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NEW JERSEY REGISTER
VOLUME 36, NUMBER 3
MONDAY, FEBRUARY 2, 2004
RULE PROPOSAL

LAW AND PUBLIC SAFETY
DIVISION OF CONSUMER AFFAIRS
STATE BOARD OF MEDICAL EXAMINERS
CONTINUING MEDICAL EDUCATION


Proposed New Rule: N.J.A.C. 13:35-6.15

Authorized By: State Board of Medical Examiners, William Roeder, Executive Director.

Authority: N.J.S.A. 45:9-2; 45:9-7.1 and 45:1-15.1.
Calendar Reference: See Summary below for explanation of exception to calendar requirement.
Proposal Number: PRN 2004-45.

Submit comments by April 2, 2004 to:

William Roeder, Executive Director

State Board of Medical Examiners

140 East Front Street

PO Box 183

Trenton, New Jersey 08625-0183

The agency proposal follows:

Summary

Pursuant to its general rulemaking authority set forth at N.J.S.A. 45:9-2 and 45:1-15.1, the State Board of Medical Examiners (the Board) is proposing a new rule at N.J.A.C. 13:35-6.15, concerning continuing medical education, in order to implement the provisions of P.L. 2001, c.307, ß 10, which is codified at N.J.S.A. 45:9-7.1. N.J.S.A. 45:9-7.1 requires all persons licensed by the Board as physicians or podiatrists, as a condition of biennial license renewal, to complete 100 credits of continuing medical education in each biennial renewal period. The Board is proposing new rule N.J.A.C. 13:35-6.15 in order to provide licensees with clear direction regarding their continuing medical education obligations. The Board believes that the proposed new rule will ensure that the continuing medical education that licensed physicians and podiatrists practicing in the State obtain is as comprehensive as possible so that such licensees may better serve the needs of their patients.

Proposed new rule N.J.A.C. 13:35-6.15(b) provides that, beginning with the biennial renewal period which commenced on July 1, 2003, all licensees (defined in subsection (a) to mean all physicians and podiatrists licensed by the Board) applying for biennial license renewal must complete 100 credits of continuing medical education in Category I or Category II courses. Category I and Category II courses are defined in subsection (a) of N.J.A.C. 13:35-6.15, consistent with N.J.S.A. 45:9-7.1(i), as those categories of medical education courses recognized by the American Medical Association as credited toward the Physician Recognition Award, and those categories of medical education courses recognized by the American Osteopathic Association or the American Podiatric Medical Association. In order to be recognized by such associations or entities as Category I and Category II courses, the courses offered must have significant educational value, and the providers of such courses must satisfy extensive requirements to ensure that the offerings are scientifically based, accurate, current, and objectively presented. Category I courses differ from Category II courses in that, at the conclusion of the former, attendees receive a written evaluation that verifies the participant's attendance and his or her achievement of established course objectives. Category II courses, on the other hand, do not provide independent verification of attendance and/or achievement of objectives. Category II activities, such as the teaching of residents and medical students, and self-study and online courses, require participants to individually determine the educational value of those activities.

The Board believes that independent verification of course completion is an important component of continuing medical education, because such verification helps to ensure that licensees have achieved established course objectives and goals. Therefore, the Board has provided in subsection (b) of N.J.A.C. 13:35-6.15, that of the 100 credits licensees must obtain, 40 of the credits must be taken in Category I courses.

Although subsection (b) provides that the requirements of the rule will be effective starting with the biennial renewal period beginning on July 1, 2003, the Board recognizes that the proposed new rule is not being adopted and promulgated by that date. Rather, once the new rule is adopted and promulgated, a licensee will have less than the statutorily mandated two years within which to complete the continuing medical education obligations. The Legislature recognized such an eventuality and provided the Board with the authority, set forth at N.J.S.A. 45:9-7.1(f), to authorize completion of continuing medical education credits on a pro-rated basis for any registration period commencing more than 12 months but less than 24 months from the July 2, 2002 effective date of the law. Therefore, so as not to unfairly burden licensees by requiring the completion of 100 credits in less than two years, the Board has provided, in paragraph (b)1, that a licenses shall only be required to complete 50 continuing medical education credits for the biennial renewal period beginning on July 1, 2003, if the new rule becomes effective on or before July 1, 2004. In such a situation, a licensee would have at least one full year to complete one half of the 100 credits. Paragraph (b)1 further specifies that 20 of the required 50 credits must be obtained in Category I courses. If a licensee obtains more than 50 credits in this renewal period, subparagraph (b)1i provides that he or she may carry over no more than 25 credits into the succeeding renewal period. In paragraph (b)2, the Board has provided that no continuing medical education shall be required for the biennial renewal period beginning on July 1, 2003, if the new rule becomes effective after July 1, 2004. The Board believes that it would be unfair to require licensees to complete any continuing medical education credits with less than one year remaining in the license renewal period.

