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As Introduced
136th
General Assembly
Regular
Session
H. B. No. 763
2025-2026
Representative White, A.
To
amend section 4731.281 and to enact
sections
4731.2911, 4731.2912, and 4731.2913
of the Revised Code
to
authorize the State Medical Board to issue limited licenses to
certain international physicians.
BE
IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section
1.
That
section 4731.281 be amended and
sections
4731.2911, 4731.2912, and 4731.2913
of the Revised Code be enacted to read as follows:
Sec.
4731.281.
(A)(1)
A license issued under this chapter to practice medicine and surgery,
osteopathic medicine and surgery, or podiatric medicine and surgery
shall be valid for a two-year period unless revoked or suspended. A
license shall expire on the date that is two years from the date of
issuance and
,
except as provided in section 4731.2911 of the Revised Code,
may be renewed for additional two-year periods. Applications for
renewal shall be submitted to the state medical board in a manner
prescribed by the board.
Each
application shall be accompanied by a biennial renewal fee of three
hundred five dollars.
The
board shall deposit the fee in accordance with section 4731.24 of the
Revised Code, except that the board shall deposit twenty dollars of
the fee into the state treasury to the credit of the physician loan
repayment fund created by section 3702.78 of the Revised Code.
(2)
The board shall provide a renewal notice to every person holding a
license to practice medicine and surgery, osteopathic medicine and
surgery, or podiatric medicine and surgery, a renewal notice. The
board may provide the notice to the person through the secretary of
any recognized medical, osteopathic, or podiatric society. The notice
shall be provided to the person at least one month prior to the date
on which the person's license expires.
(3)
Failure of any person to receive a notice of renewal from the board
shall not excuse the person from the requirements contained in this
section.
(4)
The board's notice shall inform the applicant of the renewal
procedure. The board shall provide the application for renewal in a
form determined by the board.
(5)
The applicant shall provide in the application the applicant's full
name; the applicant's residence address, business address, and
electronic mail address; the number of the applicant's license to
practice; and any other information required by the board.
(6)(a)
Except as provided in division (A)(6)(b) of this section, in the case
of an applicant who prescribes or personally furnishes opioid
analgesics or benzodiazepines, as defined in section 3719.01 of the
Revised Code, the applicant shall certify to the board whether the
applicant has been granted access to the drug database established
and maintained by the state board of pharmacy pursuant to section
4729.75 of the Revised Code.
(b)
The requirement described in division (A)(6)(a) of this section does
not apply if any of the following is the case:
(i)
The state board of pharmacy notifies the state medical board pursuant
to section 4729.861 of the Revised Code that the applicant has been
restricted from obtaining further information from the drug database.
(ii)
The state board of pharmacy no longer maintains the drug database.
(iii)
The applicant does not practice medicine and surgery, osteopathic
medicine and surgery, or podiatric medicine and surgery in this
state.
(c)
If an applicant certifies to the state medical board that the
applicant has been granted access to the drug database and the board
finds through an audit or other means that the applicant has not been
granted access, the board may take action under section 4731.22 of
the Revised Code.
(7)
The applicant shall indicate whether the applicant currently
collaborates, as that term is defined in section 4723.01 of the
Revised Code, with any clinical nurse specialists, certified
nurse-midwives, or certified nurse practitioners.
(8)
The applicant shall report any criminal offense to which the
applicant has pleaded guilty, of which the applicant has been found
guilty, or for which the applicant has been found eligible for
intervention in lieu of conviction, since last submitting an
application for a license to practice or renewal of a license.
(9)
The applicant shall execute and deliver the application to the board
in a manner prescribed by the board.
(B)
The board shall renew a license under this chapter to practice
medicine and surgery, osteopathic medicine and surgery, or podiatric
medicine and surgery upon application and qualification therefor in
accordance with this section. A renewal shall be valid for a two-year
period.
(C)
Failure of any license holder to renew and comply with this section
shall operate automatically to suspend the holder's license to
practice and if applicable, the holder's certificate to recommend
issued under section 4731.30 of the Revised Code. Continued practice
after the suspension shall be considered as practicing in violation
of section 4731.41, 4731.43, or 4731.60 of the Revised Code.
If
the license has been suspended pursuant to this division for two
years or less, it may be reinstated. The board shall reinstate a
license to practice suspended for failure to renew upon an
applicant's submission of a renewal application and payment of a
reinstatement fee of four hundred five dollars.
