S.B. No. 1062
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; creating an
1-4 offense and providing penalties.
1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-6 SECTION 1. Subsection (a), Section 1.03, Medical Practice
1-7 Act (Article 4495b, Vernon's Texas Civil Statutes), is amended by
1-8 amending Subdivisions (5) and (6) and adding Subdivisions (15) and
1-9 (16) to read as follows:
1-10 (5) "Health-care entity" means:
1-11 (A) a hospital that is licensed pursuant to
1-12 Chapter 241, Health and Safety Code or the Texas Mental Health Code
1-13 (Articles 5547-88 through 5547-100, Vernon's Texas Civil Statutes);
1-14 (B) an entity, including a health maintenance
1-15 organization, group medical practice, nursing home, health science
1-16 center, university medical school, or other health-care facility,
1-17 that provides medical or health-care services and that follows a
1-18 formal peer review process for the purposes of furthering quality
1-19 medical or health care; <and>
1-20 (C) a professional society or association, or
1-21 committee thereof, of physicians that follows a formal peer review
1-22 process for the purpose of furthering quality medical or health
1-23 care; and
1-24 (D) an organization established by a
2-1 professional society or association of physicians or of hospitals,
2-2 or both, that collects and verifies the authenticity of documents
2-3 and other data concerning the qualifications, competence, or
2-4 performance of licensed health care professionals and that acts as
2-5 a health care facility's agent pursuant to the Health Care Quality
2-6 Improvement Act of 1986, Title IV, Pub. L. 99-660 (42 U.S.C.
2-7 Section 11101 et seq.).
2-8 (6) "Medical peer review committee" or "professional
2-9 review body" means a committee of a health-care entity, the
2-10 governing board of a health-care entity, or the medical staff of a
2-11 health-care entity, provided the committee or medical staff
2-12 operates pursuant to written bylaws that have been approved by the
2-13 policy-making body or the governing board of the health-care entity
2-14 and authorized to evaluate the quality of medical and health-care
2-15 services or the competence of physicians, including those functions
2-16 specified by Section 85.204, Health and Safety Code, and its
2-17 subsequent amendments. Such a committee includes the employees and
2-18 agents of the committee, including assistants, investigators,
2-19 intervenors, attorneys, and any other persons or organizations that
2-20 serve the committee in any capacity.
2-21 (15) "Surgery" includes surgical services, surgical
2-22 procedures, surgical operations, and the procedures described in
2-23 the surgery section of the Common Procedure Coding System as
2-24 adopted by the Health Care Financing Administration of the United
2-25 States Department of Health and Human Services.
2-26 (16) "Operation" means the application of surgery or
2-27 the performance of surgical services.
3-1 SECTION 2. Sections 2.02 and 2.03, Medical Practice Act
3-2 (Article 4495b, Vernon's Texas Civil Statutes), are amended to read
3-3 as follows:
3-4 Sec. 2.02. MEMBERS, TERMS. The board is composed of 18 <15>
3-5 members whose terms of office are six years or until a successor is
3-6 appointed and qualified. Terms of office shall be staggered so
3-7 that six <five> terms expire biennially.
3-8 Sec. 2.03. Appointment to Board. Members of the board shall
3-9 be appointed by the governor and confirmed by the senate. Any
3-10 vacancy on the board shall be filled by appointment of the
3-11 governor. Any appointment made shall be without regard to race,
3-12 color, disability <creed>, sex, religion, age, or national origin,
3-13 except that a person younger than 18 years of age is not eligible
3-14 for appointment.
3-15 SECTION 3. Section 2.04, Medical Practice Act (Article
3-16 4495b, Vernon's Texas Civil Statutes), is amended to read as
3-17 follows:
3-18 Sec. 2.04. Removal from Office. (a) It is a ground for
3-19 removal from the board if a member:
3-20 (1) does not have at the time of appointment the
3-21 qualifications required by Sections 2.05(a), (b), (c), (d), and (e)
3-22 of this Act;
3-23 (2) does not maintain during service on the board the
3-24 qualifications required by Sections 2.05(a), (b), (c), (d), and (e)
3-25 of this Act;
3-26 (3) violates a prohibition established by Section
3-27 2.05(f), (g), (h), (j), or (k) of this Act;
4-1 (4) cannot discharge the member's duties for a
4-2 substantial part of the term for which the member is appointed
4-3 because of illness or disability; or
4-4 (5) is absent from more than half of the regularly
4-5 scheduled board meetings that the member is eligible to attend
4-6 during a calendar year<, during a member's service on the board,
4-7 the member fails to meet the qualifications set forth in this Act
4-8 for members of the board. The validity of an action of the board
4-9 is not affected by the fact that it was taken when a ground for
4-10 removal of a member of the board existed>.
4-11 (b) The validity of an action of the board is not affected
4-12 by the fact that it is taken when a ground for removal of a board
4-13 member exists <Each member of the board shall be present for at
4-14 least one-half of the regularly scheduled board meetings held each
4-15 year. Failure of a board member to meet this requirement is
4-16 grounds for removal of the member from the board and the removal
4-17 creates a vacancy on the board>.
4-18 (c) If the executive director has knowledge that a potential
4-19 ground for removal exists, the executive director shall notify the
4-20 president of the board of the ground. The president shall then
4-21 notify the governor that a potential ground for removal exists.
4-22 SECTION 4. Section 2.05, Medical Practice Act (Article
4-23 4495b, Vernon's Texas Civil Statutes), is amended by amending
4-24 Subsections (b), (c), (d), (g), (h), and (i) and adding Subsections
4-25 (j), (k), and (l) to read as follows:
4-26 (b) Nine members of the board must:
4-27 (1) be learned and eminent physicians licensed to
5-1 practice medicine within this state for at least three years prior
5-2 to appointment and be graduates of a reputable medical school or
5-3 college with a degree of doctor of medicine (M.D.); <and>
5-4 (2) have been actively engaged in the practice of
5-5 medicine for at least five years immediately preceding their
5-6 appointment; and
5-7 (3) have been actively engaged in organized peer
5-8 review at a health care entity for at least three years immediately
5-9 preceding their appointment.
5-10 (c) Three members of the board must:
5-11 (1) be learned and eminent physicians licensed to
5-12 practice medicine within this state for at least three years prior
5-13 to appointment and be graduates of a reputable medical school or
5-14 college with a degree of doctor of osteopathic medicine (D.O.);
5-15 <and>
5-16 (2) have been actively engaged in the practice of
5-17 medicine for at least five years immediately preceding their
5-18 appointment; and
5-19 (3) have been actively engaged in organized peer
5-20 review at a health care entity for at least three years immediately
5-21 preceding their appointment.
5-22 (d) Six <Three> members of the board must be public
5-23 representatives who are not licensed to practice medicine, who are
5-24 not financially involved in any organization subject to the
5-25 regulation of the board, and who are not providers of health care.
5-26 "Provider of health care" means:
5-27 (1) an individual who is a direct provider of health
6-1 care (including but not limited to a dentist, registered nurse,
6-2 licensed vocational nurse, chiropractor, podiatrist, physician
6-3 assistant, psychologist, athletic trainer, physical therapist,
6-4 social psychotherapist, pharmacist, optometrist, hospital
6-5 administrator, or nursing home administrator) in that the
6-6 individual's primary current activity is the provision of health
6-7 care to individuals or the administration of facilities or
6-8 institutions (including but not limited to hospitals, long-term
6-9 care facilities, out-patient facilities, and health maintenance
6-10 organizations) in which such care is provided and, when required by
6-11 law or otherwise, the individual has received professional or other
6-12 training in the provision of such care or in such administration
6-13 and is licensed or certified or holds himself out for such
6-14 provision or administration;
6-15 (2) one who is an indirect provider of health care in
6-16 that the individual holds a fiduciary position with or has a
6-17 fiduciary interest in an entity described below in this
6-18 subdivision; for purposes of this subdivision, a fiduciary position
6-19 or interest as applied to any entity means a position or interest
6-20 with respect to such entity affected with the character of a trust,
6-21 including members of boards of directors and officers, majority
6-22 shareholders, or agents, and receivers (either directly or through
6-23 their spouses) of more than one-tenth of their annual income from
6-24 any one or combination of fees or other compensation for research
6-25 into or instruction in the provision of health-care entities (or
6-26 associations or organizations composed of such entities) engaged
6-27 (or comprised of individuals who are engaged) in the provision of
7-1 health care or in the provision of health care and entities (or
7-2 associations or organizations composed of such entities engaged in
7-3 producing drugs or other such articles);
7-4 (3) one who is a member of the immediate family of an
7-5 individual described in this subsection; for purposes of this
7-6 subsection "immediate family" as applied to any individual includes
7-7 only his parents, spouse, children, brothers, and sisters who
7-8 reside in the same household;
7-9 (4) one who is engaged in or employed by an entity
7-10 issuing any policy or contract of individual or group health
7-11 insurance or hospital or medical service benefits; or
7-12 (5) one who is employed by, on the board of directors
7-13 of, or holds elective office by or under the authority of any unit
7-14 of federal, state, or local government or any organization that
7-15 receives a significant part of its funding from any such unit of
7-16 federal, state, or local government.
7-17 (g) An officer, employee, or paid consultant of a Texas
7-18 trade or professional association in the field of health care may
7-19 not be a member or employee of the board who is exempt from the
7-20 state's position classification plan or is compensated at or above
7-21 the amount prescribed by the General Appropriations Act for step 1,
7-22 salary group 17, of the position classification salary schedule.
7-23 (h) A person who is the spouse of an officer, manager, or
7-24 paid consultant of a Texas trade or professional association in the
7-25 field of health care may not be a board member and may not be a
7-26 board employee who is exempt from the state's position
7-27 classification plan or is compensated at or above the amount
8-1 prescribed by the General Appropriations Act for step 1, salary
8-2 group 17, of the position classification salary schedule.
8-3 (i) For the purposes of this section, a "Texas trade or
8-4 professional association" is a nonprofit, cooperative, and
8-5 voluntarily joined association of business or professional
8-6 competitors in this state designed to assist its members and its
8-7 industry or profession in dealing with mutual business or
8-8 professional problems and in promoting their common interest.
8-9 (j) A person may not serve as a member of the board if the
8-10 person is required to register as a lobbyist under Chapter 305,
8-11 Government Code, and its subsequent amendments, because of the
8-12 person's activities for compensation on behalf of a profession
8-13 related to the operation of the board <A person required to
8-14 register as a lobbyist under Chapter 305, Government Code, by
8-15 virtue of his activities on behalf of a trade or professional
8-16 association in the regulated profession may not act as a member of
8-17 the board>.
8-18 (k) <(h)> A person is ineligible for appointment to the
8-19 board if, at the time of appointment, the person is a stockholder,
8-20 paid full-time faculty member, or a member of the board of trustees
8-21 of a medical school.
8-22 (l) <(i)> All board members must take the official oath.
8-23 SECTION 5. Subsection (a), Section 2.07, Medical Practice
8-24 Act (Article 4495b, Vernon's Texas Civil Statutes), is amended to
8-25 read as follows:
8-26 (a) Not later than December after each regular session of
8-27 the legislature <At the first meeting of the board after each
9-1 biennial appointment>, the governor shall appoint from the members
9-2 of the board a president and the board shall elect from its members
9-3 a <president,> vice-president, secretary-treasurer, and other
9-4 officers as are required, in the opinion of the board, to carry out
9-5 its duties.
9-6 SECTION 6. Subchapter B, Medical Practice Act (Article
9-7 4495b, Vernon's Texas Civil Statutes), is amended by adding Section
9-8 2.081 to read as follows:
9-9 Sec. 2.081. TRAINING AND GUIDELINES FOR MEMBERS OF THE
9-10 BOARD. (a) The board shall establish a training program for the
9-11 members of the board.
9-12 (b) Before a member of the board may assume the member's
9-13 duties and before the member may be confirmed by the senate, the
9-14 member must complete at least one course of the training program
9-15 established under this section.
9-16 (c) A training program established under this section shall
9-17 provide information to a participant regarding:
9-18 (1) the enabling legislation that created the board to
9-19 which the member is appointed;
9-20 (2) the programs operated by the agency;
9-21 (3) the role and functions of the agency;
9-22 (4) the rules of the agency with an emphasis on the
9-23 rules that relate to disciplinary and investigatory authority;
9-24 (5) the current budget for the agency;
9-25 (6) the results of the most recent formal audit of the
9-26 agency;
9-27 (7) the requirements of the:
10-1 (A) open meetings law, Chapter 271, Acts of the
10-2 60th Legislature, Regular Session, 1967 (Article 6252-17, Vernon's
10-3 Texas Civil Statutes), and its subsequent amendments;
10-4 (B) open records law, Chapter 424, Acts of the
10-5 63rd Legislature, Regular Session, 1973 (Article 6252-17a, Vernon's
10-6 Texas Civil Statutes), and its subsequent amendments; and
10-7 (C) Administrative Procedure and Texas Register
10-8 Act (Article 6252-13a, Vernon's Texas Civil Statutes) and its
10-9 subsequent amendments;
10-10 (8) the requirements of the conflict of interest laws
10-11 and other laws relating to public officials; and
10-12 (9) any applicable ethics policies adopted by that
10-13 state agency or the Texas Ethics Commission.
