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									LLR-BOARD OF MEDICAL EXAMINERS

Approved by the Board: October 18-21, 1998 Board meeting

Amended by the Board: May 6-8, 2002 Board meeting

Service Area: Licensure, Physicians

Subject: Continuing Medical Education Requirement

Beginning January 2000, every currently licensed physician must begin to acquire at least 40 hours of
category I CME every two (2) calendar years in order to reregister his or her license. Physicians will be
required to report CME completion biennially during license re-registration. Compliance will initially be
monitored through random audits beginning in 2002.

POLICY:

Applicants for medical re-registration must complete a minimum of 40 hours of approved continuing medical
education (CME) during the previous two consecutive calendar years.

CONSIDERATIONS:

1. What constitutes "approved" CME?

Category I CME accredited by the AMA or AOA or its equivalent sponsored by a specialty board.
Documented journal club participation or more innovative formats, for example, a practitioner-designed
program offered in the office or hospital setting. The reading of journal articles is not acceptable due to the
lack of an accountable monitor.

2. Will retired physicians be required to participate?

Yes, if the physician is retired but has an active license, then he/she must comply with CME requirements.
Retired physicians without an active license are exempt from CME.

3. Will the CME be specialty specific?

Yes, in that 75 percent, or 30 of the 40 hours required every two years, must be directly related to the type of
patient care the licensee renders.

4. What action will be taken if the applicant does not meet the requirement?

Penalties will be imposed as provided by Board policy


LLR-BOARD OF MEDICAL EXAMINERS

Approved by the Board: May 16-18, 2005 Board meeting

Service Area: Licensure, Physicians

Subject: Continuing Medical Education Audit Procedures and Penalties for non-compliance

Letters are mailed to those licensees randomly chosen to be audited. A deadline to submit the required
documentation is given in the letter.
After the deadline to submit documentation verifying continued competency compliance:

        Staff date-stamps each submittal and attaches a summary/evaluation sheet.
        Staff reviews documentation for compliance.
        If compliance is clearly and unquestionably documented, staff sends a memo to licensee stating
         compliance with the continued competency requirements has been verified and thanking him/her
         for prompt response.
        If compliance is unclear or questionable, staff will submit the documentation to the Board’s
         Continuing Medical Education (CME) Committee pursuant to paragraph 4 below.

1. If documentation has not been received within 10 days of the submittal deadline:

        Staff issues a Cease & Desist Order using a template prepared by LLR’s Office of General Counsel
         (OGC) and signed by Administrator.

        Board staff prepares a Consent Agreement using a template prepared by LLR’s OGC, gets OGC to
         review it, and sends it by certified mail return receipt requested, along with a cover letter and the
         Cease & Desist Order to the licensee at the mailing address in the Board’s file.

The terms of the Consent Agreement are as follows:

First Offense: Public Reprimand, $1,000 fine, obtain the required hours of CE (none of which can be used
for the next period’s renewal) or other evidence of continued competency. The fine amount is negotiable
down to $500. In the cover letter, the licensee is given a 10-day deadline date for signing and returning the
Consent Agreement. Licensee is reinstated upon satisfaction of all requirements. Licensee will be included
in the next year’s audit.

Second Offense: Public Reprimand, $2,000 fine, obtain the required hours of CE (none of which can be
used for the next period’s renewal) or other evidence of continued competency. The fine amount is
negotiable down to $1,500. In the cover letter, the licensee is given a 10-day deadline date for signing and
returning the Consent Agreement. Licensee is reinstated upon satisfaction of all requirements.

Third Offense: Appearance before the Board at its next regular meeting.

        Put “tickler” on electronic calendar to remind staff of date due.

        Change Relaes database to show licensee’s license is NOT current after the due date passes
         without any response.

2. If documentation submitted clearly indicates the licensee has not met the required continued competency
requirement:

        Staff issues a Cease & Desist Order using a template prepared by LLR’s Office of General Counsel
         (OGC) and signed by Administrator.

        Board staff prepares a Consent Agreement using a template prepared by LLR’s OGC, gets OGC to
         review it, and sends it by certified mail return receipt requested, along with a cover letter and the
         Cease & Desist Order to the licensee at the mailing address in the Board’s file. The terms of the
         Consent Agreement are as follows:

First Offense: Public Reprimand, $1,000 fine, obtain the required hours of CE (none of which can be used
for the next period’s renewal) or other evidence of continued competency. The fine amount is negotiable
down to $500. In the cover letter, the licensee is given a 10-day deadline date for signing and returning the
Consent Agreement. Licensee is reinstated upon satisfaction of all requirements.
Second Offense: Public Reprimand, $2,000 fine, obtain the required hours of CE (none of which can be
used for the next period’s renewal) or other evidence of continued competency. The fine amount is
negotiable down to $1,500. In the cover letter, the licensee is given a 10-day deadline date for signing and
returning the Consent Agreement. Licensee is reinstated upon satisfaction of all requirements.

