By Deborah J. Juneau

The Louisiana State Board of Medical Examiners (the “Board”) published proposed rules and regulations governing the practice of polysomnography and the licensure of polysomnography technologists and technicians.  The Board will accept comments on the proposed rules until 4 p.m. on October 21, 2013.

An individual who does not hold a current license as a polysomnograhic technologist or a permit as a polysomnographic technician is prohibited from engaging in the practice of polysomnographic technology in Louisiana.  However, the prohibition does not apply to anyone who is: acting under a license issued by any licensing agency of the state of Louisiana whose scope of practice includes polysomnography; employed as a polysomnograhic technologist by the U.S. Government when acting exclusively within the course and scope of employment; licensed by the Board to practice respiratory therapy; or pursing a course of study in a CAAHEP accredited polysomnograhic technology education program while acting within the course of study.

Polysomnographic technology is the allied health specialty practiced under the direction and supervision of a physician involving the attended monitoring and testing of individuals suffering from any sleep disorder as classified in the International Classification of Sleep Disorders.  Procedures are conducted only upon written prescription or verbal order of a physician, which is based on the physician’s clinical evaluation of the patient, and under his direction and supervision.  A polysomnographic technologist is an allied health professional who possesses a current license issued by the Board to practice polysomnographic technology to perform both diagnostic and therapeutic polysomnograms under the direction and supervision of a physician.  A polysomnographic technician is an allied health professional who possesses a current permit issued by the Board to practice polysomnographic technology under the direct supervision of a physician or qualified allied health professional currently licensed by the Board whose scope of practice includes polysomnography.  A supervising physician is a qualified physician who provides direction and supervision to an individual who is licensed or direct supervision to an individual who holds a permit, to practice polysomnographic technology in Louisiana.

Technologists are required to have the direction and supervision by a physician for the proper performance of polysomnographic technology. Such direction and supervision is not construed to require the physical presence of the supervising physician, provided that the physician is immediately available to furnish assistance and direction, either in person or by telephone or electronic means, throughout the performance of the polysomnographic procedure or service.  On the other hand, a technician is required to have direct supervision by a physician or a qualified health care provider currently licensed by the Board, whose scope of practice includes polysomnography, and who is present in the area where the procedure or service is being performed and is available to furnish assistance and direction throughout the procedure or service.

Applicants for a polysomnographic technologist license who obtain a license on or before July 17, 2017 must: 1) be at least 18 years old; 2) be of good moral character; 3) have a high school diploma or GED; 4) have a current credential as a polysomnographic technologist granted on the basis of a written examination by the BRPT or the ABSM, or such other certifying entity as the Board may approve; 5) have current certification in basic cardiac life support or CPR from the American Heart Association or the American Red Cross; 6) be a U.S. citizen or possess current and valid legal authority to reside and work in the U.S.; 7) satisfy the procedures and requirements for application and examination in the rules; and 8) not be otherwise disqualified due to any ground for licensure denial.

After July 17, 2017, in addition to the requirements outlined above, an applicant must also be a graduate of a CAAHEP accredited education program in polysomnography and have passed a polysomnographic technology examination administered as a component of a certificate program approved by the Board.  However, these additional requirements apply only to new applicants who apply after July 17, 2017.  An applicant who was licensed before July 17, 2017 and who is eligible for renewal or reinstatement must meet the eligibility requirements in effect at the time of the applicant’s initial license was issued. 

Any applicant who fails the examination up to four times must complete continuing education or additional training as may be recommended by the advisory committee and approved by the Board before the applicant may be considered for licensure.  If an applicant fails the examination more than four times, such additional education and training may include a requirement that the applicant repeat all or a portion of any didactic and/or clinical training required for licensure.

A license expires each year on the last day of the month in which the licensee was born and may be renewed upon submission of the renewal application, along with all required documentation.  Licensees are required to complete not less than ten (10) hours of approved continuing professional education within the past twelve (12) months. The continuing professional education requirement for renewal of licensure does not apply to a polysomnographic technologist who is employed exclusively at an institution operated by the U.S. Government or who has been credentialed or re-credentialed on the basis of examination within twelve (12) months prior to the date of renewal. The Board set the initial licensing fees at $150 for polysomnography technologists, with renewal fees set at $75.

A license that has expired may be reinstated, subject to the conditions placed by the Board (basically the requirements to renew the license).  If the application for reinstatement is made less than two years from the date the license expired, a penalty equal to the renewal fee will be assessed.  If the application for reinstatement is made more than two years from the date the license expired, a penalty equal to twice the renewal fee will be assessed.  If the applicant has not been licensed to practice as a polysomnographic technologist or has not engaged in such practice in any state for a period of five (5) years immediately prior to the application date, will be required to have been re-credentialed by the successful passage of the examination required for initial licensure or for re-certification. However, the applicant will not be required to submit evidence of continuing professional education that would otherwise be required.

Applicants for a polysomnographic technician permit must: 1) be at least 18 years old; 2) be of good moral character; 3) have a high school diploma or GED; 4) have current certification in basic cardiac life support or CPR from the American Heart Association or the American Red Cross; 5) be a U.S. citizen or possess current and valid legal authority to reside and work in the U.S.; 6) have passed the entry level certification examination offered by the BRPT or have completed an accredited CAAHEP education program in polysomnography; 7) satisfy the procedures and requirements for application and examination in the rules; and 8) not be otherwise disqualified due to any ground for licensure denial.

A permit cannot be renewed beyond its original term, unless the applicant failed to take or failed to pass the BRPT or ABSM examination with the original permit term. A permit that is renewed under this provision is valid for twelve months or until the date on which the applicant meets and satisfies the requirements.  The proposed rule contemplates a one-time renewal under this limited provision, such that the renewed permit is not renewable thereafter, unless the Board grants an exception to the applicant.  These requirements would apply to technicians who currently hold permits. There is no requirement in the proposed rules for a polysomnographic technician to obtain continuing professional education hours.  The Board set the initial fees at $100 for polysomnography technicians, with renewal fees at $50. 

Submission of the application for license or permit constitutes an authorization for the Board to obtain information about the applicant from educational institutions, employers, physicians and health care providers, and professional organizations.  Additionally, the submission of the application is deemed to be consent by the applicant to submit to a physical or mental examination, if when, and in the manner directed by the Board and acts as a waiver of any objection to the admissibility or disclosure of any findings, reports, or recommendations pertaining to the examination.  The applicant bears the expense of any such examination required by the Board.