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CHAPTER 26 - PHYSICIANS AND SURGEONS

ARTICLE 1 - GENERAL PROVISIONS

33-26-101. Short title.

Thischapter is known and may be cited as the "Medical Practice Act".

33-26-102. Definitions.

(a) As used in this chapter:

(i) Repealed by Laws 1991, ch. 143, 2.

(ii) "A.O.A." means the American OsteopathicAssociation;

(iii) "Board" means the Wyoming state board ofmedicine;

(iv) "Errant conduct" means conduct by a licenseewhich may constitute grounds for discipline as set forth in this act;

(v) "Repealed by Laws 1991, ch. 143, 2.

(vi) "Health care entity" means any hospital, clinic,training program, professional society or committee of physicians or otherlicensed health care practitioners that follows a peer review process for thepurpose of furthering quality health care;

(vii) "Impaired" means a person who is unable topractice medicine with reasonable skill and safety to patients by reason of one(1) or more of the following:

(A) Medical incompetence;

(B) Mental illness;

(D) Chemical or alcohol impairment, addiction, dependence orabuse.

(viii) "Lapsed" means the status of a license when thelicensee fails to renew the license by July 1 of any year or when the holder ofa temporary license fails to appear for an interview at the next board meetingfollowing the date of issuance or fails to submit a written request forextension of a temporary license or when a written request for extension is notapproved by the board;

(ix) "License" means a license to practice medicine inthis state issued by the board pursuant to this chapter;

(x) "Licensee" means any person licensed by the boardunder this chapter;

(xi) "Practicing medicine" means any person who in anymanner:

(A) Advertises, holds out, or represents to the public that heis authorized to practice medicine in this state; or

(B) Offers or undertakes to prevent, diagnose, correct ortreat, in any manner, by any means, method or device, any human disease,illness, pain, wound, fracture, infirmity, defect or abnormal physical ormental condition, injury, deformity or ailment, including the management ofpregnancy and parturition; or

(C) Attaches the title of M.D., D.O., physician, surgeon,osteopathic physician or osteopathic surgeon, doctor, or any other words,letters or abbreviations or any combination thereof when used in the conduct ofany occupation or profession pertaining to the prevention, diagnosis ortreatment of human disease or condition unless the designation additionallycontains the description of another branch of the healing arts for which oneholds a valid license in this state; or

(D) Practices osteopathy; or

(E) Offers or undertakes to prescribe, order, give oradminister drugs which can only be obtained by prescription according to law;or

(F) Renders a determination of medical necessity orappropriateness of proposed treatment.

(xii) "Reactivation" after a license has lapsed meansthe completion of all requirements set forth in W.S. 33-26-305(c);

(xiii) "Sexual misconduct" means:

(A) Any behavior by a licensee which involves offers ofexchange of medical services for some form of sexual gratification;

(B) Sexual contact that occurs concurrent with thephysician-patient relationship; or

(C) Any behavior by a licensee toward a patient, formerpatient, another licensee, an employee of a health care facility, an employeeof the licensee or a relative or guardian of a patient that exploits theposition of trust, knowledge, emotions or influence of the licensee.

(xiv) "USMLE" means the United States medical licensingexamination;

(xv) "L.C.M.E." means the liaison committee on medicaleducation;

(xvi) "A.C.G.M.E." means accreditation council forgraduate medical education;

(xvii) "Fifth pathway" means an academic year ofsupervised clinical education provided by an L.C.M.E. accredited medical schoolto students who have:

(A) Repealed By Laws 2003, Ch. 190, 3.

(B) Studied at a medical school outside of the United States,Puerto Rico or Canada;

(D) Attained a score satisfactory to the sponsoring medicalschool on a screening examination; and

(E) Passed the foreign medical graduate examination in themedical sciences, parts I and II of the examination of the national board ofmedical examiners, or steps 1 and 2 of the USMLE.

(xviii) "FLEX examination" means the federation of statemedical boards licensing examination;

(xix) "R.C.P.S.C." means the royal college ofphysicians and surgeons of Canada;

(xx) "Physician-patient relationship" means arelationship between a licensee and any person formed for the purpose of thelicensee providing medical diagnosis or treatment to the person, whether or notfor compensation;

(xxi) "This act" means the Medical Practice Act;

(xxii) "Board counsel" means an attorney designated bythe board to provide legal counsel to the board and its staff in the conduct ofthe board's business;

(xxiii) "Board prosecutor" means an attorney designatedby the board to prosecute, and to provide legal counsel to interviewers andpetitioners in, disciplinary cases pending before the board pursuant to thisact and the Wyoming Administrative Procedure Act;

(xxiv) "COMLEX" means the comprehensive osteopathicmedical licensing examination, administered by the national board ofosteopathic medical examiners;

(xxv) "Condition" means a specific requirement orprohibition imposed by any medical licensing board of any jurisdiction, or byany health care facility on an applicant's or licensee's clinical privileges atthat facility, that shall be fulfilled by an applicant or licensee in order toobtain or continue to hold a license in that jurisdiction, or clinicalprivileges at that facility;

(xxvi) "E.C.F.M.G." means the educational commission forforeign medical graduates;

(xxvii) "Restriction" means a limitation placed by anymedical licensing board of any jurisdiction on an applicant's or licensee'sscope of practice in that jurisdiction, or by any health care facility on anapplicant's or licensee's clinical privileges at that facility;

(xxviii) "SPEX examination" means the federation of statemedical boards special purpose post-licensure competency examination;

(xxix) "Telemedicine" means the practice of medicine byelectronic communication or other means from a physician in a location to apatient in another location, with or without an intervening health careprovider.

