TITLE 4. PROFESSIONS AND OCCUPATIONS
CHAPTER 16. ARIZONA MEDICAL BOARD
Supp. 08-1
(Authority: A.R.S. § 32-1401 et seq.)
Editor's Note: The name of the Allopathic Board of Medical Examiners was changed to the Arizona Medical Board by Laws 2002, Ch. 254, § 9, effective August 22, 2002 (Supp. 03-2).
ARTICLE 1. GENERAL PROVISIONS
Article 1, consisting of Sections R4-16-101 through R4-16-106, adopted effective June 1, 1984.
Former Article 1, consisting of Sections R4-16-01 through R4-16-16, repealed effective June 1, 1984 (Supp. 84-3).
Section
R4-16-101. Definitions
R4-16-102. Continuing Medical Education
R4-16-103. Rehearing or Review of Board Decision
R4-16-104. Recodified
R4-16-105. Recodified
R4-16-106. Recodified
R4-16-107. Recodified
R4-16-108. Recodified
R4-16-109. Recodified
ARTICLE 2. LICENSURE
Article 2 heading, recodified to Article 3 heading, at 11 A.A.R. 1283, effective March 25, 2005 (Supp. 05-1).
Article 2, consisting of Sections R4-16-201 through R4-16-205, adopted effective September 22, 1995 (Supp. 95-3).
Section
R4-16-201. Application for Licensure
R4-16-202. Application for Pro Bono Registration
R4-16-203. Application for Locum Tenens Registration
R4-16-204. Licensure by Endorsement
R4-16-205. Miscellaneous Fees
R4-16-206. Time-frames for Licenses, Permits, and Registrations
R4-16-207. Time-frames for License Renewal; Expiration
Table 1. Time-frames
ARTICLE 3. DISPENSING OF DRUGS
Article 3 heading, recodified from Article 2 heading, at 11 A.A.R. 1283, effective March 25, 2005 (Supp. 05-1).
Article 3, consisting of Sections R4-16-301 through R4-16-303, adopted effective February 2, 2000 (Supp. 00-1).
Section
R4-16-301. Registration and Renewal
R4-16-302. Packaging and Inventory; Exception
R4-16-303. Prescribing and Dispensing Requirements
R4-16-304. Recordkeeping and Reporting Shortages
R4-16-305. Inspections; Denial and Revocation
ARTICLE 4. MEDICAL ASSISTANTS
Section
R4-16-401. Medical Assistant Training Requirements
R4-16-402. Authorized Procedures for Medical Assistants
R4-16-403. Renumbered
R4-16-404. Recodified
R4-16-405. Recodified
R4-16-406. Recodified
R4-16-407. Recodified
R4-16-408. Recodified
R4-16-409. Recodified
R4-16-410. Recodified
ARTICLE 5. EXECUTIVE DIRECTOR DUTIES
Article 5, consisting of Sections R4-16-501 through R4-16-505, renumbered by exempt rulemaking at 11 A.A.R. 1056, effective February 18, 2005 (Supp. 05-1).
Article 5, consisting of Sections R4-16-501 through R4-16-505, made by exempt rulemaking at 9 A.A.R. 2274, effective August 12, 2003 (Supp. 03-2).
Section
R4-16-501. Interim Evaluation and Investigational Interview
R4-16-502. Direct Referral to Formal Interview
R4-16-503. Request for Inactive Status and License Cancellation
R4-16-504. Interim Consent Agreement
R4-16-505. Mediated Case
R4-16-506. Referral to Formal Hearing
R4-16-507. Dismissal of Complaint
R4-16-508. Denial of License
R4-16-509. Non-disciplinary Consent Agreement
R4-16-510. Appealing Executive Director Actions
ARTICLE 6. DISCIPLINARY ACTIONS
R4-16-601. Intent
R4-16-602. Application
R4-16-603. Acts of Unprofessional Conduct
R4-16-604. Aggravating Factors Considered in Disciplinary Actions
R4-16-605. Mitigating Factors Considered in Disciplinary Actions
ARTICLE 7. OFFICE-BASED SURGERY USING SEDATION
Article 7, consisting of Sections R4-16-701 through R4-16-707, made by final rulemaking at 14 A.A.R. 380, effective January 8, 2008 (Supp. 08-1).
Section
R4-16-701. Health Care Institution License
R4-16-702. Administrative Provisions
R4-16-703. Procedure and Patient Selection
R4-16-704. Sedation Monitoring Standards
R4-16-705. Perioperative Period; Patient Discharge
R4-16-706. Emergency Drugs; Equipment and Space Used for Office-Based Surgery Using Sedation
R4-16-707. Emergency and Transfer Provisions
ARTICLE 1. GENERAL PROVISIONS
R4-16-101. Definitions
Unless the context otherwise requires, definitions prescribed under A.R.S. § 32-1401 and the following apply to this Chapter:
1. "ACLS" means advanced cardiac life support performed according to certification standards of the American Heart Association.
