Missouri Senate

Perfected

LICENSURE REQUIREMENTS FOR PHYSICIANS

The act provides that an applicant for licensure as a physician or a surgeon who does not achieve a passing score within three attempts on a licensing exam administered in one or more states may petition the State Board of Registration for the Healing Arts for an exception to such requirement based upon unusual or extenuating circumstances. Likewise, an applicant who does not pass a step of the United States Medical Licensing Examination (USMLE) within three attempts or does not pass all three steps within a seven year period may also petition the Board for an exception.

Applicants must provide proof of successful completion of the USMLE or the COMLEX, rather than just proof of completion. The act repeals the provision authorizing the Board to determined the passing score of the USMLE.

The act removes the provision that states that in order for the Board to waive licensure requirements for an applicant who is licensed in another state the applicant must be certified by a certifying agency in the applicant's area of speciality.

The state shall not require adherence to the Federation of State Medical Boards' framework as a condition for physician license renewal or any form of specialty medical board certification to practice medicine within the state. The State Board of Registration for the Healing Arts or any other state agency shall not discriminate against physicians who do not maintain specialty medical board certification.

These provisions are similar to SCS/SB 772 (2016), HB 683 (2015), SB 411 (2015), SS/SB 400 (2015), and HB 671 (2015).

COLLABORATIVE PRACTICE ARRANGEMENTS

The act also provides that a physician may enter into a collaborative practice arrangement with no more than five, rather than three, advanced practice registered nurses.

NURSING LICENSURE COMPACT

This act establishes a new nursing licensure compact in which states who are members of the compact, known as party states, may issue multistate nursing licenses for the practice of registered, licensed practical, or vocational nursing. A multistate nursing license shall authorize a nurse to practice under a multistate licensure privilege in each party state. The act does not affect the requirements established by a party state for the issuance of a single-state license.

This compact shall become effective and binding on the earlier of the date of legislative enactment of this compact by no less than twenty-six states or December 31, 2018. All party states to this compact that were also parties to the prior nurse licensure compact shall be deemed to have withdrawn from the prior compact within six months after the effective date of this compact.

Under the act, a party state must adopt procedures for considering the criminal history of applicants for an initial multistate license, and require an applicant for multistate licensure to 1) meet certain educational requirements as specified in the act, 2) pass the NCLEX-RN or NCLEX-PN examination, 3) hold or be eligible for an active, unencumbered license, 4) submit fingerprints for a criminal background check, 5) not have been convicted of a felony or a misdemeanor related to the practice of nursing, or enrolled in an alternative licensure disciplinary program, and 6) have a valid Social Security number.

A nurse practicing in a party state, not his or her home state, is subject to the jurisdiction of the licensing board, courts, and laws, of the party state in which the client is located at the time service is provided. A party state may take adverse action against a nurse's multistate licensure privilege, and shall notify the administrator of the coordinated licensure information system of any disciplinary action. The administrator shall then inform the licensee's home state of any such action by another state against the licensee.

All party states shall participate in a coordinated licensure information system, which shall include information on the licensure and disciplinary history of each nurse, and shall be administered by a nonprofit organization composed of and controlled by the party states' licensing boards. Any personally identifiable information obtained from the coordinated licensure information system by a party state licensing board shall not be shared with non-party states or disclosed to other entities or individuals except to the extent permitted by the laws of the party state contributing the information.

A nurse who holds a multistate license issued by his or her home state on the effective date the compact may retain and renew the multistate license issued by the current home state. However, a nurse who changes primary state of residence after the effective date of the compact shall meet the requirements to obtain a multistate license from a new home state. A nurse may hold a multistate license issued by the home state, in only one party state at a time. If a nurse moves to a new party state, he or she must apply for licensure in the new home state, and the multistate license issued by the prior home state will be deactivated. If a nurse moves to a non-party state then the multistate license issued by the prior home state will convert to a single-state license, valid only in the prior home state.

The licensing board of each state shall have the authority to take disciplinary action against a nurse's multistate licensure privilege to practice within the party state, but only the home state shall have the power to take adverse action against a nurse's license issued by the home state.

The Interstate Commission of Nurse Licensure Compact Administrators, composed of one designee from each party state, shall have the authority to promulgate uniform rules to implement and administer the compact. Such rules shall be binding in all party states and have force and effect of law. The act sets forth procedures and requirements that the Commission must follow in order to exercise its rulemaking powers. The Commission shall meet at least once a year and the meetings shall be open to the public. The Commission shall establish bylaws or rules to govern its conduct which shall be published on the Commission's website.

If the Commission determines that a party state has defaulted in the performance of its responsibilities under the Compact and fails to cure such default, then the party state's membership in the Compact shall be terminated upon an affirmative vote of the members of the Commission.

This act shall become effective upon notification to the Revisor of Statutes by the Commission that no less than twenty-six states have enacted the Compact, or December 31, 2018, whichever occurs earlier.

These provisions are substantially similar to SB 985 (2016).

JESSI BAKER