Arizona Board Board of Medical Examiners


Medical Doctors Rules

Protecting the Public's Health
Arizona Board of Medical Examiners
9545 E. Doubletree Ranch Rd.
Scottsdale, AZ 85258-5539   480-551-2700
(Toll Free Within Arizona: 877-255-2212)


ARIZONA ADMINISTRATIVE CODE
Title 4
PROFESSIONS AND OCCUPATIONS
Chapter 16
BOARD OF MEDICAL EXAMINERS
Pursuant to the Statutory Authority of
A.R.S. 32-1401 et seq.
 
ARTICLE 1
GENERAL PROVISIONS
R4-16-101 Continuing medical education
 

A. A physician holding an active license to practice medicine in this state shall complete 40 credit hours of the continuing medical education required by A.R.S. §32-1434 during the two calendar years preceding biennial registration. A physician may not carry excess hours over to another two-year cycle. One hour of credit is allowed for each clock hour of participation in Board approved continuing medical education activities, unless otherwise designated in subsection (B).

B. A physician may claim continuing medical education for the following:

1. Participating in an internship, residency, or fellowship a teaching institution approved by the American Medical Association, the Association of American Medical Colleges, or the American Osteopathic Association. A physician may claim one credit hour of continuing medical education for each day of training in a full-time approved program, or for a less than full-time training on a pro-rata basis. In this subsection teaching institutions define "full-time."

2. Participating in an education program for an advanced degree in a medical or medically related field in a teaching institution approved by the American Medical Association, the Association of American Medical Colleges, or the American Osteopathic Association. A physician may claim one credit hour of continuing medical education for each l day of full-time study or less than a full-time study on a pro-rata basis. In this subsection teaching institutions define "full-time".

3. Participating in full-time research in a teaching institution approved by the American Medical Association, or the Association of American Medical Colleges, or the American Osteopathic Association. A physician may claim one credit hour of continuing medical education for each l day of full-time research, or than full-time research on a pro-rata basis. In this subsection teaching institutions define "full-time".

4. Participating in an education program certified as Category 1 by an organization accredited by the Accreditation Council for Continuing Medical Education, 515 North State Street, Suite 2150, Chicago, Illinois 60610.

5. Participating in a medical education program designed to provide understanding of current developments, skills, procedures, or treatments related to the practice of medicine, that is provided by an organization or institution accredited by the Accreditation Council for Continuing Medical Education.

6. Serving as an instructor of medical students, house staff, other physicians, or allied health professionals from a hospital or other health care institution with a formal training program, if the instructional activities provide the instructor with understanding of current developments, skills, procedures, or treatments related to the practice of allopathic medicine.

7. Publishing or presenting a paper, report, or book that deals with current developments, skills, procedures, or treatments related to the practice of allopathic medicine. The physician may claim one credit hour for each hour preparing, writing, and presenting materials:

(a) Actually published or presented; and

(b) After the date of publication or presentation.

8.
A credit hour may be earned for any of the following activities that provide an understanding of current developments, skills, procedures, or treatments related to the practice of allopathic medicine:

(a)
Completing a medical education program based on self-instruction that uses videotapes, audiotapes, films, filmstrips, slides, radio broadcasts, or computers;

(b) Reading scientific journals and books;

(c) Preparing for specialty board certification or re-certification examinations;

(d) Participating on a staff or quality of care committee, or utilization review committee in a hospital, health care institution, or government agency.

C. If a physician holding an active license to practice medicine in this state fails to meet the continuing medical education requirements under subsection (A) because of illness, military service, medical or religious missionary activity, residence in a foreign country, or other circumstances, the Board, upon written application, shall grant an extension of time to complete the continuing medical education.