If
the license has been suspended pursuant to this division for more
than two years, it may be restored. Subject to section 4731.222 of
the Revised Code, the board may restore a license to practice
suspended for failure to renew upon an applicant's submission of a
restoration application, payment of a restoration fee of five hundred
five dollars, and compliance with sections 4776.01 to 4776.04 of the
Revised Code. The board shall not restore to an applicant a license
unless the board, in its discretion, decides that the results of the
criminal records check do not make the applicant ineligible for a
license issued pursuant to section 4731.14 or 4731.56 of the Revised
Code.
Any
reinstatement or restoration of a license to practice under this
section shall operate automatically to renew the holder's certificate
to recommend.
(D)
The state medical board may obtain information not protected by
statutory or common law privilege from courts and other sources
concerning malpractice claims against any person holding a license to
practice under this chapter or practicing as provided in section
4731.36 of the Revised Code.
(E)
Each renewal notice provided by the board under division (A)(2) of
this section to a person holding a license to practice medicine and
surgery or osteopathic medicine and surgery shall inform the
applicant of the reporting requirement established by division (H) of
section 3701.79 of the Revised Code. At the discretion of the board,
the information may be included on the application for renewal or on
an accompanying page.
(F)
Each person holding a license to practice medicine and surgery,
osteopathic medicine and surgery, or podiatric medicine and surgery
shall give notice to the board of a change in the license holder's
residence address, business address, or electronic mail address not
later than thirty days after the change occurs.
Sec.
4731.2911.
(A)
As used in this section, "world directory of medical schools"
means the directory of medical schools maintained by the world
federation for medical education and the foundation for advancement
of international medical education and research or their successor
organizations.
(B)
With respect to an individual educated, trained, and licensed as a
physician in a country other than the United States or Canada, the
state medical board may issue to the individual a limited license to
practice medicine and surgery or osteopathic medicine and surgery in
this state.
An
individual who seeks a limited license under this section shall
submit to the board a written application on a form prescribed and
supplied by the board. The application shall include all the
information the board considers necessary to process it. An applicant
shall include with the application a fee of three hundred five
dollars, no part of which may be returned. An application is not
considered submitted until the board receives the fee.
(C)
To be eligible for a limited license under this section, an applicant
shall submit evidence to the board demonstrating that all of the
following are the case:
(1)
The applicant has completed both of the following:
(a)
Requirements for a degree in medicine from a medical school listed in
either the world directory of medical schools or another such listing
or directory approved by the board;
(b)
Post-graduate medical training that the board determines is similar
to that required for licensure in this state or another state and
that involves practice in the following six general competency
domains: interpersonal and communication skills; medical knowledge;
patient care and procedural skills; practice-based learning and
improvement; professionalism; and systems-based practice.
(2)
The applicant held, either at the time of the applicant's departure
from the applicant's country of training or within the three years
immediately preceding the date the application is submitted, an
unrestricted license to practice medicine and surgery or osteopathic
medicine and surgery issued by the licensing authority of either of
the following:
(a)
A country other than the United States or Canada;
(b)
A province or state located in a country other than United States or
Canada.
(3)
The applicant satisfies any of the following:
(a)
Has practiced medicine and surgery or osteopathic medicine and
surgery under the license described in division (C)(2) of this
section for at least three of the last five years immediately
preceding the date the application is submitted or for another
practice period acceptable to the board;
(b)
Following completion of the requirements and training described in
division (C)(1) of this section, actively practiced medicine and
surgery or osteopathic medicine and surgery for at least ten years
under a license to practice medicine and surgery or osteopathic
medicine and surgery issued by a country, province, or state
described in division (C)(2) of this section;
(c)
Any requirement established by the board as an alternative to
satisfying division (C)(3)(a) or (b) of this section.
(4)
The applicant does not have any pending discipline before the
licensing authority described in division (C)(2) of this section.
(5)
The applicant holds a valid certification issued by the educational
commission on foreign medical graduates or an equivalent
certification as determined by the board.
(6)
The applicant has successfully passed steps one and two of the United
States medical licensing examination or comprehensive osteopathic
medical licensing examination of the United States.
(7)
The applicant has an offer of full-time employment as a physician
from a participating health care entity that meets the requirements
of division (D) of this section.
(8)
The applicant is eligible to obtain from the United States government
an immigrant status that authorizes employment as a physician in the
United State.
(9)
The applicant is in compliance with section 4731.08 of the Revised
Code.
For
purposes of division (C)(2) of this section, the applicant shall
submit as evidence a copy of the license described in that division.
