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HB-4466, As Passed House, June 3, 2026
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HOUSE BILL NO. 4466
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending sections 16221 and 16226 (MCL 333.16221 and 333.16226),
as amended by 2023 PA 209.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
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Sec. 16221. Subject to section 16221b, the department shall
investigate any allegation that 1 or more of the grounds for
disciplinary subcommittee action under this section exist, and may
investigate activities related to the practice of a health
May 07, 2025, Introduced by Reps. Greene, Outman, Rigas, Johnsen, Markkanen, Pavlov,
Maddock, Fox, Paquette, Kunse, Martin, Carra, Schriver, Woolford, Wortz and Meerman and
referred to Committee on Health Policy.
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profession by a licensee, a registrant, or an applicant for
licensure or registration. The department may hold hearings,
administer oaths, and order the taking of relevant testimony. After
its investigation, the department shall provide a copy of the
administrative complaint to the appropriate disciplinary
subcommittee. The disciplinary subcommittee shall proceed under
section 16226 if it finds that 1 or more of the following grounds
exist:
(a) Except as otherwise specifically provided in this section,
a violation of general duty, consisting of negligence or failure to
exercise due care, including negligent delegation to or supervision
of employees or other individuals, whether or not injury results,
or any conduct, practice, or condition that impairs, or may impair,
the ability to safely and skillfully engage in the practice of the
health profession.
(b) Personal disqualifications, consisting of 1 or more of the
following:
(i) Incompetence.
(ii) Subject to sections 16165 to 16170a, substance use
disorder as that term is defined in section 100d of the mental
health code, 1974 PA 258, MCL 330.1100d.
(iii) Mental or physical inability reasonably related to and
adversely affecting the licensee's or registrant's ability to
practice in a safe and competent manner.
(iv) Declaration of mental incompetence by a court of competent
jurisdiction.
(v) Conviction of a misdemeanor punishable by imprisonment for
a maximum term of 2 years; conviction of a misdemeanor involving
the illegal delivery, possession, or use of a controlled substance;
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or conviction of any felony other than a felony listed or described
in another subparagraph of this subdivision. A certified copy of
the court record is conclusive evidence of the conviction.
(vi) Lack of good moral character.
(vii) Conviction of a criminal offense under section 520e or
520g of the Michigan penal code, 1931 PA 328, MCL 750.520e and
750.520g. A certified copy of the court record is conclusive
evidence of the conviction.
(viii) Conviction of a violation of section 492a of the Michigan
penal code, 1931 PA 328, MCL 750.492a. A certified copy of the
court record is conclusive evidence of the conviction.
(ix) Conviction of a misdemeanor or felony involving fraud in
obtaining or attempting to obtain fees related to the practice of a
health profession. A certified copy of the court record is
conclusive evidence of the conviction.
(x) Final adverse administrative action by a licensure,
registration, disciplinary, or certification board involving the
holder of, or an applicant for, a license or registration regulated
by another state or a territory of the United States, by the United
States military, by the federal government, or by another country.
A certified copy of the record of the board is conclusive evidence
of the final action.
(xi) Conviction of a misdemeanor that is reasonably related to
or that adversely affects the licensee's or registrant's ability to
practice in a safe and competent manner. A certified copy of the
court record is conclusive evidence of the conviction.
(xii) Conviction of a violation of section 430 of the Michigan
penal code, 1931 PA 328, MCL 750.430. A certified copy of the court
record is conclusive evidence of the conviction.
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(xiii) Conviction of a criminal offense under section 83, 84,
316, 317, 321, 520b, 520c, 520d, or 520f of the Michigan penal
code, 1931 PA 328, MCL 750.83, 750.84, 750.316, 750.317, 750.321,
750.520b, 750.520c, 750.520d, and 750.520f. A certified copy of the
court record is conclusive evidence of the conviction.
(xiv) Conviction of a violation of section 136 or 136a of the
Michigan penal code, 1931 PA 328, MCL 750.136 and 750.136a. A
certified copy of the court record is conclusive evidence of the
conviction.
(xv) Conviction of a violation of section 90 of the Michigan
penal code, 1931 PA 328, MCL 750.90, or a violation of a state or
federal crime that is substantially similar to the violation
described in this subparagraph. A certified copy of the court
record is conclusive evidence of the conviction.
(c) Prohibited acts, consisting of 1 or more of the following:
(i) Fraud or deceit in obtaining or renewing a license or
registration.
(ii) Permitting a license or registration to be used by an
unauthorized person.
(iii) Practice outside the scope of a license.
(iv) Obtaining, possessing, or attempting to obtain or possess
a controlled substance or a drug as that term is defined in section
7105 without lawful authority; or selling, prescribing, giving
away, or administering drugs for other than lawful diagnostic or
therapeutic purposes.
(v) A final order or judgment under the protecting minors from
chemical and surgical mutilation act. A certified copy of the court
record is conclusive evidence of the final order or judgment.