D. The Board shall mail to each physician a license renewal form that includes a section regarding continuing medical education compliance. The physician shall sign and return the form certified under penalty of perjury that the continuing medical education requirements under subsection (A) are satisfied for the two-year period preceding biennial renewal. Failure to receive the license renewal form under subsection (A) shall not relieve the physician of the requirements of subsection (A). The Board may randomly audit a physician to verify compliance with the continuing medical education requirements under subsection (A).

   
R4-16-102 Rehearing or review of Board decision
  A. A motion for rehearing or review shall be filed as follows:

1. Except as provided in subsection (B), any party in a contested case may file a written motion for rehearing or review of the Board's decision, specifying generally the grounds upon which the motion is based.

2. A motion for rehearing or review shall be filed with the Board and served no later that 30 days after the decision of the Board.

3. For purposes of this Section, "service" has the same meaning as in A.R.S. §41-1092.09.

4. For purposes of this Section, a document is deemed filed when the Board receives the document.

5. For purposes of the Section, the terms "contested case" and "party" shall have the same meaning as in A.R.S. §41-1001.

B. If the Board makes a specific finding that it is necessary for a particular decision to take immediate effect to protect the public health and safety, or that a rehearing or review of the Board's decision is impracticable or contrary to the public interest, the decision shall be issued as a final decision without opportunity for rehearing or review and shall be a final administrative decision for purposes of judicial review.

C. A written response to a motion for rehearing or review may be filed and served within 15 days after service of the motion for rehearing or review. The Board may require the filing of written briefs upon any issues raised in the motion and may provide for oral argument.

D. A rehearing or review of a decision may be granted for any of the following reasons materially affecting a party's rights:

1. Irregularity in the administrative proceedings by the Board, its hearing officer, or the prevailing party, or any ruling or abuse of discretion, that deprives the moving party of a fair hearing;

2. Misconduct of the Board, its hearing officer, or the prevailing party;

3. Accident or surprise that could have not been prevented by ordinary prudence;

4. Material evidence, newly discovered, which with reasonable diligence could not have been discovered and produced at the original hearing;

5. Excessive or insufficient penalties;

6. Error in the admission or rejection of evidence, or other errors of law that occurred at the hearing;

7. The decision is the result of a passion or prejudice; or

8. The decision of findings of fact or decision is not justified by the evidence or is contrary to law.

E. A rehearing or review may be granted to all or any of the parties and on all or part of the issues for any of the reasons in subsection (D). The Board may take additional testimony, amend findings of fact and conclusions of law, or make new findings and conclusions, and affirm, modify, or reverse the original decision.

F. A rehearing or review, if granted, shall be a rehearing or review only of the question upon which the decision is found erroneous. An order granting a rehearing or review shall specify with particularity the grounds for the order.

G. Not later than 15 days after a decision is issued, the Board of its own initiative may order a rehearing or review for any reason that it might have granted a rehearing or review on motion of a party. After giving the parties notice and an opportunity to be heard on the matter, the Board may grant a timely- served motion for a rehearing or review, for a reason not stated in the motion. In either case, the Board shall specify in the order the grounds for the rehearing or review.

H. If a motion for rehearing or review is based upon affidavits, they shall be served with the motion. The opposing party may, within 15 days after service, serve opposing affidavits. The Board may extend this period for a maximum of 20 days either by the Board for good cause, or by the parties by written stipulation. The Board may permit reply affidavits.
   
R4-16-103 Licensure by Endorsement
 

A. An applicant for licensure by endorsement may make a written request of the Board for an extension of the seven-year period provided by A.R.S. § 32-1426 (B)(4) to pass one of the combinations of specified examinations. The applicant shall submit the written request to the Board with evidence that:

1.
The applicant meets all requirements for licensure and for taking the United States Medical Licensing Examination,

2.
The combination of examinations cannot be passed in the time required by law, and

3.
The applicant is:

a.
A full-time student in an approved school of medicine, as defined in A.R.S §32-1401(5);

b.
A participant in an approved hospital internship, residency, or clinical fellowship program, as defined in A.R.S. §32-1401(4); or

c.
A full-time student in a recognized medical degree program, as defined in subsection (E), concurrently or consecutively with medical school or postgraduate training.

