73R10159 SMH-D
By Cain, Berlanga H.B. No. 1677
Substitute the following for H.B. No. 1677:
By Berlanga C.S.H.B. No. 1677
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the continuation and operation of the Texas State Board
1-3 of Medical Examiners and to the regulation of the practice of
1-4 medicine, including the practice of acupuncture; providing
1-5 penalties.
1-6 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-7 SECTION 1. Section 1.03(a), Medical Practice Act (Article
1-8 4495b, Vernon's Texas Civil Statutes), is amended by amending
1-9 Subdivision (6) to read as follows:
1-10 (6) "Medical peer review committee" or "professional
1-11 review body" means a committee of a health-care entity, the
1-12 governing board of a health-care entity, or the medical staff of a
1-13 health-care entity, provided the committee or medical staff
1-14 operates pursuant to written bylaws that have been approved by the
1-15 policy-making body or the governing board of the health-care entity
1-16 and authorized to evaluate the quality of medical and health-care
1-17 services or the competence of physicians, including those functions
1-18 specified by Section 85.204, Health and Safety Code, and its
1-19 subsequent amendments. Such a committee includes the employees and
1-20 agents of the committee, including assistants, investigators,
1-21 intervenors, attorneys, and any other persons or organizations that
1-22 serve the committee in any capacity.
1-23 SECTION 2. Section 2.03, Medical Practice Act (Article
1-24 4495b, Vernon's Texas Civil Statutes), is amended to read as
2-1 follows:
2-2 Sec. 2.03. Appointment to Board. Members of the board shall
2-3 be appointed by the governor and confirmed by the senate. Any
2-4 vacancy on the board shall be filled by appointment of the
2-5 governor. Any appointment made shall be without regard to race,
2-6 color, disability <creed>, sex, religion, age, or national origin,
2-7 except that a person younger than 18 years of age is not eligible
2-8 for appointment.
2-9 SECTION 3. Section 2.04, Medical Practice Act (Article
2-10 4495b, Vernon's Texas Civil Statutes), is amended to read as
2-11 follows:
2-12 Sec. 2.04. Removal from Office. (a) It is a ground for
2-13 removal from the board if a member:
2-14 (1) does not have at the time of appointment the
2-15 qualifications required by Sections 2.05(a), (b), (c), (d), and (e)
2-16 of this Act;
2-17 (2) does not maintain during service on the board the
2-18 qualifications required by Sections 2.05(a), (b), (c), (d), and (e)
2-19 of this Act;
2-20 (3) violates a prohibition established by Section
2-21 2.05(f), (g), (h), (j), or (k) of this Act;
2-22 (4) cannot discharge the member's duties for a
2-23 substantial part of the term for which the member is appointed
2-24 because of illness or disability; or
2-25 (5) is absent from more than half of the regularly
2-26 scheduled board meetings that the member is eligible to attend
2-27 during a calendar year<, during a member's service on the board,
3-1 the member fails to meet the qualifications set forth in this Act
3-2 for members of the board. The validity of an action of the board
3-3 is not affected by the fact that it was taken when a ground for
3-4 removal of a member of the board existed>.
3-5 (b) The validity of an action of the board is not affected
3-6 by the fact that it is taken when a ground for removal of a board
3-7 member exists <Each member of the board shall be present for at
3-8 least one-half of the regularly scheduled board meetings held each
3-9 year. Failure of a board member to meet this requirement is
3-10 grounds for removal of the member from the board and the removal
3-11 creates a vacancy on the board>.
3-12 (c) If the executive director has knowledge that a potential
3-13 ground for removal exists, the executive director shall notify the
3-14 president of the board of the ground. The president shall then
3-15 notify the governor that a potential ground for removal exists.
3-16 SECTION 4. Section 2.05, Medical Practice Act (Article
3-17 4495b, Vernon's Texas Civil Statutes), is amended by amending
3-18 Subsections (b), (c), (d), (g), (h), and (i) and adding Subsections
3-19 (j), (k), and (l) to read as follows:
3-20 (b) Eight <Nine> members of the board must:
3-21 (1) be learned and eminent physicians licensed to
3-22 practice medicine within this state for at least three years prior
3-23 to appointment and be graduates of a reputable medical school or
3-24 college with a degree of doctor of medicine (M.D.); <and>
3-25 (2) have been actively engaged in the practice of
3-26 medicine for at least five years immediately preceding their
3-27 appointment; and
4-1 (3) have been actively engaged in organized peer
4-2 review at a health care entity for at least three years immediately
4-3 preceding their appointment.
4-4 (c) Three members of the board must:
4-5 (1) be learned and eminent physicians licensed to
4-6 practice medicine within this state for at least three years prior
4-7 to appointment and be graduates of a reputable medical school or
4-8 college with a degree of doctor of osteopathic medicine (D.O.);
4-9 <and>
4-10 (2) have been actively engaged in the practice of
4-11 medicine for at least five years immediately preceding their
4-12 appointment; and
4-13 (3) have been actively engaged in organized peer
4-14 review at a health care entity for at least three years immediately
4-15 preceding their appointment.
4-16 (d) Four <Three> members of the board must be public
4-17 representatives who are not licensed to practice medicine, who are
4-18 not financially involved in any organization subject to the
4-19 regulation of the board, and who are not providers of health care.
4-20 "Provider of health care" means:
4-21 (1) an individual who is a direct provider of health
4-22 care (including but not limited to a dentist, registered nurse,
4-23 licensed vocational nurse, chiropractor, podiatrist, physician
4-24 assistant, psychologist, athletic trainer, physical therapist,
4-25 social psychotherapist, pharmacist, optometrist, hospital
4-26 administrator, or nursing home administrator) in that the
4-27 individual's primary current activity is the provision of health
5-1 care to individuals or the administration of facilities or
5-2 institutions (including but not limited to hospitals, long-term
5-3 care facilities, out-patient facilities, and health maintenance
5-4 organizations) in which such care is provided and, when required by
5-5 law or otherwise, the individual has received professional or other
5-6 training in the provision of such care or in such administration
5-7 and is licensed or certified or holds himself out for such
5-8 provision or administration;
5-9 (2) one who is an indirect provider of health care in
5-10 that the individual holds a fiduciary position with or has a
5-11 fiduciary interest in an entity described below in this
5-12 subdivision; for purposes of this subdivision, a fiduciary position
5-13 or interest as applied to any entity means a position or interest
5-14 with respect to such entity affected with the character of a trust,
5-15 including members of boards of directors and officers, majority
5-16 shareholders, or agents, and receivers (either directly or through
5-17 their spouses) of more than one-tenth of their annual income from
5-18 any one or combination of fees or other compensation for research
5-19 into or instruction in the provision of health-care entities (or
5-20 associations or organizations composed of such entities) engaged
5-21 (or comprised of individuals who are engaged) in the provision of
5-22 health care or in the provision of health care and entities (or
5-23 associations or organizations composed of such entities engaged in
5-24 producing drugs or other such articles);
5-25 (3) one who is a member of the immediate family of an
5-26 individual described in this subsection; for purposes of this
5-27 subsection "immediate family" as applied to any individual includes
6-1 only his parents, spouse, children, brothers, and sisters who
6-2 reside in the same household;
6-3 (4) one who is engaged in or employed by an entity
6-4 issuing any policy or contract of individual or group health
6-5 insurance or hospital or medical service benefits; or
6-6 (5) one who is employed by, on the board of directors
6-7 of, or holds elective office by or under the authority of any unit
6-8 of federal, state, or local government or any organization that
6-9 receives a significant part of its funding from any such unit of
6-10 federal, state, or local government.
6-11 (g) An officer, employee, or paid consultant of a Texas
6-12 trade or professional association in the field of health care may
6-13 not be a member or employee of the board who is exempt from the
6-14 state's position classification plan or is compensated at or above
6-15 the amount prescribed by the General Appropriations Act for step 1,
6-16 salary group 17, of the position classification salary schedule.
6-17 (h) A person who is the spouse of an officer, manager, or
6-18 paid consultant of a Texas trade or professional association in the
6-19 field of health care may not be a board member and may not be a
6-20 board employee who is exempt from the state's position
6-21 classification plan or is compensated at or above the amount
6-22 prescribed by the General Appropriations Act for step 1, salary
6-23 group 17, of the position classification salary schedule.
6-24 (i) For the purposes of this section, a "Texas trade or
6-25 professional association" is a nonprofit, cooperative, and
6-26 voluntarily joined association of business or professional
6-27 competitors in this state designed to assist its members and its
7-1 industry or profession in dealing with mutual business or
7-2 professional problems and in promoting their common interest.
7-3 (j) A person may not serve as a member of the board if the
7-4 person is required to register as a lobbyist under Chapter 305,
7-5 Government Code, and its subsequent amendments, because of the
7-6 person's activities for compensation on behalf of a profession
7-7 related to the operation of the board <A person required to
7-8 register as a lobbyist under Chapter 305, Government Code, by
7-9 virtue of his activities on behalf of a trade or professional
7-10 association in the regulated profession may not act as a member of
7-11 the board>.
7-12 (k) <(h)> A person is ineligible for appointment to the
7-13 board if, at the time of appointment, the person is a stockholder,
7-14 paid full-time faculty member, or a member of the board of trustees
7-15 of a medical school.
7-16 (l) <(i)> All board members must take the official oath.
7-17 SECTION 5. Section 2.07(a), Medical Practice Act (Article
7-18 4495b, Vernon's Texas Civil Statutes), is amended to read as
7-19 follows:
7-20 (a) Not later than December after each regular session of
7-21 the legislature <At the first meeting of the board after each
7-22 biennial appointment>, the governor shall appoint from the members
7-23 of the board a president and the board shall elect from its members
7-24 a <president,> vice-president, secretary-treasurer, and other
7-25 officers as are required, in the opinion of the board, to carry out
7-26 its duties.
7-27 SECTION 6. Section 2.09, Medical Practice Act (Article
8-1 4495b, Vernon's Texas Civil Statutes), is amended by amending
8-2 Subsections (b), (c), (g), (k), (s), and (u) and adding Subsections
8-3 (b-1), (x), (y), (z), and (aa) to read as follows:
8-4 (b) The board shall develop and implement policies that
8-5 clearly define the respective responsibilities of the board and the
8-6 staff of the board. The board shall appoint an executive director
8-7 who shall be its chief executive and administrative officer, who
8-8 shall be charged with the primary responsibility of administering,
8-9 enforcing, and carrying out the provisions of the Medical Practice
8-10 Act under the control and supervision and at the direction of the
8-11 board. The executive director shall hold such position at the
8-12 pleasure of board and may be discharged at any time. The board may
8-13 act under its rules through the executive director, an executive
8-14 committee, or other committee, unless otherwise specified in this
8-15 Act. The executive committee shall be the president,
8-16 vice-president, and secretary-treasurer except where otherwise
8-17 provided in this Act<. Any duty of the secretary-treasurer in this
8-18 Act may be performed by the executive director within the
8-19 discretion of the board. Any reference to secretary-treasurer
8-20 shall have the same meaning as executive director when so
8-21 designated by the board>.
8-22 (b-1) The executive director may employ a chief operating
8-23 officer who shall be primarily responsible for administering,
8-24 implementing, and monitoring systems and necessary measures to
8-25 promote quality and efficiency of ongoing board operations and
8-26 other duties as may be assigned by the executive director. If the
8-27 board appoints an executive director who is not a physician
9-1 licensed to practice in this state, the executive director shall
9-2 appoint a medical director who is a physician licensed to practice
9-3 in this state and who shall be primarily responsible for
9-4 implementing and maintaining policies, systems, and measures
9-5 regarding clinical and professional issues and determinations. The
9-6 chief operating officer or medical director shall act under the
9-7 control and supervision and at the direction of the executive
9-8 director.
9-9 (c) The board may make rules and establish fees as are
9-10 reasonable relating to the granting and extension of expiration
9-11 dates of temporary licenses and the placing of licensees on
9-12 inactive status. The board shall by rule set time limits on the
9-13 periods for which licensees may hold temporary licenses or maintain
9-14 inactive status.
9-15 (g) A person may not serve as a member of the board or act
9-16 as the general counsel to the board if the person is required to
9-17 register as a lobbyist under Chapter 305, Government Code, and its
9-18 subsequent amendments, because of the person's activities for
9-19 compensation on behalf of a profession related to the operation of
9-20 the board <A person who is required personally to register as a
9-21 lobbyist under Chapter 305, Government Code, representing
9-22 physicians, health-care entities, or health-care related
9-23 professions, may not be employed by the board in any capacity>.
9-24 (k) The board <shall establish> by rule shall establish
9-25 reasonable and necessary fees so that the fees, in the aggregate,
9-26 produce sufficient revenue to cover the cost of administering this
9-27 Act. The fees set by the board may be adjusted so that the total
10-1 fees collected shall be sufficient to meet the expenses of
10-2 administering this Act. The board may not set a fee for an amount
10-3 less than the amount of that fee on September 1, 1993 <a reasonable
10-4 charge for those fees not specifically determined but authorized by
10-5 this Act>. The board may not waive collection of any fee or
10-6 penalty. Except as otherwise provided by this Act, the <The> board
10-7 shall deposit <place> all fees received under authority of this
10-8 Act, not otherwise specified, in the state treasury to the credit
10-9 of a special account in the general revenue fund. The special
10-10 account may be used only to cover the costs of administering and
10-11 enforcing this Act <into the medical licensing fund>. The board is
10-12 authorized and shall by annual budget determine the manner of
10-13 handling the funds and the purpose, consistent with this Act, for
10-14 which the same may be used. The special account is exempt from
10-15 Section 403.094(h), Government Code, and its subsequent amendments
10-16 <The budgeted expenses authorized by the board shall not be a
10-17 charge upon the general revenue of the state nor paid from the
10-18 general revenue>.
10-19 (s)(1) The board shall prepare information of public
10-20 <consumer> interest describing the functions of the board and the
10-21 board's procedures by which complaints are filed with and resolved
10-22 by the board. The board shall make the information available to
10-23 the public and appropriate state agencies.
