an individual under 18 shall inform the parent or adult caregiver of the importance of a well- child visit with a pediatrician or other licensed primary care provider and refer the patient as appropriate. Adds reporting requirements for the supervising pharmacist regarding the immunization registry. Provides that a pharmacist who holds the authority to administer injectable medications, biologicals and immunizations may delegate the authority to administer influenza and COVID-19 immunizations to a certified registered nurse practitioner, physician assistant, registered nurse or licensed practical nurse. * 2022 PA REG TEXT 568492 (NS), published and effective July 9, 2022, amends 49 PA ADC ? 27.12 (Practice of pharmacy and delegation of duties) providing that a pharmacy intern working under the direct, immediate and personal supervision of a pharmacist may administer injectable medications, biologicals and immunizations if the pharmacist and the pharmacy intern each hold an active authorization to administer injectable medications, biologicals and immunizations issued by the Board. Tennessee 2021 TN H.B. 2131 (NS) enacted and effective April 8, 2022, amends TN ST ? 63-10-204 (Definitions) updating the definition for 'Pharmacy technician' to specify what type of tasks the pharmacy technician is trained and designated to assist with, including participation in drug, dietary supplement and device selection, storage, and distribution and administration, consistent with the pharmacy technician's education, training, and experience. Virginia 2022 VA REG TEXT 604633 (NS), published January 17, 2022, effective December 22, 2021, adopts 18 VA ADC 110-21-46 (Initiation of treatment by a pharmacist) providing a list of drugs and devices that may be initiated, dispensed, or administered by a pharmacist to a patient older than 18 years of age. Requires the pharmacist to follow statewide protocol adopted by the Board for each drug or device; requires pharmacist to notify the primary care provider; and requires the pharmacist to maintain patient records and protect patient confidentiality. Wisconsin ¢ 2021 WI S.B. 300 (NS), enacted December 3, 2021 effective January 1, 2023, amends multiples sections to establish the requirements for registration of pharmacy technicians. Existing rules regulate the activities of pharmacy technicians, but pharmacy technicians are not, under current law, required to be credentialed by the board in order to practice. « 2022 WI REG TEXT 558013 (NS), published April 25, 2022, effective May 1, 2022, adopts WI ADC ? Phar 2.06 (Application procedure for service members, former service members, and their spouses) establishing the requirements for reciprocal licensure as a pharmacist for service members, former service members, and their spouses. Wyoming 2022 WY S.F. 24 (NS), enacted March 7, 2022, effective July 1, 2022, amends WY ST ? 33-24-157 (Immunization administration) providing that a licensed pharmacy technician or pharmacy intern shall only administer immunizations under the supervision of a licensed pharmacist. Provides that a pharmacy technician or pharmacy intern who intends to administer immunizations shall register with the board, but nothing in this subsection shall be deemed to require any pharmacy technician to administer immunizations to individuals who are less than 13 years of age. Provides that no employer shall discriminate against a pharmacy technician on the basis that the pharmacy technician determines not to administer immunizations to individuals who are less than 13 years of age. Physician Recent Legislation and Regulation Alabama ¢ 2021 AL REG TEXT 592884 (NS), published November 30, 2021, effective January 14, 2022, adopts AL ADC 545-X-2-.08 (Temporary Expedited License for Military Members and Spouses) providing for an expedited temporary license to practice medicine for up to twelve months for physicians who are members of the military or a spouse of a member of the military who is stationed in the state of Alabama on military orders. ¢ 2021 AL REG TEXT 600619 (NS), published November 30, 2021, effective October 29, 2021, adopts AL ADC 540-X-3-.26 (Applicants for Emergency Certificate of Qualification by Endorsement) providing the requirements for the expedited issuance of an emergency certificate of qualification to qualified physicians licensed in other states who desire to provide health care to citizens of Alabama suffering from and affected by SARS-CoV-2 and the disease known as COVID-19. Requires the emergency certificate of qualification THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. -29- to clearly indicate that it is an emergency certificate and provides that the certificate will expire at 11:59 p.m., Central Standard Time, on December 31, 2021. A physician who is issued an emergency certificate of qualification shall also be issued a restricted Alabama Controlled Substances Certificate for the purpose of treating patients suffering from and affected by COVID-19. ¢ 2021 AL REG TEXT 598752 (NS), published December 30, 2021, effective February 13, 2022, requiring registrants to provide documentation of maintenance of an active registration issued by the U.S. Drug Enforcement Administration upon initial and renewal applications. ¢ 2021 AL REG TEXT 598748 (NS), published December 30, 2021, effective February 13, 2022, requiring applicants for a certificate of qualification to submit a criminal history background check to either the Board, or to any channeler approved by the Board. Provides costs associated with conducting a criminal history background check will be