A BILL TO BE ENTITLED
AN ACT to encourage the provision of medical services to indigent persons by providing for a Retired Limited volunteer license and by broadening the applicability of a limited volunteer license and by limiting liability for nonprofit community health referral services.
The General Assembly of North Carolina enacts:
SECTION 1.  G.S. 90‑12.1A reads as rewritten:
"§ 90‑12.1A.  Limited volunteer license.
(a)	The Board may issue a " limited volunteer license" to an applicant who:
(1)	Has a license to practice medicine and surgery in another state; and
(2)	Produces a letter from the state of licensure indicating the applicant's license is active and in good standing.
			
(d)	The Board shall issue a limited license under this section within 30 days after an applicant provides the Board with information satisfying the requirements of this section.
(e)	The holder of a limited license under this section may practice medicine and surgery only at clinics that specialize in the treatment of indigent patients. The holder of the limited license may not receive compensation for services rendered at clinics specializing in the care of indigent patients.
(e1)	The holder of a limited volunteer license shall practice medicine and surgery within this State for no more than 30 days per calendar year.
(f)	The holder of a limited license issued pursuant to this section who practices medicine or surgery at places other than clinics that specialize in the treatment of indigent patients shall be guilty of a Class 3 misdemeanor and, upon conviction, shall be fined not less than twenty‑five dollars ($25.00) nor more than fifty dollars ($50.00) for each offense. The Board, in its discretion, may revoke the limited license after due notice is given to the holder of the limited license.
(g)	The Board may, by rule, require an applicant for a limited license under this section to comply with other requirements or submit additional information the Board deems appropriate."
SECTION 2.  Article 1 of Chapter 90 of the General Statutes is amended by adding a new section to read:
"§ 90‑12.1B.  Retired limited volunteer license.
(a)	The Board may issue a "retired limited volunteer license" to an applicant who is a physician and who has allowed his or her license to practice medicine and surgery in this State or another state to become inactive.
(b)	A physician holding a limited license under this section shall comply with the continuing medical education requirements pursuant to rules adopted by the Board.
(c)	The holder of a limited license under this section may practice medicine and surgery only at clinics that specialize in the treatment of indigent patients. The holder of the limited license may not receive compensation for services rendered at clinics specializing in the care of indigent patients.
(d)	The Board shall issue a limited license under this section within 30 days after an applicant provides the Board with information satisfying the requirements of this section.
(e)	The holder of a limited license issued pursuant to this section who practices medicine or surgery at places other than clinics that specialize in the treatment of indigent patients shall be guilty of a Class 3 misdemeanor and, upon conviction, shall be fined not less than twenty‑five dollars ($25.00) nor more than fifty dollars ($50.00) for each offense. The Board, in its discretion, may revoke the limited license after due notice is given to the holder of the limited license.
(f)	The Board may, by rule, require an applicant for a limited license under this section to comply with other requirements or submit additional information the Board deems appropriate."
SECTION 3.  G.S. 90‑12.4 reads as rewritten:
"§ 90‑12.4A Physician assistant limited volunteer license.
(a)	The Board shall issue a limited volunteer license to an applicant who:
(1)	Holds a current license or registration in another state; and
(2)	Produces a letter from the state of licensure indicating the applicant's license or registration is active and in good standing.
	
(b)	The Board shall issue a limited license under this section within 30 days after the applicant provides the Board with information satisfying the requirements of this section.
(c)	The holder of a limited license may perform medical acts, tasks, or functions as a physician assistant only at clinics that specialize in the treatment of indigent patients. The holder of a limited license may not receive payment or other compensation for services rendered at clinics specializing in the care of indigent patients. The holder of a limited volunteer license shall practice as a physician assistant within this State for no more than 30 days per calendar year.
(d)	Before initiating the performance of medical acts, tasks, or functions as a physician assistant licensed under this section, the physician assistant shall provide the Board the name, address, and telephone number of the physician licensed under this Article who will supervise the physician assistant in the clinic specializing in the care of indigent patients.
