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)

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).

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).

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)

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.

1. A completed form for registration, furnished by the Board, which includes the following information:

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

b. A listing of the types of drugs and devices the physician desires to dispense, including prescription-only and controlled substances; and

c. The location or locations where the physician desires to dispense.

2. A copy of the physician's current Drug Enforcement Administration Certificate of Registration for each dispensing location from which the physician desires to dispense controlled substances.

3. The statutorily required fee.

B. A physician shall renew a registration to dispense drugs and devices by complying with the requirements set forth in subsection (A) on or before June 30 of each year. When a physician has made timely and complete application for the renewal of a registration, the physician may continue to dispense until the application has been approved or denied by the board.

C. If the completed annual renewal form, all required documentation and the correct fee are not received in the Board's office on or before June 30, the physician shall not dispense drugs and devices until newly registered. The physician shall register by filing for initial registration pursuant to subsection (A) and shall not dispense drugs and devices until receipt of a new registration.

B. All drugs dispensed shall be labeled with the following information:

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

2. The date the drug is dispensed and its expiration date;

3. The patient's name; and

4. The name, form, name of the manufacturer and strength of the drug, the quantity dispensed, directions for its use, and any cautionary statement necessary for the safe and effective use of the drug.

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 which shall include, at a minimum, designation of the persons who have access to the cabinet or room and procedures for recording requests for access to drugs. This written procedure shall be made available on demand to the Board or its authorized representatives for inspection or copying. Prescription-only medications shall be stored so as not to be accessible to patients.

D. Drugs not requiring refrigeration shall be maintained in an area where the temperature does not exceed 85o F.

E. A physician shall maintain an ongoing dispensing log for all controlled substances and the prescription-only medications nalbuphine hydrochloride (Nubain) and butorphanol tartrate (Stadol) dispensed by the physician which includes separate inventory sheets for each controlled substance, nalbuphine hydrochloride, and butorphanol tartrate. The heading of a dispensing log shall include the following information:

1. The date the drug is dispensed;

2. The patient's name;

3. The name, form, name of the manufacturer and strength of the drug;

4. The number of dosage units dispensed;

5. A running total of medication dispensed; and

6. The signature of the physician or the person authorized by the physician who dispensed the medication, written next to each entry.

F. The dispensing log required in subsection (E) may be maintained on computer provided that the log is quickly accessible through either on-screen viewing or printing of a copy.

G. This section shall not apply to prepackaged, manufacturer samples of drugs, unless otherwise provided by federal law.

B. Prior to delivery to the patient, a physician shall review the prepared drugs and devices to ensure their compliance with the prescription and, additionally, ensure that the patient has been informed of the name of the drug or device, directions for its use, precautions, and storage requirements.

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

D. The person who prepares drugs and devices for dispensing shall countersign and date the original prescription form for the drugs and devices.

E. For purposes of this article, "dispensing" means the delivery of a drug or device to a patient for use outside the physician's office.

B. A physician shall maintain drug purchase orders and invoices for controlled substances, nalbuphine hydrochloride and butorphanol tartrate which are received, and original prescription orders for all drugs for a period of three years from the date of the order. Dispensing logs and destruction records shall also be maintained for three years.

C. A physician who determines that drugs have been illegally removed from the physician's office, or that a drug shortage exists in controlled substances maintained for dispensing, shall immediately notify a local law enforcement agency and thereafter, provide that agency with a report in writing, with copies to the Drug Enforcement Administration and the Board within seven days of the discovery.

D. For purposes of this section, "Schedule II drugs or other substances" means the controlled substances identified, defined or listed in A.R.S. §36-2513 and the following hallucinogenic substances:

1. Dronabinol (synthetic) in sesame oil and encapsulated in a soft gelatin capsule in a U.S. Food and Drug Administration approved drug product.

2. Nabilone.

A. A physician shall cooperate with and allow access by the Board or its authorized representatives to the physician's office and records during periodic inspections of dispensing practices by the Board. Failure to cooperate or allow access shall be grounds for revocation of a physician's registration to dispense or denial of renewal of registration.

B. Failure to comply with A.R.S. §32-1491 or this article shall constitute grounds for denial or revocation of registration.

C. A physician's registration to dispense drugs and devices shall be revoked by the Board upon occurrence of the following:

1. Suspension, revocation or cancellation of the physician's license;

2. Placement of the physician's license on inactive status;

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

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

D. A physician denied registration may request a hearing to appeal the decision by filing the request, in writing, with the Board, not later than 10 days after receipt of the notice denying the registration.

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.

Board meeting and whether the referral is for revocation, suspension or is a result of an out- of-state disciplinary action, or is due to complexity of the case.

A. Any person aggrieved by an action taken by the executive director may appeal that action to the Board. The aggrieved person shall file a written request to the Board:

1. Thirty days after notification of the action, if personally served; or
2. Thirty five days after the notification, if mailed.

B. The aggrieved person shall provide, in the written request, evidence showing:

1. An irregularity in the investigative process or the executive director's review deprived the party of a fair decision; or
2. Misconduct by Board staff, a Board consultant, or the executive director that deprived the party of a fair decision; or
3. Material evidence newly discovered that could have a bearing on the decision and that, with reasonable diligence, could not have been discovered and produced earlier.

C. The fact that the aggrieved party does not agree with the final decision is not grounds for a review by the Board.

D. If an aggrieved person fails to submit a written request within the time specified in
subsection (A), the Board is relieved of the requirement to review actions taken by the
executive director. The executive director may, however, evaluate newly provided
information that is material or substantial in content to determine whether the Board
should review the case.

E. If a written request is submitted that meets the requirements of subsection (B):

1. The Board shall consider the written request at its next regularly scheduled meeting.
2. If the written request provides new material or substantial evidence that requires additional investigation, the investigation shall be conducted as expeditiously as possible and the case shall be forwarded to the Board at the first possible regularly scheduled meeting.