borne by the applicant and are payable directly to the Board, or its designee. «2021 AL REG TEXT 598747 (NS), published December 30, 2021, effective February 13, 2022, amends AL ADC 540-X-3-.04 (Examination Requirements) updating the list of approved examinations required for a certificate of qualification. ¢ 2022 AL REG TEXT 618723 (NS), published August 31, 2022, effective October 15, 2022, repeals AL ADC Chapter 540-X-16, The Practice of Medicine or Osteopathy Across State Lines. Alaska 2022 AK REG TEXT 609989 (NS), published August 27, 2022, effective September 25, 2022, adopts 12 AK ADC 40.046 (Temporary military courtesy license) establishing standards and a process for an active-duty military member or spouse of an active duty military member of the armed forces of the United States to apply for a temporary military courtesy license to practice medicine, osteopathy, podiatry or as a physician assistant. Arkansas 2022 AR REG TEXT 622068 (NS), published July 15, 2022, effective July 3, 2022, amends AR ADC 007.29.1-42 (Licensure for Uniformed Service Members, Veterans, and Spouses) updating definitions and requirements for the temporary and expedited licensure of certain uniformed service members, veterans, and spouses. Arizona 2022 AZ REG TEXT 610778 (NS), published March 25, 2022, effective March 1, 2022, amends AZ ADC R4-22-102 (Fees and Charges) establishing the fee for an out-of-state health care provider to register to provide telehealth services in Arizona as $300 and providing that this fee is not refundable. California ¢ 2021 CAA.B. 1636 (NS), enacted September 22, 2022, effective January 1, 2023, amends CA BUS & PROF ? 480 (Acts disqualifying applicant; procedures for requesting or acting on applicant criminal history information; retention of documentation) authorizing a board to deny a license based on formal discipline that occurred earlier than 7 years preceding the date of application if the formal discipline was based on conduct that, if committed in California by a licensed physician and surgeon, would have constituted an act of sexual abuse, misconduct, or relations with a patient or sexual exploitation, as specified. Amends CA BUS & PROF ? 2232 (Revocation of license of any person who has been required to register as a sex offender; application of section; petition for probationary license) removing certain exemptions relating to automatic revocation of a license of a registered sex offender and instead requiring the board to automatically revoke a license if the licensee has been convicted, as specified, in any court in or outside of California of an offense that, if committed or attempted in California, based on the elements of the convicted offense, would have been punishable as an offense for which a specified provision of the Sex Offender Registration Act requires registration as a sex offender. Provides that a plea or verdict of guilty or a conviction after a plea of nolo contendere is deemed to be a conviction within the meaning of this section. The record of conviction shall be conclusive evidence of the fact that the conviction occurred. Also eliminates the ability of a person whose license was revoked before January 1, 2005, following registration as a sex offender to petition a superior court to determine that the individual no longer poses a risk to patients and order their license to be reinstated. Amends CA BUS & PROF ? 2307 (Reinstatement or modification of penalty after surrender, suspension, revocation of certificate or probation) prohibiting reinstatement of the license of a physician and surgeon if it was surrendered or revoked for committing an act of sexual abuse, misconduct, or relations with a patient, or following conviction of a crime requiring registration as a sex offender wherein the person engaged in the offense with a patient or client, with the exception of registration required following conviction of a misdemeanor for indecent exposure. ¢ 2021 CAA.B. 2626 (NS), enacted and effective September 27, 2022, amends CA BUS & PROF ? 2253 (Performing an abortion without a valid license; unprofessional conduct; exceptions) and CA BUS & PROF ? 3502.4 (Abortion by aspiration techniques; physician assistant training; compliance with protocols; unprofessional conduct; license and application exceptions) to prohibit the suspending or revoking of the certificate of a physician, surgeon, or physician assistant solely for performing an abortion. Prohibits the denial of an application for licensure as a physician, surgeon, or physician assistant, or suspending, revoking, or otherwise imposing discipline because the person was disciplined in another state in which they are licensed or certified solely for performing an abortion in that state, or the person was convicted in that state for an offense related solely to the performance of an abortion in that state. THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. -23- ¢ 2021 CA S.B. 923 (NS), enacted September 29, 2022, effective January 1, 2023, amends CA BUS & PROF ? 2190.1 (Educational activities; cultural and linguistic competency; understanding of implicit bias) updating continuing medical education for physicians and surgeons to include information and evidence-based cultural competency training pertinent to the treatment of, and provision of care to, individuals who identify as queer, questioning, asexual, or gender diverse, and the processes specific to those seeking gender-affirming care services. Also provides specific components, including health inequities within the transgender, gender diverse, or intersex (TGI) community, that would be suitable for evidence-based cultural competency training. ¢ 2021 CAA.B. 1954 (NS), enacted September 2, 2022, effective January 1, 2023, adopts CA BUS & PROF ? 