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NEW JERSEY REGISTER
VOLUME 37, NUMBER 2
TUESDAY, JANUARY 18, 2005
RULE PROPOSAL

LAW AND PUBLIC SAFETY
DIVISION OF CONSUMER AFFAIRS
STATE BOARD OF MEDICAL EXAMINERS
STATE BOARD OF MEDICAL EXAMINER FEES

Proposed Amendments: N.J.A.C. 13:35-6.13, 8.19, 9.6 and 10.6

Authorized By: State Board of Medical Examiners, William Roeder, Executive Director.

Authority: N.J.S.A. 45:9-2 and 45:1-3.2.
Calendar Reference: See Summary below for explanation of exception to calendar requirement.
Proposal Number: PRN 2005-29.

Submit written comments by March 19, 2005 to:

William Roeder, Executive Director

State Board of Medical Examiners

PO Box 183

Trenton, NJ 08625-0183

The agency proposal follows:

Summary

In order to cover increased investigative, administrative and program costs, the State Board of Medical Examiners (the Board) is proposing to increase initial registration fees and biennial registration renewal fees in its fee schedules at N.J.A.C. 13:35-6.13, 8.17, 9.6 and 10.6 for physicians, podiatrists, bioanalytical laboratory directorships, midwives, physician assistants, hearing aid dispensers, acupuncturists and athletic trainers. In addition, the application fee and late fee for hearing aid dispensers are proposed to be increased to be consistent with other licensees' late fees, and an application fee for athletic trainers is being specified in the rule.

Pursuant to N.J.S.A. 45:1-3.2, all professional and occupational licensing boards must fund their operating costs through the assessment of licensing and other fees. The statute further requires the fees to be set at a level that will raise sufficient funds to meet, but not exceed, the amount needed to cover costs. The proposed new fee schedules comply with these statutory requirements.

During the current fiscal year, a new physician's profiling system, which has been mandated by recently enacted legislation, P.L. 2003, c.96 (N.J.S.A. 45:9-22.21 et seq.), is being implemented by the Board and will result in an anticipated budget deficit by the conclusion of this fiscal year ending June 30, 2005. In addition, the Board office is pursuing several initiatives to provide its services to licensees and the public more effectively and efficiently. For example, the Board will be installing a new telephone system to address more effectively the volume of calls it receives and enhancements to the licensing system which will allow individuals to apply for their medical licenses online while allowing licensees the ability to renew their licenses through the Internet. Furthermore, 23 new positions are budgeted, including a Director of Education required by P.L. 2001, c.307 (N.J.S.A. 45:9-19.6), new customer service representatives and additional staff to more effectively review and process consumer complaints.

Since the last fee increase in 1995, the average rate of increase in salary expense has been approximately 6.5 percent. Much of this increase has been the result of negotiated labor contracts and increases required under civil service. In addition, fringe benefit expenses assessed by the Department of Treasury have also increased, and for this fiscal year the rate of assessment is 32.35 percent of salaries. This assessment has increased over the past several years with the rate being 24.15 percent in fiscal year 2003 and 28.15 percent in fiscal year 2004. In addition, other costs have increased significantly, such as the cost of legal representation which has increased at an average rate of approximately 8.5 percent since 1995 and now represents approximately 23 percent of the Board's budget.

In addition to the proposed new fee and fee increases, several technical changes are proposed in N.J.A.C. 13:35-8.19 to clarify that hearing aid dispensers hold licenses and not registrations.

The Board notes that a separate proposal published on October 18, 2004, in the New Jersey Register at 36 N.J.R. 4633(a), if adopted, would amend N.J.A.C. 13:35-6.13, 8.19, 9.6 and 10.6, by making some technical changes and establishing several new fees.

The Board has determined that the comment period for this proposal shall be 60 days; therefore, pursuant to N.J.A.C. 1:30-3.3(a)5, this proposal is excepted from the rulemaking calendar requirement.

Social Impact

The proposed amendments will affect all applicants obtaining their initial licenses as well as all licensees choosing to have their biennial licenses renewed on active status for the following professions: physicians, podiatrists, bioanalytical laboratory directorships, midwives, physician assistants, hearing aid dispensers, acupuncturists and athletic trainers. In addition, hearing aid dispenser license applicants will be affected with an increased application fee and hearing aid dispensers submitting late renewal applications will be affected with an increased late fee.