Subsection (c) of N.J.A.C. 13:35-6.15 exempts from the continuing medical education requirements of the proposed new rule any applicant for initial licensure who has completed an accredited graduate medical education program within 12 months prior to licensure. Such applicants, however, are required to complete an orientation course within 24 months of being licensed. The exemption from the continuing medical education requirements, and the required orientation course for such applicants, are mandated by the requirements of N.J.S.A. 45:9-7.1(g) and (h).

N.J.A.C. 13:35-6.15(d) requires an applicant for biennial license renewal to certify that he or she has completed the required number of continuing medical education credits for the preceding biennial renewal period. Subsection (d) further provides that the Board may conduct random audits to determine compliance with the continuing medical education requirements imposed by the new rule. N.J.A.C. 13:35-6.15(e) provides that a licensee who has completed more than 100 credits in a biennial renewal period may carry over up to 25 of those excess credits into the next biennial renewal period.

Subsection (f) exempts from the continuing medical education requirements of the new rule any licensee holding an inactive or retired license. Any licensee holding an inactive or retired license, or a licensee whose license is suspended or revoked, who applies to resume practice, however, must provide proof of having attained 50 credits of continuing medical education for each year that the licensee was out of practice. At least 50 credits must have been obtained in the last year preceding the application to resume practice. The Board may accept the continuing medical education completed by the applicant or may require additional credits as a condition of returning to practice in New Jersey.

N.J.A.C. 13:35-6.15(g) authorizes the Board to delineate specific topics that should be addressed as part of a licensee's continuing medical education. The Board would notify licensees of such topics through the Board newsletter, the Division of Consumer Affairs website or by direct communication to the licensees.

N.J.A.C. 13:35-6.15(h) sets forth the reporting requirements that all licensees must comply with concerning continuing medical education. A licensee must certify, on his or her application for biennial license renewal, completion of the required number of continuing medical education credits. A licensee must maintain evidence verifying completion of continuing medical education requirements for six years following the completion of the credits. Such evidence must be submitted to the Board upon request.

N.J.A.C. 13:35-6.15(i) authorizes the Board to extend the time for completion of the continuing medical education requirements outlined in the new rule, or to waive the requirements, on an individual basis for reasons of hardship, such as severe illness, disability or military service. A licensee seeking an extension and/or a waiver of the requirements must apply to the Board in writing, setting forth the reasons for the request and submitting any documentation to support the request, if applicable. A licensee must request the extension and/or waiver within 60 days of the expiration of the biennial renewal period. All requests must be submitted to the Board by certified mail, return receipt requested. An extension and/or waiver granted pursuant to subsection (i), however, is only effective for the biennial renewal period in which the extension and/or waiver is sought; a licensee must reapply to the Board in order to renew the extension and/or waiver for the next biennial renewal period.

N.J.A.C. 13:35-6.15(j) requires a licensee to provide verification and proof of compliance with the continuing medical education requirements of the proposed new rule for the prior biennial renewal period when a licensee appears before an investigative committee of the Board, or before the Medical Practitioner Review Panel, or when required to do so by Board order, directive or request. N.J.A.C. 13:35-6.15(k) provides that failure to complete the continuing medical education requirements imposed by the new rule, or falsification of any information submitted to the Board as part of a license renewal application, may result in the imposition of penalties or the suspension of an individual's license.

