216-RICR-40-05-9. Licensing of Podiatrists (version Amendment, 12/10/2012 to 04/30/2018)

RULES AND REGULATIONS FOR THE LICENSING OF PODIATRISTS [R5-29-POD] STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS DEPARTMENT OF HEALTH January 1964 AS AMENDED: September 1987 January 1991 September 1991 (E) January 2007 (re-filing in accordance with the provisions of section 42-35- 4.1 of the Rhode Island General Laws, as amended) January 1992 (E) September 2007 May 1992 June 2000 November 2001 January 2012 (re-filing in accordance with the provisions of section 42-35- 4.1 of the Rhode Island General Laws, as amended) September 2012 January 2002 (re-filing in accordance with the provisions of section 42-35- 4.1 of the Rhode Island General Laws, as amended) i INTRODUCTION These amended Rules and Regulations for the Licensing of Podiatrists [R5-29-POD] are promulgated pursuant to the authority conferred under section 5-29-5 of the General Laws of Rhode Island, as amended, and are established for the purpose of adopting minimum requirements for the licensure of podiatrists in this state. In accordance with the provisions of section 42-35-3(c) of the General Laws of Rhode Island, 1956, as amended, consideration was given to: (1) alternative approaches to the regulations; and (2) duplication or overlap with other state regulations. Based on the available information, no known alternative approach or duplication or overlap was identified. These amended regulations shall supersede all previous Rules and Regulations for the Licensing of Podiatrists, promulgated by the Rhode Island Department of Health and filed with the Secretary of State. ii TABLE OF CONTENTS Page PART I Definitions 1 Section R5-29-POD 1.0 Definitions 1 PART II Licensure Requirements 3 Section R5-29-POD 2.0 General Requirements 3 3.0 Qualifications 3 4.0 Application 3 5.0 Examination 4 6.0 Continuing Education 5 7.0 Limited Registration 5 8.0 Issuance and Renewal of License/Registration 7 9.0 Practice of Podiatry 8 10.0 Denial, Suspension, or Revocation of License 8 PART III Violations/Practices And Procedures/Severability 10 Section R5-29-POD 11.0 Violations 10 12.0 Practices and Procedures 10 13.0 Severability 10 1 PART I DEFINITIONS R5-29-POD Section 1.0 Definitions Wherever used in these rules and regulations the terms listed below shall be construed in the following manner: 1.1 "Act" refers to Chapter 5-29 of the General Laws of Rhode Island, as amended, entitled "Podiatrists.” 1.2 "Board" refers to the Board of Examiners in Podiatry established in accordance with the provisions of section 5-26-2 of the General Laws of Rhode Island, as amended. 1.3 "Department" means the Rhode Island Department of Health. 1.4 "Director" refers to the Director of the Rhode Island Department of Health. 1.5 "Division" refers to the Division of Professional Regulation, Rhode Island Department of Health. 1.6 "Foot" is defined to be the pedal extremity of the human body and its articulations, and shall include the tendons and muscles of the lower leg only as they shall be involved in the condition of the foot. 1.7 "Health care facility" means any institutional health service provider licensed pursuant to the provisions of Chapter 23-17 of the General Laws of Rhode Island, as amended. 1.8 "Health maintenance organization" means a public or private organization licensed pursuant to the provisions of Chapter 27-41 of the General Laws of Rhode Island, as amended. 1.9 "Limited registrant" means a person holding a limited registration certificate pursuant to the provisions of the Act. 1.10 "Nonprofit medical services corporation" or "nonprofit hospital service corporation" or "nonprofit podiatry/medical service corporation" means any corporation organized pursuant to Chapter 27-19 or 27-20 of the General Laws of Rhode Island, as amended for the purpose of establishing, maintaining and operating a nonprofit medical hospital. 1.11 "Peer Review Board" means any committee of a state or local podiatry association or society, or a committee or any licensed health care facility, or the podiatry staff thereof, or any committee of a podiatric care foundation or health maintenance organization, or any staff committee or consultant of a hospital, medical, or podiatric service corporation, the function of which, (1) is to evaluate and improve the quality of podiatric care rendered by providers of podiatric care service or to determine that podiatric care services rendered were professionally indicated or were performed in compliance with the applicable standard of care or that the cost for podiatric care rendered was considered reasonable by the providers of professional podiatric 2 care services in the area and shall include a committee functioning as a utilization review committee under the provisions of the health insurance for the aged act (Medicare) or as a professional standards review organization or statewide professional standards review council under the provisions of Public Law 92-603 42 USC Section 1301 et seq. (professional standards review organizations) or a similar committee or a committee of similar purpose, to evaluate or review the diagnosis or treatment of the performance or rendition of podiatric services which are performed under public podiatric programs of either state or federal design. 