GENERAL GOVERNMENT CABINET

Kentucky Board of Medical Licensure

(Amendment)

 

      201 KAR 9:310. Continuing medical education.

 

      RELATES TO: KRS 214.610, 214.620, 218A.205, 311.565(1)(b), 311.601, 620.020

      STATUTORY AUTHORITY: KRS 311.565(1)(a), (b), 311.601(1), (2)

      NECESSITY, FUNCTION, AND CONFORMITY: KRS 311.601(1) authorizes the board to promulgate an administrative regulation that establishes requirements to ensure the continuing professional competency of licensees. This administrative regulation establishes continuing medical education requirements for physicians in Kentucky, including requirements for courses relating to the use of KASPER, pain management, and addiction disorders required for physicians who prescribe or dispense controlled substances in the Commonwealth of Kentucky.

 

      Section 1. Continuing Medical Education. Except as provided in Section 4 of this administrative regulation, at the time a licensee seeks to renew his or her license, the licensee shall submit verification of satisfactory completion of a program of continuing medical education using the Continuing Medical Education Certification Form by the renewal deadline established in 201 KAR 9:051.

 

      Section 2. In order to meet the continuing medical education requirements, a licensee shall:

      (1) Submit evidence that thirty (30) of the sixty (60) hours were certified in Category I by an organization accredited by the:

      (a) Accreditation Council on Continuing Medical Education; or

      (b) The American Osteopathic Association;

      (2) Submit evidence that:

      (a) The licensee has received the American Medical Association's "physician recognition award", or the American Osteopathic Association's "osteopathic physicians' recognition award"; and

      (b) The award is in effect at the time the license is renewed;

      (3) Submit verification that the:

      (a) Licensee has completed continuing medical education requirements of any specialty organization which is recognized by the American Medical Association or American Osteopathic Association as at least equivalent to their recognition awards; and

      (b) Certification is in effect at the time a license is renewed; or

      (4) Submit verification that the licensee is in, or has been in, an approved postgraduate training program. Each year of postgraduate training shall be equivalent to fifty (50) hours of continuing medical education.

 

      Section 3. Required Hours of Continuing Education. (1)(a) For each three (3) year continuing education cycle, a licensee shall complete a total of sixty (60) hours of continuing medical education, if his or her license has been renewed for each year of a continuing medical education cycle.

      (b) If the license has not been renewed for each year of a continuing medical education cycle, a licensee shall complete twenty (20) hours of continuing medical education for each year for which the license has been renewed.

      (c) A licensee whose initial licensure was granted the first year of the continuing education cycle for which verification is submitted shall complete sixty (60) hours of continuing medical education before the end of the cycle.

      (d) A licensee whose initial licensure was granted the second year of the continuing education cycle for which verification is submitted shall complete forty (40) hours of continuing medical education before the end of the cycle.

      (e) A licensee whose initial licensure was granted the third year of the continuing education cycle for which verification is submitted shall complete twenty (20) hours of continuing medical education before the end of the cycle.

      (2) Upon renewal of licensure following the end of a three (3) year continuing education cycle, a licensee shall certify that he or she has met the continuing medical education requirements for the cycle as provided by this section.

      (3) Verification of completion of continuing medical education requirements shall be submitted upon request by the board.

 

      Section 4. Extensions of Time. (1) To request an extension of time, the licensee shall submit:

      (a) A completed Request for Extension to Complete Required CME Hours; and

      (b) The fee required by 201 KAR 9:041, Section 1(17).

      (2) The board may grant an extension of time to a physician who for sufficient cause has not yet received continuing medical education certification, following the submission of the items required by subsection (1) of this section. For the purposes of this subsection, sufficient cause includes situations such as the following:

      (a) An illness;

      (b) Any event meeting the Family Medical Leave Act (FMLA) of 1993, 29 U.S.C. 2601 et seq., Pub.L. 103-3 criteria, and the federal regulations implementing the act, 29 C.F.R. Part 825;

      (c) Financial exigencies; or

      (d) Practice circumstances making it prohibitive to attend the courses.