33-26-103. Applicability of chapter.

(a) This chapter does not apply to:

(i) Persons rendering medical assistance without compensationat the scene of an emergency;

(ii) Medical students trained in an L.C.M.E. or A.O.A.accredited or board approved school of medicine serving as clinical clerks,residents or interns under the supervision of a physician licensed in this state;

(iii) Commissioned medical officers of the United States armedservices and medical officers of the United States public health service or theUnited States department of veterans affairs in the discharge of their officialduties or within federally controlled facilities or enclaves, provided that thepersons who are licensees of the board shall be subject to the provisions ofthis act and further provided that all such persons shall be the holder of afull and unrestricted license to practice medicine in one (1) or morejurisdictions of the United States;

(iv) Any individual residing in and licensed in good standing topractice medicine in another state or country brought into this state forconsultation by a physician licensed to practice medicine in this state,provided the physician licensed in this state notifies the board of theconsultation in compliance with regulations adopted by the board;

(v) Any individual licensed to practice medicine in anotherstate who comes to this state to remove human organs from brain-dead persons;

(vi) The treatment of disease, injury, deformity or ailments byprayer or spiritual means provided that federal and state health and sanitationlaws, rules and regulations are not violated;

(vii) The gratuitous domestic administration of family remedies;

(viii) Health care providers licensed under any other chapter ofthis title engaged in the practice of the profession for which he is licensed;

(ix) Repealed By Laws 2003, Ch. 190, 3.

(x) Any person who does not represent himself to be a licensedhealth care professional who offers health care advice or nonprescriptionmedicine to another person in a social or educational situation in any mannerotherwise lawful.

ARTICLE 2 - WYOMING STATE BOARD OF MEDICINE

33-26-201. State board of medicine; composition; appointment; terms;qualifications; removal; vacancies; quorum.

(a) The Wyoming state board of medicine shall consist of five(5) physicians licensed to practice medicine in Wyoming, not less than one (1)of whom shall possess the degree of doctor of osteopathy and not less than two(2) of whom shall possess the degree of doctor of medicine, one (1) physicianassistant and two (2) lay members, appointed by the governor by and with theconsent of the senate as required by W.S. 28-12-101 through 28-12-103. Boardmembers appointed by the governor shall serve at the pleasure of the governor.The board members shall annually elect a president, a vice-president, and asecretary.

(b) Board members shall serve four (4) year terms. No boardmember shall serve more than three (3) consecutive terms.

(c) Physician and physician assistant members shall reside in,hold a full and unrestricted license and actively practice in this state. Laymembers shall reside in this state.

(d) The governor shall appoint a new board member if a vacancyoccurs. A person appointed to fill a vacancy shall serve for the unexpiredportion of the vacated term. A vacancy occurs if a member:

(i) Is absent from three (3) consecutive meetings;

(ii) No longer holds a full and unrestricted license to practicein this state or no longer engages in active practice in this state;

(iii) Resigns; or

(iv) Is removed by the governor.

(e) A quorum of the board consists of five (5) board members,including a lay member, unless otherwise specified in subsection (f) of thissection.

(f) If the board president determines that due to conflicts ofinterest or other circumstances it may not be possible to seat a quorum ofboard members to hear a disciplinary case brought pursuant to this act, thepresident may submit a written request to the governor for the appointment ofone (1) or more acting board members to hear the disciplinary case inquestion. Upon receipt of the request, the governor shall appoint therequested number of temporary board members for the sole purpose of hearing thedisciplinary case in question. Only persons who previously served as membersof the board shall be eligible for temporary appointment to hear disciplinarycases before the board. Appointments made under this subsection shall notrequire the consent of the senate pursuant to W.S. 28-12-101 through28-12-103. Persons appointed pursuant to this subsection shall be compensatedand have their expenses reimbursed in the same manner as regular board membersunder W.S. 33-26-203(c). The appointment of a person under this subsectionshall automatically terminate upon the entering of a final order in thedisciplinary case for which he was appointed.

33-26-202. Board; duties; general powers.

(a) The board shall pass upon the qualifications and determinethe fitness of all persons desiring to practice medicine in this state.

(b) The board is empowered and directed to:

(i) Grant, refuse to grant, suspend, restrict, revoke,reinstate or renew licenses to practice medicine;

(ii) Investigate allegations and take disciplinary action on thefollowing grounds:

(A) A licensee is impaired or has engaged in errant conduct;

(B) A person has violated an applicable provision of thischapter or the board's regulations.

(iii) Conduct informal interviews and contested case proceedings;

(iv) Adopt a seal;

(v) Adopt, amend, repeal, enforce and promulgate reasonablerules and regulations necessary to implement the provisions of this chapter;

(vi) Develop standards governing the delegation of a licensee'smedical responsibilities to nonphysicians;

(vii) Publish annually and submit to the governor a report whichincludes the following information:

(A) A summary of the kind and number of action taken by theboard including dates, types and origin of oral or written complaints receivedand case summaries of physicians whose licenses have been suspended or revokedand any other disciplinary actions;

(B) Board fiscal transactions for the preceding year, theamount of its accumulated cash and securities and a balance sheet showing itsfinancial condition by means of an actuarial valuation of board assets andliabilities.