For purposes of division (C)(7) of this section, the applicant shall
submit as evidence a copy of the participating health care entity's
offer of full-time employment.
If
any evidence to be submitted under this division is expressed in a
language other than English, the applicant shall submit two copies of
that evidence, one in the language other than English and another
translated into English.
(D)
A participating health entity shall meet all of the following
requirements:
(1)
The participating health entity shall be any of the following located
in this state: a hospital, federally qualified health center,
community health center, or other entity providing health services
acceptable to the board.
(2)
Subject to division (E) of this section, the participating health
entity shall assess and evaluate the holder's practice.
(3)
The participating health entity shall employ, to serve as a limited
license holder's evaluator, one or more individuals meeting the
following conditions: each individual holds a current, valid license
to practice medicine and surgery or osteopathic medicine and surgery
issued under section 4731.14 of the Revised Code, and each individual
has been granted institutional privileges by the entity.
(4)
The participating health entity shall carry medical malpractice
insurance that covers a limited license holder for the duration of
the holder's full-time employment with the entity.
(5)
The participating health entity shall not retaliate against or
discipline a limited license holder for raising a complaint or
pursuing enforcement related to the holder's full-time employment
with the entity.
(E)
A participating health entity shall assess and evaluate the practice
of each limited license holder it employs, including at the
commencement and end, and over the duration, of the holder's
employment. A participating health entity also shall establish a
program for such assessments and evaluations, which may include the
development of assessment and evaluation measures.
In
meeting the requirements of this division, a participating health
entity shall assess and evaluate each holder's practice and
competency as follows:
(1)
In accordance with criteria established by the board in rule;
(2)
In accordance with any assessment and evaluation measures developed
under the entity's program;
(3)
Across the six general competency domains described in division
(C)(1)(b) of this section.
If
a holder's assessment or evaluation identifies any practice
deficiencies, the participating health entity and holder shall engage
in efforts to address them.
(F)
The secretary and supervising member of the board shall review each
application submitted to determine if the requirements of divisions
(B) and (C) of this section have been met. In conducting such a
review, the secretary and supervising member shall not be responsible
for verifying the applicant's status as described in division (C)(8)
of this section. If the secretary and supervising member determine
that an applicant meets the requirements of divisions (B) and (C) of
this section, the board shall issue a limited license to the
applicant.
(G)
After the board issues a limited license, all of the following apply
to the board or a license holder or participating health care entity:
(1)
Before commencing employment with a participating health entity
described in division (C)(7) of this section, the holder shall obtain
from the United States government an immigrant status that authorizes
employment as a physician.
(2)
At the commencement of a holder's employment with a participating
health care entity described in division (C)(7) of this section, the
participating health care entity shall assess and evaluate the holder
as described in divisions (D)(2) and (E) of this section.
(3)
The holder shall notify the board of any change to the holder's
employment that occurs during the two-year period in which the
holder's limited license remains valid.
(4)
Every six months over the course of the two-year license period and
also on the request of the board, the holder shall submit to the
board a statement certifying whether the holder has maintained
full-time employment as a physician with a participating health
entity and whether the holder has been subject to employer discipline
because of the holder's practice.
(5)
The holder may be employed by any participating health entity that
meets the requirements of division (D) of this section, and the board
shall not require the holder to maintain full-time employment with
the participating health entity described in division (C)(7) of this
section.
(6)
At the end of a holder's employment with a participating health
entity and as part of the assessment and evaluation performed at that
time as described in division (E) of this section, the participating
health entity shall submit to the board a written recommendation
regarding the holder's fitness for a converted license.
(H)(1)
A limited license issued under this section expires on the date that
is two years from the date of its issuance and may be renewed only
once for an additional two-year period. During an initial or
additional two-year period, such a license may be revoked, suspended,
or limited or its holder may be reprimanded or placed on probation as
described in division (I) of this section.
(2)
At least one month prior to the date on which an initial two-year
period expires, the board shall provide notice to the limited license
holder that the license may be renewed for an additional period or
converted to a license to practice medicine and surgery or
osteopathic medicine and surgery issued under section 4731.14 of the
Revised Code.
(3)
At least one month prior to the date on which an additional two-year
period expires, the board shall provide notice to the license holder
that the limited license may be converted to a license to practice
medicine and surgery or osteopathic medicine and surgery issued under
section 4731.14 of the Revised Code.