 

      Section 5. (1) For each three (3) year continuing education cycle beginning on January 1, 2015, a licensee who is authorized to prescribe or dispense controlled substances within the commonwealth at any time during that cycle shall complete at least four and one-half (4.5) hours of approved continuing education hours relating to the use of KASPER, pain management, addiction disorders, or a combination of two (2) or more of those subjects. A licensee may satisfy this requirement by completing a single approved program of four and one-half (4.5) hours or longer or by completing multiple approved programs for a total of four and one-half (4.5) hours or longer for that cycle.

      (2) Each physician licensed to practice medicine or osteopathy within the Commonwealth of Kentucky who is authorized to prescribe or dispense controlled substances within the commonwealth from July 20, 2012 through the end of the three (3) year continuing education cycle beginning on January 1, 2012 and ending on December 31, 2014 shall complete at least four and one-half (4.5) hours of approved Category I Credit continuing medical education hours relating to the use of KASPER, pain management, addiction disorders, or a combination of two (2) or more of those subjects on or before December 31, 2014. The licensee may satisfy this requirement by completing a single approved program of four and one-half (4.5) hours or longer or by completing multiple approved programs for a total of four and one-half (4.5) hours or longer for this cycle.

      (3) Each physician licensed to practice medicine or osteopathy within the Commonwealth of Kentucky who is authorized to prescribe or dispense controlled substances during the calendar years 2013 and 2014, but not during any portion of 2012, shall complete at least three (3) hours of approved Category I Credit continuing medical education hours relating to the use of KASPER, pain management, addiction disorders, or a combination of two (2) or more of those subjects on or before December 31, 2014. The licensee may satisfy this requirement by completing a single approved program of three (3) hours or longer or by completing multiple approved programs for a total of three (3) hours or longer for those two (2) years.

      (4) Each physician licensed to practice medicine or osteopathy within the Commonwealth of Kentucky who is authorized to prescribe or dispense controlled substances during calendar year 2014, but not during any portion of 2012 or 2013, shall complete at least one and one-half (1.5) hours of approved Category I Credit continuing medical education hours relating to the use of KASPER, pain management, addiction disorders, or a combination of two (2) or more of those subjects on or before December 31, 2014. The licensee may satisfy this requirement by completing a single approved program of one and one-half (1.5) hours or longer or by completing multiple approved programs for a total of one and one-half (1.5) hours or longer for that calendar year.

      (5)(a) To qualify as approved continuing education under this section, the educational program shall have been approved in advance for the specified number of continuing education hours by the board.

      (b) The board may approve an educational program that:

      1. Consists of a live presentation;

      2. Is presented by a live or recorded webinar; or

      3. Is presented through an online module.

      (c) The board shall maintain a current listing of approved continuing education programs on its official Web site, www.kbml.ky.gov.

      (6)(a) In order to lawfully prescribe or dispense controlled substances within the Commonwealth of Kentucky, a licensee shall complete the required number of continuing education hours for each period designated in this section.

      (b) Failure to complete the required number of continuing education hours for the required period or to submit the required written verification within the time specified shall constitute a violation of KRS 311.595(9) and (12), which shall constitute an immediate danger to the public health, safety, or welfare, for the purposes of KRS 311.592 and 13B.125.

      (c) If the board determines that a licensee has failed to complete the required continuing education hours within the time specified or has failed to provide the written verification of completion within the time specified, the appropriate inquiry panel or its chair shall promptly issue an emergency order restricting that licensee from prescribing or dispensing controlled substances within the Commonwealth of Kentucky until the licensee has completed the required continuing education hours for that period and has provided written verification of completion to the board.

      (d) An emergency order restricting a licensee from prescribing or dispensing controlled substances within the Commonwealth of Kentucky issued pursuant to paragraph (c) of this subsection shall remain valid and in effect until the board has received written verification that the licensee has successfully completed the required continuing education hours for the time period specified. Upon receipt of the written verification, the panel or its chair shall immediately issue an order terminating the emergency order issued pursuant to this section.

