By: Parker, Moncrief S.B. No. 1062
A BILL TO BE ENTITLED
AN ACT
1-1 relating to the continuation and operation of the Texas State Board
1-2 of Medical Examiners and to the regulation of the practice of
1-3 medicine, including the practice of acupuncture; providing
1-4 penalties.
1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-6 SECTION 1. Subdivision (6), Subsection (a), Section 1.03,
1-7 Medical Practice Act (Article 4495b, Vernon's Texas Civil
1-8 Statutes), is amended to read as follows:
1-9 (6) "Medical peer review committee" or "professional
1-10 review body" means a committee of a health-care entity, the
1-11 governing board of a health-care entity, or the medical staff of a
1-12 health-care entity, provided the committee or medical staff
1-13 operates pursuant to written bylaws that have been approved by the
1-14 policy-making body or the governing board of the health-care entity
1-15 and authorized to evaluate the quality of medical and health-care
1-16 services or the competence of physicians, including those functions
1-17 specified by Section 85.204, Health and Safety Code, and its
1-18 subsequent amendments. Such a committee includes the employees and
1-19 agents of the committee, including assistants, investigators,
1-20 intervenors, attorneys, and any other persons or organizations that
1-21 serve the committee in any capacity.
1-22 SECTION 2. Section 2.03, Medical Practice Act (Article
1-23 4495b, Vernon's Texas Civil Statutes), is amended to read as
1-24 follows:
2-1 Sec. 2.03. Appointment to Board. Members of the board shall
2-2 be appointed by the governor and confirmed by the senate. Any
2-3 vacancy on the board shall be filled by appointment of the
2-4 governor. Any appointment made shall be without regard to race,
2-5 color, disability <creed>, sex, religion, age, or national origin,
2-6 except that a person younger than 18 years of age is not eligible
2-7 for appointment.
2-8 SECTION 3. Section 2.04, Medical Practice Act (Article
2-9 4495b, Vernon's Texas Civil Statutes), is amended to read as
2-10 follows:
2-11 Sec. 2.04. Removal from Office. (a) It is a ground for
2-12 removal from the board if a member:
2-13 (1) does not have at the time of appointment the
2-14 qualifications required by Sections 2.05(a), (b), (c), (d), and (e)
2-15 of this Act;
2-16 (2) does not maintain during service on the board the
2-17 qualifications required by Sections 2.05(a), (b), (c), (d), and (e)
2-18 of this Act;
2-19 (3) violates a prohibition established by Section
2-20 2.05(f), (g), (h), (j), or (k) of this Act;
2-21 (4) cannot discharge the member's duties for a
2-22 substantial part of the term for which the member is appointed
2-23 because of illness or disability; or
2-24 (5) is absent from more than half of the regularly
2-25 scheduled board meetings that the member is eligible to attend
2-26 during a calendar year<, during a member's service on the board,
2-27 the member fails to meet the qualifications set forth in this Act
3-1 for members of the board. The validity of an action of the board
3-2 is not affected by the fact that it was taken when a ground for
3-3 removal of a member of the board existed>.
3-4 (b) The validity of an action of the board is not affected
3-5 by the fact that it is taken when a ground for removal of a board
3-6 member exists <Each member of the board shall be present for at
3-7 least one-half of the regularly scheduled board meetings held each
3-8 year. Failure of a board member to meet this requirement is
3-9 grounds for removal of the member from the board and the removal
3-10 creates a vacancy on the board>.
3-11 (c) If the executive director has knowledge that a potential
3-12 ground for removal exists, the executive director shall notify the
3-13 president of the board of the ground. The president shall then
3-14 notify the governor that a potential ground for removal exists.
3-15 SECTION 4. Section 2.05, Medical Practice Act (Article
3-16 4495b, Vernon's Texas Civil Statutes), is amended by amending
3-17 Subsections (b), (d), (g), (h), and (i) and adding Subsections (j),
3-18 (k), and (l) to read as follows:
3-19 (b) Seven <Nine> members of the board must:
3-20 (1) be learned and eminent physicians licensed to
3-21 practice medicine within this state for at least three years prior
3-22 to appointment and be graduates of a reputable medical school or
3-23 college with a degree of doctor of medicine (M.D.); and
3-24 (2) have been actively engaged in the practice of
3-25 medicine for at least five years immediately preceding their
3-26 appointment.
3-27 (d) Five <Three> members of the board must be public
4-1 representatives who are not licensed to practice medicine, who are
4-2 not financially involved in any organization subject to the
4-3 regulation of the board, and who are not providers of health care.
4-4 "Provider of health care" means:
4-5 (1) an individual who is a direct provider of health
4-6 care (including but not limited to a dentist, registered nurse,
4-7 licensed vocational nurse, chiropractor, podiatrist, physician
4-8 assistant, psychologist, athletic trainer, physical therapist,
4-9 social psychotherapist, pharmacist, optometrist, hospital
4-10 administrator, or nursing home administrator) in that the
4-11 individual's primary current activity is the provision of health
4-12 care to individuals or the administration of facilities or
4-13 institutions (including but not limited to hospitals, long-term
4-14 care facilities, out-patient facilities, and health maintenance
4-15 organizations) in which such care is provided and, when required by
4-16 law or otherwise, the individual has received professional or other
4-17 training in the provision of such care or in such administration
4-18 and is licensed or certified or holds himself out for such
4-19 provision or administration;
4-20 (2) one who is an indirect provider of health care in
4-21 that the individual holds a fiduciary position with or has a
4-22 fiduciary interest in an entity described below in this
4-23 subdivision; for purposes of this subdivision, a fiduciary position
4-24 or interest as applied to any entity means a position or interest
4-25 with respect to such entity affected with the character of a trust,
4-26 including members of boards of directors and officers, majority
4-27 shareholders, or agents, and receivers (either directly or through
5-1 their spouses) of more than one-tenth of their annual income from
5-2 any one or combination of fees or other compensation for research
5-3 into or instruction in the provision of health-care entities (or
5-4 associations or organizations composed of such entities) engaged
5-5 (or comprised of individuals who are engaged) in the provision of
5-6 health care or in the provision of health care and entities (or
5-7 associations or organizations composed of such entities engaged in
5-8 producing drugs or other such articles);
5-9 (3) one who is a member of the immediate family of an
5-10 individual described in this subsection; for purposes of this
5-11 subsection "immediate family" as applied to any individual includes
5-12 only his parents, spouse, children, brothers, and sisters who
5-13 reside in the same household;
5-14 (4) one who is engaged in or employed by an entity
5-15 issuing any policy or contract of individual or group health
5-16 insurance or hospital or medical service benefits; or
5-17 (5) one who is employed by, on the board of directors
5-18 of, or holds elective office by or under the authority of any unit
5-19 of federal, state, or local government or any organization that
5-20 receives a significant part of its funding from any such unit of
5-21 federal, state, or local government.
5-22 (g) An officer, employee, or paid consultant of a Texas
5-23 trade or professional association in the field of health care may
5-24 not be a member or employee of the board who is exempt from the
5-25 state's position classification plan or is compensated at or above
5-26 the amount prescribed by the General Appropriations Act for step 1,
5-27 salary group 17, of the position classification salary schedule.
6-1 (h) A person who is the spouse of an officer, manager, or
6-2 paid consultant of a Texas trade or professional association in the
6-3 field of health care may not be a board member and may not be a
6-4 board employee who is exempt from the state's position
6-5 classification plan or is compensated at or above the amount
6-6 prescribed by the General Appropriations Act for step 1, salary
6-7 group 17, of the position classification salary schedule.
6-8 (i) For the purposes of this section, a "Texas trade or
6-9 professional association" is a nonprofit, cooperative, and
6-10 voluntarily joined association of business or professional
6-11 competitors in this state designed to assist its members and its
6-12 industry or profession in dealing with mutual business or
6-13 professional problems and in promoting their common interest.
6-14 (j) A person may not serve as a member of the board if the
6-15 person is required to register as a lobbyist under Chapter 305,
6-16 Government Code, and its subsequent amendments, because of the
6-17 person's activities for compensation on behalf of a profession
6-18 related to the operation of the board <A person required to
6-19 register as a lobbyist under Chapter 305, Government Code, by
6-20 virtue of his activities on behalf of a trade or professional
6-21 association in the regulated profession may not act as a member of
6-22 the board>.
6-23 (k) <(h)> A person is ineligible for appointment to the
6-24 board if, at the time of appointment, the person is a stockholder,
6-25 paid full-time faculty member, or a member of the board of trustees
6-26 of a medical school.
6-27 (l) <(i)> All board members must take the official oath.
7-1 SECTION 5. Subsection (a), Section 2.07, Medical Practice
7-2 Act (Article 4495b, Vernon's Texas Civil Statutes), is amended to
7-3 read as follows:
7-4 (a) Not later than December after each regular session of
7-5 the legislature <At the first meeting of the board after each
7-6 biennial appointment>, the governor shall appoint from the members
7-7 of the board a president and the board shall elect from its members
7-8 a <president,> vice-president, secretary-treasurer, and other
7-9 officers as are required, in the opinion of the board, to carry out
7-10 its duties.
7-11 SECTION 6. The Medical Practice Act (Article 4495b, Vernon's
7-12 Texas Civil Statutes), is amended by adding Section 2.081 to read
7-13 as follows:
7-14 Sec. 2.081. TRAINING AND GUIDELINES FOR MEMBERS OF THE
7-15 BOARD. (a) The board shall establish a training program for the
7-16 members of the board.
7-17 (b) Before a member of the board may assume the member's
7-18 duties, the member must complete at least one course of the
7-19 training program established under this section, and before the
7-20 member may be confirmed by the senate, the member must pass an
7-21 examination given in conjunction with the attorney general on
7-22 subjects described by Subsections (c)(7), (8), and (9) of this
7-23 section.
7-24 (c) A training program established under this section shall
7-25 provide information to a participant regarding:
7-26 (1) the enabling legislation that created the board;
7-27 (2) the programs operated by the board;
8-1 (3) the role and functions of the board;
8-2 (4) the rules of the board with an emphasis on the
8-3 rules that relate to disciplinary and investigatory authority;
8-4 (5) the current budget for the board;
8-5 (6) the results of the most recent formal audit of the
8-6 board;
8-7 (7) the requirements of the:
8-8 (A) open meetings law, Chapter 271, Acts of the
8-9 60th Legislature, Regular Session, 1967 (Article 6252-17, Vernon's
8-10 Texas Civil Statutes), and its subsequent amendments;
8-11 (B) open records law, Chapter 424, Acts of the
8-12 63rd Legislature, Regular Session, 1973 (Article 6252-17a, Vernon's
8-13 Texas Civil Statutes), and its subsequent amendments; and
8-14 (C) Administrative Procedure and Texas Register
8-15 Act (Article 6252-13a, Vernon's Texas Civil Statutes) and its
8-16 subsequent amendments;
8-17 (8) the requirements of the conflict of interest laws
8-18 and other laws relating to public officials; and
8-19 (9) any applicable ethics policies adopted by the
8-20 board or the Texas Ethics Commission.
8-21 (d) In developing the training requirements provided for in
8-22 this section, the board shall consult with the governor's office,
8-23 the attorney general's office, and the Texas Ethics Commission.
8-24 (e) In the event that another state agency or entity is
8-25 given the authority to establish the training requirements, the
8-26 board shall allow that training in lieu of developing its own
8-27 program.
9-1 SECTION 7. Section 2.09, Medical Practice Act (Article
9-2 4495b, Vernon's Texas Civil Statutes), is amended by amending
9-3 Subsections (b), (c), (g), (k), (s), and (u) and adding Subsections
9-4 (b-1), (x), (y), (z), and (aa) to read as follows:
9-5 (b) The board shall develop and implement policies that
9-6 clearly define the respective responsibilities of the board and the
9-7 staff of the board. The board shall appoint an executive director
9-8 who shall be its chief executive and administrative officer, who
9-9 shall be charged with the primary responsibility of administering,
9-10 enforcing, and carrying out the provisions of the Medical Practice
9-11 Act under the control and supervision and at the direction of the
9-12 board. The executive director shall hold such position at the
9-13 pleasure of board and may be discharged at any time. The board may
9-14 act under its rules through the executive director, an executive
9-15 committee, or other committee, unless otherwise specified in this
9-16 Act. The executive committee shall be the president,
9-17 vice-president, and secretary-treasurer except where otherwise
9-18 provided in this Act<. Any duty of the secretary-treasurer in this
9-19 Act may be performed by the executive director within the
9-20 discretion of the board. Any reference to secretary-treasurer
9-21 shall have the same meaning as executive director when so
9-22 designated by the board>.
9-23 (b-1) The executive director may employ a chief operating
9-24 officer who shall be primarily responsible for administering,
9-25 implementing, and monitoring systems and necessary measures to
9-26 promote quality and efficiency of ongoing board operations and
9-27 other duties as may be assigned by the executive director. If the
10-1 board appoints an executive director who is not a physician
10-2 licensed to practice in this state, the executive director shall
10-3 appoint a medical director who is a physician licensed to practice
10-4 in this state and who shall be primarily responsible for
10-5 implementing and maintaining policies, systems, and measures
10-6 regarding clinical and professional issues and determinations. The
10-7 chief operating officer or medical director shall act under the
10-8 control and supervision and at the direction of the executive
10-9 director.
10-10 (c) The board may make rules and establish fees as are
10-11 reasonable relating to the granting and extension of expiration
10-12 dates of temporary licenses and the placing of licensees on
10-13 inactive status. The board shall by rule set time limits on the
10-14 periods for which licensees may hold temporary licenses or maintain
10-15 inactive status.
10-16 (g) A person may not serve as a member of the board or act
10-17 as the general counsel to the board if the person is required to
10-18 register as a lobbyist under Chapter 305, Government Code, and its
10-19 subsequent amendments, because of the person's activities for
10-20 compensation on behalf of a profession related to the operation of
10-21 the board <who is required personally to register as a lobbyist
10-22 under Chapter 305, Government Code, representing physicians,
10-23 health-care entities, or health-care related professions, may not
10-24 be employed by the board in any capacity>.
