HB 5458 — Relating to professionals to be licensed by the West Virginia Board of Medicine

1 (a) The West Virginia Board of Medicine has assumed, carried on, and succeeded to all the duties, rights, powers, obligations, and liabilities heretofore belonging to or exercised by the Medical Licensing Board of West Virginia.

The board remains the sole authority for the issuance of licenses to practice allopathic medicine and surgery,surgery to practice and podiatry, and to practice as Enr CS for HB 5458 physician assistants in this state under the supervision of in collaboration with physicians licensed under this article.

The board shall consist of 15 members.

One member shall be the state health officer ex officio, with the right to vote as a member of the board.

The other 14 members shall be appointed by the Governor, with the advice and consent of the Senate.

Eight of the members shall be appointed from among individuals holding the degree of doctor of medicine, and one shall hold the degree of doctor of podiatric medicine.

Two members shall be physician assistants licensed by the board.

Each of these members must be duly licensed to practice his or her profession in this state on the date of appointment and must have been licensed and actively practicing that profession for at least five years immediately preceding the date of appointment.

Three lay members shall be appointed to represent health care consumers.

Neither the lay members nor any person of the lay members’ immediate families shall be a provider of or be employed by a provider of health care services.

The state health officer’s term shall continue for the period that he or she holds office as state health officer.

Each other member of the board shall be appointed to serve a term of five years:

Provided, That the members of the Board of Medicine holding appointments on the effective date of this section shall continue to serve as members of the Board of Medicine until the expiration of their term unless sooner removed.

Each term shall begin on October 1 of the Eng CS for HB 5458 applicable year and a member may not be appointed to more than two consecutive full terms on the board.

A person is not eligible for membership on the board who is a member of any political party executive committee or, with the exception of the state health officer, who holds any public office or public employment under the federal government or under the government of this state or any political subdivision thereof.

In making appointments to the board, the Governor shall, so far as practicable, select the members from different geographical sections of the state.

When a vacancy on the board occurs and less than one year remains in the unexpired term, the appointee shall be eligible to serve the remainder of the unexpired term and two consecutive full terms on the board.

No member may be removed from office by the Governor except for official misconduct, incompetence, neglect of duty, or gross immorality:

Provided, That the expiration, surrender, or revocation of the professional license by the board of a member of the board shall cause the membership to immediately and automatically terminate.

Eng CS for HB 5458 (d) A person is not eligible for membership on the board who is a member of any political party executive committee or, with the exception of the state health officer, who holds any public office.

Enr CS for HB 5458 "Active clinical practice" means that the licensee is engaged in the full-time practice of clinical medicine in West Virginia for a minimum of 50 percent of the licensee's professional practice.

or Eng CS for HB 5458 (C) Is employed by an entity which provides health care goods or services to West Virginia patients if the individual’s work responsibilities relate, in whole or in part, to the delivery of health care services, health care administration, management, or policy.

Enr CS for HB 5458 (k) Excepting the state health officer, whose term shall be limited to their service in that office, a member of the board immediately and automatically forfeits membership to the board if:

Eng CS for HB 5458 Every two years the board shall elect from among its members a president and vice president.

Special meetings and emergency meetings of the board may be called by the joint action of the president and vice president or by any three members of the boardboard. on seven days' prior written notice by mail postage prepaid or electronic means or, in case of emergency, on two days' notice by telephone and electronic means.

With the exception of the state health officer, members of the board shall receive compensation and expense reimbursement in accordance with section eleven, article one §30-1-11 of this chaptercode.code.

Disciplinary proceedings, prior to a finding of probable cause as provided in subsection§30-3-14(p) §30-3-14(p), section fourteen of this articlecode,code, shall be held in closed sessions, unless the party subject to discipline requests that the proceedings be held in public session.

Enr CS for HB 5458 §30-3-7.

(a) The board is autonomous and, in accordance with this article, shall determine qualifications of applicants for licenses and other practice credentials to practice medicine and surgery, to practice podiatry, and to practice as a physician assistant for a physician in collaboration with physicians licensed under this article or §30-14-1 et.

Eng CS for HB 5458 (2) Hold hearings and conduct investigations, subpoena witnesses and documents and administer oaths;

(6) Establish and certify standards for the supervision and certification of physician assistants;

(7) Authorize medical and podiatry corporations in accordance with the limitations of section§30- fifteen3-15 §30-3-15 of this article code to practice medicine and surgery or podiatry through duly licensed physicians, or podiatrists or physician assistants;

and (8) Establish the circumstances under which the approval of applications and the issuance of licenses and other practice credentials may be delegated to board staff;

Enr CS for HB 5458 (b) The board shall submit an annual report of its activities to the Legislature.