2228.5 prohibiting a physician or surgeon from denying treatment or medication to a qualified patient based solely on a positive drug screen for tetrahydrocannabinol (THC) or report of medical cannabis use without first completing a case-by-case evaluation of the patient that includes a determination that the use of medical cannabis is medically significant to the treatment or medication. Also prohibits a physician or surgeon from being punished or denied any right or privilege for having administered treatment or medication to a qualified patient within the requirements of this section and consistent with the standard of care. Colorado * 2022 CO H.B. 1050 (NS), enacted and effective June 7, 2022, amends CO ST ? 12-240-114 (International medical graduates - degree equivalence) reducing the length of postgraduate clinical training that an international medical graduate must complete to qualify for a medical license from 3 years to one year. Amends CO ST ? 12-240-119 (Reentry license - period of inactivity - international medical graduate - competency assessment - board rules - conversion to full license) allowing an international medical graduate (IMG) to obtain a reentry license if the IMG has a current or expired international medical license and meets Colorado medical board-specified qualifications and requirements, including an assessment of the IMG's competency to practice. ¢ 2022 CO REG TEXT 613089 (NS), published June 25, 2022, effective July 15, 2022, amends 3 CO ADC 713-28:130-2 (Rules and Regulations) clarifying licensure reinstatement requirements and providing that the Board will not reinstate an individual's expired license until the individual submits a Board-approved application for reinstatement and complies with stated conditions. Provides that if the individual has not practiced medicine during the two years preceding the Board's consideration of the licensee's application for reinstatement, and the individual cannot otherwise demonstrate continued competency, the Board's Licensing Panel may exercise discretion to require the individual to undertake a competency assessment or evaluation conducted by a Board-approved program, undertake a period of supervised practice, or complete an educational program. ¢ 2022 CO REG TEXT 625955 (NS), published and effective October 6, 2022, adopts 3 CO ADC 713-52:162 (Protecting Colorado's Workforce and Expanding Licensing Opportunities) prohibiting a regulator from denying a license to an applicant or from imposing disciplinary action against an individual's license based solely on a civil or criminal judgment or on professional disciplinary action against the applicant regarding the consumption, possession, cultivation, or processing of marijuana so long as the actions are lawful and consistent with professional conduct and standards of care within Colorado and did not otherwise violate Colorado law. * 2022 CO REG TEXT 625954 (NS), published and effective October 6, 2022, adopts 3 CO ADC 713-51:161 (Protections for Provision of Reproductive Health Care in Colorado) providing that no licensee or applicant shall be subject to disciplinary action against a professional license or disqualified from professional licensure for providing, assisting, seeking, or obtaining reproductive health care or as a consequence of any civil or criminal judgment, discipline, or other sanction imposed under the laws of another state so long as the care provided is lawful and consistent with professional conduct and standards of care within the State of Colorado. Delaware 2021 DE S.B. 300 (NS), enacted and effective July 29, 2022, amends DE ST TI 24 ? 1731 (Unprofessional conduct and inability to practice medicine) and DE ST TI 24 ? 1731A (Duty to report) updating language describing a physician's inability to practice medicine. Removes the phrase 'by reason of mental illness or mental incompetence; physical illness, including deterioration through the aging process or loss of motor skill; or excessive use or abuse of drugs, including alcohol' and instead replaces with 'by reason of a mental or physical disability or serious health condition that prevents a physician's ability to practice medicine in a fully competent and professional manner with reasonable skill and safety to patients.' Provides that a mental or physical disability or serious health condition does not prevent a physician's ability to practice medicine with reasonable skill and safety when the condition is reduced or ameliorated because of ongoing treatment, with or without medication, or participation in a monitoring program or because of the field of practice, the setting, or the manner of the physician's current medical practice. Florida ¢ 2022 FL REG TEXT 601833 (NS), published February 15, 2022, effective March 2, 2022, amends 64 FL ADC 64B15-13.001 (Continuing Education for Biennial Renewal) to allow all the required CME for the 2022-2024 biennial renewal period to be obtained by completion of courses offered in a distance learning format. Also, updates the list of the five most misdiagnosed conditions for the required Prevention of Medical Errors course. Adds the failure to accurately diagnose neurological and brain-related conditions and the failure to accurately diagnose cancer-related conditions. Removes retained foreign objects in surgery, failure to accurately diagnose cause of back and leg pain, and the failure to timely diagnose sepsis