S.F. _____ H.F. _____ Section 1. Section 148.2A, subsection 2, paragraph e, 1 subparagraphs (3) and (4), Code 2013, are amended to read as 2 follows: 3 (3) The majority of a At least half of the members of a 4 hearing panel containing alternate members shall be current 5 members of the board. 6 (4) The majority of a At least half of the members of a 7 hearing panel containing alternate members shall be licensed 8 to practice under this chapter . 9 Sec. 2. Section 148.6, subsection 1, Code 2013, is amended 10 to read as follows: 11 1. The board, after due notice and hearing in accordance 12 with chapter 17A , may issue an order to discipline a licensee 13 for any of the grounds set forth in section 147.55 , chapter 14 272C , or this subsection section . Notwithstanding section 15 272C.3 , licensee discipline may include a civil penalty not to 16 exceed ten twenty thousand dollars for each violation of the 17 laws and rules governing the practice of medicine . 18 Sec. 3. Section 148.7, Code 2013, is amended to read as 19 follows: 20 148.7 Procedure for licensee discipline. 21 A proceeding for the revocation or suspension of a license 22 to practice medicine and surgery or osteopathic medicine and 23 surgery , or acupuncture or to discipline a person licensed 24 to practice medicine and surgery or osteopathic medicine and 25 surgery , or acupuncture shall be substantially in accord with 26 the following procedure and with section 272C.6, subsection 27 4, to the extent the provisions in that subsection are not 28 inconsistent with this section : 29 1. The board may, upon its own motion or upon receipt of 30 a complaint in writing , order an investigation. The board 31 may, upon its own motion, order a hearing. A written notice 32 of the time and place of the hearing together with a statement 33 of the charges shall be served upon the licensee at least ten 34 days before the hearing in the manner required for the service 35 -1- LSB 1283DP (8) 85 jr/nh 1/ 6

S.F. _____ H.F. _____ of notice of the commencement of an ordinary action or by 1 restricted certified mail. 2 2. If the whereabouts of the licensee is unknown, service 3 may be had by publication as provided in the rules of civil 4 procedure upon filing the affidavit required by the rules. 5 In case the licensee fails to appear, either in person or 6 by counsel at the time and place designated in the notice, 7 the board shall proceed with the hearing as provided in this 8 section . 9 3. a. The hearing shall be before a member or members 10 designated by the board or before an administrative law 11 judge appointed by the board according to the requirements of 12 section 17A.11, subsection 1 . The presiding board member or 13 administrative law judge may issue subpoenas, administer oaths, 14 and take or cause depositions to be taken in connection with 15 the hearing. The presiding board member or administrative law 16 judge shall issue subpoenas at the request and on behalf of the 17 licensee. 18 b. The administrative law judge shall be an attorney vested 19 with full authority of the board to schedule and conduct 20 hearings. The administrative law judge shall prepare and file 21 with the board the administrative law judge’s findings of 22 fact and conclusions of law, together with a complete written 23 transcript of all testimony and evidence introduced at the 24 hearing and all exhibits, pleas, motions, objections, and 25 rulings of the administrative law judge. 26 3. At the sole discretion of the board, a disciplinary 27 hearing shall be held before one of the following: 28 a. A quorum of the board. A quorum of the board shall 29 include not less than six members, at least half of whom are 30 current board members, and the remaining alternate members 31 appointed pursuant to section 148.2A, with no more than half of 32 the quorum being public members. 33 b. A panel of not less than three board members, at least 34 two of whom are licensed in the profession. 35 -2- LSB 1283DP (8) 85 jr/nh 2/ 6

S.F. _____ H.F. _____ c. A panel of not less than three specialists appointed 1 pursuant to section 272C.6, subsection 2. 2 d. An administrative law judge. The decision to assign 3 an administrative law judge shall be within the sole 4 discretion of the board. The board may only assign cases to 5 an administrative law judge to serve as the presiding officer 6 at hearing that involve allegations of one or more violations 7 of the laws or rules governing the practice of medicine which 8 do not involve a standard of medical care determination. The 9 board shall define by rule those cases which may be assigned 10 to an administrative law judge, and the process for using 11 an administrative law judge as the presiding officer. The 12 administrative law judge shall be assigned by the division of 13 administrative hearings pursuant to section 10A.801, and shall 14 be vested with full authority of the board to schedule and 15 conduct hearings. 16 4. Disciplinary hearings held pursuant to section 272C.6, 17 subsection 1 , shall be heard by the board, or by a panel of 18 not less than six members, at least three of whom are board 19 members, and the remaining appointed pursuant to section 20 148.2A , with no more than three of the six being public 21 members. Notwithstanding chapters 17A and 21 , a disciplinary 22 hearing shall be open to the public at the discretion of the 23 licensee. 24 5. The presiding officer may issue subpoenas, administer 25 oaths, and take or cause depositions to be taken in connection 26 with the hearing. The presiding officer shall issue subpoenas 27 at the request and on behalf of the parties. If a person 28 refuses to obey a subpoena issued by the presiding officer or 29 to answer a proper question during the hearing, the presiding 30 officer may invoke the aid of the district court in requiring 31 the attendance and testimony of a person or the production 32 of papers. A failure to obey the order of the court may be 33 punished by the court as a civil contempt. 34 5. 6. A record of the proceedings shall be kept. The 35 -3- LSB 1283DP (8) 85 jr/nh 3/ 6