10-25 (k) The board <shall establish> by rule shall establish
10-26 reasonable and necessary fees so that the fees, in the aggregate,
10-27 produce sufficient revenue to cover the cost of administering this
11-1 Act. The fees set by the board may be adjusted so that the total
11-2 fees collected shall be sufficient to meet the expenses of
11-3 administering this Act. The board may not set a fee for an amount
11-4 less than the amount of that fee on September 1, 1993 <a reasonable
11-5 charge for those fees not specifically determined but authorized by
11-6 this Act>. The board may not waive collection of any fee or
11-7 penalty. Except as otherwise provided by this Act, the <The> board
11-8 shall deposit <place> all fees received under authority of this
11-9 Act, not otherwise specified, in the state treasury to the credit
11-10 of a special account in the general revenue fund. The special
11-11 account may be used only to cover the costs of administering and
11-12 enforcing this Act <into the medical licensing fund>. The board is
11-13 authorized and shall by annual budget determine the manner of
11-14 handling the funds and the purpose, consistent with this Act, for
11-15 which the same may be used. The special account is exempt from
11-16 Section 403.094(h), Government Code, and its subsequent amendments
11-17 <The budgeted expenses authorized by the board shall not be a
11-18 charge upon the general revenue of the state nor paid from the
11-19 general revenue>.
11-20 (s)(1) The board shall prepare information of public
11-21 <consumer> interest describing the functions of the board and the
11-22 board's procedures by which complaints are filed with and resolved
11-23 by the board. The board shall make the information available to
11-24 the public and appropriate state agencies.
11-25 (2) The board by rule shall establish methods by which
11-26 the public and licensees of the board are notified of the name,
11-27 mailing address, and telephone number of the board for the purpose
12-1 of directing complaints to the board. The board may provide for
12-2 that notification:
12-3 (A) on each registration form, application, or
12-4 written contract for services of an individual or entity regulated
12-5 under this Act;
12-6 (B) on a sign prominently displayed in the place
12-7 of business of each individual or entity regulated under this Act;
12-8 or
12-9 (C) in a bill for services provided by an
12-10 individual or entity regulated under this Act.
12-11 (3) The board shall list along with its regular
12-12 telephone number the toll-free telephone number that may be called
12-13 to present a complaint about a health professional if the toll-free
12-14 number is established under other state law <regulatory functions
12-15 of the board and describing the board's procedures by which
12-16 consumer complaints are filed with and resolved by the board>. On
12-17 written request the board shall make information available to the
12-18 general public for a reasonable fee to cover expenses and
12-19 appropriate state agencies including a summary of any previous
12-20 disciplinary orders by the board against a specific physician
12-21 licensed in this state, the date of the order, and the current
12-22 status of the order. The board shall establish an eight-hour
12-23 toll-free telephone number to make the information immediately
12-24 available to any caller if the board is not required to establish a
12-25 toll-free telephone number under other state law.
12-26 (u) The executive director or the executive director's
12-27 designee shall develop an intraagency career ladder program. The
13-1 program shall require intraagency posting of all non-entry-level
13-2 positions concurrently with any public posting <board shall cause
13-3 to be developed an intraagency career ladder program, one part of
13-4 which shall be the intraagency posting of each job opening with the
13-5 board in a nonentry-level position. The intraagency posting shall
13-6 be made at least 10 days before any public posting>.
13-7 (x) Each board member shall comply with the board member
13-8 training requirements established by any other state agency that is
13-9 given authority to establish the requirements for the board.
13-10 (y) The board shall provide to its members and employees, as
13-11 often as necessary, information regarding their qualifications for
13-12 office or employment under this Act and their responsibilities
13-13 under applicable laws relating to standards of conduct for state
13-14 officers or employees.
13-15 (z) The board shall develop and implement policies that
13-16 provide the public with a reasonable opportunity to appear before
13-17 the board and to speak on any issue under the jurisdiction of the
13-18 board.
13-19 (aa) The board shall prepare and maintain a written plan
13-20 that describes how a person who does not speak English can be
13-21 provided reasonable access to the board's programs. The board
13-22 shall also comply with federal and state laws for program and
13-23 facility accessibility.
13-24 SECTION 8. Subchapter B, Medical Practice Act (Article
13-25 4495b, Vernon's Texas Civil Statutes), is amended by adding Section
13-26 2.10 to read as follows:
13-27 Sec. 2.10. EQUAL EMPLOYMENT OPPORTUNITY. (a) The executive
14-1 director or the executive director's designee shall prepare and
14-2 maintain a written policy statement to assure implementation of a
14-3 program of equal employment opportunity under which all personnel
14-4 decisions are made without regard to race, color, disability, sex,
14-5 religion, age, or national origin. The policy statement must
14-6 include:
14-7 (1) personnel policies, including policies relating to
14-8 recruitment, evaluation, selection, appointment, training, and
14-9 promotion of personnel, that are in compliance with requirements of
14-10 the Commission on Human Rights Act (Article 5221k, Vernon's Texas
14-11 Civil Statutes) and its subsequent amendments;
14-12 (2) a comprehensive analysis of the board's work force
14-13 that meets federal and state guidelines;
14-14 (3) procedures by which a determination can be made of
14-15 significant underutilization in the board's work force of all
14-16 persons for whom federal or state guidelines encourage a more
14-17 equitable balance; and
14-18 (4) reasonable methods to appropriately address those
14-19 areas of significant underutilization.
14-20 (b) A policy statement prepared under Subsection (a) of this
14-21 section must cover an annual period, be updated annually and
14-22 reviewed by the Commission on Human Rights for compliance with
14-23 requirements of the Commission on Human Rights Act (Article 5221k,
14-24 Vernon's Texas Civil Statutes) and its subsequent amendments, and
14-25 be filed with the governor's office.
14-26 (c) The governor's office shall deliver a biennial report to
14-27 the legislature based on the information received under Subsection
15-1 (b) of this section. The report may be made separately or as a
15-2 part of other biennial reports made to the legislature.
15-3 SECTION 9. Subsections (a), (b), (c), (f), (h), and (i),
15-4 Section 3.01, Medical Practice Act (Article 4495b, Vernon's Texas
15-5 Civil Statutes), are amended to read as follows:
15-6 (a) All persons now lawfully qualified to practice medicine
15-7 in this state, or who are hereafter licensed for the practice of
15-8 medicine by the board, shall be registered as practitioners with
15-9 the board on or before the first day of January and thereafter
15-10 shall register in like manner annually, on or before the first day
15-11 of January of each succeeding year. Each person so registered with
15-12 the board shall pay, in connection with each annual registration
15-13 and for the receipt hereinafter provided for, a fee established by
15-14 the board which fee shall accompany the application of each person
15-15 for registration. The payment shall be made to the board. Every
15-16 person so registered shall file with the board a written
15-17 application for annual registration, setting forth his name and
15-18 mailing address, the place or places where the applicant is engaged
15-19 in the practice of medicine, and other necessary information
15-20 prescribed by the board. If the person is licensed for the
15-21 practice of medicine by another state, the District of Columbia, a
15-22 territory of the United States, Canada, any other country, or the
15-23 uniformed services of the United States, the application must
15-24 include a description of any investigations the person knows are in
15-25 progress and of any sanctions imposed by or disciplinary matters
15-26 pending in the state, district, territory, country, or service.
15-27 (b) Physicians not otherwise licensed by the board who are
16-1 participating in graduate medical education training programs
16-2 approved by the board may be issued institutional permits as
16-3 provided by rules of the board. A reasonable fee shall be charged
16-4 and deposited into the special account established by Section
16-5 2.09(k) of this Act <medical registration fund>. This permit does
16-6 not authorize the performance of medical acts except as the acts
16-7 are performed as a part of graduate medical education programs and
16-8 under the supervision of a licensed practitioner of medicine.
16-9 (c)(1) A person may renew an unexpired license by paying to
16-10 the board on or before the expiration date of the license the
16-11 required renewal fee.
16-12 (2) If a person's license has been expired for 90 days
16-13 or less, the person may renew the license by paying to the board
16-14 the required renewal fee and a fee that is one-half of the
16-15 examination fee for the license.
16-16 (3) If a person's license has been expired for longer
16-17 than 90 days but less than one year, the person may renew the
16-18 license by paying to the board all unpaid renewal fees and a fee
16-19 that is equal to the examination fee for the license.
16-20 (4) If a person's license has been expired for one
16-21 year, it is considered to have been canceled, and the person may
16-22 not renew the license. The person may obtain a new license by
16-23 submitting to reexamination and complying with the requirements and
16-24 procedures for obtaining an original license.
16-25 (5) The board may renew without examination an expired
16-26 license of a person who was licensed in this state, moved to
16-27 another state, and is currently licensed and has been in practice
17-1 in the other state for not more than two years preceding
17-2 application. The person must pay to the board a fee that is equal
17-3 to the examination fee for the license. <Failure of any licensee
17-4 to pay the annual license renewal fee on or before the 90th day
17-5 after the date it is due automatically cancels his licensure. Any
17-6 licensee whose license has been canceled because of failure to pay
17-7 the annual license renewal fee may secure reinstatement of his
17-8 license at any time within that license year upon payment of the
17-9 delinquent fee together with a penalty in an amount as the board
17-10 may determine to be reasonable. After expiration of the license
17-11 year for which the license fee was not paid, no license shall be
17-12 reinstated except upon application and satisfaction of other
17-13 conditions as the board may establish and payment of delinquent
17-14 fees and a penalty to be assessed by the board.>
17-15 (f) <In performing its duties as provided in this Act, the
17-16 board may act through the secretary-treasurer of the board. The
17-17 secretary-treasurer is entitled to a salary to be fixed by the
17-18 legislature in its General Appropriations Act for the performance
17-19 of duties under this Act.> The executive director
17-20 <secretary-treasurer> of the board shall file a surety bond with
17-21 the board. The bond shall be in an amount not less than $10,000,
17-22 be in compliance with the insurance laws of the state, and be
17-23 payable to the state for the use of the state if the executive
17-24 director <secretary-treasurer> does not faithfully discharge the
17-25 duties of the office. The board shall pay the premium on the bond.
17-26 <The salary shall be paid out of said medical registration fund and
17-27 shall not be in any way a charge upon the general revenue of the
18-1 state.>
18-2 (h) The <secretary-treasurer or the> executive director
18-3 shall review each application for licensure by examination or
18-4 reciprocity and shall recommend to the board all applicants
18-5 eligible for licensure. The <secretary-treasurer or the> executive
18-6 director also shall report to the board the names of all applicants
18-7 determined to be ineligible for licensure, together with the
18-8 reasons for each recommendation. An applicant deemed ineligible
18-9 for licensure by the <secretary-treasurer or the> executive
18-10 director may request review of such recommendation by a committee
18-11 of the board within 20 days of receipt of such notice, and the
18-12 <secretary-treasurer or the> executive director may refer any
18-13 application to said committee for a recommendation concerning
18-14 eligibility. If the committee finds the applicant ineligible for
18-15 licensure, such recommendation, together with the reasons therefor,
18-16 shall be submitted to the board unless the applicant requests a <an
18-17 appellate> hearing <before a hearing examiner appointed by the
18-18 board> within 20 days of receipt of notice of the committee's
18-19 determination. The hearing shall be before an administrative law
18-20 judge of the State Office of Administrative Hearings and shall
18-21 comply with the Administrative Procedure Act and its subsequent
18-22 amendments and the rules of the State Office of Administrative
18-23 Hearings and the board. The committee may refer any application
18-24 for determination of eligibility to the full board. The board
18-25 shall, after receiving the administrative law judge's proposed
18-26 findings of fact and conclusions of law, determine the eligibility
18-27 of the applicant for licensure <an appellate hearing on its own
19-1 motion. The board may elect to hear any appeal in lieu of
19-2 proceedings before a hearing examiner, and it shall adopt, modify,
19-3 or reject each decision made by a hearing examiner. The board also
19-4 shall adopt, modify, or reject each recommendation of ineligibility
19-5 made by the secretary-treasurer or the executive director or by the
19-6 committee, unless the applicant has requested a timely review of
19-7 the recommendation. Such action by the board shall constitute a
19-8 final administrative decision concerning licensure. Any hearing
19-9 before the board or before a hearing examiner under this subsection
19-10 becomes a contested case under the Administrative Procedure Act>.
19-11 A physician whose application for licensure is denied by the board
19-12 shall receive a written statement<, upon request,> containing the
19-13 reasons for the board's action. All reports received or gathered
19-14 by the board on each applicant are confidential and are not subject
19-15 to disclosure under the Open Records Law. The board may disclose
19-16 such reports to appropriate licensing authorities in other states
19-17 <upon request>.
19-18 (i) At least 30 days before the expiration of a person's
19-19 license, the board shall send written notice of the impending
19-20 license expiration to the person at the licensee's last known
19-21 address according to the records of the board <The board must
19-22 notify each delinquent licensee of his impending license
19-23 cancellation by registered or certified mail sent to the licensee's
19-24 address listed with the board not less than 30 days prior to the
19-25 cancellation. This requirement shall be waived when the licensee
19-26 has requested in writing that his or her license be canceled>.
19-27 SECTION 10. Subchapter C, Medical Practice Act (Article
20-1 4495b, Vernon's Texas Civil Statutes), is amended by adding Section
20-2 3.025 to read as follows:
20-3 Sec. 3.025. CONTINUING MEDICAL EDUCATION. (a) The board by
20-4 rule shall adopt, monitor, and enforce a reporting program for
20-5 continuing medical education of licensees. The board shall adopt
20-6 and administer rules:
20-7 (1) requiring the number of hours of continuing
20-8 medical education the board determines appropriate as a
20-9 prerequisite to the annual registration of a licensee under this
20-10 Act;
20-11 (2) requiring at least one-half of the hours of
20-12 continuing medical education required under Subdivision (1) of this
20-13 subsection to be approved by the board after taking into account
20-14 the standards of the American Medical Association for its
20-15 Physician's Recognition Award, the Council on Medical Specialty
20-16 Societies, or the American Osteopathic Association and permitting
20-17 the remaining hours to be composed of self-study or equivalent
20-18 self-directed continuing medical education according to guidelines
20-19 determined by the board; and
20-20 (3) adopting a process to assess a licensee's
20-21 participation in continuing medical education courses.
20-22 (b) A licensee shall be presumed to have complied with this
20-23 section if in the preceding 36 months the licensee becomes board
20-24 certified or recertified in a medical specialty and the medical
20-25 specialty program takes into consideration the standards of the
20-26 American Board of Medical Specialties, the American Medical
20-27 Association, the Advisory Board for Osteopathic Specialists and
21-1 Boards of Certification, or the American Osteopathic Association.
21-2 (c) The board may temporarily exempt a licensee from the
21-3 requirement for continuing medical education for:
21-4 (1) catastrophic illness;
21-5 (2) military service of longer than one year's
21-6 duration outside the state;
21-7 (3) medical practice and residence of longer than one
21-8 year's duration outside the United States; or
21-9 (4) good cause shown on written application of the
21-10 licensee that gives satisfactory evidence to the board that the
21-11 licensee is unable to comply with the requirement for continuing
21-12 medical education.