from the list. THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. -24- ¢ 2022 FL REG TEXT 587873 (NS), published July 26, 2022, effective August 8, 2022, amends 64 FL ADC 6488-9.012 (Standards for the Prescription of Drugs to Treat Obesity) updating the overall standards of practice for the prescribing of medication for the treatment of obesity in children and adults. ¢ 2022 FL REG TEXT 582212 (NS), published November 8, 2022, effective November 22, 2022, amends 64 FL ADC 64B8-55.001 (Disciplinary Guidelines) substantially rewriting the disciplinary guidelines used to notify applicants, licensees, and telehealth registrants of the ranges of penalties which will routinely be imposed unless the Board finds it necessary to deviate from the guidelines for the stated reasons given within this rule. lowa 2022 IA REG TEXT 617875 (NS), published November 30, 2022, effective January 4, 2022, amends |A ADC 653-9.3(147,148) (Eligibility for licensure) allowing the Board to accept resident training that is not accredited on a case-by-case basis. Allows the Board to consider any relevant factors, including the length of time the program has been in existence, the location of the program, the institution or organization that administers the program, the reason that the program is not accredited, and whether the program is accredited or recognized by certain agencies. Kansas 2022 KS REG TEXT 620019 (NS), published October 27, 2022, effective November 11, 2022, adopts KS ADC 100-6-6 (Reentry active license; medicine and surgery and osteopathic medicine) establishing the reentry plan requirements for any physician, whether an applicant or a licensee, who has not engaged in the practice of the healing arts for the 2-year period immediately preceding the filing of an application for a license or change of designation type. Louisiana 2022 LA S.B. 439 (NS), enacted June 18, 2022, effective August 1, 2022, adopts LA R.S. 37:1310.11 (Bridge year graduate physician) authorizing the Board to develop, implement, and maintain a program that allows an individual to be certified to practice medicine as a bridge year graduate physician. Establishes criteria for participation in the program and scope of practice under the certification. Maryland 2022 MD REG TEXT 607614 (NS), published February 11, 2022, effective January 1, 2022, suspends certain requirements for reinstatement for a physician whose license has been placed on inactive status or who has failed to renew a license by the license expiration date during calendar year 2021 and the first 6 months of calendar year 2022; and suspends certain requirements for an initial licensure by reciprocity if the physician submits the stated affidavits. These provisions are effective from January 1, 2022, and shall be repealed on the earlier of June 29, 2022, or the end of the federal COVID-19 Public Health Emergency. Mississippi 2021 MS REG TEXT 605532 (NS), published November 1, 2021, effective November 19, 2021, amends 30 MS ADC Pt. 2615, R. 1.7 (Supervising Physician Limited) to allow the quarterly review between a physician assistant and the supervisory physician to take place by video conferencing. Also clarifies that this meeting must, rather than should, be recorded. Nebraska 2022 NE REG TEXT 602877 (NS), published July 6, 2022, effective July 10, 2022, adopts 172 NE ADC Ch. 87 (Licensure of Surgical First Assistant) to establish the requirements for the license of the practice as a Surgical First Assistant under the Surgical First Assistant Practice Act. Included in the new sections is 172 NE ADC Ch. 87, ? 006 which specifies that supervision must be provided by a physician who is authorized to practice medicine and surgery in the state of Nebraska in accordance with NE ST ? 38-3508 (Personal supervision by a physician, defined); and nothing in these regulations will be construed to prohibit a Surgical First Assistant from being supervised by more than one physician at any time. New Hampshire 2021 NH S.B. 382 (NS), enacted June 7, 2022, effective August 6, 2022, amends NH ST ? 310-A:1-g (Telemedicine and Telehealth Services) requiring out-of-state healthcare professionals providing services through telemedicine or telehealth to be licensed, certified, or registered by the appropriate New Hampshire licensing body if the patient is physically located in New Hampshire at the time of service. New Mexico ¢ 2022 NM REG TEXT 600370 (NS), published and effective February 8, 2022, amends and adopts multiple sections in NM ADC 16.10 (Medicine and Surgery Practitioners) to update the requirements for the licensing of physicians in New Mexico. The updates include changing the term 'allopathic' physicians to physicians so that both allopathic doctors (MD's) and doctors of osteopathy (DO's) are incorporated into the rule. Adds osteopathic physician credentials, licensure, examination and continuing education requirements. Adds a list specific criminal convictions that could disqualify an applicant from receiving a license based on a previous felony conviction. Updates certain fees and makes other clarifying and conforming changes. THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. -25- ¢ 2022 NM REG TEXT 612635 (NS), published and effective July 12, 2022, clarifies the requirements regarding the approved foreign medical schools for licensure qualification. Allows a graduate to have completed a program determined by the board to be substantially equivalent to a U.S. medical school, based on Board review of a full certification Educational Commission for Foreign Medical Graduates (ECFMG) certification. New York 2021 NY S.B. 9079 (NS), enacted and effective June 13, 2022, adopts NY EDUC ? 