The Board has determined that the comment period for this proposal shall be 60 days; therefore, pursuant to N.J.A.C. 1:30-3.3(a)5, this proposal is excepted from the rulemaking calendar requirement.

Social Impact

The Board believes that proposed new rule N.J.A.C. 13:35-6.15 will have a positive impact upon licensed physicians and podiatrists practicing in the State by clarifying the scope of their continuing medical education obligations, consistent with the statutory requirements imposed by N.J.S.A. 45:9-7.l. In addition, the proposed new rule will have a positive impact upon physicians and podiatrists, as well as the patients they serve, by ensuring that the continuing medical education that such licensees receive is well rounded and current so that they may better serve the needs of their patients.

Economic Impact

The Board believes that proposed new rule N.J.A.C. 13:35-6.15 may have an economic impact upon physicians and podiatrists to the extent that such licensees will incur expenses associated with obtaining the statutorily mandated 100 credits of continuing medical education that now will be required for biennial license renewal. The Board, however, cannot estimate the expense to be borne by licensees because the cost of continuing medical education courses are established by the course providers. Moreover, the costs to be borne by licensees will vary depending on the type of courses they choose to take for continuing medical education credit.

Federal Standards Statement

A Federal standards analysis is not required because the proposed new rule is governed by N.J.S.A. 45:9-1 et seq., and is not subject to any Federal standards or requirements.

Jobs Impact

The Board believes that the proposed new rule may result in the creation of jobs in the State. The proposed new rule, which establishes minimum continuing medical education requirements that all licensed physicians and podiatrists must satisfy, may cause an increase in the number of continuing medical education courses that are currently offered to licensees in the State. Such an increase could result in the creation of additional jobs associated with the provision of continuing medical education courses, such as teaching or promotional positions available with the providers of such courses.

Agriculture Industry Impact

The proposed new rule will not have any impact upon the agriculture industry in the State.

Regulatory Flexibility Analysis

The Regulatory Flexibility Act (the Act), N.J.S.A. 52:14B-16 et seq., requires the Board to provide a description of the types and an estimate of the number of small businesses to which the proposed new rule will apply. If, for purposes of the Act, the 34,573 physicians and podiatrists licensed by the Board are considered "small businesses," then the following analysis applies.

The Act requires the Board to set forth the reporting, recordkeeping and other compliance requirements of the proposed new rule, including the kinds of professional services likely to be needed to comply with the requirements. The Act further requires the Board to estimate the initial and annual compliance costs of the proposed new rule, to outline the manner in which it has designed the proposed new rule to minimize any adverse economic impact upon small businesses, and to set forth whether the proposed new rule establishes differing compliance requirements for small businesses.

Proposed new rule N.J.A.C. 13:35-6.15 will impose various reporting, recordkeeping and compliance requirements upon physicians and podiatrists licensed by the Board, which are set forth in the Summary above.

No additional professional services will be needed to comply with the proposed new rule. The costs of compliance with the proposed new rule are discussed in the Economic Impact above. Since the Board proposes new rule N.J.A.C. 13:35- 6.15 in order to promote the health, safety and welfare of New Jersey consumers, the proposed rule will be uniformly applied and, therefore, no differing compliance requirements for any physician or podiatrist is provided based upon the size of the business.

Smart Growth Impact

The Board does not believe that the proposed new rule will have any impact upon the achievement of smart growth or upon the implementation of the State Development and Redevelopment Plan.

Full text of the proposal follows :

<< NJ ADC 13:35-6.15 >>

13:35-6.15 <<-(Reserved)->> <<+Continuing medical education+>>

<<+(a) The following words and terms, when used in this section, shall have the following meanings, unless the context clearly indicates otherwise:+>>

<<+"Category I" and "Category II" mean the categories of medical education courses recognized by the American Medical Association as credited toward the Physician Recognition Award, and those categories of medical education courses recognized by the American Osteopathic Association or the American Podiatric Medical Association.+>>

<<+"Licensee" means a physician or podiatrist licensed and subject to regulation by the Board of Medical Examiners (the "Board").+>>

