334.613. Refusal to issue or renew a license, procedure--complaint may be filed, when, requirements for proceedings on--disciplinary action authorized.
Refusal to issue or renew a license, procedure--complaint may befiled, when, requirements for proceedings on--disciplinary actionauthorized.
334.613. 1. The board may refuse to issue or renew a license topractice as a physical therapist or physical therapist assistant for one orany combination of causes stated in subsection 2 of this section. Theboard shall notify the applicant in writing of the reasons for the refusaland shall advise the applicant of the applicant's right to file a complaintwith the administrative hearing commission as provided by chapter 621,RSMo. As an alternative to a refusal to issue or renew a license topractice as a physical therapist or physical therapist assistant, the boardmay, at its discretion, issue a license which is subject to probation,restriction, or limitation to an applicant for licensure for any one or anycombination of causes stated in subsection 2 of this section. The board'sorder of probation, limitation, or restriction shall contain a statement ofthe discipline imposed, the basis therefor, the date such action shallbecome effective, and a statement that the applicant has thirty days torequest in writing a hearing before the administrative hearing commission.If the board issues a probationary, limited, or restricted license to anapplicant for licensure, either party may file a written petition with theadministrative hearing commission within thirty days of the effective dateof the probationary, limited, or restricted license seeking review of theboard's determination. If no written request for a hearing is received bythe administrative hearing commission within the thirty-day period, theright to seek review of the board's decision shall be considered as waived.
2. The board may cause a complaint to be filed with theadministrative hearing commission as provided by chapter 621, RSMo, againstany holder of a license to practice as a physical therapist or physicaltherapist assistant who has failed to renew or has surrendered his or herlicense for any one or any combination of the following causes:
(1) Use of any controlled substance, as defined in chapter 195, RSMo,or alcoholic beverage to an extent that such use impairs a person's abilityto perform the work of a physical therapist or physical therapistassistant;
(2) The person has been finally adjudicated and found guilty, orentered a plea of guilty or nolo contendere, in a criminal prosecutionunder the laws of any state or of the United States, for any offensereasonably related to the qualifications, functions, or duties of aphysical therapist or physical therapist assistant, for any offense anessential element of which is fraud, dishonesty, or an act of violence, orfor any offense involving moral turpitude, whether or not sentence isimposed;
(3) Use of fraud, deception, misrepresentation, or bribery insecuring any certificate of registration or authority, permit, or licenseissued under this chapter or in obtaining permission to take anyexamination given or required under this chapter;
(4) Misconduct, fraud, misrepresentation, dishonesty, unethicalconduct, or unprofessional conduct in the performance of the functions orduties of a physical therapist or physical therapist assistant, includingbut not limited to the following:
(a) Obtaining or attempting to obtain any fee, charge, tuition, orother compensation by fraud, deception, or misrepresentation; willfully andcontinually overcharging or overtreating patients; or charging for sessionsof physical therapy which did not occur unless the services were contractedfor in advance, or for services which were not rendered or documented inthe patient's records;
(b) Attempting, directly or indirectly, by way of intimidation,coercion, or deception, to obtain or retain a patient or discourage the useof a second opinion or consultation;
(c) Willfully and continually performing inappropriate or unnecessarytreatment or services;
(d) Delegating professional responsibilities to a person who is notqualified by training, skill, competency, age, experience, or licensure toperform such responsibilities;
(e) Misrepresenting that any disease, ailment, or infirmity can becured by a method, procedure, treatment, medicine, or device;
(f) Performing services which have been declared by board rule to beof no physical therapy value;
(g) Final disciplinary action by any professional association,professional society, licensed hospital or medical staff of the hospital,or physical therapy facility in this or any other state or territory,whether agreed to voluntarily or not, and including but not limited to anyremoval, suspension, limitation, or restriction of the person'sprofessional employment, malpractice, or any other violation of anyprovision of this chapter;