6531-b (Exceptions; reproductive health services) providing that the performance, recommendation, or provision of any reproductive health services as defined in subdivision one of this section, by a health care practitioner acting within their scope of practice, for a patient who resides in a state wherein the performance, recommendation, or provision of such reproductive health services is illegal, shall not, by itself, constitute professional misconduct under this title, or title two-A of article two of the public health law, or any other law, rule or regulation governing the licensure, certification, or authorization of such practitioner, nor shall any license, certification or authorization of a health care practitioner be revoked, suspended, or annulled or otherwise subject to any other penalty or discipline provided in the public health law or this title solely on the basis that such health care practitioner performed, recommended, or provided any such reproductive health services for a patient who resides in a state wherein the performance, recommendation, or provision of such reproductive health services is illegal. Amends NY PUB HEALTH ? 230 (State board for professional medical conduct; proceedings) to prohibit professional misconduct charges against licensed medical professionals on the basis that such professional performed, recommended or provided an abortion or other reproductive health care services for a patient who resides in a state wherein such abortion or reproductive health services are illegal. North Carolina ¢ 2022 NC REG TEXT 593739 (NS), published February 1, 2022, effective January 1, 2022, amends 21 NC ADC 32R.0102 (Approved Categories of CME) to include cultural competency or implicit bias training as a Category 1 CME. ¢ 2022 NC REG TEXT 603401 (NS), published June 1, 2022, effective May 1, 2022, updating the list of items that applicants must submit. Provides the applicant shall submit a photograph that shows a front view of the applicant's face. Provides that a graduate of a medical school not approved by LCME shall have completed 2 years of graduate medical education instead of 3 years. Updates the list of examinations accepted for licensure. North Dakota 2022 ND REG TEXT 613190 (NS), published and effective October 1, 2022, amends and repeals multiple sections in ND ADC 50 (State Board of Medical Examiners) to update the requirements for physician licensure, physician assistant licensure, continuing medical education and prescriptive practices. Affected articles include Article 50-02 (Physician Licensure), Article 50-03 (Physician Assistants) and Article 50-04 (Continuing Medical Education). Ohio ¢ 2021 OH REG TEXT 601059 (NS), published December 8, 2021, effective December 31, 2021, adopts OH ADC 4731-30-04 (Maintenance of List of Disqualifying Criminal Offenses) establishing the Medical Board requirements for a list of disqualifying criminal offenses. Defines 'list of disqualifying criminal offenses' and 'board' and provides that at least once per calendar year, the Board shall review the list of disqualifying criminal offenses. As part of the review, the board may approve the addition, deletion or modification of specific criminal offenses on the list of disqualifying criminal offenses. Provides that the board shall make the list of disqualifying criminal offenses available to the public on the board's website. * 2022 OH REG TEXT 597544 (NS), published January 12, 2022, effective January 31, 2022, updates the requirements for medical and osteopathic examinations. Provides that no applicant may exceed the maximum number of attempts for any step or level established by the national board of medical examiners or the national board of osteopathic medical examiners, as effective on the date of application for a license. Provides for a waiver if the applicant demonsirates that a step or level was completed within the maximum number of attempts permitted by the national board of medical examiners or the national board of osteopathic medical examiners, at the time the step or level was successfully completed, provided that the applicant did not exceed six attempts for the step or level. Oklahoma 2022 OK REG TEXT 607826 (NS), published September 1, 2022, effective September 11, 2022, amends OK ADC 510:10-3-1 (Full licensure requirements) changing the section title from 'General' and updating the licensing requirements for osteopathic physicians. Provides that no person shall be licensed by the Board unless and until that person first fully complies with all licensure provisions of the Act and Rules and has satisfied the Board of the ability to practice osteopathic medicine and surgery with reasonable skill and safety. Strikes language prohibiting the issuance of a temporary license for certain classes of Resident physicians. Updates the postgraduate training and application requirements. Provides that applicants for licensure shall not begin practice until their license information is publicly provided on the Board's website. Amends OK ADC 510:10-3-4 (Licensure by endorsement) updating the requirements for licensure by reciprocity. Provides that an applicant shall: (1) Complete and submit the uniform application together with all applicable fees and required documentation; (2) Provide evidence of graduation from a medical school accredited by the Commission on Osteopathic College Accreditation (COCA); (3) Provide license verification from each state in which the applicant THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. -26- is