21-13 (d) A temporary exemption under Subsection (c) of this
21-14 section may not exceed one year but may be renewed annually.
21-15 (e) Subsection (a) of this section does not apply to a
21-16 licensee who is retired and has been exempted by rule from paying
21-17 the annual registration fee.
21-18 (f) This section does not prevent the board from taking
21-19 disciplinary action with respect to a licensee or an applicant for
21-20 a license by requiring additional hours of continuing medical
21-21 education or of specific course subjects.
21-22 SECTION 11. Subsections (a) through (f), Section 3.03,
21-23 Medical Practice Act (Article 4495b, Vernon's Texas Civil
21-24 Statutes), are amended to read as follows:
21-25 (a) The board, at its sole discretion and upon payment by an
21-26 applicant of a fee prescribed by the board under this Act, may
21-27 grant a license to practice medicine to any <reputable> physician
22-1 who is a graduate of an acceptable <a reputable> medical college as
22-2 determined by the board and who<:>
22-3 <(1)> is a licensee of another state or Canadian
22-4 province having requirements for physician registration and
22-5 practice substantially equivalent to those established by the laws
22-6 of this state<; or>
22-7 <(2) is qualified by an examination for a certificate
22-8 to practice medicine under a commission in the uniformed services
22-9 of the United States>.
22-10 (b) An application for a license under this section must be
22-11 in writing and upon a form prescribed by the board. The
22-12 application must be accompanied by:
22-13 (1) a diploma or photograph of a diploma awarded to
22-14 the applicant by an acceptable <a reputable> medical college and a
22-15 certified transcript showing courses and grades <or a certificate,
22-16 license, or commission issued to the applicant by the Medical Corps
22-17 of the uniformed services of the United States>;
22-18 (2) a license or a certified copy of a license to
22-19 practice medicine lawfully issued to the applicant<, on
22-20 examination,> by some other state or a Canadian province that
22-21 requires in its examination the same general degree of fitness
22-22 required by this state and that grants the same reciprocal
22-23 privileges to persons licensed by the board; <or>
22-24 (3) a certification made by <an executive officer of
22-25 the uniformed services of the United States,> the president or
22-26 secretary of the board that issued the license<,> or a duly
22-27 constituted registration office of the state or Canadian province
23-1 that issued the certificate or license, reciting that the
23-2 accompanying certificate or license has not been canceled,
23-3 suspended, or revoked <except by honorable discharge from the
23-4 Medical Corps of the uniformed services of the United States> and
23-5 reciting that the statement of the qualifications made in the
23-6 application for medical license in Texas is true and correct; and
23-7 (4) evidence of a passing grade on an examination
23-8 required by the board.
23-9 (c) Applicants for a license under this section must
23-10 subscribe to an oath in writing before an officer authorized by law
23-11 to administer oaths. The written oath must be a part of the
23-12 application. The application must:
23-13 (1) state that:
23-14 (A) <(1)> the license, certificate, or authority
23-15 under which the applicant has most recently practiced medicine in
23-16 the state or Canadian province from which the applicant is
23-17 transferring to this state <removed> or in the uniformed service in
23-18 which the applicant served is <was at the time of the removal or
23-19 completion of service> in full force and not restricted, canceled,
23-20 suspended, or revoked;
23-21 (B) <(2)> the applicant is the identical person
23-22 to whom the certificate or<,> license<, or commission> and the
23-23 diploma were issued;
23-24 (C) <(3)> no proceeding has been instituted
23-25 against the applicant for the restriction, cancellation,
23-26 suspension, or revocation of the certificate, license, or authority
23-27 to practice medicine in the state, Canadian province, or uniformed
24-1 service of the United States in which it was issued; and
24-2 (D) <(4)> no prosecution is pending against the
24-3 applicant in any state, federal, or Canadian court for any offense
24-4 that under the laws of this state is a felony;
24-5 (2) include a description of any sanctions imposed by
24-6 or disciplinary matters pending in the state or Canadian province
24-7 in which the applicant was or is licensed or certified to practice
24-8 medicine; and
24-9 (3) include evidence of postgraduate training required
24-10 by the board.
24-11 (d) An applicant for a license under this section must <A
24-12 "reputable physician" means one who would> be eligible for
24-13 examination by the board. <A "reputable medical school or college"
24-14 means a medical school or college that was approved by the board at
24-15 the time the applicant's degree was conferred.>
24-16 (e) In addition to other licensure requirements, the board
24-17 may require by rule and regulation that an applicant who is a
24-18 licensee of another state or Canadian province and who is a
24-19 graduate <graduates> of a medical school <schools> located outside
24-20 of the United States and Canada, or the school itself <schools
24-21 themselves>, provide additional information to the board concerning
24-22 the medical school attended prior to approval of the applicant.
24-23 (f) The board may refuse to issue a license to an applicant
24-24 who is a licensee of another state or Canadian province and who
24-25 graduated from a medical school outside of the United States and
24-26 Canada if it finds that the applicant does not possess the
24-27 requisite qualifications to provide the same standard of medical
25-1 care as provided by a licensed physician in this state.
25-2 SECTION 12. Subchapter C, Medical Practice Act (Article
25-3 4495b, Vernon's Texas Civil Statutes), is amended by adding Section
25-4 3.0305 to read as follows:
25-5 Sec. 3.0305. TEMPORARY LICENSE FOR OUT-OF-STATE
25-6 PRACTITIONERS. (a) On application, the board shall grant a
25-7 temporary license to practice medicine. An applicant for a
25-8 temporary license under this section must:
25-9 (1) have a current, active, and unrestricted license,
25-10 without any pending disciplinary matters, as a physician in another
25-11 state, the District of Columbia, or a territory of the United
25-12 States that has licensing requirements that are substantially
25-13 equivalent to the requirements of this Act;
25-14 (2) have passed a national or other examination
25-15 recognized by the board relating to the practice of medicine; and
25-16 (3) be sponsored by a person licensed by the board
25-17 under this Act with whom the temporary license holder may practice
25-18 under this section.
25-19 (b) An applicant for a temporary license may be excused from
25-20 the requirement of Subsection (a)(3) of this section if the board
25-21 determines that compliance with that subsection constitutes a
25-22 hardship to the applicant.
25-23 (c) A temporary license is valid until the date the board
25-24 approves or denies the temporary license holder's application for a
25-25 license. The board shall issue a license under this Act to the
25-26 holder of a temporary license under this section if:
25-27 (1) the temporary license holder passes the
26-1 examination required by Section 3.05 of this Act;
26-2 (2) the board verifies that the temporary license
26-3 holder has satisfied the academic and experience requirements for a
26-4 license under this Act; and
26-5 (3) the temporary license holder has satisfied any
26-6 other license requirements under this Act.
26-7 (d) The board must assemble the documents and information
26-8 necessary to process a temporary license holder's application for a
26-9 license not later than the 90th day after the date the temporary
26-10 license is issued and complete the processing of the application
26-11 not later than the 90th day after the date the documents and
26-12 information are assembled. If by the 180th day after the date the
26-13 temporary license is issued the board has not completed the
26-14 processing of the application, the board shall review the
26-15 application to determine the cause of the delay.
26-16 SECTION 13. Section 3.04, Medical Practice Act (Article
26-17 4495b, Vernon's Texas Civil Statutes), is amended to read as
26-18 follows:
26-19 Sec. 3.04. Qualification of Licensee. (a) An applicant, to
26-20 be eligible for the examination and issuance of a license, must
26-21 present satisfactory proof to the board that the applicant:
26-22 (1) is at least 21 years of age;
26-23 (2) is of good professional character;
26-24 (3) has completed 60 semester hours of college courses
26-25 other than in medical school, which courses would be acceptable, at
26-26 the time of completion, to The University of Texas for credit on a
26-27 bachelor of arts degree or a bachelor of science degree; and
27-1 (4) is a graduate of an acceptable <a> medical school
27-2 or college that was approved by the board at the time the degree
27-3 was conferred<;> and has completed a one-year program of graduate
27-4 medical training approved by the board.
27-5 (b) The <(5) has successfully completed a one year program
27-6 of graduate medical training approved by the board. In addition to
27-7 other licensure requirements, the board may require by rule and
27-8 regulation that graduates of medical schools located outside the
27-9 United States and Canada comply with other requirements that the
27-10 board considers appropriate, including but not limited to
27-11 additional graduate medical training in the United States, except
27-12 those who qualify for licensure in Section 5.04 of this Act.
27-13 However, the> applicant shall be eligible for examination prior to
27-14 complying with the graduate training requirement of Subsection
27-15 (a)(4) <Subdivision (5) of Subsection (a)> of this section but
27-16 shall not be eligible for the issuance of an unrestricted license
27-17 until the requirements of Subsection (a) of this section <this
27-18 subsection> have been satisfied.
27-19 (c) <(b)> Applications for examination must be made in
27-20 writing, verified by affidavit, filed with the board on forms
27-21 prescribed by the board, and accompanied by documents and a fee as
27-22 the board determines to be reasonable.
27-23 (d) To be recognized by the board for the purposes of this
27-24 subchapter, all allopathic or osteopathic medical education
27-25 instruction taught in the United States must be accredited by an
27-26 accrediting body officially recognized by the United States
27-27 Department of Education and the Council on Postsecondary
28-1 Accreditation as the accrediting body for medical education leading
28-2 to the doctor of medicine degree or the doctor of osteopathy degree
28-3 in the United States.
28-4 (e) The requirements for eligibility for licensure of a
28-5 graduate of an unapproved foreign medical school are set out in
28-6 Section 5.035 of this Act, and the requirements for eligibility for
28-7 licensure of a person who has completed all of the didactic work of
28-8 a foreign medical school but has not graduated from the school
28-9 (Fifth Pathway Program) are set out in Section 5.04 of this Act.
28-10 SECTION 14. Subsections (a), (c), and (e), Section 3.05,
28-11 Medical Practice Act (Article 4495b, Vernon's Texas Civil
28-12 Statutes), are amended to read as follows:
28-13 (a) All examinations for license to practice medicine shall
28-14 be conducted in writing in the English language and in a manner as
28-15 to be entirely fair and impartial to all individuals and to every
28-16 school or system of medicine. <All applicants shall be known to
28-17 the examiners only by numbers, without names or other method of
28-18 identification on examination papers by which members of the board
28-19 may be able to identify the applicants or examinees, until after
28-20 the general averages of the examinees' numbers in the class have
28-21 been determined and license granted or refused.> Examinations
28-22 shall be conducted on and cover those subjects generally taught by
28-23 medical schools, a knowledge of which is commonly and generally
28-24 required of candidates for the degree of doctor of medicine or
28-25 doctor of osteopathy conferred by schools or colleges of medicine
28-26 approved by the board, and the examinations shall also be conducted
28-27 on and cover the subject of medical jurisprudence. Examinations
29-1 shall be prepared by a national testing service or prepared by the
29-2 board and validated by qualified independent testing professionals.
29-3 On satisfactory examination conducted as required by this Act under
29-4 rules of the board, applicants may <shall> be granted licenses to
29-5 practice medicine. All questions and answers, with the grades
29-6 attached, shall be preserved for one year in the executive office
29-7 of the board or such other repository as the board by rule may
29-8 direct. All applicants examined at the same time shall be given
29-9 identical questions. All certificates shall be attested by the
29-10 seal of the board. The board in its discretion may give the
29-11 examination for license in two or more parts.
29-12 (c) All applicants for license to practice medicine in this
29-13 state not otherwise licensed under the provisions of law must
29-14 successfully pass a uniform <an> examination approved by the board
29-15 as determined by rule. The board is authorized to adopt and
29-16 enforce all rules of procedure not inconsistent with statutory
29-17 requirements. All applicants shall be given due notice of the date
29-18 and place of the examination<; provided that the partial
29-19 examinations provided for in this Act shall not be disturbed by
29-20 this section>. If any applicant, because of failure to pass the
29-21 required examination, is refused a license, the applicant, at a
29-22 time as the board may fix, shall be permitted to take a subsequent
29-23 examination not more than two additional times <upon any subjects
29-24 required in the original examination> as the board may prescribe on
29-25 the payment of a fee as the board may determine to be reasonable.
29-26 In the event satisfactory grades shall be made on the subjects
29-27 prescribed and taken on the reexamination, the board may grant the
30-1 applicant a license to practice medicine. The board shall
30-2 determine the credit to be given examinees on answers turned in on
30-3 the subjects of complete and partial examination, and its decision
30-4 is final.
30-5 (e) Within 90 <30> days after the day on which an
30-6 examination is administered under this Act, the board shall notify
30-7 each examinee of the results of the examination. However, if an
30-8 examination is graded or reviewed by a national testing service,
30-9 the board shall notify each examinee of the results of the
30-10 examination not later than the 30th day <within four weeks> after
30-11 the date the board receives the results from the testing service.
30-12 If the notice of the examination results will be delayed for longer
30-13 than 90 days after the examination, the board shall notify the
30-14 examinee of the reason for the delay before the 90th day.
30-15 SECTION 15. Subdivision (5), Subsection (d), Section 3.06,
30-16 Medical Practice Act (Article 4495b, Vernon's Texas Civil
30-17 Statutes), is amended by adding Paragraph (G) to read as follows:
30-18 (G) An advertisement for a site serving a
30-19 medically underserved population shall include the name and
30-20 business address of the supervising physician for the site.
30-21 SECTION 16. Section 3.06, Medical Practice Act (Article
30-22 4495b, Vernon's Texas Civil Statutes), is amended by adding
30-23 Subsections (g) and (h) to read as follows:
30-24 (g) This Act does not prohibit a nonprofit clinic that is
30-25 operated by a nonprofit hospital or organization and that primarily
30-26 serves a financially indigent population from:
30-27 (1) contracting with a physician to provide services
31-1 at the clinic;
31-2 (2) paying a physician a minimum guarantee to assure
31-3 the physician's availability;
31-4 (3) billing to and collecting from patients as the
31-5 physician's agent the physician's professional fees; or
31-6 (4) retaining any professional fees collected under
31-7 Subdivision (3) of this subsection up to the amount of the minimum
31-8 guarantee fee and a reasonable collection fee.
31-9 (h) In Subsection (g) of this section, "financially indigent
31-10 population" means persons meeting Medicaid eligibility requirements
31-11 or uninsured persons who are accepted for care with no obligation
31-12 to pay or with a discounted obligation to pay for services rendered
31-13 based on the clinic's eligibility system.