2. "Agent" means an item or element that causes an effect.
3. "Approved medical assistant training program" means a program accredited by any of the following:
a. The Commission on Accreditation of Allied Health Education Programs;
b. The Accrediting Bureau of Health Education Schools;
c. A medical assisting program accredited by any accrediting agency recognized by the United States Department of Education; or
d. A training program:
i. Designed and offered by a licensed allopathic physician;
ii. That meets or exceeds any of the prescribed accrediting programs in subsection (a), (b), or (c); and
iii. That verifies the entry-level competencies of a medical assistant prescribed under R4-16-402(A).
4. "Ausculation" means the act of listening to sounds within the human body either directly or through use of a stethoscope or other means.
5. "BLS" means basic life support performed according to certification standards of the American Heart Association.
6. "Capnography" means monitoring the concentration of exhaled carbon dioxide of a sedated patient to determine the adequacy of the patient's ventilatory function.
7. "Deep sedation" means a drug-induced depression of consciousness during which a patient:
a. Cannot be easily aroused, but
b. Responds purposefully following repeated or painful stimulation, and
c. May partially lose the ability to maintain ventilatory function.
8. "Discharge" means a written or electronic documented termination of office-based surgery to a patient.
9. "Drug" means the same as in A.R.S. § 32-1901.
10. "Emergency" means an immediate threat to the life or health of a patient.
11. "Emergency drug" means a drug that is administered to a patient in an emergency.
12. "General Anesthesia" means a drug-induced loss of consciousness during which a patient:
a. Is unarousable even with painful stimulus; and
b. May partially or completely lose the ability to maintain ventilatory, neuromuscular, or cardiovascular function or airway.
13. "Health care professional" means a registered nurse defined in A.R.S. § 32-1601, registered nurse practitioner defined in A.R.S. § 32-1601, physician assistant defined in A.R.S. § 32-2501, and any individual authorized to perform surgery according to A.R.S. Title 32 who participates in office-based surgery using sedation at a physician's office.
14. "Informed consent" means advising a patient of the:
a. Purpose for and alternatives to the office-based surgery using sedation,
b. Associated risks of office-based surgery using sedation, and
c. Possible benefits and complications from the office-based surgery using sedation.
15. "Inpatient" has the same meaning as in A.A.C. R9-10-201.
16. "Malignant hyperthermia" means a life-threatening condition in an individual who has a genetic sensitivity to inhalant anesthetics and depolarizing neuromuscular blocking drugs that occurs during or after the administration of an inhalant anesthetic or depolarizing neuromuscular blocking drug.
17. "Minimal Sedation" means a drug-induced state during which:
a. A patient responds to verbal commands,
b. Cognitive function and coordination may be impaired, and
c. A patient's ventilatory and cardiovascular functions are unaffected.
18. "Moderate Sedation" means a drug-induced depression of consciousness during which:
a. A patient responds to verbal commands or light tactile stimulation, and
b. No interventions are required to maintain ventilatory or cardiovascular function.
19. "Monitor" means to assess the condition of a patient.
20. "Office-based surgery" means a medical procedure conducted in a physician's office or other outpatient setting that is not part of a licensed hospital or licensed ambulatory surgical center. (A.R.S. § 32-1401(20)).
21. "PALS" means pediatric life support performed according to certification standards of the American Academy of Pediatrics or the American Heart Association.
22. "Patient" means an individual receiving office-based surgery using sedation.
23. "Physician" has the same meaning as doctor of medicine as defined in A.R.S. § 32-1401.
24. "Rescue" means to correct adverse physiologic consequences of deeper than intended level of sedation and return the patient to the intended level of sedation.
25. "Sedation" means minimum sedation, moderate sedation, or deep sedation.
26. "Staff member" means an individual who:
a. Is not a health care professional, and
b. Assists with office-based surgery using sedation under the supervision of the physician performing the office-based surgery using sedation.
27. "Transfer" means a physical relocation of a patient from a physician's office to a licensed health care institution.
Historical Note
Former Rule 12. Former Section R4-16-01 repealed, new Section R4-16-101 adopted effective June 1, 1984 (Supp. 84-3). Section repealed, new Section renumbered from R4-16-103 effective September 22, 1995 (Supp. 95-3). Amended by final rulemaking at 8 A.A.R. 830, February 7, 2002 (Supp. 02-1). Amended by final rulemaking at 8 A.A.R. 4270, effective November 18, 2002 (Supp. 02-3). Former Section R4-16-101 recodified to R4-16-102 at 11 A.A.R. 1283, effective March 25, 2005 (Supp. 05-1). New Section made by final rulemaking at 12 A.A.R. 823, effective February 23, 2006 (Supp. 06-1). Amended by final rulemaking at 14 A.A.R. 380, effective January 8, 2008 (Supp. 08-1).
