ALBME

Significant New/Amended Rules

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The Board and Commission proposed new rules to formally state the requirements in Alabama Acts No. 2021-100 for expedited MD/DO/PA/AA temporary licenses for military members and their spouses and to establish application procedures.

Temporary licenses may be issued on an expedited basis to qualified applicants for a twelve month period so that these military members and their spouses can begin to work while applying for permanent licensure.


540-X-9-.10, Joint Guidelines for Medical Records Management

Proposed amendments to the joint guidelines of the Board and Commission concerning medical records management clarify and expand requirements for retention, destruction, and disposition of medical records. Comment period ends Oct. 5, 2021.


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Proposed amendments to multiple rules in Chapter 540-X-7, Assistants to Physicians, were made to mirror the earlier changes to the Advanced Practice Nurses:  Collaborative Practice rules. 

The FTE expansion was adopted on an emergency basis on June 14, 2021, so that all collaborative/supervisory agreements would be affected on the same date.  These rule amendments make the remaining changes to the PA/AA rules to match recent changes to the CRNP/CNM rules.

For a detailed description, see Changes to Advanced Practice Nurses:  Collaborative Practice Rules Effective June 14, 2021 below.


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540-X-8-.01   Definitions:  Added definition for Covering Physician

  • Agrees in writing to be readily available to collaborative/provide medical oversight and direct medical intervention if needed
  • Covering Physician must be in same medical practice, practice group, or multidisciplinary medical team, or of the same or similar practice specialty as the collaborating physician

540-X-8-.03/.17 Qualifications for Approval to Practice as a Certified Registered Nurse Practitioner/as a Certified Nurse Midwife

  • *EFFECTIVE JANUARY 2024* added provision to obtain CME prescribed by Board of Nursing between 48 months prior to or within 12 months of commencement of a collaborative practice

540-X-8-.04/.18 Qualifications for Physicians in Collaborative Practice with Certified Registered Nurse Practitioners/Certified Nurse Midwives

  • Removed "board eligible" as a qualification
  • Adds as a qualification practice for one year AND the collaborative practice site is limited to licensed hospital
  • *EFFECTIVE JAN. 1, 2024* added provision to obtain CME prescribed by Board of Medical Examiners between 48 months prior to or within 12 months of commencement of a collaborative practice

540-X-8-.08/.22 Requirements for Collaborative Practice by Physicians and Certified Registered Nurse Practitioners/Certified Nurse Midwives

  • Added provision for collaborating physician to be readily available at each practice site or for provisions to be made for professional oversight/direction by a covering physician
  • Collaborating physician shall certify annually that any covering physician continues to agree to serve in that capacity/will inform the medical board of the termination of a covering physician within 10 days

540-X-8-.12/.26 Limitations upon Utilization of Certified Registered Nurse Practitioners/Certified Nurse Midwives

  • Amended maximum number of allowed supervisory and collaborative agreements from 160 hours/four FTEs to 360 hours/nine FTEs (combination of CRNPs/CNMs/PAs)
  • If collaborating with more than four FTEs/week, must engage in documented QA review with each CRNP/CNM every month for six months after commencement
  • Physician must disclose existence of all supervisory and collaborative agreements

540-X-7-.26, Limitations upon Utilization of Physician Assistants (Emergency Rule Amendment Effective June 14, 2021; permanent rule anticipated effective date Oct. 15, 2021)

  • Amended maximum number of allowed supervisory and collaborative agreements from 160 hours/four FTEs to 360 hours/nine FTEs (combination of CRNPs/CNMs/PAs)
  • If collaborating with more than four FTEs/week, must engage in documented QA review with each P.A. every month for six months after approval of the registration agreement
  • Physician must disclose existence of all supervisory and collaborative agreements