(viii) Publicize information regarding the filing of complaints;

(ix) Comply with all applicable federal law;

(x) Verify the status of licenses and privileges held bylicensees and applicants for licensure with the federation of state medicalboards, medical licensing boards in other jurisdictions and federal data banks,and to provide verification of the status of licenses held in this state bylicensees to the entities specified in this paragraph;

(xi) Annually review any licensee whose license is restricted oris issued subject to any condition;

(xii) Participate in and contract with a program or programs toassist in the return to practice of licensees who have exhibited disruptivebehaviors, substance dependence or abuse or are suffering from physical ormental impairment;

(xiii) Take all reasonable action, including the promulgation ofrules and regulations, necessary to enforce this chapter;

(xiv) Adopt, amend, repeal, enforce and promulgate reasonablerules and regulations necessary to implement and administer continuing medicaleducation requirements of its licensees.

(xv) Publish nonbinding advisory opinions or other guidance onthe application and interpretation of this act and the rules and regulationspromulgated pursuant to this act;

(xvi) Request criminal history background information forpurposes of licensure and discipline, as authorized under W.S. 7-19-106(a);

(xvii) Use, retain or employ investigators, the offices of theattorney general, the state division of criminal investigation, any other investigatoryor fact finding agency and medical specialty consultants, as necessary, toinvestigate and evaluate complaints against licensees and possible violationsof this act and the board's rules;

(xviii) Adopt rules and regulations for the practice of medicine inWyoming by physicians and physician assistants not otherwise licensed inWyoming in the event of a public health emergency or pandemic;

(xix) Adopt rules and regulations for the practice oftelemedicine.

33-26-203. Board; employment and salary of executive director; andother employees; per diem and expenses of members.

(a) The board may employ or contract with an executivedirector, board counsel, board prosecutor and other necessary staff. Theexecutive director shall not be a board member.

(b) The executive director's compensation and terms ofemployment shall, and board counsel's and the board prosecutor's compensationmay, be set by the board. The compensation of other staff shall be set by thehuman resources division of the department of administration and information.

(c) Board members shall receive salary in the same manner andamount as members of the Wyoming legislature and shall be reimbursed for actualand necessary expenses and mileage incurred in the performance of theirofficial duties. Any incidental expenses necessarily incurred by the board orany member, if approved by the board, shall be paid from the account from feescollected pursuant to this chapter.

ARTICLE 3 - LICENSING

33-26-301. License required.

(a) No person shall practice medicine in this state without alicense granted by the board, or as otherwise provided by law.

(b) Upon appropriate application, fulfillment of eligibilitycriteria and successful completion of all other requirements, the board maygrant:

(i) A license to practice medicine, subject to annual renewal;

(ii) A temporary license to practice medicine pursuant to W.S.33-26-304(a);

(iii) A restricted or conditional license;

(iv) An inactive license, provided the qualifications for andthe conditions of this license shall be established by rule;

(v) A medical training license pursuant to W.S. 33-26-304(c);

(vi) An emeritus license, allowing retired physicians to providehealth care without remuneration, provided the qualifications for and theconditions of this license shall be established by rule;

(vii) A volunteer license, allowing physicians not otherwiselicensed in Wyoming to practice medicine in the state without remuneration,provided the qualifications for and conditions of this license shall beestablished by rule;

(viii) An administrative medicine license for physicians notproviding patient care, provided the qualifications for and the conditions ofthis license shall be established by rule.

33-26-302. USMLE examination.

(a) The board shall adopt regulations for the qualification forand administration of the USMLE.

(b) Repealed By Laws 2003, Ch. 190, 3.

(d) Repealed By Laws 2003, Ch. 190, 3.

(e) Repealed By Laws 2003, Ch. 190, 3.

(f) Repealed By Laws 2003, Ch. 190, 3.

33-26-303. Requirements for granting license.

(a) The board may grant a license to practice medicine in thisstate to any applicant who demonstrates, to the board, that he:

(i) Repealed By Laws 2003, Ch. 190, 3.

(ii) Has graduated from a school of medicine accredited by theL.C.M.E., a school of osteopathy accredited by the A.O.A., a Canadianaccredited school of medicine or has been certified by the E.C.F.M.G.;

(iii) Repealed By Laws 2003, Ch. 190, 3.

(iv) Has provided written evidence that he has completed atleast one (1) year of postgraduate training in an A.C.G.M.E, A.O.A. orR.C.P.S.C. accredited program;

(v) Has presented other credentials and qualificationsequivalent to or exceeding the criteria in paragraph (iv) of this subsection asmay be considered by the board to demonstrate competency to practice medicinein this state;

(vi) Has successfully completed all three (3) parts of theUSMLE, national boards, the FLEX, a board approved, state constructedlicensing examination, the examination by the licentiate of the medical councilof Canada or the COMLEX, provided the conditions and requirements forcompletion of all parts of the examinations shall be established by board rule;

(vii) Has completed an application form provided or approved bythe board;

(viii) Has paid the appropriate fees pursuant to W.S. 33-26-307;

(ix) Has completed to the satisfaction of a majority of boardmembers, if required pursuant to board rule, a personal interview consisting ofinquiry and oral response to medical knowledge, personal and professionalhistory and intentions for practicing medicine in this state; and

(x) Repealed By Laws 2009, Ch. 201, 2.

