540-X-16-.01 Authority. The practice of medicine or osteopathy across state lines is regulated pursuant to 97-166 Ala. Acts.

Authors: Wendell R. Morgan, Patricia E. Shaner, Attorneys for the Alabama Board of Medical Examiners

Statutory Authority: Act 97-166

History: New Rule: Filed September 17, 1997; effective October 22, 1997.

540-X-16-.02 Definitions. The following definitions shall apply to these rules;

(1) Practice of Medicine or Osteopathy Across State Lines. The practice of medicine or osteopathy across states lines means the practice of medicine or osteopathy as defined in Code of Ala. 1975, §34-24-50(1), as it applies to:

(a) The rendering of a written or otherwise documented medical opinion concerning the diagnosis or treatment of a patient located within this state by a physician located outside this state as a result of transmission of individual patient data by electronic or other means from within this state to such physician or his or her agent; or

(b) The rendering of treatment to a patient located within this state by a physician located outside this state as a result of transmission of individual patient data by electronic or other means from this state to such physician or his or her agent.

(c) This definition is not intended to include an informal consultation between a licensed physician located in this state and a physician located outside this state provided that the consultation is conducted without compensation to or the expectation of compensation to either physician and does not result in the formal rendering of a written or otherwise documented medical opinion concerning the diagnosis or treatment of a patient by the physician located outside this state.

(2) Exemptions. Exemptions to the practice of medicine or osteopathy across state lines are defined as follows:

(a) A physician who engages in the practice of medicine across state lines in a medical emergency, as defined in these rules, is not subject to the provisions of 97-166 Ala. Acts;

(b) A physician who engages in the practice of medicine or osteopathy across state lines on an irregular or infrequent basis, as defined in these rules, is not subject to the provisions of 97-166 Ala. Acts.

(3) Medical Emergency. A medical emergency is a condition or circumstance that, in the best clinical judgment of the attending physician on the facts before him or her, so compromises the health, safety or well-being of the patient as to require immediate treatment.

(4) Irregular or Infrequent. The irregular or infrequent practice of medicine across state lines is deemed to occur if such practice occurs less than ten (10) times in a calendar year or involves fewer than ten (10) patients in a calendar year or comprises less than one percent (1%) of the physician’s diagnostic or therapeutic practice.

(5) Board. Board means the State Board of Medical Examiners created under Code of Ala. 1975, §34-24-53.

(6) Commission. Commission means the Medical Licensure Commission created under Code of Ala. 1975, §34-24-310.

(7) Special Purpose License. A special purpose license is a license issued by the Commission to practice medicine or osteopathy across state lines which:

(a) Is only issued to an applicant whose principal practice location and license to practice is located in a state or territory of the United States whose laws permit or allow issuance of a special purpose license to practice medicine or osteopathy across state lines or a similar license to a physician whose principal practice location and license is located in the State of Alabama;

(b) Limits the licensee solely to the practice of medicine or osteopathy across state lines as defined in these rules.

Authors: Wendell R. Morgan, Patricia E. Shaner, Attorneys for the Alabama Board of Medical Examiners

Statutory Authority: Act 97-166

History: New Rule: Filed September 17, 1997; effective October 22, 1997.

540-X-16-.03 License Requirement. To engage in the practice of medicine or osteopathy across state lines in the State of Alabama, a person shall hold a current special purpose license to practice medicine or osteopathy across state lines issued in accordance with the provisions of 97-166 Ala. Acts, the rules of the Board, and the rules of the Commission, or a person shall hold a full, unrestricted and current license issued under Code of Ala. 1975, §34-24-334 and Chapter 3 of the rules of the Board.

Authors: Wendell R. Morgan, Patricia E. Shaner, Attorneys for the Alabama Board of Medical Examiners

Statutory Authority: Act 97-166

History: New Rule: Filed September 17, 1997; effective October 22, 1997.

540-X-16-.04 Qualifications For A Certificate Of Qualification For A Special Purpose License. An applicant shall be eligible for issuance of a certificate of qualification to practice medicine or osteopathy across state lines if all of the following requirements are met:

(1) The applicant holds a full and unrestricted license to practice medicine or osteopathy in any and all states of the United States or territories in which such individual is licensed.

(2) The applicant has not had any previous disciplinary action or other action taken against the applicant by any state or licensing jurisdiction, provided, however, that in the event of previous disciplinary or other action taken against the applicant, the Board may issue a certificate of qualification if it finds that the previous disciplinary action or other action does not indicate that the physician is a potential threat to the public.

(3) The applicant completes and submits an application form for a certificate of qualification for a special purpose license. The form of the application is set forth in Appendix A to Chapter 16.

(4) The applicant submits an application fee in the amount of $175.00.

Authors: Wendell R. Morgan, Patricia E. Shaner, Attorneys for the Alabama Board of Medical Examiners

Statutory Authority: Act 97-166

History: New Rule: Filed September 17, 1997; effective October 22, 1997.

540-X-16-.05 Issuance Of Certificate Of Qualification, Transmittal To Medical Licensure Commission. A certificate of qualification for a special purpose license issued by the Board shall be numbered, signed by the Chairman of the Board or his designee, and transmitted to the Medical Licensure Commission.

Authors: Wendell R. Morgan, Patricia E. Shaner, Attorneys for the Alabama Board of Medical Examiners

Statutory Authority: Act 97-166

History: New Rule: Filed September 17, 1997; effective October 22, 1997.

540-X-16-.06 Appeal From Denial Of Application For Certificate Of Qualification For Special Purpose License. An applicant may appeal the decision of the Board denying an application for a certificate of qualification for special purpose license to the Medical Licensure Commission. Appeals will be governed by Rule 540-X-5-.05.

Authors: Wendell R. Morgan, Patricia E. Shaner, Attorneys for the Alabama Board of Medical Examiners

Statutory Authority: Act 97-166

History: New Rule: Filed September 17, 1997; effective October 22, 1997.

(a) The issuance by the Commission of a special purpose license to practice medicine or osteopathy across state lines subjects the licensee to the jurisdiction of the Board and the Commission in all matters set forth in Sections 34-24-50 to 34-24-83, inclusive, Code of Ala. 1975, and Sections 34-24-310 to 34-24-406, inclusive, Code of Ala. 1975, and the rules and regulations of the Commission and the board, including all matters related to discipline.

(b) It shall be the affirmative duty of every licensee to report to the Board of Medical Examiners in writing within fifteen days of the initiation of any disciplinary action against the license to practice medicine or osteopathy of the licensee by any state or territory in which the licensee is licensed.

(c) By accepting a special purpose license, the licensee agrees to produce patient medical records or other materials as requested by the Board and to appear before the Board or any of its committees following receipt of a written notice issued by the Board or its authorized representation.

(d) A special purpose license to practice medicine of osteopathy across state lines in subject to each of the grounds for disciplinary action as provided in Section 34-24-360, Code of Ala. 1975, in accordance with the procedures set out in Section 34-24-361, Code of Ala. 1975, and the Alabama Administrative Procedure Act.

(e) The holder of a special purpose license shall comply with all laws, rules, and regulations governing the maintenance of patient medical records, including patient confidentiality requirements, regardless of the state where the medical records of any patient within this state are maintained.

Authors: Wendell R. Morgan, Patricia E. Shaner, Attorneys for the Alabama Board of Medical Examiners

Statutory Authority: Act 97-166

History: New Rule: Filed September 17, 1997; effective October 22, 1997.