(d) Except as otherwise specifically provided in this section,
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unethical business practices, consisting of 1 or more of the
following:
(i) False or misleading advertising.
(ii) Dividing fees for referral of patients or accepting
kickbacks on medical or surgical services, appliances, or
medications purchased by or in behalf of patients.
(iii) Fraud or deceit in obtaining or attempting to obtain third
party reimbursement.
(e) Except as otherwise specifically provided in this section,
unprofessional conduct, consisting of 1 or more of the following:
(i) Misrepresentation to a consumer or patient or in obtaining
or attempting to obtain third party reimbursement in the course of
professional practice.
(ii) Betrayal of a professional confidence.
(iii) Promotion for personal gain of an unnecessary drug,
device, treatment, procedure, or service.
(iv) Either of the following:
(A) A requirement by a licensee other than a physician or a
registrant that an individual purchase or secure a drug, device,
treatment, procedure, or service from another person, place,
facility, or business in which the licensee or registrant has a
financial interest.
(B) A referral by a physician for a designated health service
that violates 42 USC 1395nn or a regulation promulgated under that
section. For purposes of this subdivision, 42 USC 1395nn and the
regulations promulgated under that section as they exist on June 3,
2002 are incorporated by reference. A disciplinary subcommittee
shall apply 42 USC 1395nn and the regulations promulgated under
that section regardless of the source of payment for the designated
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health service referred and rendered. If 42 USC 1395nn or a
regulation promulgated under that section is revised after June 3,
2002, the department shall officially take notice of the revision.
Within 30 days after taking notice of the revision, the department
shall decide whether or not the revision pertains to referral by
physicians for designated health services and continues to protect
the public from inappropriate referrals by physicians. If the
department decides that the revision does both of those things, the
department may promulgate rules to incorporate the revision by
reference. If the department does promulgate rules to incorporate
the revision by reference, the department shall not make any
changes to the revision. As used in this sub-subparagraph,
"designated health service" means that term as defined in 42 USC
1395nn and the regulations promulgated under that section and
"physician" means that term as defined in sections 17001 and 17501.
(v) For a physician who makes referrals under 42 USC 1395nn or
a regulation promulgated under that section, refusing to accept a
reasonable proportion of patients eligible for Medicaid and
refusing to accept payment from Medicaid or Medicare as payment in
full for a treatment, procedure, or service for which the physician
refers the individual and in which the physician has a financial
interest. A physician who owns all or part of a facility in which
the physician provides surgical services is not subject to this
subparagraph if a referred surgical procedure the physician
performs in the facility is not reimbursed at a minimum of the
appropriate Medicaid or Medicare outpatient fee schedule, including
the combined technical and professional components.
(vi) Any conduct by a licensee or registrant with a patient
while the licensee or registrant is acting within the health
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profession for which the licensee or registrant is licensed or
registered, including conduct initiated by a patient or to which
the patient consents, that is sexual or may reasonably be
interpreted as sexual, including, but not limited to, sexual
intercourse, kissing in a sexual manner, or touching of a body part
for any purpose other than appropriate examination, treatment, or
comfort.
(vii) Offering to provide practice-related services, such as
drugs, in exchange for sexual favors.
(viii) A violation of section 16655(4) by a dental therapist.
(f) Failure to notify under section 16222(3) or (4).
(g) Failure to report a change of name or mailing address as
required in section 16192.
(h) A violation, or aiding or abetting in a violation, of this
article or of a rule promulgated under this article.
(i) Failure to comply with a subpoena issued pursuant to this
part, failure to respond to a complaint issued under this article,
article 7, or article 8, failure to appear at a compliance
conference or an administrative hearing, or failure to report under
section 16222(1) or 16223.
(j) Failure to pay an installment of an assessment levied
under the insurance code of 1956, 1956 PA 218, MCL 500.100 to
500.8302, within 60 days after notice by the appropriate board.
(k) A violation of section 17013 or 17513.
(l) Failure to meet 1 or more of the requirements for licensure
or registration under section 16174.
(m) A violation of section 17015, 17015a, or 17515.
(n) Failure to comply with section 9206(3).
(o) A violation of section 5654 or 5655.
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(p) A violation of section 16274.
(q) A violation of section 17020 or 17520.
(r) A violation of the medical records access act, 2004 PA 47,
MCL 333.26261 to 333.26271.
(s) A violation of section 17764(2).
(t) Failure to comply with the terms of a practice agreement
described in section 17047(2)(a) or (b), 17547(2)(a) or (b), or
18047(2)(a) or (b).
(u) A violation of section 7303a(2).
(v) A violation of section 7303a(4) or (5).
(w) A violation of section 7303b.
(x) A violation of section 17754a.
(y) Beginning January 1, 2021, a A violation of section 24507
or 24509.