R4-16-102. Continuing Medical Education
A. A physician holding an active license to practice medicine in this state shall complete 40 credit hours of the continuing medical education required by A.R.S. § 32-1434 during the two calendar years preceding biennial registration. A physician may not carry excess hours over to another two-year cycle. One hour of credit is allowed for each clock hour of participation in continuing medical education activities, unless otherwise designated in subsection (B).
B. A physician may claim continuing medical education for the following:
1. Participating in an internship, residency, or fellowship at a teaching institution approved by the American Medical Association, the Association of American Medical Colleges, or the American Osteopathic Association. A physician may claim one credit hour of continuing medical education for each one day of training in a full-time approved program, or for a less than full-time training on a pro rata basis. In this subsection teaching institutions define "full-time."
2. Participating in an education program for an advanced degree in a medical or medically-related field in a teaching institution approved by the American Medical Association, the Association of American Medical Colleges, or the American Osteopathic Association. A physician may claim one credit hour of continuing medical education for each one day of full-time study or less than a full-time study on a pro rata basis. In this subsection teaching institutions define "full-time".
3. Participating in full-time research in a teaching institution approved by the American Medical Association, the Association of American Medical Colleges, or the American Osteopathic Association. A physician may claim one credit hour of continuing medical education for each one day of full-time research, or less than full-time research on a pro rata basis. In this subsection teaching institutions define "full-time".
4. Participating in an education program certified as Category 1 by an organization accredited by the Accreditation Council for Continuing Medical Education, 515 North State Street, Suite 2150, Chicago, Illinois 60610.
5. Participating in a medical education program designed to provide understanding of current developments, skills, procedures, or treatments related to the practice of medicine, that is provided by an organization or institution accredited by the Accreditation Council for Continuing Medical Education.
6. Serving as an instructor of medical students, house staff, other physicians, or allied health professionals from a hospital or other health care institution with a formal training program, if the instructional activities provide the instructor with understanding of current developments, skills, procedures, or treatments related to the practice of allopathic medicine.
7. Publishing or presenting a paper, report, or book that deals with current developments, skills, procedures, or treatments related to the practice of allopathic medicine. The physician may claim one credit hour for each hour preparing, writing, and presenting materials:
a. Actually published or presented; and
b. After the date of publication or presentation.
8. A credit hour may be earned for any of the following activities that provide an understanding of current developments, skills, procedures, or treatments related to the practice of allopathic medicine:
a. Completing a medical education program based on self-instruction that uses videotapes, audiotapes, films, filmstrips, slides, radio broadcasts, or computers;
b. Reading scientific journals and books;
c. Preparing for specialty board certification or recertification examinations;
d. Participating on a staff or quality of care committee, or utilization review committee in a hospital, health care institution, or government agency.
C. If a physician holding an active license to practice medicine in this state fails to meet the continuing medical education requirements under subsection (A) because of illness, military service, medical or religious missionary activity, or residence in a foreign country, upon written application, shall grant an extension of time to complete the continuing medical education.
D. The Board shall mail to each physician a license renewal form that includes a section regarding continuing medical education compliance. The physician shall sign and return the form certified under penalty of perjury that the continuing medical education requirements under subsection (A) are satisfied for the two-calendar-year period preceding biennial renewal. Failure to receive the license renewal form under subsection (A) shall not relieve the physician of the requirements of subsection (A). The Board may randomly audit a physician to verify compliance with the continuing medical education requirements under subsection (A).
Historical Note
Former Rule 16. Former Section R4-16-02 repealed, new Section R4-16-102 adopted effective June 1, 1984 (Supp. 84-3). Section repealed, new Section renumbered from R4-16-106 effective September 22, 1995 (Supp. 95-3). Amended by final rulemaking at 6 A.A.R. 1881, effective May 3, 2000 (Supp. 00-2). Former Section R4-16-102 recodified to R4-16-103; New Section R4-16-102 recodified from R4-16-101 at 11 A.A.R. 1283, effective March 25, 2005 (Supp. 05-1).
R4-16-103. Rehearing or Review of Board Decision
A. A motion for rehearing or review shall be filed as follows:
1. Except as provided in subsection (B), any party in a contested case may file a written motion for rehearing or review of the Board's decision, specifying generally the grounds upon which the motion is based.
2. A motion for rehearing or review shall be filed with the Board and served no later that 30 days after the decision of the Board.
3. For purposes of this Section, "service" has the same meaning as in A.R.S. § 41-1092.09.
4. For purposes of this Section, a document is deemed filed when the Board receives the document.
5. For purposed of the Section, the terms "contested case" and "party" shall have the same meaning as in A.R.S. § 41-1001.
B. If the Board makes a specific finding that it is necessary for a particular decision to take immediate effect to protect the public health and safety, or that a rehearing or review of the Board's decision is impracticable or contrary to the public interest, the decision shall be issued as a final decision without opportunity for rehearing or review and shall be a final administrative decision for purposes of judicial review.