      (e) If a licensee who is affected by an emergency order issued pursuant to this section requests an emergency hearing pursuant to KRS 13B.125(3), the hearing officer conducting the emergency hearing shall affirm the emergency order if presented with written notification on board letterhead stating that the board has not received the required written verification that the licensee completed the required continuing education hours for the continuing medical education cycle by the deadline date for the cycle.

      (7) If a licensee prescribes or dispenses a controlled substance within the Commonwealth of Kentucky during any period after the licensee has failed to complete the required continuing education hours within the time specified or has failed to provide written verification of completion within the time specified, each instance of prescribing or dispensing of a controlled substance shall constitute a separate violation of KRS 311.595(12) and (9), as illustrated by KRS 311.597(1)(b), and shall serve as the basis for disciplinary sanctions pursuant to KRS 311.595.

 

      Section 6. Each licensee practicing in the specialty of pediatrics, radiology, family medicine, or emergency medicine and each licensee practicing in an urgent care practice environment shall complete at least one (1) hour of continuing medical education regarding the recognition and prevention of pediatric abusive head trauma in a course approved by the board pursuant to KRS 620.020, prior to December 31, 2017, or within five (5) years of initial licensure.

 

      Section 7. A licensee may obtain Category I continuing medical education credit for documented service to the board as a medical or osteopathic consultant. The service shall be credited at the rate of one (1) hour of continuing medical education per two (2) hours of service as a consultant, not to exceed twenty (20) hours continuing medical education credit in a three (3) year continuing education cycle.

 

      Section 8[7]. The board may randomly require physicians submitting certification of continuing medical education to demonstrate satisfactory completion of the continuing medical education requirements stated in the certification.

 

      Section 9[8]. (1) A licensee shall be fined $200 or more, if he or she fails to:

      (a) Certify timely completion of the continuing medical education requirements; or

      (b) Obtain an extension of time for completion of the continuing medical education requirements.

      (2)(a) A licensee who obtains an extension of time shall be granted an extension of six (6) months to come into compliance.

      (b) If a licensee has not completed the continuing medical education requirements within the six (6) month extension established by this subsection, his or her license shall:

      1. Be immediately suspended; and

      2. Remain suspended until the licensee has submitted verifiable evidence that he or she has completed the continuing education requirements.

 

      Section 10[9]. A waiver of the requirements established by the provisions of this administrative regulation shall not be granted.

 

      Section 11[10]. Incorporation by Reference. (1) The following material is incorporated by reference:

      (a) "Continuing Medical Education Certification Form", January 2013; and

      (b) "Request for Extension to Complete Required CME Hours", January 2013.

      (2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Board of Medical Licensure, 310 Whittington Parkway, Suite 1B, Louisville, Kentucky 40222, Monday through Friday, 8 a.m. to 4:30 p.m.[, Monday through Friday.]

 

RUSSELL L. TRAVIS, M.D., President

      APPROVED BY AGENCY: December 28, 2017

      FILED WITH LRC: January 2, 2018 at 10 a.m.

      PUBLIC HEARING AND PUBLIC COMMENT PERIOD: A public hearing on this administrative regulation shall be held on February 22, 2018 at 9:00 a.m., at the offices of the Kentucky Board of Medical Licensure, 310 Whittington Parkway, Suite 1B, Louisville, Kentucky 40222. Individuals interested in being heard at this hearing shall notify this agency in writing by February 15, 2018, five (5) workdays prior to the hearing, of their intent to attend. If no notification of intent to attend the hearing was received by that date, the hearing may be cancelled. This hearing will not be transcribed unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on the proposed administrative regulation. Written comments shall be accepted until February 28, 2018. Send written notification of intent to be heard at the public hearing or written comments on the proposed administrative regulation to the contact person.