(e)	The holder of a limited license issued pursuant to this section who practices as a physician assistant at places other than clinics that specialize in the treatment of indigent patients shall be guilty of a Class 3 misdemeanor and, upon conviction, shall be fined not less than twenty‑five dollars ($25.00) nor more than fifty dollars ($50.00) for each offense. The Board, in its discretion, may revoke the limited license after due notice is given to the holder of the limited license.
(f)	The Board may, by rule, require an applicant for a limited license under this section to comply with other requirements or submit additional information the Board deems appropriate."
SECTION 4.  Article 1 of Chapter 90 of the General Statutes is amended by adding a new section to read:
"§ 90‑12.4B.  Physician Assistant retired limited volunteer license.
(a)	The Board may issue a "retired limited volunteer license" to an applicant who is a physician assistant and who has allowed his or her license to become inactive.
(b)	A physician assistant holding a retired limited volunteer license under this section shall comply with the continuing medical education requirements pursuant to rules adopted by the Board.
(c)	The holder of a retired limited volunteer license under this section may perform medical acts, tasks, or functions as a physician assistant only at clinics that specialize in the treatment of indigent patients. The holder of a retired limited volunteer license may not receive compensation for services rendered at clinics specializing in the care of indigent patients.
(d)	The Board shall issue a retired limited volunteer license under this section within 30 days after an applicant provides the Board with information satisfying the requirements of this section.
(e)	The holder of a retired limited volunteer license issued pursuant to this section who practices as a physician assistant at places other than clinics that specialize in the treatment of indigent patients shall be guilty of a Class 3 misdemeanor and, upon conviction, shall be fined not less than twenty‑five dollars ($25.00) nor more than fifty dollars ($50.00) for each offense. The Board, in its discretion, may revoke the limited license after due notice is given to the holder of the limited license.
(f)	The Board may, by rule, require an applicant for a retired limited volunteer license under this section to comply with other requirements or submit additional information the Board deems appropriate."
SECTION 5.  G.S. 90‑13.1 reads as rewritten:
"§ 90‑13.1.  License fees.
(a)	Each applicant for a license to practice medicine and surgery in this State under either G.S. 90‑9.1 or G.S. 90‑9.2 shall pay to the North Carolina Medical Board an application fee of three hundred fifty dollars ($350.00).
(b)	Each applicant for a limited license to practice in a medical education and training program under G.S. 90‑12.01 shall pay to the Board a fee of one hundred dollars ($100.00).
(c)	An applicant for a limited volunteer license under G.S. 90‑12.1A or G.S. 90‑12.1B shall not pay a fee.
(d)	A fee of twenty‑five dollars ($25.00) shall be paid for the issuance of a duplicate license.
(e)	All fees shall be paid in advance to the North Carolina Medical Board, to be held in a fund for the use of the Board.
(f)	For the initial and annual licensure of an anesthesiologist assistant, the Board may require the payment of a fee not to exceed one hundred fifty dollars ($150.00)."
SECTION 6.  G.S. 90‑13.2 reads as rewritten:
"§ 90‑13.2.  Registration every year with Board.
(a)	Every person licensed to practice medicine by the North Carolina Medical Board shall register annually with the Board within 30 days of the person's birthday.
(b)	A person who registers with the Board shall report to the Board the person's name and office and residence address and any other information required by the Board, and shall pay an annual registration fee of one hundred seventy‑five dollars ($175.00), except those who have a limited license to practice in a medical education and training program approved by the Board for the purpose of education or training shall pay a registration fee of one hundred twenty‑five dollars ($125.00), those who have a retired limited volunteer license pursuant to G.S. 90‑12.1B shall pay an annual registration fee of twenty‑five dollars ($25.00), and those who have a limited volunteer license pursuant to G.S. 90‑12.1A shall pay no annual registration fee. However, licensees who have a limited license to practice for the purpose of education and training under G.S. 90‑12.01 shall not be required to pay more than one annual registration fee for each year of training.