B.
If the Board determines that the applicant satisfies the requirements of subsection (A), the Board shall grant the extension.

C.
An extension shall not exceed 10 years from
The date on which the applicant successfully completes the first part of the combination of examinations.

D.
If the Board denies the request for extension, the applicant may request a hearing by filing a written notice with the Board no later than 30 days after receipt of notice of the Board's action. A hearing shall be conducted according to A.R.S. Title 41, Chapter 6, Article 10.

E.
In this Section, a "recognized degree program" means an education program offered by a college or university approved by the New England Association of Schools and Colleges, Middle States Association of Colleges and Secondary Schools, North Central Association of Colleges and Schools, Northwest Association of Schools and Colleges, Southern Association of Colleges and Schools, or Western Association of Schools and Colleges: or accredited by the United States Department of Education, Council on Postsecondary Accreditation, Association of American Medical Colleges, the Association of Canadian Medical Colleges, or the American Medical Association.

F.
An applicant for licensure by endorsement under A.R.S. §32-1426(C) shall:

1.
Provide proof of passing an examination specified in A.R.S. §32-1426(A) less than ten years before the date of filing a license application with the Board,

2.
Hold a current certification in an American Board of Medical Specialty ("ABMS"), and

3.
Take and pass the Special Purposes Examination (SPEX).

   
R4-16-104 Time Frames for License, Permit, or Registration
  A. For each type of license, permit, or registration issued by the Board, the overall time frame described in A.R.S. §41-1072(2) is listed in Table 1.

B. For each time of license, permit, or registration issued by the Board, the administrative completeness review time frame described in A.R.S. §41-1072(1) is listed in Table 1 and begins on the date the Board receives an application and all required documents and information.

1. If the required application is not administratively complete, the Board shall send to the applicant, a deficiency notice.

a. The notice shall state each deficiency and the information needed to complete the application and documents.

b. Within the time provided in Table 1 for response to a deficiency notice, beginning on the date of mailing of a deficiency notice, an applicant shall submit to the Board the missing documents and information specified in the notice. The time frame for the Board to finish the administrative completeness review is suspended from the date the Board mails the deficiency notice to the applicant until the date the Board receives the missing documentation and information.

c. Under A.R.S. §32-1427(E), an applicant for an initial license by examination or endorsement who disagrees with the deficiency notice may request a hearing before the Board at its next regular meeting if there is time at that meeting to hear the matter. The board shall not delay a requested hearing beyond 1 regularly scheduled meeting. At any hearing granted under this subsection, the applicant shall have the burden of proof to demonstrate that the alleged deficiencies do not exist.

d. Under A.R.S. §32-1427(F), if an applicant for initial license by examination or endorsement does not submit the missing documents and information indicated in the deficiency notice within the time frame specified in subsection (B)(1)(b), the Board shall deem the application withdrawn.

2. If the application is administratively complete, the Board shall send a written notice of administrative completeness to the applicant.

3. If the application and submitted documents and information do not contain all of the components required by statute and rule, the Board shall send a written notice to the applicant informing the applicant that the application is deemed withdrawn.

C. For each type of license, permit, or registration issued by the Board, the substantive review time frame described in A.R.S. §41-1072(3) is listed at Table 1 and begins on the date the Board sends written notice of administrative completeness to the applicant.

1. During the substantive review time frame, the Board may make 1 comprehensive written request for additional information. The applicant shall submit to the Board the additional information identified by the comprehensive written request within the time provided in Table 1, beginning on the date of mailing of the comprehensive written request for additional information. The time frame for the Board to finish the substantive review is suspended from the date the Board mails the comprehensive written request for additional information to the applicant until the Board receives the additional information.