(h) Administering treatment without sufficient examination, or forother than medically accepted therapeutic or experimental or investigativepurposes duly authorized by a state or federal agency, or not in the courseof professional physical therapy practice;
(i) Engaging in or soliciting sexual relationships, whetherconsensual or nonconsensual, while a physical therapist or physicaltherapist assistant/patient relationship exists; making sexual advances,requesting sexual favors, or engaging in other verbal conduct or physicalcontact of a sexual nature with patients or clients;
(j) Terminating the care of a patient without adequate notice orwithout making other arrangements for the continued care of the patient;
(k) Failing to furnish details of a patient's physical therapyrecords to treating physicians, other physical therapists, or hospitalsupon proper request; or failing to comply with any other law relating tophysical therapy records;
(l) Failure of any applicant or licensee, other than the licenseesubject to the investigation, to cooperate with the board during anyinvestigation;
(m) Failure to comply with any subpoena or subpoena duces tecum fromthe board or an order of the board;
(n) Failure to timely pay license renewal fees specified in thischapter;
(o) Violating a probation agreement with this board or any otherlicensing agency;
(p) Failing to inform the board of the physical therapist's orphysical therapist assistant's current telephone number, residence, andbusiness address;
(q) Advertising by an applicant or licensee which is false ormisleading, or which violates any rule of the board, or which claimswithout substantiation the positive cure of any disease, or professionalsuperiority to or greater skill than that possessed by any other physicaltherapist or physical therapist assistant. An applicant or licensee shallalso be in violation of this provision if the applicant or licensee has afinancial interest in any organization, corporation, or association whichissues or conducts such advertising;
(5) Any conduct or practice which is or might be harmful or dangerousto the mental or physical health of a patient or the public; orincompetency, gross negligence, or repeated negligence in the performanceof the functions or duties of a physical therapist or physical therapistassistant. For the purposes of this subdivision, "repeated negligence"means the failure, on more than one occasion, to use that degree of skilland learning ordinarily used under the same or similar circumstances by themember of the applicant's or licensee's profession;
(6) Violation of, or attempting to violate, directly or indirectly,or assisting or enabling any person to violate, any provision of thischapter, or of any lawful rule adopted under this chapter;
(7) Impersonation of any person licensed as a physical therapist orphysical therapist assistant or allowing any person to use his or herlicense or diploma from any school;
(8) Revocation, suspension, restriction, modification, limitation,reprimand, warning, censure, probation, or other final disciplinary actionagainst a physical therapist or physical therapist assistant for a licenseor other right to practice as a physical therapist or physical therapistassistant by another state, territory, federal agency or country, whetheror not voluntarily agreed to by the licensee or applicant, including butnot limited to the denial of licensure, surrender of the license, allowingthe license to expire or lapse, or discontinuing or limiting the practiceof physical therapy while subject to an investigation or while actuallyunder investigation by any licensing authority, medical facility, branch ofthe armed forces of the United States of America, insurance company, court,agency of the state or federal government, or employer;
(9) A person is finally adjudged incapacitated or disabled by a courtof competent jurisdiction;
(10) Assisting or enabling any person to practice or offer topractice who is not licensed and currently eligible to practice under thischapter; or knowingly performing any act which in any way aids, assists,procures, advises, or encourages any person to practice physical therapywho is not licensed and currently eligible to practice under this chapter;
(11) Issuance of a license to practice as a physical therapist orphysical therapist assistant based upon a material mistake of fact;
(12) Failure to display a valid license pursuant to practice as aphysical therapist or physical therapist assistant;
(13) Knowingly making, or causing to be made, or aiding, or abettingin the making of, a false statement in any document executed in connectionwith the practice of physical therapy;
(14) Soliciting patronage in person or by agents or representatives,or by any other means or manner, under the person's own name or under thename of another person or concern, actual or pretended, in such a manner asto confuse, deceive, or mislead the public as to the need or necessity foror appropriateness of physical therapy services for all patients, or thequalifications of an individual person or persons to render, or performphysical therapy services;