currently or was previously licensed. Adopts OK ADC 510:10-3-11 (Resident training license) to establish the requirements for a Resident Training license for medical school graduates during their first year of postgraduate training, also known as PGY-1. Adopts OK ADC 510:10-3-12 (Temporary Resident License) to establish the requirements for a temporary license for certain classes of Resident physicians. Adopts OK ADC 510:10-3-13 (Volunteer and Emeritus Medical License) to establish the requirements for a volunteer medical license for physicians who are retired from active practice. Amends OK ADC 510:10-4-3 (Eligibility, Limits, and Responsibilities of supervising osteopathic physician) to increase the number of mid-level practitioners that a physician may supervise from 4 to 6. Provides that subject to approval, disapproval, or modification by the Board, the Executive Director of the Board may temporarily approve a written request to supervise 7 or more mid-level practitioners between regularly scheduled meeting of the Board. Under no circumstance shall the Executive Director approve more than 10 mid-level practitioners without expressed approval of the Board. Provides that all supervising osteopathic physicians shall have a written agreement with each mid-level practitioner they supervise to memorialize the extent of the authority of the mid-level practitioner to practice under the supervision of the physician; and the written agreement shall comply with Oklahoma law. Oregon * 2022 OR REG TEXT 597029 (NS), published January 12, 2022, effective January 15, 2022, amends OR ADC 847-050-0037 (Supervision) updating the requirements for the supervising physician, agent or the supervising physicians in the supervising physician organization. ¢ 2022 OR REG TEXT 597028 (NS), published January 12, 2022, effective January 11, 2022, amends OR ADC 847-008-0075 (Mandatory Pain Management Education) updating the pain management continuing education requirements. Requires new licensees to complete the one-hour training at initial licensure and all licensees every 24 months. Updates licenses that are exempt from this requirement. Requires licensees to report and attest to completing the required pain management continuing education hours during the license registration renewal. Provides continuing education will be audited during the license registration renewal. ¢ 2022 OR REG TEXT 588242 (NS), published and effective April 7, 2022, amends OR ADC 847-010-0073 (Reporting Requirements) to update the definition for 'medical incompetence'. Also updates the definition of 'unprofessional or dishonorable conduct' to provide separate types of conduct that are contrary to or inconsistent with recognized standards of ethics of the medical, podiatric, or acupuncture professions. * 2022 OR REG TEXT 612012 (NS), published July 12, 2022, effective July 15, 2022, amends and adopts multiple sections in OR ADC 847-050 (Physician Assistant) to implement 2021 OR H.B. 3036 (NS) shifting the practice of a physician assistant from a supervision to collaboration model, with collaboration agreements, starting July 15, 2022. PAs will transition to a collaboration agreement starting July 15, 2022, through December 31, 2023. PAs may continue practicing under an existing practice agreement or description during the transition period. * 2022 OR REG TEXT 619267 (NS), published and effective October 12, 2022, updating the requirements regarding the physician Health Professionals' Services Program (HPSP). Amends OR ADC 847-065-0030 (Procedure for Board Referrals) providing that the referral must include a statement that the licensee has agreed to report any citation for the use or possession of any DEA scheduled substances, including but not limited to citations for Class E violations, to the contractor within 3 business days of the citation. Amends OR ADC 847-065-0035 (Procedure for Self-Referred Licensees) updating the requirements for the provisional enrollment agreement and requiring the licensee to meet all eligibility requirements to participate in the HPSP to move from provisional enrollment to final enrollment. Makes other clarifying changes. Amends OR ADC 847-065-0060 (Completion requirements) providing that licensees who receive a diagnosis of substance use disorder, mild, or have a mental health diagnosis without substance use disorder must be enrolled in the program for a minimum of 2 years, and licensees who receive a diagnosis of substance use disorder, moderate or severe, with or without a mental health disorder, must be enrolled in the program for a minimum of 5 years. Provides that licensees may be required to be enrolled for a longer period of time if the evaluator or contractor is able to document concerns for the safety of the public or licensee or if otherwise directed by the Oregon Medical Board. ¢ 2022 OR REG TEXT 619244 (NS), published October 12, 2022, effective January 1, 2023, adopts OR ADC 847-010-0200 (Physician and Physician Assistant Volunteer Practice) allowing a health care practitioner to practice in Oregon in connection with a coordinating organization or other entity without compensation for 30 days each calendar year. Defines 'health care practitioner" and requires a health care practitioner to submit required information to the Board at least 10 days prior to commencing volunteer practice. Pennsylvania 2021 PA H.B. 245 (NS), enacted and effective April 19, 2022, amends PA ST 63 P.S. ? 