2. The Board shall issue a written notice of denial of license, permit, or registration if the Board determines that the applicant does not meet all of the substantive criteria required by statute and rule for a license, permit, or registration.

3. The Board shall issue a written notice informing the applicant that the application is deemed withdrawn if the applicant does not submit the requested additional information within the time frame in Table 1.

4. If the applicant meets all of the substantive criteria required by statute and rule for license, permit, or registration, the Board shall issue a license, permit, or registration to the applicant.

Table 1. Time Frames (in calendar days)

Type of License Overall Time- Frame Administrative Review Time- Frame  Time of Respond to Deficiency Notice Substantive Review Time-Frame Time to Respond to Request for Additional Information
Initial License by Examination 240 120 365  120 90
Initial License by Endorsement 240 120  365 120  90
Locum Tenens or Pro Bono Registration 120 60 30 60 30
Temporary License
60
30
30
30
30
Teaching License
40
20
30
20
30
Educational Teaching Permit
20
10
10
10 
10
Training Permit
40
20
30
20 
30
Short Term Training Permit
40
20
30
20
30
One-year Training Permit
40
20
30
20
30
Registration to Dispense Controlled Substances and Prescription-only Drugs and Devices
150
45
30
105
30

 

 

   
R4-16-105 Time Frames for License Renewal
  A. For renewal of licensure, the overall time frame described in A.R.S. §41-1072(2) is 90 calendar days.

B. For renewal of licensure, the administrative completeness review time frame described in A.R.S. §41-1072(1) is 90 calendar days and begins on the date the Board receives the renewal application.

1. If the required application is not administratively complete, the Board shall send to the applicant a deficiency notice. The notice shall state each deficiency and the documents and information needed to complete the renewal application.

2. The 90-day time frame for the Board to finish the administrative completeness review is suspended from the date the Board mails the deficiency notice to the applicant until the date the Board receives the needed documents and information.

3. If an applicant does not submit a complete renewal application before May 1, the applicant's license expires, except that the license of a physician who does not renew the license and who has been advised in writing that an investigation is pending at the time the license is due to expire does not expire until the investigation is resolved. The license of a physician for whom an investigation is pending is suspended on the date it would otherwise expire and the physician shall not practice in this state until the investigation is resolved.

4. If the submitted application is administratively complete, the Board shall send a written notice of renewal to the applicant.

 

   
R4-16-106 Application for Licensure
  A. For purposes of this Article, unless otherwise specified:

1. "ECFMG" means Educational Commission for Foreign Medical Graduates.

2. "FLEX" means Federation Licensing Examination.

3. "LMCC" means Licentiate of the Medical Council of Canada.

4. "Medical Condition" means the following physiological, mental, or psychological conditions or disorders:

a. chronic and uncorrected orthopedic, visual, speech, or hearing impairments;

b. cerebral palsy, epilepsy, muscular dystrophy, multiple sclerosis, cancer, heart disease, diabetes, mental retardation, HIV disease, or tuberculosis; or

c. specific learning disabilities, dementia, Alzheimer's, bipolar disorder, schizophrenia, paranoia, or any psychotic disorder.

5. "SPEX" means Special Purposes Examination.

6. "USMLE" means United States Medical Licensing Examination.

B. An applicant for licensure to practice medicine by endorsement, Step
3 of the USMLE, or by endorsement with the SPEX shall submit the following information on an application form provided by the Board:

1. Applicant's full name, social security number, business and home addresses, business and home telephone numbers, and date and place of birth;

2. Names of the states or provinces in which the applicant has applied for or has been granted a license or registration to practice medicine, including license number, date issued, and current status of the license;

3. Whether the applicant has had an application for medical licensure denied or rejected by another state or province licensing board, and if so, an explanation;

4. Whether any disciplinary or rehabilitative action has ever been taken against the applicant by another licensing board, including other health professions, and if so, an explanation;