31-14 SECTION 17. Section 3.08, Medical Practice Act (Article
31-15 4495b, Vernon's Texas Civil Statutes), is amended to read as
31-16 follows:
31-17 Sec. 3.08. Grounds for Refusal to Admit Persons to
31-18 Examination and to Issue License and Renewal License And For
31-19 Disciplinary Action. The board may refuse to admit persons to its
31-20 examinations and to issue a license to practice medicine to any
31-21 person and may take disciplinary action against any person for any
31-22 of the following reasons:
31-23 (1) submission of a false or misleading statement,
31-24 document, or certificate to the board in an application for
31-25 examination or licensure; the presentation to the board of any
31-26 license, certificate, or diploma that was illegally or fraudulently
31-27 obtained; the practice of fraud or deception in taking or passing
32-1 an examination;
32-2 (2) conviction of a crime of the grade of a felony or
32-3 a crime of a lesser degree that involves moral turpitude;
32-4 (3) intemperate use of alcohol or drugs that, in the
32-5 opinion of the board, could endanger the lives of patients;
32-6 (4) unprofessional or dishonorable conduct that is
32-7 likely to deceive or defraud the public or injure the public.
32-8 Unprofessional or dishonorable conduct likely to deceive or defraud
32-9 the public includes but is not limited to the following acts:
32-10 (A) committing any act that is in violation of
32-11 the laws of the State of Texas if the act is connected with the
32-12 physician's practice of medicine. A complaint, indictment, or
32-13 conviction of a law violation is not necessary for the enforcement
32-14 of this provision. Proof of the commission of the act while in the
32-15 practice of medicine or under the guise of the practice of medicine
32-16 is sufficient for action by the board under this section;
32-17 (B) failing to keep complete and accurate
32-18 records of purchases and disposals of drugs listed in Chapter 481,
32-19 Health and Safety Code, or of controlled substances scheduled in
32-20 the Federal Comprehensive Drug Abuse Prevention and Control Act of
32-21 1970, 21 U.S.C.A. Section 801 et seq. (Public Law 91-513). A
32-22 physician shall keep records of his purchases and disposals of
32-23 these drugs to include without limitation the date of purchase, the
32-24 sale or disposal of the drugs by the physician, the name and
32-25 address of the person receiving the drugs, and the reason for the
32-26 disposing or dispensing of the drugs to the person. A failure to
32-27 keep the records for a reasonable time is grounds for revoking,
33-1 canceling, suspending, or probating the license of any practitioner
33-2 of medicine. The board or its representative may enter and inspect
33-3 a physician's place(s) of practice during reasonable business hours
33-4 for the purpose of verifying the correctness of these records and
33-5 of taking inventory of the prescription drugs on hand;
33-6 (C) writing prescriptions for or dispensing to a
33-7 person known to be an abuser <a habitual user> of narcotic drugs,
33-8 controlled substances, or dangerous drugs or to a person who the
33-9 physician should have known was an abuser <a habitual user> of the
33-10 narcotic drugs, controlled substances, or dangerous drugs. This
33-11 provision does not apply to those persons:
33-12 (i) being treated by the physician for
33-13 their narcotic use after the physician notifies the board in
33-14 writing of the name and address of the person being so treated; or
33-15 (ii) who the physician is treating for
33-16 intractable pain under the Intractable Pain Treatment Act (Article
33-17 4495c, Revised Statutes) and its subsequent amendments;
33-18 (D) writing false or fictitious prescriptions
33-19 for dangerous drugs as defined by Chapter 483, Health and Safety
33-20 Code, of controlled substances scheduled in the Texas Controlled
33-21 Substances Act (Chapter 481, Health and Safety Code) <(Article
33-22 4476-15, Vernon's Texas Civil Statutes)>, or of controlled
33-23 substances scheduled in the Federal Comprehensive Drug Abuse
33-24 Prevention and Control Act of 1970, 21 U.S.C.A. Section 801 et seq.
33-25 (Public Law 91-513);
33-26 (E) prescribing or administering a drug or
33-27 treatment that is nontherapeutic in nature or nontherapeutic in the
34-1 manner the drug or treatment is administered or prescribed;
34-2 (F) prescribing, administering, or dispensing in
34-3 a manner not consistent with public health and welfare dangerous
34-4 drugs as defined by Chapter 483, Health and Safety Code, controlled
34-5 substances scheduled in the Texas Controlled Substances Act
34-6 (Chapter 481, Health and Safety Code) <(Article 4476-15, Vernon's
34-7 Texas Civil Statutes)>, or controlled substances scheduled in the
34-8 Federal Comprehensive Drug Abuse Prevention and Control Act of
34-9 1970, 21 U.S.C.A. Section 801 et seq. (Public Law 91-513);
34-10 (G) persistently or <and> flagrantly
34-11 overcharging or overtreating patients;
34-12 (H) failing to supervise adequately the
34-13 activities of those acting under the supervision of the physician;
34-14 or
34-15 (I) delegating professional medical
34-16 responsibility or acts to a person if the delegating physician
34-17 knows or has reason to know that the person is not qualified by
34-18 training, experience, or licensure to perform the responsibility or
34-19 acts;
34-20 (5) violation or attempted violation, direct or
34-21 indirect, of any valid rules issued under this Act, either as a
34-22 principal, accessory, or accomplice;
34-23 (6) use of any advertising statement that is false,
34-24 misleading, or deceptive;
34-25 (7) advertising professional superiority or the
34-26 performance of professional service in a superior manner if the
34-27 advertising is not readily subject to verification;
35-1 (8) purchase, sale, barter, or use or any offer to
35-2 purchase, sell, barter, or use any medical degree, license,
35-3 certificate, diploma, or transcript of license, certificate, or
35-4 diploma in or incident to an application to the board for a license
35-5 to practice medicine;
35-6 (9) altering, with fraudulent intent, any medical
35-7 license, certificate, diploma, or transcript of a medical license,
35-8 certificate, or diploma;
35-9 (10) using any medical license, certificate, diploma,
35-10 or transcript of a medical license, certificate, or diploma that
35-11 has been fraudulently purchased, issued, or counterfeited or that
35-12 has been materially altered;
35-13 (11) impersonating or acting as proxy for another in
35-14 any examination required by this Act for a medical license; or
35-15 engaging in conduct which subverts or attempts to subvert any
35-16 examination process required by this Act for a medical license.
35-17 Conduct which subverts or attempts to subvert the medical licensing
35-18 examination process includes, but is not limited to:
35-19 (A) conduct which violates the security of the
35-20 examination materials, as prescribed by board rules;
35-21 (B) conduct which violates the standard of test
35-22 administration, as prescribed by board rules; or
35-23 (C) conduct which violates the accreditation
35-24 process, as prescribed by board rules;
35-25 (12) impersonating a licensed practitioner or
35-26 permitting or allowing another to use his license or certificate to
35-27 practice medicine in this state for the purpose of diagnosing,
36-1 treating, or offering to treat sick, injured, or afflicted human
36-2 beings;
36-3 (13) employing, directly or indirectly, any person
36-4 whose license to practice medicine has been suspended, canceled, or
36-5 revoked or association in the practice of medicine with any person
36-6 or persons whose license to practice medicine has been suspended,
36-7 canceled, or revoked or any person who has been convicted of the
36-8 unlawful practice of medicine in Texas or elsewhere;
36-9 (14) performing or procuring a criminal abortion or
36-10 aiding or abetting in the procuring of a criminal abortion or
36-11 attempting to perform or procure a criminal abortion or attempting
36-12 to aid or abet the performance or procurement of a criminal
36-13 abortion;
36-14 (15) aiding or abetting, directly or indirectly, the
36-15 practice of medicine by any person, partnership, association, or
36-16 corporation not duly licensed to practice medicine by the board;
36-17 (16) inability to practice medicine with reasonable
36-18 skill and safety to patients by reason of illness, drunkenness,
36-19 excessive use of drugs, narcotics, chemicals, or any other type of
36-20 material or as a result of any mental or physical condition. In
36-21 enforcing this subdivision the board shall, upon probable cause,
36-22 request a physician to submit to a mental or physical examination
36-23 by physicians designated by the board. If the physician refuses to
36-24 submit to the examination, the board shall issue an order requiring
36-25 the physician to show cause why he should not be required to submit
36-26 to the examination and shall schedule a hearing on the order within
36-27 30 days after notice is served on the physician. The physician
37-1 shall be notified by either personal service or certified mail with
37-2 return receipt requested. At the hearing, the physician and his
37-3 attorney are entitled to present any testimony and other evidence
37-4 to show why the physician should not be required to submit to the
37-5 examination. After a complete hearing, the board shall issue an
37-6 order either requiring the physician to submit to the examination
37-7 or withdrawing the request for examination. An appeal from the
37-8 decision of the board shall be taken under the Administrative
37-9 Procedure Act;
37-10 (17) judgment by a court of competent jurisdiction
37-11 that a person licensed to practice medicine is of unsound mind;
37-12 (18) professional failure to practice medicine in an
37-13 acceptable manner consistent with public health and welfare;
37-14 (19) being removed, suspended, or having disciplinary
37-15 action taken by his peers in any professional medical association
37-16 or society, whether the association or society is local, regional,
37-17 state, or national in scope, or being disciplined by a licensed
37-18 hospital or medical staff of a hospital, including removal,
37-19 suspension, limitation of hospital privileges, or other
37-20 disciplinary action, if that action in the opinion of the board was
37-21 based on unprofessional conduct or professional incompetence that
37-22 was likely to harm the public, provided that the board finds that
37-23 the actions were appropriate and reasonably supported by evidence
37-24 submitted to it. The action does not constitute state action on
37-25 the part of the association, society, or hospital medical staff;
37-26 (20) repeated or recurring meritorious health-care
37-27 liability claims that in the opinion of the board evidence
38-1 professional incompetence likely to injure the public; or
38-2 (21) suspension, revocation, <or> restriction, or
38-3 other disciplinary action by another state of a license to practice
38-4 medicine, or disciplinary action by the uniformed services of the
38-5 United States, based upon acts by the licensee similar to acts
38-6 described in this section. A certified copy of the record of the
38-7 state taking the action is conclusive evidence of it.
38-8 SECTION 18. Subchapter C, Medical Practice Act (Article
38-9 4495b, Vernon's Texas Civil Statutes), is amended by adding Section
38-10 3.085 to read as follows:
38-11 Sec. 3.085. RESTRICTIONS ON BIDDING AND ADVERTISING.
38-12 (a) The board may not adopt rules restricting competitive bidding
38-13 or advertising by a person regulated by the board except to
38-14 prohibit false, misleading, or deceptive practices by the person.
38-15 (b) The board may not include in its rules to prohibit
38-16 false, misleading, or deceptive practices by a person regulated by
38-17 the board a rule that:
38-18 (1) restricts the use of any medium for advertising;
38-19 (2) restricts the person's personal appearance or use
38-20 of the person's voice in an advertisement;
38-21 (3) relates to the size or duration of an
38-22 advertisement by the person; or
38-23 (4) restricts the person's advertisement under a trade
38-24 name.
38-25 SECTION 19. Section 3.10, Medical Practice Act (Article
38-26 4495b, Vernon's Texas Civil Statutes), is amended to read as
38-27 follows:
39-1 Sec. 3.10. FEES AND OTHER FUNDS. (a) All annual
39-2 registration fees collected and other funds received by the board
39-3 shall be deposited, except as otherwise provided by this Act,
39-4 <placed in the State Treasury> to the credit of the special account
39-5 established by Section 2.09(k) of this Act <medical registration
39-6 fund. The fees deposited to this special fund shall be credited to
39-7 the appropriations of the board and may be spent only as provided
39-8 by the General Appropriations Act, this Act, or other applicable
39-9 statutes. Money in that fund may be used by the board and under
39-10 its direction in the enforcement of this Act, the prohibition of
39-11 the unlawful practice of medicine, the dissemination of information
39-12 to prevent the violation of the laws, and the prosecution of those
39-13 who violate the laws. All distributions from the fund may be made
39-14 only upon written approval of the secretary-treasurer of the board
39-15 or his designated representative, and the comptroller shall upon
39-16 requisition of the board from time to time draw warrants upon the
39-17 State Treasurer for the amounts specified in the requisition.>
39-18 <(b) The board may not set, charge, collect, receive, or
39-19 deposit any of the following fees in excess of:>
39-20 <(1) for processing and granting a license by
39-21 reciprocity to a licensee of another state.....................$700>
39-22 <(2) for processing an application and
39-23 administration of a partial examination for
39-24 licensure......................................................$700>
39-25 <(3) for processing an application and
39-26 administration of a complete examination for
39-27 licensure......................................................$700>
40-1 <(4) for processing an application and
40-2 issuance of a temporary license................................$200>
40-3 <(5) for processing an application and
40-4 issuance of a duplicate license................................$200>
40-5 <(6) for processing an application and
40-6 issuance of a license of reinstatement after a lapse
40-7 or cancellation of a license...................................$700>
40-8 <(7) for processing an application and
40-9 issuance of an annual registration of a licensee...............$200>
40-10 <(8) for processing and issuance of an
40-11 institutional permit for interns, residents, and
40-12 others in approved medical training programs...................$200>
40-13 <(9) for processing an application and
40-14 issuance of an endorsement to other state medical
40-15 boards.........................................................$200>
40-16 <(10) for processing and issuance of a permit
40-17 to a physician who supervises a physician assistant............$200>
40-18 <(11) for processing and issuance of a permit
40-19 to a physician who supervises an acupuncturist..............$200>.
40-20 (b) <(c)> The board may set and collect a sales charge for
40-21 making copies of any paper of record in the office of the board and
40-22 for any printed material published by the board. The charges shall
40-23 be in amounts considered sufficient to reimburse the board for the
40-24 actual expense.
40-25 (c) <(d)> The financial transactions of the board are
40-26 subject to audit by the state auditor in accordance with Chapter
40-27 321, Government Code.
41-1 (d) The board shall file annually with the governor and the
41-2 presiding officer of each house of the legislature a complete and
41-3 detailed written report accounting for all funds received and
41-4 disbursed by the board during the preceding fiscal year. The
41-5 annual report must be in the form and reported in the time provided
41-6 by the General Appropriations Act <(e) On or before the first day
41-7 of January each year, the board shall file with the governor and
41-8 the presiding officer of each house of the legislature a complete
41-9 and detailed written report accounting for all funds received and
41-10 disbursed by the board during the preceding year>.