10-14 (d) In developing the training requirements provided for in
10-15 this section, the board shall consult with the governor's office,
10-16 the attorney general's office, and the Texas Ethics Commission.
10-17 (e) In the event that another state agency or entity is
10-18 given the authority to establish the training requirements, the
10-19 board shall allow that training in lieu of developing its own
10-20 program.
10-21 SECTION 7. Section 2.09, Medical Practice Act (Article
10-22 4495b, Vernon's Texas Civil Statutes), is amended by amending
10-23 Subsections (b), (c), (g), (k), (s), and (u) and adding Subsections
10-24 (b-1), (x), (y), (z), and (aa) to read as follows:
10-25 (b) The board shall develop and implement policies that
10-26 clearly define the respective responsibilities of the board and the
10-27 staff of the board. The board shall appoint an executive director
11-1 who shall be its chief executive and administrative officer, who
11-2 shall be charged with the primary responsibility of administering,
11-3 enforcing, and carrying out the provisions of the Medical Practice
11-4 Act under the control and supervision and at the direction of the
11-5 board. The executive director shall hold such position at the
11-6 pleasure of board and may be discharged at any time. The board may
11-7 act under its rules through the executive director, an executive
11-8 committee, or other committee, unless otherwise specified in this
11-9 Act. The executive committee shall be the president,
11-10 vice-president, and secretary-treasurer except where otherwise
11-11 provided in this Act<. Any duty of the secretary-treasurer in this
11-12 Act may be performed by the executive director within the
11-13 discretion of the board. Any reference to secretary-treasurer
11-14 shall have the same meaning as executive director when so
11-15 designated by the board>.
11-16 (b-1) The executive director may employ a chief operating
11-17 officer who shall be primarily responsible for administering,
11-18 implementing, and monitoring systems and necessary measures to
11-19 promote quality and efficiency of ongoing board operations and
11-20 other duties as may be assigned by the executive director. If the
11-21 board appoints an executive director who is not a physician
11-22 licensed to practice in this state, the executive director shall
11-23 appoint a medical director who is a physician licensed to practice
11-24 in this state and who shall be primarily responsible for
11-25 implementing and maintaining policies, systems, and measures
11-26 regarding clinical and professional issues and determinations. The
11-27 chief operating officer or medical director shall act under the
12-1 control and supervision and at the direction of the executive
12-2 director.
12-3 (c) The board may make rules and establish fees as are
12-4 reasonable relating to the granting and extension of expiration
12-5 dates of temporary licenses and the placing of licensees on
12-6 inactive status. The board shall by rule set time limits on the
12-7 periods for which licensees may hold temporary licenses or maintain
12-8 inactive status.
12-9 (g) A person may not serve as a member of the board or act
12-10 as the general counsel to the board if the person is required to
12-11 register as a lobbyist under Chapter 305, Government Code, and its
12-12 subsequent amendments, because of the person's activities for
12-13 compensation on behalf of a profession related to the operation of
12-14 the board <who is required personally to register as a lobbyist
12-15 under Chapter 305, Government Code, representing physicians,
12-16 health-care entities, or health-care related professions, may not
12-17 be employed by the board in any capacity>.
12-18 (k) The board <shall establish> by rule shall establish
12-19 reasonable and necessary fees so that the fees, in the aggregate,
12-20 produce sufficient revenue to cover the cost of administering this
12-21 Act. The fees set by the board may be adjusted so that the total
12-22 fees collected shall be sufficient to meet the expenses of
12-23 administering this Act. The board may not set a fee for an amount
12-24 less than the amount of that fee on September 1, 1993 <a reasonable
12-25 charge for those fees not specifically determined but authorized by
12-26 this Act>. The board may not waive collection of any fee or
12-27 penalty. The board shall place all fees received under authority
13-1 of this Act, not otherwise specified, into the medical licensing
13-2 fund. The board is authorized and shall by annual budget determine
13-3 the manner of handling the funds and the purpose, consistent with
13-4 this Act, for which the same may be used. The budgeted expenses
13-5 authorized by the board shall not be a charge upon the general
13-6 revenue of the state nor paid from the general revenue.
13-7 (s)(1) The board shall prepare information of public
13-8 <consumer> interest describing the functions of the board and the
13-9 board's procedures by which complaints are filed with and resolved
13-10 by the board. The board shall make the information available to
13-11 the public and appropriate state agencies.
13-12 (2) The board by rule shall establish methods by which
13-13 the public and licensees of the board are notified of the name,
13-14 mailing address, and telephone number of the board for the purpose
13-15 of directing complaints to the board. The board may provide for
13-16 that notification:
13-17 (A) on each registration form, application, or
13-18 written contract for services of an individual or entity regulated
13-19 under this Act;
13-20 (B) on a sign prominently displayed in the place
13-21 of business of each individual or entity regulated under this Act;
13-22 or
13-23 (C) in a bill for services provided by an
13-24 individual or entity regulated under this Act.
13-25 (3) The board shall list along with its regular
13-26 telephone number the toll-free telephone number that may be called
13-27 to present a complaint about a health professional if the toll-free
14-1 number is established under other state law <regulatory functions
14-2 of the board and describing the board's procedures by which
14-3 consumer complaints are filed with and resolved by the board>. On
14-4 written request the board shall make information available to the
14-5 general public for a reasonable fee to cover expenses and
14-6 appropriate state agencies including a summary of any previous
14-7 disciplinary orders by the board against a specific physician
14-8 licensed in this state, the date of the order, and the current
14-9 status of the order. The board shall establish an eight-hour
14-10 toll-free telephone number to make the information immediately
14-11 available to any caller if the board is not required to establish a
14-12 toll-free telephone number under other state law.
14-13 (u) The executive director or the executive director's
14-14 designee shall develop an intra-agency career ladder program. The
14-15 program shall require intra-agency posting of all non-entry-level
14-16 positions concurrently with any public posting <board shall cause
14-17 to be developed an intraagency career ladder program, one part of
14-18 which shall be the intraagency posting of each job opening with the
14-19 board in a nonentry-level position. The intraagency posting shall
14-20 be made at least 10 days before any public posting>.
14-21 (x) Each board member shall comply with the board member
14-22 training requirements established by any other state agency that is
14-23 given authority to establish the requirements for the board.
14-24 (y) The board shall provide to its members and employees, as
14-25 often as necessary, information regarding their qualifications for
14-26 office or employment under this Act and their responsibilities
14-27 under applicable laws relating to standards of conduct for state
15-1 officers or employees.
15-2 (z) The board shall develop and implement policies that
15-3 provide the public with a reasonable opportunity to appear before
15-4 the board and to speak on any issue under the jurisdiction of the
15-5 board.
15-6 (aa) The board shall prepare and maintain a written plan
15-7 that describes how a person who does not speak English can be
15-8 provided reasonable access to the board's programs. The board
15-9 shall also comply with federal and state laws for program and
15-10 facility accessibility.
15-11 SECTION 8. Subchapter B, Medical Practice Act (Article
15-12 4495b, Vernon's Texas Civil Statutes), is amended by adding Section
15-13 2.10 to read as follows:
15-14 Sec. 2.10. EQUAL EMPLOYMENT OPPORTUNITY. (a) The executive
15-15 director or the executive director's designee shall prepare and
15-16 maintain a written policy statement to assure implementation of a
15-17 program of equal employment opportunity under which all personnel
15-18 decisions are made without regard to race, color, disability, sex,
15-19 religion, age, or national origin. The policy statement must
15-20 include:
15-21 (1) personnel policies, including policies relating to
15-22 recruitment, evaluation, selection, appointment, training, and
15-23 promotion of personnel, that are in compliance with requirements of
15-24 the Commission on Human Rights Act (Article 5221k, Vernon's Texas
15-25 Civil Statutes) and its subsequent amendments;
15-26 (2) a comprehensive analysis of the board's work force
15-27 that meets federal and state guidelines;
16-1 (3) procedures by which a determination can be made of
16-2 significant underuse in the board's work force of all persons for
16-3 whom federal or state guidelines encourage a more equitable
16-4 balance; and
16-5 (4) reasonable methods to appropriately address those
16-6 areas of significant underuse.
16-7 (b) A policy statement prepared under Subsection (a) of this
16-8 section must cover an annual period, be updated annually and
16-9 reviewed by the Commission on Human Rights for compliance with
16-10 requirements of the Commission on Human Rights Act (Article 5221k,
16-11 Vernon's Texas Civil Statutes) and its subsequent amendments, and
16-12 be filed with the governor's office.
16-13 (c) The governor's office shall deliver a biennial report to
16-14 the legislature based on the information received under Subsection
16-15 (b) of this section. The report may be made separately or as a
16-16 part of other biennial reports made to the legislature.
16-17 SECTION 9. Subsections (a), (c), (f), (h), and (i), Section
16-18 3.01, Medical Practice Act (Article 4495b, Vernon's Texas Civil
16-19 Statutes), are amended to read as follows:
16-20 (a) All persons now lawfully qualified to practice medicine
16-21 in this state, or who are hereafter licensed for the practice of
16-22 medicine by the board, shall be registered as practitioners with
16-23 the board on or before the first day of January and thereafter
16-24 shall register in like manner annually, on or before the first day
16-25 of January of each succeeding year. Each person so registered with
16-26 the board shall pay, in connection with each annual registration
16-27 and for the receipt hereinafter provided for, a fee established by
17-1 the board which fee shall accompany the application of each person
17-2 for registration. The payment shall be made to the board. Every
17-3 person so registered shall file with the board a written
17-4 application for annual registration, setting forth his name and
17-5 mailing address, the place or places where the applicant is engaged
17-6 in the practice of medicine, and other necessary information
17-7 prescribed by the board. If the person is licensed for the
17-8 practice of medicine by another state, the District of Columbia, a
17-9 territory of the United States, Canada, any other country, or the
17-10 uniformed services of the United States, the application must
17-11 include a description of any investigations the person knows are in
17-12 progress and of any sanctions imposed by or disciplinary matters
17-13 pending in the state, district, territory, country, or service.
17-14 (c)(1) A person may renew an unexpired license by paying to
17-15 the board on or before the expiration date of the license the
17-16 required renewal fee.
17-17 (2) If a person's license has been expired for 90 days
17-18 or less, the person may renew the license by paying to the board
17-19 the required renewal fee and a fee that is one-half of the
17-20 examination fee for the license.
17-21 (3) If a person's license has been expired for longer
17-22 than 90 days but less than one year, the person may renew the
17-23 license by paying to the board all unpaid renewal fees and a fee
17-24 that is equal to the examination fee for the license.
17-25 (4) If a person's license has been expired for one
17-26 year, it is considered to have been canceled, and the person may
17-27 not renew the license. The person may obtain a new license by
18-1 submitting to reexamination and complying with the requirements and
18-2 procedures for obtaining an original license.
18-3 (5) The board may renew without examination an expired
18-4 license of a person who was licensed in this state, moved to
18-5 another state, and is currently licensed and has been in practice
18-6 in the other state for not more than two years preceding
18-7 application. The person must pay to the board a fee that is equal
18-8 to the examination fee for the license. <Failure of any licensee
18-9 to pay the annual license renewal fee on or before the 90th day
18-10 after the date it is due automatically cancels his licensure. Any
18-11 licensee whose license has been canceled because of failure to pay
18-12 the annual license renewal fee may secure reinstatement of his
18-13 license at any time within that license year upon payment of the
18-14 delinquent fee together with a penalty in an amount as the board
18-15 may determine to be reasonable. After expiration of the license
18-16 year for which the license fee was not paid, no license shall be
18-17 reinstated except upon application and satisfaction of other
18-18 conditions as the board may establish and payment of delinquent
18-19 fees and a penalty to be assessed by the board.>
18-20 (f) <In performing its duties as provided in this Act, the
18-21 board may act through the secretary-treasurer of the board. The
18-22 secretary-treasurer is entitled to a salary to be fixed by the
18-23 legislature in its General Appropriations Act for the performance
18-24 of duties under this Act.> The executive director
18-25 <secretary-treasurer> of the board shall file a surety bond with
18-26 the board. The bond shall be in an amount not less than $10,000,
18-27 be in compliance with the insurance laws of the state, and be
19-1 payable to the state for the use of the state if the executive
19-2 director <secretary-treasurer> does not faithfully discharge the
19-3 duties of the office. The board shall pay the premium on the bond.