10-24 (2) The board by rule shall establish methods by which
10-25 the public and licensees of the board are notified of the name,
10-26 mailing address, and telephone number of the board for the purpose
10-27 of directing complaints to the board. The board may provide for
11-1 that notification:
11-2 (A) on each registration form, application, or
11-3 written contract for services of an individual or entity regulated
11-4 under this Act;
11-5 (B) on a sign prominently displayed in the place
11-6 of business of each individual or entity regulated under this Act;
11-7 or
11-8 (C) in a bill for services provided by an
11-9 individual or entity regulated under this Act.
11-10 (3) The board shall list along with its regular
11-11 telephone number the toll-free telephone number that may be called
11-12 to present a complaint about a health professional if the toll-free
11-13 number is established under other state law <regulatory functions
11-14 of the board and describing the board's procedures by which
11-15 consumer complaints are filed with and resolved by the board>. On
11-16 written request the board shall make information available to the
11-17 general public for a reasonable fee to cover expenses and
11-18 appropriate state agencies including a summary of any previous
11-19 disciplinary orders by the board against a specific physician
11-20 licensed in this state, the date of the order, and the current
11-21 status of the order. The board shall establish an eight-hour
11-22 toll-free telephone number to make the information immediately
11-23 available to any caller if the board is not required to establish a
11-24 toll-free telephone number under other state law.
11-25 (u) The executive director or the executive director's
11-26 designee shall develop an intra-agency career ladder program. The
11-27 program shall require intra-agency posting of all nonentry level
12-1 positions concurrently with any public posting <board shall cause
12-2 to be developed an intraagency career ladder program, one part of
12-3 which shall be the intraagency posting of each job opening with the
12-4 board in a nonentry-level position. The intraagency posting shall
12-5 be made at least 10 days before any public posting>.
12-6 (x) Each board member shall comply with the board member
12-7 training requirements established by any other state agency that is
12-8 given authority to establish the requirements for the board.
12-9 (y) The board shall provide to its members and employees, as
12-10 often as necessary, information regarding their qualifications for
12-11 office or employment under this Act and their responsibilities
12-12 under applicable laws relating to standards of conduct for state
12-13 officers or employees.
12-14 (z) The board shall develop and implement policies that
12-15 provide the public with a reasonable opportunity to appear before
12-16 the board and to speak on any issue under the jurisdiction of the
12-17 board.
12-18 (aa) The board shall prepare and maintain a written plan
12-19 that describes how a person who does not speak English can be
12-20 provided reasonable access to the board's programs. The board
12-21 shall also comply with federal and state laws for program and
12-22 facility accessibility.
12-23 SECTION 7. The Medical Practice Act (Article 4495b, Vernon's
12-24 Texas Civil Statutes) is amended by adding Section 2.10 to read as
12-25 follows:
12-26 Sec. 2.10. EQUAL EMPLOYMENT OPPORTUNITY. (a) The executive
12-27 director or the executive director's designee shall prepare and
13-1 maintain a written policy statement to assure implementation of a
13-2 program of equal employment opportunity under which all personnel
13-3 decisions are made without regard to race, color, disability, sex,
13-4 religion, age, or national origin. The policy statement must
13-5 include:
13-6 (1) personnel policies, including policies relating to
13-7 recruitment, evaluation, selection, appointment, training, and
13-8 promotion of personnel, that are in compliance with requirements of
13-9 the Commission on Human Rights Act (Article 5221k, Vernon's Texas
13-10 Civil Statutes) and its subsequent amendments;
13-11 (2) a comprehensive analysis of the board's work force
13-12 that meets federal and state guidelines;
13-13 (3) procedures by which a determination can be made of
13-14 significant underuse in the board's work force of all persons for
13-15 whom federal or state guidelines encourage a more equitable
13-16 balance; and
13-17 (4) reasonable methods to appropriately address those
13-18 areas of significant underuse.
13-19 (b) A policy statement prepared under Subsection (a) of this
13-20 section must cover an annual period, be updated annually and
13-21 reviewed by the Commission on Human Rights for compliance with
13-22 requirements of the Commission on Human Rights Act (Article 5221k,
13-23 Vernon's Texas Civil Statutes) and its subsequent amendments, and
13-24 be filed with the governor's office.
13-25 (c) The governor's office shall deliver a biennial report to
13-26 the legislature based on the information received under Subsection
13-27 (b) of this section. The report may be made separately or as a
14-1 part of other biennial reports made to the legislature.
14-2 SECTION 8. Sections 3.01(a), (b), (c), (f), (h), and (i),
14-3 Medical Practice Act (Article 4495b, Vernon's Texas Civil
14-4 Statutes), are amended to read as follows:
14-5 (a) All persons now lawfully qualified to practice medicine
14-6 in this state, or who are hereafter licensed for the practice of
14-7 medicine by the board, shall be registered as practitioners with
14-8 the board on or before the first day of January and thereafter
14-9 shall register in like manner annually, on or before the first day
14-10 of January of each succeeding year. Each person so registered with
14-11 the board shall pay, in connection with each annual registration
14-12 and for the receipt hereinafter provided for, a fee established by
14-13 the board which fee shall accompany the application of each person
14-14 for registration. The payment shall be made to the board. Every
14-15 person so registered shall file with the board a written
14-16 application for annual registration, setting forth his name and
14-17 mailing address, the place or places where the applicant is engaged
14-18 in the practice of medicine, and other necessary information
14-19 prescribed by the board. If the person is licensed for the
14-20 practice of medicine by another state, the District of Columbia, a
14-21 territory of the United States, Canada, any other country, or the
14-22 uniformed services of the United States, the application must
14-23 include a description of any investigations the person knows are in
14-24 progress and of any sanctions imposed by or disciplinary matters
14-25 pending in the state, district, territory, country, or service.
14-26 (b) Physicians not otherwise licensed by the board who are
14-27 participating in graduate medical education training programs
15-1 approved by the board may be issued institutional permits as
15-2 provided by rules of the board. A reasonable fee shall be charged
15-3 and deposited into the special account established by Section
15-4 2.09(k) of this Act <medical registration fund>. This permit does
15-5 not authorize the performance of medical acts except as the acts
15-6 are performed as a part of graduate medical education programs and
15-7 under the supervision of a licensed practitioner of medicine.
15-8 (c)(1) A person may renew an unexpired license by paying to
15-9 the board on or before the expiration date of the license the
15-10 required renewal fee.
15-11 (2) If a person's license has been expired for 90 days
15-12 or less, the person may renew the license by paying to the board
15-13 the required renewal fee and a fee that is one-half of the
15-14 examination fee for the license.
15-15 (3) If a person's license has been expired for longer
15-16 than 90 days but less than one year, the person may renew the
15-17 license by paying to the board all unpaid renewal fees and a fee
15-18 that is equal to the examination fee for the license.
15-19 (4) If a person's license has been expired for one
15-20 year, it is considered to have been canceled, and the person may
15-21 not renew the license. The person may obtain a new license by
15-22 submitting to reexamination and complying with the requirements and
15-23 procedures for obtaining an original license.
15-24 (5) The board may renew without examination an expired
15-25 license of a person who was licensed in this state, moved to
15-26 another state, and is currently licensed and has been in practice
15-27 in the other state for not more than two years preceding
16-1 application. The person must pay to the board a fee that is equal
16-2 to the examination fee for the license. <Failure of any licensee
16-3 to pay the annual license renewal fee on or before the 90th day
16-4 after the date it is due automatically cancels his licensure. Any
16-5 licensee whose license has been canceled because of failure to pay
16-6 the annual license renewal fee may secure reinstatement of his
16-7 license at any time within that license year upon payment of the
16-8 delinquent fee together with a penalty in an amount as the board
16-9 may determine to be reasonable. After expiration of the license
16-10 year for which the license fee was not paid, no license shall be
16-11 reinstated except upon application and satisfaction of other
16-12 conditions as the board may establish and payment of delinquent
16-13 fees and a penalty to be assessed by the board.>
16-14 (f) <In performing its duties as provided in this Act, the
16-15 board may act through the secretary-treasurer of the board. The
16-16 secretary-treasurer is entitled to a salary to be fixed by the
16-17 legislature in its General Appropriations Act for the performance
16-18 of duties under this Act.> The executive director
16-19 <secretary-treasurer> of the board shall file a surety bond with
16-20 the board. The bond shall be in an amount not less than $10,000,
16-21 be in compliance with the insurance laws of the state, and be
16-22 payable to the state for the use of the state if the executive
16-23 director <secretary-treasurer> does not faithfully discharge the
16-24 duties of the office. The board shall pay the premium on the bond.
16-25 <The salary shall be paid out of said medical registration fund and
16-26 shall not be in any way a charge upon the general revenue of the
16-27 state.>
17-1 (h) The <secretary-treasurer or the> executive director
17-2 shall review each application for licensure by examination or
17-3 reciprocity and shall recommend to the board all applicants
17-4 eligible for licensure. The <secretary-treasurer or the> executive
17-5 director also shall report to the board the names of all applicants
17-6 determined to be ineligible for licensure, together with the
17-7 reasons for each recommendation. An applicant deemed ineligible
17-8 for licensure by the <secretary-treasurer or the> executive
17-9 director may request review of such recommendation by a committee
17-10 of the board within 20 days of receipt of such notice, and the
17-11 <secretary-treasurer or the> executive director may refer any
17-12 application to said committee for a recommendation concerning
17-13 eligibility. If the committee finds the applicant ineligible for
17-14 licensure, such recommendation, together with the reasons therefor,
17-15 shall be submitted to the board unless the applicant requests a <an
17-16 appellate> hearing <before a hearing examiner appointed by the
17-17 board> within 20 days of receipt of notice of the committee's
17-18 determination. The hearing shall be before an administrative law
17-19 judge of the State Office of Administrative Hearings and shall
17-20 comply with the Administrative Procedure Act and its subsequent
17-21 amendments and the rules of the State Office of Administrative
17-22 Hearings and the board. The committee may refer any application
17-23 for determination of eligibility to the full board. The board
17-24 shall, after receiving the administrative law judge's proposed
17-25 findings of fact and conclusions of law, determine the eligibility
17-26 of the applicant for licensure <an appellate hearing on its own
17-27 motion. The board may elect to hear any appeal in lieu of
18-1 proceedings before a hearing examiner, and it shall adopt, modify,
18-2 or reject each decision made by a hearing examiner. The board also
18-3 shall adopt, modify, or reject each recommendation of ineligibility
18-4 made by the secretary-treasurer or the executive director or by the
18-5 committee, unless the applicant has requested a timely review of
18-6 the recommendation. Such action by the board shall constitute a
18-7 final administrative decision concerning licensure. Any hearing
18-8 before the board or before a hearing examiner under this subsection
18-9 becomes a contested case under the Administrative Procedure Act>.
18-10 A physician whose application for licensure is denied by the board
18-11 shall receive a written statement<, upon request,> containing the
18-12 reasons for the board's action. All reports received or gathered
18-13 by the board on each applicant are confidential and are not subject
18-14 to disclosure under the Open Records Law. The board may disclose
18-15 such reports to appropriate licensing authorities in other states
18-16 <upon request>.
18-17 (i) At least 30 days before the expiration of a person's
18-18 license, the board shall send written notice of the impending
18-19 license expiration to the person at the licensee's last known
18-20 address according to the records of the board <The board must
18-21 notify each delinquent licensee of his impending license
18-22 cancellation by registered or certified mail sent to the licensee's
18-23 address listed with the board not less than 30 days prior to the
18-24 cancellation. This requirement shall be waived when the licensee
18-25 has requested in writing that his or her license be canceled>.
18-26 SECTION 9. The Medical Practice Act (Article 4495b, Vernon's
18-27 Texas Civil Statutes) is amended by adding Section 3.025 to read as
19-1 follows:
19-2 Sec. 3.025. CONTINUING MEDICAL EDUCATION. (a) The board by
19-3 rule shall adopt, monitor, and enforce a reporting program for
19-4 continuing medical education of licensees. The board shall adopt
19-5 and administer rules:
19-6 (1) requiring the number of hours of continuing
19-7 medical education the board determines appropriate as a
19-8 prerequisite to the annual registration of a licensee under this
19-9 Act;
19-10 (2) requiring at least one-half of the hours of
19-11 continuing medical education required under Subdivision (1) of this
19-12 subsection to be approved by the board after taking into account
19-13 the standards of the American Medical Association for its
19-14 Physician's Recognition Award, the Council on Medical Specialty
19-15 Societies, or the American Osteopathic Association and permitting
19-16 the remaining hours to be composed of self-study or equivalent
19-17 self-directed continuing medical education according to guidelines
19-18 determined by the board; and
19-19 (3) adopting a process to assess a licensee's
19-20 participation in continuing medical education courses.
19-21 (b) A licensee shall be presumed to have complied with this
19-22 section if in the preceding 36 months the licensee becomes board
19-23 certified or recertified in a medical specialty and the medical
19-24 specialty program takes into consideration the standards of the
19-25 American Board of Medical Specialties, the American Medical
19-26 Association, the Advisory Board for Osteopathic Specialists and
19-27 Boards of Certification, or the American Osteopathic Association.
20-1 (c) The board may temporarily exempt a licensee from the
20-2 requirement for continuing medical education for:
20-3 (1) catastrophic illness;
20-4 (2) military service of longer than one year's
20-5 duration outside the state;
20-6 (3) medical practice and residence of longer than one
20-7 year's duration outside the United States; or
20-8 (4) good cause shown on written application of the
20-9 licensee that gives satisfactory evidence to the board that the
20-10 licensee is unable to comply with the requirement for continuing
20-11 medical education.
20-12 (d) A temporary exemption under Subsection (c) of this
20-13 section may not exceed one year but may be renewed annually.
20-14 (e) Subsection (a) of this section does not apply to a
20-15 licensee who is retired and has been exempted by rule from paying
20-16 the annual registration fee.
20-17 (f) This section does not prevent the board from taking
20-18 disciplinary action with respect to a licensee or an applicant for
20-19 a license by requiring additional hours of continuing medical
20-20 education or of specific course subjects.