41-11 SECTION 20. Section 3.11A, Medical Practice Act (Article
41-12 4495b, Vernon's Texas Civil Statutes), is amended to read as
41-13 follows:
41-14 Sec. 3.11A. Disposition of <Increase in> fees. (a) This
41-15 section applies to each <Each> of the following fees <imposed by or
41-16 under another section of this Act is increased by $200>:
41-17 (1) fee for processing and granting a license by
41-18 reciprocity to a licensee of another state;
41-19 (2) fee for processing an application and
41-20 administration of a partial examination for licensure;
41-21 (3) fee for processing an application and
41-22 administration of a complete examination for licensure;
41-23 (4) fee for processing an application and issuance of
41-24 a license of reinstatement after a lapse or cancellation of a
41-25 license; and
41-26 (5) fee for processing an application and issuance of
41-27 an annual registration of a licensee.
42-1 (b) Of each fee <increase> collected, $50 shall be deposited
42-2 to the credit of the foundation school fund and $150 shall be
42-3 deposited to the credit of the general revenue fund. This
42-4 subsection applies to the disposition of the stated portion of each
42-5 fee <increase> regardless of any other provision of law providing
42-6 for a different disposition of funds.
42-7 SECTION 21. Section 4.01, Medical Practice Act (Article
42-8 4495b, Vernon's Texas Civil Statutes), is amended to read as
42-9 follows:
42-10 Sec. 4.01. Grounds for Cancellation, Revocation, Suspension,
42-11 and Probation of License. (a) The board shall, except for good
42-12 cause shown, revoke or suspend a license, place on probation a
42-13 person whose license has been suspended, or reprimand a licensee
42-14 for a violation of this Act or a rule of the board <Except as
42-15 provided herein, the board may cancel, revoke, or suspend the
42-16 license of any practitioner of medicine or impose any other
42-17 authorized means of discipline upon proof of the violation of this
42-18 Act in any respect> or for any cause for which the board is
42-19 authorized to refuse to admit persons to its examination and to
42-20 issue a license and renewal license, including an initial
42-21 conviction or the initial finding of the trier of fact of guilt of
42-22 a felony or misdemeanor involving moral turpitude.
42-23 (b) On proof that a practitioner of medicine has been
42-24 initially convicted of a felony or the initial finding of the trier
42-25 of fact of guilt of a felony under Chapter 481, Health and Safety
42-26 Code, Section 485.033, Health and Safety Code, Chapter 483, Health
42-27 and Safety Code, or the Federal Comprehensive Drug Abuse Prevention
43-1 and Control Act of 1970, 21 U.S.C.A. Section 801 et seq. (Public
43-2 Law 91-513), the board shall suspend the practitioner's license.
43-3 On the practitioner's final conviction for such a felony offense,
43-4 the board shall revoke the practitioner's license.
43-5 (c) The board shall suspend the license of a practitioner
43-6 who is serving a prison term in a state or federal penitentiary
43-7 during his incarceration regardless of the offense.
43-8 SECTION 22. Section 4.04, Medical Practice Act (Article
43-9 4495b, Vernon's Texas Civil Statutes), is redesignated as Section
43-10 4.02 and amended to read as follows:
43-11 Sec. 4.02 <4.04>. COMPLAINT; INVESTIGATION. (a) Any
43-12 person, including a partnership, association, corporation, or other
43-13 entity, may file a complaint against a licensee with the board, or
43-14 the board may file a complaint on its own initiative. The board
43-15 shall adopt rules concerning the investigation of a complaint filed
43-16 with the board. The rules adopted under this subsection shall:
43-17 (1) distinguish between categories of complaints;
43-18 (2) ensure that complaints are not dismissed without
43-19 appropriate consideration;
43-20 (3) require that the board be advised of a complaint
43-21 that is dismissed and that a letter be sent to the person who filed
43-22 the complaint explaining the action taken on the dismissed
43-23 complaint;
43-24 (4) ensure that the person who filed the complaint has
43-25 an opportunity to explain the allegations made in the complaint;
43-26 and
43-27 (5) prescribe guidelines concerning the categories of
44-1 complaints that require the use of a private investigator and the
44-2 procedures for the board to obtain the services of a private
44-3 investigator.
44-4 (b) The board shall keep an information file about each
44-5 complaint filed with the board. The board's information file shall
44-6 be kept current and contain a record for each complaint of:
44-7 (1) potential witnesses contacted in relation to the
44-8 complaint;
44-9 (2) a summary of findings made at each step of the
44-10 complaint process;
44-11 (3) an explanation of the legal basis and reason for a
44-12 complaint that is dismissed; and
44-13 (4) other relevant information.
44-14 (c) If a written complaint is filed with the board that the
44-15 board has authority to resolve, the board, at least as frequently
44-16 as quarterly and until final disposition of the complaint, shall
44-17 notify the parties to the complaint of the status of the complaint
44-18 unless the notice would jeopardize an investigation.
44-19 (d) The board by rule shall adopt a form to standardize
44-20 information concerning complaints made to the board. The board by
44-21 rule shall prescribe information to be provided to a person when
44-22 the person files a complaint with the board.
44-23 (e) The board shall provide reasonable assistance to a
44-24 person who wishes to file a complaint with the board.
44-25 (f) Except as otherwise provided by this section, all
44-26 investigations shall be conducted by the board or persons
44-27 authorized by the board to conduct them. The board may commission
45-1 investigators as peace officers for the purpose of enforcing this
45-2 Act. However, investigators of the board so commissioned as peace
45-3 officers may not carry a firearm or exercise arrest powers. Each
45-4 complaint against a physician which requires a determination of
45-5 medical competency shall be reviewed by a board member, consultant,
45-6 or employee with medical background considered sufficient by the
45-7 board.
45-8 (g) <(b)> Unless it would jeopardize an investigation, the
45-9 board shall notify the physician that a complaint has been filed
45-10 and the nature of the complaint. The board shall make a
45-11 preliminary investigation of the complaint. The first
45-12 consideration of the board shall be whether the physician
45-13 constitutes a continuing threat to the public welfare.
45-14 (h) The board may, unless precluded by the law or this Act,
45-15 make a disposition of any complaint or matter relating to this Act,
45-16 or of any contested case by stipulation, agreed settlement, or
45-17 consent order. The board shall dispose of a complaint, contested
45-18 case, or other matter in writing, and if appropriate, the physician
45-19 shall sign the writing. An agreed disposition is a disciplinary
45-20 order for purposes of reporting under this Act and of
45-21 administrative hearings and proceedings by state and federal
45-22 regulatory agencies regarding the practice of medicine. An agreed
45-23 disposition is a public record.
45-24 (i) In civil or criminal litigation, an agreed disposition
45-25 is a settlement agreement under Rule 408, Texas Rules of Civil
45-26 Evidence, and Rule 408, Texas Rules of Criminal Evidence. This
45-27 subsection does not apply to a licensee who has previously entered
46-1 into an agreed disposition with the board of a different
46-2 disciplinary matter or whose license the board is seeking to
46-3 revoke.
46-4 (j) The board shall adopt such rules as are appropriate to
46-5 carry out this section <such disposition. Such disposition shall
46-6 be considered a disciplinary order>.
46-7 (k) The board shall dispose of all complaints in a timely
46-8 manner. The board shall establish a schedule for conducting each
46-9 phase of a complaint that is under the control of the board not
46-10 later than the 30th day after the date the complaint is received by
46-11 the board. The schedule shall be kept in the information file for
46-12 the complaint and all parties shall be notified of the projected
46-13 time requirements for pursuing the complaint. A change in the
46-14 schedule must be noted in the complaint information file, and all
46-15 parties to the complaint must be notified not later than the 14th
46-16 day after the date the change is made unless the notice would
46-17 jeopardize an investigation.
46-18 (l) The executive director of the board shall notify the
46-19 board of a complaint that extends beyond the time prescribed by the
46-20 board for resolving the complaint so that the board may take
46-21 necessary action on the complaint.
46-22 (m) Except in the case of a suspension under Section 4.13 of
46-23 this Act or in accordance with the terms of an agreement between
46-24 the board and a licensee, no revocation, suspension, involuntary
46-25 modification, or disciplinary action relating to a license is
46-26 effective unless, before board proceedings are instituted:
46-27 (1) the board has served notice, in a manner
47-1 consistent with the requirements for service under Subsection (g)
47-2 of this section, to the physician of the facts or conduct alleged
47-3 to warrant the intended action; and
47-4 (2) the physician was given an opportunity to show
47-5 compliance with all requirements of law for the retention of the
47-6 license either in writing or through personal appearance at an
47-7 informal meeting with one or more representatives of the board, at
47-8 the option of the licensee.
47-9 (n) If the licensee exercises the option to personally
47-10 appear at an informal meeting with one or more representatives of
47-11 the board and the informal meeting is held, the staff of the board
47-12 and the representatives of the board shall be subject to the ex
47-13 parte provisions of the Administrative Procedure Act with regard to
47-14 subsequent contacts with board members and administrative law
47-15 judges concerning the case.
47-16 SECTION 23. Subchapter D, Medical Practice Act (Article
47-17 4495b, Vernon's Texas Civil Statutes) is amended by adding Section
47-18 4.025 to read as follows:
47-19 Sec. 4.025. INFORMAL PROCEEDINGS. (a) The board by rule
47-20 shall adopt procedures governing:
47-21 (1) informal disposition of a contested case under
47-22 Section 13(e), Administrative Procedure Act, and its subsequent
47-23 amendments; and
47-24 (2) informal proceedings held in compliance with
47-25 Section 18(c), Administrative Procedure Act, and its subsequent
47-26 amendments.
47-27 (b) Rules adopted under this section must provide the
48-1 complainant and the licensee an opportunity to be heard and must
48-2 require the presence of the board's legal counsel or a
48-3 representative of the office of the attorney general to advise the
48-4 board or board's employees.
48-5 SECTION 24. Section 4.02, Medical Practice Act (Article
48-6 4495b, Vernon's Texas Civil Statutes), is redesignated as Section
48-7 4.03 and amended to read as follows:
48-8 Sec. 4.03 <4.02>. Initiation of Charges. (a) Proceedings,
48-9 unless otherwise specified, under this Act or other applicable law
48-10 and charges against a licensee may be instituted by a duly
48-11 authorized representative of the board <on its own initiative or by
48-12 any person>. Charges must be in writing and on sworn affidavit
48-13 filed with the records custodian or assistant records custodian of
48-14 the board detailing the nature of the charges as required by this
48-15 Act or other applicable law. The president or an authorized <his>
48-16 designee shall <set a time and place for a hearing and shall> cause
48-17 a copy of the charges<, together with a notice of the time and
48-18 place fixed for the hearing> to be served on the respondent or the
48-19 respondent's counsel of record.
48-20 (b) The president or designee shall notify the State Office
48-21 of Administrative Hearings of a formal complaint.
48-22 (c) A formal complaint shall be in writing and shall allege
48-23 with reasonable certainty the specific act or acts relied on by the
48-24 agency to constitute a violation of a specific statute or rule.
48-25 The formal complaint shall be specific enough to enable a person of
48-26 common understanding to know what is meant by the formal complaint
48-27 and shall contain a degree of certainty that will give the person
49-1 who is the subject of the formal complaint notice of the particular
49-2 act or acts alleged to be a violation of a specific statute or
49-3 rule.
49-4 (d) The board shall adopt reasonable rules to promote
49-5 discovery by all parties to contested cases.
49-6 (e) In this section, "formal complaint" means a written
49-7 statement made by a credible person under oath that is filed and
49-8 presented by a representative of the board charging a person with
49-9 having committed an act or acts that if proven could affect the
49-10 legal rights or privileges of a licensee or other person under the
49-11 jurisdiction of the board.
49-12 SECTION 25. Section 4.03, Medical Practice Act (Article
49-13 4495b, Vernon's Texas Civil Statutes), is redesignated as Section
49-14 4.04 and amended to read as follows:
49-15 Sec. 4.04 <4.03>. Notice. (a) Service of process notifying
49-16 the respondent of <the time and place of> a hearing about <and the
49-17 nature of> the charges against the person shall be made in
49-18 accordance with the requirements of the Administrative Procedure
49-19 Act and its subsequent amendments <person or by mail. Notice shall
49-20 be sufficient if made in person or if sent by registered or
49-21 certified mail to the person charged at the address shown in the
49-22 board files or on his most recent application for registration or
49-23 renewal, no later than 10 days before the hearing>.
49-24 (b) If service of notice as prescribed by Subsection (a) of
49-25 this section is impossible or cannot be effected, the board shall
49-26 cause to be published once a week for two successive weeks a notice
49-27 of the hearing in a newspaper published in the county of the last
50-1 known place of practice in Texas of the person, if known. If the
50-2 licensee is not currently practicing in Texas as evidenced by
50-3 information in the board files, or if the last county of practice
50-4 is unknown, publication shall be in a newspaper in Travis County.
50-5 When publication of notice is used, the date of hearing may not be
50-6 less than 10 days after the date of the last publication of notice.
50-7 SECTION 26. Section 4.05, Medical Practice Act (Article
50-8 4495b, Vernon's Texas Civil Statutes), is amended to read as
50-9 follows:
50-10 Sec. 4.05. Hearings, Rules. (a) The <president of the>
50-11 board by rule shall adopt procedures governing formal disposition
50-12 of a contested case under the Administrative Procedure Act and its
50-13 subsequent amendments. A formal hearing shall be conducted by an
50-14 administrative law judge employed by the State Office of
50-15 Administrative Hearings <designate one of the following alternative
50-16 procedures for the conduct of each individual contested case in a
50-17 disciplinary matter:>
50-18 <(1) a hearing before the board itself where a quorum
50-19 of the board shall be present for the hearing and decision at the
50-20 conclusion of the hearing;>
50-21 <(2) a hearing committee appointed by the president of
50-22 the board, provided that the hearing committee shall be composed of
50-23 not less than three members of the board and the composition of
50-24 such committee shall be consistent with the provisions of Sections
50-25 2.08 and 2.09 of this Act; or>
50-26 <(3) a hearing before a hearing examiner appointed by
50-27 the board to conduct a hearing and to prepare and submit to the
51-1 board for action a proposal for decision as provided in the
51-2 Administrative Procedure and Texas Register Act (Article 6252-13a,
51-3 Vernon's Texas Civil Statutes).>
51-4 <Any individual conducting a hearing under this subchapter is
51-5 empowered to administer oaths and to receive evidence at the
51-6 hearing and shall report the hearing as prescribed by board rules>.
51-7 Notwithstanding any other provision of this Act or other law, the
51-8 board may, in its sole discretion, employ, retain, and compensate
51-9 such attorneys, consultants, and other professionals as it deems
51-10 necessary and appropriate to serve as <hearing examiners,> board
51-11 consultants or<,> special counsel to prosecute on behalf of the
51-12 hearings division and investigating division such complaints as are
51-13 filed with the board, court reporters, and other staff deemed
51-14 necessary or appropriate by the board to prepare for or represent
51-15 the board in <conduct> the hearings authorized by this section.
