Iowa Admin. Code r. 653-23.1 - Grounds for discipline
The board has authority to impose discipline for any violation of Iowa Code chapter 147, 148, 148E, 252J, 272C or 272D or the rules promulgated thereunder. The grounds for discipline apply to physicians and acupuncturists. This rule is not subject to waiver pursuant to 653-Chapter 3 or any other provision of law. The board may impose any of the disciplinary sanctions set forth in 653-subrule 25.25(1), including civil penalties in an amount not to exceed $10,000, when the board determines that the licensee is guilty of any of the following acts or offenses:
(1) Violating any of the grounds for the
revocation or suspension of a license as listed in Iowa Code section
147.55,
148.6,
148E.8,
272C.10,
or
272C.15.
(2) Professional incompetency. Professional
incompetency includes, but is not limited to, any of the following:
a. Willful or repeated gross
malpractice;
b. Willful or gross
negligence;
c. A substantial lack
of knowledge or ability to discharge professional obligations within the scope
of the physician's or surgeon's practice;
d. A substantial deviation by the physician
from the standards of learning or skill ordinarily possessed and applied by
other physicians or surgeons in the state of Iowa acting in the same or similar
circumstances;
e. A failure by a
physician or surgeon to exercise in a substantial respect that degree of care
which is ordinarily exercised by the average physician or surgeon in the state
of Iowa acting in the same or similar circumstances;
f. A willful or repeated departure from or
the failure to conform to the minimal standard of acceptable and prevailing
practice of medicine and surgery or osteopathic medicine and surgery in the
state of Iowa;
g. Failure to meet
the acceptable and prevailing standard of care when delegating or supervising
medical services provided by another physician, health care practitioner, or
other individual who is collaborating with or acting as an agent, associate, or
employee of the physician responsible for the patient's care, whether or not
injury results.
(3)
Practice harmful or detrimental to the public. Practice harmful or detrimental
to the public includes, but is not limited to, the failure of a physician to
possess and exercise that degree of skill, learning and care expected of a
reasonable, prudent physician acting in the same or similar circumstances in
this state, or when a physician is unable to practice medicine with reasonable
skill and safety as a result of a mental or physical impairment or chemical
abuse.
(4) Unprofessional conduct.
Engaging in unethical or unprofessional conduct includes, but is not limited
to, the committing by a licensee of an act contrary to honesty, justice or good
morals, whether the same is committed in the course of the licensee's practice
or otherwise, and whether committed within this state or elsewhere; or a
violation of the standards and principles of medical ethics or
653-13.7 (147,148,272C) or
653-13.20 (147,148) as
interpreted by the board.
(5)
Sexual misconduct. Engaging in sexual misconduct includes, but is not limited
to, engaging in conduct set out at 653-subrule 13.7(4) or 13.7(6) as
interpreted by the board.
(6)
Substance abuse. Substance abuse includes, but is not limited to, excessive use
of alcohol, drugs, narcotics, chemicals or other substances in a manner which
may impair a licensee's ability to practice the profession with reasonable
skill and safety.
(7)
Indiscriminately or promiscuously prescribing, administering or dispensing any
drug for other than lawful purpose includes, but is not limited to:
a. Self-prescribing or self-dispensing
controlled substances.
b.
Prescribing or dispensing controlled substances to members of the licensee's
immediate family.
(1) Prescribing or
dispensing controlled substances to members of the licensee's immediate family
is allowable for an acute condition or on an emergency basis when the licensee
conducts an examination, establishes a medical record, and maintains proper
documentation.
(2) Immediate family
includes the physician's spouse or domestic partner and either of the
physician's, spouse's, or domestic partner's parents, stepparents or
grandparents; the physician's natural or adopted children or stepchildren and
any child's spouse, domestic partner or children; the siblings of the physician
or the physician's spouse or domestic partner and the sibling's spouse or
domestic partner; or anyone else living with the physician.
(8) Physical or mental
impairment. Physical or mental impairment includes, but is not limited to, any
physical, neurological or mental condition which may impair a physician's
ability to practice the profession with reasonable skill and safety. Being
adjudged mentally incompetent by a court of competent jurisdiction shall
automatically suspend a license for the duration of the license unless the
board orders otherwise.
(9) Felony
criminal conviction. Being convicted of a felony in the courts of this state,
another state, the United States, or any country, territory or other
jurisdiction, as defined in Iowa Code section
148.6(2)
"b."
(10)
Violation of the laws or rules governing the practice of medicine or
acupuncture of this state, another state, the United States, or any country,
territory or other jurisdiction. Violation of the laws or rules governing the
practice of medicine includes, but is not limited to, willful or repeated
violation of the provisions of these rules or the provisions of Iowa Code
chapter 147, 148, 148E or 272C or other state or federal laws or rules
governing the practice of medicine.