20-21 SECTION 10. Section 3.03, Medical Practice Act (Article
20-22 4495b, Vernon's Texas Civil Statutes), is amended by amending
20-23 Subsections (a)-(f) to read as follows:
20-24 (a) The board, at its sole discretion and upon payment by an
20-25 applicant of a fee prescribed by the board under this Act, may
20-26 grant a license to practice medicine to any <reputable> physician
20-27 who is a graduate of an acceptable <a reputable> medical college as
21-1 determined by the board and who<:>
21-2 <(1)> is a licensee of another state or Canadian
21-3 province having requirements for physician registration and
21-4 practice substantially equivalent to those established by the laws
21-5 of this state<; or>
21-6 <(2) is qualified by an examination for a certificate
21-7 to practice medicine under a commission in the uniformed services
21-8 of the United States>.
21-9 (b) An application for a license under this section must be
21-10 in writing and upon a form prescribed by the board. The
21-11 application must be accompanied by:
21-12 (1) a diploma or photograph of a diploma awarded to
21-13 the applicant by an acceptable <a reputable> medical college and a
21-14 certified transcript showing courses and grades <or a certificate,
21-15 license, or commission issued to the applicant by the Medical Corps
21-16 of the uniformed services of the United States>;
21-17 (2) a license or a certified copy of a license to
21-18 practice medicine lawfully issued to the applicant<, on
21-19 examination,> by some other state or a Canadian province that
21-20 requires in its examination the same general degree of fitness
21-21 required by this state and that grants the same reciprocal
21-22 privileges to persons licensed by the board; <or>
21-23 (3) a certification made by <an executive officer of
21-24 the uniformed services of the United States,> the president or
21-25 secretary of the board that issued the license<,> or a duly
21-26 constituted registration office of the state or Canadian province
21-27 that issued the certificate or license, reciting that the
22-1 accompanying certificate or license has not been canceled,
22-2 suspended, or revoked <except by honorable discharge from the
22-3 Medical Corps of the uniformed services of the United States> and
22-4 reciting that the statement of the qualifications made in the
22-5 application for medical license in Texas is true and correct; and
22-6 (4) evidence of a passing grade on an examination
22-7 required by the board.
22-8 (c) Applicants for a license under this section must
22-9 subscribe to an oath in writing before an officer authorized by law
22-10 to administer oaths. The written oath must be a part of the
22-11 application. The application must:
22-12 (1) state that:
22-13 (A) <(1)> the license, certificate, or authority
22-14 under which the applicant has most recently practiced medicine in
22-15 the state or Canadian province from which the applicant is
22-16 transferring to this state <removed> or in the uniformed service in
22-17 which the applicant served is <was at the time of the removal or
22-18 completion of service> in full force and not restricted, canceled,
22-19 suspended, or revoked;
22-20 (B) <(2)> the applicant is the identical person
22-21 to whom the certificate or<,> license<, or commission> and the
22-22 diploma were issued;
22-23 (C) <(3)> no proceeding has been instituted
22-24 against the applicant for the restriction, cancellation,
22-25 suspension, or revocation of the certificate, license, or authority
22-26 to practice medicine in the state, Canadian province, or uniformed
22-27 service of the United States in which it was issued; and
23-1 (D) <(4)> no prosecution is pending against the
23-2 applicant in any state, federal, or Canadian court for any offense
23-3 that under the laws of this state is a felony;
23-4 (2) include a description of any sanctions imposed by
23-5 or disciplinary matters pending in the state or Canadian province
23-6 in which the applicant was or is licensed or certified to practice
23-7 medicine; and
23-8 (3) include evidence of postgraduate training required
23-9 by the board.
23-10 (d) An applicant for a license under this section must <A
23-11 "reputable physician" means one who would> be eligible for
23-12 examination by the board. <A "reputable medical school or college"
23-13 means a medical school or college that was approved by the board at
23-14 the time the applicant's degree was conferred.>
23-15 (e) In addition to other licensure requirements, the board
23-16 may require by rule and regulation that an applicant who is a
23-17 licensee of another state or Canadian province and who is a
23-18 graduate <graduates> of a medical school <schools> located outside
23-19 of the United States and Canada, or the school itself <schools
23-20 themselves>, provide additional information to the board concerning
23-21 the medical school attended prior to approval of the applicant.
23-22 (f) The board may refuse to issue a license to an applicant
23-23 who is a licensee of another state or Canadian province and who
23-24 graduated from a medical school outside of the United States and
23-25 Canada if it finds that the applicant does not possess the
23-26 requisite qualifications to provide the same standard of medical
23-27 care as provided by a licensed physician in this state.
24-1 SECTION 11. The Medical Practice Act (Article 4495b,
24-2 Vernon's Texas Civil Statutes) is amended by adding Section 3.0305
24-3 to read as follows:
24-4 Sec. 3.0305. TEMPORARY LICENSE FOR OUT-OF-STATE
24-5 PRACTITIONERS. (a) On application, the board shall grant a
24-6 temporary license to practice medicine. An applicant for a
24-7 temporary license under this section must:
24-8 (1) have a current, active, and unrestricted license,
24-9 without any pending disciplinary matters, as a physician in another
24-10 state, the District of Columbia, or a territory of the United
24-11 States that has licensing requirements that are substantially
24-12 equivalent to the requirements of this Act;
24-13 (2) have passed a national or other examination
24-14 recognized by the board relating to the practice of medicine; and
24-15 (3) be sponsored by a person licensed by the board
24-16 under this Act with whom the temporary license holder may practice
24-17 under this section.
24-18 (b) An applicant for a temporary license may be excused from
24-19 the requirement of Subsection (a)(3) of this section if the board
24-20 determines that compliance with that subsection constitutes a
24-21 hardship to the applicant.
24-22 (c) A temporary license is valid until the date the board
24-23 approves or denies the temporary license holder's application for a
24-24 license. The board shall issue a license under this Act to the
24-25 holder of a temporary license under this section if:
24-26 (1) the temporary license holder passes the
24-27 examination required by Section 3.05 of this Act;
25-1 (2) the board verifies that the temporary license
25-2 holder has satisfied the academic and experience requirements for a
25-3 license under this Act; and
25-4 (3) the temporary license holder has satisfied any
25-5 other license requirements under this Act.
25-6 (d) The board must assemble the documents and information
25-7 necessary to process a temporary license holder's application for a
25-8 license not later than the 90th day after the date the temporary
25-9 license is issued and complete the processing of the application
25-10 not later than the 90th day after the date the documents and
25-11 information are assembled. If by the 180th day after the date the
25-12 temporary license is issued the board has not completed the
25-13 processing of the application, the board shall review the
25-14 application to determine the cause of the delay.
25-15 SECTION 12. Section 3.04, Medical Practice Act (Article
25-16 4495b, Vernon's Texas Civil Statutes), is amended to read as
25-17 follows:
25-18 Sec. 3.04. Qualification of Licensee. (a) An applicant, to
25-19 be eligible for the examination and issuance of a license, must
25-20 present satisfactory proof to the board that the applicant:
25-21 (1) is at least 21 years of age;
25-22 (2) is of good professional character;
25-23 (3) has completed 60 semester hours of college courses
25-24 other than in medical school, which courses would be acceptable, at
25-25 the time of completion, to The University of Texas for credit on a
25-26 bachelor of arts degree or a bachelor of science degree; and
25-27 (4) is a graduate of an acceptable <a> medical school
26-1 or college that was approved by the board at the time the degree
26-2 was conferred<;> and has completed a one-year program of graduate
26-3 medical training approved by the board.
26-4 (b) The <(5) has successfully completed a one year program
26-5 of graduate medical training approved by the board. In addition to
26-6 other licensure requirements, the board may require by rule and
26-7 regulation that graduates of medical schools located outside the
26-8 United States and Canada comply with other requirements that the
26-9 board considers appropriate, including but not limited to
26-10 additional graduate medical training in the United States, except
26-11 those who qualify for licensure in Section 5.04 of this Act.
26-12 However, the> applicant shall be eligible for examination prior to
26-13 complying with the graduate training requirement of Subsection
26-14 (a)(4) <Subdivision (5) of Subsection (a)> of this section but
26-15 shall not be eligible for the issuance of an unrestricted license
26-16 until the requirements of Subsection (a) of this section <this
26-17 subsection> have been satisfied.
26-18 (c) <(b)> Applications for examination must be made in
26-19 writing, verified by affidavit, filed with the board on forms
26-20 prescribed by the board, and accompanied by documents and a fee as
26-21 the board determines to be reasonable.
26-22 (d) To be recognized by the board for the purposes of this
26-23 subchapter, all allopathic or osteopathic medical education
26-24 instruction taught in the United States must be accredited by an
26-25 accrediting body officially recognized by the United States
26-26 Department of Education and the Council on Postsecondary
26-27 Accreditation as the accrediting body for medical education leading
27-1 to the doctor of medicine degree or the doctor of osteopathy degree
27-2 in the United States.
27-3 (e) The requirements for eligibility for licensure of a
27-4 graduate of an unapproved foreign medical school are set out in
27-5 Section 5.035 of this Act, and the requirements for eligibility for
27-6 licensure of a person who has completed all of the didactic work of
27-7 a foreign medical school but has not graduated from the school
27-8 (Fifth Pathway Program) are set out in Section 5.04 of this Act.
27-9 SECTION 13. Sections 3.05(a), (c), and (e), Medical Practice
27-10 Act (Article 4495b, Vernon's Texas Civil Statutes), are amended to
27-11 read as follows:
27-12 (a) All examinations for license to practice medicine shall
27-13 be conducted in writing in the English language and in a manner as
27-14 to be entirely fair and impartial to all individuals and to every
27-15 school or system of medicine. <All applicants shall be known to
27-16 the examiners only by numbers, without names or other method of
27-17 identification on examination papers by which members of the board
27-18 may be able to identify the applicants or examinees, until after
27-19 the general averages of the examinees' numbers in the class have
27-20 been determined and license granted or refused.> Examinations
27-21 shall be conducted on and cover those subjects generally taught by
27-22 medical schools, a knowledge of which is commonly and generally
27-23 required of candidates for the degree of doctor of medicine or
27-24 doctor of osteopathy conferred by schools or colleges of medicine
27-25 approved by the board, and the examinations shall also be conducted
27-26 on and cover the subject of medical jurisprudence. Examinations
27-27 shall be prepared by a national testing service or prepared by the
28-1 board and validated by qualified independent testing professionals.
28-2 On satisfactory examination conducted as required by this Act under
28-3 rules of the board, applicants may <shall> be granted licenses to
28-4 practice medicine. All questions and answers, with the grades
28-5 attached, shall be preserved for one year in the executive office
28-6 of the board or such other repository as the board by rule may
28-7 direct. All applicants examined at the same time shall be given
28-8 identical questions. All certificates shall be attested by the
28-9 seal of the board. The board in its discretion may give the
28-10 examination for license in two or more parts.
28-11 (c) All applicants for license to practice medicine in this
28-12 state not otherwise licensed under the provisions of law must
28-13 successfully pass a uniform <an> examination approved by the board
28-14 as determined by rule. The board is authorized to adopt and
28-15 enforce all rules of procedure not inconsistent with statutory
28-16 requirements. All applicants shall be given due notice of the date
28-17 and place of the examination<; provided that the partial
28-18 examinations provided for in this Act shall not be disturbed by
28-19 this section>. If any applicant, because of failure to pass the
28-20 required examination, is refused a license, the applicant, at a
28-21 time as the board may fix, shall be permitted to take a subsequent
28-22 examination not more than two additional times <upon any subjects
28-23 required in the original examination> as the board may prescribe on
28-24 the payment of a fee as the board may determine to be reasonable.
28-25 In the event satisfactory grades shall be made on the subjects
28-26 prescribed and taken on the reexamination, the board may grant the
28-27 applicant a license to practice medicine. The board shall
29-1 determine the credit to be given examinees on answers turned in on
29-2 the subjects of complete and partial examination, and its decision
29-3 is final.
29-4 (e) Within 90 <30> days after the day on which an
29-5 examination is administered under this Act, the board shall notify
29-6 each examinee of the results of the examination. However, if an
29-7 examination is graded or reviewed by a national testing service,
29-8 the board shall notify each examinee of the results of the
29-9 examination not later than the 30th day <within four weeks> after
29-10 the date the board receives the results from the testing service.
29-11 If the notice of the examination results will be delayed for longer
29-12 than 90 days after the examination, the board shall notify the
29-13 examinee of the reason for the delay before the 90th day.
29-14 SECTION 14. Section 3.06(d)(5), Medical Practice Act
29-15 (Article 4495b, Vernon's Texas Civil Statutes), is amended by
29-16 adding Paragraph (G) to read as follows:
29-17 (G) An advertisement for a site serving a
29-18 medically underserved population shall include the name and
29-19 business address of the supervising physician for the site.
29-20 SECTION 15. Section 3.08, Medical Practice Act (Article
29-21 4495b, Vernon's Texas Civil Statutes), is amended to read as
29-22 follows:
29-23 Sec. 3.08. Grounds for Refusal to Admit Persons to
29-24 Examination and to Issue License and Renewal License And For
29-25 Disciplinary Action. The board may refuse to admit persons to its
29-26 examinations and to issue a license to practice medicine to any
29-27 person and may take disciplinary action against any person for any
30-1 of the following reasons:
30-2 (1) submission of a false or misleading statement,
30-3 document, or certificate to the board in an application for
30-4 examination or licensure; the presentation to the board of any
30-5 license, certificate, or diploma that was illegally or fraudulently
30-6 obtained; the practice of fraud or deception in taking or passing
30-7 an examination;
30-8 (2) conviction of a crime of the grade of a felony or
30-9 a crime of a lesser degree that involves moral turpitude;
30-10 (3) intemperate use of alcohol or drugs that, in the
30-11 opinion of the board, could endanger the lives of patients;
30-12 (4) unprofessional or dishonorable conduct that is
30-13 likely to deceive or defraud the public or injure the public.
