As Introduced

136th General Assembly

Regular Session H. B. No. 763

2025-2026

To amend section 4731.281 and to enact sections 4731.2911, 4731.2912, and 4731.2913 of the Revised Code to authorize the State Medical Board to issue limited licenses to certain international physicians.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section 1. That section 4731.281 be amended and sections 4731.2911, 4731.2912, and 4731.2913 of the Revised Code be enacted to read as follows:

Sec. 4731.281. (A)(1) A license issued under this chapter to practice medicine and surgery, osteopathic medicine and surgery, or podiatric medicine and surgery shall be valid for a two-year period unless revoked or suspended. A license shall expire on the date that is two years from the date of issuance and, except as provided in section 4731.2911 of the Revised Code, may be renewed for additional two-year periods. Applications for renewal shall be submitted to the state medical board in a manner prescribed by the board.

Each application shall be accompanied by a biennial renewal fee of three hundred five dollars.

The board shall deposit the fee in accordance with section 4731.24 of the Revised Code, except that the board shall deposit twenty dollars of the fee into the state treasury to the credit of the physician loan repayment fund created by section 3702.78 of the Revised Code.

(2) The board shall provide a renewal notice to every person holding a license to practice medicine and surgery, osteopathic medicine and surgery, or podiatric medicine and surgery, a renewal notice. The board may provide the notice to the person through the secretary of any recognized medical, osteopathic, or podiatric society. The notice shall be provided to the person at least one month prior to the date on which the person's license expires.

(3) Failure of any person to receive a notice of renewal from the board shall not excuse the person from the requirements contained in this section.

(4) The board's notice shall inform the applicant of the renewal procedure. The board shall provide the application for renewal in a form determined by the board.

(5) The applicant shall provide in the application the applicant's full name; the applicant's residence address, business address, and electronic mail address; the number of the applicant's license to practice; and any other information required by the board.

(6)(a) Except as provided in division (A)(6)(b) of this section, in the case of an applicant who prescribes or personally furnishes opioid analgesics or benzodiazepines, as defined in section 3719.01 of the Revised Code, the applicant shall certify to the board whether the applicant has been granted access to the drug database established and maintained by the state board of pharmacy pursuant to section 4729.75 of the Revised Code.

(b) The requirement described in division (A)(6)(a) of this section does not apply if any of the following is the case:

(i) The state board of pharmacy notifies the state medical board pursuant to section 4729.861 of the Revised Code that the applicant has been restricted from obtaining further information from the drug database.

(ii) The state board of pharmacy no longer maintains the drug database.

(iii) The applicant does not practice medicine and surgery, osteopathic medicine and surgery, or podiatric medicine and surgery in this state.

(c) If an applicant certifies to the state medical board that the applicant has been granted access to the drug database and the board finds through an audit or other means that the applicant has not been granted access, the board may take action under section 4731.22 of the Revised Code.

(7) The applicant shall indicate whether the applicant currently collaborates, as that term is defined in section 4723.01 of the Revised Code, with any clinical nurse specialists, certified nurse-midwives, or certified nurse practitioners.

(8) The applicant shall report any criminal offense to which the applicant has pleaded guilty, of which the applicant has been found guilty, or for which the applicant has been found eligible for intervention in lieu of conviction, since last submitting an application for a license to practice or renewal of a license.

(9) The applicant shall execute and deliver the application to the board in a manner prescribed by the board.

(B) The board shall renew a license under this chapter to practice medicine and surgery, osteopathic medicine and surgery, or podiatric medicine and surgery upon application and qualification therefor in accordance with this section. A renewal shall be valid for a two-year period.

(C) Failure of any license holder to renew and comply with this section shall operate automatically to suspend the holder's license to practice and if applicable, the holder's certificate to recommend issued under section 4731.30 of the Revised Code. Continued practice after the suspension shall be considered as practicing in violation of section 4731.41, 4731.43, or 4731.60 of the Revised Code.

If the license has been suspended pursuant to this division for two years or less, it may be reinstated. The board shall reinstate a license to practice suspended for failure to renew upon an applicant's submission of a renewal application and payment of a reinstatement fee of four hundred five dollars.