19-4 <The salary shall be paid out of said medical registration fund and
19-5 shall not be in any way a charge upon the general revenue of the
19-6 state.>
19-7 (h) The <secretary-treasurer or the> executive director
19-8 shall review each application for licensure by examination or
19-9 reciprocity and shall recommend to the board all applicants
19-10 eligible for licensure. The <secretary-treasurer or the> executive
19-11 director also shall report to the board the names of all applicants
19-12 determined to be ineligible for licensure, together with the
19-13 reasons for each recommendation. An applicant deemed ineligible
19-14 for licensure by the <secretary-treasurer or the> executive
19-15 director may request review of such recommendation by a committee
19-16 of the board within 20 days of receipt of such notice, and the
19-17 <secretary-treasurer or the> executive director may refer any
19-18 application to said committee for a recommendation concerning
19-19 eligibility. If the committee finds the applicant ineligible for
19-20 licensure, such recommendation, together with the reasons therefor,
19-21 shall be submitted to the board unless the applicant requests a <an
19-22 appellate> hearing <before a hearing examiner appointed by the
19-23 board> within 20 days of receipt of notice of the committee's
19-24 determination. The hearing shall be before an administrative law
19-25 judge of the State Office of Administrative Hearings and shall
19-26 comply with the Administrative Procedure Act and its subsequent
19-27 amendments and the rules of the State Office of Administrative
20-1 Hearings and the board. The committee may refer any application
20-2 for determination of eligibility to the full board. The board
20-3 shall, after receiving the administrative law judge's proposed
20-4 findings of fact and conclusions of law, determine the eligibility
20-5 of the applicant for licensure <an appellate hearing on its own
20-6 motion. The board may elect to hear any appeal in lieu of
20-7 proceedings before a hearing examiner, and it shall adopt, modify,
20-8 or reject each decision made by a hearing examiner. The board also
20-9 shall adopt, modify, or reject each recommendation of ineligibility
20-10 made by the secretary-treasurer or the executive director or by the
20-11 committee, unless the applicant has requested a timely review of
20-12 the recommendation. Such action by the board shall constitute a
20-13 final administrative decision concerning licensure. Any hearing
20-14 before the board or before a hearing examiner under this subsection
20-15 becomes a contested case under the Administrative Procedure Act>.
20-16 A physician whose application for licensure is denied by the board
20-17 shall receive a written statement<, upon request,> containing the
20-18 reasons for the board's action. All reports received or gathered
20-19 by the board on each applicant are confidential and are not subject
20-20 to disclosure under the Open Records Law. The board may disclose
20-21 such reports to appropriate licensing authorities in other states
20-22 <upon request>.
20-23 (i) At least 30 days before the expiration of a person's
20-24 license, the board shall send written notice of the impending
20-25 license expiration to the person at the licensee's last known
20-26 address according to the records of the board <The board must
20-27 notify each delinquent licensee of his impending license
21-1 cancellation by registered or certified mail sent to the licensee's
21-2 address listed with the board not less than 30 days prior to the
21-3 cancellation. This requirement shall be waived when the licensee
21-4 has requested in writing that his or her license be canceled>.
21-5 SECTION 10. Subchapter C, Medical Practice Act (Article
21-6 4495b, Vernon's Texas Civil Statutes), is amended by adding Section
21-7 3.025 to read as follows:
21-8 Sec. 3.025. CONTINUING MEDICAL EDUCATION. (a) The board by
21-9 rule shall adopt, monitor, and enforce a reporting program for
21-10 continuing medical education of licensees. The board shall adopt
21-11 and administer rules:
21-12 (1) requiring the number of hours of continuing
21-13 medical education the board determines appropriate as a
21-14 prerequisite to the annual registration of a licensee under this
21-15 Act;
21-16 (2) requiring at least one-half of the hours of
21-17 continuing medical education required under Subdivision (1) of this
21-18 subsection to be approved by the board after taking into account
21-19 the standards of the American Medical Association for its
21-20 Physician's Recognition Award, the Council on Medical Specialty
21-21 Societies, or the American Osteopathic Association and permitting
21-22 the remaining hours to be composed of self-study or equivalent
21-23 self-directed continuing medical education according to guidelines
21-24 determined by the board; and
21-25 (3) adopting a process to assess a licensee's
21-26 participation in continuing medical education courses.
21-27 (b) A licensee shall be presumed to have complied with this
22-1 section if in the preceding 36 months the licensee becomes board
22-2 certified or recertified in a medical specialty and the medical
22-3 specialty program takes into consideration the standards of the
22-4 American Board of Medical Specialties, the American Medical
22-5 Association, the Advisory Board for Osteopathic Specialists and
22-6 Boards of Certification, or the American Osteopathic Association.
22-7 (c) The board may temporarily exempt a licensee from the
22-8 requirement for continuing medical education for:
22-9 (1) catastrophic illness;
22-10 (2) military service of longer than one year's
22-11 duration outside the state;
22-12 (3) medical practice and residence of longer than one
22-13 year's duration outside the United States; or
22-14 (4) good cause shown on written application of the
22-15 licensee that gives satisfactory evidence to the board that the
22-16 licensee is unable to comply with the requirement for continuing
22-17 medical education.
22-18 (d) A temporary exemption under Subsection (c) of this
22-19 section may not exceed one year but may be renewed annually.
22-20 (e) Subsection (a) of this section does not apply to a
22-21 licensee who is retired and has been exempted by rule from paying
22-22 the annual registration fee.
22-23 (f) This section does not prevent the board from taking
22-24 disciplinary action with respect to a licensee or an applicant for
22-25 a license by requiring additional hours of continuing medical
22-26 education or of specific course subjects.
22-27 SECTION 11. Section 3.03, Medical Practice Act (Article
23-1 4495b, Vernon's Texas Civil Statutes), is amended by amending
23-2 Subsections (a) through (f) and adding Subsection (h) to read as
23-3 follows:
23-4 (a) The board, at its sole discretion and upon payment by an
23-5 applicant of a fee prescribed by the board under this Act, may
23-6 grant a license to practice medicine to any <reputable> physician
23-7 who is a graduate of an acceptable <a reputable> medical college as
23-8 determined by the board and who<:>
23-9 <(1)> is a licensee of another state or Canadian
23-10 province having requirements for physician registration and
23-11 practice substantially equivalent to those established by the laws
23-12 of this state<; or>
23-13 <(2) is qualified by an examination for a certificate
23-14 to practice medicine under a commission in the uniformed services
23-15 of the United States>.
23-16 (b) An application for a license under this section must be
23-17 in writing and upon a form prescribed by the board. The
23-18 application must be accompanied by:
23-19 (1) a diploma or photograph of a diploma awarded to
23-20 the applicant by an acceptable <a reputable> medical college and a
23-21 certified transcript showing courses and grades <or a certificate,
23-22 license, or commission issued to the applicant by the Medical Corps
23-23 of the uniformed services of the United States>;
23-24 (2) a license or a certified copy of a license to
23-25 practice medicine lawfully issued to the applicant<, on
23-26 examination,> by some other state or a Canadian province that
23-27 requires in its examination the same general degree of fitness
24-1 required by this state and that grants the same reciprocal
24-2 privileges to persons licensed by the board; <or>
24-3 (3) a certification made by <an executive officer of
24-4 the uniformed services of the United States,> the president or
24-5 secretary of the board that issued the license<,> or a duly
24-6 constituted registration office of the state or Canadian province
24-7 that issued the certificate or license, reciting that the
24-8 accompanying certificate or license has not been canceled,
24-9 suspended, or revoked <except by honorable discharge from the
24-10 Medical Corps of the uniformed services of the United States> and
24-11 reciting that the statement of the qualifications made in the
24-12 application for medical license in Texas is true and correct; and
24-13 (4) evidence of a passing grade on an examination
24-14 required by the board.
24-15 (c) Applicants for a license under this section must
24-16 subscribe to an oath in writing before an officer authorized by law
24-17 to administer oaths. The written oath must be a part of the
24-18 application. The application must:
24-19 (1) state that:
24-20 (A) <(1)> the license, certificate, or authority
24-21 under which the applicant has most recently practiced medicine in
24-22 the state or Canadian province from which the applicant is
24-23 transferring to this state <removed> or in the uniformed service in
24-24 which the applicant served is <was at the time of the removal or
24-25 completion of service> in full force and not restricted, canceled,
24-26 suspended, or revoked;
24-27 (B) <(2)> the applicant is the identical person
25-1 to whom the certificate or<,> license<, or commission> and the
25-2 diploma were issued;
25-3 (C) <(3)> no proceeding has been instituted
25-4 against the applicant for the restriction, cancellation,
25-5 suspension, or revocation of the certificate, license, or authority
25-6 to practice medicine in the state, Canadian province, or uniformed
25-7 service of the United States in which it was issued; and
25-8 (D) <(4)> no prosecution is pending against the
25-9 applicant in any state, federal, or Canadian court for any offense
25-10 that under the laws of this state is a felony;
25-11 (2) include a description of any sanctions imposed by
25-12 or disciplinary matters pending in the state or Canadian province
25-13 in which the applicant was or is licensed or certified to practice
25-14 medicine; and
25-15 (3) include evidence of postgraduate training required
25-16 by the board.
25-17 (d) An applicant for a license under this section must <A
25-18 "reputable physician" means one who would> be eligible for
25-19 examination by the board. <A "reputable medical school or college"
25-20 means a medical school or college that was approved by the board at
25-21 the time the applicant's degree was conferred.>
25-22 (e) In addition to other licensure requirements, the board
25-23 may require by rule and regulation that an applicant who is a
25-24 licensee of another state or Canadian province and who is a
25-25 graduate <graduates> of a medical school <schools> located outside
25-26 of the United States and Canada, or the school itself <schools
25-27 themselves>, provide additional information to the board concerning
26-1 the medical school attended prior to approval of the applicant.
26-2 (f) The board may refuse to issue a license to an applicant
26-3 who is a licensee of another state or Canadian province and who
26-4 graduated from a medical school outside of the United States and
26-5 Canada if it finds that the applicant does not possess the
26-6 requisite qualifications to provide the same standard of medical
26-7 care as provided by a licensed physician in this state.
26-8 (h) The board may not refuse to issue a license to an
26-9 applicant under Subsection (f) of this section if the applicant:
26-10 (1) for the preceding five years has been a licensee
26-11 of another state or a Canadian province;
26-12 (2) is not the subject of a sanction imposed by or
26-13 disciplinary matter pending in any state or Canadian province in
26-14 which the applicant is licensed to practice medicine; and
26-15 (3) is either specialty board certified by a board
26-16 that is a member of the American Board of Medical Specialties or a
26-17 specialty board approved by the American Osteopathic Association or
26-18 successfully passes an examination that the board shall determine
26-19 by rule.
26-20 SECTION 12. Subchapter C, Medical Practice Act (Article
26-21 4495b, Vernon's Texas Civil Statutes), is amended by adding Section
26-22 3.0305 to read as follows:
26-23 Sec. 3.0305. TEMPORARY LICENSE FOR OUT-OF-STATE
26-24 PRACTITIONERS. (a) On application, the board shall grant a
26-25 temporary license to practice medicine. An applicant for a
26-26 temporary license under this section must:
26-27 (1) have a current, active, and unrestricted license,
27-1 without any pending disciplinary matters, as a physician in another
27-2 state, the District of Columbia, or a territory of the United
27-3 States that has licensing requirements that are substantially
27-4 equivalent to the requirements of this Act;
27-5 (2) have passed a national or other examination
27-6 recognized by the board relating to the practice of medicine; and
27-7 (3) be sponsored by a person licensed by the board
27-8 under this Act with whom the temporary license holder may practice
27-9 under this section.
27-10 (b) An applicant for a temporary license may be excused from
27-11 the requirement of Subsection (a)(3) of this section if the board
27-12 determines that compliance with that subsection constitutes a
27-13 hardship to the applicant.
27-14 (c) A temporary license is valid until the date the board
27-15 approves or denies the temporary license holder's application for a
27-16 license. The board shall issue a license under this Act to the
27-17 holder of a temporary license under this section if:
27-18 (1) the temporary license holder passes the
27-19 examination required by Section 3.05 of this Act;
27-20 (2) the board verifies that the temporary license
27-21 holder has satisfied the academic and experience requirements for a
27-22 license under this Act; and
27-23 (3) the temporary license holder has satisfied any
27-24 other license requirements under this Act.
27-25 (d) The board must assemble the documents and information
27-26 necessary to process a temporary license holder's application for a
27-27 license not later than the 90th day after the date the temporary
28-1 license is issued and complete the processing of the application
28-2 not later than the 90th day after the date the documents and
28-3 information are assembled. If by the 180th day after the date the
28-4 temporary license is issued the board has not completed the
28-5 processing of the application, the board shall review the
28-6 application to determine the cause of the delay.
28-7 SECTION 13. Section 3.04, Medical Practice Act (Article
28-8 4495b, Vernon's Texas Civil Statutes), is amended to read as
28-9 follows:
28-10 Sec. 3.04. Qualification of Licensee. (a) An applicant, to
28-11 be eligible for the examination and issuance of a license, must
28-12 present satisfactory proof to the board that the applicant:
28-13 (1) is at least 21 years of age;
28-14 (2) is of good professional character;
28-15 (3) has completed 60 semester hours of college courses
28-16 other than in medical school, which courses would be acceptable, at
28-17 the time of completion, to The University of Texas for credit on a
28-18 bachelor of arts degree or a bachelor of science degree; and
28-19 (4) is a graduate of an acceptable <a> medical school
28-20 or college that was approved by the board at the time the degree
28-21 was conferred<;> and has completed a one-year program of graduate
28-22 medical training approved by the board.