30-14 Unprofessional or dishonorable conduct likely to deceive or defraud
30-15 the public includes but is not limited to the following acts:
30-16 (A) committing any act that is in violation of
30-17 the laws of the State of Texas if the act is connected with the
30-18 physician's practice of medicine. A complaint, indictment, or
30-19 conviction of a law violation is not necessary for the enforcement
30-20 of this provision. Proof of the commission of the act while in the
30-21 practice of medicine or under the guise of the practice of medicine
30-22 is sufficient for action by the board under this section;
30-23 (B) failing to keep complete and accurate
30-24 records of purchases and disposals of drugs listed in Chapter 481,
30-25 Health and Safety Code, or of controlled substances scheduled in
30-26 the Federal Comprehensive Drug Abuse Prevention and Control Act of
30-27 1970, 21 U.S.C.A. Section 801 et seq. (Public Law 91-513). A
31-1 physician shall keep records of his purchases and disposals of
31-2 these drugs to include without limitation the date of purchase, the
31-3 sale or disposal of the drugs by the physician, the name and
31-4 address of the person receiving the drugs, and the reason for the
31-5 disposing or dispensing of the drugs to the person. A failure to
31-6 keep the records for a reasonable time is grounds for revoking,
31-7 canceling, suspending, or probating the license of any practitioner
31-8 of medicine. The board or its representative may enter and inspect
31-9 a physician's place(s) of practice during reasonable business hours
31-10 for the purpose of verifying the correctness of these records and
31-11 of taking inventory of the prescription drugs on hand;
31-12 (C) writing prescriptions for or dispensing to a
31-13 person known to be an abuser <a habitual user> of narcotic drugs,
31-14 controlled substances, or dangerous drugs or to a person who the
31-15 physician should have known was an abuser <a habitual user> of the
31-16 narcotic drugs, controlled substances, or dangerous drugs. This
31-17 provision does not apply to those persons:
31-18 (i) being treated by the physician for
31-19 their narcotic use after the physician notifies the board in
31-20 writing of the name and address of the person being so treated; or
31-21 (ii) who the physician is treating for
31-22 intractable pain under the Intractable Pain Treatment Act (Article
31-23 4495c, Revised Statutes) and its subsequent amendments;
31-24 (D) writing false or fictitious prescriptions
31-25 for dangerous drugs as defined by Chapter 483, Health and Safety
31-26 Code, of controlled substances scheduled in the Texas Controlled
31-27 Substances Act (Chapter 481, Health and Safety Code) <(Article
32-1 4476-15, Vernon's Texas Civil Statutes)>, or of controlled
32-2 substances scheduled in the Federal Comprehensive Drug Abuse
32-3 Prevention and Control Act of 1970, 21 U.S.C.A. Section 801 et
32-4 seq. (Public Law 91-513);
32-5 (E) prescribing or administering a drug or
32-6 treatment that is nontherapeutic in nature or nontherapeutic in the
32-7 manner the drug or treatment is administered or prescribed;
32-8 (F) prescribing, administering, or dispensing in
32-9 a manner not consistent with public health and welfare dangerous
32-10 drugs as defined by Chapter 483, Health and Safety Code, controlled
32-11 substances scheduled in the Texas Controlled Substances Act
32-12 (Chapter 481, Health and Safety Code) <(Article 4476-15, Vernon's
32-13 Texas Civil Statutes)>, or controlled substances scheduled in the
32-14 Federal Comprehensive Drug Abuse Prevention and Control Act of
32-15 1970, 21 U.S.C.A. Section 801 et seq. (Public Law 91-513);
32-16 (G) persistently or <and> flagrantly
32-17 overcharging or overtreating patients;
32-18 (H) failing to supervise adequately the
32-19 activities of those acting under the supervision of the physician;
32-20 or
32-21 (I) delegating professional medical
32-22 responsibility or acts to a person if the delegating physician
32-23 knows or has reason to know that the person is not qualified by
32-24 training, experience, or licensure to perform the responsibility or
32-25 acts;
32-26 (5) violation or attempted violation, direct or
32-27 indirect, of any valid rules issued under this Act, either as a
33-1 principal, accessory, or accomplice;
33-2 (6) use of any advertising statement that is false,
33-3 misleading, or deceptive;
33-4 (7) advertising professional superiority or the
33-5 performance of professional service in a superior manner if the
33-6 advertising is not readily subject to verification;
33-7 (8) purchase, sale, barter, or use or any offer to
33-8 purchase, sell, barter, or use any medical degree, license,
33-9 certificate, diploma, or transcript of license, certificate, or
33-10 diploma in or incident to an application to the board for a license
33-11 to practice medicine;
33-12 (9) altering, with fraudulent intent, any medical
33-13 license, certificate, diploma, or transcript of a medical license,
33-14 certificate, or diploma;
33-15 (10) using any medical license, certificate, diploma,
33-16 or transcript of a medical license, certificate, or diploma that
33-17 has been fraudulently purchased, issued, or counterfeited or that
33-18 has been materially altered;
33-19 (11) impersonating or acting as proxy for another in
33-20 any examination required by this Act for a medical license; or
33-21 engaging in conduct which subverts or attempts to subvert any
33-22 examination process required by this Act for a medical license.
33-23 Conduct which subverts or attempts to subvert the medical licensing
33-24 examination process includes, but is not limited to:
33-25 (A) conduct which violates the security of the
33-26 examination materials, as prescribed by board rules;
33-27 (B) conduct which violates the standard of test
34-1 administration, as prescribed by board rules; or
34-2 (C) conduct which violates the accreditation
34-3 process, as prescribed by board rules;
34-4 (12) impersonating a licensed practitioner or
34-5 permitting or allowing another to use his license or certificate to
34-6 practice medicine in this state for the purpose of diagnosing,
34-7 treating, or offering to treat sick, injured, or afflicted human
34-8 beings;
34-9 (13) employing, directly or indirectly, any person
34-10 whose license to practice medicine has been suspended, canceled, or
34-11 revoked or association in the practice of medicine with any person
34-12 or persons whose license to practice medicine has been suspended,
34-13 canceled, or revoked or any person who has been convicted of the
34-14 unlawful practice of medicine in Texas or elsewhere;
34-15 (14) performing or procuring a criminal abortion or
34-16 aiding or abetting in the procuring of a criminal abortion or
34-17 attempting to perform or procure a criminal abortion or attempting
34-18 to aid or abet the performance or procurement of a criminal
34-19 abortion;
34-20 (15) aiding or abetting, directly or indirectly, the
34-21 practice of medicine by any person, partnership, association, or
34-22 corporation not duly licensed to practice medicine by the board;
34-23 (16) inability to practice medicine with reasonable
34-24 skill and safety to patients by reason of illness, drunkenness,
34-25 excessive use of drugs, narcotics, chemicals, or any other type of
34-26 material or as a result of any mental or physical condition. In
34-27 enforcing this subdivision the board shall, upon probable cause,
35-1 request a physician to submit to a mental or physical examination
35-2 by physicians designated by the board. If the physician refuses to
35-3 submit to the examination, the board shall issue an order requiring
35-4 the physician to show cause why he should not be required to submit
35-5 to the examination and shall schedule a hearing on the order within
35-6 30 days after notice is served on the physician. The physician
35-7 shall be notified by either personal service or certified mail with
35-8 return receipt requested. At the hearing, the physician and his
35-9 attorney are entitled to present any testimony and other evidence
35-10 to show why the physician should not be required to submit to the
35-11 examination. After a complete hearing, the board shall issue an
35-12 order either requiring the physician to submit to the examination
35-13 or withdrawing the request for examination. An appeal from the
35-14 decision of the board shall be taken under the Administrative
35-15 Procedure Act;
35-16 (17) judgment by a court of competent jurisdiction
35-17 that a person licensed to practice medicine is of unsound mind;
35-18 (18) professional failure to practice medicine in an
35-19 acceptable manner consistent with public health and welfare;
35-20 (19) being removed, suspended, or having disciplinary
35-21 action taken by his peers in any professional medical association
35-22 or society, whether the association or society is local, regional,
35-23 state, or national in scope, or being disciplined by a licensed
35-24 hospital or medical staff of a hospital, including removal,
35-25 suspension, limitation of hospital privileges, or other
35-26 disciplinary action, if that action in the opinion of the board was
35-27 based on unprofessional conduct or professional incompetence that
36-1 was likely to harm the public, provided that the board finds that
36-2 the actions were appropriate and reasonably supported by evidence
36-3 submitted to it. The action does not constitute state action on
36-4 the part of the association, society, or hospital medical staff;
36-5 (20) repeated or recurring meritorious health-care
36-6 liability claims that in the opinion of the board evidence
36-7 professional incompetence likely to injure the public; or
36-8 (21) suspension, revocation, <or> restriction, or
36-9 other disciplinary action by another state of a license to practice
36-10 medicine, or disciplinary action by the uniformed services of the
36-11 United States, based upon acts by the licensee similar to acts
36-12 described in this section. A certified copy of the record of the
36-13 state taking the action is conclusive evidence of it.
36-14 SECTION 16. The Medical Practice Act (Article 4495b,
36-15 Vernon's Texas Civil Statutes) is amended by adding Section 3.085
36-16 to read as follows:
36-17 Sec. 3.085. RESTRICTIONS ON BIDDING AND ADVERTISING. (a)
36-18 The board may not adopt rules restricting competitive bidding or
36-19 advertising by a person regulated by the board except to prohibit
36-20 false, misleading, or deceptive practices by the person.
36-21 (b) The board may not include in its rules to prohibit
36-22 false, misleading, or deceptive practices by a person regulated by
36-23 the board a rule that:
36-24 (1) restricts the use of any medium for advertising;
36-25 (2) restricts the person's personal appearance or use
36-26 of the person's voice in an advertisement;
36-27 (3) relates to the size or duration of an
37-1 advertisement by the person; or
37-2 (4) restricts the person's advertisement under a trade
37-3 name.
37-4 SECTION 17. Section 3.10, Medical Practice Act (Article
37-5 4495b, Vernon's Texas Civil Statutes), is amended to read as
37-6 follows:
37-7 Sec. 3.10. FEES AND OTHER FUNDS. (a) All annual
37-8 registration fees collected and other funds received by the board
37-9 shall be deposited, except as otherwise provided by this Act,
37-10 <placed in the State Treasury> to the credit of the special account
37-11 established by Section 2.09(k) of this Act. <medical registration
37-12 fund. The fees deposited to this special fund shall be credited to
37-13 the appropriations of the board and may be spent only as provided
37-14 by the General Appropriations Act, this Act, or other applicable
37-15 statutes. Money in that fund may be used by the board and under
37-16 its direction in the enforcement of this Act, the prohibition of
37-17 the unlawful practice of medicine, the dissemination of information
37-18 to prevent the violation of the laws, and the prosecution of those
37-19 who violate the laws. All distributions from the fund may be made
37-20 only upon written approval of the secretary-treasurer of the board
37-21 or his designated representative, and the comptroller shall upon
37-22 requisition of the board from time to time draw warrants upon the
37-23 State Treasurer for the amounts specified in the requisition.>
37-24 <(b) The board may not set, charge, collect, receive, or
37-25 deposit any of the following fees in excess of:>
37-26 <(1) for processing and granting a license by
37-27 reciprocity to a licensee of another state.....................$700>
38-1 <(2) for processing an application and
38-2 administration of a partial examination for
38-3 licensure......................................................$700>
38-4 <(3) for processing an application and
38-5 administration of a complete examination for
38-6 licensure......................................................$700>
38-7 <(4) for processing an application and
38-8 issuance of a temporary license................................$200>
38-9 <(5) for processing an application and
38-10 issuance of a duplicate license................................$200>
38-11 <(6) for processing an application and
38-12 issuance of a license of reinstatement after a lapse
38-13 or cancellation of a license...................................$700>
38-14 <(7) for processing an application and
38-15 issuance of an annual registration of a licensee...............$200>
38-16 <(8) for processing and issuance of an
38-17 institutional permit for interns, residents, and
38-18 others in approved medical training programs...................$200>
38-19 <(9) for processing an application and
38-20 issuance of an endorsement to other state medical
38-21 boards.........................................................$200>
38-22 <(10) for processing and issuance of a permit
38-23 to a physician who supervises a physician assistant............$200>
38-24 <(11) for processing and issuance of a permit
38-25 to a physician who supervises an acupuncturist..............$200.>
38-26 (b) <(c)> The board may set and collect a sales charge for
38-27 making copies of any paper of record in the office of the board and
39-1 for any printed material published by the board. The charges shall
39-2 be in amounts considered sufficient to reimburse the board for the
39-3 actual expense.
39-4 (c) <(d)> The financial transactions of the board are
39-5 subject to audit by the state auditor in accordance with Chapter
39-6 321, Government Code.
39-7 (d) The board shall file annually with the governor and the
39-8 presiding officer of each house of the legislature a complete and
39-9 detailed written report accounting for all funds received and
39-10 disbursed by the board during the preceding fiscal year. The
39-11 annual report must be in the form and reported in the time provided
39-12 by the General Appropriations Act <(e) On or before the first day
39-13 of January each year, the board shall file with the governor and
39-14 the presiding officer of each house of the legislature a complete
39-15 and detailed written report accounting for all funds received and
39-16 disbursed by the board during the preceding year>.
39-17 SECTION 18. Section 3.11A, Medical Practice Act (Article
39-18 4495b, Vernon's Texas Civil Statutes), is amended to read as
39-19 follows:
39-20 Sec. 3.11A. Disposition of <Increase in> fees. (a) This
39-21 section applies to each <Each> of the following fees <imposed by or
39-22 under another section of this Act is increased by $200>:
39-23 (1) fee for processing and granting a license by
39-24 reciprocity to a licensee of another state;
39-25 (2) fee for processing an application and
39-26 administration of a partial examination for licensure;
39-27 (3) fee for processing an application and
40-1 administration of a complete examination for licensure;
40-2 (4) fee for processing an application and issuance of
40-3 a license of reinstatement after a lapse or cancellation of a
40-4 license; and
40-5 (5) fee for processing an application and issuance of
40-6 an annual registration of a licensee.
40-7 (b) Of each fee <increase> collected, $50 shall be deposited
40-8 to the credit of the foundation school fund and $150 shall be
40-9 deposited to the credit of the general revenue fund. This
40-10 subsection applies to the disposition of the stated portion of each
40-11 fee <increase> regardless of any other provision of law providing
40-12 for a different disposition of funds.