C. A written response to a motion for rehearing or review may be filed and served within 15 days after service of the motion for rehearing or review. The Board may require the filing of written briefs upon any issues raised in the motion and may provide for oral argument.
D. A rehearing or review of a decision may be granted for any of the following reasons materially affecting a party's rights:
1. Irregularity in the administrative proceedings by the Board, its hearing officer, or the prevailing party, or any ruling or abuse of discretion, that deprives the moving party of a fair hearing;
2. Misconduct of the Board, its hearing officer, or the prevailing party;
3. Accident or surprise that could have not been prevented by ordinary prudence;
4. Material evidence, newly discovered, which with reasonable diligence could not have been discovered and produced at the original hearing;
5. Excessive or insufficient penalties;
6. Error in the admission or rejection of evidence, or other errors of law that occurred at the hearing;
7. The decision is the result of a passion or prejudice; or
8. The decision of findings of fact or decision is not justified by the evidence or is contrary to law.
E. A rehearing or review may be granted to all or any of the parties and on all or part of the issues for any of the reasons in subsection (D). The Board may take additional testimony, amend findings of fact and conclusions of law, or make new findings and conclusions, and affirm, modify, or reverse the original decision.
F. A rehearing or review, if granted, shall be a rehearing or review only of the question upon which the decision is found erroneous. An order granting a rehearing or review shall specify with particularity the grounds for the order.
G. Not later than 15 days after a decision is issued, the Board of its own initiative may order a rehearing or review for any reason that it might have granted a rehearing or review on motion of a party. After giving the parties notice and an opportunity to be heard on the matter, the Board may grant a timely-served motion for a rehearing or review, for a reason not stated in the motion. In either case, the Board shall specify in the order the grounds for the rehearing or review.
H. If a motion for rehearing or review is based upon affidavits, they shall be served with the motion. The opposing party may, within 15 days after service, serve opposing affidavits. The Board may extend this period for a maximum of 20 days either by the Board for good cause, or by the parties by written stipulation. The Board may permit reply affidavits.
Historical Note
Former Rule 17; Amended effective August 19, 1977 (Supp. 77-4). Former Section R4-16-03 repealed, new Section R4-16-103 adopted effective June 1, 1984 (Supp. 84-3). Section R4-16-103 renumbered to R4-16-101 effective September 22, 1995 (Supp. 95-3). New Section adopted effective May 20, 1997 (Supp. 97-2). Amended by final rulemaking at 8 A.A.R. 830, February 7, 2002 (Supp. 02-1). Amended by final rulemaking at 8 A.A.R. 4270, effective November 18, 2002 (Supp. 02-3). Former Section R4-16-103 recodified to R4-16-204; new Section R4-16-103 recodified from R4-16-102 at 11 A.A.R. 1283, effective March 25, 2005 (Supp. 05-1).
R4-16-104. Recodified
Historical Note
Former Rule 18. Former Section R4-16-04 repealed, new Section R4-16-104 adopted effective June 1, 1984 (Supp. 84-3). Section repealed effective September 22, 1995 (Supp. 95-3). New Section adopted effective January 20, 1998 (Supp. 98-1). Section recodified to R4-16-206 at 11 A.A.R. 1283, effective March 25, 2005 (Supp. 05-1).
R4-16-105. Recodified
Historical Note
Former Rule 19. Former Section R4-16-05 repealed, new Section R4-16-105 adopted effective June 1, 1984 (Supp. 84-3). Section repealed effective September 22, 1995 (Supp. 95-3). New Section adopted effective January 20, 1998 (Supp. 98-1). Section recodified to R4-16-207 at 11 A.A.R. 1283, effective March 25, 2005 (Supp. 05-1).
R4-16-106. Recodified
Historical Note
Former Rule 21. Former Section R4-16-06 repealed, new Section R4-16-106 adopted effective June 1, 1984 (Supp. 84-3). Section R4-16-106 renumbered to R4-16-102 effective September 22, 1995 (Supp. 95-3). New Section adopted by final rulemaking at 6 A.A.R. 1881, effective May 3, 2000 (Supp. 00-2). Section recodified to R4-16-201 at 11 A.A.R. 1283, effective March 25, 2005 (Supp. 05-1).
R4-16-107. Recodified
Historical Note
New Section adopted by final rulemaking at 6 A.A.R. 1881, effective May 3, 2000 (Supp. 00-2). Section recodified to R4-16-202 at 11 A.A.R. 1283, effective March 25, 2005 (Supp. 05-1).
R4-16-108. Recodified
Historical Note
New Section adopted by final rulemaking at 6 A.A.R. 1881, effective May 3, 2000 (Supp. 00-2). Section recodified to R4-16-203 at 11 A.A.R. 1283, effective March 25, 2005 (Supp. 05-1).
