SECTIONS 2450-2459.7 - California Statutes

BUSINESS AND PROFESSIONS CODE

SECTION 2450-2459.7

2450. There is a Board of Osteopathic Examiners of the State of
California, established by the Osteopathic Act, which shall be known
as the Osteopathic Medical Board of California which enforces this
chapter relating to persons holding or applying for physician's and
surgeon's certificates issued by the Osteopathic Medical Board of
California under the Osteopathic Act.
Persons who elect to practice using the term of suffix "M.D.," as
provided in Section 2275, shall not be subject to this article, and
the Medical Board of California shall enforce the provisions of this
chapter relating to persons who made the election.

2450.1. Protection of the public shall be the highest priority for
the Osteopathic Medical Board of California in exercising its
licensing, regulatory, and disciplinary functions. Whenever the
protection of the public is inconsistent with other interests sought
to be promoted, the protection of the public shall be paramount.

2450.3. There is within the jurisdiction of the Osteopathic Medical
Board of California a Naturopathic Medicine Committee authorized
under the Naturopathic Doctors Act (Chapter 8.2 (commencing with
Section 3610)). This section shall become inoperative on January 1,
2013, and, as of that date is repealed, unless a later enacted
statute that is enacted before January 1, 2013, deletes or extends
that date. The repeal of this section renders the Naturopathic
Medicine Committee subject to the review required by Division 1.2
(commencing with Section 473).

2451. The words "Medical Board of California," the term "board," or
any reference to a division of the Medical Board of California as
used in this chapter shall be deemed to mean the Osteopathic Medical
Board of California, where that board exercises the functions granted
to it by the Osteopathic Act.

2452. This chapter applies to the Osteopathic Medical Board of
California so far as consistent with the Osteopathic Act. Unless
otherwise provided, this article is administered by the board.

2453. (a) It is the policy of this state that holders of M.D.
degrees and D.O. degrees shall be accorded equal professional status
and privileges as licensed physicians and surgeons.
(b) Notwithstanding any other provision of law, no health facility
subject to licensure under Chapter 2 (commencing with Section 1250)
of Division 2 of the Health and Safety Code, no health care service
plan, nonprofit hospital service plan, policy of disability
insurance, self-insured employer welfare benefit plan, and no agency
of the state or of any city, county, city and county, district, or
other political subdivision of the state shall discriminate with
respect to employment, staff privileges, or the provision of, or
contracts for, professional services against a licensed physician and
surgeon on the basis of whether the physician and surgeon holds an
M.D. or D.O. degree. This section shall not be construed to require a
disability insurer health care service plan or hospital service plan
to employ, offer staff privileges, or contract for professional
services with a class of physician who holds an M.D. or D.O. degree.
However, this subdivision shall not prohibit a school of allopathic
medicine or a school of osteopathic medicine from employing a
physician and surgeon as an instructor on the basis of whether the
physician and surgeon holds an M.D. or D.O. degree, where the subject
matter to be taught specifically requires allopathic or osteopathic
training and experience.
(c) Whenever the health facility staffing requirements for staff
or department privileges mandate that the physician who has been
granted privileges be certified or eligible for certification by an
appropriate American medical board, that position must be made
available on an equal basis to an osteopathic physician who is
certified or eligible for certification by the appropriate American
osteopathic board.
(d) Whenever an entity that contracts with physicians and surgeons
or osteopathic physicians to provide managed care or risk-based care
requires that the physician who is responsible for the contract be
certified or eligible for certification by an appropriate American
medical board, the contract reference to American medical board shall
be construed to mean American Osteopathic Board when the contracting
physician is an osteopathic physician.
(e) Staff self-government, involving M.D. and D.O. physicians and
surgeons, with respect to the professional work performed in the
health facility, shall be accomplished by holding periodic meetings
of the staff to review and analyze at regular intervals their
clinical experience. Patient medical records shall be the basis for
such review and analysis.
(f) The physician and surgeon staff shall be required to establish
controls that are designed to ensure the achievement and maintenance
of high standards of professional and ethical practices including a
provision that all members of the physician and surgeon staff be
required to demonstrate their ability to perform surgical and other
procedures competently and to the satisfaction of an appropriate
committee or committees of the staff at the time of original
application for appointment to the staff and at least every two years
thereafter.
(g) No health facility may adopt written bylaws in accordance with
legal requirements that in any way are construed to circumvent the
intent of the Legislature or any other nondiscriminatory provisions
contained in either the Medical Practice Act or in any provisions
applicable to osteopathic physicians.
(h) No entity that contracts with physicians and surgeons to
provide managed care or risk-based care may adopt written bylaws in
accordance with legal requirements that in any way are construed to
circumvent the intent of the Legislature or any other
nondiscriminatory provisions contained in either the Medical Practice
Act or in any provisions applicable to osteopathic physicians.
(i) For the purposes of this section, no professional medical or
osteopathic association may mandate membership in their respective
organizations as a prerequisite for a physician to obtain staff
privileges, employment, or in the offering of a contract for
services.
(j) Any violation of subdivisions (b), (c), (d), (e), (f), (g),
(h), and (i) may be enjoined in an action brought in the name of the
people of the State of California by the district attorney of the
county in which the violation occurs, upon receipt of a complaint by
an aggrieved physician and surgeon.