Eng CS for HB 5458 The state health officer, in addition to being a member of the board, shall act as its secretary.

Such The record may include, in accordance with rules established by the board, additional items relating to the individual's record of professional practice that will facilitate proper review of such individual's professional competence.

(c) A physician, podiatrist, physician assistant or applicant, or authorized representative thereof, has the right, upon request, to examine his or her own individual historical record Enr CS for HB 5458 maintained by the board pursuant to this article and to place into such record a statement of reasonable length of his or her own view of the correctness or relevance of any information existing in such record.

Such The statement shall at all times accompany that part of the record in contention.

Eng CS for HB 5458 (e) A physician, podiatrist, physician assistant or applicant shall be provided written notice within thirty 30 days of the placement and substance of any information in his or her individual historical record that pertains to him or her and that was not submitted to the board by him or her.

(f) Except for information relating to biographical background, education, professional training and practice, a voluntary agreement entered into pursuant to subsection §30-3-9(h) of this sectioncodecode and which has been disclosed to the board, prior disciplinary action by any entity, or information contained on the licensure application, the board shall expunge information in an individual's historical record unless it has initiated a proceeding for a hearing upon such information within two years of the placing of the information into the historical record.

(h)(1) In order to encourage voluntary participation in monitored alcohol chemical dependency or major mental illness programs and in recognition of the fact that major mental illness, alcoholism and chemical dependency are illnesses, a physician, podiatrist or physician assistant licensed, certified or otherwise lawfully practicing in this state or applying for a license to practice in this state may enter into a voluntary agreement with the physician health program as defined in section two, article three-d §30-3D-2 of this chapter code.

Enr CS for HB 5458 (2) Any voluntary agreement entered into pursuant to this subsection shall not be considered a disciplinary action or order by the board, shall not be disclosed to the board and shall not be public information if:

Eng CS for HB 5458 (A) SuchTheThe voluntary agreement is the result of the physician, podiatrist or physician assistant self-enrolling or voluntarily participating in the board-designated physician health program;

(B) The board has not received nor filed any written complaints regarding said physician, podiatrist or physician assistant relating to an alcohol, chemical dependency or major mental illness affecting the care and treatment of patients, nor received any reports pursuant to subsection§30-3- §30-3-14(b),14(b) section fourteen of this articlecodecode relating to an alcohol or chemical dependency impairment;

(3) If any physician, podiatrist or physician assistant enters into a voluntary agreement with the board-approved physician health program, pursuant to this subsection and then fails to comply with or fulfill the terms of said agreement, the physician health program shall report the noncompliance to the board within twenty-four2424 hours.

The board may initiate disciplinary proceedings pursuant to subsection §30-3-14(a)(1), section fourteen of this articlecodecode or may permit continued participation in the physician health program or both.

In the board's annual report of its activities to the Legislature required under section seven §30-3-7 of this articlecode,code, the board shall include information regarding the success of the voluntary agreement Enr CS for HB 5458 mechanism established therein:

Provided, That in making suchthethe report, Eng CS for HB 5458 the board shallmaymay not disclose any personally identifiable information relating to any physician, podiatrist or physician assistant participating in a voluntary agreement as provided herein.

Licenses to practice allopathic and podiatric medicine and surgerysurgery. or podiatry.

(a) ALicense personto seekingPractice licensureAllopathic asMedicine anand allopathicSurgery. physician shall apply to the board.

(b) License to Practice Allopathic Medicine and Surgery.

The board may grant a license to practice allopathic medicine and surgery to an applicant A license may be granted to an applicant who has graduated and received the degree of doctor of medicine or its equivalent from a school of medicine located within the United States, the Commonwealth of Puerto Rico, or Canada, and is approved by the Liaison Committee on Medical Education LCME or by the board, and who:

EngEnr CS for HB 5458 (2) Pays the applicable fees;

(A) Is physically and mentally capable of goodengaging moralin character;the practice of medicine and surgery;

(BA)(B) IsHas, physicallywithin and10 mentallyconsecutive capableyears, passed all component parts of engagingthe USMLE or any prior examination or examination series approved by the board which relates to a national standard, is administered in the practiceEnglish oflanguage, and is designed to ascertain an applicant’s fitness to practice medicine and surgery;surgery:

(CB) Has, within 10 consecutive years, passed all component parts of the United States Medical Licensing ExaminationUSMLE or any prior examination or examination series approved by the board which relates to a national standard, is administered in the English language, and is designed to ascertain an applicant’s fitness to practice medicine and surgery:

(DC)(C) Has successfully completed:completed one year of approved graduate medical education;

oneand year(D) Meets any other criteria for licensure set forth in this article or in rules promulgated by the board pursuant to §30-3-7 of approvedthis graduatecode medicaland education;in accordance with §29A-3-1 et seq.

and (i) A minimum of one year of graduate clinical training in a program is approved by the Accreditation Council for Graduate Medical Education;

or (ii) A graduate medical education residency program outside of the United States and a minimum of one year of fellowship training in the United States in a clinical field related to the applicant’s residency training which was completed:

(I) At an institution that sponsors or operates a residency program in the same clinical field or a related clinical field approved by the Accreditation Council for Graduate Medical Education;

or (II) At a time when accreditation was not available for the fellowship’s clinical field and the board has determined that the training was similar to accredited training due to objective standards, including, but not limited to, the presence of other accredited programs at the sponsoring institution during the applicant’s clinical training at the fellowship location;

and (ED) Meets any other criteria for licensure set forth in this article or in rules promulgated by the board pursuant to §30-3-7 of this code and in accordance with §29A-3-1 et seq.

Eng(b) CS for HB 5458 (cb) License to Practice Allopathic Medicine and Surgery – International Medical Graduates who have completed approved graduate medical education.

The board may grant a license to practice allopathic medicine and surgery to an applicant A license may be granted to an applicant who has received the degree of doctor of medicine or its equivalent from a an approved school of medicine located outside of the United States, the Commonwealth of Puerto Rico, and Canada, who:

(A) Is physically and mentally capable of goodengaging moralin character;the practice of medicine and surgery;

(BA)(B) IsHas, physicallywithin and10 mentallyconsecutive capableyears, passed all component parts of engagingthe USMLE or any prior examination or examination series approved by the board which relates to a national standard, is administered in the practiceEnglish oflanguage, and is designed to ascertain an applicant’s fitness to practice medicine and surgery;surgery:

(CB)Provided, Has,That within 10 consecutive years, passed all component parts of the Unitedboard Statesmay Medicalaccept Licensingan Examination USMLE or any prior examination orEnr examinationCS seriesfor approvedHB by5458 thesequence board which relateswas tosuccessfully acompleted nationalin standard,more isthan administered10 inconsecutive theyears Englishif language,the andapplicant isholds designedcurrent tospecialty ascertainboard ancertification applicant’sfrom fitnessa tomember practiceboard medicineof andABMS; surgery:

Provided,(C) ThatHas the board may accept an examination sequence which was successfully completedcompleted: in more than 10 consecutive years if the applicant holds current specialty board certification from a member board of ABMS;

(DC)(i) HasTwo successfullyyears completed:of approved graduate medical education;

(i)or A(ii) minimumOne year of twoapproved yearsgraduate ofmedical graduateeducation clinicaland trainingthe approvedapplicant byholds thea Accreditationcurrent Councilcertification forby Graduatea Medicalmember Education;board of the ABMS;

Two(D) yearsHolds ofa approvedvalid graduateECFMG medicalcertification education;or:

or (ii) A minimum of one year of graduate clinical training approved by the Accreditation Council for Graduate Medical Education or one year of fellowship training which comports with the requirements of subparagraph (iii) of this paragraph One year of approved graduate medical Eng CS for HB 5458 education and the applicant holds a current certification by a member board of the American Board of Medical SpecialtiesABMS;

or (iii) A graduate medical education residency program outside of the United States and a minimum of two years of fellowship training in the United States in a clinical field related to the applicant’s residency training which was completed:

(I) At an institution that sponsors or operates a residency program in the same clinical field or a related clinical field approved by the Accreditation Council for Graduate Medical Education;

or (II) At a time when accreditation was not available for the fellowship’s clinical field and the board has determined that the training was similar to accredited training due to objective standards, including, but not limited to, the presence of other accredited programs at the sponsoring institution during the applicant’s clinical training at the fellowship location;

(ED) Holds a valid ECFMG certificate certification issued by the Educational Commission for Foreign Medical Graduates or:

(FE)(E) Can communicate in the English language;

and (GF)(F) Meets any other criteria for licensure set forth in this article or in rules promulgated by the board pursuant to §30-3-7 of this code and in accordance with §29A-3-1 et seq.