Table 1. Recodified
Historical Note
Table 1 adopted effective January 20, 1998 (Supp. 98-1). Table 1 recodified to the end of Article 2 at 11 A.A.R. 1283, effective March 25, 2005 (Supp. 05-1).
R4-16-109. Recodified
Historical Note
New Section made by final rulemaking at 8 A.A.R. 830, February 7, 2002 (Supp. 02-1). Amended by final rulemaking at 8 A.A.R. 4270, effective November 18, 2002 (Supp. 02-3). Section recodified to R4-16-205 at 11 A.A.R. 1283, effective March 25, 2005 (Supp. 05-1).
ARTICLE 2. LICENSURE
R4-16-201. Application for Licensure
A. For purposes of this Article, unless otherwise specified:
1. "ECFMG" means Educational Commission for Foreign Medical Graduates.
2. "FLEX" means Federation Licensing Examination.
3. "LMCC" means Licentiate of the Medical Council of Canada.
4. "Medical Condition" means the following physiological, mental, or psychological conditions or disorders: (a) chronic and uncorrected orthopedic, visual, speech, or hearing impairments; (b) cerebral palsy, epilepsy, muscular dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, HIV disease, or tuberculosis; or (c) specific learning disabilities, dementia, Alzheimer's, bipolar disorder, schizophrenia, paranoia, or any psychotic disorder.
5. "SPEX" means Special Purposes Examination.
6. "USMLE" means United States Medical Licensing Examination.
B. An applicant for licensure to practice medicine by endorsement, Step 3 of the USMLE, or by endorsement with the SPEX shall submit the following information on an application form provided by the Board:
1. Applicant's full name, social security number, business and home addresses, business and home telephone numbers, and date and place of birth;
2. Names of the states or provinces in which the applicant has applied for or has been granted a license or registration to practice medicine, including license number, date issued, and current status of the license;
3. Whether the applicant has had an application for medical licensure denied or rejected by another state or province licensing board, and if so, an explanation;
4. Whether any disciplinary or rehabilitative action has ever been taken against the applicant by another licensing board, including other health professions, and if so, an explanation;
5. Whether any disciplinary actions, restrictions, or limitations have been taken against the applicant while participating in any type of training program or by any health care provider, and if so, an explanation;
6. Whether the applicant has been found in violation of a statute, rule, or regulation of any domestic or foreign governmental agency, and if so, an explanation;
7. Whether the applicant is currently under investigation by any medical board or peer review body, and if so, an explanation;
8. Whether the applicant has ever had a medical license disciplined resulting in a revocation, suspension, limitation, restriction, probation, voluntarily surrender, cancellation during an investigation or entered into a consent agreement or stipulation, and if so, an explanation;
9. Whether the applicant has had hospital privileges revoked, denied, suspended, or restricted, and if so, an explanation;
10. Whether the applicant has been named as a defendant in a malpractice matter currently pending or that resulted in a settlement or judgment against the applicant, and if so, an explanation;
11. Whether the applicant has been subjected to any regulatory disciplinary action, including censure, practice restriction, suspension, sanction, or removal from practice, imposed by any agency of the federal or state government, and if so, an explanation;
12. Whether the applicant has had the authority to prescribe, dispense, or administer medications limited, restricted, modified, denied, surrendered, or revoked by a federal or state agency, and if so, an explanation;
13. Whether the applicant, within the last five years, has or had a medical condition that impairs or limits the applicant's ability to safely practice medicine, and if so, an explanation;
14. Whether the applicant engages in the illegal use of any controlled substance, habit- forming drug, or prescription medication, and if so, an explanation;
15. Whether the applicant has consumed intoxicating beverages resulting in the applicant's present ability to exercise the judgment and skills of a medical professional, being impaired or limited, and if so, an explanation;
16. Whether the applicant has been found guilty or entered into a plea of no contest to a felony, or misdemeanor involving moral turpitude in any state, and if so, an explanation;
17. A complete list of the applicant's internship, residency, and fellowship training;
18. Whether the applicant is currently certified by any of the American Board of Medical Specialties;
19. The applicant's intended specialty;
20. Consistent with the Board's statutory authority, other information the Board may deem necessary to fully evaluate the applicant;
21. A photograph of passport quality no larger than 2 1/2 x 3 inches taken not more than 60 days before the date of application; and
22. A notarized statement, signed by the applicant, verifying the truthfulness of the information provided, and that the applicant has not engaged in any acts prohibited by Arizona law or Board rules, and authorizing release of any required records or documents to complete application review.