28-23 (b) The <(5) has successfully completed a one year program
28-24 of graduate medical training approved by the board. In addition to
28-25 other licensure requirements, the board may require by rule and
28-26 regulation that graduates of medical schools located outside the
28-27 United States and Canada comply with other requirements that the
29-1 board considers appropriate, including but not limited to
29-2 additional graduate medical training in the United States, except
29-3 those who qualify for licensure in Section 5.04 of this Act.
29-4 However, the> applicant shall be eligible for examination prior to
29-5 complying with the graduate training requirement of Subsection
29-6 (a)(4) <Subdivision (5) of Subsection (a)> of this section but
29-7 shall not be eligible for the issuance of an unrestricted license
29-8 until the requirements of Subsection (a) of this section <this
29-9 subsection> have been satisfied.
29-10 (c) <(b)> Applications for examination must be made in
29-11 writing, verified by affidavit, filed with the board on forms
29-12 prescribed by the board, and accompanied by documents and a fee as
29-13 the board determines to be reasonable.
29-14 (d) To be recognized by the board for the purposes of this
29-15 subchapter, all allopathic or osteopathic medical education
29-16 instruction taught in the United States must be accredited by an
29-17 accrediting body officially recognized by the United States
29-18 Department of Education and the Council on Postsecondary
29-19 Accreditation as the accrediting body for medical education leading
29-20 to the doctor of medicine degree or the doctor of osteopathy degree
29-21 in the United States.
29-22 (e) The requirements for eligibility for licensure of a
29-23 graduate of an unapproved foreign medical school are set out in
29-24 Section 5.035 of this Act, and the requirements for eligibility for
29-25 licensure of a person who has completed all of the didactic work of
29-26 a foreign medical school but has not graduated from the school
29-27 (Fifth Pathway Program) are set out in Section 5.04 of this Act.
30-1 SECTION 14. Subsections (a), (c), and (e), Section 3.05,
30-2 Medical Practice Act (Article 4495b, Vernon's Texas Civil
30-3 Statutes), are amended to read as follows:
30-4 (a) All examinations for license to practice medicine shall
30-5 be conducted in writing in the English language and in a manner as
30-6 to be entirely fair and impartial to all individuals and to every
30-7 school or system of medicine. <All applicants shall be known to
30-8 the examiners only by numbers, without names or other method of
30-9 identification on examination papers by which members of the board
30-10 may be able to identify the applicants or examinees, until after
30-11 the general averages of the examinees' numbers in the class have
30-12 been determined and license granted or refused.> Examinations
30-13 shall be conducted on and cover those subjects generally taught by
30-14 medical schools, a knowledge of which is commonly and generally
30-15 required of candidates for the degree of doctor of medicine or
30-16 doctor of osteopathy conferred by schools or colleges of medicine
30-17 approved by the board, and the examinations shall also be conducted
30-18 on and cover the subject of medical jurisprudence. Examinations
30-19 shall be prepared by a national testing service or prepared by the
30-20 board and validated by qualified independent testing professionals.
30-21 On satisfactory examination conducted as required by this Act under
30-22 rules of the board, applicants may <shall> be granted licenses to
30-23 practice medicine. All questions and answers, with the grades
30-24 attached, shall be preserved for one year in the executive office
30-25 of the board or such other repository as the board by rule may
30-26 direct. All applicants examined at the same time shall be given
30-27 identical questions. All certificates shall be attested by the
31-1 seal of the board. The board in its discretion may give the
31-2 examination for license in two or more parts.
31-3 (c) All applicants for license to practice medicine in this
31-4 state not otherwise licensed under the provisions of law must
31-5 successfully pass a uniform <an> examination approved by the board
31-6 as determined by rule. The board is authorized to adopt and
31-7 enforce all rules of procedure not inconsistent with statutory
31-8 requirements. All applicants shall be given due notice of the date
31-9 and place of the examination<; provided that the partial
31-10 examinations provided for in this Act shall not be disturbed by
31-11 this section>. If any applicant, because of failure to pass the
31-12 required examination, is refused a license, the applicant, at a
31-13 time as the board may fix, shall be permitted to take a subsequent
31-14 examination not more than two additional times <upon any subjects
31-15 required in the original examination> as the board may prescribe on
31-16 the payment of a fee as the board may determine to be reasonable.
31-17 In the event satisfactory grades shall be made on the subjects
31-18 prescribed and taken on the reexamination, the board may grant the
31-19 applicant a license to practice medicine. The board shall
31-20 determine the credit to be given examinees on answers turned in on
31-21 the subjects of complete and partial examination, and its decision
31-22 is final.
31-23 (e) Within 90 <30> days after the day on which an
31-24 examination is administered under this Act, the board shall notify
31-25 each examinee of the results of the examination. However, if an
31-26 examination is graded or reviewed by a national testing service,
31-27 the board shall notify each examinee of the results of the
32-1 examination not later than the 30th day <within four weeks> after
32-2 the date the board receives the results from the testing service.
32-3 If the notice of the examination results will be delayed for longer
32-4 than 90 days after the examination, the board shall notify the
32-5 examinee of the reason for the delay before the 90th day.
32-6 SECTION 15. Subdivision (5), Subsection (d), Section 3.06,
32-7 Medical Practice Act (Article 4495b, Vernon's Texas Civil
32-8 Statutes), is amended by adding Paragraph (G) to read as follows:
32-9 (G) An advertisement for a site serving a
32-10 medically underserved population shall include the name and
32-11 business address of the supervising physician for the site.
32-12 SECTION 16. Section 3.06, Medical Practice Act (Article
32-13 4495b, Vernon's Texas Civil Statutes), is amended by adding
32-14 Subsections (g) and (h) to read as follows:
32-15 (g) This Act does not prohibit a nonprofit clinic that is
32-16 operated by a nonprofit hospital or organization and that primarily
32-17 serves a financially indigent population from:
32-18 (1) contracting with a physician to provide services
32-19 at the clinic;
32-20 (2) paying a physician a minimum guarantee to assure
32-21 the physician's availability;
32-22 (3) billing to and collecting from patients as the
32-23 physician's agent the physician's professional fees; or
32-24 (4) retaining any professional fees collected under
32-25 Subdivision (3) of this subsection up to the amount of the minimum
32-26 guarantee fee and a reasonable collection fee.
32-27 (h) In Subsection (g) of this section, "financially indigent
33-1 population" means persons meeting Medicaid eligibility requirements
33-2 or uninsured persons who are accepted for care with no obligation
33-3 to pay or with a discounted obligation to pay for services rendered
33-4 based on the clinic's eligibility system.
33-5 SECTION 17. Section 3.08, Medical Practice Act (Article
33-6 4495b, Vernon's Texas Civil Statutes), is amended to read as
33-7 follows:
33-8 Sec. 3.08. Grounds for Refusal to Admit Persons to
33-9 Examination and to Issue License and Renewal License And For
33-10 Disciplinary Action. The board may refuse to admit persons to its
33-11 examinations and to issue a license to practice medicine to any
33-12 person and may take disciplinary action against any person for any
33-13 of the following reasons:
33-14 (1) submission of a false or misleading statement,
33-15 document, or certificate to the board in an application for
33-16 examination or licensure; the presentation to the board of any
33-17 license, certificate, or diploma that was illegally or fraudulently
33-18 obtained; the practice of fraud or deception in taking or passing
33-19 an examination;
33-20 (2) conviction of a crime of the grade of a felony or
33-21 a crime of a lesser degree that involves moral turpitude;
33-22 (3) intemperate use of alcohol or drugs that, in the
33-23 opinion of the board, could endanger the lives of patients;
33-24 (4) unprofessional or dishonorable conduct that is
33-25 likely to deceive or defraud the public or injure the public.
33-26 Unprofessional or dishonorable conduct likely to deceive or defraud
33-27 the public includes but is not limited to the following acts:
34-1 (A) committing any act that is in violation of
34-2 the laws of the State of Texas if the act is connected with the
34-3 physician's practice of medicine. A complaint, indictment, or
34-4 conviction of a law violation is not necessary for the enforcement
34-5 of this provision. Proof of the commission of the act while in the
34-6 practice of medicine or under the guise of the practice of medicine
34-7 is sufficient for action by the board under this section;
34-8 (B) failing to keep complete and accurate
34-9 records of purchases and disposals of drugs listed in Chapter 481,
34-10 Health and Safety Code, or of controlled substances scheduled in
34-11 the Federal Comprehensive Drug Abuse Prevention and Control Act of
34-12 1970, 21 U.S.C.A. Section 801 et seq. (Public Law 91-513). A
34-13 physician shall keep records of his purchases and disposals of
34-14 these drugs to include without limitation the date of purchase, the
34-15 sale or disposal of the drugs by the physician, the name and
34-16 address of the person receiving the drugs, and the reason for the
34-17 disposing or dispensing of the drugs to the person. A failure to
34-18 keep the records for a reasonable time is grounds for revoking,
34-19 canceling, suspending, or probating the license of any practitioner
34-20 of medicine. The board or its representative may enter and inspect
34-21 a physician's place(s) of practice during reasonable business hours
34-22 for the purpose of verifying the correctness of these records and
34-23 of taking inventory of the prescription drugs on hand;
34-24 (C) writing prescriptions for or dispensing to a
34-25 person known to be an abuser <a habitual user> of narcotic drugs,
34-26 controlled substances, or dangerous drugs or to a person who the
34-27 physician should have known was an abuser <a habitual user> of the
35-1 narcotic drugs, controlled substances, or dangerous drugs. This
35-2 provision does not apply to those persons:
35-3 (i) being treated by the physician for
35-4 their narcotic use after the physician notifies the board in
35-5 writing of the name and address of the person being so treated; or
35-6 (ii) who the physician is treating for
35-7 intractable pain under the Intractable Pain Treatment Act (Article
35-8 4495c, Revised Statutes) and its subsequent amendments;
35-9 (D) writing false or fictitious prescriptions
35-10 for dangerous drugs as defined by Chapter 483, Health and Safety
35-11 Code, of controlled substances scheduled in the Texas Controlled
35-12 Substances Act (Chapter 481, Health and Safety Code) <(Article
35-13 4476-15, Vernon's Texas Civil Statutes)>, or of controlled
35-14 substances scheduled in the Federal Comprehensive Drug Abuse
35-15 Prevention and Control Act of 1970, 21 U.S.C.A. Section 801 et
35-16 seq. (Public Law 91-513);
35-17 (E) prescribing or administering a drug or
35-18 treatment that is nontherapeutic in nature or nontherapeutic in the
35-19 manner the drug or treatment is administered or prescribed;
35-20 (F) prescribing, administering, or dispensing in
35-21 a manner not consistent with public health and welfare dangerous
35-22 drugs as defined by Chapter 483, Health and Safety Code, controlled
35-23 substances scheduled in the Texas Controlled Substances Act
35-24 (Chapter 481, Health and Safety Code) <(Article 4476-15, Vernon's
35-25 Texas Civil Statutes)>, or controlled substances scheduled in the
35-26 Federal Comprehensive Drug Abuse Prevention and Control Act of
35-27 1970, 21 U.S.C.A. Section 801 et seq. (Public Law 91-513);
36-1 (G) persistently or <and> flagrantly
36-2 overcharging or overtreating patients;
36-3 (H) failing to supervise adequately the
36-4 activities of those acting under the supervision of the physician;
36-5 or
36-6 (I) delegating professional medical
36-7 responsibility or acts to a person if the delegating physician
36-8 knows or has reason to know that the person is not qualified by
36-9 training, experience, or licensure to perform the responsibility or
36-10 acts;
36-11 (5) violation or attempted violation, direct or
36-12 indirect, of any valid rules issued under this Act, either as a
36-13 principal, accessory, or accomplice;
36-14 (6) use of any advertising statement that is false,
36-15 misleading, or deceptive;
36-16 (7) advertising professional superiority or the
36-17 performance of professional service in a superior manner if the
36-18 advertising is not readily subject to verification;
36-19 (8) purchase, sale, barter, or use or any offer to
36-20 purchase, sell, barter, or use any medical degree, license,
36-21 certificate, diploma, or transcript of license, certificate, or
36-22 diploma in or incident to an application to the board for a license
36-23 to practice medicine;
36-24 (9) altering, with fraudulent intent, any medical
36-25 license, certificate, diploma, or transcript of a medical license,
36-26 certificate, or diploma;
36-27 (10) using any medical license, certificate, diploma,
37-1 or transcript of a medical license, certificate, or diploma that
37-2 has been fraudulently purchased, issued, or counterfeited or that
37-3 has been materially altered;
37-4 (11) impersonating or acting as proxy for another in
37-5 any examination required by this Act for a medical license; or
37-6 engaging in conduct which subverts or attempts to subvert any
37-7 examination process required by this Act for a medical license.
