ANNUAL REPORT FOR JANUARY 1 TO DECEMBER 31, 2024
PG 2 | ALBME
In 2024, the Board continued its
physician and gain experience in
commitment to licensees by creating
preparation for re-applying for the
free, accredited, online CME courses
match, came online in July 2024. We
to facilitate compliance with the
anticipate a great deal of interest with
education requirements for physicians
the 2025 Match.
in collaborative and supervisory
William M. Perkins Executive Director
practices. The Board also created a free, accredited, online course to meet a new requirement for all licensees to obtain professional boundaries CME. The live controlled substances prescribing courses are now free for all licensees. This has all been accomplished without increasing renewal license fees, which have not been raised since 2008.
The emerging therapy that most occupied the Board’s attention in 2024 was semaglutide/GLP-1s for weight control. The popularity of the medications and shortages resulted in issues with counterfeit products being sold online and improperly compounded products being purchased by physicians for compounding in the office. Following its September 2023 advisory about
Applications for Bridge Year Graduate
growing concerns surrounding these
Permits, designed to assist recent
medications, the Board issued a
medical school graduates who did
declaratory ruling in August 2024 for
not match into a residency program
physicians compounding any drugs in
to practice for one year under the
their offices.
supervision of an Alabama-licensed
Alabama Board of Medical Examiners bme@albme.gov
|
albme.gov
2024 ANNUAL REPORT | PG 3
MD/DO CERTIFICATES OF QUALIFICATION In 2024, there were increases in full certificates of qualification issued to both MDs and DOs. The other categories of certificates of qualification remained essentially stable.
The Physician Workforce Act of 2023 established a mechanism for limited,
Certificates of Qualification Issued 2023
2024
59
56
2
2
BRIDGE YEAR GRADUATE PHYSICIANS
supervised practice by graduates of accredited medical schools who applied to, but were not accepted into,
Retired Senior Volunteer
a residency training program for the
Limited DO
first year following medical school graduation (“bridge year graduate
248
260
physicians” or “BYG physicians”).
Limited MD
The Act authorized the Board to issue BYG physicians permits to practice
2 3
1 2
214
251
75
76
medicine in Alabama under the
Temporary Military DO Temporary Military MD Prior Temporary Military MD/DO - 3 Converted To Full License - 2 Expired
supervision of an Alabama-licensed physician. At the end of the supervised practice period, the supervising
Full DO Full MD/DO Applicants Accepting Non-Disciplinary Citation With Administrative Charge
physician will provide a statement of the medical competence of the BYG physician that can be submitted with an additional application to match into a residency.
1,084
1,189
Full MD
Certificate of Qualification Renewals 2023
2024
In 2024, Board rules were promulgated pursuant to the Act that specified the qualifications for a permit, qualifications of the supervising physician, how the permits are issued, grounds for denial, requirements for
475
1,612 total
537
1,761 total
supervised practice, and limitations upon utilization of BYG physicians. The Board looks forward to accepting
7 8 Limited COQ Renewal Retired Senior Volunteer Renewal
applications following the Match in March 2025.
PG 4 | ALBME
CONTROLLED SUBSTANCES/PAIN MANAGEMENT REGISTRATIONS ISSUED IN 2024 There were modest increases in the number of Alabama Controlled Substances Certificates issued in 2024, commensurate with the increased number of licenses issued. Pain Management registrations showed a modest increase from 2023.
Pain Management Services Registrations
Alabama Controlled Substances Certificates 2023
2024
1,431
1,463
367
398
2023
2024
582
557 445
13,233
472
Renewed
Initial Location Additional Locations
13,526 112 Expired Reissued
Initial Location Additional Locations
New Issued Expired Reissued Renewed
17
102
14 3
110
14
1 New Issued
64 38
13
60
46
Initial Location Additional Locations
14
Physician Assistant Licenses 2023 1,414
2024 1,616
440
500
1,391
1,534
Licenses Renewed Registered to Physicians (New) Total Registrations
2023
2024
2 75
48 6
211
220
Qualified AL Controlled Substances Certificates Issued Expired Reissued Renewed
Limited Purpose Schedule II Permits 1 44 35 2 164
169
PA LICENSES/ REGISTRATIONS ISSUED IN 2024 The number of Physician Assistant Licenses and Registrations increased from 2023, while the number of Qualified Alabama Controlled Substances Certificates for PAs fell slightly.