5. Whether any disciplinary actions, restrictions, or limitations have been taken against the applicant while participating in any type of training program or by any health care provider, and if so, an explanation;

6. Whether the applicant has been found in violation of a statute, rule, or regulation of any domestic or foreign governmental agency, and if so, an explanation;

7. Whether the applicant is currently under investigation by any medical board or peer review body, and if so, an explanation;

8. Whether the applicant has ever had a medical license disciplined resulting in a revocation, suspension, limitation, restriction, probation, voluntarily surrender, cancellation during an investigation or Whether the applicant has had hospital privileges revoked, denied, suspended, or restricted, and if so, an explanation;

10. Whether the applicant has been named as a defendant in a malpractice matter currently pending or that resulted in a settlement or judgment against the applicant, and if so, an explanation;

11. Whether the applicant has been subjected to any regulatory disciplinary action, including censure, practice restriction, suspension, sanction, or removal from practice, imposed by any agency of the federal or state government, and if so, an explanation;

12. Whether the applicant has had the authority to prescribe, dispense, or administer medications limited, restricted, modified, denied, surrendered, or revoked by a federal or state agency, and if so, an explanation;

13. Whether the applicant, within the last 5 years, has or had a medical condition that impairs or limits the applicant's ability to safely practice medicine, and if so, an explanation;

14. Whether the applicant engages in the illegal use of any controlled substance, habit- forming drug, or prescription medication, and if so, an explanation;

15. Whether the applicant has consumed intoxicating beverages resulting in the applicant's present ability to exercise the judgment and skills of a medical professional, being impaired or limited, and if so, an explanation;

16. Whether the applicant has been found guilty or entered into a plea of no contest to a felony, or misdemeanor involving moral turpitude in any state, and if so, an explanation;

17. A complete list of the applicant's internship, residency, and fellowship training;

18. Whether the applicant is currently certified by any of the American Board of Medical Specialties;

19. The applicant's intended specialty;

20. Consistent with the Board's statutory authority, other information the Board may deem necessary to fully evaluate the applicant;

21. A photograph of passport quality no larger than 2 ½ X 3 inches taken not more than 60 days before the date of application; and

22. A notarized statement, signed by the applicant, verifying the truthfulness of the information provided, and that the applicant has not engaged in any acts prohibited by Arizona law or Board rules, and authorizing release of any required records or documents to complete application review.

C. In addition to the application form, an applicant for licensure to practice medicine by endorsement, Step 3 of the USMLE, or endorsement with the SPEX shall submit the following:

1. Certified copy of the applicant's birth certificate or passport;

2. Certified evidence of legal name change if the applicant's legal name is different from that shown on the document submitted under subsection (B)(1);

3. Complete list of all hospital affiliations and employment for the past 5 years;

4. Verification of any medical malpractice matter currently pending or resulting in a settlement or judgment against the applicant, including a copy of the complaint and either the agreed terms of settlement or the judgment. The verification must contain the name and address of each defendant, the name and address of each plaintiff, the date and location of the occurrence which created the claim and a statement specifying the nature of the occurrence resulting in the medical malpractice action; and

5. The fee required in A.R.S. §32-1436.

D. In addition to the requirements of subsections (A) and (B), an applicant for licensure to practice medicine by endorsement, by Step 3 of the USMLE, or by endorsement with the SPEX shall have the following directly submitted to the Board:

1. The following forms must be included with the application and be completed by persons other than the applicant:
a. Medical College Certification,

b. Postgraduate Training Certification,

c. Clinical Instructor Certification,

d. ECFMG certification if applicant is an international graduate,

e. Federation of State Medical Boards Disciplinary Search,

f. American Medical Association Physician Profile, and

g. Verification of American Board of Medical Specialty Certification, if applicable;

2. Examination and Board History Report scores for USMLE, FLEX, and SPEX;

3. Verification of LMCC exam score, state written exam score, or national board exam score;

4. Verification of licensure from every state in which the applicant has ever held a medical license; and

5. Verification of all hospital affiliations and employment for the past 5 years. This must be submitted by the verifying entity on its official letterhead
   
R4-16-107 Application for Pro Bono Registration
  A. An applicant for a pro bono registration to practice medicine shall submit an application on a form provided by the Board that provides the information required by R4-16-106(B).