422.29 (License without restriction) requiring a graduate of an unaccredited medical college to have completed successfully, as a resident, two years of approved graduate medical training instead of three years. Amends PA ST 63 P.S. ? 422.33 (Temporary license) providing that a temporary license empowers the licensee to teach or demonstrate advanced medical and surgical techniques in Pennsylvania; participate in a medical or surgical procedure necessary for the well-being of a specific patient in Pennsylvania; practice medicine and surgery at a camp or resort for no more than three months; attend to the medical and surgical needs of a person visiting Pennsylvania for no more than three months; practice medicine and surgery in Pennsylvania in response to a need for medical care created by a declaration of disaster emergency issued by the Governor or any other Federal, State or local disaster emergency for a duration determined by the board; or engage in any other purpose as deemed appropriate by the board on a case-by-case basis. Provides that the board may impose any appropriate THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. -27- limitation in scope, duration or site of practice on the temporary license. Temporary licensees shall be deemed health care providers who conduct 50% or less of their health care business or practice in Pennsylvania for the purposes of the Medical Care Availability and Reduction of Error (Mcare) Act. South Carolina 2022 SC REG TEXT 589049 (NS), published and effective May 27, 2022, adopts SC ADC 81-75 (Emergency Temporary Licenses) establishing the requirements for the Board to authorize the issuance of emergency temporary licenses to physicians, physician assistants, and respiratory care practitioners actively licensed to practice in another state upon the declaration of a state of emergency by the Governor. Tennessee ¢ 2021 TN S.B. 1902 (NS), enacted and effective May 3, 2022, establishes the requirements for a short-term visitor clinical training license for eligible foreign medical graduates and physicians as a limited, temporary license to engage in the supervised practice of medicine for up to 90 days. ¢ 2022 TN REG TEXT 529141 (NS), published April 27, 2022, effective July 21, 2022, to update the continuing medical education requirements. Updates the hours required, waivers, and exemptions; what is acceptable continuing education; proof of compliance; and requirements regarding violations and disciplinary orders. Requires documentation of successful completion of the continuing medical education requirements provided in TN ADC 1050-02-.12 (Continuing Education Requirements). Provides that an osteopathic physician may satisfy 1 hour of continuing education through the performance of 1 hour of voluntary provision of healthcare services. The maximum number of annual hours that can be received by performing voluntary healthcare services is 4 hours. Texas 2022 TX REG TEXT 610000 (NS), published July 1, 2022, effective July 7, 2022, amends 22 TX ADC ? 173.3 (Physician-lInitiated Updates) updating and adding events that must be included in the physician's profile information and reported to the Board within 30 days after the event. Vermont 2022 VT REG TEXT 602404 (NS), published June 10, 2022, effective July 1, 2022, amends multiple sections in VT ADC 12-5-200 (Rules of the Board of Medical Practice) to update the requirements for the licensing or certification, and regulation of physicians, physician assistants, podiatrists, anesthesiologist assistants, and radiologist assistants by the Board of Medical Practice. Changes include updating the qualifications for physician licensure; updating the Board's powers and duties, and the Board's complaint, investigation, and hearing processes; updating the requirements for Physician Assistants; updating the provision for reciprocity of licensure from any other state when in good standing; adding an option for the Board to offer non-disciplinary financial penalties for administrative infractions in lieu of possible discipline; and providing written procedures for the Board to conduct hearings remotely when needed. Virginia 2022 VA REG TEXT 607588 (NS), published February 14, 2022, effective April 1, 2022, amends 18 VA ADC 85-20-141 (Licensure by endorsement) to change licensure by endorsement requirements in medicine, osteopathic medicine, and podiatry to only require verification that the most recent license held in another United States jurisdiction or in Canada is in good standing. West Virginia ¢ 2022 WV S.B. 603 (NS), enacted March 23, 2022, effective June 6, 2022, amends WV ST ? ?30-3-10 (Licenses to practice medicine and surgery or podiatry) providing that the board shall not issue an initial license, reinstate, or reactivate a license, to any individual whose license has been revoked, suspended, surrendered, or deactivated in another state based upon conduct which is substantially equivalent to an act of unprofessional conduct prohibited by WV ST ? 30-3-14(c) (Professional discipline of physicians and podiatrists; reporting of information to board pertaining to medical professional liability and professional incompetence required; penalties; grounds for license denial and discipline of physicians and podiatrist; investigations; physical and mental examinations; hearings; sanctions; summary sanctions; reporting by the board; reapplication; civil and criminal immunity; voluntary limitation of license; probable cause determination; referral to law-enforcement authorities) or the board's legislative rules, until reinstatement of his or her license in that state. * 2022 WV S.B. 585 (NS), enacted March 23, 2022, effective June 8, 2022, adopts WV ST ? 