If the license has been suspended pursuant to this division for more than two years, it may be restored. Subject to section 4731.222 of the Revised Code, the board may restore a license to practice suspended for failure to renew upon an applicant's submission of a restoration application, payment of a restoration fee of five hundred five dollars, and compliance with sections 4776.01 to 4776.04 of the Revised Code. The board shall not restore to an applicant a license unless the board, in its discretion, decides that the results of the criminal records check do not make the applicant ineligible for a license issued pursuant to section 4731.14 or 4731.56 of the Revised Code.

Any reinstatement or restoration of a license to practice under this section shall operate automatically to renew the holder's certificate to recommend.

(D) The state medical board may obtain information not protected by statutory or common law privilege from courts and other sources concerning malpractice claims against any person holding a license to practice under this chapter or practicing as provided in section 4731.36 of the Revised Code.

(E) Each renewal notice provided by the board under division (A)(2) of this section to a person holding a license to practice medicine and surgery or osteopathic medicine and surgery shall inform the applicant of the reporting requirement established by division (H) of section 3701.79 of the Revised Code. At the discretion of the board, the information may be included on the application for renewal or on an accompanying page.

(F) Each person holding a license to practice medicine and surgery, osteopathic medicine and surgery, or podiatric medicine and surgery shall give notice to the board of a change in the license holder's residence address, business address, or electronic mail address not later than thirty days after the change occurs.

Sec. 4731.2911. (A) As used in this section, "world directory of medical schools" means the directory of medical schools maintained by the world federation for medical education and the foundation for advancement of international medical education and research or their successor organizations.

(B) With respect to an individual educated, trained, and licensed as a physician in a country other than the United States or Canada, the state medical board may issue to the individual a limited license to practice medicine and surgery or osteopathic medicine and surgery in this state.

An individual who seeks a limited license under this section shall submit to the board a written application on a form prescribed and supplied by the board. The application shall include all the information the board considers necessary to process it. An applicant shall include with the application a fee of three hundred five dollars, no part of which may be returned. An application is not considered submitted until the board receives the fee.

(C) To be eligible for a limited license under this section, an applicant shall submit evidence to the board demonstrating that all of the following are the case:

(1) The applicant has completed both of the following:

(a) Requirements for a degree in medicine from a medical school listed in either the world directory of medical schools or another such listing or directory approved by the board;

(b) Post-graduate medical training that the board determines is similar to that required for licensure in this state or another state and that involves practice in the following six general competency domains: interpersonal and communication skills; medical knowledge; patient care and procedural skills; practice-based learning and improvement; professionalism; and systems-based practice.

(2) The applicant held, either at the time of the applicant's departure from the applicant's country of training or within the three years immediately preceding the date the application is submitted, an unrestricted license to practice medicine and surgery or osteopathic medicine and surgery issued by the licensing authority of either of the following:

(a) A country other than the United States or Canada;

(b) A province or state located in a country other than United States or Canada.

(3) The applicant satisfies any of the following:

(a) Has practiced medicine and surgery or osteopathic medicine and surgery under the license described in division (C)(2) of this section for at least three of the last five years immediately preceding the date the application is submitted or for another practice period acceptable to the board;

(b) Following completion of the requirements and training described in division (C)(1) of this section, actively practiced medicine and surgery or osteopathic medicine and surgery for at least ten years under a license to practice medicine and surgery or osteopathic medicine and surgery issued by a country, province, or state described in division (C)(2) of this section;

(4) The applicant does not have any pending discipline before the licensing authority described in division (C)(2) of this section.

(5) The applicant holds a valid certification issued by the educational commission on foreign medical graduates or an equivalent certification as determined by the board.

(6) The applicant has successfully passed steps one and two of the United States medical licensing examination or comprehensive osteopathic medical licensing examination of the United States.

(7) The applicant has an offer of full-time employment as a physician from a participating health care entity that meets the requirements of division (D) of this section.

(8) The applicant is eligible to obtain from the United States government an immigrant status that authorizes employment as a physician in the United State.

(9) The applicant is in compliance with section 4731.08 of the Revised Code.