(xi) Meets any additional requirements that the board may imposeby regulation which are necessary to implement this act.

(b) A person who has pled guilty to or has been convicted of afelony or any crime that is a felony under Wyoming law in any state or federalcourt or in any court of similar jurisdiction in another country may apply forlicensure provided, the board may deny licensure based upon the plea orconviction alone.

(c) A person whose medical license has been revoked, suspended,restricted, had conditions placed on it or been voluntarily or involuntarilyrelinquished or surrendered, by or to another state medical or licensing board,or has a disciplinary action pending before another state medical or licensingboard, may apply for licensure provided, however, the board may deny licensurebased upon the revocation, suspension, restrictions, conditions,relinquishment, surrender of licensure or pending disciplinary action alone.

(d) A person whose clinical privileges at a health carefacility have been revoked, suspended, restricted, had conditions placed uponthem or been voluntarily or involuntarily resigned, or against whom a clinicalprivilege action is pending at a health care facility, may apply for licensureprovided, however, the board may deny licensure based upon the revocation,suspension, restrictions, conditions, resignation of privileges or pendingclinical privilege action alone.

33-26-304. Temporary license to practice medicine; medical traininglicense; application; qualifications.

(a) The board may issue a temporary license for a term thatexpires at 8:00 a.m. on the first day of the next regularly scheduled boardmeeting to a person who:

(i) Completes an application as approved by the board fortemporary licensure;

(ii) Meets all licensing requirements of W.S. 33-26-303 exceptthat the board may defer the interview required by W.S. 33-26-303(a)(ix) at itsdiscretion until no later than the next board meeting;

(iii) Pays a temporary license fee in an amount set by the board.

(b) The board, in its discretion may extend a temporary licensefor an additional term no longer than 8:00 a.m. on the first day of the secondregularly scheduled board meeting following the date of the initial issuance ofa temporary license.

(c) The board may issue a medical training license for a termthat expires at 12:01 a.m. July 1 of each year to a person who:

(i) Has signed a contract with an A.C.G.M.E. accreditedresidency program located in this state;

(ii) Has graduated from a school of medicine accredited by theL.C.M.E., a school of osteopathy accredited by the A.O.A. or a Canadianaccredited school of medicine, or has been certified by the E.C.F.M.G.;

(iii) Has successfully completed steps one (1) and two (2) of theUSMLE or the COMLEX;

(iv) Is under the supervision of residency faculty;

(v) Has completed an application form provided by the board;

(vi) Has paid the appropriate fees pursuant to W.S. 33-26-307;and

(vii) Repealed By Laws 2009, Ch. 201, 2.

(viii) Meets any additional requirements that the board may imposeby regulation which are necessary to implement this act.

(d) A person who has pled guilty to or has been convicted of afelony or any crime that is a felony under Wyoming law in any state or federalcourt or in any court of similar jurisdiction in another country may apply forlicensure, provided the board may deny licensure based upon the plea orconviction alone.

(e) A person whose medical license has been revoked, suspended,restricted, had conditions placed on it or been voluntarily or involuntarilyrelinquished or surrendered, by or to another state medical or licensing board,or has a disciplinary action pending before another state medical or licensingboard, may apply for licensure provided, however, the board may deny licensurebased upon the revocation, suspension, restrictions, conditions,relinquishment, surrender of licensure or pending disciplinary action alone.

(f) A person whose clinical privileges at a health carefacility have been revoked, suspended, restricted, had conditions placed uponthem or been voluntarily or involuntarily resigned, or against whom a clinicalprivilege action is pending at a health care facility, may apply for licensureprovided, however, the board may deny licensure based upon the revocation,suspension, restrictions, conditions, resignation of privileges or pendingclinical privilege action alone.

33-26-305. Annual renewal; expiration; reactivation of lapsed andinactive licenses; restoration of emeritus licenses to active status;duplicates.

(a) All licenses other than temporary licenses and medicaltraining licenses shall lapse annually on a date or dates to be established byrules adopted by the board. A licensee may renew his license each year by submittinga renewal application containing information required by the board, accompaniedby proof of compliance with and fulfillment of continuing medical educationrequirements of the board in the manner set forth in the board's continuingmedical education rules and regulations and a renewal fee to the board in anamount set by the board pursuant to W.S. 33-26-307. The licensee additionallyshall report any disciplinary action pending or taken by a state examiningboard, a health care entity or the grievance committee of a medical societyduring the preceding year.

(b) Repealed By Laws 2003, Ch. 190, 3.

(c) The board may reactivate a lapsed or inactive license ifthe applicant meets the requirements established by the rules and regulationspromulgated by the board.

(d) A licensee shall apply to the board for a duplicate licenseif his license is stolen, lost or destroyed. Upon proof of properidentification, the required fee and submission of other information as theboard may require, the board shall issue a duplicate license bearing on itsface the word "DUPLICATE".