40-13 SECTION 19. Section 4.01, Medical Practice Act (Article
40-14 4495b, Vernon's Texas Civil Statutes), is amended to read as
40-15 follows:
40-16 Sec. 4.01. Grounds for Cancellation, Revocation, Suspension,
40-17 and Probation of License. (a) The board shall, except for good
40-18 cause shown, revoke or suspend a license, place on probation a
40-19 person whose license has been suspended, or reprimand a licensee
40-20 for a violation of this Act or a rule of the board <Except as
40-21 provided herein, the board may cancel, revoke, or suspend the
40-22 license of any practitioner of medicine or impose any other
40-23 authorized means of discipline upon proof of the violation of this
40-24 Act in any respect> or for any cause for which the board is
40-25 authorized to refuse to admit persons to its examination and to
40-26 issue a license and renewal license, including an initial
40-27 conviction or the initial finding of the trier of fact of guilt of
41-1 a felony or misdemeanor involving moral turpitude.
41-2 (b) On proof that a practitioner of medicine has been
41-3 initially convicted of a felony or the initial finding of the trier
41-4 of fact of guilt of a felony under Chapter 481, Health and Safety
41-5 Code, Section 485.033, Health and Safety Code, Chapter 483, Health
41-6 and Safety Code, or the Federal Comprehensive Drug Abuse Prevention
41-7 and Control Act of 1970, 21 U.S.C.A. Section 801 et seq. (Public
41-8 Law 91-513), the board shall suspend the practitioner's license.
41-9 On the practitioner's final conviction for such a felony offense,
41-10 the board shall revoke the practitioner's license.
41-11 (c) The board shall suspend the license of a practitioner
41-12 who is serving a prison term in a state or federal penitentiary
41-13 during his incarceration regardless of the offense.
41-14 SECTION 20. Section 4.04, Medical Practice Act (Article
41-15 4495b, Vernon's Texas Civil Statutes), is redesignated as Section
41-16 4.02 and amended to read as follows:
41-17 Sec. 4.02 <4.04>. COMPLAINT; INVESTIGATION. (a) Any
41-18 person, including a partnership, association, corporation, or other
41-19 entity, may file a complaint against a licensee with the board, or
41-20 the board may file a complaint on its own initiative. The board
41-21 shall adopt rules concerning the investigation of a complaint filed
41-22 with the board. The rules adopted under this subsection shall:
41-23 (1) distinguish between categories of complaints;
41-24 (2) ensure that complaints are not dismissed without
41-25 appropriate consideration;
41-26 (3) require that the board be advised of a complaint
41-27 that is dismissed and that a letter be sent to the person who filed
42-1 the complaint explaining the action taken on the dismissed
42-2 complaint;
42-3 (4) ensure that the person who filed the complaint has
42-4 an opportunity to explain the allegations made in the complaint;
42-5 and
42-6 (5) prescribe guidelines concerning the categories of
42-7 complaints that require the use of a private investigator and the
42-8 procedures for the board to obtain the services of a private
42-9 investigator.
42-10 (b) The board shall keep an information file about each
42-11 complaint filed with the board. The board's information file shall
42-12 be kept current and contain a record for each complaint of:
42-13 (1) potential witnesses contacted in relation to the
42-14 complaint;
42-15 (2) a summary of findings made at each step of the
42-16 complaint process;
42-17 (3) an explanation of the legal basis and reason for a
42-18 complaint that is dismissed; and
42-19 (4) other relevant information.
42-20 (c) If a written complaint is filed with the board that the
42-21 board has authority to resolve, the board, at least as frequently
42-22 as quarterly and until final disposition of the complaint, shall
42-23 notify the parties to the complaint of the status of the complaint
42-24 unless the notice would jeopardize an investigation.
42-25 (d) The board by rule shall adopt a form to standardize
42-26 information concerning complaints made to the board. The board by
42-27 rule shall prescribe information to be provided to a person when
43-1 the person files a complaint with the board.
43-2 (e) The board shall provide reasonable assistance to a
43-3 person who wishes to file a complaint with the board.
43-4 (f) Except as otherwise provided by this section, all
43-5 investigations shall be conducted by the board or persons
43-6 authorized by the board to conduct them. The board may commission
43-7 investigators as peace officers for the purpose of enforcing this
43-8 Act. However, investigators of the board so commissioned as peace
43-9 officers may not carry a firearm or exercise arrest powers. Each
43-10 complaint against a physician which requires a determination of
43-11 medical competency shall be reviewed by a board member, consultant,
43-12 or employee with medical background considered sufficient by the
43-13 board.
43-14 (g) <(b)> Unless it would jeopardize an investigation, the
43-15 board shall notify the physician that a complaint has been filed
43-16 and the nature of the complaint. The board shall make a
43-17 preliminary investigation of the complaint. The first
43-18 consideration of the board shall be whether the physician
43-19 constitutes a continuing threat to the public welfare.
43-20 (h) The board may, unless precluded by the law or this Act,
43-21 make a disposition of any complaint or matter relating to this Act,
43-22 or of any contested case by stipulation, agreed settlement, or
43-23 consent order. The board shall dispose of a complaint, contested
43-24 case, or other matter in writing, and if appropriate, the physician
43-25 shall sign the writing. An agreed disposition is a disciplinary
43-26 order for purposes of reporting under this Act and of
43-27 administrative hearings and proceedings by state and federal
44-1 regulatory agencies regarding the practice of medicine. An agreed
44-2 disposition is a public record.
44-3 (i) In civil or criminal litigation, an agreed disposition
44-4 is a settlement agreement under Rule 408, Texas Rules of Civil
44-5 Evidence, and Rule 408, Texas Rules of Criminal Evidence. This
44-6 subsection does not apply to a licensee who has previously entered
44-7 into an agreed disposition with the board of a different
44-8 disciplinary matter or whose license the board is seeking to
44-9 revoke.
44-10 (j) The board shall adopt such rules as are appropriate to
44-11 carry out this section <such disposition. Such disposition shall
44-12 be considered a disciplinary order>.
44-13 (k) The board shall dispose of all complaints in a timely
44-14 manner. The board shall establish a schedule for conducting each
44-15 phase of a complaint that is under the control of the board not
44-16 later than the 30th day after the date the complaint is received by
44-17 the board. The schedule shall be kept in the information file for
44-18 the complaint and all parties shall be notified of the projected
44-19 time requirements for pursuing the complaint. A change in the
44-20 schedule must be noted in the complaint information file, and all
44-21 parties to the complaint must be notified not later than the 14th
44-22 day after the date the change is made unless the notice would
44-23 jeopardize an investigation.
44-24 (l) The executive director of the board shall notify the
44-25 board of a complaint that extends beyond the time prescribed by the
44-26 board for resolving the complaint so that the board may take
44-27 necessary action on the complaint.
45-1 (m) Except in the case of a suspension under Section 4.13 of
45-2 this Act or in accordance with the terms of an agreement between
45-3 the board and a licensee, no revocation, suspension, involuntary
45-4 modification, or disciplinary action relating to a license is
45-5 effective unless, before board proceedings are instituted:
45-6 (1) the board has served notice, in a manner
45-7 consistent with the requirements for service under Subsection (g)
45-8 of this section, to the physician of the facts or conduct alleged
45-9 to warrant the intended action; and
45-10 (2) the physician was given an opportunity to show
45-11 compliance with all requirements of law for the retention of the
45-12 license either in writing or through personal appearance at an
45-13 informal meeting with one or more representatives of the board, at
45-14 the option of the licensee.
45-15 (n) If the licensee exercises the option to personally
45-16 appear at an informal meeting with one or more representatives of
45-17 the board and the informal meeting is held, the staff of the board
45-18 and the representatives of the board shall be subject to the ex
45-19 parte provisions of the Administrative Procedure Act with regard to
45-20 subsequent contacts with board members and administrative law
45-21 judges concerning the case.
45-22 SECTION 21. The Medical Practice Act (Article 4495b,
45-23 Vernon's Texas Civil Statutes) is amended by adding Section 4.025
45-24 to read as follows:
45-25 Sec. 4.025. INFORMAL PROCEEDINGS. (a) The board by rule
45-26 shall adopt procedures governing:
45-27 (1) informal disposition of a contested case under
46-1 Section 13(e), Administrative Procedure Act, and its subsequent
46-2 amendments; and
46-3 (2) informal proceedings held in compliance with
46-4 Section 18(c), Administrative Procedure Act, and its subsequent
46-5 amendments.
46-6 (b) Rules adopted under this section must provide the
46-7 complainant and the licensee an opportunity to be heard and must
46-8 require the presence of the board's legal counsel or a
46-9 representative of the office of the attorney general to advise the
46-10 board or board's employees.
46-11 SECTION 22. Section 4.02, Medical Practice Act (Article
46-12 4495b, Vernon's Texas Civil Statutes), is redesignated as Section
46-13 4.03 and amended to read as follows:
46-14 Sec. 4.03 <4.02>. Initiation of Charges. (a) Proceedings,
46-15 unless otherwise specified, under this Act or other applicable law
46-16 and charges against a licensee may be instituted by a duly
46-17 authorized representative of the board <on its own initiative or by
46-18 any person>. Charges must be in writing and on sworn affidavit
46-19 filed with the records custodian or assistant records custodian of
46-20 the board detailing the nature of the charges as required by this
46-21 Act or other applicable law. The president or an authorized <his>
46-22 designee shall <set a time and place for a hearing and shall> cause
46-23 a copy of the charges<, together with a notice of the time and
46-24 place fixed for the hearing> to be served on the respondent or the
46-25 respondent's counsel of record.
46-26 (b) The president or designee shall notify the State Office
46-27 of Administrative Hearings of a formal complaint.
47-1 (c) A formal complaint shall be in writing and shall allege
47-2 with reasonable certainty the specific act or acts relied on by the
47-3 agency to constitute a violation of a specific statute or rule.
47-4 The formal complaint shall be specific enough to enable a person of
47-5 common understanding to know what is meant by the formal complaint
47-6 and shall contain a degree of certainty that will give the person
47-7 who is the subject of the formal complaint notice of the particular
47-8 act or acts alleged to be a violation of a specific statute or
47-9 rule.
47-10 (d) The board shall adopt reasonable rules to promote
47-11 discovery by all parties to contested cases.
47-12 (e) In this section, "formal complaint" means a written
47-13 statement made by a credible person under oath that is filed and
47-14 presented by a representative of the board charging a person with
47-15 having committed an act or acts that if proven could affect the
47-16 legal rights or privileges of a licensee or other person under the
47-17 jurisdiction of the board.
47-18 SECTION 23. Section 4.03, Medical Practice Act (Article
47-19 4495b, Vernon's Texas Civil Statutes), is redesignated as Section
47-20 4.04 and amended to read as follows:
47-21 Sec. 4.04 <4.03>. Notice. (a) Service of process notifying
47-22 the respondent of <the time and place of> a hearing about <and the
47-23 nature of> the charges against the person shall be made in
47-24 accordance with the requirements of the Administrative Procedure
47-25 Act and its subsequent amendments <person or by mail. Notice shall
47-26 be sufficient if made in person or if sent by registered or
47-27 certified mail to the person charged at the address shown in the
48-1 board files or on his most recent application for registration or
48-2 renewal, no later than 10 days before the hearing>.
48-3 (b) If service of notice as prescribed by Subsection (a) of
48-4 this section is impossible or cannot be effected, the board shall
48-5 cause to be published once a week for two successive weeks a notice
48-6 of the hearing in a newspaper published in the county of the last
48-7 known place of practice in Texas of the person, if known. If the
48-8 licensee is not currently practicing in Texas as evidenced by
48-9 information in the board files, or if the last county of practice
48-10 is unknown, publication shall be in a newspaper in Travis County.
48-11 When publication of notice is used, the date of hearing may not be
48-12 less than 10 days after the date of the last publication of notice.
48-13 SECTION 24. Section 4.05, Medical Practice Act (Article
48-14 4495b, Vernon's Texas Civil Statutes), is amended to read as
48-15 follows:
48-16 Sec. 4.05. Hearings, Rules. (a) The <president of the>
48-17 board by rule shall adopt procedures governing formal disposition
48-18 of a contested case under the Administrative Procedure Act and its
48-19 subsequent amendments. A formal hearing shall be conducted by an
48-20 administrative law judge employed by the State Office of
48-21 Administrative Hearings <designate one of the following alternative
48-22 procedures for the conduct of each individual contested case in a
48-23 disciplinary matter:>
48-24 <(1) a hearing before the board itself where a quorum
48-25 of the board shall be present for the hearing and decision at the
48-26 conclusion of the hearing;>
48-27 <(2) a hearing committee appointed by the president of
49-1 the board, provided that the hearing committee shall be composed of
49-2 not less than three members of the board and the composition of
49-3 such committee shall be consistent with the provisions of Sections
49-4 2.08 and 2.09 of this Act; or>
49-5 <(3) a hearing before a hearing examiner appointed by
49-6 the board to conduct a hearing and to prepare and submit to the
49-7 board for action a proposal for decision as provided in the
49-8 Administrative Procedure and Texas Register Act (Article 6252-13a,
49-9 Vernon's Texas Civil Statutes).>
49-10 <Any individual conducting a hearing under this subchapter is
49-11 empowered to administer oaths and to receive evidence at the
49-12 hearing and shall report the hearing as prescribed by board rules>.
49-13 Notwithstanding any other provision of this Act or other law, the
49-14 board may, in its sole discretion, employ, retain, and compensate
49-15 such attorneys, consultants, and other professionals as it deems
49-16 necessary and appropriate to serve as <hearing examiners,> board
49-17 consultants or<,> special counsel to prosecute on behalf of the
49-18 hearings division and investigating division such complaints as are
49-19 filed with the board, court reporters, and other staff deemed
49-20 necessary or appropriate by the board to prepare for or represent
49-21 the board in <conduct> the hearings authorized by this section.