<<+(b) Except as provided in (b)1 and 2 and (c) below, a licensee applying for a biennial license renewal shall complete, in each biennial renewal period commencing with the biennial renewal period beginning on July 1, 2003, 100 continuing medical education credits in Category I or Category II courses, of which at least 40 of such credits shall be in Category I.+>>

<<+1. A licensee shall be required to complete 50 continuing medical education credits for the biennial renewal period beginning on July 1, 2003, if this section becomes effective on or before July 1, 2004, of which at least 20 credits shall be in Category I courses.+>>

<<+i. A licensee who completes credits in excess of the 50 continuing medical education credits required pursuant to (b)1 above may apply no more than 25 of the excess credits to the continuing medical education requirements for the following biennial period only.+>>

<<+2. A licensee shall be exempt from the continuing medical education requirements for the biennial renewal period beginning on July 1, 2003, if this section becomes effective after July 1, 2004.+>>

<<+(c) An applicant for initial licensure who has completed an accredited graduate medical education program within 12 months prior to licensure shall be exempt from the continuing medical education requirements of this section for the initial biennial period of licensure. Notwithstanding such exemption from the continuing medical education requirements, the applicant, once licensed by the Board, shall complete, within 24 months of becoming licensed, an orientation course which is presented or approved by the Board.+>>

<<+(d) A licensee shall certify on the application for biennial licensure renewal that he or she has completed the required number of continuing medical education credits. The Board may conduct random audits to determine licensee compliance with the continuing medical education requirements of this section.+>>

<<+(e) A licensee who completes credits in excess of the 100 continuing medical education credits required pursuant to this section may apply no more than 25 of the excess credits to the continuing medical education requirements for the following biennial period only.+>>

<<+(f) Licensees holding an inactive or retired license shall be exempt from continuing medical education requirements, except that any licensee holding an inactive or retired license, or whose license is suspended or revoked, who applies to resume practice shall provide proof of having attained 50 credits of continuing medical education for each year out of practice in New Jersey. At least 50 credits shall have been obtained in the year preceding the application to resume practice. At the time of application to resume practice, the licensee shall provide proof of the completed continuing medical education during the period while out of practice in New Jersey. The Board may accept such continuing medical education credits or require additional credits as a condition to return to practice.+>>

<<+(g) The Board may delineate specific topics of medical education which the Board deems necessary to address a particular issue or problem. Notification of the specific topic(s) shall be through the Board newsletter, the Division of Consumer Affairs website or by direct communication to licensees.+>>

<<+(h) To report continuing medical education credits, a licensee shall:+>>

<<+1. Certify, on the application for biennial renewal, completion of the required number of continuing medical education credits; and+>>

<<+2. Maintain all evidence of verification of continuing medical education requirements for a period of six years after completion of the credits and submit such documentation to the Board upon request.+>>

<<+(i) The Board may extend the time period for completion of continuing medical education requirements or may waive continuing medical education requirements on an individual basis for reasons of hardship, such as severe illness, disability or military service, consistent with the following:+>>

<<+1. A licensee seeking an extension and/or waiver of the continuing medical education requirements shall apply to the Board in writing and set forth in specific detail the reasons for requesting the extension and/or waiver. The licensee shall submit to the Board all documentation in support of the extension and/or waiver;+>>

<<+2. A licensee shall apply for an extension and/or waiver within 60 days of the expiration of the biennial renewal period. All requests shall be sent to the Board office, by certified mail, return receipt requested; and+>>

<<+3. An extension and/or waiver granted pursuant to this section shall be effective for the biennial licensure period in which the extension and/or waiver is granted. If the condition(s) which necessitated the extension and/or waiver continues into the next biennial period, the licensee shall apply to the Board for the renewal of such extension and/or waiver for the new biennial period.+>>

<<+(j) A licensee shall provide verification and proof of compliance with continuing medical education requirements for the prior biennial renewal period when appearing before an investigative committee of the Board or the Medical Practitioner Review Panel, or when required to do so pursuant to a Board Order, Directive or request.+>>

<<+(k) Failure to complete continuing medical education requirements or falsification of any information submitted on a renewal application shall provide cause for penalties and/or license suspension pursuant to N.J.S.A. 45:1-21.+>>

 

  

  

  

  

  

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