(e) The board may restore an emeritus license to active statusif the applicant meets the requirements established by the rules andregulations promulgated by the board.

33-26-306. Repealed by Laws 1995, ch. 129, 2.

33-26-307. Fees.

(a) The board shall set by regulation appropriate licenseapplication, renewal and reactivation fees, examination fees and fees forinformation verification or document production and other services of the boardto be charged under this chapter.

(i) Repealed By Laws 2003, Ch. 190, 3.

(ii) Repealed By Laws 2003, Ch. 190, 3.

(iii) Repealed By Laws 2003, Ch. 190, 3.

(iv) Repealed By Laws 2003, Ch. 190, 3.

(v) Repealed By Laws 2003, Ch. 190, 3.

(vi) Repealed By Laws 2003, Ch. 190, 3.

(vii) Repealed By Laws 2003, Ch. 190, 3.

(b) All money received or collected under this chapter shall bepaid to the state treasurer for deposit in a separate account. The money in theaccount is subject at all times to the warrant of the state auditor drawn uponwritten requisition attested by the executive director of the board for thepayment of any board expenses.

ARTICLE 4 - INVESTIGATIONS AND DISCIPLINARY PROCEEDINGS

33-26-401. Board duties; investigation; interview.

(a) The board shall investigate, upon a written and signedcomplaint or by its own motion, any information that if proven would fallwithin the jurisdiction of the board and would constitute a violation of thisact.

(b) Before holding a contested case hearing, the board shallconduct an informal interview with the licensee unless the licensee waives aninterview.

(c) Notwithstanding any other provision of law the board mayrequire, by administrative subpoena, the testimony of licensees and witnessesand the production of evidence relating to any matter under investigation.

(d) All evidence admitted into the record of any contested casehearing held before the board shall be subject to the confidentialityprovisions set forth in W.S. 33-26-408 unless waived by the licensee.

(e) The board retains jurisdiction over only those licensees towhom temporary or full licenses were granted and who are subject to ongoinginvestigation by the board, regardless of whether the license expired, lapsedor was relinquished during or after the alleged occurrence of conductproscribed by W.S. 33-26-402 by the licensee.

33-26-402. Grounds for suspension; revocation; restriction; impositionof conditions; refusal to renew or other disciplinary action.

(a) The board may refuse to renew, and may revoke, suspend orrestrict a license or take other disciplinary action, including the impositionof conditions or restrictions upon a license on one (1) or more of thefollowing grounds:

(i) Renewing, obtaining or attempting to obtain or renew alicense by bribery, fraud or misrepresentation;

(ii) Impersonating another licensee or practicing medicine undera false or assumed name;

(iii) Making false or misleading statements regarding thelicensee's skill or the efficacy or value of his treatment or remedy for ahuman disease, injury, deformity, ailment, pregnancy or delivery of infants;

(iv) Permitting or allowing any person to use his diploma,license or certificate of registration;

(v) Advertising the practice of medicine in a misleading, falseor deceptive manner;

(vi) Obtaining any fee or claim for payment of a fee by fraud ormisrepresentation;

(vii) Sexual misconduct;

(viii) Conviction of or pleading guilty or nolo contendere to afelony or any crime that is a felony under Wyoming law in any jurisdiction;

(ix) Aiding or abetting the practice of medicine by a person notlicensed by the board;

(x) Violating or attempting to violate or assist in theviolation of any provision of this chapter or any other applicable provision oflaw;

(xi) Except as permitted by law, repeatedly prescribing oradministering, selling or supplying any drug legally classified as a narcotic,addicting or scheduled drug to a known abuser;

(xii) Repeatedly prescribing, selling, supplying or administeringany drug legally classified as a narcotic, addicting or scheduled drug to aparent, spouse or child of the applicant or licensee, or to himself;

(xiii) Presigning blank prescription forms;

(xiv) Failing or refusing to properly guard against the spread ofcontagious, infectious or communicable diseases;

(xv) Failure to appropriately supervise nonphysicians to whomthe licensee has delegated medical responsibilities;

(xvi) Delegating responsibilities to a person who is notqualified by training, experience or licensure;

(xvii) Delegating medical responsibilities to a person who isunable to safely, skillfully and competently provide medical care to patientsor that are beyond the scope of the specialty areas in which the licensee andthe person are trained and experienced;

(xviii) Willful and consistent utilization of medical service ortreatment which is inappropriate or unnecessary;

(xix) A manifest incapacity to practice medicine with reasonableskill and safety to patients;

(xx) Possession of any physical or mental disability includingdeterioration due to aging which renders the practice of medicine unsafe;

(xxi) Use of a drug or intoxicant to such a degree as to renderthe licensee unable to practice medicine or surgery with reasonable skill andsafety to patients;

(xxii) Practicing medicine below the applicable standard of care,regardless of causation or damage;

(xxiii) Failure to submit to an informal interview or a mental,physical or medical competency examination following a proper request by theboard pursuant to W.S. 33-26-403;

(xxiv) Failure to report a personal injury claim as required byW.S. 33-26-409;

(xxv) Suspension, probation, imposition of conditions orrestrictions, relinquishment, surrender or revocation of a license to practicemedicine in another jurisdiction;

(xxvi) Any action by a health care entity that:

(A) Adversely affects clinical privileges for a period ofthirty (30) or more consecutive days;

(B) Results in the surrender of clinical privileges to thehealth care entity while the licensee is under investigation by the health careentity for possible professional incompetence or improper professional conduct;or

(C) Results in the surrender of clinical privileges in returnfor the health care entity not conducting an investigation for possibleprofessional incompetence or improper professional conduct.