49-22 <All hearings conducted under this subchapter by the board shall
49-23 comply with the provisions of the Administrative Procedure Act and
49-24 the board's rules.>
49-25 (b) <The licensee shall have the right to produce witnesses
49-26 or evidence on the person's behalf, to cross-examine witnesses, and
49-27 to have subpoenas issued by the board to be served at the
50-1 licensee's expense.>
50-2 <(c)> The board shall, after receiving the administrative
50-3 law judge's findings of fact and conclusions of law <the hearing>,
50-4 determine the charges upon their merits.
50-5 (c) <(d)> All complaints, adverse reports, investigation
50-6 files, other investigation reports, and other investigative
50-7 information in the possession of, received or gathered by the board
50-8 or its employees or agents relating to a licensee, an application
50-9 for license, or a criminal investigation or proceedings are
50-10 privileged and confidential and are not subject to discovery,
50-11 subpoena, or other means of legal compulsion for their release to
50-12 anyone other than the board or its employees or agents involved in
50-13 licensee discipline. Not later than 30 days after receiving a
50-14 written request from a licensee who is the subject of a formal
50-15 complaint initiated and filed under Section 4.03 of this Act or
50-16 from the licensee's counsel of record and subject to any other
50-17 privileges or restrictions set forth by rule, statute, or legal
50-18 precedent, and unless good cause is shown for delay, the board
50-19 shall provide the licensee with access to all information in its
50-20 possession that the board intends to offer into evidence in
50-21 presenting its case in chief at the contested hearing on the
50-22 complaint. However, the board is not required to provide board
50-23 investigative reports or investigative memoranda, the identity of
50-24 nontestifying complainants, attorney-client communications,
50-25 attorney-work product, or other materials covered by a privilege as
50-26 recognized by the Texas Rules of Civil Procedure or the Texas Rules
50-27 of Civil Evidence. The furnishing of information shall not
51-1 constitute a waiver of privilege or confidentiality under this
51-2 section, this Act, or other applicable law. Investigative
51-3 <However, investigative> information in the possession of the board
51-4 or its employees or agents which relates to licensee discipline may
51-5 be disclosed to the appropriate licensing authority in another
51-6 state, the District of Columbia, or a territory or country in which
51-7 the licensee is licensed or has applied for a license, or to a peer
51-8 review committee reviewing an application for privileges or the
51-9 qualifications of the licensee with respect to retaining
51-10 privileges. If the investigative information in the possession of
51-11 the board or its employees or agents indicates a crime may have
51-12 been committed, the information shall be reported to the proper law
51-13 enforcement agency. The board shall cooperate and assist all law
51-14 enforcement agencies conducting criminal investigations of
51-15 licensees by providing information which is relevant to the
51-16 criminal investigation to the investigating agency. Any
51-17 information disclosed by the board to an investigative agency shall
51-18 remain confidential and shall not be disclosed by the investigating
51-19 agency except as necessary to further the investigation. The board
51-20 shall provide information upon the written request of a health-care
51-21 entity about a complaint filed against a licensee that was resolved
51-22 after investigation by a disciplinary order of the board or by an
51-23 agreed settlement and the basis of and current status of any
51-24 complaint under active investigation. The board shall keep
51-25 information on file about each complaint filed with the board,
51-26 consistent with this Act. If a written complaint is filed with the
51-27 board relating to a person licensed by the board, the board, at
52-1 least as often as quarterly and until final determination of the
52-2 action to be taken relative to the complaint, shall notify the
52-3 parties to the complaint <complaining party> consistent with this
52-4 Act of the status of the complaint unless the notice would
52-5 jeopardize an active investigation.
52-6 (d) <(e)> The board in its discretion may accept the
52-7 voluntary surrender of a license. No license may be returned
52-8 unless the board determines, under rules established by it, that
52-9 the licensee is competent to resume practice.
52-10 SECTION 25. Section 4.10, Medical Practice Act (Article
52-11 4495b, Vernon's Texas Civil Statutes), is amended to read as
52-12 follows:
52-13 Sec. 4.10. Petition for Reinstatement. (a) Upon
52-14 application, the board may reissue a license to practice medicine
52-15 to a person whose license has been canceled, revoked, or suspended,
52-16 but the application, in the case of revocation, may not be made
52-17 prior to one year after the revocation was issued or became final
52-18 and must be made upon payment of the fees as established by the
52-19 board and in the manner and form and under the conditions as the
52-20 board may require. Further, the board may not reinstate or reissue
52-21 a license to a person whose license has been canceled, revoked, or
52-22 suspended because of a felony conviction under Chapter 481, Health
52-23 and Safety Code, Section 485.033, Health and Safety Code, Chapter
52-24 483, Health and Safety Code, or the Federal Comprehensive Drug
52-25 Abuse Prevention and Control Act of 1970, 21 U.S.C.A. Section 801
52-26 et seq. (Public Law 91-513), except on an express determination
52-27 based on substantial evidence contained in an investigative report
53-1 indicating that the reinstatement or reissue of the license is in
53-2 the best interests of the public and of the person whose license
53-3 has been canceled, revoked, or suspended.
53-4 (b) A decision by the board to deny an application to
53-5 reinstate or reissue a license is subject to judicial review in the
53-6 manner provided by Section 4.09 of this Act.
53-7 SECTION 26. Section 4.11, Medical Practice Act (Article
53-8 4495b, Vernon's Texas Civil Statutes), is amended to read as
53-9 follows:
53-10 Sec. 4.11. Monitoring of License Holder; Probation.
53-11 (a) The board by rule shall develop a system for monitoring the
53-12 compliance with the requirements of this Act of license holders who
53-13 are the subject of disciplinary action. Rules adopted under this
53-14 section shall include procedures for monitoring a license holder
53-15 who is ordered by the board to perform certain acts to ascertain
53-16 that the license holder performs the required acts and to identify
53-17 and monitor license holders who are the subject of disciplinary
53-18 action and who present a continuing threat to the public welfare
53-19 through the practice of medicine.
53-20 (b) The board upon majority vote may provide that the order
53-21 canceling, revoking, or suspending a license or imposing any other
53-22 method of discipline be probated so long as the probationer
53-23 conforms to the orders, conditions, and rules that the board may
53-24 set out as the terms of probation. However, the board may not
53-25 grant probation to a person whose license has been canceled,
53-26 revoked, or suspended because of a felony conviction under Chapter
53-27 481, Health and Safety Code, Section 485.033, Health and Safety
54-1 Code, Chapter 483, Health and Safety Code, or the Federal
54-2 Comprehensive Drug Abuse Prevention and Control Act of 1970, 21
54-3 U.S.C.A. Section 801 et seq. (Public Law 91-513), except on an
54-4 express determination, based on substantial evidence, that the
54-5 grant of probation is in the best interests of the public and of
54-6 the person whose license has been suspended, revoked, or canceled.
54-7 The board, at the time of probation, shall set out the period of
54-8 time that constitutes the probationary period. The board may not
54-9 grant probation to a physician who poses, through the practice of
54-10 medicine, a continuing threat to the public welfare.
54-11 (c) <(b)> The board may at any time while a license holder
54-12 <the probationer> remains on probation, with adequate grounds being
54-13 shown, cause <hold> a hearing to be held and, upon proof of a
54-14 violation of the order <majority vote>, rescind the probation and
54-15 enforce the board's original action and may impose any disciplinary
54-16 action permitted under Section 4.12 of this Act in addition to or
54-17 in lieu of enforcing the original order. The board <and> shall
54-18 revoke or suspend a probationer's license <do so> if the board
54-19 determines that the probationer poses, through the practice of
54-20 medicine, a continuing threat to the public welfare.
54-21 (d) <(c)> The hearing to rescind the probation shall be
54-22 governed by the same provisions as are set forth in this subchapter
54-23 for other charges.
54-24 SECTION 27. Section 4.12, Medical Practice Act (Article
54-25 4495b, Vernon's Texas Civil Statutes), is amended to read as
54-26 follows:
54-27 Sec. 4.12. Methods of Discipline. (a) Except as otherwise
55-1 provided in Section 4.01, if the board finds any person to have
55-2 committed any of the acts set forth in Section 3.08 of this Act, it
55-3 shall enter an order imposing one or more of the following:
55-4 (1) deny the person's application for a license or
55-5 other authorization to practice medicine;
55-6 (2) administer a public reprimand;
55-7 (3) suspend, limit, or restrict the person's license
55-8 or other authorization to practice medicine, including limiting the
55-9 practice of the person to or by the exclusion of one or more
55-10 specified activities of medicine or stipulating periodic board
55-11 review;
55-12 (4) revoke the person's license or other authorization
55-13 to practice medicine;
55-14 (5) require the person to submit to care, counseling,
55-15 or treatment of physicians designated by the board as a condition
55-16 for the initial, continued, or renewal of a license or other
55-17 authorization to practice medicine;
55-18 (6) require the person to participate in a program of
55-19 education or counseling prescribed by the board;
55-20 (7) require the person to practice under the direction
55-21 of a physician designated by the board for a specified period of
55-22 time; <or>
55-23 (8) require the person to perform public service
55-24 considered appropriate by the board; or
55-25 (9) assess an administrative penalty against the
55-26 person as provided by Section 4.125 of this Act.
55-27 (b) Providing however, if the board determines that, through
56-1 the practice of medicine, the physician poses a continuing threat
56-2 to the public welfare, it shall revoke, suspend or deny the
56-3 license.
56-4 (c) In addition to the other disciplinary actions authorized
56-5 by this section, the board may issue a written reprimand to a
56-6 license holder who violates this Act or require that a license
56-7 holder who violates this Act participate in continuing education
56-8 programs. The board shall specify the continuing education
56-9 programs that may be attended and the number of hours that must be
56-10 completed by an individual license holder to fulfill the
56-11 requirements of this subsection.
56-12 (d) If a license suspension is probated, the board may
56-13 require the license holder to:
56-14 (1) report regularly to the board on matters that are
56-15 the basis of the probation;
56-16 (2) limit practice to the areas prescribed by the
56-17 board; or
56-18 (3) continue or review continuing professional
56-19 education until the license holder attains a degree of skill
56-20 satisfactory to the board in those areas that are the basis of the
56-21 probation.
56-22 (e) The schedule of sanctions adopted by the board by rule
56-23 shall be used by the State Office of Administrative Hearings for
56-24 any sanction imposed as the result of a hearing conducted by that
56-25 office.
56-26 SECTION 28. The Medical Practice Act (Article 4495b,
56-27 Vernon's Texas Civil Statutes) is amended by adding Section 4.125
57-1 to read as follows:
57-2 Sec. 4.125. ADMINISTRATIVE PENALTY. (a) The board by order
57-3 may impose an administrative penalty against a person licensed or
57-4 regulated under this Act who violates this Act or a rule or order
57-5 adopted under this Act.
57-6 (b) The penalty for a violation may be in an amount not to
57-7 exceed $5,000. Each day a violation continues or occurs is a
57-8 separate violation for purposes of imposing a penalty.
57-9 (c) The amount of the penalty shall be based on:
57-10 (1) the seriousness of the violation, including the
57-11 nature, circumstances, extent, and gravity of any prohibited acts,
57-12 and the hazard or potential hazard created to the health, safety,
57-13 or economic welfare of the public;
57-14 (2) the economic harm to property or the environment
57-15 caused by the violation;
57-16 (3) the history of previous violations;
57-17 (4) the amount necessary to deter future violations;
57-18 (5) efforts to correct the violation; and
57-19 (6) any other matter that justice may require.
57-20 (d) The board by rule shall prescribe the procedure by which
57-21 it may impose an administrative penalty.
57-22 (e) All proceedings under this section are subject to the
57-23 Administrative Procedure Act and its subsequent amendments.
57-24 (f) If the board by order finds that a violation has
57-25 occurred and imposes an administrative penalty, the board shall
57-26 give notice to the person of the board's order. The notice must
57-27 include a statement of the right of the person to judicial review
58-1 of the order.
58-2 (g) Within 30 days after the date the board's order imposing
58-3 the penalty is final as provided by Section 16(c), Administrative
58-4 Procedure Act, and its subsequent amendments, the person shall:
58-5 (1) pay the amount of the penalty;
58-6 (2) pay the amount of the penalty and file a petition
58-7 for judicial review contesting the occurrence of the violation, the
58-8 amount of the penalty, or both the occurrence of the violation and
58-9 the amount of the penalty; or
58-10 (3) without paying the amount of the penalty, file a
58-11 petition for judicial review contesting the occurrence of the
58-12 violation, the amount of the penalty, or both the occurrence of the
58-13 violation and the amount of the penalty.
58-14 (h) Within the 30-day period, a person who acts under
58-15 Subsection (g)(3) of this section may:
58-16 (1) stay enforcement of the penalty by:
58-17 (A) paying the amount of the penalty to the
58-18 court for placement in an escrow account; or
58-19 (B) giving to the court a supersedeas bond that
58-20 is approved by the court for the amount of the penalty and that is
58-21 effective until all judicial review of the board's order is final;
58-22 or
58-23 (2) request the court to stay enforcement of the
58-24 penalty by:
58-25 (A) filing with the court a sworn affidavit of
58-26 the person stating that the person is financially unable to pay the
58-27 amount of the penalty and is financially unable to give the
59-1 supersedeas bond; and
59-2 (B) giving a copy of the affidavit to the
59-3 executive director by certified mail.
59-4 (i) An executive director who receives a copy of an
59-5 affidavit under Subsection (h)(2) of this section may file with the
59-6 court, within five days after the date the copy is received, a
59-7 contest to the affidavit. The court shall hold a hearing on the
59-8 facts alleged in the affidavit as soon as practicable and shall
59-9 stay the enforcement of the penalty on finding that the alleged
59-10 facts are true. The person who files an affidavit has the burden
59-11 of proving that the person is financially unable to pay the amount
59-12 of the penalty and to give a supersedeas bond.
59-13 (j) If the person does not pay the amount of the penalty and
59-14 the enforcement of the penalty is not stayed, the executive
59-15 director may refer the matter to the attorney general for
59-16 collection of the amount of the penalty.
59-17 (k) If on appeal the court sustains the occurrence of the
59-18 violation, the court may uphold or reduce the amount of the penalty
59-19 and order the person to pay the full or reduced amount of the
59-20 penalty. If the court does not sustain the occurrence of the
59-21 violation, the court shall order that no penalty is owed.