2453.5. Individuals possessing physician's and surgeon's
certificates issued by the Osteopathic Medical Board of California
shall not hold themselves out to be board certified unless the board
certification has been granted by the appropriate certifying board,
as authorized by the American Osteopathic Association or the American
Board of Medical Specialties, or is the result of a postgraduate
training program approved by the Accreditation Council for Graduate
Medical Education.

2454.5. In order to ensure the continuing competence of licensed
osteopathic physicians and surgeons, the board shall adopt and
administer standards for the continuing education of those licensees.
The board shall require each licensed osteopathic physician and
surgeon to demonstrate satisfaction of the continuing education
requirements as a condition for the renewal of a license at intervals
of not less than one year nor more than three years. Commencing
January 1, 1995, the board shall require each licensed osteopathic
physician and surgeon to complete a minimum of 150 hours of American
Osteopathic Association continuing education hours during each
three-year cycle, of which 60 hours must be completed in American
Osteopathic Association Category 1 continuing education hours as a
condition for renewal of an active license.
For purposes of this section, "American Osteopathic Association
Category 1" means continuing education activities and programs
approved for Category 1 credit by the Committee on Continuing Medical
Education of the American Osteopathic Association.

2455. The amount of fees and refunds is that established by the
following schedule for any certificate issued by the Osteopathic
Medical Board of California. All other fees and refunds for any
certificate issued by the Osteopathic Medical Board of California
which are not prescribed in this schedule, are prescribed in Sections
2455.1 and 2456. Any and all fees received by the Osteopathic
Medical Board of California shall be for the sole purpose of the
operation of the board and shall not be used for any other purpose,
except as specified in Section 2455.1.
(a) Each applicant for an original or reciprocity Physicians and
Surgeons Certificate shall pay an application fee in a sum not to
exceed four hundred dollars ($400) at the time his or her application
is filed.
(b) The biennial license fee, unless otherwise provided, shall be
set by the board on or before November 1 of each year for the ensuing
calendar year at a sum as the board determines necessary to defray
the expenses of administering this chapter, under the Osteopathic
Act, relating to the issuance of certificates to those applicants,
which sum, however, shall not exceed four hundred dollars ($400) nor
be less than twenty-five dollars ($25).
(c) The board shall set a biennial license fee in an amount less
than that levied pursuant to subdivision (b) that shall be paid by
any applicant who indicates to the board in writing that he or she
does not intend to practice under the Osteopathic Act during the
current renewal period.
(d) The fee for failure to pay the biennial license fee shall be
50 percent of the renewal fee but not more than two hundred dollars
($200).

2455.1. (a) In addition to the fees charged pursuant to Section
2455, and at the time those fees are charged, the board shall charge
each applicant for an original or reciprocity certificate or for a
biennial license an additional twenty-five-dollar ($25) fee for the
purposes of this section. This twenty-five-dollar ($25) fee shall be
due and payable along with the fee for the original or reciprocity
certificate or the biennial license.
(b) The board shall transfer all funds collected pursuant to this
section, on a monthly basis, to the Medically Underserved Account for
Physicians created by Section 128555 of the Health and Safety Code
for the purposes of the Steven M. Thompson Physician Corps Loan
Repayment Program. Notwithstanding Section 128555 of the Health and
Safety Code, these funds shall not be used to provide funding for the
Physician Volunteer Program.