(xxvii) Unprofessional or dishonorable conduct not otherwise specifiedin this subsection, including but not limited to:

(A) Repealed By Laws 2003, Ch. 190, 3.

(B) Failure to conform to the applicable standard of care;

(D) Engaging in any conduct or practice that is harmful ordangerous to the health of a patient or the public;

(E) Engaging in conduct intended to or likely to deceive,defraud or harm the public;

(F) Using any false, fraudulent or deceptive statement in anydocument connected with the practice of medicine including the intentionalfalsification or fraudulent alteration of a patient or health care facilityrecord;

(G) Failing to prepare and maintain legible and completewritten medical records that accurately describe the medical services renderedto the patient, including the patient's history, pertinent findings,examination, results, test results and all treatment provided;

(H) Practicing outside of the scope of the licensee's expertiseand training;

(J) Repeatedly engaging in harassing, disruptive or abusivebehavior directed at staff, co-workers, a patient or a patient's relative orguardian or that interferes with the provision of patient care;

(K) Engaging in conduct that constitutes moral turpitude,including but not limited to conviction of or pleading guilty or nolocontendere to domestic abuse, stalking, sexual assault, sexual abuse orunlawful exploitation of a minor, indecent exposure, incest or distribution ofpornography;

(M) Failing or neglecting to attempt to inform a patient withina reasonable time of the results of a laboratory test indicating the need forfurther clinical review;

(N) Improperly terminating a physician-patient relationship;

(O) Representing that a manifestly incurable disease orcondition can be permanently cured or that any disease or condition can becured by a secret method, procedure, treatment, medicine or device if therepresentation is untrue;

(P) Intentionally or negligently releasing or disclosingconfidential patient information. This restriction shall not apply todisclosures permitted or required by state or federal law or when disclosure isnecessary to prevent imminent risk of harm to the patient or others;

(Q) Failing or refusing to transfer a copy of patient recordsto the patient or the patient's legally designated representative within thirty(30) days after receipt of a written request;

(R) Utilization of experimental forms of therapy without properinformed consent from the patient, without conforming to generally-acceptedcriteria or standard protocols, without keeping detailed, legible records orwithout having periodic analysis of the study and results reviewed by acommittee of peers;

(S) Except in emergency situations where the consent of thepatient or the patient's legally designated representative cannot be reasonablyobtained, assisting in the care or treatment of a patient without the consentof the patient, the attending physician or the patient's legal representative;

(T) Using or engaging in fraud or deceit to obtain third partyreimbursement.

(xxviii) Upon proper request by the board, failure or refusal toproduce documents or other information relevant to any investigation conductedby the board, whether the complaint is filed against the licensee or any otherlicensee;

(xxix) Repealed By Laws 2003, Ch. 190, 3.

(xxx) Repealed By Laws 2003, Ch. 190, 3.

(xxxi) Violation of any board rule or regulation;

(xxxii) Acquiring or attempting or conspiring to acquire any drugclassified as a narcotic, addicting or scheduled drug by fraud or deception;

(xxxiii) Initially prescribing any controlled substance specified inW.S. 35-7-1016 through 35-7-1022 for any person through the Internet, the WorldWide Web or a similar proprietary or common carrier electronic system absent adocumented physician-patient relationship;

(xxxiv) Violating any final order, consent decree or stipulationbetween the board and the licensee.

(b) Upon a finding of ineligibility for licensure or refusal togrant a license under subsection (a) of this section, the board shall file itswritten order and findings.

33-26-403. Impaired physicians.

(a) The board may order a licensee to undergo one (1) or moremental, physical or medical competency examinations by examiners deemedappropriate by the board if it has reasonable cause to believe that thelicensee may be impaired. If a disciplinary proceeding is pending against thelicensee at the time of the order, the proceeding shall be stayed until theresults of the examination have been finalized and submitted to the board.

(b) Every licensee is deemed to have consented to and shallsubmit to a board ordered mental, physical, or medical competency examinationand to have waived all objections to the production of the report of theexamination to the board and the admissibility of the report of the examinationin any board proceedings in which the licensee is or may become a respondent. If a licensee fails to submit to an examination when ordered by the board, theboard may initiate a disciplinary proceeding against the licensee or amend apending complaint to include a claim based upon a violation of this section.

(d) The licensee may submit additional information to theboard, including but not limited to medical reports, consultations orlaboratory reports obtained through an examination performed by a practitionerdesignated by the licensee.

(e) The results of any board ordered mental, physical competencyor medical competency examination shall be provided to the licensee and theboard prior to any further board action.

33-26-404. Voluntary and mandatory revocation; restriction; suspension.

(a) A licensee may request the board, in writing, to accept thevoluntary relinquishment, restriction or suspension of his license. The boardmay, but shall not be required to accept the relinquished license, grant therequest for restriction or suspension, attach conditions to the license orwaive the commencement of any proceedings under this article. Removal of avoluntary relinquishment, restriction or suspension is subject to the procedurefor reinstatement of a license as provided in this article.