(11) Violation of a lawful order of the
board, previously entered by the board in a disciplinary or licensure hearing,
or violation of the terms and provisions of a consent agreement or settlement
agreement entered into between a licensee and the board.
(12) Violation of an initial agreement or
health contract entered into with the Iowa physician health program
(IPHP).
(13) Failure to comply with
an evaluation order. Failure to comply with an order of the board requiring a
licensee to submit to evaluation under Iowa Code section
148.6(2)
"h" or 272C.9(1).
(14) Knowingly making misleading, deceptive,
untrue or fraudulent representations in the practice of a profession. Knowingly
making misleading, deceptive, untrue or fraudulent representations in the
practice of a profession includes, but is not limited to, an intentional
perversion of the truth, either orally or in writing, by a physician in the
practice of medicine and surgery or osteopathic medicine and surgery or by an
acupuncturist.
(15) Fraud in
procuring a license. Fraud in procuring a license includes, but is not limited
to, an intentional perversion of the truth in making application for a license
to practice acupuncture, medicine and surgery, or osteopathic medicine and
surgery in this state, and includes false representations of material fact,
whether by word orby conduct, by false or misleading allegations, orby
concealment of that which should have been disclosed when making application
for a license in this state, or attempting to file or filing with the board any
false or forged document submitted with an application for a license in this
state.
(16) Fraud in
representations as to skill or ability. Fraud in representations as to skill or
ability includes, but is not limited to, a licensee's having made misleading,
deceptive or untrue representations as to the acupuncturist's or physician's
competency to perform professional services for which the licensee is not
qualified to perform by education, training or experience.
(17) Use of untruthful or improbable
statements in advertisements. Use of untruthful or improbable statements in
advertisements includes, but is not limited to, an action by a licensee in
making known to the public information or intention which is false, deceptive,
misleading or promoted through fraud or misrepresentation and includes
statements which may consist of, but are not limited to:
a. Inflated or unjustified claims which lead
to expectations of favorable results;
b. Self-laudatory claims that imply that the
licensee is skilled in a field or specialty of practice for which the licensee
is not qualified;
c.
Representations that are likely to cause the average person to misunderstand;
or
d. Extravagant claims or claims
of extraordinary skills not recognized by the medical profession.
(18) Obtaining any fee by fraud or
misrepresentation.
(19) Acceptance
of remuneration for referral of a patient to other health professionals in
violation of the law or medical ethics.
(20) Knowingly submitting a false report of
continuing education or failure to submit the required reports of continuing
education.
(21) Knowingly aiding,
assisting, procuring, or advising a person in the unlawful practice of
acupuncture, medicine and surgery, or osteopathic medicine and
surgery.
(22) Failure to report
disciplinary action. Failure to report a license revocation, suspension or
other disciplinary action taken against the licensee by a professional
licensing authority of another state, an agency of the United States
government, or any country, territory or other jurisdiction within 30 days of
the final action by such licensing authority. A stay by an appellate court
shall not negate this requirement; however, if such disciplinary action is
overturned or reversed by a court of last resort, such report shall be expunged
from the records of the board.
(23)
Failure to report voluntary agreements. Failure to report any voluntary
agreement to restrict the practice of acupuncture, medicine and surgery, or
osteopathic medicine and surgery entered into with this state, another state,
the United States, an agency of the federal government, or any country,
territory or other jurisdiction.
(24) Failure to notify the board within 30
days after occurrence of any settlement or adverse judgment of a malpractice
claim or action.
(25) Failure to
file the reports required by
653-22.2 (272C) within 30 days
concerning wrongful acts or omissions committed by another licensee.
(26) Failure to comply with a valid subpoena
issued by the board pursuant to Iowa Code sections
17A.13 and
272C.6
and 653-subrule 24.2(6) and rule
653-25.12 (17A).
(27) Failure to submit to a board-ordered
mental, physical, clinical competency, or substance abuse evaluation or drug or
alcohol screening.
(28) The
inappropriate use of a rubber stamp to affix a signature to a prescription. A
person who is unable, due to a disability, to make a written signature or mark,
however, may substitute in lieu of a signature a rubber stamp which is adopted
by the disabled person for all purposes requiring a signature and which is
affixed by the disabled person or affixed by another person upon the request of
the disabled person and in the presence of the disabled person.
(29) Maintaining any presigned prescription
which is intended to be completed and issued at a later time.
(30) Failure to comply with the
recommendations issued by the Centers for Disease Control and Prevention of the
United States Department of Health and Human Services for preventing
transmission of human immunodeficiency virus and hepatitis B virus to patients
during exposure-prone invasive procedures, or with the protocols established
pursuant to Iowa Code chapter 139A.