1.12 "Person" means any individual, partnership, firm, corporation, association, trust or estate, state or political subdivision or instrumentality of a state. 1.13 "Podiatric residency" means one year of post doctoral training sponsored by and primarily conducted in an institution approved by the Council on Podiatric Medical Education of the American Podiatric Medical Association. 1.14 “Podiatrist” means a person with a license to practice podiatric medicine and surgery in this state under the provisions of the Act. “Podiatrist,” a person licensed as described in the Act, shall be considered a physician and surgeon of the foot and ankle. For the purposes of reimbursement by and for subscriber benefits/participation agreements with health maintenance organizations, nonprofit medical service corporations, for-profit medical service corporations, and third party insurers, it shall be unlawful to discriminate against podiatrists. 1.15 "Podiatry and podiatrist" are synonymous with "chiropody and chiropodist." 1.16 "Practice of podiatry": Any person shall be said to be practicing podiatry within the meaning of the Act who uses or permits to be used, directly or indirectly, for profit or otherwise, for himself or for any other person, in connection with his name, the word "podiatrist" or "podiatric physician and surgeon," or the title DPM, or any other words, letters, titles, or descriptive matter, personal or not, which directly or indirectly implies the practice of podiatry, or who owns, leases, maintains, or operates a podiatry business in any office or other room or rooms where podiatry operations are performed, or directly or indirectly is manager, proprietor or conductor of the same; or who directly or indirectly informs the public in any language, orally, in writing, or by drawings, demonstrations, specimens, signs, or pictures that he/she can perform or will attempt to perform foot operations of any kind; or who undertakes, by any means or method, gratuitously or for a salary, fee, money or other reward paid or granted directly or indirectly to himself or to any other person, to diagnose or profess to diagnose, or to treat or profess to treat, or to prescribe for or profess to prescribe for any of the lesions, diseases, disorders, or deficiencies of the pedal extremity. The foot is defined to be the pedal extremity of the human body and its articulations, and shall include the tendons and muscles of the lower leg only as they shall be involved in the condition of the foot. 1.17 "Recognized college or university" means an institution of higher learning approved by the Office of Higher Education of any given state. 3 PART II LICENSURE REQUIREMENTS R5-29-POD Section 2.0 General Requirements 2.1 Any person desiring to commence to practice podiatry and to continue to practice podiatry in this state must possess a license to practice podiatry in accordance with the statutory and regulatory requirements herein. 2.1.1 Furthermore, no person granted a license under the statutory and regulatory provisions herein, shall display or use the title "doctor" or its synonym without the designation of "chiropodist" or "podiatrist" and shall not mislead the public as to the limited professional qualification to treat human ailments pursuant to sections 5-29- 23 and 5-29-25 of the Act. Section 3.0 Qualifications for Licensure 3.1 An applicant seeking licensure to practice podiatry must: a) have attained the age of eighteen (18) years of age or older. b) be of good moral character; c) have completed a satisfactory course of at least three (3) years of study in a duly recognized college or university. d) The applicant shall provide evidence of satisfactory completion of a course of study in podiatric medicine approved and accredited by the Council on Podiatric Medical Education of the American Podiatric Medical Association. The degree of doctor of podiatric medicine shall be conferred upon the applicant from the same college as was his/her course of study. e) have satisfactorily completed a one (1) year residency in Podiatric Medicine as defined, recognized and accredited by the Council on Podiatric Medical Education of the American Podiatric Medical Association. Said program must also have been accredited by the aforementioned body at the time of residency participation. f) have satisfactorily passed the National Board of Podiatric Examination and the Podiatric Medical Licensing Examination for States (PM LEXIS Examination). g) meet such other requirements as set forth by regulation or as may be established by the Board. Section 4.0 Application for Licensure and Fee 4.1 Application for licensure shall be made on forms provided by the Division which shall be completed, notarized and submitted to the Division sixty (60) days prior to the scheduled date of examination. 