51-16 <All hearings conducted under this subchapter by the board shall
51-17 comply with the provisions of the Administrative Procedure Act and
51-18 the board's rules.>
51-19 (b) <The licensee shall have the right to produce witnesses
51-20 or evidence on the person's behalf, to cross-examine witnesses, and
51-21 to have subpoenas issued by the board to be served at the
51-22 licensee's expense.>
51-23 <(c)> The board shall, after receiving the administrative
51-24 law judge's findings of fact and conclusions of law <the hearing>,
51-25 determine the charges upon their merits.
51-26 (c) <(d)> All complaints, adverse reports, investigation
51-27 files, other investigation reports, and other investigative
52-1 information in the possession of, received or gathered by the board
52-2 or its employees or agents relating to a licensee, an application
52-3 for license, or a criminal investigation or proceedings are
52-4 privileged and confidential and are not subject to discovery,
52-5 subpoena, or other means of legal compulsion for their release to
52-6 anyone other than the board or its employees or agents involved in
52-7 licensee discipline. Not later than 30 days after receiving a
52-8 written request from a licensee who is the subject of a formal
52-9 complaint initiated and filed under Section 4.03 of this Act or
52-10 from the licensee's counsel of record and subject to any other
52-11 privileges or restrictions set forth by rule, statute, or legal
52-12 precedent, and unless good cause is shown for delay, the board
52-13 shall provide the licensee with access to all information in its
52-14 possession that the board intends to offer into evidence in
52-15 presenting its case in chief at the contested hearing on the
52-16 complaint. However, the board is not required to provide board
52-17 investigative reports or investigative memoranda, the identity of
52-18 nontestifying complainants, attorney-client communications,
52-19 attorney-work product, or other materials covered by a privilege as
52-20 recognized by the Texas Rules of Civil Procedure or the Texas Rules
52-21 of Civil Evidence. The furnishing of information shall not
52-22 constitute a waiver of privilege or confidentiality under this
52-23 section, this Act, or other applicable law. Investigative
52-24 <However, investigative> information in the possession of the board
52-25 or its employees or agents which relates to licensee discipline may
52-26 be disclosed to the appropriate licensing authority in another
52-27 state, the District of Columbia, or a territory or country in which
53-1 the licensee is licensed or has applied for a license, or to a peer
53-2 review committee reviewing an application for privileges or the
53-3 qualifications of the licensee with respect to retaining
53-4 privileges. If the investigative information in the possession of
53-5 the board or its employees or agents indicates a crime may have
53-6 been committed, the information shall be reported to the proper law
53-7 enforcement agency. The board shall cooperate and assist all law
53-8 enforcement agencies conducting criminal investigations of
53-9 licensees by providing information which is relevant to the
53-10 criminal investigation to the investigating agency. Any
53-11 information disclosed by the board to an investigative agency shall
53-12 remain confidential and shall not be disclosed by the investigating
53-13 agency except as necessary to further the investigation. The board
53-14 shall provide information upon the written request of a health-care
53-15 entity about a complaint filed against a licensee that was resolved
53-16 after investigation by a disciplinary order of the board or by an
53-17 agreed settlement and the basis of and current status of any
53-18 complaint under active investigation. The board shall keep
53-19 information on file about each complaint filed with the board,
53-20 consistent with this Act. If a written complaint is filed with the
53-21 board relating to a person licensed by the board, the board, at
53-22 least as often as quarterly and until final determination of the
53-23 action to be taken relative to the complaint, shall notify the
53-24 parties to the complaint <complaining party> consistent with this
53-25 Act of the status of the complaint unless the notice would
53-26 jeopardize an active investigation.
53-27 (d) <(e)> The board in its discretion may accept the
54-1 voluntary surrender of a license. No license may be returned
54-2 unless the board determines, under rules established by it, that
54-3 the licensee is competent to resume practice.
54-4 SECTION 27. Section 4.10, Medical Practice Act (Article
54-5 4495b, Vernon's Texas Civil Statutes), is amended to read as
54-6 follows:
54-7 Sec. 4.10. Petition for Reinstatement. (a) Upon
54-8 application, the board may reissue a license to practice medicine
54-9 to a person whose license has been canceled, revoked, or suspended,
54-10 but the application, in the case of revocation, may not be made
54-11 prior to one year after the revocation was issued or became final
54-12 and must be made upon payment of the fees as established by the
54-13 board and in the manner and form and under the conditions as the
54-14 board may require. Further, the board may not reinstate or reissue
54-15 a license to a person whose license has been canceled, revoked, or
54-16 suspended because of a felony conviction under Chapter 481, Health
54-17 and Safety Code, Section 485.033, Health and Safety Code, Chapter
54-18 483, Health and Safety Code, or the Federal Comprehensive Drug
54-19 Abuse Prevention and Control Act of 1970, 21 U.S.C.A. Section 801
54-20 et seq. (Public Law 91-513), except on an express determination
54-21 based on substantial evidence contained in an investigative report
54-22 indicating that the reinstatement or reissue of the license is in
54-23 the best interests of the public and of the person whose license
54-24 has been canceled, revoked, or suspended.
54-25 (b) A decision by the board to deny an application to
54-26 reinstate or reissue a license is subject to judicial review in the
54-27 manner provided by Section 4.09 of this Act.
55-1 SECTION 28. Section 4.11, Medical Practice Act (Article
55-2 4495b, Vernon's Texas Civil Statutes), is amended to read as
55-3 follows:
55-4 Sec. 4.11. Monitoring of License Holder; Probation.
55-5 (a) The board by rule shall develop a system for monitoring the
55-6 compliance with the requirements of this Act of license holders who
55-7 are the subject of disciplinary action. Rules adopted under this
55-8 section shall include procedures for monitoring a license holder
55-9 who is ordered by the board to perform certain acts to ascertain
55-10 that the license holder performs the required acts and to identify
55-11 and monitor license holders who are the subject of disciplinary
55-12 action and who present a continuing threat to the public welfare
55-13 through the practice of medicine.
55-14 (b) The board upon majority vote may provide that the order
55-15 canceling, revoking, or suspending a license or imposing any other
55-16 method of discipline be probated so long as the probationer
55-17 conforms to the orders, conditions, and rules that the board may
55-18 set out as the terms of probation. However, the board may not
55-19 grant probation to a person whose license has been canceled,
55-20 revoked, or suspended because of a felony conviction under Chapter
55-21 481, Health and Safety Code, Section 485.033, Health and Safety
55-22 Code, Chapter 483, Health and Safety Code, or the Federal
55-23 Comprehensive Drug Abuse Prevention and Control Act of 1970, 21
55-24 U.S.C.A. Section 801 et seq. (Public Law 91-513), except on an
55-25 express determination, based on substantial evidence, that the
55-26 grant of probation is in the best interests of the public and of
55-27 the person whose license has been suspended, revoked, or canceled.
56-1 The board, at the time of probation, shall set out the period of
56-2 time that constitutes the probationary period. The board may not
56-3 grant probation to a physician who poses, through the practice of
56-4 medicine, a continuing threat to the public welfare.
56-5 (c) <(b)> The board may at any time while a license holder
56-6 <the probationer> remains on probation, with adequate grounds being
56-7 shown, cause <hold> a hearing to be held and, upon proof of a
56-8 violation of the order <majority vote>, rescind the probation and
56-9 enforce the board's original action and may impose any disciplinary
56-10 action permitted under Section 4.12 of this Act in addition to or
56-11 in lieu of enforcing the original order. The board <and> shall
56-12 revoke or suspend a probationer's license <do so> if the board
56-13 determines that the probationer poses, through the practice of
56-14 medicine, a continuing threat to the public welfare.
56-15 (d) <(c)> The hearing to rescind the probation shall be
56-16 governed by the same provisions as are set forth in this subchapter
56-17 for other charges.
56-18 SECTION 29. Section 4.12, Medical Practice Act (Article
56-19 4495b, Vernon's Texas Civil Statutes), is amended to read as
56-20 follows:
56-21 Sec. 4.12. Methods of Discipline. (a) Except as otherwise
56-22 provided in Section 4.01, if the board finds any person to have
56-23 committed any of the acts set forth in Section 3.08 of this Act, it
56-24 shall enter an order imposing one or more of the following:
56-25 (1) deny the person's application for a license or
56-26 other authorization to practice medicine;
56-27 (2) administer a public reprimand;
57-1 (3) suspend, limit, or restrict the person's license
57-2 or other authorization to practice medicine, including limiting the
57-3 practice of the person to or by the exclusion of one or more
57-4 specified activities of medicine or stipulating periodic board
57-5 review;
57-6 (4) revoke the person's license or other authorization
57-7 to practice medicine;
57-8 (5) require the person to submit to care, counseling,
57-9 or treatment of physicians designated by the board as a condition
57-10 for the initial, continued, or renewal of a license or other
57-11 authorization to practice medicine;
57-12 (6) require the person to participate in a program of
57-13 education or counseling prescribed by the board;
57-14 (7) require the person to practice under the direction
57-15 of a physician designated by the board for a specified period of
57-16 time; <or>
57-17 (8) require the person to perform public service
57-18 considered appropriate by the board; or
57-19 (9) assess an administrative penalty against the
57-20 person as provided by Section 4.125 of this Act.
57-21 (b) Providing however, if the board determines that, through
57-22 the practice of medicine, the physician poses a continuing threat
57-23 to the public welfare, it shall revoke, suspend or deny the
57-24 license.
57-25 (c) In addition to the other disciplinary actions authorized
57-26 by this section, the board may issue a written reprimand to a
57-27 license holder who violates this Act or require that a license
58-1 holder who violates this Act participate in continuing education
58-2 programs. The board shall specify the continuing education
58-3 programs that may be attended and the number of hours that must be
58-4 completed by an individual license holder to fulfill the
58-5 requirements of this subsection.
58-6 (d) If a license suspension is probated, the board may
58-7 require the license holder to:
58-8 (1) report regularly to the board on matters that are
58-9 the basis of the probation;
58-10 (2) limit practice to the areas prescribed by the
58-11 board; or
58-12 (3) continue or review continuing professional
58-13 education until the license holder attains a degree of skill
58-14 satisfactory to the board in those areas that are the basis of the
58-15 probation.
58-16 (e) The schedule of sanctions adopted by the board by rule
58-17 shall be used by the State Office of Administrative Hearings for
58-18 any sanction imposed as the result of a hearing conducted by that
58-19 office.
58-20 SECTION 30. Subchapter D, Medical Practice Act (Article
58-21 4495b, Vernon's Texas Civil Statutes), is amended by adding Section
58-22 4.125 to read as follows:
58-23 Sec. 4.125. ADMINISTRATIVE PENALTY. (a) The board by order
58-24 may impose an administrative penalty against a person licensed or
58-25 regulated under this Act who violates this Act or a rule or order
58-26 adopted under this Act.
58-27 (b) The penalty for a violation may be in an amount not to
59-1 exceed $5,000. Each day a violation continues or occurs is a
59-2 separate violation for purposes of imposing a penalty.
59-3 (c) The amount of the penalty shall be based on:
59-4 (1) the seriousness of the violation, including the
59-5 nature, circumstances, extent, and gravity of any prohibited acts,
59-6 and the hazard or potential hazard created to the health, safety,
59-7 or economic welfare of the public;
59-8 (2) the economic harm to property or the environment
59-9 caused by the violation;
59-10 (3) the history of previous violations;
59-11 (4) the amount necessary to deter future violations;
59-12 (5) efforts to correct the violation; and
59-13 (6) any other matter that justice may require.
59-14 (d) The board by rule shall prescribe the procedure by which
59-15 it may impose an administrative penalty.
59-16 (e) All proceedings under this section are subject to the
59-17 Administrative Procedure Act and its subsequent amendments.
59-18 (f) If the board by order finds that a violation has
59-19 occurred and imposes an administrative penalty, the board shall
59-20 give notice to the person of the board's order. The notice must
59-21 include a statement of the right of the person to judicial review
59-22 of the order.
59-23 (g) Within 30 days after the date the board's order imposing
59-24 the penalty is final as provided by Section 16(c), Administrative
59-25 Procedure Act, and its subsequent amendments, the person shall:
59-26 (1) pay the amount of the penalty;
59-27 (2) pay the amount of the penalty and file a petition
60-1 for judicial review contesting the occurrence of the violation, the
60-2 amount of the penalty, or both the occurrence of the violation and
60-3 the amount of the penalty; or
60-4 (3) without paying the amount of the penalty, file a
60-5 petition for judicial review contesting the occurrence of the
60-6 violation, the amount of the penalty, or both the occurrence of the
60-7 violation and the amount of the penalty.
60-8 (h) Within the 30-day period, a person who acts under
60-9 Subsection (g)(3) of this section may:
60-10 (1) stay enforcement of the penalty by:
60-11 (A) paying the amount of the penalty to the
60-12 court for placement in an escrow account; or
60-13 (B) giving to the court a supersedeas bond that
60-14 is approved by the court for the amount of the penalty and that is
60-15 effective until all judicial review of the board's order is final;
60-16 or
60-17 (2) request the court to stay enforcement of the
60-18 penalty by:
60-19 (A) filing with the court a sworn affidavit of
60-20 the person stating that the person is financially unable to pay the
60-21 amount of the penalty and is financially unable to give the
60-22 supersedeas bond; and
60-23 (B) giving a copy of the affidavit to the
60-24 executive director by certified mail.
60-25 (i) An executive director who receives a copy of an
60-26 affidavit under Subsection (h)(2) of this section may file with the
60-27 court, within five days after the date the copy is received, a
61-1 contest to the affidavit. The court shall hold a hearing on the
61-2 facts alleged in the affidavit as soon as practicable and shall
61-3 stay the enforcement of the penalty on finding that the alleged
61-4 facts are true. The person who files an affidavit has the burden
61-5 of proving that the person is financially unable to pay the amount
61-6 of the penalty and to give a supersedeas bond.
61-7 (j) If the person does not pay the amount of the penalty and
61-8 the enforcement of the penalty is not stayed, the executive
61-9 director may refer the matter to the attorney general for
61-10 collection of the amount of the penalty.
61-11 (k) If on appeal the court sustains the occurrence of the
61-12 violation, the court may uphold or reduce the amount of the penalty
61-13 and order the person to pay the full or reduced amount of the
61-14 penalty. If the court does not sustain the occurrence of the
61-15 violation, the court shall order that no penalty is owed.