The fee increases will enable the Board to continue to meet its operating expenses incurred in fulfilling its statutory obligations to evaluate applicants for licensure, investigate complaints, initiate appropriate disciplinary and enforcement actions and regulate the practice of medicine. In addition, this fee increase will allow for necessary improvements to the operations of the Board office which will inure to the benefit of consumers, applicants, licensees and related businesses and institutions.

Economic Impact

The proposed new fee schedules will have an economic impact on approximately 38,000 licensed individuals as well as applicants for licensure who will be required to pay increased licensing fees.

The initial registration fee for physicians is proposed to be increased from $340.00 to $610.00 for fees paid during the first year of a biennial renewal period and from $170.00 to $305.00 for fees paid during the second year of a biennial renewal period. The biennial registration renewal fee is proposed to be increased from $340.00 to $610.00.

For podiatrists, the initial registration fee is proposed to be increased from $230.00 to $410.00 for fees paid during the first year of a biennial renewal period and from $115.00 to $205.00 for fees paid during the second year of a biennial renewal period. The biennial registration renewal fee is proposed to be increased from $230.00 to $410.00.

For bioanalytical laboratory directorships, the initial registration fee is proposed to be increased from $230.00 to $270.00 for fees paid during the first year of a biennial renewal period and from $115.00 to $135.00 for fees paid during the second year of a biennial renewal period. The biennial registration renewal fee is proposed to be increased from $230.00 to $270.00.

For midwives, the initial registration fee is proposed to be increased from $230.00 to $270.00 for fees paid during the first year of a biennial renewal period and from $115.00 to $135.00 for fees paid during the second year of a biennial renewal period. The biennial registration renewal fee is proposed to be increased from $230.00 to $270.00.

For physician assistants, the initial license fee is proposed to be increased from $190.00 to $220.00 for fees paid during the first year of a biennial renewal period and from $95.00 to $110.00 for fees paid during the second year of a biennial renewal period. The biennial license renewal fee is proposed to be increased from $190.00 to $220.00.

For hearing aid dispensers, the initial license fee is proposed to be increased from $150.00 to $180.00 for fees paid during the first year of a biennial renewal period and from $75.00 to $90.00 for fees paid during the second year of a biennial renewal period. The biennial license renewal fee is proposed to be increased from $150.00 to $180.00. In addition and in order to be more consistent with fees charged to other licensees, the application fee charged to persons applying for licensure as a hearing aid dispenser is proposed to be increased from $20.00 to $50.00 and the late fee charged to hearing aid dispensers who submit their renewal applications after the deadline is proposed to be increased from $25.00 to $50.00.

For acupuncturists, the initial registration fee is proposed to be increased from $230.00 to $270.00 for fees paid during the first year of a biennial renewal period and from $115.00 to $135.00 for fees paid during the second year of a biennial renewal period. The biennial registration renewal fee is proposed to be increased from $230.00 to $270.00.

For athletic trainers, the initial license fee is proposed to be increased from $70.00 to $80.00 for fees paid during the first year of a biennial renewal period and from $35.00 to $40.00 for fees paid during the second year of a biennial renewal period. The biennial license renewal fee is proposed to be increased from $70.00 to $80.00. In addition, a $100.00 application fee for person applying to be licensed as an athletic trainer is being codified in this rule.

The proposed fee increases and new fee will generate sufficient revenues to enable the Board to continue to comply with N.J.S.A. 45:1-3.2, which requires all professional and occupational licensing Boards within the scope of Subtitle 1 of Chapter 45 of the statutes to raise funds to cover operating costs. In compliance with the statute, the sums to be raised are estimated not to exceed the amount required to fund the Board's operations. The proposed amendments do not impose any direct costs on the public.

Federal Standards Statement

A Federal standards analysis is not required because the proposed rule amendments are not subject to any Federal standards or requirements.

Jobs Impact

The Board does not expect that the proposed rule amendments will result in the creation or loss of jobs in the State.

Agriculture Industry Impact

The Board believes that the proposed rule amendments will not affect the agriculture industry in the State.

Regulatory Flexibility Analysis

The Regulatory Flexibility Act (the Act), N.J.S.A. 52:14B-16 et seq., requires that the Board provide a description of the types and an estimate of the number of small businesses to which the rules apply. If, for purposes of the Act, the approximately 38,000 licensees of the Board and Committees under the Board are considered "small businesses," then the following analysis applies.