(dc)(c) License to Practice Allopathic Medicine and Surgery – International Medical Graduates who have not completed two years of approved graduate medical education.

Eng CS for HB 5458 The board may grant a license to practice allopathic medicine and surgery to an applicant who has received the degree of doctor of medicine or its equivalent from an approved school of medicine located outside of the United States, the Commonwealth of Puerto Rico, and Canada and who has not completed approved graduate medical education in the United States or Canada if the applicant:

Enr CS for HB 5458 (1) Satisfies all the requirements of §30-3-10(b) of this code except for the completion of approved graduate medical education;

and Eng CS for HB 5458 (D) Demonstrates competency to practice administrative medicine.

Enr CS for HB 5458 (3) The board may deny an application for an administrative medicine license and may discipline an administrative medicine licensee who, after a hearing, has been adjudged by the board as unqualified due to any reason set forth in §30-3-14 of this code or the board’s rules and pursuant to the processes set forth therein.

(e) ALicense personto seekingpractice licensurepodiatric asmedicine and surgery - The board may grant a podiatristlicense shallto applypractice podiatric medicine and surgery to thean board.applicant who:

A license may be granted to an applicant whoLicense to practice podiatric medicine and surgery - The board may grant a license to practice podiatric medicine and surgery to an applicant who:

(A) Is physically and mentally capable of goodengaging moralin character;the practice of podiatric medicine and surgery;

(BA)(B) IsHas physicallygraduated and mentallyreceived capablethe degree of engagingdoctor inof thepodiatric practicemedicine or its equivalent from a school of podiatric medicine andapproved surgery;by the Council of Podiatric Medical Education or by the board;

(CB)(C) HasHas, graduatedwithin and10 receivedconsecutive theyears, degreepassed ofall doctorcomponent parts of podiatricthe medicineAPMLE, or itsany equivalentprior fromexamination aor schoolexamination ofseries podiatric medicine approved by the Councilboard ofwhich Podiatricrelates Medicalto Educationa ornational bystandard, is administered in the board;English language, and is designed to ascertain an applicant’s fitness to practice podiatric medicine;

(DC)(D) Has,Has withinsuccessfully 10completed consecutivea years,minimum passedof allone componentyear parts of thegraduate Americanclinical Podiatrictraining Medicalin Licensinga ExaminationAPMLE,program or any prior examination or examination series Eng CS for HB 5458 approved by the boardCouncil whichon relatesPodiatric toMedical aEducation nationalor standard, is administered in the EnglishColleges language,of andPodiatric isMedicine. designed to ascertain an applicant’s fitness to practice podiatric medicine;

(ED) Has successfully completed a minimum of one year of graduate clinical training in a program approved by the Council on Podiatric Medical Education or the Colleges of Podiatric Medicine.

and (FE)Enr CS for HB 5458 (E) Meets any other reasonable criteria for licensure set forth in this article or in legislative rules promulgated by the board.

(e)(f) NotwithstandingAn anyapplicant offor thea provisionslicense ofmay thisbe article,required by the boardboard, mayin issueits discretion, to appear for a restrictedpersonal licenseinterview and may be required to anproduce applicantoriginal indocuments extraordinaryfor circumstancesreview underby the followingboard. conditions:

(1)(g) UponAll alicenses findingto bypractice themedicine boardand thatsurgery basedgranted prior to July 1, 2008, and valid on thethat applicant’sdate exceptionalshall education,continue training,in andfull practiceeffect credentials,for the applicant’sterm practiceand inunder the stateconditions wouldprovided beby beneficiallaw toat the publictime welfare;of the granting of the license.

(2)(h) UponThe board may not issue a findinglicense byto thea boardperson thatnot thepreviously applicant’slicensed education,in training,West andVirginia practicewhose credentialslicense arehas substantiallybeen equivalentrevoked toor thesuspended requirementsin another state until reinstatement of licensurehis establishedor her license in thisthat article;state.

