1. (a) Each osteopathic physician and surgeon submitting the biennial renewal fee shall submit satisfactory proof to the Board of ongoing compliance with the provisions of this article at the times specified herein.
2. (b) As a condition of renewal, each osteopathic physician and surgeon shall complete the continuing medical education (CME) requirements set forth in Section 2454.5 of the Code and this section during the two years immediately preceding their license expiration date, unless otherwise provided in this section or a waiver is obtained as provided in Section 1637. This two-year period is defined as the “CME requirement period.” Each osteopathic physician and surgeon shall provide satisfactory documentation of their CME completion or exemption to the Board as specified in Section 1636.

3. (c) CME courses shall also meet the following criteria to be acceptable:

   1. (1) Any CME course that includes a direct patient care component and is offered by a CME provider located in this state shall contain curriculum that includes cultural and linguistic competency and an understanding of implicit bias in the practice of medicine as provided in Section 2190.1 of the Code. “Direct patient care” shall have the meaning as set forth in paragraph (2) of subsection (f).
   2. (2) Any CME courses taken that meet the criteria in Section 2190.15 of the Code shall not together comprise more than 15 hours of the total hours of CME completed by an osteopathic physician and surgeon to satisfy the continuing educational requirement established by Section 2454.5 of the Code.
4. (d) For those osteopathic physicians and surgeons licensed on or after January 1, 2023, the initial CME requirement period shall be from the date of initial licensure to the first license expiration date. Subsequent two-year CME periods shall not include CME earned during a preceding two-year CME requirement period.

5. (e) In addition to meeting the requirements of subsections (b) and (c), as a condition of renewal, unless otherwise exempted or a waiver is obtained as specified in this section, osteopathic physicians and surgeons shall complete the following:

   1. (1) a one-time, 12-hour CME course in pain management and the treatment of terminally ill and dying patients meeting the requirements of this section and Section 2190.5 of the Code within four years of their initial license or by their second renewal date, whichever occurs first.

      1. (A) At a minimum, course content for a course in pain management and the treatment of terminally ill and dying patients shall include the practices for pain management in medicine, palliative and end-of-life care for terminally ill and dying patients, and the risks of addiction associated with the use of Schedule II drugs.
      2. (B) For the course component involving the risks of addiction associated with the use of Schedule II drugs mentioned in subsection (e)(1)(A), at a minimum, the course content shall include regulatory requirements for prescribers and dispensers, strategies for identifying substance use, and procedures and practices for treating and managing substance use disorder patients.
      3. (C) CME hours earned in fulfillment of this requirement shall be counted by the Board towards the total CME hours each osteopathic physician and surgeon is required to complete during each CME requirement period as provided by Section 2454.5 of the Code.

   2. (2) a course on the risks of addiction associated with the use of Schedule II drugs that contains, at a minimum, the course content specified in subsection (e)(1)(B).

      1. (A) CME hours earned in fulfillment of this requirement shall be counted by the Board towards the total CME hours each osteopathic physician and surgeon is required to complete during each CME requirement period as provided by Section 2454.5 of the Code.
      2. (B) The Board shall deem this requirement to be met for the applicable CME requirement period if the osteopathic physician and surgeon completed the 12-hour CME course specified in subsection (e)(1) during that CME requirement period.
   3. (3) if applicable, all general internists and family osteopathic physicians and surgeons who have a patient population of which over 25 percent are 65 years of age or older shall complete at least 10 hours in a course required by Section 2190.3 of the Code.

6. (f) Osteopathic physicians and surgeons (“physicians”) meeting any of the following criteria at the time of renewal shall be deemed exempt from the requirements of subsection (e)(1):

   1. (1) Physicians practicing in pathology or radiology specialty areas as required by Section 2190.5 of the Code;
   2. (2) Physicians not engaged in direct patient care. “Direct patient care” means personal contact or face-to-face interaction with a patient located in California (“California patient”), including health assessments, counseling, treatments, patient education, prescribing or administering medications, or any task authorized by the Act or described in Sections 2051 or 2052 of the Code that involves personal interaction with the California patient. “Personal contact” shall include communication by any method of direct interaction with the patient or via telehealth as provided in Section 2290.5 of the Code;
   3. (3) Physicians that do not provide patient consultations regarding a California patient;
   4. (4) Physicians who have completed a one-time continuing education course of 12 credit hours in the subject of treatment and management of opiate-dependent patients, including eight hours of training in buprenorphine treatment, or other similar medicinal treatment, for opioid use disorders; or,

   5. (5) Physicians who are deemed a “qualifying physician” as specified in Section 2190.6 of the Code, which means a physician meets any of the following conditions:

      1. (A) The physician holds a board certification in addiction psychiatry or addiction medicine from the American Board of Medical Specialties,
      2. (B) The physician holds an addiction certification from the American Society of Addiction Medicine or the American Board of Addiction Medicine,
      3. (C) The physician holds a board certification in addiction medicine from the American Osteopathic Association.

      4. (D) The physician has completed not less than eight hours of training (through classroom situations, seminars at professional society meetings, electronic communications, or otherwise) that is provided by the American Society of Addiction Medicine, the American Academy of Addiction Psychiatry, the American Medical Association, the American Osteopathic Association, or the American Psychiatric Association. Such training shall include:

         1. 1. opioid maintenance and detoxification;
         2. 2. appropriate clinical use of all drugs approved by the Food and Drug Administration for the treatment of opioid use disorder;
         3. 3. initial and periodic patient assessments (including substance use monitoring);
         4. 4. individualized treatment planning, overdose reversal, and relapse prevention;
         5. 5. counseling and recovery support services;
         6. 6. staffing roles and considerations;
         7. 7. diversion control; and,
         8. 8. other best practices.
      5. (E) The physician has participated as an investigator in one or more clinical trials leading to the approval of a narcotic drug in schedule III, IV, or V for maintenance or detoxification treatment, as demonstrated by a statement submitted to the U.S. Secretary of Health and Human Services by the sponsor of such approved drug.

Note: Authority cited: Osteopathic Act (Initiative Measure, Stats. 1923, p. xciii), Section 1; and Sections 2018, 2451, 2190.5, 2454.5, 2456.1 and 3600-1, Business and Professions Code. Reference: Sections 2190.1, 2190.15, 2190.3, 2190.5, 2190.6, 2452 and 2454.5, Business and Professions Code.

History

1. Repealer of chapter 16 (sections 1600-1697, not consecutive) and new chapter 16 (sections 1600-1697, not consecutive and Appendix) filed 12-10-87; operative 1-9-88 (Register 87, No. 52). For prior history, see Registers 81, No. 50; 81, No. 36; 81, No. 9; 80, No. 40; 78, No. 15; 77, No. 21; and 63, No. 25.

2. Amendment of subsections (b), (c), (d) and (e) filed 9-28-90; operative 10-28-90 (Register 90, No. 45).

3. Amendment of subsections (c) and (e) filed 3-23-94; operative 4-22-94 (Register 94, No. 12).

4. Amendment of subsections (a), (e) and Note filed 1-26-95; operative 1-26-95 pursuant to Government Code section 11343.4(d) (Register 95, No. 4).

5. Change without regulatory effect amending subsection (a) and Note filed 1-15-2025 pursuant to section 100, title 1, California Code of Regulations (Register 2025, No. 3).

6. Amendment of section heading, section and Note filed 7-10-2025; operative 10-1-2025 (Register 2025, No. 28).