B. In addition to the application, an applicant for a pro bono registration to practice medicine shall submit the following:

1. Certified copy of the applicant's medical degree diploma;

2. Certified copies of internship, residency, or fellowship certificates;

3. Photocopy of any current license to practice medicine in another state, territory, or possession of the United States or the District of Columbia, along with a letter from the medical board issuing the license, certifying that the license is current and in good standing;

4. Certified copy of ECFMG certificate, if applicable;

5. The fee required in §A.R.S. 32-1436.

C. In addition to the requirements of subsections (A) and (B), an applicant for pro bono registration shall have the following directly submitted to the Board:

1. American Medical Association physician profile;

2. Federation of State Medical Boards disciplinary search; and

3. Verification of licensure from every state in which the applicant has ever held a license.
   
R4-16-108 Application for Locum Tenens Registration
  A. An applicant for a locum tenens registration to practice medicine shall submit an application on a form provided by the Board that provides the information required by R4-16-107(A).

B. In addition to the application, an applicant for a locum tenens registration to practice medicine shall submit the following:

1. Certified copy of the applicant's medical degree diploma;

2. Certified copies of internship, residency, or fellowship certificates;

3. A statement completed by the sponsoring Arizona-licensed physician giving the reason for the request for issuance of the registration; and

4. Certified copy of ECFMG certificate, if applicable.

C. In addition to the requirements of subsections (A) and (B), an applicant for locum tenens registration shall have the following directly submitted to the Board:

1. American Medical Association physician profile;

2. Federation of State Medical Boards disciplinary search; and

3. Verification of licensure from every state in which the applicant has ever held a license.
   
ARTICLE 2
DISPENSING OF DRUGS
   
R4-16-201 Registration and renewal
  A. A physician who wishes to dispense a controlled substance as defined in A.R.S. 32-1901(12), a prescription-only drug as defined in A.R.S. 32-1901(65), or a prescription-only device as defined in A.R.S. 32-1901(64) shall be currently licensed to practice medicine in Arizona and shall provide to the Board the following:

1. A completed registration form that includes the following information:

a. The physician's name, license number, and field of practice;

b. A list of the types of drugs and devices the physician will dispense; and

c. The location or locations where the physician will dispense a controlled substance, a prescription-only drug, or a prescription-only device.

2. A copy of the physician's current Drug Enforcement Administration Certificate of Registration for each dispensing location from which the physician will dispense a controlled substance.

3. The fees required in A.R.S. 32-1436.

B. A physician shall renew a registration to dispense a controlled substance, a prescription-only drug, or a prescription-only device by complying with the requirements in subsection (A) on or before June 30 of each year. If a physician has made timely and complete application for the renewal of a registration, the physician may continue to dispense until the Board approves or denies the renewal application.

C. If the completed annual renewal form, all required documentation, and the fee are not received in the Board's office on or before June 30, the physician shall not dispense any controlled substances, prescription-only drugs, or prescription-only devices until re-registered. The physician shall re-register by filing for initial registration under subsection (A) and shall not dispense a controlled substance, a prescription-only drug, or a prescription-only device until receipt of the re-registration.

   
R4-16-202 Packaging and inventory; exception
 

A. A physician shall dispense all controlled substances and prescription-only drugs in prepackaged containers or in light-resistant containers with consumer safety caps, that comply with standards specified in the official compendium as defined in A.R.S. 32-1901(49) and state and federal law, unless a patient or a patient's representative requests a non-safety cap.