      CONTACT PERSON: Leanne K. Diakov, General Counsel, Kentucky Board of Medical Licensure, 310 Whittington Parkway, Suite 1B, Louisville, Kentucky 40222, phone (502) 429-7150, fax (502) 429-7118, email Leanne.Diakov@ky.gov.

 

REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT

 

Contact Person: Leanne K. Diakov

      (1) Provide a brief summary of:

      (a) What this administrative regulation does: This administrative regulation establishes the requirements for obtaining continuing medical education hours for physicians in the Commonwealth of Kentucky.

      (b) The necessity of this administrative regulation: It is necessary to promulgate this regulation to establish the requirements for obtaining continuing medical education hours for physicians in the Commonwealth of Kentucky.

      (c) How this administrative regulation conforms to the content of the authorizing statutes: This administrative regulation acts specifically to establish the requirements for obtaining continuing medical education hours for physicians practicing in the Commonwealth of Kentucky.

      (d) How this administrative regulation currently assists or will assist in the effective administration of the statutes: This administrative regulation acts specifically to establish the requirements for obtaining continuing medical education hours for physicians practicing in the Commonwealth of Kentucky.

      (2) If this is an amendment to an existing administrative regulation, provide a brief summary of:

      (a) How the amendment will change this existing administrative regulation: This amendment will allow one (1) hour of Category I continuing medical education credit for two (2) hours of documented service to the board as a consultant, not to exceed twenty (20) hours in a three (3) year cycle.

      (b) The necessity of the amendment to this administrative regulation: The amendment is necessary to state how many hours of service may be credited toward the required continuing medical education credits in a three-year cycle for physicians who provide a public service as board consultants.

      (c) How the amendment conforms to the content of the authorizing statutes: This amendment establishes the requirements for obtaining continuing medical education hours for physicians practicing in the Commonwealth of Kentucky and providing a public service as a consultant to the board.

      (d) How the amendment will assist in the effective administration of the statutes: The amendment provides clear guidance on how many hours of service may be credited toward the required continuing medical education credits in a three-year cycle for physicians who provide a public service as board consultants.

      (3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation: This amendment will affect all physicians who are licensed in the Commonwealth of Kentucky. The amendment will affect those physicians who qualify and choose to engage in public service as board consultants.

      (4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:

      (a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment: None.

      (b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3): None.

      (c) As a result of compliance, what benefits will accrue to the entities identified in question (3): Physicians who practice in the Commonwealth of Kentucky and qualify and choose to provide a public service as a consultant to the board will be able to claim one (1) hour of Category I continuing medical education credit for two (2) hours of documented service to the board as a consultant, not to exceed twenty (20) hours in a three (3) year cycle.

      (5) Provide an estimate of how much it will cost to implement this administrative regulation:

      (a) Initially: None.

      (b) On a continuing basis: None.

      (6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation: Funding comes directly from applicants/licensees.

      (7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change, if it is an amendment: No increase in fees.

      (8) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees: Will not increase any fees.

      (9) TIERING: Is tiering applied? Tiering was not appropriate in this administrative regulation because the administrative regulation applies equally to those individuals regulated by it.

 

FISCAL NOTE ON STATE OR LOCAL GOVERNMENT

 

      (1) What units, parts or divisions of state or local government (including cities, counties, fire departments, or school districts) will be impacted by this administrative regulation? The Kentucky Board of Medical Licensure will be impacted by this administrative regulation.

      (2) Identify each state or federal statute or federal regulation that requires or authorizes the action taken by the administrative regulation: KRS 311.565(1)(a), (b), 311.601(1), (2)

      (3) Estimate the effect of this administrative regulation on the expenditures and revenues of a state or local government agency (including cities, counties, fire departments, or school districts) for the first full year the administrative regulation is to be in effect. None

      (a) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for the first year? None

      (b) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for subsequent years? None

      (c) How much will it cost to administer this program for the first year? None

      (d) How much will it cost to administer this program for subsequent years? None

      Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.

      Revenues (+/-):

      Expenditures (+/-):

      Other Explanation: