Sub-Chapter 1: General Provisions
§ 1750. Definitions
As used in this chapter:
(1) "Approved hospital" means a hospital approved by the American Osteopathic Association (AOA) or Accreditation Council for Graduate Medical Education (ACGME).
(2) "Approved program" means a one-year internship or postgraduate program approved by the AOA or the ACGME.
(3) "Accredited school or college of osteopathic medicine" means a school approved by the AOA or by the board according to its rules.
(4) "Board" means the board of osteopathic physicians and surgeons created under section 1791 of this title.
(5) "Disciplinary action" includes any action taken by the board against a person licensed under this chapter or an applicant premised on a finding that the person has engaged in unprofessional conduct. The term includes all sanctions of any kind, including obtaining injunctions, refusing to grant or renew a license, suspending or revoking a license, and issuing warnings.
(6) "Medical director" means, for purposes of this chapter, an osteopathic physician who is board-certified or board-eligible in his or her field of specialty, as determined by the AOA or the American Board of Medical Specialties (ABMS), and who is charged by a health maintenance organization with responsibility for overseeing all clinical activities of the plan in this state, or his or her designee.
(7) "Health maintenance organization", as used in this section, shall have the same meaning as defined in 18 V.S.A. § 9402(10).
(8) "Member" means any individual who has entered into a contract with a health maintenance organization for the provision of health care services, or on whose behalf such an arrangement has been made, as well as the individual's dependents covered by the contract.
(9) "Osteopathic physician" means a person licensed under this chapter to practice osteopathic medicine.
(10) "Practice of osteopathic medicine" means the diagnosis, treatment, operation, or prescription for any human disease, pain, injury, deformity, or other physical or mental condition, which practice is based in part upon educational standards and requirements which emphasize the importance of the neuromusculoskeletal structure and manipulative treatment in the maintenance and restoration of health. (Added 1989, No. 253 (Adj. Sess.), § 1; amended 1999, No. 133 (Adj. Sess.), § 15; 2001, No. 129 (Adj. Sess.), § 23, eff. June 13, 2002.)
§ 1751. Application of laws; rights
Osteopathic physicians and surgeons shall be subject to the provisions of law relating to communicable diseases and to the granting of certificates of births and deaths and the issuance of certificates relating to the commitment of mentally ill individuals, and such reports and certificates shall be accepted by the office or department to whom the same are made or presented, equally with the reports and certificates of physicians of any other school of medicine; and such physicians shall have the same rights with respect to the rendering of medical services under the provisions of public health, welfare, and assistance laws and rules. (Amended 1989, No. 253 (Adj. Sess.), § 2.)
§ 1752. Prohibition; penalty
(a) No person shall perform any of the following acts:
(1) Practice or attempt to practice osteopathic medicine or hold herself or himself out as being able to do so in this state without first having obtained a license from the board.
(2) Use, in connection with the person's name any letters, words, or insignia indicating that the person is an osteopathic physician unless the person is licensed in accordance with this chapter.
(3) Practice or attempt to practice osteopathic medicine during license revocation or suspension.
(b) A person violating any of the provisions of subsection (a) of this section shall be subject to the penalties provided in 3 V.S.A. § 127(c). (Amended 1989, No. 253 (Adj. Sess.), § 3; 2007, No. 29, § 30.)
§ 1753. Exemptions
(a) The provisions of subdivision 1752(a)(1) of this title, relating to practice, shall not apply to the following persons acting within the scope of their respective practices:
(1) A person licensed to practice medicine and surgery under chapter 23 of this title.
(2) A person licensed to practice chiropractic medicine under chapter 10 of this title.
(3) A physician assistant licensed or registered pursuant to chapter 31 of this title.
(b) The provisions of subdivision 1752(a)(1) of this title shall not apply to any person or persons giving aid, assistance, or relief in emergency or accident cases pending the arrival of a licensed physician or surgeon.
(c) The provisions of this chapter shall not apply to:
(1) A commissioned officer of the U.S. Armed Forces or Public Health Service when acting within the scope of his or her official duties.
(2) A nonresident licensed osteopathic physician or surgeon who is called to treat or to consult on a particular case in this State provided he or she does not otherwise practice in this State. (Added 1989, No. 253 (Adj. Sess.), § 4; amended 2013, No. 27, § 19; 2013, No. 34, § 30a.)
Sub-Chapter 2: Board Of Osteopathic Physicians And Surgeons
§ 1791. Composition of the board; qualifications; term of office
(a) A board of osteopathic physicians and surgeons is created. The board shall consist of five members. Board members shall be appointed by the governor pursuant to 3 V.S.A. §§ 129b and 2004.
(b) Three members of the board shall be osteopathic physicians licensed and in good standing in this state who are graduates of an accredited school of osteopathic medicine and who reside and have resided and actively practiced osteopathic medicine in this state during the two years immediately preceding their appointments. Two members shall be public members. A public member shall not be a member of any other health-related licensing board, nor have a financial interest personally or through a spouse, parent, child, brother, or sister in the activities regulated under this chapter, other than as a consumer or possible consumer of osteopathic medical services.
(c) A majority of the members of the board shall constitute a quorum, and all action shall be taken upon a majority vote of the members present and voting.
(d), (e) [Deleted.] (Amended 1989, No. 253 (Adj. Sess.), § 5; 2005, No. 27, § 48.)
§ 1792. Powers; duties
(a) In addition to its other powers and duties, the board shall:
(1) Provide general information to applicants.
(2) Explain appeal procedures to licensees and applicants and complaint procedures to the public.
(3) Adopt rules which establish the activities that must be completed by an applicant in order to fulfill the experience requirements of this chapter. The rules shall require that the applicant's experience be under the supervision of an osteopathic physician licensed under this chapter. Such activities shall be designed to ensure that all applicants acquire experience in critical areas of osteopathic medicine, but shall not limit admission to licensure unless there is good reason to believe that licensure of a particular applicant would be inconsistent with safeguarding the public welfare.
(b) The board may:
(1) Adopt rules necessary for the performance of its duties.
(2) Issue subpoenas to compel the attendance of witnesses at any investigation or hearing.
(3) Issue orders relating to discovery in the same manner as a judge under the Vermont Rules of Civil Procedure.
(c) The board shall lack the power to condition, limit, or alter in any way the express terms of this chapter. (Amended 1989, No. 253 (Adj. Sess.), § 6.)
§ 1793. Repealed. 1989, No. 253 (Adj. Sess.), § 19.
§ 1794. Fees
Applicants and persons regulated under this chapter shall pay the
(A) Licensure $500.00
(B) Limited temporary license $ 50.00
(2) Biennial license renewal $500.00
(3) Annual limited temporary license renewal $100.00
(Amended 1989, No. 253 (Adj. Sess.), § 7; 1991, No. 167 (Adj. Sess.), § 35; 1993, No. 108 (Adj. Sess.), § 18; 1997, No. 59, § 57, eff. June 30, 1997; 1999, No. 49, § 177; 2001, No. 143 (Adj. Sess.), § 27, eff. June 13, 2002; 2005, No. 202 (Adj. Sess.), § 16; 2011, No. 128 (Adj. Sess.), § 1.)
Sub-Chapter 3: Licenses And Examination
§ 1830. Application
To apply for licensure as an osteopathic physician a person shall apply to the board on a form furnished by the board. The application shall be accompanied by payment of the required fees and evidence of eligibility as requested by the board. (Added 1989, No. 253 (Adj. Sess.), § 8.)
§ 1831. Qualifications for licensure
(a) To be eligible for licensure as an osteopathic physician, an applicant shall have attained the age of majority and shall provide evidence, acceptable to the board, that he or she has satisfactorily completed all of the following:
(1) A course of study in osteopathic education from an accredited school or college of osteopathic medicine as evidenced by a graduation certificate.
(2) Documentation of no less than one year of an approved program of postgraduate training.
(b) In addition to the requirements of subsection (a) of this section, an applicant shall pass the Comprehensive Osteopathic Medical Licensing Examination - USA (COMLEX) or the United States Medical Licensing Examination (USMLE) or their successor or equivalent examinations approved by the board unless the applicant is exempt from all or a part of the examination under the provisions of section 1832 or 1832a of this title.
(c) In addition to the requirements of this section, an applicant shall present evidence of good character and competence relating to his or her fitness to practice osteopathic medicine from the chief of service and two other active physician staff members at the hospital or institution where the applicant was last affiliated, if the applicant has been affiliated with a hospital or institution. The board may seek evidence relating to the character and competence of the applicant from other sources. At the discretion of the board, the applicant may present evidence relating to character and competence from different sources. (Amended 1971, No. 184 (Adj. Sess.), § 21, eff. March 29, 1972; 1989, No. 250 (Adj. Sess.), §§ 49, 50; 1989, No. 253 (Adj. Sess.), § 9; 2009, No. 103 (Adj. Sess.), § 16.)
§ 1832. Examination
The board or its designee shall administer examinations to applicants for licensure at least twice each year if applications are pending. Examinations shall be designed and implemented to ensure that all applicants are admitted to practice unless there is good reason to believe that practice by a particular applicant would be inconsistent with the public health, safety, and welfare; they shall not be designed for the purpose of limiting the number of licensees. (Amended 1989, No. 253 (Adj. Sess.), § 10; 2009, No. 103 (Adj. Sess.), § 17.)
§ 1832a. Licensure without examination
(a) A person shall be entitled to licensure without examination if he or she is a diplomate of the National Board of Examiners for Osteopathic Physicians and Surgeons.
(b) A person shall be entitled to licensure without examination if, at the time of application, he or she produces satisfactory evidence of the following and, in the judgment of the board, he or she is qualified in all respects for a license:
(1) Licensure in another state whose requirements are substantially equivalent to the requirements of this chapter.
(2) The person has been granted a diploma by an accredited school or college of osteopathic medicine.
(c) Applicants for licensure under subsection (b) of this section may be required to appear for a personal interview before the board. (Added 1989, No. 253 (Adj. Sess.), § 11.)
§ 1833. Reexamination
A person who fails to pass the Vermont examination required under section 1832 of this title may apply for reexamination and may, upon payment of the examination fee, sit for any regularly scheduled examination. If an applicant does not pass the entire examination, the applicant shall not be required to retake any section of an examination which the applicant has previously passed. (Amended 1989, No. 253 (Adj. Sess.), § 12.)
§ 1834. Limited temporary license
(a) An applicant for a limited temporary license shall meet the following requirements:
(1) Have attained the age of majority.
(2) Be a graduate of an accredited school or college of osteopathic medicine.
(3) Be appointed as an intern, resident, fellow, or medical officer in an approved hospital or in a clinic which is affiliated with an approved hospital, or in any hospital or institution maintained by the state, or in any clinic or outpatient clinic affiliated with or maintained by the state.
(b) The board may grant a limited temporary license for a period of one year to an applicant who furnishes satisfactory proof of meeting the requirements set forth in subsection (a) of this section, and pays the required fee. A temporary license may be renewed or reissued only four times whether or not consecutive.
(c) A limited temporary license shall entitle the applicant to practice only in the hospital or other institution designated on the applicant's limited temporary license and in clinics or outpatient clinics operated by or affiliated with such designated hospital or institution and only under the direct supervision and control of an osteopathic or allopathic physician licensed under this chapter or chapter 23 of this title. The supervising physician shall provide the board with information regarding the names and addresses of the supervising physician and the limited temporary licensee and the name of the hospital or other institution in which the person will practice.
(d) The supervising physician shall be responsible for negligent or wrongful acts or omissions of the limited temporary licensee.
(e) The limited temporary licensee shall at all times exercise the same standard of care and skill as an osteopathic physician, practicing in the same specialty, in the state of Vermont.
(f) A limited temporary license shall expire upon occurrence of any of the following events:
(1) The death or legal incompetency of the supervising physician.
(2) Withdrawal of the filing by the supervising physician, provided the supervising physician gives 10 days' written notice to the licensee and the hospital or institution.
(g) A limited temporary license granted under this section shall expire immediately upon termination of the licensee's appointment as intern, resident, fellow, or medical officer of the designated hospital or institution. (Amended 1989, No. 253 (Adj. Sess.), § 13.)
§ 1835. Repealed. 1989, No. 253 (Adj. Sess.), § 19.
§ 1836. Biennial renewal of license; continuing education
(a) Licenses shall be renewed every two years.
(b) Biennially, the Board shall forward a renewal form to each licensee. Upon receipt of the completed form, evidence of compliance with the provisions of subsection (c) of this section, and the renewal fee, the Board shall issue a new license.
(c) As a condition of renewal a licensee shall complete a minimum of 30 hours of continuing medical education, approved by the Board by rule, during the preceding two-year period. At least 40 percent of these hours must be osteopathic medical education.
(d) A lapsed license shall be reinstated upon payment of the biennial renewal fee, the late renewal penalty, and compliance with the other provisions of this section. (Amended 1989, No. 250 (Adj. Sess.), § 51; 1989, No. 253 (Adj. Sess.), § 14; 2013, No. 27, § 20.)
§ 1837. Health maintenance organization; medical director
A medical director who is an osteopathic physician employed by a health maintenance organization with members in this state shall possess a full and unrestricted license, or a special purpose license pursuant to subchapter 5 of chapter 33 of this title, issued by the board. (Added 1999, No. 133 (Adj. Sess.), § 16; amended 2001, No. 129 (Adj. Sess.), § 24, eff. June 13, 2002.)
Sub-Chapter 4: Denials; Unprofessional Conduct And Discipline
§ 1841. Preliminary decisions
When the board intends to deny an application for licensure or makes any other decision that would prevent an applicant from obtaining a license, the board shall send the applicant written notice of its preliminary decision by certified mail. The notice shall include a specific statement of the reasons for the action. Within 30 days of the date that an applicant receives such notice, the applicant may file a petition with the board for review of its preliminary decision. In cases where the preliminary decision is based upon failure to pass the Vermont osteopathic licensure examination, the applicant may request and shall receive, within 30 days from the date of receipt of the request, further and more specific information on the content of questions which were answered incorrectly, and what the correct answers should have been. This information shall be provided by the testing service if one has been used. At the hearing to review the preliminary decision, which, if the applicant chooses, may not take place until the board has responded to inquiries about the questions and answers, the burden shall be on the applicant to show that licensure should be granted. After the hearing, the board shall issue a final decision which affirms or reverses its preliminary denial or decision explaining the reasons therefor. (Added 1989, No. 253 (Adj. Sess.), § 15.)
§ 1842. Unprofessional conduct
(a) A person licensed under this chapter shall not engage in unprofessional conduct. If such conduct is committed by an applicant it shall be grounds for denial of a license.
(b) Unprofessional conduct means the following conduct and conduct set forth in 3 V.S.A. § 129a.
(1) Inability to practice osteopathic medicine with reasonable skill and safety to patients by reason of illness or use of alcohol, drugs, narcotics, chemicals, or any other type of material or as a result of any mental or physical condition.
(2) Misrepresentation or concealment of a material fact in the obtaining of a license to practice osteopathic medicine, or renewal or reinstatement of a license.
(3) Suspension or revocation of the physician's license to practice osteopathic medicine and surgery by competent authority in any state, federal, or foreign jurisdiction.
(4) Willful disregard of the subpoena or notice of the board.
(5) Failure to keep written medical records justifying the course of treatment of the patient, including patient histories, examination results, and test results.
(6) Exploitation of a patient for financial, personal, or professional gain.
(7) Performing professional services which have not been authorized by the patient or his or her legal representative.
(8) Performing any procedure or prescribing any therapy which, by the prevailing standards of medical practice in the community, would constitute experimentation of a human subject, without first obtaining full, informed, and written consent.
(9) Delegating professional responsibilities to a person who the licensee knows or has reason to know is not qualified by training, experience, or licensure to perform them.
(10) Agreeing with any other person or organization, or subscribing to any code of ethics or organizational bylaws, when the intent or primary effect of that agreement, code, or bylaw is to restrict or limit the flow of information concerning alleged or suspected unprofessional conduct to the board.
(11) Use of the services of an anesthesiologist assistant in a manner that is inconsistent with the provisions of chapter 29 of this title.
(12) Use of the services of a radiologist assistant in a manner that is inconsistent with the provisions of chapter 52 of this title. (Added 1989, No. 253 (Adj. Sess.), § 15; amended 1997, No. 145 (Adj. Sess.), § 42; 2003, No. 34, § 2, eff. May 23, 2003; 2009, No. 103 (Adj. Sess.), § 19b, eff. May 12, 2010.)
§ 1843. Disciplinary action
(a) In connection with a disciplinary action, the board may refuse to accept the return of a license tendered by the subject of a disciplinary investigation and may notify relevant state, federal, and local agencies and appropriate bodies in other states of the status of any pending or completed disciplinary case against a licensee, provided that the board has served notice of charges against the licensee or taken disciplinary action against that person.
(b) The burden of proof in a disciplinary action shall be on the state to show by a preponderance of the evidence that the person has engaged in unprofessional conduct.
(c) After hearing, and upon a finding of unprofessional conduct, the board may take disciplinary action against an osteopathic physician or applicant.
(d)(1) Before, during, or after a hearing, the board may approve a negotiated agreement between the parties when it is in the best interest of the public health, safety, or welfare to do so. Such an agreement may include, without limitation, any of the following conditions or restrictions which may be in addition to or in lieu of suspension:
(A) A requirement that a licensee submit to care or counseling.
(B) A restriction that a licensee practice only under supervision of a named person or a person with specified credentials.
(C) A requirement that a licensee participate in continuing education as defined by the board, in order to overcome specified deficiencies.
(D) A requirement that the licensee's scope of practice be restricted to a specified extent.
(2) Such an agreement may be modified by the parties after obtaining the approval of the board. An individual directly affected by an agreement approved under this section may petition the board for modification of the terms of the agreement.
(e) The board may reinstate a revoked license on terms and conditions it deems proper. (Added 1989, No. 253 (Adj. Sess.), § 15.)
§ 1844. Appeal
A party aggrieved by a decision of the board may appeal as provided in 3 V.S.A. chapter 5. (Added 1989, No. 253 (Adj. Sess.), § 15.)
§ 1845. Repealed. 2005, No. 148 (Adj. Sess.), § 54.
Sub-Chapter 5: Health Maintenance Organization Medical Director
§ 1851. License requirement
No person shall engage in the practice of osteopathic medicine as a medical director for a health maintenance organization covering persons in this state, hold himself or herself out as qualified to do the same, or use any title, word, or abbreviation to indicate or induce others to believe that he or she is licensed to practice osteopathic medicine as a medical director for a health maintenance organization covering persons in this state unless he or she is actually so licensed in accordance with the provisions of this subchapter. (Added 2001, No. 129 (Adj. Sess.), § 25, eff. June 13, 2002.)
§ 1852. Issuance of license
(a) The board may issue a special purpose license to practice osteopathic medicine as a medical director for a health maintenance organization covering persons in this state upon application from a person holding a full and unrestricted license to practice medicine in any and all states of the United States or its territories in which such individual is licensed, provided there has not been previous disciplinary or other action against the applicant by any state or jurisdiction. In the event of previous disciplinary or other action against the applicant, the board may, in its discretion, issue a license to practice osteopathic medicine as a medical director for a health maintenance organization covering persons in this state if it finds that the previous disciplinary or other action does not indicate that the osteopathic physician is a potential threat to the public.
(b) An individual shall submit an application to the board on a form provided by the board. Such special purpose license issued by the board limits the licensee solely to the practice of osteopathic medicine as a medical director for a health maintenance organization covering persons in this state. The special purpose license in this state is valid for the term of two years, and may be renewed upon submission of a renewal application on forms provided by the board. (Added 2001, No. 129 (Adj. Sess.), § 25, eff. June 13, 2002.)
§ 1853. Effect of license
(a) The issuance by the board of a special purpose license to practice osteopathic medicine as a medical director for a health maintenance organization covering persons in this state shall subject the licensee to the jurisdiction of the board in all matters set forth in this chapter and implementing rules, including all matters related to discipline. In addition, the licensee agrees by acceptance of such license to produce patient medical records and materials as requested by the board, and to appear before the board or any of its committees within 10 days following receipt of a written notice issued by the board. Such notice may be issued by the board pursuant to any complaint or report filed or any complaint initiated by the board or any of its committees when records or materials are deemed relevant to that complaint or report.
(b) Failure of the licensee to appear or to produce records or materials as requested, after appropriate notice, allows the board to suspend or revoke the licensee's special purpose license at its discretion. Notwithstanding any other provision of law to the contrary, such suspension or revocation of a license may be effected prior to a hearing, after appropriate notice, and if the board finds an ongoing and continuous threat to the public. Such action taken by the board shall be deemed a disciplinary action for purpose of action by any other state. (Added 2001, No. 129 (Adj. Sess.), § 25, eff. June 13, 2002.)
§ 1854. Patient medical records
Any licensee holding a special purpose license to practice osteopathic medicine as a medical director for a health maintenance organization covering persons in this state shall comply with all laws and rules governing the maintenance of patient medical records, including patient confidentiality requirements, regardless of where the medical records of any patient within this state are maintained. (Added 2001, No. 129 (Adj. Sess.), § 25, eff. June 13, 2002.)
§ 1855. Sanctions
Nothing in this subchapter shall be interpreted to limit or restrict the board's authority to discipline any osteopathic physician licensed to practice in this state who violates the provisions of this chapter while engaging in the practice of osteopathic medicine as a medical director for a health maintenance organization covering persons in this state. (Added 2001, No. 129 (Adj. Sess.), § 25, eff. June 13, 2002.)
§ 1856. Fees
Applicants and persons regulated under this subchapter shall be subject to the application and renewal fees set forth in section 1794 of this chapter. (Added 2001, No. 129 (Adj. Sess.), § 25, eff. June 13, 2002; amended 2013, No. 27, § 21.)