4 4.2 Such application shall be accompanied by the following documents and fee (non-returnable and non-refundable) unless for due cause pursuant to section 5-29-7 of the Act); a) three (3) statements of good moral character from reputable individuals in this state other than relatives; b) i) For U.S. born: a certified copy of birth certificate; ii) for those born outside the U.S.: proof of citizenship or lawful alien status; c) two (2) recent identification photographs of the applicant, head and shoulder front view, approximately 2 x 3 inches in size; one photograph shall be signed on the reverse side by the dean or registrar of the school attesting to the likeness of the photograph to that of the applicant submitted directly by the school; d) supporting certified transcripts of education credentials as required in section 3.0 herein, signed by the dean or registrar of the school or college verifying the dates of attendance and completion of podiatric program. Such documentation must consist of original statements and/or photocopies bearing the signature of the dean or registrar and the imprint of the school and must be sent directly by the school; e) a statement from a responsible authority for the residency program verifying successful completion of the residency program and submitted directly to the Board, including a certificate of successful completion of the requirements of section 3.1 herein; f) the results of the National Board of Podiatric Examination of the National Board of Podiatry Examiners AND the PM LEXIS examination, shall be submitted directly to the Board; g) a statement from the Board of Podiatry Examiners in each state in which the applicant has held or holds licensure, to be submitted directly to the Board of this state attesting to the licensure status of the applicant during the time period applicant held licensure in said state; h) the application fee as set forth in the Rules and Regulations Pertaining to the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health; and i) such other information as may be deemed necessary by the Board. Section 5.0 Examination 5.1 By Examination: Applicants shall be required to pass an examination to test the applicant's knowledge and skills to practice podiatry in this state, pursuant to the statutory and regulatory provisions herein. 5.1.1 For written examination the Board requires the applicants to successfully pass the National Board of Podiatric Examination, and the PM LEXIS, which can be taken upon satisfactory completion of the didactic requirements herein. 5.1.2 The current PMLexis examination fee shall be made payable directly to the National Board of 5 Podiatric Medical Examiners. 5.2 Re-Examination: 5.2.1 The current PMLexis re-examination fee shall be made payable directly to the National Board of Podiatric Medical Examiners. 5.2.2 In accordance with section 5-29-9 of the Rhode Island General Laws, as amended, there shall be no reciprocity in granting licenses for the practice of podiatric medicine and surgery to licensees from other states or countries. 5.2.3 Applicants seeking licensure under this section shall be subject to the same application requirements as listed in section 4.0 herein. Section 6.0 Continuing Education 6.1 Every podiatrist licensed to practice podiatry in this state under the provisions of the Act and the regulations herein, shall on or before the 30th of September of each year, have satisfactorily completed a minimum of fifteen (15) continuing medical education credits as approved by the Board of Examiners in Podiatry. Such approval shall be based on the Standards, Requirements, and Guidelines for Approval of Continuing Education in Podiatric Medicine of the Council on Podiatric Medical Education of the American Podiatry Medical Association. 6.2 Satisfactory evidence of successful completion of at least fifteen (15) credits of continuing education approved by the Board and completed in the year preceding relicensure must be submitted to the Board and accompany the application for license renewal. 6.3 It shall be the sole responsibility of the individual podiatrist to obtain documentation from the approved sponsoring or co-sponsoring organization, agency or other, of his or her participation in a continuing education course including the date, time, sponsoring agency and number of credits obtained. 6.3.1 Those documents must be safeguarded by the podiatrist for review by the Board if required. Only a summary list of those documents, not the documents themselves, shall be submitted to the Board with the application for renewal of license. 6.4 Failure to provide satisfactory evidence of continuing education as required herein shall be cause for denial of license renewal. Section 7.0 Limited Registration 7.1 Except for podiatrists licensed pursuant to the Act, no person shall perform the duties of an intern, resident, fellow or podiatry officer in this state without holding a limited podiatric registration pursuant to section 5-29-13 of the Act, and registered with the Division as a hospital podiatric officer. 