(c)	A physician who is not actively engaged in the practice of medicine in North Carolina and who does not wish to register the license may direct the Board to place the license on inactive status.
(d)	A physician who is not actively engaged in the practice of medicine in North Carolina and who does not wish to register the license may direct the Board to place the license on inactive status.
(e)	A physician who fails to register as required by this section shall pay an additional fee of fifty dollars ($50.00) to the Board. The license of any physician who fails to register and who remains unregistered for a period of 30 days after certified notice of the failure is automatically inactive. The Board shall retain jurisdiction over the holder of the inactive license.
(f)	Except as provided in G.S. 90‑12.1B, a person whose license is inactive shall not practice medicine in North Carolina nor be required to pay the annual registration fee.
(g)	Upon payment of all accumulated fees and penalties, the license of the physician may be reinstated, subject to the Board requiring the physician to appear before the Board for an interview and to comply with other licensing requirements. The penalty may not exceed the maximum fee for a license under G.S. 90‑13.1."
SECTION 7.  G.S. 90‑21.16 reads as rewritten:
"§ 90‑21.16.  Volunteer health care professionals; liability limitation.
(a)	This section applies as follows:
(1)	Any volunteer medical or health care provider at a facility of a local health department or at a nonprofit community health center,
(2)	Any volunteer medical or health care provider rendering services to a patient referred by a local health department as defined in G.S. 130A‑2(5), nonprofit community health center, or nonprofit community health referral service at the provider's place of employment,
(3)	Any volunteer medical or health care provider serving as medical director of an emergency medical services (EMS) agency, or
	
(5)	Any volunteer medical or health care provider licensed or certified in this State who provides services within the scope of the provider's license or certification at a free clinic facility,
who receives no compensation for medical services or other related services rendered at the facility, center, agency, or clinic, or who neither charges nor receives a fee for medical services rendered to the patient referred by a local health department, nonprofit community health center, or nonprofit community health referral service at the provider's place of employment shall not be liable for damages for injuries or death alleged to have occurred by reason of an act or omission in the rendering of the services unless it is established that the injuries or death were caused by gross negligence, wanton conduct, or intentional wrongdoing on the part of the person rendering the services. The free clinic, local health department facility, nonprofit community health center, nonprofit community health referral service, or agency shall use due care in the selection of volunteer medical or health care providers, and this subsection shall not excuse the free clinic, health department facility, community health center, or agency for the failure of the volunteer medical or health care provider to use ordinary care in the provision of medical services to its patients.
(b)	Nothing in this section shall be deemed or construed to relieve any person from liability for damages for injury or death caused by an act or omission on the part of such person while rendering health care services in the normal and ordinary course of his or her business or profession. Services provided by a medical or health care provider who receives no compensation for his or her services and who voluntarily renders such services at the provider's place of employment, facilities of free clinics, local health departments as defined in G.S. 130A‑2, nonprofit community health centers, or as a volunteer medical director of an emergency medical services (EMS) agency, are deemed not to be in the normal and ordinary course of the volunteer medical or health care provider's business or profession.
(c)	As used in this section, a "free clinic" is a nonprofit, 501(c)(3) tax‑exempt organization organized for the purpose of providing health care services without charge or for a minimum fee to cover administrative costs and that maintains liability insurance covering the acts and omissions of the free clinic and any liability pursuant to subsection (a) of this section.
(d)	A nonprofit community health referral service that refers low‑income patients to physicians for free services is not liable for the acts or omissions of the physician in rendering service to that patient if the nonprofit community health referral service maintains liability insurance covering the acts and omissions of the nonprofit health referral service and any liability pursuant to subsection (a) of this section.(e)	As used in this section, a "nonprofit community health referral service" is a nonprofit, 501(c)(3) tax‑exempt organization organized to provide for no charge the referral of low‑income, uninsured patients to volunteer health care providers who provide health care services without charge to patients."
SECTION 8.  This act is effective when it becomes law.