(3)(i) UponThe board may not issue an initial license, reinstate, or reactivate a findinglicense, byto theany boardindividual thatwhose thelicense applicanthas receivedbeen hisrevoked, suspended, surrendered, or herdeactivated post-graduatein medicalanother trainingstate outsidebased upon conduct which is substantially equivalent to an act of unprofessional conduct prohibited by §30-3-14(c) of this code or the Unitedboard’s Stateslegislative andrules, itsuntil territories;reinstatement of his or her license in that state.

(4)(j) ThatThe board need not reject a candidate for a nonmaterial technical or administrative error or omission in the restrictedapplication licenseprocess issuedthat underis extraordinaryunrelated circumstancesto the candidate’s professional qualifications as long as there is approvedsufficient byinformation aavailable voteto ofthe threeboard fourthsto ofdetermine the memberseligibility and qualifications of the board;candidate for licensure.

and (5) That orders denying applications for a restricted license under this subsection are not appealable.

(f) The board may propose rules for legislative approval in accordance with the provisions of §29A-3-1 et seq.

of this code that establish and regulate the restricted license issued to an applicant in extraordinary circumstances pursuant to the provisions of this section.

Eng CS for HB 5458 (gf) Personal interviews by board members of all applicants are not required.

An applicant for a license may be required by the board, in its discretion, to appear for a personal interview and may be required to produce original documents for review by the board.

(hg) All licenses to practice medicine and surgery granted prior to July 1, 2008, and valid on that date shall continue in full effect for the term and under the conditions provided by law at the time of the granting of the license:

Provided, That the provisions of subsection (d) of this section do not apply to any person legally entitled to practice chiropody or podiatry in this state prior to June 11, 1965:

Provided, however, That all persons licensed to practice chiropody prior to June 11, 1965, are permitted to use the term “chiropody-podiatry” and shall have the rights, privileges, and responsibilities of a podiatrist set out in this article.

(ih) The board shall may not issue a license to a person not previously licensed in West Virginia whose license has been revoked or suspended in another state until reinstatement of his or her license in that state.

(ji) The board shall may not issue an initial license, reinstate, or reactivate a license, to any individual whose license has been revoked, suspended, surrendered, or deactivated in another state based upon conduct which is substantially equivalent to an act of unprofessional conduct prohibited by §30-3-14(c) of this code or the board’s legislative rules, until reinstatement of his or her license in that state.

(kj) The board need not reject a candidate for a nonmaterial technical or administrative error or omission in the application process that is unrelated to the candidate’s professional qualifications as long as there is sufficient information available to the board to determine the eligibility and qualifications of the candidate for licensure.

"Without examination" means that the board may not require an applicant to sit for the USMLE or any prior examination or examination series approved by the board to be eligible for Eng CS for HB 5458 licensure.

Individuals who have failed one or more steps of an approved licensing examination are not Enr CS for HB 5458 eligible for licensure pursuant to this section until such time as the failed test attempt has been superseded by a successful exam attempt.

Eng CS for HB 5458 (1) The board shall issue a limited license to practice allopathic medicine and surgery, without examination, to an individual appointed to a West Virginia medical school faculty who Enr CS for HB 5458 holds a valid license to practice medicine and surgery from another state, the District of Columbia, the Commonwealth of Puerto Rico, or Canada and who:

(3) A physician issued a medical school faculty license under this section shall keep all medical licenses issued by other jurisdictions in good standing and shall notify the board, within 15 Eng CS for HB 5458 days of its occurrence, of any denial, suspension or revocation of or any limitation placed on a medical license issued by another jurisdiction.

Enr CS for HB 5458 (d) Summer Camp License.

[Repealed.] CS for HB 5458 §30-3-11b.

Enr CS for HB 5458 [Repealed.] ARTICLE 3H.

"ACS permit" means a permit issued to an individual who has attained Active Candidate Status to take the ABGC certification examination in general genetics and genetic counseling Eng CS for HB 5458 which authorizes the permit holder to practice genetic counseling under the supervision of a qualified supervisor.

Enr CS for HB 5458 "Board" means the West Virginia Board of Medicine established in §30-3-1 et seq.

Eng CS for HB 5458 (a) Effective July 1, 2026, and except as provided in subsection (b) of this section, a person may not engage, or offer to engage, in the practice of genetic counseling to patients in this state without a current, valid license issued by the board.