For purposes of division (C)(2) of this section, the applicant shall submit as evidence a copy of the license described in that division. For purposes of division (C)(7) of this section, the applicant shall submit as evidence a copy of the participating health care entity's offer of full-time employment.

If any evidence to be submitted under this division is expressed in a language other than English, the applicant shall submit two copies of that evidence, one in the language other than English and another translated into English.

(D) A participating health entity shall meet all of the following requirements:

(1) The participating health entity shall be any of the following located in this state: a hospital, federally qualified health center, community health center, or other entity providing health services acceptable to the board.

(2) Subject to division (E) of this section, the participating health entity shall assess and evaluate the holder's practice.

(3) The participating health entity shall employ, to serve as a limited license holder's evaluator, one or more individuals meeting the following conditions: each individual holds a current, valid license to practice medicine and surgery or osteopathic medicine and surgery issued under section 4731.14 of the Revised Code, and each individual has been granted institutional privileges by the entity.

(4) The participating health entity shall carry medical malpractice insurance that covers a limited license holder for the duration of the holder's full-time employment with the entity.

(5) The participating health entity shall not retaliate against or discipline a limited license holder for raising a complaint or pursuing enforcement related to the holder's full-time employment with the entity.

(E) A participating health entity shall assess and evaluate the practice of each limited license holder it employs, including at the commencement and end, and over the duration, of the holder's employment. A participating health entity also shall establish a program for such assessments and evaluations, which may include the development of assessment and evaluation measures.

In meeting the requirements of this division, a participating health entity shall assess and evaluate each holder's practice and competency as follows:

(1) In accordance with criteria established by the board in rule;

(2) In accordance with any assessment and evaluation measures developed under the entity's program;

(3) Across the six general competency domains described in division (C)(1)(b) of this section.

If a holder's assessment or evaluation identifies any practice deficiencies, the participating health entity and holder shall engage in efforts to address them.

(F) The secretary and supervising member of the board shall review each application submitted to determine if the requirements of divisions (B) and (C) of this section have been met. In conducting such a review, the secretary and supervising member shall not be responsible for verifying the applicant's status as described in division (C)(8) of this section. If the secretary and supervising member determine that an applicant meets the requirements of divisions (B) and (C) of this section, the board shall issue a limited license to the applicant.

(G) After the board issues a limited license, all of the following apply to the board or a license holder or participating health care entity:

(1) Before commencing employment with a participating health entity described in division (C)(7) of this section, the holder shall obtain from the United States government an immigrant status that authorizes employment as a physician.

(2) At the commencement of a holder's employment with a participating health care entity described in division (C)(7) of this section, the participating health care entity shall assess and evaluate the holder as described in divisions (D)(2) and (E) of this section.

(3) The holder shall notify the board of any change to the holder's employment that occurs during the two-year period in which the holder's limited license remains valid.

(4) Every six months over the course of the two-year license period and also on the request of the board, the holder shall submit to the board a statement certifying whether the holder has maintained full-time employment as a physician with a participating health entity and whether the holder has been subject to employer discipline because of the holder's practice.

(5) The holder may be employed by any participating health entity that meets the requirements of division (D) of this section, and the board shall not require the holder to maintain full-time employment with the participating health entity described in division (C)(7) of this section.

(6) At the end of a holder's employment with a participating health entity and as part of the assessment and evaluation performed at that time as described in division (E) of this section, the participating health entity shall submit to the board a written recommendation regarding the holder's fitness for a converted license.

(H)(1) A limited license issued under this section expires on the date that is two years from the date of its issuance and may be renewed only once for an additional two-year period. During an initial or additional two-year period, such a license may be revoked, suspended, or limited or its holder may be reprimanded or placed on probation as described in division (I) of this section.

(2) At least one month prior to the date on which an initial two-year period expires, the board shall provide notice to the limited license holder that the license may be renewed for an additional period or converted to a license to practice medicine and surgery or osteopathic medicine and surgery issued under section 4731.14 of the Revised Code.

(3) At least one month prior to the date on which an additional two-year period expires, the board shall provide notice to the license holder that the limited license may be converted to a license to practice medicine and surgery or osteopathic medicine and surgery issued under section 4731.14 of the Revised Code.