2455.2. (a) A licensed osteopathic physician and surgeon shall
report to the Osteopathic Medical Board of California, at the time of
initial licensure, any specialty board certification that he or she
holds that is issued by a member board of the American Board of
Medical Specialties or approved by the Osteopathic Medical Board of
California.
(b) A licensed osteopathic physician and surgeon shall also report
to the board, at the time of license renewal, his or her practice
status, designated as one of the following:
(1) Full-time practice in California.
(2) Full-time practice outside of California.
(3) Part-time practice in California.
(4) Medical administrative employment that does not include direct
patient care.
(5) Retired.
(6) Other practice status, as may be further defined by the board.
(c) A licensed osteopathic physician and surgeon may report to the
board, at the time of initial licensure and license renewal, and the
board shall collect, information regarding his or her cultural
background and foreign language proficiency.
(d) The information collected pursuant to this section may be
placed on the board's Internet Web site.
(e) This section shall become operative on July 1, 2010.

2456. (a) Each person holding a certificate issued by the
Osteopathic Medical Board of California residing in or out of
California shall pay the board a biennial license fee.
(b) Fictitious name permits issued by the Osteopathic Medical
Board of California as provided in Section 2415 shall expire on
December 31 of each year. The initial permit fee shall not exceed one
hundred dollars ($100) and the renewal permit fee shall not exceed
one hundred dollars ($100).

2456.1. All osteopathic physician's and surgeon's certificates
shall expire at 12 midnight on the last day of the birth month of the
licensee during the second year of a two-year term if not renewed on
or before that day.
The board shall establish by regulation procedures for the
administration of a birth date renewal program, including, but not
limited to, the establishment of a system of staggered license
expiration dates such that a relatively equal number of licenses
expire monthly.
To renew an unexpired license, the licensee shall, on or before
the dates on which it would otherwise expire, apply for renewal on a
form prescribed by the board and pay the prescribed renewal fee.

2456.2. (a) The board shall notify in writing by certified mail,
return receipt requested, any physician and surgeon who does not
renew his or her license within 60 days from its date of expiration.
(b) Any licensee who does not renew his or her expired license on
or before its date of expiration shall pay all the following fees:
(1) The renewal fee in effect at the time of renewal.
(2) The delinquency fee required by Section 2455.
(c) Notwithstanding any other provision of law, the renewal of any
expired physician's and surgeon's license within six months from its
date of expiration shall be retroactive to the date of expiration of
that license.

2456.3. Except as provided in Section 2429, a license which has
expired may be renewed at any time within five years after its
expiration by filing an application for renewal on a form prescribed
by the board and payment of all accrued renewal fees and any other
fees required by Section 2455. Except as provided in Section 2456.2,
renewal under this section shall be effective on the date on which
the renewal application is filed, on the date on which the renewal
fee or accrued renewal fees are paid, or on the date on which the
delinquency fee or the delinquency fee and penalty fee, if any, are
paid, whichever last occurs. If so renewed, the license shall
continue in effect through the expiration date set forth in Section
2456.1 which next occurs after the effective date of the renewal.

2457. The failure of any person holding a certificate issued by the
Osteopathic Medical Board of California to pay the biennial license
fee during the time his or her certificate remains in force shall
automatically work a forfeiture of his or her certificate after a
period of 60 days from the date of expiration.
The certificate shall not be restored except upon written
application and the payment to the Osteopathic Medical Board of
California of the fee provided by this article. No examination shall
be required for the reissuance of a certificate that was forfeited
under the provisions of this section.