Enr CS for HB 5458 (1) Any person, such as a physician, advanced practiced registered nurse, or physician assistant, who is lawfully practicing within the scope of the person's profession, is engaged in work of a nature consistent with the person's training, and has a license, permit, registration, certification, or other authorization to practice his or her profession in West Virginia;

(c) Effective July 1, 2026, any person who is not licensed by the board as a genetic counselor may not hold himself or herself out to the public as a genetic counselor, and may not, in Eng CS for HB 5458 connection with his or her name or place of business, use the terms "genetic counselor", "licensed genetic counselor", or any words, letters, abbreviations or insignia indicating or implying that the person holds a genetic counseling license.

Enr CS for HB 5458 §30-3H-4.

Eng CS for HB 5458 (b) The board's annual report to the Legislature shall include a statistical analysis of complaints received, charges investigated, charges dismissed after investigation, the grounds for each such dismissal and disciplinary proceedings and disposition.

Enr CS for HB 5458 (2) Submits an application for licensure to the board on a form approved by the board;

(b) The board may not issue an initial license, reinstate, or reactivate a license, to any individual whose license has been revoked, suspended, surrendered, or deactivated in another Eng CS for HB 5458 state based upon conduct which is substantially equivalent to an act of unprofessional conduct prohibited by §30-3H-9 of this code or the board's legislative rules, until reinstatement of his or her license in that state.

Enr CS for HB 5458 §30-3H-6.

Eng CS for HB 5458 (e) The board may, and only once, extend an ACS permit for a limited period specified by the board, if the person maintains Active Candidate Status with the ABGC and has not failed the ABGC certification exam during the initial permit period.

Enr CS for HB 5458 (g) The board shall issue a certificate to each person who is approved for supervised genetic counseling practice under this article.

(e) The board may waive all or a portion of the continuing education requirement for biennial renewal for a licensee who shows to the satisfaction of the board that the licensee was Eng CS for HB 5458 unable to complete the requirements due to serious illness, military services, or other demonstrated hardship.

Enr CS for HB 5458 (g) If a license automatically expires and reinstatement is sought within one year of the automatic expiration, then an applicant shall submit:

Eng CS for HB 5458 (3) Identifying, ordering, and coordinating genetic laboratory tests and other diagnostic studies as appropriate for genetic assessment, consistent with practice-based competencies provided by ACGC;

Enr CS for HB 5458 (6) Evaluating the patient’s or family's responses to the condition or risk of recurrence and providing patient-centered counseling and anticipatory guidance;

Eng CS for HB 5458 (f) Not withstanding any other provision of this code to the contrary, and to the degree permitted by federal law, genetic counselors shall be considered providers and may not be reimbursed at rates lower than other providers who render similar genetic counseling services by health insurers as well as health plans operated or paid for by the state.

(b) All hearings and procedures related to denial of a license, and all complaints, investigations, hearings, and procedures regarding a genetic counselor license and/or an ACS Enr CS for HB 5458 permit and the discipline accorded thereto, shall be in accordance with the processes and procedures set forth in §30-3-1 et seq.

Eng CS for HB 5458 (5) Developed a physical or mental disability or other condition that presents a danger in continuing to practice genetic counseling to patients, the public, or other health care personnel;

Enr CS for HB 5458 (9) Aided, assisted, or abetted the unlawful practice of genetic counseling;

Eng CS for HB 5458 (e) Whenever it finds any person unqualified because of any of the grounds set forth in §30-3H-7(b) of this code, the board may enter an order imposing one or more of the following:

Enr CS for HB 5458 (5) Require him or her to submit to care, counseling, or treatment designated by the board as a condition for initial or continued licensure or renewal of licensure or other authorization to practice genetic counseling;

Eng CS for HB 5458 (i) The board may report final disciplinary action taken against a genetic counselor to any national database that includes information about disciplinary action taken against health care professionals.

Enr CS for HB 5458 §30-3H-10.

and Eng CS for HB 5458 (3) The formal disciplinary action taken against the genetic counselor by the facility relating to professional ethics, professional incompetence, professional malpractice, or drug or alcohol abuse.

40Enr CS for HB 5458 The Clerk of the House of Delegates and the Clerk of the Senate hereby certify that the foregoing bill is correctly enrolled.

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Clerk of the House of Delegates ...............................................................

Clerk of the Senate Originated in the House of Delegates.

In effect 90 days from passage.

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Speaker of the House of Delegates ...............................................................

President of the Senate __________ The within is ................................................

this the...........................................

Day of ..........................................................................................................., 2026.

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Governor 37