C. In addition to the application form, an applicant for licensure to practice medicine by endorsement, Step 3 of the USMLE, or endorsement with the SPEX shall submit the following:
1. Certified copy of the applicant's birth certificate or passport;
2. Certified evidence of legal name change if the applicant's legal name is different from that shown on the document submitted under subsection (B)(1);
3. Complete list of all hospital affiliations and employment for the past five years;
4. Verification of any medical malpractice matter currently pending or resulting in a settlement or judgment against the applicant, including a copy of the complaint and either the agreed terms of settlement or the judgment. The verification must contain the name and address of each defendant, the name and address of each plaintiff, the date and location of the occurrence which created the claim and a statement specifying the nature of the occurrence resulting in the medical malpractice action; and
5. The fee required in A.R.S. § 32-1436.
D. In addition to the requirements of subsections (A) and (B), an applicant for licensure to practice medicine by endorsement, by Step 3 of the USMLE, or by endorsement with the SPEX shall have the following directly submitted to the Board:
1. The following forms must be included with the application and be completed by persons other than the applicant:
a. Medical College Certification,
b. Postgraduate Training Certification,
c. Clinical Instructor Certification,
d. ECFMG certification if applicant is an international graduate,
e. Federation of State Medical Boards Disciplinary Search,
f. American Medical Association Physician Profile, and
g. Verification of American Board of Medical Specialty Certification, if applicable;
2. Examination and Board History Report scores for USMLE, FLEX, and SPEX;
3. Verification of LMCC exam score, state written exam score, or national board exam score;
4. Verification of licensure from every state in which the applicant has ever held a medical license; and
5. Verification of all hospital affiliations and employment for the past five years. This must be submitted by the verifying entity on its official letterhead.
Historical Note
Adopted effective September 22, 1995 (Supp. 95-3). Amended by final rulemaking at 8 A.A.R. 2319, effective May 9, 2002 (Supp. 02-2). Former Section R4-16-201 recodified to R4-16-301; New Section R4-16-201 recodified from R4-16-106 at 11 A.A.R. 1283, effective March 25, 2005 (Supp. 05-1).
R4-16-202. Application for Pro Bono Registration
A. An applicant for a pro bono registration to practice medicine shall submit an application on a form provided by the Board that provides the information required by R4-16-106(B).
B. In addition to the application, an applicant for a pro bono registration to practice medicine shall submit the following:
1. Certified copy of the applicant's medical degree diploma;
2. Certified copies of internship, residency, or fellowship certificates;
3. Photocopy of any current license to practice medicine in another state, territory, or possession of the United States or the District of Columbia, along with a letter from the medical board issuing the license, certifying that the license is current and in good standing;
4. Certified copy of ECFMG certificate, if applicable;
5. The fee required in A.R.S. § 32-1436.
C. In addition to the requirements of subsections (A) and (B), an applicant for pro bono registration shall have the following directly submitted to the Board:
1. American Medical Association physician profile;
2. Federation of State Medical Boards disciplinary search; and
3. Verification of licensure from every state in which the applicant has ever held a license.
Historical Note
Adopted effective September 22, 1995 (Supp. 95-3). Amended by final rulemaking at 8 A.A.R. 2319, effective May 9, 2002 (Supp. 02-2). Former Section R4-16-202 recodified to R4-16-302; New Section R4-16-202 recodified from R4-16-107 at 11 A.A.R. 1283, effective March 25, 2005 (Supp. 05-1).
R4-16-203. Application for Locum Tenens Registration
A. An applicant for a locum tenens registration to practice medicine shall submit an application on a form provided by the Board that provides the information required by R4-16-107(A).
B. In addition to the application, an applicant for a locum tenens registration to practice medicine shall submit the following:
1. Certified copy of the applicant's medical degree diploma;
2. Certified copies of internship, residency, or fellowship certificates;
3. A statement completed by the sponsoring Arizona-licensed physician giving the reason for the request for issuance of the registration; and
4. Certified copy of ECFMG certificate, if applicable.
C. In addition to the requirements of subsections (A) and (B), an applicant for locum tenens registration shall have the following directly submitted to the Board:
1. American Medical Association physician profile;
2. Federation of State Medical Boards disciplinary search; and
3. Verification of licensure from every state in which the applicant has ever held a license.
Historical Note
Adopted effective September 22, 1995 (Supp. 95-3). Amended by final rulemaking at 8 A.A.R. 2319, effective May 9, 2002 (Supp. 02-2). Former Section R4-16-203 recodified to R4-16-303; New Section R4-16-203 recodified from R4-16-108 at 11 A.A.R. 1283, effective March 25, 2005 (Supp. 05-1).
R4-16-204. Licensure by Endorsement
A. An applicant for licensure by endorsement may make a written request of the Board, for an extension of the seven-year period provided by A.R.S. § 32-1426(B)(4) to pass one of the combinations of specified examinations. The applicant shall submit the written request to the Board with evidence that:
1. The applicant meets all requirements for licensure and for taking the United States Medical Licensing Examination,
2. The combination of examinations cannot be passed in the time required by law, and
3. The applicant is:
a. A full-time student in an approved school of medicine, as defined in A.R.S. § 32-1401(5);
b. A participant in an approved hospital internship, residency, or clinical fellowship program, as defined in A.R.S. § 32-1401(4); or
c. A full-time student in a recognized medical degree program, as defined in subsection (E), concurrently or consecutively with medical school or postgraduate training.