59-22 (l) When the judgment of the court becomes final, the court
59-23 shall proceed under this subsection. If the person paid the amount
59-24 of the penalty and if that amount is reduced or is not upheld by
59-25 the court, the court shall order that the appropriate amount plus
59-26 accrued interest be remitted to the person. The rate of the
59-27 interest is the rate charged on loans to depository institutions by
60-1 the New York Federal Reserve Bank, and the interest shall be paid
60-2 for the period beginning on the date the penalty was paid and
60-3 ending on the date the penalty is remitted. If the person gave a
60-4 supersedeas bond and if the amount of the penalty is not upheld by
60-5 the court, the court shall order the release of the bond. If the
60-6 person gave a supersedeas bond and if the amount of the penalty is
60-7 reduced, the court shall order the release of the bond after the
60-8 person pays the amount.
60-9 (m) A penalty collected under this section shall be remitted
60-10 to the comptroller for deposit in the general revenue fund.
60-11 SECTION 29. The Medical Practice Act (Article 4495b,
60-12 Vernon's Texas Civil Statutes) is amended by adding Section 4.126
60-13 to read as follows:
60-14 Sec. 4.126. CIVIL PENALTY. (a) If it appears that a person
60-15 is in violation of or is threatening to violate this Act or a rule
60-16 or order adopted by the board, the attorney general may institute
60-17 an action for a civil penalty of $1,000 for each violation. Each
60-18 day of a violation shall constitute a separate violation.
60-19 (b) A civil action filed under this section by the attorney
60-20 general must be filed in a district court in Travis County or the
60-21 county in which the violation occurred.
60-22 (c) The attorney general may recover reasonable expenses
60-23 incurred in obtaining a civil penalty under this section, including
60-24 court costs, reasonable attorney's fees, investigative costs,
60-25 witness fees, and deposition expenses.
60-26 (d) A civil penalty recovered in an action by the attorney
60-27 general under this section shall be deposited in the general
61-1 revenue fund.
61-2 SECTION 30. Section 4.13, Medical Practice Act (Article
61-3 4495b, Vernon's Texas Civil Statutes), is amended to read as
61-4 follows:
61-5 Sec. 4.13. Temporary Suspension of License. (a) The
61-6 president of the board, with the approval of the board, shall
61-7 appoint a three-member disciplinary panel consisting of members of
61-8 the board for the purpose of determining whether a person's license
61-9 to practice medicine in this state should be temporarily suspended
61-10 under this section.
61-11 (b) If the disciplinary panel <executive committee of the
61-12 board> determines from the evidence or information presented to it
61-13 that a person licensed to practice medicine in this state by his
61-14 continuation in practice would constitute a continuing threat to
61-15 the public welfare, the disciplinary panel <executive committee of
61-16 the board> shall temporarily suspend the license of that person.
61-17 (c) The license may be suspended under this section without
61-18 notice or hearing on the complaint, provided institution of
61-19 proceedings for a hearing before the board is initiated
61-20 simultaneously with the temporary suspension and provided that a
61-21 hearing is held as soon as can be accomplished under the
61-22 Administrative Procedure Act and this Act.
61-23 (d) Notwithstanding the open meetings law, Chapter 271, Acts
61-24 of the 60th Legislature, Regular Session, 1967 (Article 6252-17,
61-25 Vernon's Texas Civil Statutes), the disciplinary panel may hold a
61-26 meeting by telephone conference call if immediate action is
61-27 required and the convening at one location of the disciplinary
62-1 panel is inconvenient for any member of the disciplinary panel.
62-2 SECTION 31. Subchapter E, Medical Practice Act (Article
62-3 4495b, Vernon's Texas Civil Statutes), is amended by adding Section
62-4 5.035 to read as follows:
62-5 Sec. 5.035. GRADUATES OF UNAPPROVED FOREIGN MEDICAL SCHOOLS.
62-6 (a) An applicant who is a graduate of a medical school that is
62-7 located outside the United States and Canada and that was not
62-8 approved by the board at the time the degree was conferred, to be
62-9 eligible for the issuance of a license, must present satisfactory
62-10 proof to the board that the applicant:
62-11 (1) meets the requirements set out in Sections
62-12 3.04(a)(1), (2), and (3) of this Act;
62-13 (2) is a graduate of a school whose curriculum meets
62-14 the requirements for an unapproved medical school as determined by
62-15 a committee of experts selected by the Texas Higher Education
62-16 Coordinating Board;
62-17 (3) has successfully completed three years of graduate
62-18 medical training in the United States or Canada that was approved
62-19 by the board on the date the training was completed;
62-20 (4) is eligible for licensure to practice medicine in
62-21 the country in which the school is located;
62-22 (5) possesses a valid certificate issued by the
62-23 Educational Commission for Foreign Medical Graduates;
62-24 (6) has the ability to communicate in the English
62-25 language; and
62-26 (7) has passed the examination required by the board
62-27 of all applicants for license as required by Section 3.05 of this
63-1 Act.
63-2 (b) In addition to other licensure requirements, the board
63-3 may require by rule that a graduate of an unapproved medical school
63-4 located outside the United States and Canada or the school of which
63-5 the person is a graduate provide additional information to the
63-6 board concerning the school before approving the applicant.
63-7 (c) The board may refuse to issue a license to an applicant
63-8 who graduated from an unapproved medical school located outside the
63-9 United States and Canada if it finds that the applicant does not
63-10 possess the requisite qualifications to provide the same standard
63-11 of medical care as provided by a physician licensed in this state.
63-12 (d) The board may refuse to issue a license to an applicant
63-13 who graduated from an unapproved medical school located outside the
63-14 United States and Canada if the applicant fails to provide the
63-15 board evidence to establish that the applicant completed medical
63-16 education or professional training substantially equivalent to that
63-17 provided by a medical school in this state.
63-18 SECTION 32. Section 5.04, Medical Practice Act, is amended
63-19 to read as follows:
63-20 Sec. 5.04. FIFTH PATHWAY FOR FOREIGN MEDICAL SCHOOL
63-21 STUDENTS. (a) An applicant <Notwithstanding any other provision
63-22 of law, an individual> who has been a student of a foreign medical
63-23 school, to be eligible for the issuance of a license, must present
63-24 satisfactory proof to the board that the applicant <is eligible for
63-25 licensure to practice medicine in this state if he>:
63-26 (1) meets the requirements set out in Sections
63-27 3.04(a)(1), (2), and (3) of this Act;
64-1 (2) has studied medicine in an acceptable <a
64-2 reputable> medical school as defined by the board located outside
64-3 the United States and Canada;
64-4 (3) <(2)> has completed all of the didactic work of
64-5 the foreign medical school but has not graduated from the school;
64-6 (4) <(3)> has attained a score satisfactory to a
64-7 medical school in the United States approved by the Liaison
64-8 Committee on Medical Education on a qualifying examination and has
64-9 satisfactorily completed one academic year of supervised clinical
64-10 training for foreign medical students as defined by the American
64-11 Medical Association Council on Medical Education (Fifth Pathway
64-12 Program) under the direction of the medical school in the United
64-13 States;
64-14 (5) <(4)> has attained a passing score on the
64-15 Educational Commission <Council> for Foreign Medical Graduates
64-16 examination, or other examination, if required by the board; <and>
64-17 (6) has successfully completed three years of graduate
64-18 medical training in the United States or Canada that was approved
64-19 by the board on the date the training was completed; and
64-20 (7) <(5)> has passed the examination required by the
64-21 board of all applicants for license as required by Section 3.05 of
64-22 this Act.
64-23 (b) Satisfaction of the requirements of Subsection (a) of
64-24 this section are in lieu of the completion of any requirements of
64-25 the foreign medical school beyond completion of the didactic work,
64-26 and no other medical education requirements shall be a condition of
64-27 licensure to practice medicine in this state.
65-1 (c) Satisfaction of the requirements specified in Subsection
65-2 (a) of this section shall be in lieu of certification by the
65-3 Educational Commission <Council> for Foreign Medical Graduates, and
65-4 the certification is not a condition of licensure to practice
65-5 medicine in this state for candidates who have completed the
65-6 requirements of Subsection (a) of this section.
65-7 (d) A hospital that is licensed by this state, that is
65-8 operated by the state or a political subdivision of the state, or
65-9 that receives state financial assistance, directly or indirectly,
65-10 may not require an individual who has been a student of a foreign
65-11 medical school but has not graduated from the school to satisfy any
65-12 requirements other than those contained in <Subdivisions (1), (2),
65-13 (3), and (4) of> Subsection (a) of this section prior to commencing
65-14 an internship or residency.
65-15 (e) A document granted by a medical school located outside
65-16 the United States issued after the completion of all the didactic
65-17 work of the foreign medical school shall, on certification by the
65-18 medical school in the United States in which the training was
65-19 received of satisfactory completion by the person to whom the
65-20 document was issued of the requirements listed in Subdivision (4)
65-21 <(3)> of Subsection (a) of this section, be considered the
65-22 equivalent of a degree of doctor of medicine or doctor of
65-23 osteopathy for purposes of licensure.
65-24 SECTION 33. Section 5.08(k), Medical Practice Act (Article
65-25 4495b, Vernon's Texas Civil Statutes), is amended to read as
65-26 follows:
65-27 (k) A physician shall furnish copies of medical records
66-1 requested, or a summary or narrative of the records, pursuant to a
66-2 written consent for release of the information as provided by
66-3 Subsection (j) of this section, except if the physician determines
66-4 that access to the information would be harmful to the physical,
66-5 mental, or emotional health of the patient, and the physician may
66-6 delete confidential information about another person who has not
66-7 consented to the release. The information shall be furnished by
66-8 the physician within 30 days after the date of receipt of the
66-9 request <a reasonable period of time> and reasonable fees for
66-10 furnishing the information shall be paid by the patient or someone
66-11 on his behalf. If the physician denies the request, in whole or in
66-12 part, the physician shall furnish the patient a written statement,
66-13 signed and dated, stating the reason for the denial. A copy of the
66-14 statement denying the request shall be placed in the patient's
66-15 medical records. In this subsection, "medical records" means any
66-16 records pertaining to the history, diagnosis, treatment, or
66-17 prognosis of the patient.
66-18 SECTION 34. Section 5.10, Medical Practice Act (Article
66-19 4495b, Vernon's Texas Civil Statutes), is amended to read as
66-20 follows:
66-21 Sec. 5.10. Sunset provision. The Texas State Board of
66-22 Medical Examiners is subject to Chapter 325, Government Code (Texas
66-23 Sunset Act). Unless continued in existence as provided by that
66-24 chapter, the board is abolished and this Act expires September 1,
66-25 2005 <1993>.
66-26 SECTION 35. The Medical Practice Act (Article 4495b,
66-27 Vernon's Texas Civil Statutes) is amended by adding Subchapter F to
67-1 read as follows:
67-2 SUBCHAPTER F. ACUPUNCTURE PRACTICE
67-3 Sec. 6.01. LEGISLATIVE FINDINGS AND PURPOSE. The
67-4 legislature finds that:
67-5 (1) the review and establishment of statewide
67-6 standards for the training, education, and discipline of persons
67-7 performing acupuncture are in the public interest; and
67-8 (2) the health, safety, and welfare of the people of
67-9 this state are best served by an orderly system of regulating the
67-10 practice of acupuncture.
67-11 Sec. 6.02. DEFINITIONS. In this subchapter:
67-12 (1) "Acupuncture" means:
67-13 (A) the insertion of an acupuncture needle and
67-14 the application of moxibustion to specific areas of the human body
67-15 as a primary mode of therapy to treat and mitigate a human
67-16 condition; and
67-17 (B) the administration of thermal or electrical
67-18 treatments or the recommendation of dietary guidelines, therapeutic
67-19 exercise, or dietary or herbal supplements in conjunction with the
67-20 treatment described by Paragraph (A) of this subdivision.
67-21 (2) "Acupuncturist" means a person who practices
67-22 acupuncture.
67-23 (3) "Acupuncture board" means the Texas State Board of
67-24 Acupuncture Examiners.
67-25 (4) "Chiropractor" means a licensee of the Texas Board
67-26 of Chiropractic Examiners.
67-27 (5) "Executive director" means the executive director
68-1 of the Texas State Board of Medical Examiners.
68-2 (6) "Medical board" means the Texas State Board of
68-3 Medical Examiners.
68-4 (7) "Physician" means a licensee of the Texas State
68-5 Board of Medical Examiners.
68-6 Sec. 6.03. EXEMPTION; LIMITATION. (a) This subchapter does
68-7 not apply to a health care professional licensed under another
68-8 subchapter of this Act or another statute of this state and acting
68-9 within the scope of the license.
68-10 (b) This subchapter does not:
68-11 (1) limit the practice of medicine by a physician or
68-12 permit the unauthorized practice of medicine; or
68-13 (2) permit a person to dispense, administer, or supply
68-14 any controlled substance, narcotic, or dangerous drug if the person
68-15 is not otherwise authorized by law to do so.
68-16 Sec. 6.04. ACUPUNCTURE BOARD. (a) The Texas State Board of
68-17 Acupuncture Examiners is composed of nine members appointed by the
68-18 governor as follows:
68-19 (1) four acupuncturists who have at least five years
68-20 of experience in the practice of acupuncture in this state and are
68-21 not licensed in this state as physicians;
68-22 (2) two physicians who are licensed in this state and
68-23 are experienced in the practice of acupuncture; and
68-24 (3) three members of the general public who are not
68-25 licensed or trained in a health care profession and who represent
68-26 the public.
68-27 (b) The following persons may not serve on the acupuncture
69-1 board:
69-2 (1) a person who is required to register as a lobbyist
69-3 under Chapter 305, Government Code, and its subsequent amendments;
69-4 and
69-5 (2) a person who is currently employed by or serving
69-6 as president, vice-president, secretary, or treasurer of a
69-7 statewide or national organization incorporated for the purpose of
69-8 representing a health care profession in this state or the United
69-9 States.
69-10 (c) Members of the acupuncture board hold office for
69-11 staggered terms of six years, with three members' terms expiring
69-12 January 31 of each odd-numbered year.
69-13 (d) The governor shall designate a presiding officer of the
69-14 acupuncture board from the members of the acupuncture board.