37-8 Conduct which subverts or attempts to subvert the medical licensing
37-9 examination process includes, but is not limited to:
37-10 (A) conduct which violates the security of the
37-11 examination materials, as prescribed by board rules;
37-12 (B) conduct which violates the standard of test
37-13 administration, as prescribed by board rules; or
37-14 (C) conduct which violates the accreditation
37-15 process, as prescribed by board rules;
37-16 (12) impersonating a licensed practitioner or
37-17 permitting or allowing another to use his license or certificate to
37-18 practice medicine in this state for the purpose of diagnosing,
37-19 treating, or offering to treat sick, injured, or afflicted human
37-20 beings;
37-21 (13) employing, directly or indirectly, any person
37-22 whose license to practice medicine has been suspended, canceled, or
37-23 revoked or association in the practice of medicine with any person
37-24 or persons whose license to practice medicine has been suspended,
37-25 canceled, or revoked or any person who has been convicted of the
37-26 unlawful practice of medicine in Texas or elsewhere;
37-27 (14) performing or procuring a criminal abortion or
38-1 aiding or abetting in the procuring of a criminal abortion or
38-2 attempting to perform or procure a criminal abortion or attempting
38-3 to aid or abet the performance or procurement of a criminal
38-4 abortion;
38-5 (15) aiding or abetting, directly or indirectly, the
38-6 practice of medicine by any person, partnership, association, or
38-7 corporation not duly licensed to practice medicine by the board;
38-8 (16) inability to practice medicine with reasonable
38-9 skill and safety to patients by reason of illness, drunkenness,
38-10 excessive use of drugs, narcotics, chemicals, or any other type of
38-11 material or as a result of any mental or physical condition. In
38-12 enforcing this subdivision the board shall, upon probable cause,
38-13 request a physician to submit to a mental or physical examination
38-14 by physicians designated by the board. If the physician refuses to
38-15 submit to the examination, the board shall issue an order requiring
38-16 the physician to show cause why he should not be required to submit
38-17 to the examination and shall schedule a hearing on the order within
38-18 30 days after notice is served on the physician. The physician
38-19 shall be notified by either personal service or certified mail with
38-20 return receipt requested. At the hearing, the physician and his
38-21 attorney are entitled to present any testimony and other evidence
38-22 to show why the physician should not be required to submit to the
38-23 examination. After a complete hearing, the board shall issue an
38-24 order either requiring the physician to submit to the examination
38-25 or withdrawing the request for examination. An appeal from the
38-26 decision of the board shall be taken under the Administrative
38-27 Procedure Act;
39-1 (17) judgment by a court of competent jurisdiction
39-2 that a person licensed to practice medicine is of unsound mind;
39-3 (18) professional failure to practice medicine in an
39-4 acceptable manner consistent with public health and welfare;
39-5 (19) being removed, suspended, or having disciplinary
39-6 action taken by his peers in any professional medical association
39-7 or society, whether the association or society is local, regional,
39-8 state, or national in scope, or being disciplined by a licensed
39-9 hospital or medical staff of a hospital, including removal,
39-10 suspension, limitation of hospital privileges, or other
39-11 disciplinary action, if that action in the opinion of the board was
39-12 based on unprofessional conduct or professional incompetence that
39-13 was likely to harm the public, provided that the board finds that
39-14 the actions were appropriate and reasonably supported by evidence
39-15 submitted to it. The action does not constitute state action on
39-16 the part of the association, society, or hospital medical staff;
39-17 (20) repeated or recurring meritorious health-care
39-18 liability claims that in the opinion of the board evidence
39-19 professional incompetence likely to injure the public; or
39-20 (21) suspension, revocation, <or> restriction, or
39-21 other disciplinary action by another state of a license to practice
39-22 medicine, or disciplinary action by the uniformed services of the
39-23 United States, based upon acts by the licensee similar to acts
39-24 described in this section. A certified copy of the record of the
39-25 state taking the action is conclusive evidence of it.
39-26 SECTION 18. Subchapter C, Medical Practice Act (Article
39-27 4495b, Vernon's Texas Civil Statutes), is amended by adding Section
40-1 3.085 to read as follows:
40-2 Sec. 3.085. RESTRICTIONS ON BIDDING AND ADVERTISING.
40-3 (a) The board may not adopt rules restricting competitive bidding
40-4 or advertising by a person regulated by the board except to
40-5 prohibit false, misleading, or deceptive practices by the person.
40-6 (b) The board may not include in its rules to prohibit
40-7 false, misleading, or deceptive practices by a person regulated by
40-8 the board a rule that:
40-9 (1) restricts the use of any medium for advertising;
40-10 (2) restricts the person's personal appearance or use
40-11 of the person's voice in an advertisement;
40-12 (3) relates to the size or duration of an
40-13 advertisement by the person; or
40-14 (4) restricts the person's advertisement under a trade
40-15 name.
40-16 SECTION 19. Subsections (b), (c), (d), and (e), Section
40-17 3.10, Medical Practice Act (Article 4495b, Vernon's Texas Civil
40-18 Statutes), are amended to read as follows:
40-19 (b) <The board may not set, charge, collect, receive, or
40-20 deposit any of the following fees in excess of:>
40-21 <(1) for processing and granting a license by
40-22 reciprocity to a licensee of another state.....................$700>
40-23 <(2) for processing an application and
40-24 administration of a partial examination for
40-25 licensure......................................................$700>
40-26 <(3) for processing an application and
40-27 administration of a complete examination for
41-1 licensure......................................................$700>
41-2 <(4) for processing an application and
41-3 issuance of a temporary license................................$200>
41-4 <(5) for processing an application and
41-5 issuance of a duplicate license................................$200>
41-6 <(6) for processing an application and
41-7 issuance of a license of reinstatement after a lapse
41-8 or cancellation of a license...................................$700>
41-9 <(7) for processing an application and
41-10 issuance of an annual registration of a licensee...............$200>
41-11 <(8) for processing and issuance of an
41-12 institutional permit for interns, residents, and
41-13 others in approved medical training programs...................$200>
41-14 <(9) for processing an application and
41-15 issuance of an endorsement to other state medical
41-16 boards.........................................................$200>
41-17 <(10) for processing and issuance of a permit
41-18 to a physician who supervises a physician assistant............$200>
41-19 <(11) for processing and issuance of a permit
41-20 to a physician who supervises an acupuncturist...............$200.>
41-21 <(c)> The board may set and collect a sales charge for
41-22 making copies of any paper of record in the office of the board and
41-23 for any printed material published by the board. The charges shall
41-24 be in amounts considered sufficient to reimburse the board for the
41-25 actual expense.
41-26 (c) <(d)> The financial transactions of the board are
41-27 subject to audit by the state auditor in accordance with Chapter
42-1 321, Government Code.
42-2 (d) The board shall file annually with the governor and the
42-3 presiding officer of each house of the legislature a complete and
42-4 detailed written report accounting for all funds received and
42-5 disbursed by the board during the preceding fiscal year. The
42-6 annual report must be in the form and reported in the time provided
42-7 by the General Appropriations Act <(e) On or before the first day
42-8 of January each year, the board shall file with the governor and
42-9 the presiding officer of each house of the legislature a complete
42-10 and detailed written report accounting for all funds received and
42-11 disbursed by the board during the preceding year>.
42-12 SECTION 20. Section 3.11A, Medical Practice Act (Article
42-13 4495b, Vernon's Texas Civil Statutes), is amended to read as
42-14 follows:
42-15 Sec. 3.11A. Disposition of <Increase in> fees. (a) This
42-16 section applies to each <Each> of the following fees <imposed by or
42-17 under another section of this Act is increased by $200>:
42-18 (1) fee for processing and granting a license by
42-19 reciprocity to a licensee of another state;
42-20 (2) fee for processing an application and
42-21 administration of a partial examination for licensure;
42-22 (3) fee for processing an application and
42-23 administration of a complete examination for licensure;
42-24 (4) fee for processing an application and issuance of
42-25 a license of reinstatement after a lapse or cancellation of a
42-26 license; and
42-27 (5) fee for processing an application and issuance of
43-1 an annual registration of a licensee.
43-2 (b) Of each fee <increase> collected, $50 shall be deposited
43-3 to the credit of the foundation school fund and $150 shall be
43-4 deposited to the credit of the general revenue fund. This
43-5 subsection applies to the disposition of the stated portion of each
43-6 fee <increase> regardless of any other provision of law providing
43-7 for a different disposition of funds.
43-8 SECTION 21. Section 4.01, Medical Practice Act (Article
43-9 4495b, Vernon's Texas Civil Statutes), is amended to read as
43-10 follows:
43-11 Sec. 4.01. Grounds for Cancellation, Revocation, Suspension,
43-12 and Probation of License. (a) The board shall, except for good
43-13 cause shown, revoke or suspend a license, place on probation a
43-14 person whose license has been suspended, or reprimand a licensee
43-15 for a violation of this Act or a rule of the board <Except as
43-16 provided herein, the board may cancel, revoke, or suspend the
43-17 license of any practitioner of medicine or impose any other
43-18 authorized means of discipline upon proof of the violation of this
43-19 Act in any respect> or for any cause for which the board is
43-20 authorized to refuse to admit persons to its examination and to
43-21 issue a license and renewal license, including an initial
43-22 conviction or the initial finding of the trier of fact of guilt of
43-23 a felony or misdemeanor involving moral turpitude.
43-24 (b) On proof that a practitioner of medicine has been
43-25 initially convicted of a felony or the initial finding of the trier
43-26 of fact of guilt of a felony under Chapter 481, Health and Safety
43-27 Code, Section 485.033, Health and Safety Code, Chapter 483, Health
44-1 and Safety Code, or the Federal Comprehensive Drug Abuse Prevention
44-2 and Control Act of 1970, 21 U.S.C.A. Section 801 et seq. (Public
44-3 Law 91-513), the board shall suspend the practitioner's license.
44-4 On the practitioner's final conviction for such a felony offense,
44-5 the board shall revoke the practitioner's license.
44-6 (c) The board shall suspend the license of a practitioner
44-7 who is serving a prison term in a state or federal penitentiary
44-8 during his incarceration regardless of the offense.
44-9 SECTION 22. Section 4.04, Medical Practice Act (Article
44-10 4495b, Vernon's Texas Civil Statutes), is redesignated as Section
44-11 4.02 and amended to read as follows:
44-12 Sec. 4.02 <4.04>. COMPLAINT; INVESTIGATION. (a) Any
44-13 person, including a partnership, association, corporation, or other
44-14 entity, may file a complaint against a licensee with the board, or
44-15 the board may file a complaint on its own initiative. The board
44-16 shall adopt rules concerning the investigation of a complaint filed
44-17 with the board. The rules adopted under this subsection shall:
44-18 (1) distinguish between categories of complaints;
44-19 (2) ensure that complaints are not dismissed without
44-20 appropriate consideration;
44-21 (3) require that the board be advised of a complaint
44-22 that is dismissed and that a letter be sent to the person who filed
44-23 the complaint explaining the action taken on the dismissed
44-24 complaint;
44-25 (4) ensure that the person who filed the complaint has
44-26 an opportunity to explain the allegations made in the complaint;
44-27 and
45-1 (5) prescribe guidelines concerning the categories of
45-2 complaints that require the use of a private investigator and the
45-3 procedures for the board to obtain the services of a private
45-4 investigator.
45-5 (b) The board shall keep an information file about each
45-6 complaint filed with the board. The board's information file shall
45-7 be kept current and contain a record for each complaint of:
45-8 (1) potential witnesses contacted in relation to the
45-9 complaint;
45-10 (2) a summary of findings made at each step of the
45-11 complaint process;
45-12 (3) an explanation of the legal basis and reason for a
45-13 complaint that is dismissed; and
45-14 (4) other relevant information.
45-15 (c) If a written complaint is filed with the board that the
45-16 board has authority to resolve, the board, at least as frequently
45-17 as quarterly and until final disposition of the complaint, shall
45-18 notify the parties to the complaint of the status of the complaint
45-19 unless the notice would jeopardize an investigation.
45-20 (d) The board by rule shall adopt a form to standardize
45-21 information concerning complaints made to the board. The board by
45-22 rule shall prescribe information to be provided to a person when
45-23 the person files a complaint with the board.
45-24 (e) The board shall provide reasonable assistance to a
45-25 person who wishes to file a complaint with the board.
45-26 (f) Except as otherwise provided by this section, all
45-27 investigations shall be conducted by the board or persons
46-1 authorized by the board to conduct them. The board may commission
46-2 investigators as peace officers for the purpose of enforcing this
46-3 Act. However, investigators of the board so commissioned as peace
46-4 officers may not carry a firearm or exercise arrest powers. Each
46-5 complaint against a physician which requires a determination of
46-6 medical competency shall be reviewed by a board member, consultant,
46-7 or employee with medical background considered sufficient by the
46-8 board.
46-9 (g) <(b)> Unless it would jeopardize an investigation, the
46-10 board shall notify the physician that a complaint has been filed
46-11 and the nature of the complaint. The board shall make a
46-12 preliminary investigation of the complaint. The first
46-13 consideration of the board shall be whether the physician
46-14 constitutes a continuing threat to the public welfare.
46-15 (h) The board may, unless precluded by the law or this Act,
46-16 make a disposition of any complaint or matter relating to this Act,
46-17 or of any contested case by stipulation, agreed settlement, or
46-18 consent order. The board shall dispose of a complaint, contested
46-19 case, or other matter in writing, and if appropriate, the physician
46-20 shall sign the writing. An agreed disposition is a disciplinary
46-21 order for purposes of reporting under this Act and of
46-22 administrative hearings and proceedings by state and federal
46-23 regulatory agencies regarding the practice of medicine. An agreed
46-24 disposition is a public record.
