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MONDAY, JUNE 6, 2005

Proposed Amendment: N.J.A.C. 13:35-6.13

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 2005-206.

Submit written comments by August 5, 2005 to:

William Roeder, Executive Director

State Board of Medical Examiners

PO Box 183

Trenton, NJ 08625-0183

The agency proposal follows:


On January 18, 2005, the State Board of Medical Examiners (the Board) published a fee increase proposal in the New Jersey Register at 37 N.J.R. 206(a) in which the Board proposed increases in initial registration fees and biennial registration renewal fees in its fee schedules at N.J.A.C. 13:35- 6.13, 8.19, 9.6 and 10.6 for physicians, podiatrists, bioanalytical laboratory directorships, midwives, physician assistants, hearing aid dispensers, acupuncturists and athletic trainers. In addition, the Board proposed to increase the application fee and late fee for hearing aid dispensers to be consistent with other licensees' late fees and to set an application fee for athletic trainers. The increases were proposed to cover increased costs in Board operations. The most significant amount of funding derived from the proposed increases, both as a percentage increase and dollar increase, would have been from increasing the initial and renewal licensing fees for physicians from $340.00 to $610.00, or approximately 79 percent, for the biennial licensing period. All other licensing and registration fees would have increased by approximately 10 percent.

During the 60-day comment period for the initial fee increase proposal, the Board received a sufficient number of comments to warrant a public hearing on the proposal. A public hearing was conducted on March 2, 2005. After consideration of the public hearing report and the written comments received by the Board, the Board decided that a reduction in the initial and biennial licensing fees for physicians was appropriate and that an increase in the licensing fees for podiatrists and bioanalytical lab directors would provide a more equitable distribution of the burden of funding the Board's operations. Specifically, on April 13, 2005, the Board adopted a fee schedule that included an initial and renewal biennial licensing fee for physicians of $580.00, or $30.00 less than proposed. (The adopted fee schedule is published elsewhere in this issue of the New Jersey Register.)

The Board also approved this proposal that would increase the initial and biennial licensing fees for podiatrists to $580.00 so that podiatrists would pay the same licensing fee as physicians. The Board believes that a licensing fee for podiatrists is appropriate at this amount since there is little difference in the administration of these licenses and podiatrists are also included in the physician profiling system established by N.J.S.A. 45:9- 22.22. The proposed increase in the biennial licensing fees for bioanalytical laboratory directors, when combined with the increase that was adopted by the Board on April 13, 2005, would result in an overall increase of approximately 70 percent which is approximately the same rate of increase as for physicians' licensing fees.

As noted in the Board's initial proposal, 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 schedule complies with these statutory requirements.

Also as noted in the Board's initial proposal, 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 has installed 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 Division's website. Furthermore, 17 new positions have been 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. This number of positions was reduced from the 23 new positions as initially proposed.

Since the last fee increase in 1995, the average rate of increase in salary expense for Board staff has been approximately 6.5 percent. Much of this increase has been the result of negotiated labor contracts and salary increases required under civil service. Fringe benefit expenses assessed by the Department of Treasury have also increased; 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.

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 applicants obtaining their initial licenses as well as all licensees choosing to have their biennial licenses renewed on active status for podiatrists and bioanalytical laboratory directorships.

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 which will inure to the benefit of consumers, applicants, licensees and related businesses and institutions.

Economic Impact

The proposed fee increases will have an economic impact on approximately 1,150 licensed podiatrists and 270 licensed bioanalytical laboratory directors as well as applicants for licensure, all of whom will be required to pay increased licensing fees.

The initial license fee for podiatrists is proposed to be increased from $410.00 to $580.00 for fees paid during the first year of a biennial renewal period and from $205.00 to $290.00 for fees paid during the second year of a biennial renewal period. The biennial license renewal fee is proposed to be increased from $410.00 to $580.00.

For bioanalytical laboratory directorships, the initial license fee is proposed to be increased from $270.00 to $390.00 for fees paid during the first year of a biennial renewal period and from $135.00 to $195.00 for fees paid during the second year of a biennial renewal period. The biennial license renewal fee is proposed to be increased from $270.00 to $390.00.

The proposed fee increases 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 to raise funds to cover operating costs. In compliance with the statute, the sums to be raised are estimated to cover, but not 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 effected 1,420 licensees of 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 requirements 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 under 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 license fees have been set at the lowest amount that will cover the Board's operating expense. 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 proposal 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. (No change.)

2. Podiatry (license)

i.-ii. (No change.)

iii. Initial license fee

(1) If paid during the first year of a biennial renewal period 580.00
(2) If paid during the second year of a biennial renewal period 290.00

iv. (No change.)

v. Biennial license 580.00

vi.-vii. (No change.)

3. Bioanalytical laboratory directorship, plenary or specialty license

i.-iii. (No change.)

iv. Initial license fee

(1) If paid during the first year of a biennial renewal period 390.00
(2) If paid during the second year of a biennial renewal period 195.00
v. Biennial license 390.00
4.-6. (No change.)

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