2457.5. (a) In addition to Article 12 (commencing with Section
2220), the charging, or obtaining of an unconscionable fee for
professional services rendered to a patient by an osteopathic
physician and surgeon constitutes unprofessional conduct and is
grounds for disciplinary action.
(b) A fee is unconscionable within the meaning of this section
when it is so exorbitant and wholly disproportionate to the services
performed as to shock the conscience of physicians of ordinary
prudence practicing in the same community. Factors to be considered,
where appropriate, in determining the reasonableness of a fee, are
based on the circumstances existing at the time of the service and
shall include, but not be limited to, the following:
(1) The time and effort required.
(2) The novelty and difficulty of the procedure and treatment.
(3) The skill required to perform the procedure or treatment
properly.
(4) The likelihood, if apparent to the patient, that the proper
treatment of the patient will preclude the physician from
remuneration from other sources.
(5) Any requirements or conditions imposed by the patient or by
the circumstances.
(6) The nature and length of the professional relationship with
the patient.
(7) The experience, reputation, and ability of the physician
performing the services.
(8) The results obtained.
(9) The existence of full fee disclosure and knowing patient
consent.

2458. When the prosecution for a violation of this chapter is
initiated by the Osteopathic Medical Board of California, 75 percent
of all fines and forfeitures of bail shall be paid upon the
collection by the proper officer of the court to the board to be
deposited by it to the credit of the contingent fund of the
Osteopathic Medical Board of California.
The payment to the board shall be made without placing the fine or
forfeiture of bail in any special, contingent, or general fund in
any city, county, or city and county.

2459. The Osteopathic Medical Board of California shall not issue
any drugless practitioner's certificates under this chapter or any
other law.
All persons holding drugless practitioner's certificates may
continue to practice under the authorization of their certificates
and may renew them, subject to this chapter.

2459.5. An osteopathic physician and surgeon licensed pursuant to
the Osteopathic Initiative Act may utilize the services of an aide to
assist the osteopathic physician and surgeon in the rendering of
osteopathic manipulative treatment. The aide shall at all times be
under the orders, direction, and immediate supervision of the
osteopathic physician and surgeon. Nothing in this section shall
authorize an aide to function independently of the osteopathic
physician and surgeon or shall be construed as authorizing an
osteopathic aide to practice medicine, surgery, or any other form of
healing art.

2459.6. (a) For the purposes of Section 2459.5 and this section:
(1) "Osteopathic physician and surgeon" means a person defined in
the Osteopathic Initiative Act.
(2) "Osteopathic manipulative treatment" means the therapeutic
application of manually guided forces by an osteopathic physician and
surgeon to alleviate somatic dysfunction.
(3) "Somatic dysfunction" means an impaired or altered function of
related components of the somatic system.
(4) An "osteopathic aide" means an unlicensed person who assists
an osteopathic physician and surgeon in the provision of osteopathic
manipulative treatment provided that assistance is rendered under the
supervision of an osteopathic physician and surgeon licensed
pursuant to the Osteopathic Initiative Act. An aide is not authorized
to perform osteopathic manipulative procedures.
(5) "Under the orders, direction and immediate supervision" means
the evaluation of the patient by the osteopathic physician prior to
the performing of an osteopathic manipulative treatment
patient-related task by the aide, the formulation and recording in
the patient's record by the osteopathic physician and surgeon of an
osteopathic manipulative treatment program based upon the evaluation,
and any other information available to the osteopathic physician and
surgeon prior to any delegation of a task to an aide. The
osteopathic physician and surgeon shall assign only those
patient-related tasks that can be safely and effectively performed by
the aide. The supervising osteopathic physician and surgeon shall be
responsible at all times for the conduct of the aide while he or she
is on duty and shall provide continuous and immediate supervision of
the aide. The osteopathic physician and surgeon shall be in the same
facility as, and in proximity to, the location where the aide is
performing patient-related tasks and shall be readily available at
all times to provide advice or instructions to the aide.
(6) A "patient-related task" is restricted to assisting the
osteopathic physician and surgeon in the rendering of osteopathic
manipulative treatment.
(b) Osteopathic aides may not use roentgen rays and radioactive
materials.
(c) The board shall require the supervising osteopathic physician
and surgeon to conduct orientation of the aide regarding
patient-related tasks.
(d) No osteopathic physician and surgeon shall supervise more than
two osteopathic aides at any one time.

2459.7. Notwithstanding any other provision of law, no osteopathic
physician and surgeon shall utilize an osteopathic aide to perform
services other than those specified in Sections 2459.5 and 2459.6. A
violation of this section constitutes unprofessional conduct and is
grounds for disciplinary action.