(4) To be eligible for renewal of a limited license, the license holder shall pay to the board a renewal fee of three hundred five dollars, no part of which may be returned, and shall demonstrate to the board that the holder has maintained over the course of the license period full-time employment as a physician with a participating health entity.

If the holder pays the fee and makes such a demonstration prior to the limited license's expiration date, the board shall renew the limited license for one additional two-year period.

(5) To be eligible to convert a limited license to a license issued under section 4731.14 of the Revised Code, the limited license holder shall pay to the board a conversion fee of three hundred five dollars, no part of which may be returned, and shall submit evidence to the board demonstrating that the holder has done all of the following:

(a) Maintained over the course of each license period full-time employment as a physician with a participating health entity;

(b) Successfully passed step three of the United States medical licensing examination or comprehensive osteopathic medical licensing examination of the United States;

(c) Successfully completed each of the holder's participating health entity's assessments and evaluations described in division (E) of this section;

(d) Successfully addressed any practice deficiencies identified by an assessment and evaluation program as described in division (E) of this section;

(e) Successfully engaged in independent and unsupervised practice in the six general competency domains described in division (C)(1)(b) of this section.

If the holder pays the fee and makes such a demonstration prior to the limited license's expiration date, the board shall convert the limited license to a license issued under section 4731.14 of the Revised Code, unless a recommendation described in division (G)(6) of this section demonstrates to the board that the holder is not fit for such a license.

After a limited license is converted to a license issued under section 4731.14 of the Revised Code, the license is then subject to the renewal schedule and requirements described in section 4731.281 of the Revised Code.

(I)(1) The board may revoke, suspend, limit, or refuse to renew or reinstate a limited license issued under this section, or reprimand or place on probation the holder of such a license, if the holder fails to maintain full-time employment as a physician with a participating entity at any point during the two-year period in which the holder's limited license remains valid.

(2) The board also may revoke, suspend, limit, or refuse to issue, renew, or reinstate a limited license issued under this section, or reprimand or place on probation the holder of such a license, for any of the reasons specified in division (B) of section 4731.22 of the Revised Code.

(3) Any action taken under division (I)(1) or (2) of this section shall be be taken in accordance with Chapter 119. of the Revised Code.

(J) The board shall adopt rules to establish criteria by which a participating health entity shall assess and evaluate the medical practice of a limited license holder.The board may adopt additional rules as necessary to implement this section. All rules shall be adopted in accordance with Chapter 119. of the Revised Code.

Sec. 4731.2912. (A) The state medical board may require a participating health care entity, as described in section 4731.2911 of the Revised Code, to provide the board with data and other information that the entity maintains concerning the effectiveness of the entity's assessment and evaluation program established under division (E) of section 4731.2911 of the Revised Code. Such data and information shall be provided to the board in the manner the board prescribes.

(B) On receipt of data and other information under this section, the board may share it with any other entities that the board considers appropriate and shall include it in the board's annual report required by section 149.01 of the Revised Code. In sharing and reporting under this division, the board shall not include data or information that identifies, or tends to identify, any particular individual.

Sec. 4731.2913. (A) As used in this section, "accreditation council for graduate medical education" means the organization known by that name or its successor organization.

(B) The state medical board shall appoint a council for the purpose of advising the board on issues relating to physicians practicing in this state but trained in countries other than the United States and Canada, in particular, physicians holding limited licenses issued under section 4731.2911 of the Revised Code. The council shall consist of both of the following:

(1) Members with experience in recruiting or employing internationally trained physicians. Such members shall include representatives of physician residency programs and individuals familiar with residency and fellowship program education standards established by the accreditation council for graduate medical education.

(2) Members with experience in assessing or evaluating the practice of internationally trained physicians. Such members shall include representatives of programs established by participating health entities under division (E) of section 4731.2911 of the Revised Code.

(1) Determine the council's total number of members;

(2) Appoint the council's membership;

(3) Establish the council's duties, which shall include issuing recommendations to the board to assist it in determining the practice eligibility of applicants seeking limited licenses under section 4731.2911 of the Revised Code;

(4) Specify the frequency of council meetings, which may be conducted remotely.

Section 2. That existing section 4731.281 of the Revised Code is hereby repealed.