To The Board of Medical Examiners of the State of Alabama:

I hereby make application for a certificate of qualification to practice

medicine or osteopathy across state lines in the State of Alabama, and submit

the following statement concerning my qualifications for a special purpose

license

1. Name in Full ______________________________________________________________

2. Principal Practice Address Street/P.O. Box __________ City __________ State

___ Zip __________

3. Place of Birth __________ Date of Birth __________ MD ___ DO ___

Social Security # __________ Sex ___ Telephone (H) __________ (W)

__________

4. List all states where you are licensed to practice medicine or osteopathy.

It is required that each state complete one of the verification forms

which will be attached to your application.

____________________ ____________________ ____________________

____________________ ____________________ ____________________

____________________ ____________________ ____________________

____________________ ____________________ ____________________

YES NO

5. Has your certificate of qualification or license to practice ____ ____

medicine in any state been suspended, revoked, restricted,

curtailed or voluntarily surrendered under threat of

suspension or revocation or disciplined in any manner?

6. Have you ever been denied a certificate of qualification or a ____ ____

license to practice medicine in any state or has your

application for a certificate of qualification or license to

practice medicine or osteopathy been withdrawn under threat

of denial?

7. Has a disciplinary action been initiated in any state in which ____ ____

you currently hold a license to practice medicine or

osteopathy?

IF ANY OF THE ABOVE ANSWERS ARE IN THE AFFIRMATIVE, PLEASE EXPLAIN IN DETAIL ON AN ATTACHED SHEET

DECLARATION FOR CERTIFICATE OF QUALIFICATION FOR SPECIAL PURPOSE LICENSE

In connection with my application for a certificate of qualification for a

special purpose license to practice medicine or osteopathy across state

lines, I understand and acknowledge that:

a. A special purpose license only permits the holder to engage in the practice of medicine across state lines on patients located in the State of Alabama but does not authorize the holder to be physically present and engage in the general practice of medicine within the State of Alabama.

b. It is the affirmative duty of the holder of a special purpose license to report to the Alabama Board of Medical Examiners in writing within fifteen days of the initiation of any disciplinary action against the license to practice medicine or osteopathy of the licensee by any state or territory in which the license is licensed.

c. By accepting a special purpose license, the licensee agrees to produce patient records or materials as requested by the Board of Medical Examiners or the Medical Licensure Commission and to appear before the Board or the Commission or any of its committees following the receipt of a written notice by the Board or Commission.

d. The issuance of a special purpose license subjects the licensee to the jurisdiction of the Alabama Board of Medical Examiners and the Medical Licensure Commission of Alabama and the respective statutes and regulations under which they operate, including all matters related to discipline.

e. Failure to renew a special purpose license according to the renewal schedule shall result in the automatic revocation of the special purpose license. In the event of the automatic revocation of a special purpose license for failure to renew, the licensee must reapply for a new special purpose license.

AFFIDAVIT AND RELEASE

I, __________, certify after being duly sworn, that all of the information supplied in the foregoing application is true and correct to the best of my knowledge. I acknowledge that any false or untrue statement or representation

made in this application may result in the revocation of the license granted to me and criminal prosecution to the fullest extent of the law.

I further authorize the release of this application and any information submitted with it or information collected by the Alabama Board of Medical Examiners in connection with this application, including derogatory information to any person or organization having a legitimate need for the

information and release the Alabama Board of Medical Examiners from all liability for the release of this information.

I further authorize the release of information, including derogatory information, which may be in the possession of other individuals or organizations to the Alabama Board of Medical Examiners and release this person or any organization from any liability for the release of information.

Date____________________ ______________________________

Applicant's Signature

County of ________________

State of _________________

Before me the undersigned authority, personally appeared __________, who is known to me and who being first duly sworn states that all of the information

in the foregoing application is true and correct to the best of his/her knowledge.

SWORN to and subscribed before me this ___ day of __________, 19___.

________________________________

Notary Public

My Commission Expires: _________

Photo al2650

Authors: Wendell R. Morgan, Patricia E. Shaner, Attorneys for the Alabama Board of Medical Examiners

Statutory Authority: Act 97-166

History: New Appendix: Filed September 17, 1997; effective October 22, 1997.