69-15 (e) A vacancy on the acupuncture board shall be filled by
69-16 appointment of the governor.
69-17 (f) A member of the acupuncture board may not receive
69-18 compensation for service on the board but is entitled to receive a
69-19 per diem as set by legislative appropriation for transportation and
69-20 related expenses incurred for each day that the member engages in
69-21 the business of the board.
69-22 (g) The acupuncture board is subject to the open meetings
69-23 law, the open records law, and the Administrative Procedure Act and
69-24 any subsequent amendments.
69-25 (h) The acupuncture board is subject to Chapter 325,
69-26 Government Code (Texas Sunset Act). Unless continued in existence
69-27 as provided by that chapter, the board is abolished and this
70-1 subchapter expires September 1, 1997.
70-2 Sec. 6.05. POWERS AND DUTIES OF ACUPUNCTURE BOARD. (a)
70-3 Subject to the advice and approval of the medical board, the
70-4 acupuncture board shall:
70-5 (1) establish qualifications for an acupuncturist to
70-6 practice in this state;
70-7 (2) establish minimum educational and training
70-8 requirements necessary for the acupuncture board to recommend that
70-9 the medical board issue a license to practice acupuncture;
70-10 (3) administer an examination that is validated by
70-11 independent testing professionals for a license to practice
70-12 acupuncture;
70-13 (4) develop requirements for licensure by endorsement
70-14 of other states;
70-15 (5) prescribe the application form for a license to
70-16 practice acupuncture;
70-17 (6) make recommendations on applications for licenses
70-18 to practice acupuncture;
70-19 (7) establish a procedure for reporting and processing
70-20 complaints relating to the practice of acupuncture under this
70-21 article;
70-22 (8) establish the requirements for a tutorial program
70-23 for students who have completed at least 48 semester hours of
70-24 college; and
70-25 (9) recommend additional rules as are necessary for
70-26 the administration and enforcement of this subchapter.
70-27 (b) Notwithstanding Subsection (a) of this section, the
71-1 acupuncture board has no independent rulemaking authority.
71-2 Sec. 6.06. LICENSE REQUIRED. A person may not practice
71-3 acupuncture in this state unless the person holds a license to
71-4 practice acupuncture issued by the medical board under this
71-5 subchapter.
71-6 Sec. 6.07. QUALIFICATIONS OF ACUPUNCTURISTS. (a) An
71-7 applicant for a license to practice acupuncture who is not
71-8 otherwise licensed under this subchapter must pass an examination
71-9 approved by the acupuncture board.
71-10 (b) To be eligible for the examination, an applicant must:
71-11 (1) be at least 21 years of age;
71-12 (2) have completed at least 48 semester hours of
71-13 college courses, including basic science courses as determined by
71-14 the advisory board; and
71-15 (3) be a graduate of an acceptable acupuncture school
71-16 whose entrance requirements and course of instruction meet
71-17 standards set by the acupuncture board.
71-18 (c) A reputable acupuncture school must:
71-19 (1) maintain a resident course of instruction
71-20 equivalent to not less than six terms of four months each for a
71-21 total of not less than 1,800 instructional hours;
71-22 (2) provide supervised patient treatment for at least
71-23 two terms of the resident course of instruction;
71-24 (3) maintain a course of instruction in
71-25 anatomy-histology, bacteriology, physiology, symptomatology,
71-26 pathology, meridian and point locations, hygiene, and public
71-27 health; and
72-1 (4) have the necessary teaching force and facilities
72-2 for proper instruction in required subjects.
72-3 (d) In establishing standards for the entrance requirements
72-4 and course of instruction of an acupuncture school, the acupuncture
72-5 board may consider the standards set by the National Accreditation
72-6 Commission for Schools and Colleges of Acupuncture and Oriental
72-7 Medicine.
72-8 (e) The examination shall be conducted on practical and
72-9 theoretical acupuncture and other subjects required by the
72-10 acupuncture board.
72-11 (f) An application for examination must be:
72-12 (1) in writing on a form prescribed by the acupuncture
72-13 board;
72-14 (2) verified by affidavit;
72-15 (3) filed with the executive director of the medical
72-16 board; and
72-17 (4) accompanied by a fee set by the medical board.
72-18 (g) The medical board shall notify all applicants of the
72-19 time and place of the examination.
72-20 (h) The examination may be in writing, by a practical
72-21 demonstration of the applicant's skill, or both, as the acupuncture
72-22 board may require.
72-23 Sec. 6.08. ASSISTANCE BY MEDICAL BOARD. The medical board
72-24 shall provide administrative and clerical employees as necessary to
72-25 enable the acupuncture board to carry out this subchapter.
72-26 Sec. 6.09. FEES. (a) The medical board shall set and
72-27 collect fees in amounts that are reasonable and necessary to cover
73-1 the costs of administering and enforcing this subchapter without
73-2 the use of any other funds generated by the medical board.
73-3 (b) Fees collected by the medical board under this
73-4 subchapter shall be deposited by the medical board in the state
73-5 treasury to the credit of a special account in the general revenue
73-6 fund. The special account may be used only to cover the costs of
73-7 administering and enforcing this subchapter. The special account
73-8 is exempt from Section 403.094(h), Government Code, and its
73-9 subsequent amendments.
73-10 Sec. 6.10. ISSUANCE OF LICENSE. (a) After consulting the
73-11 acupuncture board, the medical board shall issue a license to
73-12 practice acupuncture in this state to a person who meets the
73-13 requirements of this subchapter and the rules adopted under this
73-14 subchapter.
73-15 (b) The medical board shall by rule provide for the annual
73-16 renewal of a license to practice acupuncture.
73-17 Sec. 6.11. DENIAL OF LICENSE; DISCIPLINE OF LICENSE HOLDER.
73-18 (a) A license to practice acupuncture may be denied or, after
73-19 notice and hearing, suspended, probated, or revoked if the
73-20 applicant for a license or the holder of a license:
73-21 (1) uses drugs or intoxicating liquors to an extent
73-22 that affects the person's professional competence;
73-23 (2) obtains or attempts to obtain a license by fraud
73-24 or deception;
73-25 (3) is adjudged mentally incompetent by a court of
73-26 competent jurisdiction;
73-27 (4) practices acupuncture in a manner detrimental to
74-1 the public health and welfare;
74-2 (5) violates this subchapter or a rule adopted under
74-3 this subchapter;
74-4 (6) is convicted of a felony or a crime involving
74-5 moral turpitude; or
74-6 (7) holds himself out as a physician or surgeon or any
74-7 combination or derivative of those terms unless the person is also
74-8 licensed by the medical board as a physician or surgeon.
74-9 (b) Except as provided by Subsection (c) of this section, a
74-10 license to practice acupuncture shall be denied or, after notice
74-11 and hearing, revoked if the holder of a license has performed
74-12 acupuncture on a person who was not evaluated by a physician or
74-13 dentist, as appropriate, for the condition being treated within six
74-14 months before the date acupuncture was performed.
74-15 (c) The holder of a license may perform acupuncture on a
74-16 person who was referred by a doctor licensed to practice
74-17 chiropractic by the Texas Board of Chiropractic Examiners if the
74-18 licensee commences the treatment within 30 days of the date of the
74-19 referral. The licensee shall refer the person to a physician after
74-20 performing acupuncture 20 times or for 30 days, whichever occurs
74-21 first, if no substantial improvement occurs in the person's
74-22 condition for which the referral was made.
74-23 (d) The holder of a license must obtain reasonable
74-24 documentation that the evaluation required by Subsection (b) of
74-25 this section has taken place. If the licensee is unable to
74-26 determine that an evaluation has taken place, the licensee must
74-27 obtain a written statement signed by the person on a form
75-1 prescribed by the acupuncture board that states that the person has
75-2 been evaluated by a physician within the prescribed time frame.
75-3 The form shall contain a clear statement that the person should be
75-4 evaluated by a physician for the condition being treated by the
75-5 licensee.
75-6 (e) The medical board with advice from the acupuncture board
75-7 by rule may modify the requirement of the time frame or the scope
75-8 of the evaluation under Subsection (b) of this section.
75-9 (f) The medical board with advice from the acupuncture board
75-10 by rule may modify the requirement of the time frame for
75-11 commencement of treatment after referral by a chiropractor or the
75-12 number of treatments or days before referral to a physician is
75-13 required under Subsection (c) of this section.
75-14 (g) Notwithstanding Subsections (b) and (c) of this section,
75-15 an acupuncturist holding a current and valid license may without a
75-16 referral from a physician, dentist, or chiropractor perform
75-17 acupuncture on a person for smoking addiction, weight loss, or, as
75-18 established by the medical board with advice from the acupuncture
75-19 board by rule, substance abuse.
75-20 Sec. 6.12. OFFENSE. (a) A person commits an offense if the
75-21 person violates Section 6.06 of this Act.
75-22 (b) An offense under Subsection (a) of this section is a
75-23 Class A misdemeanor.
75-24 (c) Each day of a violation constitutes a separate offense.
75-25 Sec. 6.13. INJUNCTIVE RELIEF; CIVIL PENALTY. (a) The
75-26 medical board, the attorney general, or a district or county
75-27 attorney may bring a civil action to compel compliance with this
76-1 subchapter or to enforce a rule adopted under this subchapter.
76-2 (b) In addition to injunctive relief or any other remedy
76-3 provided by law, a person who violates this subchapter or a rule
76-4 adopted under this subchapter is liable to the state for a civil
76-5 penalty in an amount not to exceed $2,000 for each violation. Each
76-6 day a violation continues or occurs is a separate violation for
76-7 purposes of imposing a civil penalty. The attorney general, at the
76-8 request of the medical board or on the attorney general's own
76-9 initiative, may bring a civil action to collect a civil penalty
76-10 under this subsection. A civil penalty recovered shall be
76-11 deposited to the credit of the general revenue fund.
76-12 Sec. 6.14. AUTOMATIC LICENSURE. (a) With the approval of
76-13 the medical board, the acupuncture board shall establish
76-14 appropriate and reasonable requirements to determine those persons
76-15 practicing acupuncture on the effective date of this subchapter who
76-16 are eligible for immediate approval for a license to practice
76-17 acupuncture under this section.
76-18 (b) This section only applies to a person who meets the
76-19 requirements for immediate licensure under this section and who
76-20 applies for immediate approval on or before June 1, 1994.
76-21 (c) This section expires June 2, 1994.
76-22 SECTION 36. (a) As soon as possible on or after the
76-23 effective date of this Act, the governor shall appoint 15 new
76-24 members to the Texas State Board of Medical Examiners in accordance
76-25 with Section 2.05, Medical Practice Act (Article 4495b, Vernon's
76-26 Texas Civil Statutes), as amended by this Act. In making the
76-27 appointments, the governor shall designate five members for terms
77-1 expiring April 13, 1995, five members for terms expiring April 13,
77-2 1997, and five members for terms expiring April 13, 1999. The
77-3 members appointed under this subsection may not perform the
77-4 functions of the board until the day after the date a majority of
77-5 the new members take office.
77-6 (b) Until the date the new members of the Texas State Board
77-7 of Medical Examiners may begin performing the functions of the
77-8 board under Subsection (a) of this section, the members serving on
77-9 the board immediately before the effective date of this Act shall
77-10 continue to carry out the functions of the board. On the date the
77-11 new members may begin performing the functions of the board, the
77-12 offices of the members serving immediately before the effective
77-13 date of this Act are abolished.
77-14 (c) The changes in law made by this Act in the
77-15 qualifications of, and the prohibitions applying to, members of the
77-16 Texas State Board of Medical Examiners do not affect the
77-17 entitlement of a member serving on the board immediately before the
77-18 effective date of this Act to continue to carry out the functions
77-19 of the board for the period prescribed by Subsection (b) of this
77-20 section. The changes in law apply only to a member appointed on or
77-21 after the effective date of this Act. This Act does not prohibit a
77-22 person who is a member of the board on the effective date of this
77-23 Act from being reappointed to the board if the person has the
77-24 qualifications required for a member under the Medical Practice Act
77-25 (Article 4495b, Vernon's Texas Civil Statutes), as amended by this
77-26 Act.
77-27 (d) The changes in law made by this Act relating to an
78-1 administrative penalty or civil penalty apply only to a violation
78-2 of the Medical Practice Act (Article 4495b, Vernon's Texas Civil
78-3 Statutes) or a rule or order adopted by the Texas State Board of
78-4 Medical Examiners that occurs on or after the effective date of
78-5 this Act. A violation occurs on or after the effective date of
78-6 this Act only if each element of the violation occurs on or after
78-7 that date. A violation that occurs before the effective date of
78-8 this Act is governed by the law in effect on the date the violation
78-9 occurred, and the former law is continued in effect for that
78-10 purpose.
78-11 (e) A person is not required to obtain a license to practice
78-12 acupuncture under Subchapter F, Medical Practice Act (Article
78-13 4495b, Vernon's Texas Civil Statutes), as added by this Act, until
78-14 June 1, 1994.
78-15 (f) The Texas State Board of Medical Examiners shall adopt
78-16 rules under Subchapter F, Medical Practice Act (Article 4495b,
78-17 Vernon's Texas Civil Statutes), as added by this Act, not later
78-18 than February 1, 1994.
78-19 (g) Not later than January 1, 1994, the governor shall make
78-20 initial appointments to the Texas State Board of Acupuncture
78-21 Examiners and shall designate three members for terms expiring
78-22 January 31, 1995, three members for terms expiring January 31,
78-23 1997, and three members for terms expiring January 31, 1999.
78-24 (h) Notwithstanding other provisions of this Act, Sections
78-25 6.06 and 6.12 of the Medical Practice Act (Article 4495b, Vernon's
78-26 Texas Civil Statutes), as added by this Act, take effect June 1,
78-27 1994.
79-1 SECTION 37. This Act takes effect September 1, 1993.
79-2 SECTION 38. The importance of this legislation and the
79-3 crowded condition of the calendars in both houses create an
79-4 emergency and an imperative public necessity that the
79-5 constitutional rule requiring bills to be read on three several
79-6 days in each house be suspended, and this rule is hereby suspended.