SENATE BILL No. 220

      An Act concerning the Kansas healing arts act; relating to the supervision and direction of
      certain personnel by persons licensed to practice the healing arts; amending K.S.A. 1997
      Supp. 65-2837 and repealing the existing section.

Be it enacted by the Legislature of the State of Kansas:

    New Section 1. (a) Every responsible licensee who directs, super-
vises, orders, refers, accepts responsibility for, enters into practice pro-
tocols with, or who delegates acts which constitute the practice of the
healing arts to other persons shall:

    (1) Be actively engaged in the practice of the healing arts in Kansas;

    (2) review and keep current any required practice protocols between
the responsible licensee and such persons, as may be determined by the
board;

    (3) direct, supervise, order, refer, enter into a practice protocol with,
or delegate to such persons only those acts and functions which the re-
sponsible licensee knows or has reason to believe such person is com-
petent and authorized by law to perform;

    (4) direct, supervise, order, refer, enter into a practice protocol with,
or delegate to other persons only those acts and functions which are
within the normal and customary specialty, competence and lawful prac-
tice of the responsible licensee;

    (5) provide for a qualified, substitute licensee who accepts responsi-
bility for the direction, supervision, delegation and practice protocols with
such persons when the responsible licensee is temporarily absent.

    (b) ``Responsible licensee'' means a person licensed by the state board
of healing arts to practice medicine and surgery or chiropractic who has
accepted responsibility for the actions of persons who perform acts pur-
suant to practice protocols with, or at the order of, or referral, direction,
supervision or delegation from such responsible licensee.

    (c) Notwithstanding the provisions of this section, K.S.A. 65-2896 to
65-2897b, inclusive, and amendments thereto, shall govern the direction
and supervision of physicians' assistants by persons licensed by the state
board of healing arts to practice medicine and surgery.

    (d) Nothing in subsection (a)(4) shall be construed to prohibit a per-
son licensed to practice medicine and surgery from ordering, authorizing
or directing anesthesia care by a registered nurse anesthetist pursuant to
K.S.A. 65-1158 and amendments thereto.

    (e) Nothing in this section shall be construed to prohibit a person
licensed to practice medicine and surgery from ordering, authorizing or
directing physical therapy services pursuant to K.S.A. 65-2901 et seq. and
amendments thereto.

    (f) Nothing in this section shall be construed to prohibit a person
licensed to practice medicine and surgery from entering into a co-man-
agement relationship with an optometrist pursuant to K.S.A. 65-1501 et
seq. and amendments thereto.

    (g) This section shall be part of and supplemental to the Kansas heal-
ing arts act.

    Sec. 2. K.S.A. 1997 Supp. 65-2837 is hereby amended to read as
follows: 65-2837. As used in K.S.A. 65-2836, and amendments thereto,
and in this section:

    (a) ``Professional incompetency'' means:

    (1) One or more instances involving failure to adhere to the appli-
cable standard of care to a degree which constitutes gross negligence, as
determined by the board.

    (2) Repeated instances involving failure to adhere to the applicable
standard of care to a degree which constitutes ordinary negligence, as
determined by the board.

    (3) A pattern of practice or other behavior which demonstrates a
manifest incapacity or incompetence to practice medicine.

    (b) ``Unprofessional conduct'' means:

    (1) Solicitation of professional patronage through the use of fraudu-
lent or false advertisements, or profiting by the acts of those representing
themselves to be agents of the licensee.

    (2) Representing to a patient that a manifestly incurable disease, con-
dition or injury can be permanently cured.

    (3) Assisting in the care or treatment of a patient without the consent
of the patient, the attending physician or the patient's legal representa-
tives.

    (4) The use of any letters, words, or terms, as an affix, on stationery,
in advertisements, or otherwise indicating that such person is entitled to
practice a branch of the healing arts for which such person is not licensed.

    (5) Performing, procuring or aiding and abetting in the performance
or procurement of a criminal abortion.

    (6) Willful betrayal of confidential information.

    (7) Advertising professional superiority or the performance of pro-
fessional services in a superior manner.

    (8) Advertising to guarantee any professional service or to perform
any operation painlessly.

    (9) Participating in any action as a staff member of a medical care
facility which is designed to exclude or which results in the exclusion of
any person licensed to practice medicine and surgery from the medical
staff of a nonprofit medical care facility licensed in this state because of
the branch of the healing arts practiced by such person or without just
cause.

    (10) Failure to effectuate the declaration of a qualified patient as
provided in subsection (a) of K.S.A. 65-28,107, and amendments thereto.

    (11) Prescribing, ordering, dispensing, administering, selling, supply-
ing or giving any amphetamines or sympathomimetic amines, except as
authorized by K.S.A. 65-2837a, and amendments thereto.

    (12) Conduct likely to deceive, defraud or harm the public.