S.F. _____ H.F. _____ licensee shall have the opportunity to appear personally and 1 by an attorney, with the right to produce evidence on the 2 licensee’s own behalf, to examine and cross-examine witnesses, 3 and to examine documentary evidence produced against the 4 licensee. 5 6. If a person refuses to obey a subpoena issued by the 6 presiding member or administrative law judge or to answer a 7 proper question during the hearing, the presiding member or 8 administrative law judge may invoke the aid of a court of 9 competent jurisdiction or judge of this court in requiring 10 the attendance and testimony of the person and the production 11 of papers. A failure to obey the order of the court may be 12 punished by the court as a civil contempt may be punished. 13 7. Unless the hearing is held before a quorum of the entire 14 board, the presiding officer shall prepare and file with the 15 board the proposed findings of fact, conclusions of law, and 16 decision and order, with a complete written transcript of the 17 proceeding, together with all exhibits presented , shall be 18 considered by the entire board at the earliest practicable time 19 pleadings, motions, objections, and rulings within sixty days 20 of the date of the hearing absent compelling circumstances . 21 The licensee and the licensee’s attorney shall have the 22 opportunity to appear personally to present the licensee’s 23 position and arguments to the board. The board shall determine 24 the charge or charges upon the merits on the basis of the 25 evidence in the record before it. 26 8. The proposed findings of fact, conclusions of law, and 27 decision and order may be appealed to the full board by either 28 party by serving on the executive director, either in person or 29 by certified mail, a notice of appeal within thirty days after 30 service of the proposed findings of fact, conclusions of law, 31 and decision and order on the appealing party. 32 8. 9. If a majority of the members of the board vote in 33 favor of finding the licensee guilty of an act or offense 34 specified in section 147.55 or 148.6 , the board shall prepare 35 -4- LSB 1283DP (8) 85 jr/nh 4/ 6

S.F. _____ H.F. _____ written findings of fact and its decision , conclusions of law, 1 and a decision and order imposing one or more of the following 2 disciplinary measures: 3 a. Suspend the licensee’s license to practice the profession 4 for a period to be determined by the board. 5 b. Revoke the licensee’s license to practice the profession. 6 c. Suspend imposition of judgment and penalty or impose 7 the judgment and penalty, but suspend enforcement and place 8 the physician or acupuncturist on probation. The probation 9 ordered may be vacated upon noncompliance. The board may 10 restore and reissue a license to practice medicine and surgery 11 or osteopathic medicine and surgery, or acupuncture, but may 12 impose a disciplinary or corrective measure which the board 13 might originally have imposed. A copy of the board’s order, 14 findings of fact, conclusions of law, and decision and order , 15 shall be served on the licensee in the manner of service of an 16 original notice or by certified mail return receipt requested. 17 9. 10. Judicial review of the board’s action may be 18 sought in accordance with the terms of the Iowa administrative 19 procedure Act, chapter 17A . 20 10. 11. The board’s order revoking or suspending a license 21 to practice medicine and surgery or osteopathic medicine 22 and surgery , or acupuncture, or to discipline a licensee 23 shall remain in force and effect until the appeal is finally 24 determined and disposed of upon its merit. 25 EXPLANATION 26 This bill relates to disciplinary procedures before the 27 board of medicine. 28 The bill provides that at least half of the members of a 29 disciplinary hearing panel containing alternate members shall 30 be members of the board of medicine and at least half the 31 members shall be licensed to practice under Code chapter 148. 32 The bill increases the board’s maximum civil penalty from 33 $10,000 to $20,000 and specifies that this penalty may be 34 assessed for each violation. 35 -5- LSB 1283DP (8) 85 jr/nh 5/ 6

S.F. _____ H.F. _____ Relating to disciplinary procedures, the bill rewrites 1 the existing provisions to provide additional detail. The 2 bill specifies that the procedures for licensee discipline 3 in Code section 148.7 apply to persons licensed to practice 4 acupuncture. 5 The bill specifies that a disciplinary hearing may be 6 presided over by any of the following, at the discretion 7 of the board: a quorum of the entire board; a panel of at 8 least three board members; a panel made up of specialists; 9 or an administrative law judge. The bill rewrites existing 10 provisions relating to the power of the presiding officer to 11 issue subpoenas and the enforcement of those subpoenas. 12 The bill allows an administrative law judge to hear certain 13 board-assigned contested cases without a hearing panel. The 14 bill codifies in Code chapter 148 provisions that are generally 15 set out in Code chapter 17A relating to the decision in a 16 contested case. If a quorum of the entire board hears the 17 case, the board decision is final agency action. If less than 18 a quorum or an administrative law judge hears the case, the 19 decision may be appealed to the entire board. 20 -6- LSB 1283DP (8) 85 jr/nh 6/ 6