(b) Unless the board and the licensee have agreed to therelinquishment of or imposition of restrictions or conditions on a license, theboard shall conduct a proceeding to refuse to renew or reinstate, revoke,restrict or suspend a license on the grounds set forth in W.S. 33-26-402(a) asa contested case under the Wyoming Administrative Procedure Act.

(d) Upon receipt from the department of family services of acertified copy of an order from a court to withhold, suspend or otherwiserestrict a license issued by the board, the board shall notify the party namedin the court order of the withholding, suspension or restriction of the licensein accordance with the terms of the court order. No appeal under the WyomingAdministrative Procedure Act shall be allowed for a license withheld, suspendedor restricted under this subsection.

33-26-405. Order of the board.

(a) Following a hearing to refuse to renew or reinstate,revoke, restrict or suspend a license on the grounds set forth in W.S.33-26-402(a), the board shall enter its order and findings pursuant to theWyoming Administrative Procedure Act. The board may take one (1) or more of thefollowing actions:

(i) Dismiss the proceedings;

(ii) Issue a public or private reprimand;

(iii) Order probation and provide terms;

(iv) Impose a civil fine not exceeding twenty-five thousanddollars ($25,000.00);

(v) Suspend the license;

(vi) Revoke the license;

(vii) Place restrictions on the license;

(viii) Assess part or all of the cost of the proceeding against adisciplined licensee;

(ix) Take other action as the board in its discretion findsproper;

(x) Place the licensee on probation.

(b) Restriction of a license may include, but is not limitedto, the following:

(i) Restricting the practice to certain areas of medicine orforbidding the practice of certain areas of medicine;

(ii) Requiring the licensee to practice medicine under thesupervision of another physician in a clinic or other controlled setting, andsetting the conditions of the licensee's practice of medicine;

(iii) Forbidding the use of certain medical procedures withoutconsultation with and approval by another physician.

33-26-406. Reinstatement of license; removal of restrictions orconditions from a license.

(a) A person whose license has been voluntarily relinquished,revoked, restricted or suspended, or had conditions or restrictions placed uponhis license, voluntarily or by action of the board, may petition forreinstatement of his license or for removal of any restrictions or conditionsplaced upon his license pursuant to W.S. 33-26-405 not less than six (6) monthsafter final judicial review of a board order accepting relinquishment of, or revoking,restricting, placing conditions upon or suspending the petitioner's license orsix (6) months after the date of the board order if there is no judicialreview.

(b) The petitioner shall submit a petition in writing to theboard that, at a minimum, sets forth and provides information regarding thepetitioner's fulfillment of any and all conditions or compliance with allrestrictions imposed upon petitioner by any prior order of the board or successin correcting the conduct that formed the basis for revocation orrelinquishment of petitioner's license.

(c) Upon receipt of the petition, the board shall set thematter for hearing in accordance with the provisions of the WyomingAdministrative Procedure Act. The burden of proof upon the petitioner at thehearing shall be to demonstrate, by a preponderance of evidence, that:

(i) Petitioner has corrected the conduct that formed the basisfor the revocation or relinquishment of petitioner's license and thatpetitioner is able to safely, skillfully and competently resume the practice ofmedicine; or

(ii) Petitioner has fulfilled all conditions or complied withall restrictions imposed upon petitioner by any prior order of the board, hasotherwise corrected the conduct or condition which formed the basis for therestrictions or conditions placed on petitioner's license and is able tosafely, skillfully and competently practice medicine in this state.

(d) After a hearing conducted pursuant to subsection (c) ofthis section, the board shall issue specific findings of facts, conclusions oflaw and a final order:

(i) Reinstating the license;

(ii) Reinstating the license subject to restrictions orconditions;

(iii) Removing or modifying the restrictions or conditions of thelicense; or

(iv) Denying reinstatement of the license or removal of therestrictions or conditions on the license.

(e) Any final order issued by the board hereunder shall besubject to judicial review as provided for by W.S. 33-26-407.

(f) If the board denies a reinstatement or removal ofrestrictions or conditions, future petitions for reinstatement or removal ofrestrictions or conditions may be submitted not less than one (1) year afterthe board's final order denying reinstatement or removal of restrictions orconditions.

(g) Notwithstanding subsections (a) through (d) of thissection, if a license is suspended under W.S. 33-26-404(d), the license may bereissued without a hearing as provided in this section upon receipt from thedepartment of family services of notice that the applicant has complied withthe terms of the court order that resulted in the suspension or restriction ofthe license under W.S. 33-26-404(d).

33-26-407. Judicial review.

(a) Judicial review of the findings of the board may beobtained pursuant to the Wyoming Administrative Procedure Act. All finaladministrative orders of the board shall remain effective pending any judicialreview, except where the board finds that the licensee's continued practicepresents no danger to the public.

(b) In any disciplinary proceeding against a licensee, theboard shall bear the burden of proving a violation of this act by clear andconvincing evidence.

33-26-408. Protected action and communication.