B. If the Board determines that the applicant satisfies the requirements of subsection (A), the Board shall grant the extension.
C. An extension shall not exceed 10 years from the date on which the applicant successfully completes the first part of the combination of examinations.
D. If the Board denies the request for extension, the applicant may request a hearing by filing a written notice with the Board no later than 30 days after receipt of notice of the Board's action. A hearing shall be conducted according to A.R.S. Title 41, Chapter 6, Article 10.
E. In this Section, a "recognized degree program" means an education program offered by a college or university approved by the New England Association of Schools and Colleges, Middle States Association of Colleges and Secondary Schools, North Central Association of Colleges and Schools, Northwest Association of Schools and Colleges, Southern Association of Colleges and Schools, or Western Association of Schools and Colleges or accredited by the United States Department of Education, Council on Postsecondary Accreditation, Association of American Medical Colleges, the Association of Canadian Medical Colleges, or the American Medical Association.
F. An applicant for licensure by endorsement under A.R.S. § 32-1426(C) who provides proof of passing an examination specified in A.R.S. § 32-1426(A) more than ten years before the date of filing shall:
1. Hold a current certification in an American Board of Medical Specialty ("ABMS"), or
2. Take and pass the Special Purposes Examination (SPEX).
Historical Note
Adopted effective September 22, 1995 (Supp. 95-3). Amended by final rulemaking at 8 A.A.R. 2319, effective May 9, 2002 (Supp. 02-2). Former Section R4-16-204 recodified to R4-16-304; New Section R4-16-204 recodifed from R4-16-103 at 11 A.A.R. 1283, effective March 25, 2005 (Supp. 05-1).
R4-16-205. Miscellaneous Fees
The following fees are established:
1. Application to practice allopathic medicine, $500;
2. For issuing an initial license, $450, which may be prorated from date of issuance to date of license renewal;
3. Two-year license renewal, $450;
4. Reactivation of an inactive license, $450, which may be prorated from date of reactivation to date of license renewal;
5. Application for a temporary license to practice medicine, $200;
6. Locum tenens registration, $200;
7. Duplicate license, $50;
8. Annual registration of an approved internship, residency, clinical fellowship program, or short-term residency program, $25;
9. Annual teaching license at an approved school of medicine or at an approved hospital internship, residency, or clinical fellowship program, $225;
10. Five-day teaching permit at an approved school of medicine or at an approved hospital internship, residency, or clinical fellowship program, $100;
11. Copy of the annual allopathic medical directory, $30;
12. Initial registration to dispense drugs and devices, $200;
13. Annual renewal to dispense drugs and devices, $100;
14. Penalty fee for late renewal of an active license, $350;
15. Verifying a license, $5 per request;
16. Copies of the minutes of all Board meetings during a fiscal year, $15 per meeting;
17. Copies of records, documents, letters, minutes, applications, and files, $1 for the first three pages and 25¢ for each additional page;
18. Sale of computerized tapes or diskettes not requiring programming, $100; and
19. A wallet card is provided free of charge at time of licensure, additional wallet cards, $10.
Historical Note
Adopted effective September 22, 1995 (Supp. 95-3). Amended by final rulemaking at 8 A.A.R. 2319, effective May 9, 2002 (Supp. 02-2). Former Section R4-16-205 recodified to R4-16-305; New Section R4-16-205 recodifed from R4-16-109 at 11 A.A.R. 1283, effective March 25, 2005 (Supp. 05-1).
R4-16-206. Time-frames for Licenses, Permits, and Registrations
A. For each type of license, permit, or registration issued by the Board, the overall time-frame under A.R.S. § 41-1072(2) is shown on Table 1.
B. For each type of license, permit, or registration issued by the Board, the administrative completeness review time-frame under A.R.S. § 41-1072(1) is shown on Table 1 and begins on the date the Board receives an application and all required documentation and information.
1. If the required application is not administratively complete, the Board shall send a written deficiency notice to the applicant.
a. In the deficiency notice, the Board shall state each deficiency and the information required to complete the application or supporting documentation. In the deficiency notice, the Board shall include a written notice that the application is withdrawn if the applicant does not submit the additional information within the time provided for response.
b. Within the time provided in Table 1 for response to a deficiency notice, the applicant shall submit to the Board the requested documentation or information specified in the notice. The time-frame for the Board to finish the administrative completeness review is suspended from the date of the notice until the date the Board receives the requested documentation or information from the applicant.
2. Within 30 days after receipt of a deficiency notice, an applicant may submit a written hearing request to the Board.
3. The Board shall schedule and conduct the applicant's deficiency hearing according to provisions prescribed under A.R.S. § 32-1427(E).