61-16 (l) When the judgment of the court becomes final, the court
61-17 shall proceed under this subsection. If the person paid the amount
61-18 of the penalty and if that amount is reduced or is not upheld by
61-19 the court, the court shall order that the appropriate amount plus
61-20 accrued interest be remitted to the person. The rate of the
61-21 interest is the rate charged on loans to depository institutions by
61-22 the New York Federal Reserve Bank, and the interest shall be paid
61-23 for the period beginning on the date the penalty was paid and
61-24 ending on the date the penalty is remitted. If the person gave a
61-25 supersedeas bond and if the amount of the penalty is not upheld by
61-26 the court, the court shall order the release of the bond. If the
61-27 person gave a supersedeas bond and if the amount of the penalty is
62-1 reduced, the court shall order the release of the bond after the
62-2 person pays the amount.
62-3 (m) A penalty collected under this section shall be remitted
62-4 to the comptroller for deposit in the general revenue fund.
62-5 SECTION 31. Subchapter D, Medical Practice Act (Article
62-6 4495b, Vernon's Texas Civil Statutes), is amended by adding Section
62-7 4.126 to read as follows:
62-8 Sec. 4.126. CIVIL PENALTY. (a) If it appears that a person
62-9 is in violation of or is threatening to violate this Act or a rule
62-10 or order adopted by the board, the attorney general may institute
62-11 an action for a civil penalty of $1,000 for each violation. Each
62-12 day of a violation shall constitute a separate violation.
62-13 (b) A civil action filed under this section by the attorney
62-14 general must be filed in a district court in Travis County or the
62-15 county in which the violation occurred.
62-16 (c) The attorney general may recover reasonable expenses
62-17 incurred in obtaining a civil penalty under this section, including
62-18 court costs, reasonable attorney fees, investigative costs, witness
62-19 fees, and deposition expenses.
62-20 (d) A civil penalty recovered in an action by the attorney
62-21 general under this section shall be deposited in the general
62-22 revenue fund.
62-23 SECTION 32. Section 4.13, Medical Practice Act (Article
62-24 4495b, Vernon's Texas Civil Statutes), is amended to read as
62-25 follows:
62-26 Sec. 4.13. Temporary Suspension of License. (a) The
62-27 president of the board, with the approval of the board, shall
63-1 appoint a three-member disciplinary panel consisting of members of
63-2 the board for the purpose of determining whether a person's license
63-3 to practice medicine in this state should be temporarily suspended
63-4 under this section.
63-5 (b) If the disciplinary panel <executive committee of the
63-6 board> determines from the evidence or information presented to it
63-7 that a person licensed to practice medicine in this state by his
63-8 continuation in practice would constitute a continuing threat to
63-9 the public welfare, the disciplinary panel <executive committee of
63-10 the board> shall temporarily suspend the license of that person.
63-11 (c) The license may be suspended under this section without
63-12 notice or hearing on the complaint, provided institution of
63-13 proceedings for a hearing before the board is initiated
63-14 simultaneously with the temporary suspension and provided that a
63-15 hearing is held as soon as can be accomplished under the
63-16 Administrative Procedure Act and this Act.
63-17 (d) Notwithstanding the open meetings law, Chapter 271, Acts
63-18 of the 60th Legislature, Regular Session, 1967 (Article 6252-17,
63-19 Vernon's Texas Civil Statutes), the disciplinary panel may hold a
63-20 meeting by telephone conference call if immediate action is
63-21 required and the convening at one location of the disciplinary
63-22 panel is inconvenient for any member of the disciplinary panel.
63-23 SECTION 33. Subchapter E, Medical Practice Act (Article
63-24 4495b, Vernon's Texas Civil Statutes), is amended by adding Section
63-25 5.035 to read as follows:
63-26 Sec. 5.035. GRADUATES OF UNAPPROVED FOREIGN MEDICAL SCHOOLS.
63-27 (a) An applicant who is a graduate of a medical school that is
64-1 located outside the United States and Canada and that was not
64-2 approved by the board at the time the degree was conferred, to be
64-3 eligible for the issuance of a license, must present satisfactory
64-4 proof to the board that the applicant:
64-5 (1) meets the requirements set out in Sections
64-6 3.04(a)(1), (2), and (3) of this Act;
64-7 (2) is a graduate of a school whose curriculum meets
64-8 the requirements for an unapproved medical school as determined by
64-9 a committee of experts selected by the Texas Higher Education
64-10 Coordinating Board;
64-11 (3) has successfully completed three years of graduate
64-12 medical training in the United States or Canada that was approved
64-13 by the board on the date the training was completed;
64-14 (4) is eligible for licensure to practice medicine in
64-15 the country in which the school is located;
64-16 (5) possesses a valid certificate issued by the
64-17 Educational Commission for Foreign Medical Graduates;
64-18 (6) has the ability to communicate in the English
64-19 language; and
64-20 (7) has passed the examination required by the board
64-21 of all applicants for license as required by Section 3.05 of this
64-22 Act.
64-23 (b) In addition to other licensure requirements, the board
64-24 may require by rule that a graduate of an unapproved medical school
64-25 located outside the United States and Canada or the school of which
64-26 the person is a graduate provide additional information to the
64-27 board concerning the school before approving the applicant.
65-1 (c) The board may refuse to issue a license to an applicant
65-2 who graduated from an unapproved medical school located outside the
65-3 United States and Canada if it finds that the applicant does not
65-4 possess the requisite qualifications to provide the same standard
65-5 of medical care as provided by a physician licensed in this state.
65-6 (d) The board may refuse to issue a license to an applicant
65-7 who graduated from an unapproved medical school located outside the
65-8 United States and Canada if the applicant fails to provide the
65-9 board evidence to establish that the applicant completed medical
65-10 education or professional training substantially equivalent to that
65-11 provided by a medical school in this state.
65-12 SECTION 34. Section 5.04, Medical Practice Act (Article
65-13 4495b, Vernon's Texas Civil Statutes), is amended to read as
65-14 follows:
65-15 Sec. 5.04. FIFTH PATHWAY FOR FOREIGN MEDICAL SCHOOL
65-16 STUDENTS. (a) An applicant <Notwithstanding any other provision
65-17 of law, an individual> who has been a student of a foreign medical
65-18 school, to be eligible for the issuance of a license, must present
65-19 satisfactory proof to the board that the applicant <is eligible for
65-20 licensure to practice medicine in this state if he>:
65-21 (1) meets the requirements set out in Sections
65-22 3.04(a)(1), (2), and (3) of this Act;
65-23 (2) has studied medicine in an acceptable <a
65-24 reputable> medical school as defined by the board located outside
65-25 the United States and Canada;
65-26 (3) <(2)> has completed all of the didactic work of
65-27 the foreign medical school but has not graduated from the school;
66-1 (4) <(3)> has attained a score satisfactory to a
66-2 medical school in the United States approved by the Liaison
66-3 Committee on Medical Education on a qualifying examination and has
66-4 satisfactorily completed one academic year of supervised clinical
66-5 training for foreign medical students as defined by the American
66-6 Medical Association Council on Medical Education (Fifth Pathway
66-7 Program) under the direction of the medical school in the United
66-8 States;
66-9 (5) <(4)> has attained a passing score on the
66-10 Educational Commission <Council> for Foreign Medical Graduates
66-11 examination, or other examination, if required by the board; <and>
66-12 (6) has successfully completed three years of graduate
66-13 medical training in the United States or Canada that was approved
66-14 by the board on the date the training was completed; and
66-15 (7) <(5)> has passed the examination required by the
66-16 board of all applicants for license as required by Section 3.05 of
66-17 this Act.
66-18 (b) Satisfaction of the requirements of Subsection (a) of
66-19 this section are in lieu of the completion of any requirements of
66-20 the foreign medical school beyond completion of the didactic work,
66-21 and no other medical education requirements shall be a condition of
66-22 licensure to practice medicine in this state.
66-23 (c) Satisfaction of the requirements specified in Subsection
66-24 (a) of this section shall be in lieu of certification by the
66-25 Educational Commission <Council> for Foreign Medical Graduates, and
66-26 the certification is not a condition of licensure to practice
66-27 medicine in this state for candidates who have completed the
67-1 requirements of Subsection (a) of this section.
67-2 (d) A hospital that is licensed by this state, that is
67-3 operated by the state or a political subdivision of the state, or
67-4 that receives state financial assistance, directly or indirectly,
67-5 may not require an individual who has been a student of a foreign
67-6 medical school but has not graduated from the school to satisfy any
67-7 requirements other than those contained in <Subdivisions (1), (2),
67-8 (3), and (4) of> Subsection (a) of this section prior to commencing
67-9 an internship or residency.
67-10 (e) A document granted by a medical school located outside
67-11 the United States issued after the completion of all the didactic
67-12 work of the foreign medical school shall, on certification by the
67-13 medical school in the United States in which the training was
67-14 received of satisfactory completion by the person to whom the
67-15 document was issued of the requirements listed in Subdivision (4)
67-16 <(3)> of Subsection (a) of this section, be considered the
67-17 equivalent of a degree of doctor of medicine or doctor of
67-18 osteopathy for purposes of licensure.
67-19 SECTION 35. Section 5.08, Medical Practice Act (Article
67-20 4495b, Vernon's Texas Civil Statutes), is amended by amending
67-21 Subsections (d) and (k) and adding Subsection (n) to read as
67-22 follows:
67-23 (d) The prohibitions of this section continue to apply to
67-24 confidential communications or records concerning any patient
67-25 irrespective of when the patient received the services of a
67-26 physician, except for medical records 100 years old or older
67-27 requested for historical purposes.
68-1 (k) A physician shall furnish copies of medical records
68-2 requested, or a summary or narrative of the records, pursuant to a
68-3 written consent for release of the information as provided by
68-4 Subsection (j) of this section, except if the physician determines
68-5 that access to the information would be harmful to the physical,
68-6 mental, or emotional health of the patient, and the physician may
68-7 delete confidential information about another person who has not
68-8 consented to the release. The information shall be furnished by
68-9 the physician within 30 days after the date of receipt of the
68-10 request <a reasonable period of time> and reasonable fees for
68-11 furnishing the information shall be paid by the patient or someone
68-12 on his behalf. If the physician denies the request, in whole or in
68-13 part, the physician shall furnish the patient a written statement,
68-14 signed and dated, stating the reason for the denial. A copy of the
68-15 statement denying the request shall be placed in the patient's
68-16 medical records. In this subsection, "medical records" means any
68-17 records pertaining to the history, diagnosis, treatment, or
68-18 prognosis of the patient.
68-19 (n) A person who may provide a copy of a record or a summary
68-20 of the record to another under this section may provide the copy,
68-21 summary, or narrative:
68-22 (1) on paper; or
68-23 (2) on microfilm, microfiche, computer hard disk,
68-24 magnetic tape, optical disk, or by means of another appropriate
68-25 medium, including a machine-readable medium, if the person who is
68-26 to provide and the person who is to receive the copy, summary, or
68-27 narrative agree to a form authorized by this subdivision.
69-1 SECTION 36. Section 5.10, Medical Practice Act (Article
69-2 4495b, Vernon's Texas Civil Statutes), is amended to read as
69-3 follows:
69-4 Sec. 5.10. Sunset provision. The Texas State Board of
69-5 Medical Examiners is subject to Chapter 325, Government Code (Texas
69-6 Sunset Act). Unless continued in existence as provided by that
69-7 chapter, the board is abolished and this Act expires September 1,
69-8 2005 <1993>.
69-9 SECTION 37. The Medical Practice Act (Article 4495b,
69-10 Vernon's Texas Civil Statutes) is amended by adding Subchapter F to
69-11 read as follows:
69-12 SUBCHAPTER F. ACUPUNCTURE PRACTICE
69-13 Sec. 6.01. LEGISLATIVE FINDINGS AND PURPOSE. The
69-14 legislature finds that:
69-15 (1) the review and establishment of statewide
69-16 standards for the training, education, and discipline of persons
69-17 performing acupuncture are in the public interest; and
69-18 (2) the health, safety, and welfare of the people of
69-19 this state are best served by an orderly system of regulating the
69-20 practice of acupuncture.
69-21 Sec. 6.02. DEFINITIONS. In this subchapter:
69-22 (1) "Acupuncture" means:
69-23 (A) the insertion of an acupuncture needle and
69-24 the application of moxibustion to specific areas of the human body
69-25 as a primary mode of therapy to treat and mitigate a human
69-26 condition; and
69-27 (B) the administration of thermal or electrical
70-1 treatments or the recommendation of dietary guidelines, therapeutic
70-2 exercise, or dietary or herbal supplements in conjunction with the
70-3 treatment described by Paragraph (A) of this subdivision.
70-4 (2) "Acupuncturist" means a person who practices
70-5 acupuncture.
70-6 (3) "Acupuncture board" means the Texas State Board of
70-7 Acupuncture Examiners.
70-8 (4) "Chiropractor" means a licensee of the Texas Board
70-9 of Chiropractic Examiners.
70-10 (5) "Executive director" means the executive director
70-11 of the Texas State Board of Medical Examiners.
70-12 (6) "Medical board" means the Texas State Board of
70-13 Medical Examiners.
70-14 (7) "Physician" means a licensee of the Texas State
70-15 Board of Medical Examiners.
70-16 Sec. 6.03. EXEMPTION; LIMITATION. (a) This subchapter does
70-17 not apply to a health care professional licensed under another
70-18 subchapter of this Act or another statute of this state and acting
70-19 within the scope of the license.
70-20 (b) This subchapter does not:
70-21 (1) limit the practice of medicine by a physician or
70-22 permit the unauthorized practice of medicine; or
70-23 (2) permit a person to dispense, administer, or supply
70-24 any controlled substance, narcotic, or dangerous drug if the person
70-25 is not otherwise authorized by law to do so.
70-26 Sec. 6.04. ACUPUNCTURE BOARD. (a) The Texas State Board of
70-27 Acupuncture Examiners is composed of nine members appointed by the
71-1 governor as follows:
71-2 (1) four acupuncturists who have at least five years
71-3 of experience in the practice of acupuncture in this state and are
71-4 not licensed in this state as physicians;
71-5 (2) two physicians who are licensed in this state and
71-6 are experienced in the practice of acupuncture; and
71-7 (3) three members of the general public who are not
71-8 licensed or trained in a health care profession and who represent
71-9 the public.
71-10 (b) The following persons may not serve on the acupuncture
71-11 board:
71-12 (1) a person who is required to register as a lobbyist
71-13 under Chapter 305, Government Code, and its subsequent amendments;
71-14 and
71-15 (2) a person who is currently employed by or serving
71-16 as president, vice-president, secretary, or treasurer of a
71-17 statewide or national organization incorporated for the purpose of
71-18 representing a health care profession in this state or the United
71-19 States.