46-25 (i) In civil litigation, an agreed disposition is a
46-26 settlement agreement under Rule 408, Texas Rules of Civil Evidence.
46-27 This subsection does not apply to a licensee who has previously
47-1 entered into an agreed disposition with the board of a different
47-2 disciplinary matter or whose license the board is seeking to
47-3 revoke.
47-4 (j) The board shall adopt such rules as are appropriate to
47-5 carry out this section <such disposition. Such disposition shall
47-6 be considered a disciplinary order>.
47-7 (k) The board shall dispose of all complaints in a timely
47-8 manner. The board shall establish a schedule for conducting each
47-9 phase of a complaint that is under the control of the board not
47-10 later than the 30th day after the date the complaint is received by
47-11 the board. The schedule shall be kept in the information file for
47-12 the complaint and all parties shall be notified of the projected
47-13 time requirements for pursuing the complaint. A change in the
47-14 schedule must be noted in the complaint information file, and all
47-15 parties to the complaint must be notified not later than the 14th
47-16 day after the date the change is made unless the notice would
47-17 jeopardize an investigation.
47-18 (l) The executive director of the board shall notify the
47-19 board of a complaint that extends beyond the time prescribed by the
47-20 board for resolving the complaint so that the board may take
47-21 necessary action on the complaint.
47-22 (m) Except in the case of a suspension under Section 4.13 of
47-23 this Act or in accordance with the terms of an agreement between
47-24 the board and a licensee, no revocation, suspension, involuntary
47-25 modification, or disciplinary action relating to a license is
47-26 effective unless, before board proceedings are instituted:
47-27 (1) the board has served notice, in a manner
48-1 consistent with the requirements for service under Subsection (g)
48-2 of this section, to the physician of the facts or conduct alleged
48-3 to warrant the intended action; and
48-4 (2) the physician was given an opportunity to show
48-5 compliance with all requirements of law for the retention of the
48-6 license either in writing or through personal appearance at an
48-7 informal meeting with one or more representatives of the board, at
48-8 the option of the licensee.
48-9 (n) If the licensee exercises the option to personally
48-10 appear at an informal meeting with one or more representatives of
48-11 the board and the informal meeting is held, the staff of the board
48-12 and the representatives of the board shall be subject to the ex
48-13 parte provisions of the Administrative Procedure Act with regard to
48-14 contacts with board members and administrative law judges
48-15 concerning the case.
48-16 SECTION 23. Subchapter D, Medical Practice Act (Article
48-17 4495b, Vernon's Texas Civil Statutes), is amended by adding Section
48-18 4.025 to read as follows:
48-19 Sec. 4.025. INFORMAL PROCEEDINGS. (a) The board by rule
48-20 shall adopt procedures governing:
48-21 (1) informal disposition of a contested case under
48-22 Section 13(e), Administrative Procedure Act, and its subsequent
48-23 amendments; and
48-24 (2) informal proceedings held in compliance with
48-25 Section 18(c), Administrative Procedure Act, and its subsequent
48-26 amendments.
48-27 (b) Rules adopted under this section must provide the
49-1 complainant and the licensee an opportunity to be heard and must
49-2 require the presence of the board's legal counsel or a
49-3 representative of the office of the attorney general to advise the
49-4 board or board's employees. The rules shall provide that the
49-5 staff of the board at the meeting shall present to the
49-6 representative of the board the facts the staff reasonably believes
49-7 it could prove by competent evidence or qualified witnesses at a
49-8 hearing. The physician is entitled to reply to the staff's
49-9 presentation and present the facts the physician reasonably
49-10 believes the physician could prove by competent evidence or
49-11 qualified witnesses at a hearing. After ample time is given for
49-12 the presentations, the representative of the board shall recommend
49-13 that the investigation be closed or attempt to mediate the disputed
49-14 matters and make a recommendation regarding the disposition of the
49-15 case in the absence of a hearing under the provisions of applicable
49-16 law concerning contested cases.
49-17 SECTION 24. Section 4.02, Medical Practice Act (Article
49-18 4495b, Vernon's Texas Civil Statutes), is redesignated as Section
49-19 4.03 and amended to read as follows:
49-20 Sec. 4.03 <4.02>. Initiation of Charges. (a) Proceedings,
49-21 unless otherwise specified, under this Act or other applicable law
49-22 and charges against a licensee may be instituted by a duly
49-23 authorized representative of the board <on its own initiative or by
49-24 any person>. Charges must be in writing and on sworn affidavit
49-25 filed with the records custodian or assistant records custodian of
49-26 the board detailing the nature of the charges as required by this
49-27 Act or other applicable law. The president or an authorized <his>
50-1 designee shall <set a time and place for a hearing and shall> cause
50-2 a copy of the charges<, together with a notice of the time and
50-3 place fixed for the hearing> to be served on the respondent or the
50-4 respondent's counsel of record.
50-5 (b) The president or designee shall notify the State Office
50-6 of Administrative Hearings of a formal complaint.
50-7 (c) A formal complaint shall be in writing and shall allege
50-8 with reasonable certainty the specific act or acts relied on by the
50-9 agency to constitute a violation of a specific statute or rule.
50-10 The formal complaint shall be specific enough to enable a person of
50-11 common understanding to know what is meant by the formal complaint
50-12 and shall contain a degree of certainty that will give the person
50-13 who is the subject of the formal complaint notice of the particular
50-14 act or acts alleged to be a violation of a specific statute or
50-15 rule.
50-16 (d) The board shall adopt reasonable rules to promote
50-17 discovery by all parties to contested cases.
50-18 (e) In this section, "formal complaint" means a written
50-19 statement made by a credible person under oath that is filed and
50-20 presented by a representative of the board charging a person with
50-21 having committed an act or acts that if proven could affect the
50-22 legal rights or privileges of a licensee or other person under the
50-23 jurisdiction of the board.
50-24 SECTION 25. Section 4.03, Medical Practice Act (Article
50-25 4495b, Vernon's Texas Civil Statutes), is redesignated as Section
50-26 4.04 and amended to read as follows:
50-27 Sec. 4.04 <4.03>. Notice. (a) Service of process notifying
51-1 the respondent of <the time and place of> a hearing about <and the
51-2 nature of> the charges against the person shall be made in
51-3 accordance with the requirements of the Administrative Procedure
51-4 Act and its subsequent amendments <person or by mail. Notice shall
51-5 be sufficient if made in person or if sent by registered or
51-6 certified mail to the person charged at the address shown in the
51-7 board files or on his most recent application for registration or
51-8 renewal, no later than 10 days before the hearing>.
51-9 (b) If service of notice as prescribed by Subsection (a) of
51-10 this section is impossible or cannot be effected, the board shall
51-11 cause to be published once a week for two successive weeks a notice
51-12 of the hearing in a newspaper published in the county of the last
51-13 known place of practice in Texas of the person, if known. If the
51-14 licensee is not currently practicing in Texas as evidenced by
51-15 information in the board files, or if the last county of practice
51-16 is unknown, publication shall be in a newspaper in Travis County.
51-17 When publication of notice is used, the date of hearing may not be
51-18 less than 10 days after the date of the last publication of notice.
51-19 SECTION 26. Section 4.05, Medical Practice Act (Article
51-20 4495b, Vernon's Texas Civil Statutes), is amended to read as
51-21 follows:
51-22 Sec. 4.05. Hearings, Rules. (a) The <president of the>
51-23 board by rule shall adopt procedures governing formal disposition
51-24 of a contested case under the Administrative Procedure Act and its
51-25 subsequent amendments. A formal hearing shall be conducted by an
51-26 administrative law judge employed by the State Office of
51-27 Administrative Hearings <designate one of the following alternative
52-1 procedures for the conduct of each individual contested case in a
52-2 disciplinary matter:>
52-3 <(1) a hearing before the board itself where a quorum
52-4 of the board shall be present for the hearing and decision at the
52-5 conclusion of the hearing;>
52-6 <(2) a hearing committee appointed by the president of
52-7 the board, provided that the hearing committee shall be composed of
52-8 not less than three members of the board and the composition of
52-9 such committee shall be consistent with the provisions of Sections
52-10 2.08 and 2.09 of this Act; or>
52-11 <(3) a hearing before a hearing examiner appointed by
52-12 the board to conduct a hearing and to prepare and submit to the
52-13 board for action a proposal for decision as provided in the
52-14 Administrative Procedure and Texas Register Act (Article 6252-13a,
52-15 Vernon's Texas Civil Statutes).>
52-16 <Any individual conducting a hearing under this subchapter is
52-17 empowered to administer oaths and to receive evidence at the
52-18 hearing and shall report the hearing as prescribed by board rules>.
52-19 Notwithstanding any other provision of this Act or other law, the
52-20 board may, in its sole discretion, employ, retain, and compensate
52-21 such attorneys, consultants, and other professionals as it deems
52-22 necessary and appropriate to serve as <hearing examiners,> board
52-23 consultants or<,> special counsel to prosecute on behalf of the
52-24 hearings division and investigating division such complaints as are
52-25 filed with the board, court reporters, and other staff deemed
52-26 necessary or appropriate by the board to prepare for or represent
52-27 the board in <conduct> the hearings authorized by this section.
53-1 <All hearings conducted under this subchapter by the board shall
53-2 comply with the provisions of the Administrative Procedure Act and
53-3 the board's rules.>
53-4 (b) <The licensee shall have the right to produce witnesses
53-5 or evidence on the person's behalf, to cross-examine witnesses, and
53-6 to have subpoenas issued by the board to be served at the
53-7 licensee's expense.>
53-8 <(c)> The board shall, after receiving the administrative
53-9 law judge's findings of fact and conclusions of law <the hearing>,
53-10 determine the charges upon their merits.
53-11 (c) <(d)> All complaints, adverse reports, investigation
53-12 files, other investigation reports, and other investigative
53-13 information in the possession of, received or gathered by the board
53-14 or its employees or agents relating to a licensee, an application
53-15 for license, or a criminal investigation or proceedings are
53-16 privileged and confidential and are not subject to discovery,
53-17 subpoena, or other means of legal compulsion for their release to
53-18 anyone other than the board or its employees or agents involved in
53-19 licensee discipline. Not later than 30 days after receiving a
53-20 written request from a licensee who is the subject of a formal
53-21 complaint initiated and filed under Section 4.03 of this Act or
53-22 from the licensee's counsel of record and subject to any other
53-23 privileges or restrictions set forth by rule, statute, or legal
53-24 precedent, and unless good cause is shown for delay, the board
53-25 shall provide the licensee with access to all information in its
53-26 possession that the board intends to offer into evidence in
53-27 presenting its case in chief at the contested hearing on the
54-1 complaint. However, the board is not required to provide board
54-2 investigative reports or investigative memoranda, the identity of
54-3 nontestifying complainants, attorney-client communications,
54-4 attorney-work product, or other materials covered by a privilege as
54-5 recognized by the Texas Rules of Civil Procedure or the Texas Rules
54-6 of Civil Evidence. The furnishing of information shall not
54-7 constitute a waiver of privilege or confidentiality under this
54-8 section, this Act, or other applicable law. Investigative
54-9 <However, investigative> information in the possession of the board
54-10 or its employees or agents which relates to licensee discipline may
54-11 be disclosed to the appropriate licensing authority in another
54-12 state, the District of Columbia, or a territory or country in which
54-13 the licensee is licensed or has applied for a license, or to a peer
54-14 review committee reviewing an application for privileges or the
54-15 qualifications of the licensee with respect to retaining
54-16 privileges. If the investigative information in the possession of
54-17 the board or its employees or agents indicates a crime may have
54-18 been committed, the information shall be reported to the proper law
54-19 enforcement agency. The board shall cooperate and assist all law
54-20 enforcement agencies conducting criminal investigations of
54-21 licensees by providing information which is relevant to the
54-22 criminal investigation to the investigating agency. Any
54-23 information disclosed by the board to an investigative agency shall
54-24 remain confidential and shall not be disclosed by the investigating
54-25 agency except as necessary to further the investigation. The board
54-26 shall provide information upon the written request of a health-care
54-27 entity about a complaint filed against a licensee that was resolved
55-1 after investigation by a disciplinary order of the board or by an
55-2 agreed settlement and the basis of and current status of any
55-3 complaint under active investigation. The board shall keep
55-4 information on file about each complaint filed with the board,
55-5 consistent with this Act. If a written complaint is filed with the
55-6 board relating to a person licensed by the board, the board, at
55-7 least as often as quarterly and until final determination of the
55-8 action to be taken relative to the complaint, shall notify the
55-9 parties to the complaint <complaining party> consistent with this
55-10 Act of the status of the complaint unless the notice would
55-11 jeopardize an active investigation.
55-12 (d) <(e)> The board in its discretion may accept the
55-13 voluntary surrender of a license. No license may be returned
55-14 unless the board determines, under rules established by it, that
55-15 the licensee is competent to resume practice.