(15) Using, or permitting the use of, the person's name under thedesignation of "physical therapist", "physiotherapist", "registeredphysical therapist", "P.T.", "Ph.T.", "P.T.T.", "D.P.T.", "M.P.T." or"R.P.T.", "physical therapist assistant", "P.T.A.", "L.P.T.A.", "C.P.T.A.",or any similar designation with reference to the commercial exploitation ofany goods, wares or merchandise;
(16) Knowingly making or causing to be made a false statement ormisrepresentation of a material fact, with intent to defraud, for paymentunder chapter 208, RSMo, or chapter 630, RSMo, or for payment from TitleXVIII or Title XIX of the federal Medicare program;
(17) Failure or refusal to properly guard against contagious,infectious, or communicable diseases or the spread thereof; maintaining anunsanitary facility or performing professional services under unsanitaryconditions; or failure to report the existence of an unsanitary conditionin any physical therapy facility to the board, in writing, within thirtydays after the discovery thereof;
(18) Any candidate for licensure or person licensed to practice as aphysical therapist or physical therapist assistant paying or offering topay a referral fee or, notwithstanding section 334.010 to the contrary,practicing or offering to practice professional physical therapyindependent of the prescription and direction of a person licensed andregistered as a physician and surgeon under this chapter, as a physicianassistant under this chapter, as a chiropractor under chapter 331, RSMo, asa dentist under chapter 332, RSMo, as a podiatrist under chapter 330, RSMo,or any licensed and registered physician, chiropractor, dentist, orpodiatrist practicing in another jurisdiction, whose license is in goodstanding;
(19) Any candidate for licensure or person licensed to practice as aphysical therapist or physical therapist assistant treating or attemptingto treat ailments or other health conditions of human beings other than byprofessional physical therapy and as authorized by sections 334.500 to334.685;
(20) A pattern of personal use or consumption of any controlledsubstance unless it is prescribed, dispensed, or administered by aphysician who is authorized by law to do so;
(21) Failing to maintain adequate patient records under 334.602;
(22) Attempting to engage in conduct that subverts or undermines theintegrity of the licensing examination or the licensing examinationprocess, including but not limited to utilizing in any manner recalled ormemorized licensing examination questions from or with any person orentity, failing to comply with all test center security procedures,communicating or attempting to communicate with any other examinees duringthe test, or copying or sharing licensing examination questions or portionsof questions;
(23) Any candidate for licensure or person licensed to practice as aphysical therapist or physical therapist assistant who requests, receives,participates or engages directly or indirectly in the division,transferring, assigning, rebating or refunding of fees received forprofessional services or profits by means of a credit or other valuableconsideration such as wages, an unearned commission, discount or gratuitywith any person who referred a patient, or with any relative or businessassociate of the referring person;
(24) Being unable to practice as a physical therapist or physicaltherapist assistant with reasonable skill and safety to patients by reasonsof incompetency, or because of illness, drunkenness, excessive use ofdrugs, narcotics, chemicals, or as a result of any mental or physicalcondition. The following shall apply to this subdivision:
(a) In enforcing this subdivision the board shall, after a hearing bythe board, upon a finding of probable cause, require a physical therapistor physical therapist assistant to submit to a reexamination for thepurpose of establishing his or her competency to practice as a physicaltherapist or physical therapist assistant conducted in accordance withrules adopted for this purpose by the board, including rules to allow theexamination of the pattern and practice of such physical therapist's orphysical therapist assistant's professional conduct, or to submit to amental or physical examination or combination thereof by a facility orprofessional approved by the board;
(b) For the purpose of this subdivision, every physical therapist andphysical therapist assistant licensed under this chapter is deemed to haveconsented to submit to a mental or physical examination when directed inwriting by the board;