(4)
To be eligible for renewal of a limited license, the license holder
shall pay to the board a renewal fee of three hundred five dollars,
no part of which may be returned, and shall demonstrate to the board
that the holder has maintained over the course of the license period
full-time employment as a physician with a participating health
entity.
If
the holder pays the fee and makes such a demonstration prior to the
limited license's expiration date, the board shall renew the limited
license for one additional two-year period.
(5)
To be eligible to convert a limited license to a license issued under
section 4731.14 of the Revised Code, the limited license holder shall
pay to the board a conversion fee of three hundred five dollars, no
part of which may be returned, and shall submit evidence to the board
demonstrating that the holder has done all of the following:
(a)
Maintained over the course of each license period full-time
employment as a physician with a participating health entity;
(b)
Successfully passed step three of the United States medical licensing
examination or comprehensive osteopathic medical licensing
examination of the United States;
(c)
Successfully completed each of the holder's participating health
entity's assessments and evaluations described in division (E) of
this section;
(d)
Successfully addressed any practice deficiencies identified by an
assessment and evaluation program as described in division (E) of
this section;
(e)
Successfully engaged in independent and unsupervised practice in the
six general competency domains described in division (C)(1)(b) of
this section.
If
the holder pays the fee and makes such a demonstration prior to the
limited license's expiration date, the board shall convert the
limited license to a license issued under section 4731.14 of the
Revised Code, unless a recommendation described in division (G)(6) of
this section demonstrates to the board that the holder is not fit for
such a license.
After
a limited license is converted to a license issued under section
4731.14 of the Revised Code, the license is then subject to the
renewal schedule and requirements described in section 4731.281 of
the Revised Code.
(I)(1)
The board may revoke, suspend, limit, or refuse to renew or reinstate
a limited license issued under this section, or reprimand or place on
probation the holder of such a license, if the holder fails to
maintain full-time employment as a physician with a participating
entity at any point during the two-year period in which the holder's
limited license remains valid.
(2)
The board also may revoke, suspend, limit, or refuse to issue, renew,
or reinstate a limited license issued under this section, or
reprimand or place on probation the holder of such a license, for any
of the reasons specified in division (B) of section 4731.22 of the
Revised Code.
(3)
Any action taken under division (I)(1) or (2) of this section shall
be be taken in accordance with Chapter 119. of the Revised Code.
(J)
The board shall adopt rules to establish criteria by which a
participating health entity shall assess and evaluate the medical
practice of a limited license holder.The board may adopt additional
rules as necessary to implement this section. All rules shall be
adopted in accordance with Chapter 119. of the Revised Code.
Sec.
4731.2912.
(A)
The state medical board may require a participating health care
entity, as described in section 4731.2911 of the Revised Code, to
provide the board with data and other information that the entity
maintains concerning the effectiveness of the entity's assessment and
evaluation program established under division (E) of section
4731.2911 of the Revised Code. Such data and information shall be
provided to the board in the manner the board prescribes.
(B)
On receipt of data and other information under this section, the
board may share it with any other entities that the board considers
appropriate and shall include it in the board's annual report
required by section 149.01 of the Revised Code. In sharing and
reporting under this division, the board shall not include data or
information that identifies, or tends to identify, any particular
individual.
Sec.
4731.2913.
(A)
As used in this section, "accreditation council for graduate
medical education" means the organization known by that name or
its successor organization.
(B)
The state medical board shall appoint a council for the purpose of
advising the board on issues relating to physicians practicing in
this state but trained in countries other than the United States and
Canada, in particular, physicians holding limited licenses issued
under section 4731.2911 of the Revised Code. The council shall
consist of both of the following:
(1)
Members with experience in recruiting or employing internationally
trained physicians. Such members shall include representatives of
physician residency programs and individuals familiar with residency
and fellowship program education standards established by the
accreditation council for graduate medical education.
(2)
Members with experience in assessing or evaluating the practice of
internationally trained physicians. Such members shall include
representatives of programs established by participating health
entities under division (E) of section 4731.2911 of the Revised Code.
(C)
The board shall do all of the following:
(1)
Determine the council's total number of members;
(2)
Appoint the council's membership;
(3)
Establish the council's duties, which shall include issuing
recommendations to the board to assist it in determining the practice
eligibility of applicants seeking limited licenses under section
4731.2911 of the Revised Code;
(4)
Specify the frequency of council meetings, which may be conducted
remotely.
Section
2.
That
existing section 4731.281 of the Revised Code is hereby repealed.