    (13) Making a false or misleading statement regarding the licensee's
skill or the efficacy or value of the drug, treatment or remedy prescribed
by the licensee or at the licensee's direction in the treatment of any dis-
ease or other condition of the body or mind.

    (14) Aiding or abetting the practice of the healing arts by an unli-
censed, incompetent or impaired person.

    (15) Allowing another person or organization to use the licensee's
license to practice the healing arts.

    (16) Commission of any act of sexual abuse, misconduct or exploita-
tion related to the licensee's professional practice.

    (17) The use of any false, fraudulent or deceptive statement in any
document connected with the practice of the healing arts including the
intentional falsifying or fraudulent altering of a patient or medical care
facility record.

    (18) Obtaining any fee by fraud, deceit or misrepresentation.

    (19) Directly or indirectly giving or receiving any fee, commission,
rebate or other compensation for professional services not actually and
personally rendered, other than through the legal functioning of lawful
professional partnerships, corporations or associations.

    (20) Failure to transfer patient records to another licensee when re-
quested to do so by the subject patient or by such patient's legally des-
ignated representative.

    (21) Performing unnecessary tests, examinations or services which
have no legitimate medical purpose.

    (22) Charging an excessive fee for services rendered.

    (23) Prescribing, dispensing, administering, distributing a prescrip-
tion drug or substance, including a controlled substance, in an excessive,
improper or inappropriate manner or quantity or not in the course of the
licensee's professional practice.

    (24) Repeated failure to practice healing arts with that level of care,
skill and treatment which is recognized by a reasonably prudent similar
practitioner as being acceptable under similar conditions and circum-
stances.

    (25) Failure to keep written medical records which accurately de-
scribe the services rendered to the patient, including patient histories,
pertinent findings, examination results and test results.

    (26) Delegating professional responsibilities to a person when the
licensee knows or has reason to know that such person is not qualified by
training, experience or licensure to perform them.

    (27) Using experimental forms of therapy without proper informed
patient consent, without conforming to generally accepted criteria or stan-
dard protocols, without keeping detailed legible records or without having
periodic analysis of the study and results reviewed by a committee or
peers.

    (28) Prescribing, dispensing, administering or distributing an ana-
bolic steroid or human growth hormone for other than a valid medical
purpose. Bodybuilding, muscle enhancement or increasing muscle bulk
or strength through the use of an anabolic steroid or human growth hor-
mone by a person who is in good health is not a valid medical purpose.

    (29) Referring a patient to a health care entity for services if the
licensee has a significant investment interest in the health care entity,
unless the licensee informs the patient in writing of such significant in-
vestment interest and that the patient may obtain such services elsewhere.

    (30) Failing to properly supervise, direct or delegate acts which con-
stitute the healing arts to persons who perform professional services pur-
suant to such licensee's direction, supervision, order, referral, delegation
or practice protocols.

    (c) ``False advertisement'' means any advertisement which is false,
misleading or deceptive in a material respect. In determining whether
any advertisement is misleading, there shall be taken into account not
only representations made or suggested by statement, word, design, de-
vice, sound or any combination thereof, but also the extent to which the
advertisement fails to reveal facts material in the light of such represen-
tations made.

    (d) ``Advertisement'' means all representations disseminated in any
manner or by any means, for the purpose of inducing, or which are likely
to induce, directly or indirectly, the purchase of professional services.

    (e) ``Licensee'' for purposes of this section and K.S.A. 65-2836, and
amendments thereto, shall mean all persons issued a license, permit or
special permit pursuant to article 28 of chapter 65 of the Kansas Statutes
Annotated.

    (f) ``License'' for purposes of this section and K.S.A. 65-2836, and
amendments thereto, shall mean any license, permit or special permit
granted under article 28 of chapter 65 of the Kansas Statutes Annotated.

    (g) ``Health care entity'' means any corporation, firm, partnership or
other business entity which provides services for diagnosis or treatment
of human health conditions and which is owned separately from a refer-
ring licensee's principle practice.

    (h) ``Significant investment interest'' means ownership of at least 10%
of the value of the firm, partnership or other business entity which owns
or leases the health care entity, or ownership of at least 10% of the shares
of stock of the corporation which owns or leases the health care entity.

    Sec. 3. K.S.A. 1997 Supp. 65-2837 is hereby repealed.

    Sec. 4. This act shall take effect and be in force from and after its
publication in the statute book.

I hereby certifiy that the above Bill originated in the
Senate, and passed that body

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Senate adopted
Conference Committe Report __________________________________

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President of the Senate.

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Secretary of the Senate.

Passed the House
as amended __________________________

House adopted
Conference Committee Report __________________________

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Speaker of the House.

__________________________________

Chief Clerk of the House.

Approved __________________________

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Governor.