(c) In addition to ordering a physical or mental examination todetermine competency, the board may, notwithstanding any other law limitingaccess to medical or other health data, obtain medical data and healthrecords relating to a physical therapist, physical therapist assistant orapplicant without the physical therapist's, physical therapist assistant'sor applicant's consent;
(d) Written notice of the reexamination or the physical or mentalexamination shall be sent to the physical therapist or physical therapistassistant, by registered mail, addressed to the physical therapist orphysical therapist assistant at the physical therapist's or physicaltherapist assistant's last known address. Failure of a physical therapistor physical therapist assistant to submit to the examination when directedshall constitute an admission of the allegations against the physicaltherapist or physical therapist assistant, in which case the board mayenter a final order without the presentation of evidence, unless thefailure was due to circumstances beyond the physical therapist's orphysical therapist assistant's control. A physical therapist or physicaltherapist assistant whose right to practice has been affected under thissubdivision shall, at reasonable intervals, be afforded an opportunity todemonstrate that the physical therapist or physical therapist assistant canresume the competent practice as a physical therapist or physical therapistassistant with reasonable skill and safety to patients;
(e) In any proceeding under this subdivision neither the record ofproceedings nor the orders entered by the board shall be used against aphysical therapist or physical therapist assistant in any other proceeding.Proceedings under this subdivision shall be conducted by the board withoutthe filing of a complaint with the administrative hearing commission;
(f) When the board finds any person unqualified because of any of thegrounds set forth in this subdivision, it may enter an order imposing oneor more of the disciplinary measures set forth in subsection 3 of thissection.
3. After the filing of such complaint before the administrativehearing commission, the proceedings shall be conducted in accordance withthe provisions of chapter 621, RSMo. Upon a finding by the administrativehearing commission that the grounds provided in subsection 2 of thissection for disciplinary action are met, the board may, singly or incombination:
(1) Warn, censure or place the physical therapist or physicaltherapist assistant named in the complaint on probation on such terms andconditions as the board deems appropriate for a period not to exceed tenyears;
(2) Suspend the physical therapist's or physical therapistassistant's license for a period not to exceed three years;
(3) Restrict or limit the physical therapist's or physical therapistassistant's license for an indefinite period of time;
(4) Revoke the physical therapist's or physical therapist assistant'slicense;
(5) Administer a public or private reprimand;
(6) Deny the physical therapist's or physical therapist assistant'sapplication for a license;
(7) Permanently withhold issuance of a license;
(8) Require the physical therapist or physical therapist assistant tosubmit to the care, counseling or treatment of physicians designated by theboard at the expense of the physical therapist or physical therapistassistant to be examined;
(9) Require the physical therapist or physical therapist assistant toattend such continuing educational courses and pass such examinations asthe board may direct.
4. In any order of revocation, the board may provide that thephysical therapist or physical therapist assistant shall not apply forreinstatement of the physical therapist's or physical therapist assistant'slicense for a period of time ranging from two to seven years following thedate of the order of revocation. All stay orders shall toll this timeperiod.
5. Before restoring to good standing a license issued under thischapter which has been in a revoked, suspended, or inactive state for anycause for more than two years, the board may require the applicant toattend such continuing medical education courses and pass such examinationsas the board may direct.
6. In any investigation, hearing or other proceeding to determine aphysical therapist's, physical therapist assistant's or applicant's fitnessto practice, any record relating to any patient of the physical therapist,physical therapist assistant, or applicant shall be discoverable by theboard and admissible into evidence, regardless of any statutory or commonlaw privilege which such physical therapist, physical therapist assistant,applicant, record custodian, or patient might otherwise invoke. Inaddition, no such physical therapist, physical therapist assistant,applicant, or record custodian may withhold records or testimony bearingupon a physical therapist's, physical therapist assistant's, or applicant'sfitness to practice on the ground of privilege between such physicaltherapist, physical therapist assistant, applicant, or record custodian anda patient.
(L. 2008 S.B. 788)