7.1.1 Hospital podiatric officers may be granted limited podiatric registration for such time 6 as said Division may prescribe, provided the following criteria are met: a) an application, on behalf of the applicant signed by the administrator/chief executive officer of a hospital licensed in Rhode Island is submitted to the Division accompanied by the following: i. a signed statement by the chief of the medical staff attesting to the approval of the applicant's credentials in accordance with the credentialing process of the medical staff by-laws; ii. a signed statement that the applicant has not previously held a limited podiatric registration; iii. information satisfactory to the Board if submitted by the hospital regarding the duties and responsibilities of the applicant and the person to be responsible for the supervision of the applicant; and b) limited podiatric registration issued to a hospital podiatric officer under the provisions herein shall be valid for a period of not more than one (1) year from the date of issuance and may be renewed annually at the discretion of the Board. 7.2 Limited hospital podiatric officer registration shall entitle the holder thereof to practice podiatry in the hospital or other institution designated on the certificate of limited registration, or outside such hospital or other institution for the treatment, under the supervision of one of its medical officers who is a duly licensed physician and/or podiatrist of persons accepted by it as patients, or in any hospital, institution, clinic or program affiliated for training purposes with the hospital, institution or clinic designated on such certificate which affiliation is approved by the Division and the Council of Podiatric Medical Education of the American Podiatric Medical Association. In all cases the practice of podiatry under a limited podiatric registration shall be in accordance with regulations established by the hospital, institution or other clinic designated on the certificate. 7.2.1 It shall be the responsibility of each hospital, clinic, or other institution to submit, on or before the first of June of each year to the Division for its approval, a list of affiliated hospitals, institutions, clinics or programs providing training programs for interns, residents, fellow or podiatric officers. 7.2.2 Any hospital, clinic or institution providing training programs for interns, residents, fellows, or podiatric officers, which are subject to statutory licensure in this state, must hold a current license as may be required. 7.3 Application For Limited Registration 7.3.1 An applicant for limited podiatric registration shall submit through the hospital, institution or clinic, to the Division satisfactory proof of: a) having attained eighteen (18) years of age or older; 7 b) good moral character; c) having creditably completed not less than two (2) years of study in a legally chartered podiatry school accredited by the Council of Podiatric Medical Education of the American Podiatry Association having power to grant degrees in podiatry; d) appointment as an intern, resident, fellow or podiatry officer in a hospital licensed in this state or other institution or clinic pursuant to section 7.2 herein; and e) such other information as may be deemed necessary. 7.3.2 A registration fee as set forth in the Rules and Regulations Pertaining to the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health must accompany each application for limited podiatric registration. Section 8.0 Issuance and Renewal of License and Limited Registration 8.1 Licensure: 8.1.1 Upon completion of the aforementioned requirements, the Director may issue a license to those applicants found to have satisfactorily met all the requirements herein. Said license unless sooner suspended or revoked shall expire biennially on the date of expiration. 8.1.2 Thirty days prior to expiration date of license, the Administrator of the Division shall mail an application for renewal of license to every person whose license expires. Every person licensed who intends to engage in podiatry during the ensuing year, shall file a renewal application duly executed together with the renewal fee as set forth in the Rules and Regulations Pertaining to the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health. The renewal fee of shall be accompanied by evidence of completion of a minimum of fifteen (15) continuing medical education credits per year as approved by the Board and in accordance with section 6.0 herein. 8.2 Limited Registration: 8.2.1 A limited registration certificate shall be issued by the Division to applicants who have submitted credentials found to be satisfactory pursuant to section 7.0 herein. Furthermore, the limited podiatric registration shall be issued through the hospital, clinic, institution or other program designated on the application for limited podiatric registration and approved by the Division. 