(31) Failure by a physician with HIV or HBV
who practices in a hospital setting, and who performs exposure-prone
procedures, to report the physician's HIV or HBV status to an expert review
panel established by a hospital under Iowa Code section
139A.22(1) or to an expert review panel established by
the department of public health under Iowa Code section
139A.22(3).
(32) Failure by a physician with HIV or HBV
who practices outside a hospital setting, and who performs exposure-prone
procedures, to report the physician's HIV or HBV status to an expert review
panel established by the department of public health under Iowa Code section
139A.22(3).
(33) Failure by a physician subject to the
reporting requirements of 23.1(31) and 23.1(32) to comply with the
recommendations of an expert review panel established by the department of
public health pursuant to Iowa Code section
139A.22(3),
with hospital protocols established pursuant to Iowa Code section
139A.22(1),
or with health care facility procedures established pursuant to Iowa Code
section
139A.22(2).
(34) Noncompliance with a support order or
with a written agreement for payment of support as evidenced by a certificate
of noncompliance issued pursuant to Iowa Code chapter 252J. Disciplinary
proceedings initiated under this rule shall follow the procedures set forth in
Iowa Code chapter 252J and 653-Chapter 15.
(35) Rescinded IAB 3/11/20, effective
4/15/20.
(36) Improper management
of medical records. Improper management of medical records includes, but is not
limited to, failure to maintain timely, accurate, and complete medical
records.
(37) Failure to transfer
medical records to another physician in a timely fashion when legally requested
to do so by the subject patient or by a legally designated representative of
the subject patient.
(38) Failure
to respond to or comply with a board investigation initiated pursuant to Iowa
Code section
272C.3
and 653-24.2 (17A,147,148,272C).
(39) Failure to
comply with the direct billing requirements for anatomic pathology services
established in Iowa Code Supplement section
147.106.
(40) Failure to submit an additional
completed fingerprint card and applicable fee, within 30 days of a request made
by board staff, when a previous fingerprint submission has been determined to
be unacceptable.
(41) Failure to
respond to the board or submit continuing education materials during a board
audit, within 30 days of a request made by board staff or within the extension
of time if one had been granted.
(42) Failure to respond to the board or
submit requested mandatory training for identifying and reporting abuse
materials during a board audit, within 30 days of a request made by board staff
or within the extension of time if one had been granted.
(43) Nonpayment of state debt as evidenced by
a certificate of noncompliance issued pursuant to 2008 Iowa Acts, Senate File
2428, division II, and 653-Chapter 12.
(44) Voluntary agreements. The board may take
disciplinary action against a physician if that physician has entered into a
voluntary agreement to restrict the practice of medicine in another state,
district, territory, or country.
a. The board
will use the following criteria to determine if a physician has entered into a
voluntary agreement within the meaning of Iowa Code section
148.12 and
this rule.
(1) The voluntary agreement was
signed during or at the conclusion of a disciplinary investigation, or to
prevent a matter from proceeding to a disciplinary investigation.
(2) The agreement includes any or all of the
following:
1. Education or testing that is
beyond the jurisdiction's usual requirement for a license or license
renewal.
2. An assignment beyond
what is required for license renewal or regular practice, e.g., adoption of a
protocol, use of a chaperone, completion of specified continuing education, or
completion of a writing assignment.
3. A prohibition or limitation on practice
privileges, e.g., a restriction on prescribing or administering controlled
substances.
4. Compliance with an
educational plan.
5. A requirement
that surveys or reviews of patients or patient records be conducted.
6. A practice monitoring
requirement.
7. A special
notification requirement for a change of address.
8. Payment that is not routinely required of
all physicians in that jurisdiction, such as a civil penalty, fine, or
reimbursement of any expenses.
9.
Any other activity or requirements imposed by the board that are beyond the
usual licensure requirements for obtaining, renewing, or reinstating a license
in that jurisdiction.
b. A certified copy of the voluntary
agreement shall be considered prima facie evidence.
(45) Performing or attempting to perform any
surgical or invasive procedure on the wrong patient or at the wrong anatomical
site or performing the wrong surgical procedure on a patient.
(46) Violation of the standards of practice
for medical directors who delegate and supervise medical aesthetic services
performed by nonphysician persons at a medical spa as set out at rule
653-13.8 (148,272C).
(47) Failure to provide the board, within 14
days of a request by the board as set out at 653-paragraph
13.8(5)"l," written verification of the education and training
of all nonphysician persons who perform medical aesthetic services at a medical
spa.
(48) Failure to file with the
board a written report and a copy of the hospital disciplinary action within 30
days of any hospital disciplinary action or the licensee's voluntary action to
avoid a hospital investigation or hospital disciplinary action, as required by
rule 653-22.5 (272C).
This rule is intended to implement Iowa Code chapters 17A, 147, 148, 272C and 272D.
Notes
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