The Act requires the Board to set forth the reporting, recordkeeping and other compliance requirement including the kind of professional services likely to be needed to comply with the requirements of the proposed rule amendments.

The Board does not believe that the proposed rule amendments will require any additional reporting or recordkeeping requirements. Compliance requirements consist of paying an increased initial license fee and an increased renewal fee in a timely manner. The compliance costs are set out in the Economic Impact above. There are no capital costs associated with compliance, and no professional services are needed in order to comply. The increased initial and renewal licensee fees have been set at the lowest amount that will cover the Board's operating expense, and to ensure a sufficient source of revenue and assess the fees equally among all licensees, no difference in fees is proposed based on the size of the licensee's business.

Smart Growth Impact

The Board does not believe that the proposed rule amendments will have any impact upon the achievement of smart growth or upon the implementation of the State Development and Redevelopment Plan.

Full text of the proposed amendments follows :

<< NJ ADC 13:35-6.13 >>

13:35-6.13 Fee schedule

(a) The following fees shall be charged by the Board of Medical Examiners:

1. Medicine and Surgery (M.D. or D.O. license)

i. (No change.)

ii. Initial registration fee

(1) If paid during the first year of a biennial renewal period 610.00
(2) If paid during the second year of a biennial renewal period 305.00

iii.-v. (No change.)

vi. Biennial registration 610.00

vii.-viii. (No change.)

2. Podiatry (license)

i.-ii. (No change.)

iii. Initial registration fee

(1) If paid during the first year of a biennial renewal period 410.00
(2) If paid during the second year of a biennial renewal period 205.00

iv. (No change.)

v. Biennial registration 410.00

vi.-vii. (No change.)

3. Bio-analytical laboratory directorship, plenary license

i.-iii. (No change.)

iv. Initial registration fee

(1) If paid during the first year of a biennial renewal period 270.00
(2) If paid during the second year of a biennial renewal period 135.00
v. Biennial registration 270.00

4. (No change.)

5. Midwifery (license)

i.-iii. (No change.)

iv. Initial registration fee

(1) If paid during the first year of a biennial renewal period 270.00
(2) If paid during the second year of a biennial renewal period 135.00
v. Biennial registration 270.00

6.-7. (No change.)

8. Physician assistant (license)

i.-ii. (No change.)

iii. Initial license fee

(1) If paid during the first year of a biennial renewal period 220.00
(2) If paid during the second year of a biennial renewal period 110.00
iv. License renewal fee, biennial 220.00

v.-viii. (No change.)

9. (No change.)

<< NJ ADC 13:35-8.19 >>

13:35-8.19 Fee schedule

(a) The fee schedule for the Hearing Aid Dispensers Examining Committee of the State Board of Medical Examiners, in the Division of Consumer Affairs in the Department of Law and Public Safety, shall be as follows:

1. Application fee $50.00 (non-refundable)

2.-4. (No change.)

5. Initial <<-Registration->> <<+License+>> Fee

i. If paid during the first year of a biennial renewal period $180.00
ii. If paid during the second year of a biennial renewal period $90.00

6. (No change.)

7. Biennial license renewal $180.00

8. (No change.)

9. Late fee $50.00
10. Reinstatement, Biennial License $100.00

11.-12. (No change.)

(b)-(c) (No change.)

SUBCHAPTER 9. ACUPUNCTURE

<< NJ ADC 13:35-9.6 >>

13:35-9.6 Fee schedule

(a) The Board shall charge the following fees:

1.-3. (No change.)

4. Initial Registration Fee

i. If paid during the first year of a biennial renewal period $270.00
ii. If paid during the second year of a biennial renewal period $135.00
5. Biennial Registration $270.00

6.-11. (No change.)

(b)-(e) (No change.)

<< NJ ADC 13:35-10.6 >>

13:35-10.6 Fees

(a) The following fees shall be charged by the Board for athletic trainer licensure:

1. Application Fee ............................................... $100.00

<<-1.->><<+2.+>> (No change in text.)

<<-2.->><<+3.+>> Initial Licensure Fee

i. If paid during the first year of a biennial renewal period .... $80.00
ii. If paid during the second year of a biennial renewal period .. $40.00
4. Biennial renewal .............................................. $80.00

Recodify existing 4.-5. as <<+5.-6.+>> (No change in text.)



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