730-3-11c (Administrative medicine license) to establish the requirements for an administrative medicine license for physicians. A physician with an administrative medicine license may manage the integration of clinical medicine, strategy, operations, and other business activities related to the delivery of health care services, advise organizations, both public and private, on health care matters; authorize and deny financial payments for care; organize and direct research programs; review care provided for quality; and perform other similar duties that do not require or involve direct patient care. * 2022 WV S.B. 606 (NS), enacted March 28, 2022, effective June 9, 2022, to require reports of specified gross misconduct within 30 days of the reportable incident or within 30 days of the person's knowledge of the incident. Provides that failure to report constitutes unprofessional conduct and is subject to disciplinary action. Provides an exception. Provides immunity from civil liability for good faith THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. -28- reports. Requires the board to propose rules to define sexual misconduct and identify prohibited professional misconduct, including sexual misconduct, for which an application may be denied and/or a license or authorization to practice may be subject to disciplinary action. ¢ 2022 WV REG TEXT 587565 (NS), published May 13, 2022, effective July 1, 2022, providing that an emergency registration expires 60 days after issuance or 5 business days after the declared state of emergency terminates, whichever is sooner, and thereafter, the emergency registrant must hold an active West Virginia license or interstate telehealth registration to practice medicine and surgery to patients in West Virginia. * 2022 WV REG TEXT 618450 (NS), published July 1, 2022, effective August 5, 2022, adopts WV ADC ? 11-1A-5 (Qualification and Application for an Administrative Medicine License; Conversion of License Type) to establish the requirements for an administrative medicine license. An administrative medicine license means a medical license restricted to the practice of administrative medicine. A physician with an administrative medicine license may manage the integration of clinical medicine, strategy, operations, and other business activities related to the delivery of health care services, advise organizations, both public and private, on health care matters; authorize and deny financial payments for care; organize and direct research programs; review care provided for quality; and perform other similar duties that do not require or involve direct patient care. Wisconsin ¢ 2022 WI REG TEXT 514559 (NS), published January 31, 2022, effective February 1, 2022, amends WI ADC ? Med 10.03 (Unprofessional conduct) to include as unprofessional conduct the failure to notify the Department of Safety and Professional Services within 48 hours of the entry of judgment of conviction of any crime as required by WI ADC ? SPS 4.09(2) (Credential holder charges or convictions). ¢ 2022 WI REG TEXT 569128 (NS), published January 31, 2022, effective February 1, 2022, amends WI ADC ? MED 13.02 (Continuing medical education required; waiver) requiring a physician who holds a U.S. Drug Enforcement Administration number to complete 2 of the 30 required hours of continuing medical education from a Board-approved educational course or program related to opioid prescribing and other controlled substances for the renewal date occurring on November 1, 2023. Interstate Licensing Compacts Recent Legislation and Regulation Colorado 2022 CO S.B. 77 (NS), enacted June 8, 2022, effective August 10, 2022, adopts CO ST ? 24-60-4302 (Compact approved and ratified) to enact the 'Interstate Licensed Professional Counselors Compact', establishing specified procedures and requirements for licensed professional counselors to obtain and maintain a compact privilege to practice professional counseling in a member state. Indiana 2022 IN S.B. 251 (NS), enacted March 10, 2022, effective July 1, 2022, adopts IN ST 25-22.5-16 (Interstate Medical Licensure Compact) the Interstate Medical Licensure Compact to establish a streamlined process of licensing physicians in multiple states. Provides definitions, eligibility and application requirements, fees and disciplinary actions New Jersey 2020 NJ S.B. 523 (NS), enacted and effective January 10, 2022, adopts uncodified sections supplementing NJ ST 45 (Professions and Occupations) entering New Jersey into the Interstate Medical Licensure Compact. Ohio 2022 OH REG TEXT 607969 (NS), published May 11, 2022, effective May 31, 2022, adopts OH ADC 4731-38-01 (Licenses Issued or Renewed Under the Interstate Medical Licensure Compact) establishing the requirements for applying or renewing a license through the Interstate Medical Licensure Compact. Rhode Island 2021 RI H.B. 8047 (NS) and 2021 RI S.B. 2606 (NS) adopts new Chapter 91 (Interstate Medical Licensure Compact) in Title 5 of the General Laws (Business and Professions) to create the Interstate Medical Licensure Compact for physicians. Utah 2022 UT S.B. 151 (NS), enacted March 24, 2022, effective May 4, 2022, repeals UT ST ? 58-31d-101 (Title) and reenacts as UT ST ? 58-31d-101 (Advanced Practice Registered Nurse Compact) to enacts the Advanced Practice Registered Nurse Compact and repeals the previously enacted compact. © Copyright Thomson/West - NETSCAN's Health Policy Tracking Service Produced by Thomson Reuters Accelus Regulatory Intelligence 27-Jun-2023 THOMSON REUTERS © 2023 Thomson Reuters. No claim to original U.S. Government Works. -29-