55-16 SECTION 27. Section 4.10, Medical Practice Act (Article
55-17 4495b, Vernon's Texas Civil Statutes), is amended to read as
55-18 follows:
55-19 Sec. 4.10. Petition for Reinstatement. (a) Upon
55-20 application, the board may reissue a license to practice medicine
55-21 to a person whose license has been canceled, revoked, or suspended,
55-22 but the application, in the case of revocation, may not be made
55-23 prior to one year after the revocation was issued or became final
55-24 and if denied by the board may not be brought more frequently than
55-25 annually and must be made upon payment of the fees as established
55-26 by the board and in the manner and form and under the conditions as
55-27 the board may require. Further, the board may not reinstate or
56-1 reissue a license to a person whose license has been canceled,
56-2 revoked, or suspended because of a felony conviction under Chapter
56-3 481, Health and Safety Code, Section 485.033, Health and Safety
56-4 Code, Chapter 483, Health and Safety Code, or the Federal
56-5 Comprehensive Drug Abuse Prevention and Control Act of 1970, 21
56-6 U.S.C.A. Section 801 et seq. (Public Law 91-513), except on an
56-7 express determination based on substantial evidence contained in an
56-8 investigative report indicating that the reinstatement or reissue
56-9 of the license is in the best interests of the public and of the
56-10 person whose license has been canceled, revoked, or suspended.
56-11 (b) In addition to the requirements of Subsection (a) of
56-12 this section, to be eligible for reinstatement or reissuance of a
56-13 license, an applicant must prove that it is in the best interests
56-14 of the public and of the person whose license has been canceled,
56-15 revoked, or suspended to reinstate or reissue the license.
56-16 (c) A decision by the board to deny an application to
56-17 reinstate or reissue a license is subject to judicial review in the
56-18 manner provided by Section 4.09 of this Act.
56-19 SECTION 28. Section 4.11, Medical Practice Act (Article
56-20 4495b, Vernon's Texas Civil Statutes), is amended to read as
56-21 follows:
56-22 Sec. 4.11. Monitoring of License Holder; Probation.
56-23 (a) The board by rule shall develop a system for monitoring the
56-24 compliance with the requirements of this Act of license holders who
56-25 are the subject of disciplinary action. Rules adopted under this
56-26 section shall include procedures for monitoring a license holder
56-27 who is ordered by the board to perform certain acts to ascertain
57-1 that the license holder performs the required acts and to identify
57-2 and monitor license holders who are the subject of disciplinary
57-3 action and who present a continuing threat to the public welfare
57-4 through the practice of medicine.
57-5 (b) The board upon majority vote may provide that the order
57-6 canceling, revoking, or suspending a license or imposing any other
57-7 method of discipline be probated so long as the probationer
57-8 conforms to the orders, conditions, and rules that the board may
57-9 set out as the terms of probation. However, the board may not
57-10 grant probation to a person whose license has been canceled,
57-11 revoked, or suspended because of a felony conviction under Chapter
57-12 481, Health and Safety Code, Section 485.033, Health and Safety
57-13 Code, Chapter 483, Health and Safety Code, or the Federal
57-14 Comprehensive Drug Abuse Prevention and Control Act of 1970, 21
57-15 U.S.C.A. Section 801 et seq. (Public Law 91-513), except on an
57-16 express determination, based on substantial evidence, that the
57-17 grant of probation is in the best interests of the public and of
57-18 the person whose license has been suspended, revoked, or canceled.
57-19 The board, at the time of probation, shall set out the period of
57-20 time that constitutes the probationary period. The board may not
57-21 grant probation to a physician who poses, through the practice of
57-22 medicine, a continuing threat to the public welfare.
57-23 (c) <(b)> The board may at any time while a license holder
57-24 <the probationer> remains on probation, with adequate grounds being
57-25 shown, cause <hold> a hearing to be held and, upon proof of a
57-26 violation of the order <majority vote>, rescind the probation and
57-27 enforce the board's original action and may impose any disciplinary
58-1 action permitted under Section 4.12 of this Act in addition to or
58-2 in lieu of enforcing the original order. The board <and> shall
58-3 revoke or suspend a probationer's license <do so> if the board
58-4 determines that the probationer poses, through the practice of
58-5 medicine, a continuing threat to the public welfare.
58-6 (d) <(c)> The hearing to rescind the probation shall be
58-7 governed by the same provisions as are set forth in this subchapter
58-8 for other charges.
58-9 SECTION 29. Section 4.12, Medical Practice Act (Article
58-10 4495b, Vernon's Texas Civil Statutes), is amended to read as
58-11 follows:
58-12 Sec. 4.12. Methods of Discipline. (a) Except as otherwise
58-13 provided in Section 4.01, if the board finds any person to have
58-14 committed any of the acts set forth in Section 3.08 of this Act, it
58-15 shall enter an order imposing one or more of the following:
58-16 (1) deny the person's application for a license or
58-17 other authorization to practice medicine;
58-18 (2) administer a public reprimand;
58-19 (3) suspend, limit, or restrict the person's license
58-20 or other authorization to practice medicine, including limiting the
58-21 practice of the person to or by the exclusion of one or more
58-22 specified activities of medicine or stipulating periodic board
58-23 review;
58-24 (4) revoke the person's license or other authorization
58-25 to practice medicine;
58-26 (5) require the person to submit to care, counseling,
58-27 or treatment of physicians designated by the board as a condition
59-1 for the initial, continued, or renewal of a license or other
59-2 authorization to practice medicine;
59-3 (6) require the person to participate in a program of
59-4 education or counseling prescribed by the board;
59-5 (7) require the person to practice under the direction
59-6 of a physician designated by the board for a specified period of
59-7 time; <or>
59-8 (8) require the person to perform public service
59-9 considered appropriate by the board; or
59-10 (9) assess an administrative penalty against the
59-11 person as provided by Section 4.125 of this Act.
59-12 (b) Providing however, if the board determines that, through
59-13 the practice of medicine, the physician poses a continuing threat
59-14 to the public welfare, it shall revoke, suspend or deny the
59-15 license.
59-16 (c) In addition to the other disciplinary actions authorized
59-17 by this section, the board may issue a written reprimand to a
59-18 license holder who violates this Act or require that a license
59-19 holder who violates this Act participate in continuing education
59-20 programs. The board shall specify the continuing education
59-21 programs that may be attended and the number of hours that must be
59-22 completed by an individual license holder to fulfill the
59-23 requirements of this subsection.
59-24 (d) If a license suspension is probated, the board may
59-25 require the license holder to:
59-26 (1) report regularly to the board on matters that are
59-27 the basis of the probation;
60-1 (2) limit practice to the areas prescribed by the
60-2 board; or
60-3 (3) continue or review continuing professional
60-4 education until the license holder attains a degree of skill
60-5 satisfactory to the board in those areas that are the basis of the
60-6 probation.
60-7 (e) The schedule of sanctions adopted by the board by rule
60-8 shall be used by the State Office of Administrative Hearings for
60-9 any sanction imposed as the result of a hearing conducted by that
60-10 office.
60-11 SECTION 30. Subchapter D, Medical Practice Act (Article
60-12 4495b, Vernon's Texas Civil Statutes), is amended by adding Section
60-13 4.125 to read as follows:
60-14 Sec. 4.125. ADMINISTRATIVE PENALTY. (a) The board by order
60-15 may impose an administrative penalty against a person licensed or
60-16 regulated under this Act who violates this Act or a rule or order
60-17 adopted under this Act.
60-18 (b) The penalty for a violation may be in an amount not to
60-19 exceed $5,000. Each day a violation continues or occurs is a
60-20 separate violation for purposes of imposing a penalty.
60-21 (c) The amount of the penalty shall be based on:
60-22 (1) the seriousness of the violation, including the
60-23 nature, circumstances, extent, and gravity of any prohibited acts,
60-24 and the hazard or potential hazard created to the health, safety,
60-25 or economic welfare of the public;
60-26 (2) the economic harm to property or the environment
60-27 caused by the violation;
61-1 (3) the history of previous violations;
61-2 (4) the amount necessary to deter future violations;
61-3 (5) efforts to correct the violation; and
61-4 (6) any other matter that justice may require.
61-5 (d) The board by rule shall prescribe the procedure by which
61-6 it may impose an administrative penalty.
61-7 (e) All proceedings under this section are subject to the
61-8 Administrative Procedure Act and its subsequent amendments.
61-9 (f) If the board by order finds that a violation has
61-10 occurred and imposes an administrative penalty, the board shall
61-11 give notice to the person of the board's order. The notice must
61-12 include a statement of the right of the person to judicial review
61-13 of the order.
61-14 (g) Within 30 days after the date the board's order imposing
61-15 the penalty is final as provided by Section 16(c), Administrative
61-16 Procedure Act, and its subsequent amendments, the person shall:
61-17 (1) pay the amount of the penalty;
61-18 (2) pay the amount of the penalty and file a petition
61-19 for judicial review contesting the occurrence of the violation, the
61-20 amount of the penalty, or both the occurrence of the violation and
61-21 the amount of the penalty; or
61-22 (3) without paying the amount of the penalty, file a
61-23 petition for judicial review contesting the occurrence of the
61-24 violation, the amount of the penalty, or both the occurrence of the
61-25 violation and the amount of the penalty.
61-26 (h) Within the 30-day period, a person who acts under
61-27 Subsection (g)(3) of this section may:
62-1 (1) stay enforcement of the penalty by:
62-2 (A) paying the amount of the penalty to the
62-3 court for placement in an escrow account; or
62-4 (B) giving to the court a supersedeas bond that
62-5 is approved by the court for the amount of the penalty and that is
62-6 effective until all judicial review of the board's order is final;
62-7 or
62-8 (2) request the court to stay enforcement of the
62-9 penalty by:
62-10 (A) filing with the court a sworn affidavit of
62-11 the person stating that the person is financially unable to pay the
62-12 amount of the penalty and is financially unable to give the
62-13 supersedeas bond; and
62-14 (B) giving a copy of the affidavit to the
62-15 executive director by certified mail.
62-16 (i) An executive director who receives a copy of an
62-17 affidavit under Subsection (h)(2) of this section may file with the
62-18 court, within five days after the date the copy is received, a
62-19 contest to the affidavit. The court shall hold a hearing on the
62-20 facts alleged in the affidavit as soon as practicable and shall
62-21 stay the enforcement of the penalty on finding that the alleged
62-22 facts are true. The person who files an affidavit has the burden
62-23 of proving that the person is financially unable to pay the amount
62-24 of the penalty and to give a supersedeas bond.
62-25 (j) If the person does not pay the amount of the penalty and
62-26 the enforcement of the penalty is not stayed, the executive
62-27 director may refer the matter to the attorney general for
63-1 collection of the amount of the penalty.
63-2 (k) If on appeal the court sustains the occurrence of the
63-3 violation, the court may uphold or reduce the amount of the penalty
63-4 and order the person to pay the full or reduced amount of the
63-5 penalty. If the court does not sustain the occurrence of the
63-6 violation, the court shall order that no penalty is owed.
63-7 (l) When the judgment of the court becomes final, the court
63-8 shall proceed under this subsection. If the person paid the amount
63-9 of the penalty and if that amount is reduced or is not upheld by
63-10 the court, the court shall order that the appropriate amount plus
63-11 accrued interest be remitted to the person. The rate of the
63-12 interest is the rate charged on loans to depository institutions by
63-13 the New York Federal Reserve Bank, and the interest shall be paid
63-14 for the period beginning on the date the penalty was paid and
63-15 ending on the date the penalty is remitted. If the person gave a
63-16 supersedeas bond and if the amount of the penalty is not upheld by
63-17 the court, the court shall order the release of the bond. If the
63-18 person gave a supersedeas bond and if the amount of the penalty is
63-19 reduced, the court shall order the release of the bond after the
63-20 person pays the amount.
63-21 (m) A penalty collected under this section shall be remitted
63-22 to the comptroller for deposit in the general revenue fund.
63-23 SECTION 31. Subchapter D, Medical Practice Act (Article
63-24 4495b, Vernon's Texas Civil Statutes), is amended by adding Section
63-25 4.126 to read as follows:
63-26 Sec. 4.126. CIVIL PENALTY. (a) If it appears that a person
63-27 is in violation of or is threatening to violate this Act or a rule
64-1 or order adopted by the board, the attorney general may institute
64-2 an action for a civil penalty of $1,000 for each violation. Each
64-3 day of a violation shall constitute a separate violation.
64-4 (b) A civil action filed under this section by the attorney
64-5 general must be filed in a district court in Travis County or the
64-6 county in which the violation occurred.
64-7 (c) The attorney general may recover reasonable expenses
64-8 incurred in obtaining a civil penalty under this section, including
64-9 court costs, reasonable attorney fees, investigative costs, witness
64-10 fees, and deposition expenses.
64-11 (d) A civil penalty recovered in an action by the attorney
64-12 general under this section shall be deposited in the general
64-13 revenue fund.
64-14 (e) The attorney general may not institute an action for a
64-15 civil penalty against a person described by Section 3.06(c) or (e)
64-16 of this Act if the person is not in violation of or threatening to
64-17 violate this Act or a rule or order adopted by the board.