2024 ANNUAL REPORT | PG 5
MEDICAL CANNABIS—PHYSICIAN MEDICAL CANNABIS CERTIFICATION PERMIT Pursuant to the provisions of the Darren Wesley “Ato” Hall Compassion Act, the Board of Medical Examiners approved rules to regulate the physician recommendation of medical cannabis in November 2021. These regulations are codified in Ala. Admin. Code R. 540-X-25. In 2024, after hearing from interested parties, the Board reviewed and amended several provisions of these rules to better protect and ensure the safety of unborn children who might inadvertently be harmed by medical cannabis consumption. The Medical Association of the State of Alabama launched the mandatory training course for physicians seeking to become Registered Certifying Physicians in May 2023. The Medical Association
“In 2024, the Board reviewed and amended several provisions [of the Act] to better protect the safety of unborn children.”
is preparing to launch a campaign to increase physician awareness of the course once the Cannabis Commission completes its licensure process. Pursuant to Ala. Admin. Code R. 540-X-25-.04(5), the Board is prepared to begin accepting applications and issuing Alabama Medical Cannabis Certification Permits to qualified physicians once the Cannabis Commission issues its initial licenses to dispensaries and/or integrated facilities.
PG 6 | ALBME
ANESTHESIOLOGIST ASSISTANT LICENSES/ REGISTRATIONS ISSUED IN 2024
BOARD-SPONSORED CONTINUING MEDICAL EDUCATION In 2024, the Board and Commission
There were more Anesthesiologist
redoubled their efforts to ensure that
Assistant Licenses issued than in 2023,
all licensees are aware of and meet
and total AA registrations to physicians
their continuing medical education
also increased in 2024.
Anesthesiologist Assistants (AA)
requirements and maintain the highest
2023
Free Online Courses to Meet CME
5 34
levels of competency.
2024 1
Requirement For Collaborating/
9
Supervising Physicians and
44
Physician Assistants 15
18
35
46
In 2021, the Board added a requirement for collaborating/supervising physicians and assistants to physicians to obtain Continuing Medical Education (CME)
Licenses Issued Granted Temporary License (None Issued) Temporary Converted To Full License (None Issued) Expired Licenses Reissued (None Issued 2023) Licenses Renewed Registered To Physicians (New) Total Registrations
prescribed by the Board. Physicians who only act as covering physicians are not required to obtain this CME. For those who were not in a collaborative or supervisory practice as of Jan. 1, 2025, the CME may be obtained within twelve months of obtaining a new collaborative or supervisory practice. To assist licensees in meeting this requirement, the Board developed free online courses for licensed physicians, physician assistants, and anesthesiologist assistants. These courses can be accessed through the Board and Commission website.
2024 ANNUAL REPORT | PG 7
ADVANCED PRACTICE NURSES (CRNP/CNM) AND COLLABORATIVE PHARMACY PRACTICES IN 2024
ENFORCEMENT ISSUES Enforcement issues are investigations
The number of collaborations between physicians and CRNP/
of complaints and other alleged
CNMs continues to rise. A new category of collaborative
misconduct reported to the Board.
practice with pharmacists did not demonstrate any growth.
Advanced Practice Nurses (CRNP/CNM) 2023 16
175 775 232
16
Collaborative and Supervisory Practice Education Opportunities 4 Educational Site Visits 9 Practice Compliance Seminars
88
Collaborative And Supervisory Practice Audits
868
Limited Purpose Schedule II Permits Renewed
2024
25
256
1,325
1,223
439
Limited Purpose Schedule II Permits Issued
403
2023
2024
Pending Review Referred For Other Resolution
2
15
31
14
Referred For Formal Investigation/ Pending
139
102
124
122
Qualified Alabama Controlled Substances Certificates Renewed Expired Qualified Alabama Controlled Substances Certificates Reissued
45
13
Expired Limited Purpose Schedule II Permits Reissued
Enforcement Issues
Qualified Alabama Controlled Substances Certificates Issued
Referred For Formal Investigation/ Resolved
Resolved Without Formal Investigation Prescribing Related
46
72 368 total
3,902
3,981
Number Of Physicians In Collaboration
3,215
3,499
Collaboration Registrations Issued
16
67 365 total
PG 8 | ALBME
BOARD DISCIPLINARY/CONFIDENTIAL ACTIONS The Board has the authority to discipline Alabama Controlled Substances registrations, to deny or enter voluntary restrictions on certificates of qualification, and to discipline Assistant to Physician licenses. There was an increase from 2023 in the number of Letters of Concern issued in 2024. The number of physicians ordered to complete continuing medical education also rose in 2024, with 25 being related to prescribing issues.