71-20 (c) Members of the acupuncture board hold office for
71-21 staggered terms of six years, with three members' terms expiring
71-22 January 31 of each odd-numbered year.
71-23 (d) The governor shall designate a presiding officer of the
71-24 acupuncture board from the members of the acupuncture board.
71-25 (e) A vacancy on the acupuncture board shall be filled by
71-26 appointment of the governor.
71-27 (f) A member of the acupuncture board may not receive
72-1 compensation for service on the board but is entitled to receive a
72-2 per diem as set by legislative appropriation for transportation and
72-3 related expenses incurred for each day that the member engages in
72-4 the business of the board.
72-5 (g) The acupuncture board is subject to the open meetings
72-6 law, the open records law, and the Administrative Procedure Act and
72-7 any subsequent amendments.
72-8 (h) The acupuncture board is subject to Chapter 325,
72-9 Government Code (Texas Sunset Act). Unless continued in existence
72-10 as provided by that chapter, the board is abolished and this
72-11 subchapter expires September 1, 1997.
72-12 Sec. 6.05. POWERS AND DUTIES OF ACUPUNCTURE BOARD.
72-13 (a) Subject to the advice and approval of the medical board, the
72-14 acupuncture board shall:
72-15 (1) establish qualifications for an acupuncturist to
72-16 practice in this state;
72-17 (2) establish minimum educational and training
72-18 requirements necessary for the acupuncture board to recommend that
72-19 the medical board issue a license to practice acupuncture;
72-20 (3) administer an examination that is validated by
72-21 independent testing professionals for a license to practice
72-22 acupuncture;
72-23 (4) develop requirements for licensure by endorsement
72-24 of other states;
72-25 (5) prescribe the application form for a license to
72-26 practice acupuncture;
72-27 (6) make recommendations on applications for licenses
73-1 to practice acupuncture;
73-2 (7) establish a procedure for reporting and processing
73-3 complaints relating to the practice of acupuncture under this
73-4 article;
73-5 (8) establish the requirements for a tutorial program
73-6 for students who have completed at least 48 semester hours of
73-7 college; and
73-8 (9) recommend additional rules as are necessary for
73-9 the administration and enforcement of this subchapter.
73-10 (b) Notwithstanding Subsection (a) of this section, the
73-11 acupuncture board has no independent rulemaking authority.
73-12 Sec. 6.06. LICENSE REQUIRED. A person may not practice
73-13 acupuncture in this state unless the person holds a license to
73-14 practice acupuncture issued by the medical board under this
73-15 subchapter.
73-16 Sec. 6.07. QUALIFICATIONS OF ACUPUNCTURISTS. (a) An
73-17 applicant for a license to practice acupuncture who is not
73-18 otherwise licensed under this subchapter must pass an examination
73-19 approved by the acupuncture board.
73-20 (b) To be eligible for the examination, an applicant must:
73-21 (1) be at least 21 years of age;
73-22 (2) have completed at least 48 semester hours of
73-23 college courses, including basic science courses as determined by
73-24 the advisory board; and
73-25 (3) be a graduate of an acceptable acupuncture school
73-26 whose entrance requirements and course of instruction meet
73-27 standards set by the acupuncture board.
74-1 (c) A reputable acupuncture school must:
74-2 (1) maintain a resident course of instruction
74-3 equivalent to not less than six terms of four months each for a
74-4 total of not less than 1,800 instructional hours;
74-5 (2) provide supervised patient treatment for at least
74-6 two terms of the resident course of instruction;
74-7 (3) maintain a course of instruction in
74-8 anatomy-histology, bacteriology, physiology, symptomatology,
74-9 pathology, meridian and point locations, hygiene, and public
74-10 health; and
74-11 (4) have the necessary teaching force and facilities
74-12 for proper instruction in required subjects.
74-13 (d) In establishing standards for the entrance requirements
74-14 and course of instruction of an acupuncture school, the acupuncture
74-15 board may consider the standards set by the National Accreditation
74-16 Commission for Schools and Colleges of Acupuncture and Oriental
74-17 Medicine.
74-18 (e) The examination shall be conducted on practical and
74-19 theoretical acupuncture and other subjects required by the
74-20 acupuncture board.
74-21 (f) An application for examination must be:
74-22 (1) in writing on a form prescribed by the acupuncture
74-23 board;
74-24 (2) verified by affidavit;
74-25 (3) filed with the executive director of the medical
74-26 board; and
74-27 (4) accompanied by a fee set by the medical board.
75-1 (g) The medical board shall notify all applicants of the
75-2 time and place of the examination.
75-3 (h) The examination may be in writing, by a practical
75-4 demonstration of the applicant's skill, or both, as the acupuncture
75-5 board may require.
75-6 Sec. 6.08. ASSISTANCE BY MEDICAL BOARD. The medical board
75-7 shall provide administrative and clerical employees as necessary to
75-8 enable the acupuncture board to carry out this subchapter.
75-9 Sec. 6.09. FEES. (a) The medical board shall set and
75-10 collect fees in amounts that are reasonable and necessary to cover
75-11 the costs of administering and enforcing this subchapter without
75-12 the use of any other funds generated by the medical board.
75-13 (b) Fees collected by the medical board under this
75-14 subchapter shall be deposited by the medical board in the state
75-15 treasury to the credit of a special account in the general revenue
75-16 fund. The special account may be used only to cover the costs of
75-17 administering and enforcing this subchapter. The special account
75-18 is exempt from Section 403.094(h), Government Code, and its
75-19 subsequent amendments.
75-20 Sec. 6.10. ISSUANCE OF LICENSE. (a) After consulting the
75-21 acupuncture board, the medical board shall issue a license to
75-22 practice acupuncture in this state to a person who meets the
75-23 requirements of this subchapter and the rules adopted under this
75-24 subchapter.
75-25 (b) The medical board shall by rule provide for the annual
75-26 renewal of a license to practice acupuncture.
75-27 Sec. 6.11. DENIAL OF LICENSE; DISCIPLINE OF LICENSE HOLDER.
76-1 (a) A license to practice acupuncture may be denied or, after
76-2 notice and hearing, suspended, probated, or revoked if the
76-3 applicant for a license or the holder of a license:
76-4 (1) uses drugs or intoxicating liquors to an extent
76-5 that affects the person's professional competence;
76-6 (2) obtains or attempts to obtain a license by fraud
76-7 or deception;
76-8 (3) is adjudged mentally incompetent by a court of
76-9 competent jurisdiction;
76-10 (4) practices acupuncture in a manner detrimental to
76-11 the public health and welfare;
76-12 (5) violates this subchapter or a rule adopted under
76-13 this subchapter;
76-14 (6) is convicted of a felony or a crime involving
76-15 moral turpitude; or
76-16 (7) holds himself out as a physician or surgeon or any
76-17 combination or derivative of those terms unless the person is also
76-18 licensed by the medical board as a physician or surgeon.
76-19 (b) Except as provided by Subsection (c) of this section, a
76-20 license to practice acupuncture shall be denied or, after notice
76-21 and hearing, revoked if the holder of a license has performed
76-22 acupuncture on a person who was not evaluated by a physician or
76-23 dentist, as appropriate, for the condition being treated within six
76-24 months before the date acupuncture was performed.
76-25 (c) The holder of a license may perform acupuncture on a
76-26 person who was referred by a doctor licensed to practice
76-27 chiropractic by the Texas Board of Chiropractic Examiners if the
77-1 licensee commences the treatment within 30 days of the date of the
77-2 referral. The licensee shall refer the person to a physician after
77-3 performing acupuncture 20 times or for 30 days, whichever occurs
77-4 first, if no substantial improvement occurs in the person's
77-5 condition for which the referral was made.
77-6 (d) The holder of a license must obtain reasonable
77-7 documentation that the evaluation required by Subsection (b) of
77-8 this section has taken place. If the licensee is unable to
77-9 determine that an evaluation has taken place, the licensee must
77-10 obtain a written statement signed by the person on a form
77-11 prescribed by the acupuncture board that states that the person has
77-12 been evaluated by a physician within the prescribed time frame.
77-13 The form shall contain a clear statement that the person should be
77-14 evaluated by a physician for the condition being treated by the
77-15 licensee.
77-16 (e) The medical board with advice from the acupuncture board
77-17 by rule may modify the requirement of the time frame or the scope
77-18 of the evaluation under Subsection (b) of this section.
77-19 (f) The medical board with advice from the acupuncture board
77-20 by rule may modify the requirement of the time frame for
77-21 commencement of treatment after referral by a chiropractor or the
77-22 number of treatments or days before referral to a physician is
77-23 required under Subsection (c) of this section.
77-24 (g) Notwithstanding Subsections (b) and (c) of this section,
77-25 an acupuncturist holding a current and valid license may without a
77-26 referral from a physician, dentist, or chiropractor perform
77-27 acupuncture on a person for smoking addiction, weight loss, or, as
78-1 established by the medical board with advice from the acupuncture
78-2 board by rule, substance abuse.
78-3 Sec. 6.12. OFFENSE. (a) A person commits an offense if the
78-4 person violates Section 6.06 of this Act.
78-5 (b) An offense under Subsection (a) of this section is a
78-6 Class A misdemeanor.
78-7 (c) Each day of a violation constitutes a separate offense.
78-8 Sec. 6.13. INJUNCTIVE RELIEF; CIVIL PENALTY. (a) The
78-9 medical board, the attorney general, or a district or county
78-10 attorney may bring a civil action to compel compliance with this
78-11 subchapter or to enforce a rule adopted under this subchapter.
78-12 (b) In addition to injunctive relief or any other remedy
78-13 provided by law, a person who violates this subchapter or a rule
78-14 adopted under this subchapter is liable to the state for a civil
78-15 penalty in an amount not to exceed $2,000 for each violation. Each
78-16 day a violation continues or occurs is a separate violation for
78-17 purposes of imposing a civil penalty. The attorney general, at the
78-18 request of the medical board or on the attorney general's own
78-19 initiative, may bring a civil action to collect a civil penalty
78-20 under this subsection. A civil penalty recovered shall be
78-21 deposited to the credit of the general revenue fund.
78-22 Sec. 6.14. AUTOMATIC LICENSURE. (a) With the approval of
78-23 the medical board, the acupuncture board shall establish
78-24 appropriate and reasonable requirements to determine those persons
78-25 practicing acupuncture on the effective date of this subchapter who
78-26 are eligible for immediate approval for a license to practice
78-27 acupuncture under this section.
79-1 (b) This section only applies to a person who meets the
79-2 requirements for immediate licensure under this section and who
79-3 applies for immediate approval on or before June 1, 1994.
79-4 (c) This section expires June 2, 1994.
79-5 SECTION 38. Subsection (a), Section 19, Texas Medical
79-6 Physics Practice Act (Article 4512n, Vernon's Texas Civil
79-7 Statutes), is amended to read as follows:
79-8 (a) The board may issue a license to practice medical
79-9 physics in this state, without an examination, to a person who,
79-10 before September 1, 1994, is a resident of this state and:
79-11 (1) has an earned bachelor's, master's, or doctoral
79-12 degree from an accredited college or university that signifies the
79-13 completion of courses approved by the board in physics, medical
79-14 physics, biophysics, radiological physics, medical health physics,
79-15 or nuclear engineering and demonstrated to the board's satisfaction
79-16 the completion of at least two years of full-time work experience
79-17 in the five years preceding January 1, 1993, <the effective date of
79-18 this Act> in the medical physics specialty for which application is
79-19 made; or
79-20 (2) has completed a training course approved by the
79-21 board in physics, medical physics, biophysics, radiological
79-22 physics, or medical health physics and demonstrated to the board's
79-23 satisfaction the completion of at least 10 years of full-time work
79-24 experience in the 12 years preceding January 1, 1993, <the
79-25 effective date of this Act> in the medical physics specialty for
79-26 which application is made.
79-27 SECTION 39. (a) The changes in law made by this Act in the
80-1 qualifications of, and the prohibitions applying to, members of the
80-2 Texas State Board of Medical Examiners do not affect the
80-3 entitlement of a member serving on the board immediately before the
80-4 effective date of this Act to continue to carry out the functions
80-5 of the board for the remainder of the member's term. The changes
80-6 in law apply only to a member appointed on or after the effective
80-7 date of this Act. This Act does not prohibit a person who is a
80-8 member of the board on the effective date of this Act from being
80-9 reappointed to the board if the person has the qualifications
80-10 required for a member under the Medical Practice Act (Article
80-11 4495b, Vernon's Texas Civil Statutes), as amended by this Act. As
80-12 the terms of members of the board expire or as vacancies occur on
80-13 the board, the governor shall appoint members to the board to
80-14 achieve, as soon as possible, the membership plan prescribed for
80-15 the board by this Act.
80-16 (b) The changes in law made by this Act relating to an
80-17 administrative penalty or civil penalty apply only to a violation
80-18 of the Medical Practice Act (Article 4495b, Vernon's Texas Civil
80-19 Statutes) or a rule or order adopted by the Texas State Board of
80-20 Medical Examiners that occurs on or after the effective date of
80-21 this Act. A violation occurs on or after the effective date of
80-22 this Act only if each element of the violation occurs on or after
80-23 that date. A violation that occurs before the effective date of
80-24 this Act is governed by the law in effect on the date the violation
80-25 occurred, and the former law is continued in effect for that
80-26 purpose.
80-27 (c) A person is not required to obtain a license to practice
81-1 acupuncture under Subchapter F, Medical Practice Act (Article
81-2 4495b, Vernon's Texas Civil Statutes), as added by this Act, until
81-3 June 1, 1994.
81-4 (d) The Texas State Board of Medical Examiners shall adopt
81-5 rules under Subchapter F, Medical Practice Act (Article 4495b,
81-6 Vernon's Texas Civil Statutes), as added by this Act, not later
81-7 than February 1, 1994.
81-8 (e) Not later than January 1, 1994, the governor shall make
81-9 initial appointments to the Texas State Board of Acupuncture
81-10 Examiners and shall designate three members for terms expiring
81-11 January 31, 1995, three members for terms expiring January 31,
81-12 1997, and three members for terms expiring January 31, 1999.
81-13 (f) Notwithstanding other provisions of this Act, Sections
81-14 6.06 and 6.12 of the Medical Practice Act (Article 4495b, Vernon's
81-15 Texas Civil Statutes), as added by this Act, take effect June 1,
81-16 1994.
81-17 SECTION 40. This Act takes effect September 1, 1993.
81-18 SECTION 41. The importance of this legislation and the
81-19 crowded condition of the calendars in both houses create an
81-20 emergency and an imperative public necessity that the
81-21 constitutional rule requiring bills to be read on three several
81-22 days in each house be suspended, and this rule is hereby suspended.