Third Offense: Appearance before the Board at its next regular meeting.

        Put “tickler” on electronic calendar to remind staff of date due.

        Change Relaes database to show licensee’s license is NOT current after the due date passes
         without any response.

3. If documentation submitted clearly indicates the licensee obtained the CE hours or other evidence of
continued competency AFTER signing the renewal form:

        Board staff prepares a Consent Agreement using a template prepared by LLR’s Office of General
         Counsel (OGC), gets OGC to review it, and sends it by certified mail return receipt requested,
         along with a cover letter to the licensee at the mailing address in the Board’s file. The terms of the
         Consent Agreement are as follows:

First Offense: Public Reprimand, $1,000 fine, obtain the required hours of CE (none of which can be used
for the next period’s renewal) or other evidence of continued competency. The fine amount is negotiable
down to $500. In the cover letter, the licensee is given a 10-day deadline date for signing and returning the
Consent Agreement. Licensee is reinstated upon satisfaction of all requirements.

Second Offense: Public Reprimand, $2,000 fine, obtain the required hours of CE (none of which can be
used for the next period’s renewal) or other evidence of continued competency. The fine amount is
negotiable down to $1,500. In the cover letter, the licensee is given a 10-day deadline date for signing and
returning the Consent Agreement. Licensee is reinstated upon satisfaction of all requirements.

Third Offense: Appearance before the Board at its next regular meeting.

        Put “tickler” on electronic calendar to remind staff of date due.

        Change Relaes database to show licensee’s license is NOT current after the due date passes
         without any response.

4. If documentation submitted has questionable CME credits and staff is unable to determine if the credits
meet CME or other continued competency requirements:

        Indicate on an evaluation sheet which of the continued competency requirements are in question
         and why (is it a provider issue, date-obtained issue, subject issue?) and submit the documentation
         to the Board’s CME Committee for an opinion.

        If the continued competency submitted is approved by the CME Committee:
               o Staff sends a memo to licensee stating compliance with Continued Competency
                   requirements has been verified and thanking him/her for prompt response.

B. If continued competency submittal is disallowed by the CME Committee:

        Notify licensee that continued competency submittal was disallowed and the reason for the
         disallowance.
        Notify the licensee that he/she has 180 days to make up the deficiency or comply. Give a specific
         date deadline for submitting documentation of compliance.
        Put “tickler” on electronic calendar to remind staff of date due.
C. If continued competency submittal is disallowed by the CME Committee and the licensee does not timely
comply:

        Staff issues a Cease & Desist Order using a template prepared by LLR’s Office of General Counsel
         (OGC) and signed by Administrator.

        Board staff prepares a Consent Agreement using a template prepared by LLR’s OGC, gets OGC to
         review it, and sends it by certified mail return receipt requested, along with a cover letter and the
         Cease & Desist Order to the licensee at the public address in the Board’s file. The terms of the
         Consent Agreement are as follows:

First Offense: Public Reprimand, $1,000 fine, obtain the required hours of CE (none of which can be used
for the next period’s renewal) or other evidence of continued competency. The fine amount is negotiable
down to $500. In the cover letter, the licensee is given a 10-day deadline date for signing and returning the
Consent Agreement. Licensee is reinstated upon satisfaction of all requirements.

Second Offense: Public Reprimand, $2,000 fine, obtain the required hours of CE (none of which can be
used for the next period’s renewal) or other evidence of continued competency. The fine amount is
negotiable down to $1,500. In the cover letter, the licensee is given a 10-day deadline date for signing and
returning the Consent Agreement. Licensee is reinstated upon satisfaction of all requirements.

Third Offense: Appearance before the Board at its next regular meeting.

        Put “tickler” on electronic calendar to remind staff of date due.

        Change Relaes database to show licensee’s license is NOT current after the due date passes
         without any response.

Upon receipt of the signed Consent Agreement:

        Staff sends letter acknowledging receipt and stating the license was reinstated on the date the
         Consent Agreement was received. Staff sends copy of signed, final CA to the licensee. Relaes
         database is changed to reflect licensee’s return to active status. Staff posts the Consent Agreement
         on the Board’s Web site.

        Staff sends completed Consent Agreement to Office of Investigations and Enforcement for filing
         and storage.

If a licensee refuses to sign (or ignores) a Consent Agreement or Cease and Desist Order, the case
immediately will be referred to the Office of Investigations and Enforcement.

								
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