Disciplinary
Confidential Continued
ACSC
Voluntary Restriction On Certificate Of Qualification
Temporary Suspension
0
Entered
0
Surrender
4
Amended
0
Reinstated With Restrictions
1
Terminated
3
Reinstated With Voluntary Agreement
1
Licensees’ Files Flagged
Reinstatement Or Petition To Lift Restrictions Denied
1
ABME Physician Monitoring Program (As Adjusted From 2023)
Restrictions And/Or Limitations Modified Or Terminated
3
– Licensees Currently Monitored
263
Consent Order/Settlement Agreement
10
– Licensees Monitored Since 1990
1,902
QACSC Denied
0
Temporary Suspension
1
Hearing Pending
1
Settlement Agreement
1
Certificate Of Qualification Denied
1
Certificate Of Qualification And/Or Medical License Surrendered
9
Physician Assistant Licenses Disciplined/Restricted
0
Anesthesiologist Assistant Licenses Disciplined/Restricted
0
Confidential Voluntary Agreements
39
Prescribing Related
4
Agreements Amended
2
Agreements Terminated
7
21
Non-Disciplinary Board Orders
30
Continuing Medical Education
21
Prescribing Related
12
Evaluation
9
Interviews Conducted
44
Letters Of Concern
40
Prescribing Related
15
Cases Sent For Expert Review
4
Formal Filings With The Medical Licensure Commission Administrative Complaints Filed
18
Administrative Complaints With Petition For Summary Suspension Of Medical License
8
Surrender
2
Hearing Pending
6
Notice Of Intent To Contest Reinstatement Filed
6
Administrative Fines Assessed
22
(ABME – 12 And MLC – 10) Administrative Costs Assessed (ABME – 0 And MLC – 5)
5
2024 ANNUAL REPORT | PG 9
ALABAMA OPIOID OVERDOSE AND ADDICTION COUNCIL The Board continued its participation in the Alabama Opioid Overdose and Addiction Council’s Prescribers & Dispensers standing committee in 2024 with a focus on equipping controlled substances providers with training. Expansions to the online medical professionals training platform, AlaHOPE.org, resulted in the addition of five new free courses. A total of 1,668 course completions were documented in 2024 with learners in 20 states and one Canadian province. Opioid prescription rates continued to fall dramatically in Alabama, largely the result of education to medical providers in the provision of care to opioid-using persons, with emphasis on alternative treatments for pain and interdisciplinary care. The year 2024 also showed a consistent decline in the number of overdose deaths in Alabama.
PG 10 | ALBME
2024 BOARD AND COMMISSION MEMBERS
Alabama Board of Medical Examiners
State of Alabama Medical Licensure Commission
Charles M. A. Rogers, IV, M.D.
Jorge A. Alsip, M.D.
Chairman, Bay Minette
Chairman, Daphne
Hernando D. Carter, M.D.
Paul M. Nagrodzki, M.D.
Vice-Chairman, Birmingham
Vice-Chairman, Birmingham
Aruna T. Arora, M.D. Huntsville
Kenneth W. Aldridge, M.D. Tuscaloosa
Gregory W. Ayers, M.D. Birmingham
Craig H. Christopher, M.D. Birmingham
Tonya E. Bradley, M.D. Auburn
Howard Joseph Falgout, M.D. Tuscaloosa
Eli L. Brown, M.D. Birmingham
Mr. L. Daniel Morris Montgomery
Adam C. Harrison, D.O. Cullman
Nina P. Nelson-Garrett, M.D. Montgomery
Nina S. Ford Johnson, M.D. Mobile
Pamela D. Varner, M.D. Birmingham
Beverly F. Jordan, M.D. Enterprise George T. Koulianos, M.D. Mobile Mark H. LeQuire, M.D. Montgomery William J. Schneider, M.D. Huntsville William Jay Suggs, M.D. Decatur David R. Thrasher, M.D. Montgomery Jane A. Weida, M.D. Tuscaloosa Amanda J. Williams, M.D. Montgomery
Alabama Board of Medical Examiners 848 Washington Ave Montgomery, AL 36104 (334) 242-4116 www.albme.gov