B. All controlled substances and prescription-only drugs dispensed shall be labeled with the following information:

1. The physician's name, address, and telephone number;

2. The date the controlled substance and prescription-only drug is dispensed;

3. The patient's name;

4. The controlled substance and prescription-only drug name, strength, and dosage, form, name of manufacturer, the quantity dispensed, directions for use, and any cautionary statement necessary for the safe and effective use of the controlled substance and prescription-only drug; and

5. A beyond-use-date not to exceed one year from the date of dispensing or the manufacturer's expiration date if less than one year.

C. A physician shall secure all controlled substances in a locked cabinet or room and shall control access to the cabinet or room by a written procedure that includes, at a minimum, designation of the persons who have access to the cabinet or room and procedures for recording requests for access to the cabinet or room. This written procedure shall be made available on demand to the Board or its authorized representatives for inspection or copying. Prescription-only drugs shall be stored so as not to be accessible to patients.

D. Controlled substances and prescription-only drugs not requiring refrigeration shall be maintained in an area where the temperature does not exceed 85F.

E. A physician shall maintain an ongoing dispensing log for all controlled substances and the prescription-only drug nalbuphine hydrochloride (Nubain) dispensed by the physician. The dispensing log shall include the following:

1. A separate inventory sheet for each controlled substance and prescription-only drug;

2. The date the drug is dispensed;

3. The patient's name;

4. The controlled substance and prescription-only drug name, strength, dosage, form, and name of the manufacturer;

5. The number of dosage units dispensed,

6. A running total of each controlled substance and prescription-only drug dispensed; and

7. The signature of the physician written next to each entry.

F. A physician may use a computer to maintain the dispensing log required in subsection (E) if the log is quickly accessible through either on-screen viewing or printing of a copy.

G. This Section does not apply to a prepackaged, manufacturer sample of a controlled substance and prescription-only drug, unless otherwise provided by federal law.

   
R4-16-203 Prescribing and dispensing requirements
 

A. A physician shall record on the patient's medical record the name, strength, dosage, and form, of the controlled substance, prescription-only drug, or prescription-only device dispensed, the quantity or volume dispensed, the date the controlled substance, prescription-only drug, or prescription-only device is dispensed, the medical reasons for dispensing the controlled substance, prescription-only drug, or prescription-only device, and the number of refills authorized.

B. Before dispensing a controlled substance, prescription-only drug, or prescription-only device to a patient, a physician shall review the prepared controlled substance, prescription-only drug, or prescription-only device to ensure that:

1. The container label and contents comply with the prescription, and

2. The patient is informed of the name of the controlled substance, prescription-only drug, or prescription-only device, directions for use, precautions, and storage requirements.

C. A physician shall purchase all dispensed controlled substances, prescription-only drugs, or prescription-only devices from a manufacturer or distributor approved by the United States Food and Drug Administration, or a pharmacy holding a current permit from the Arizona Board of Pharmacy.

D. The person who prepares a controlled substance, prescription-only drug, or prescription-only device for dispensing shall countersign and date the original prescription form for the controlled substance, prescription-only drug, or prescription-only device.

E. For purposes of this Article, "dispensing" means the delivery of a controlled substance, prescription-only drug, or a prescription-only device to a patient for use outside the physician's office.

   
R4-16-204 Recordkeeping and reporting shortages
 

A. A physician who dispenses a controlled substance or prescription-only drug shall ensure that an original prescription dispensed from the physician's office is dated, consecutively numbered in the order in which it is originally dispensed, and filed separately from patient medical records. A physician shall ensure that an original prescription be maintained in three separate files, as follows:

1. Schedule II controlled substances;

2. Schedule III, IV, and V controlled substances; and

3. Prescription-only drugs.

B. A physician shall ensure that purchase orders and invoices are maintained for all controlled substances and prescription-only drugs dispensed for profit and not for profit for three years from the date of the purchase order or invoice. Purchase orders and invoices shall be maintained in three separate files as follows:

1. Schedule II controlled substances only;

2. Schedule III, IV, and V controlled substances and nalbuphine; and

3. All other prescription-only drugs.

C. A physician who discovers a theft or loss of a controlled substance or a dangerous drug, as defined in A.R.S. 13-3401, from the physician's office shall:

1. Immediately notify the local law enforcement agency,

2. Provide that agency with a written report, and

3. Send a copy to the Drug Enforcement Administration and the Board within seven days of the discovery.

D. For purposes of this Section, controlled substances are identified, defined, or listed in A.R.S. Title 36, Chapter 27.

   
R4-16-205 Inspections; denial and revocation
 

A. A physician shall cooperate with and allow access to the physician's office and records for periodic inspection of dispensing practices by the Board or its authorized representative. Failure to cooperate or allow access shall be grounds for revocation of a physician's registration to dispense a controlled substance, prescription-only drug, or prescription-only device or denial of renewal of the physician's dispensing registration.

B. Failure to comply with A.R.S. 32-1491 or this Article constitutes grounds for denial or revocation of dispensing registration.

C. The Board shall revoke a physician's registration to dispense a controlled substance, prescription-only drug, or prescription-only device upon occurrence of the following:

1. Suspending, revoking, surrendering, or canceling the physician's license;

2. Placing the physician's license on inactive status;

3. Failing to timely renew the physician's license; or

4. Restricting the physician's ability to prescribe or administer medication, including loss or expiration of the physician's Drug Enforcement Administration Certificate of Registration.

D. If the Board denies a physician's dispensing registration, the physician may appeal the decision by filing a request, in writing, with the Board, no later than 30 days after receipt of the notice denying the registration.

   
ARTICLE 3
MEDICAL ASSISTANTS
   
R4-16-301 Definitions
  For the purposes of A.R.S. Title 32, Chapter 13 and of this Chapter, unless the context otherwise requires:

"Approved medical assistant training program" means a program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP), the Accrediting Bureau of Health Education Schools (ABHES), a medical assisting program accredited by any accrediting agency recognized by the United States Department of Education, or a training program designed and offered by a licensed allopathic physician, that meets or exceeds any of these 3 accrediting programs, and verifies the entry level competencies of a medical assistant referenced in R4-16-303.
   
R4-16-302 Medical Assistant Training requirements
  A. The supervising physician or physician assistant shall ensure that a medical assistant satisfies 1 of the following training requirements prior to the medical assistant's employment:

1. Completion of an approved medical assistant training program.

2. Completion of an unapproved medical assistant training program and passage of the medical assistant examination administered by either the American Association of Medical Assistants or the American Medical Technologists.
B. This rule does not apply to any person who:

1. Prior to the effective date of these rules completed an unapproved medical assistant training program and was employed as a medical assistant since completion of the program.

2. Prior to the effective date of these rules was directly supervised by the same physician, group of physicians, or physician assistant for at least 2000 hours.

3. Completes a medical services training program of the Armed Forces of the United States.

   
R4-16-303 Authorized Procedures for Medical Assistants
  A medical assistant may, under the direct supervision of a physician or a physician assistant, perform the medical procedures listed in the, April 1999, Commission on Accreditation of Allied Health Education Program's, "Standards and Guidelines for an Accredited Educational Program for the Medical Assistant, Section (2)(A)(5)(a through c)." The address is 35 East Wacker Drive, Suite 1970, Chicago, Illinois 60601. This material is incorporated by reference, does not include any later amendments or editions of the incorporated matter, and is on file with the Office of the Secretary of State. Additionally, a medical assistant may, under the direct supervision of a physician or physician assistant, administer whirlpool treatments, diathermy treatments, electronic galvation stimulation treatments, ultrasound therapy, massage therapy, traction treatments, apply Transcutaneous Nerve Stimulation units, and apply hot and cold packs.
 

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