Sec. 16226. (1) After finding the existence of 1 or more of
the grounds for disciplinary subcommittee action listed in section
16221, a disciplinary subcommittee shall impose 1 or more of the
following sanctions for each violation:
Violations of Section 16221 Sanctions
Subdivision (a), (b)(i), Probation, limitation, denial,
(b)(ii), (b)(iii), (b)(iv), suspension, revocation,
(b)(v), (b)(vi), (b)(vii), permanent revocation,
(b)(ix), (b)(x), (b)(xi), restitution, or fine.
or (b)(xii)
Subdivision (b)(viii) or
(c)(v)
Revocation, permanent revocation,
or denial.
Subdivision (b)(xiii) Permanent revocation for a
violation described in
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subsection (5); otherwise,
probation, limitation, denial,
suspension, revocation,
restitution, or fine.
Subdivision (b)(xiv) or
(b)(xv)
Permanent revocation.
Subdivision (c)(i) Denial, revocation, suspension,
probation, limitation, or fine.
Subdivision (c)(ii) Denial, suspension, revocation,
restitution, or fine.
Subdivision (c)(iii) Probation, denial, suspension,
revocation, restitution, or fine.
Subdivision (c)(iv) Fine, probation, denial,
or (d)(iii) suspension, revocation, permanent
revocation, or restitution.
Subdivision (d)(i) Reprimand, fine, probation,
or (d)(ii) denial, or restitution.
Subdivision (e)(i), Reprimand, fine, probation,
(e)(iii), (e)(iv), (e)(v), limitation, suspension,
(h), or (r) revocation, permanent revocation,
denial, or restitution.
Subdivision (e)(ii) Reprimand, probation, suspension,
or (i) revocation, permanent
revocation, restitution, denial,
or fine.
Subdivision (e)(vi), Probation, suspension, revocation,
(e)(vii), or (e)(viii) limitation, denial, restitution,
or fine.
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Subdivision (f) Reprimand, denial, limitation,
probation, or fine.
Subdivision (g) Reprimand or fine.
Subdivision (j) Suspension or fine.
Subdivision (k), (o), Reprimand, probation, suspension,
or (q) revocation, permanent revocation,
or fine.
Subdivision (l) Reprimand, denial, or limitation.
Subdivision (m) or (n) Denial, revocation, restitution,
probation, suspension,
limitation, reprimand, or fine.
Subdivision (p) Revocation.
Subdivision (s) Revocation, permanent revocation,
fine, or restitution.
Subdivision (t) Denial, revocation, probation,
suspension, limitation, reprimand,
or fine.
Subdivision (u) or (w) Probation, limitation, denial,
fine, suspension, revocation, or
permanent revocation.
Subdivision (v) Denial, fine, reprimand,
probation, limitation,
suspension, revocation, or
permanent revocation.
Subdivision (x) Subject to subsection (7), fine.
Subdivision (y) Fine.
(2) Determination of sanctions for violations under this
section must be made by a disciplinary subcommittee. If, during
judicial review, the court of appeals determines that a final
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decision or order of a disciplinary subcommittee prejudices
substantial rights of the petitioner for 1 or more of the grounds
listed in section 106 of the administrative procedures act of 1969,
MCL 24.306, and holds that the final decision or order is unlawful
and is to be set aside, the court shall state on the record the
reasons for the holding and may remand the case to the disciplinary
subcommittee for further consideration.
(3) A disciplinary subcommittee may impose a fine in an amount
that does not exceed $250,000.00 for a violation of section
16221(a) or (b). A disciplinary subcommittee shall impose a fine of
at least $25,000.00 if the violation of section 16221(a) or (b)
results in the death of 1 or more patients.
(4) A disciplinary subcommittee may require a licensee or
registrant or an applicant for licensure or registration who has
violated this article, article 7, or article 8 or a rule
promulgated under this article, article 7, or article 8 to
satisfactorily complete an educational program, a training program,
or a treatment program, a mental, physical, or professional
competence examination, or a combination of those programs and
examinations.
(5) A disciplinary subcommittee shall impose the sanction of
permanent revocation for a violation of section 16221(b)(xiii) if the
violation occurred while the licensee or registrant was acting
within the health profession for which the licensee or registrant
was licensed or registered.
(6) Except as otherwise provided in subsection (5) and this
subsection, a disciplinary subcommittee shall not impose the
sanction of permanent revocation under this section without a
finding that the licensee or registrant engaged in a pattern of
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intentional acts of fraud or deceit resulting in personal financial
gain to the licensee or registrant and harm to the health of
patients under the licensee's or registrant's care. This subsection
does not apply if a disciplinary subcommittee finds that a licensee
or registrant has violated section 16221(b)(xiv), or (b)(xv), or
(c)(v).
(7) A disciplinary subcommittee shall impose a fine of not
more than $250.00 for each violation of section 16221(x).
Enacting section 1. This amendatory act does not take effect
unless Senate Bill No. ____ (request no. S00335'25) or House Bill
No. 4467 (request no. H00335'25) of the 103rd Legislature is
enacted into law.