8.2.2 Limited podiatric registration for hospital podiatric officer shall be valid for a period of not more than one (1) year from the date of issuance and may be renewed at the discretion of the Division. 8 8.3 Limited Registration: Academic Faculty 8.3.1 Notwithstanding any other provisions of the Act, a podiatrist of noteworthy and recognized professional attainment who is a clearly outstanding podiatrist and who has been offered by the dean of a medical school or podiatry school in this state a full-time academic appointment, is eligible for a limited registration while serving on the academic staff of the medical school or podiatry school. Upon recommendation of the dean of an accredited school of medicine, podiatry in this state, the board in its discretion, after being satisfied that the applicant is a graduate of a foreign podiatry school and a person of professional rank whose knowledge and special training will benefit that medical school, podiatry school may issue to that podiatrist a limited registration to engage in the practice of podiatry to the extent that the practice is incidental to a necessary part of his or her academic appointment and then only in the hospital or hospitals and out-patient clinics connected with the medical school or podiatry school. 8.3.2 Except to the extent authorized by this section, the registrant shall not engage in the practice of podiatry or receive compensation for that practice, unless he or she is issued a license to practice podiatry. The registration is valid for a period of not more than one year expiring on the 30th day of June following its initial effective date but may be renewed annually. Provided, that such registration automatically expires when the holder's relationship with the medical school or podiatry school is terminated. 8.3.3 The application fee for the registration authorized under this section shall be as set forth in the Rules and Regulations Pertaining to the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health. The application fee for biennial renewal shall be as set forth in the Rules and Regulations Pertaining to the Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health. Section 9.0 Practice of Podiatry 9.1 Podiatrists licensed to practice podiatry in this state shall be governed by the prevailing standards of practice. 9.2 Furthermore, no person licensed to practice podiatry shall advertise by written or spoken words of a character tending to deceive or mislead the public. Section 10.0 Denial, Suspension or Revocation of License 10.1 The license of any podiatrist violating any of the provisions of the Act and the regulations herein, after such person has been afforded an opportunity to be heard by the Division may be suspended for a period of not less than sixty (60) days; provided however, that if the license of such person has previously been suspended for a prior violation, then after such hearing, the Division may either revoke the license of such person or suspend the same for a period of not less than six (6) months. 9 10.2 Furthermore, the Division may suspend or revoke the license of any podiatrist, after due notice and hearing, if the licensee is found: a) not to be of good moral character; b) to have violated any of the laws of the state involving moral turpitude or affecting the ability of any podiatrist to practice podiatry; c) to have been guilty of any fraud or deception committed in obtaining such license; and/or d) to be guilty of gross unprofessional conduct or conduct of a character likely to deceive or defraud the public. Gross unprofessional conduct shall include but not be limited to those provisions as set forth in section 5-29-16 of the Act. 10 PART III VIOLATIONS/PRACTICES AND PROCEDURES/SEVERABILITY Section 11.0 Violations 11.1 Any person who violates the provisions of the Act and the regulations herein shall be subject to the appropriate sanctions of sections 5-29-23, 5-29-33, 5-29-34, and 5-29-36 of the Act. Section 12.0 Rules Governing Practices and Procedures 12.1 All hearings and reviews required under the provisions of the Act and the rules and regulations herein, shall be held in accordance with the provisions of the rules and regulations of the Rhode Island Department of Health, entitled Rules and Regulations of the Rhode Island Department of Health Regarding the Practices and Procedures Before the Department of Health and Access to Public Records of the Department of Health (R42-35-PP). Section 13.0 Severability 13.1 If any provisions of the rules and regulations herein or the application to any facility or circumstances shall not affect the provisions or application of the rules and regulations which can be given effect, and to this end the provisions of the rules and regulations are declared to be severable. Podiatrists_Final_Sept2012.doc Monday, 17 September 2012