4. In addition to hearing provisions prescribed under subsection (B)(3), the Board shall send the following to the applicant in writing:
a. A notice of a scheduled hearing at least 21 days before the hearing date; and
b. The Board's decision within 30 days after the hearing that shall include notice of any applicable right of appeal.
C. For each type of license, permit, or registration issued by the Board, the substantive review time-frame under A.R.S. § 41-1072(3) is shown on Table 1.
1. The Board may request additional information from an applicant according to provisions prescribed under A.R.S. § 41-1075 during the substantive review time-frame. In any request for additional information, the Board shall include a written notice that the application is withdrawn if the applicant does not submit the additional information within the time provided for response.
2. In response to a single comprehensive written request from the Board under A.R.S. § 41-1075(A), the applicant shall submit the information identified to the Board within the time to respond specified in Table 1. The time-frame for the Board to finish the substantive review is suspended from the date the Board sends the comprehensive written request for additional information until the date the Board receives the additional information from the applicant.
3. If the Board determines that the applicant does not meet all substantive criteria for a license, permit, or registration as required under A.R.S. Title 32, Chapter 13 or this Chapter, the Board shall send written notice of denial to the applicant. The Board shall include notification of any applicable right of appeal in the denial notice.
4. If the applicant meets all substantive criteria for a license, permit, or registration required under A.R.S. Title 32, Chapter 13 and this Chapter, the Board shall issue the applicable license, permit, or registration to the applicant.
Historical Note
New Section recodified from R4-16-104 at 11 A.A.R. 1283, effective March 25, 2005 (Supp. 05-1). Amended by final rulemaking at 11 A.A.R. 2944, effective September 10, 2005 (Supp. 05-3).
R4-16-207. Time-frames for License Renewal; Expiration
A. For license renewal, the overall time-frame under A.R.S. § 41-1072(2) is 90 days.
B. For license renewal, the administrative completeness review time-frame described in A.R.S. § 41-1072(1) is 45 days and begins on the date the Board receives the renewal application.
1. If the required application is not administratively complete, the Board shall send a written deficiency notice to the applicant.
a. In a deficiency notice, the Board shall state each deficiency and the information required to complete the application or supporting documentation.
b. Within 60 days after the Board sends a deficiency notice, the applicant shall submit to the Board the requested documentation or information specified in the notice. The time-frame for the Board to finish the administrative completeness review is suspended from the date of the notice until the date the Board receives the requested documentation or information from the applicant.
2. The provisions prescribed under R4-16-206(B)(2) through (B)(4) apply to this Section.
C. For license renewal, the substantive review time-frame under A.R.S. § 41-1072(3) is 45 days.
1. During the substantive review time-frame, the Board may request additional information according to provisions prescribed under A.R.S. § 41-1075.
2. The applicant shall submit to the Board information identified by a single comprehensive written request from the Board for additional information allowed under A.R.S. § 41-1075(A) within 60 days after the Board sends its request.
3. If the applicant meets all license renewal substantive criteria and remits the applicable fee required under A.R.S. Title 31, Chapter 13 and this Chapter, the Board shall issue a license renewal to the applicant.
D. If a person holding an active license does not apply for license renewal according to the biennial renewal requirement or fails to meet time-frame requirements under this Section, the person's license expires according to provisions prescribed under A.R.S § 32-1430(A) unless the person is under investigation according to provisions prescribed under A.R.S. § 32-3202.
Historical Note
New Section recodified from R4-16-105 at 11 A.A.R. 1283, effective March 25, 2005 (Supp. 05-1). Amended by final rulemaking at 11 A.A.R. 2944, effective September 10, 2005 (Supp. 05-3).
Table 1. Time-frames
Time-frames (in calendar days)
|
Type of License
|
Overall Time-frame
|
Administrative Review Time-frame
|
Time to Respond to
Deficiency Notice
|
Substantive Review Time-frame
|
Time to Respond to Request for Additional
Information
|
|
Initial License by Examination
|
240
|
120
|
365
|
120
|
90
|
|
Initial License by Endorsement
|
240
|
120
|
365
|
120
|
90
|
|
Locum Tenens or Pro Bono Registration
|
120
|
60
|
30
|
60
|
30
|
|
Temporary License
|
60
|
30
|
30
|
30
|
30
|
|
Teaching License
|
40
|
20
|
30
|
20
|
30
|
|
Educational Teaching Permit
|
20
|
10
|
30
|
10
|
10
|
|
Training Permit
|
40
|
20
|
30
|
20
|
30
|
|
Short Term Training Permit
|
40
|
20
|
30
|
20
|
30
|
|
One-year Training Permit
|
40
|
20
|
30
|
20
|
30
|
|
Registration to Dispense Controlled Substances and Prescription-only Drugs and Devices
|
150
|
45
|
30
|
105
|
30
|