(a) There shall be no liability on the part of and no actionfor damages against:

(i) Board and examination committee members acting within thescope of their functions without malice and in the reasonable belief that theiractions were warranted;

(ii) Any person providing information voluntarily or pursuant toa subpoena, in good faith to a peer review committee or in good faith to theboard or the examining committee without malice and in reasonable belief thatthe information is accurate.

(b) All board records shall be maintained and protected fromharm.

(c) Final findings of fact, conclusions of law, orders of theboard entered and any consent decree, stipulation or agreement to which theboard is a party in any disciplinary docket of the board are public documents.The board may order, under special circumstances and upon entry of specificfindings setting forth those circumstances, that a consent decree, stipulationor agreement to which the board is a party in any disciplinary docket is not apublic document.

(d) The board shall promptly report and provide all finalorders entered by it to the chief of the medical staff and hospitaladministrator of each hospital in which the licensee has medical staffprivileges and to all appropriate agencies including the federation of statemedical boards, the national practitioner data bank and other state medicalboards.

(e) This section shall not be construed to prohibit the UnitedStates or the state of Wyoming from obtaining information from the boardconcerning a physician who is the subject of a criminal investigation. Uponpetition to a state or federal district court, supported by affidavit, thejudge may order the Wyoming board of medicine to release records of anyproceedings, testimony of witnesses and reports or investigation for in-camerainspection by the judge, or the judge may deny the petition for failure to showgood cause. The petition shall state the nature of the criminal investigationand the identity of the physician who is under investigation. If the judgegrants the petition and orders the board to produce the board's records forin-camera inspection, the board shall comply within ten (10) days after entryof the order or as otherwise ordered by the court. Upon receipt of therecords, the judge shall inspect them to determine what material, if any, isrelevant to the criminal investigation. Material deemed to be relevant shallbe made available to the investigation if otherwise admissible under theWyoming Rules of Evidence. All records and material deemed by the court to beirrelevant or otherwise inadmissible under the Wyoming Rules of Evidence shallbe returned to the board and the contents thereof shall not be divulged.

(f) The following documents are not public documents and arenot subject to disclosure by the board to any person or entity nor are theysubject to discovery in any civil or administrative action or admissible in anynonboard proceeding except when necessary for further board action, in anyaction in which the board may be named as a party or upon judicial review of aboard order:

(i) Investigative notes, attorney's notes and work product andreports, pleadings, correspondence, witness statements and depositiontranscripts and copies of original medical and prescription records in thepossession of the board, whether acquired by the board, by any agent of theboard or by any agency that has cooperated with or provided information to theboard regarding the investigation of a disciplinary docket; and

(ii) Any and all records of the board regarding licensureapplications and proceedings thereon.

(g) A respondent in a disciplinary case shall not be entitledto copies of investigative material unless the material is relevant to anongoing investigation or a contested case hearing.

(h) The confidentiality of all documents and informationdescribed in this section shall exist and continue regardless of whether theconfidential material is in the custody of any agency of the United States orany other agency of the state of Wyoming with whom the board has cooperated oris cooperating in an investigation.

(j) This section shall not be construed to prohibit the boardfrom publishing in a directory or otherwise disclosing, general informationabout its licensees and former licensees including names, practice addresses,dates of licensure, licensure by other states, areas of practice, education,training and specialty board certifications.

33-26-409. Health care entity reports required; malpractice.

(a) Each health care entity shall report:

(i) Any action it takes against a licensee on the grounds thatthe licensee is impaired, or has engaged in conduct constituting a ground fordisciplinary action in W.S. 33-26-402;

(ii) Any action that:

(A) Adversely affects the clinical privileges of a licensee fora period exceeding thirty (30) days;

(B) Accepts the surrender of a physician's clinical privilege:

(I) While the licensee is under investigation by the entity forpossible incompetence or improper professional conduct; or

(II) In return for not conducting an investigation as specifiedin this subparagraph; or

(C) In the case of an entity which is a professional society,takes a professional review action which adversely affects the membership of alicensee in the society.

(b) Each licensee shall report to the board any personal injuryor wrongful death claim made because of any alleged act, error or omission ofthe licensee. Failure to report the claim shall be grounds for disciplinaryaction by the board. As used in this subsection, "claim" means aproperly filed complaint with the district court which names the licensee asdefendant or a third party defendant and alleges that damages sustained by theplaintiff are due to an alleged act, error or omission of the licensee whileengaged in the practice of medicine.

(c) Each insurer providing health care professional liabilityinsurance in this state shall report to the board all claims for which areserve has been established against a licensee. Reports required by thissubsection shall be made within sixty (60) days of the time the claim comes tothe attention of the insurer.

(d) Other reports required by this section shall be made withinninety (90) days of the time the claim comes to the attention of the personresponsible for reporting. Reports shall be in the form and contain informationrequired by the board. Any entity or person subject to the reportingrequirements of this section shall be subject to a fine up to one hundreddollars ($100.00) for each violation of this section. Each day that arequirement of this section is not met shall constitute a separate violation.In the event that the board is required to bring a civil action to enforce thissection, the violating party shall additionally be liable to the board for allreasonable attorney's fees and costs incurred by the board in prosecuting theaction.

33-26-410. Effect of violation.

(a) Any person engaged in the practice of medicine or aidingand abetting another in the practice of medicine without a license granted by theboard is guilty of a misdemeanor and upon conviction shall be