64-18 SECTION 32. Section 4.13, Medical Practice Act (Article
64-19 4495b, Vernon's Texas Civil Statutes), is amended to read as
64-20 follows:
64-21 Sec. 4.13. Temporary Suspension of License. (a) The
64-22 president of the board, with the approval of the board, shall
64-23 appoint a three-member disciplinary panel consisting of members of
64-24 the board for the purpose of determining whether a person's license
64-25 to practice medicine in this state should be temporarily suspended
64-26 under this section.
64-27 (b) If the disciplinary panel <executive committee of the
65-1 board> determines from the evidence or information presented to it
65-2 that a person licensed to practice medicine in this state by his
65-3 continuation in practice would constitute a continuing threat to
65-4 the public welfare, the disciplinary panel <executive committee of
65-5 the board> shall temporarily suspend the license of that person.
65-6 (c) The license may be suspended under this section without
65-7 notice or hearing on the complaint, provided institution of
65-8 proceedings for a hearing before the board is initiated
65-9 simultaneously with the temporary suspension and provided that a
65-10 hearing is held as soon as can be accomplished under the
65-11 Administrative Procedure Act and this Act.
65-12 (d) Notwithstanding the open meetings law, Chapter 271, Acts
65-13 of the 60th Legislature, Regular Session, 1967 (Article 6252-17,
65-14 Vernon's Texas Civil Statutes), the disciplinary panel may hold a
65-15 meeting by telephone conference call if immediate action is
65-16 required and the convening at one location of the disciplinary
65-17 panel is inconvenient for any member of the disciplinary panel.
65-18 SECTION 33. Subchapter E, Medical Practice Act (Article
65-19 4495b, Vernon's Texas Civil Statutes), is amended by adding Section
65-20 5.035 to read as follows:
65-21 Sec. 5.035. GRADUATES OF UNAPPROVED FOREIGN MEDICAL SCHOOLS.
65-22 (a) An applicant who is a graduate of a medical school that is
65-23 located outside the United States and Canada and that was not
65-24 approved by the board at the time the degree was conferred, to be
65-25 eligible for the issuance of a license, must present satisfactory
65-26 proof to the board that the applicant:
65-27 (1) meets the requirements set out in Sections
66-1 3.04(a)(1), (2), and (3) of this Act;
66-2 (2) is a graduate of a school whose curriculum meets
66-3 the requirements for an unapproved medical school as determined by
66-4 a committee of experts selected by the Texas Higher Education
66-5 Coordinating Board;
66-6 (3) has successfully completed three years of graduate
66-7 medical training in the United States or Canada that was approved
66-8 by the board on the date the training was completed;
66-9 (4) is eligible for licensure to practice medicine in
66-10 the country in which the school is located;
66-11 (5) possesses a valid certificate issued by the
66-12 Educational Commission for Foreign Medical Graduates;
66-13 (6) has the ability to communicate in the English
66-14 language; and
66-15 (7) has passed the examination required by the board
66-16 of all applicants for license as required by Section 3.05 of this
66-17 Act.
66-18 (b) In addition to other licensure requirements, the board
66-19 may require by rule that a graduate of an unapproved medical school
66-20 located outside the United States and Canada or the school of which
66-21 the person is a graduate provide additional information to the
66-22 board concerning the school before approving the applicant.
66-23 (c) The board may refuse to issue a license to an applicant
66-24 who graduated from an unapproved medical school located outside the
66-25 United States and Canada if it finds that the applicant does not
66-26 possess the requisite qualifications to provide the same standard
66-27 of medical care as provided by a physician licensed in this state.
67-1 (d) The board may refuse to issue a license to an applicant
67-2 who graduated from an unapproved medical school located outside the
67-3 United States and Canada if the applicant fails to provide the
67-4 board evidence to establish that the applicant completed medical
67-5 education or professional training substantially equivalent to that
67-6 provided by a medical school in this state.
67-7 SECTION 34. Section 5.04, Medical Practice Act (Article
67-8 4495b, Vernon's Texas Civil Statutes), is amended to read as
67-9 follows:
67-10 Sec. 5.04. FIFTH PATHWAY FOR FOREIGN MEDICAL SCHOOL
67-11 STUDENTS. (a) An applicant <Notwithstanding any other provision
67-12 of law, an individual> who has been a student of a foreign medical
67-13 school, to be eligible for the issuance of a license, must present
67-14 satisfactory proof to the board that the applicant <is eligible for
67-15 licensure to practice medicine in this state if he>:
67-16 (1) meets the requirements set out in Sections
67-17 3.04(a)(1), (2), and (3) of this Act;
67-18 (2) has studied medicine in an acceptable <a
67-19 reputable> medical school as defined by the board located outside
67-20 the United States and Canada;
67-21 (3) <(2)> has completed all of the didactic work of
67-22 the foreign medical school but has not graduated from the school;
67-23 (4) <(3)> has attained a score satisfactory to a
67-24 medical school in the United States approved by the Liaison
67-25 Committee on Medical Education on a qualifying examination and has
67-26 satisfactorily completed one academic year of supervised clinical
67-27 training for foreign medical students as defined by the American
68-1 Medical Association Council on Medical Education (Fifth Pathway
68-2 Program) under the direction of the medical school in the United
68-3 States;
68-4 (5) <(4)> has attained a passing score on the
68-5 Educational Commission <Council> for Foreign Medical Graduates
68-6 examination, or other examination, if required by the board; <and>
68-7 (6) has successfully completed three years of graduate
68-8 medical training in the United States or Canada that was approved
68-9 by the board on the date the training was completed; and
68-10 (7) <(5)> has passed the examination required by the
68-11 board of all applicants for license as required by Section 3.05 of
68-12 this Act.
68-13 (b) Satisfaction of the requirements of Subsection (a) of
68-14 this section are in lieu of the completion of any requirements of
68-15 the foreign medical school beyond completion of the didactic work,
68-16 and no other medical education requirements shall be a condition of
68-17 licensure to practice medicine in this state.
68-18 (c) Satisfaction of the requirements specified in Subsection
68-19 (a) of this section shall be in lieu of certification by the
68-20 Educational Commission <Council> for Foreign Medical Graduates, and
68-21 the certification is not a condition of licensure to practice
68-22 medicine in this state for candidates who have completed the
68-23 requirements of Subsection (a) of this section.
68-24 (d) A hospital that is licensed by this state, that is
68-25 operated by the state or a political subdivision of the state, or
68-26 that receives state financial assistance, directly or indirectly,
68-27 may not require an individual who has been a student of a foreign
69-1 medical school but has not graduated from the school to satisfy any
69-2 requirements other than those contained in <Subdivisions (1), (2),
69-3 (3), and (4) of> Subsection (a) of this section prior to commencing
69-4 an internship or residency.
69-5 (e) A document granted by a medical school located outside
69-6 the United States issued after the completion of all the didactic
69-7 work of the foreign medical school shall, on certification by the
69-8 medical school in the United States in which the training was
69-9 received of satisfactory completion by the person to whom the
69-10 document was issued of the requirements listed in Subdivision (4)
69-11 <(3)> of Subsection (a) of this section, be considered the
69-12 equivalent of a degree of doctor of medicine or doctor of
69-13 osteopathy for purposes of licensure.
69-14 SECTION 35. Section 5.08, Medical Practice Act (Article
69-15 4495b, Vernon's Texas Civil Statutes), is amended by amending
69-16 Subsections (d) and (k) and adding Subsection (n) to read as
69-17 follows:
69-18 (d) The prohibitions of this section continue to apply to
69-19 confidential communications or records concerning any patient
69-20 irrespective of when the patient received the services of a
69-21 physician, except for medical records 100 years old or older
69-22 requested for historical purposes.
69-23 (k) A physician shall furnish copies of medical records
69-24 requested, or a summary or narrative of the records, pursuant to a
69-25 written consent for release of the information as provided by
69-26 Subsection (j) of this section, except if the physician determines
69-27 that access to the information would be harmful to the physical,
70-1 mental, or emotional health of the patient, and the physician may
70-2 delete confidential information about another person who has not
70-3 consented to the release. The information shall be furnished by
70-4 the physician within 30 days after the date of receipt of the
70-5 request <a reasonable period of time> and reasonable fees for
70-6 furnishing the information shall be paid by the patient or someone
70-7 on his behalf. If the physician denies the request, in whole or in
70-8 part, the physician shall furnish the patient a written statement,
70-9 signed and dated, stating the reason for the denial. A copy of the
70-10 statement denying the request shall be placed in the patient's
70-11 medical records. In this subsection, "medical records" means any
70-12 records pertaining to the history, diagnosis, treatment, or
70-13 prognosis of the patient.
70-14 (n) A person who may provide a copy of a record or a summary
70-15 of the record to another under this section may provide the copy,
70-16 summary, or narrative:
70-17 (1) on paper; or
70-18 (2) on microfilm, microfiche, computer hard disk,
70-19 magnetic tape, optical disk, or by means of another appropriate
70-20 medium, including a machine-readable medium, if the person who is
70-21 to provide and the person who is to receive the copy, summary, or
70-22 narrative agree to a form authorized by this subdivision.
70-23 SECTION 36. Section 5.10, Medical Practice Act (Article
70-24 4495b, Vernon's Texas Civil Statutes), is amended to read as
70-25 follows:
70-26 Sec. 5.10. Sunset provision. The Texas State Board of
70-27 Medical Examiners is subject to Chapter 325, Government Code (Texas
71-1 Sunset Act). Unless continued in existence as provided by that
71-2 chapter, the board is abolished and this Act expires September 1,
71-3 2005 <1993>.
71-4 SECTION 37. The Medical Practice Act (Article 4495b,
71-5 Vernon's Texas Civil Statutes) is amended by adding Subchapter F to
71-6 read as follows:
71-7 SUBCHAPTER F. ACUPUNCTURE PRACTICE
71-8 Sec. 6.01. LEGISLATIVE FINDINGS AND PURPOSE. The
71-9 legislature finds that:
71-10 (1) the review and establishment of statewide
71-11 standards for the training, education, and discipline of persons
71-12 performing acupuncture are in the public interest; and
71-13 (2) the health, safety, and welfare of the people of
71-14 this state are best served by an orderly system of regulating the
71-15 practice of acupuncture.
71-16 Sec. 6.02. DEFINITIONS. In this subchapter:
71-17 (1) "Acupuncture" means:
71-18 (A) the insertion of an acupuncture needle and
71-19 the application of moxibustion to specific areas of the human body
71-20 as a primary mode of therapy to treat and mitigate a human
71-21 condition; and
71-22 (B) the administration of thermal or electrical
71-23 treatments or the recommendation of dietary guidelines, energy flow
71-24 exercise, or dietary or herbal supplements in conjunction with the
71-25 treatment described by Paragraph (A) of this subdivision.
71-26 (2) "Acupuncturist" means a person who practices
71-27 acupuncture.
72-1 (3) "Acupuncture board" means the Texas State Board of
72-2 Acupuncture Examiners.
72-3 (4) "Chiropractor" means a licensee of the Texas Board
72-4 of Chiropractic Examiners.
72-5 (5) "Executive director" means the executive director
72-6 of the Texas State Board of Medical Examiners.
72-7 (6) "Medical board" means the Texas State Board of
72-8 Medical Examiners.
72-9 (7) "Physician" means a licensee of the Texas State
72-10 Board of Medical Examiners.
72-11 Sec. 6.03. EXEMPTION; LIMITATION. (a) This subchapter does
72-12 not apply to a health care professional licensed under another
72-13 subchapter of this Act or another statute of this state and acting
72-14 within the scope of the license.
72-15 (b) This subchapter does not:
72-16 (1) limit the practice of medicine by a physician or
72-17 permit the unauthorized practice of medicine; or
72-18 (2) permit a person to dispense, administer, or supply
72-19 any controlled substance, narcotic, or dangerous drug if the person
72-20 is not otherwise authorized by law to do so.
72-21 Sec. 6.04. ACUPUNCTURE BOARD. (a) The Texas State Board of
72-22 Acupuncture Examiners is composed of nine members appointed by the
72-23 governor as follows:
72-24 (1) four acupuncturists who have at least five years
72-25 of experience in the practice of acupuncture in this state and are
72-26 not licensed in this state as physicians;
72-27 (2) two physicians who are licensed in this state and
73-1 are experienced in the practice of acupuncture; and
73-2 (3) three members of the general public who are not
73-3 licensed or trained in a health care profession and who represent
73-4 the public.
73-5 (b) The following persons may not serve on the acupuncture
73-6 board:
73-7 (1) a person who is required to register as a lobbyist
73-8 under Chapter 305, Government Code, and its subsequent amendments;
73-9 and
73-10 (2) a person who is currently employed by or serving
73-11 as president, vice-president, secretary, or treasurer of a
73-12 statewide or national organization incorporated for the purpose of
73-13 representing a health care profession in this state or the United
73-14 States.
73-15 (c) Members of the acupuncture board hold office for
73-16 staggered terms of six years, with three members' terms expiring
73-17 January 31 of each odd-numbered year.
73-18 (d) The governor shall designate a presiding officer of the
73-19 acupuncture board from the members of the acupuncture board.
73-20 (e) A vacancy on the acupuncture board shall be filled by
73-21 appointment of the governor.
73-22 (f) A member of the acupuncture board may not receive
73-23 compensation for service on the board but is entitled to receive a
73-24 per diem as set by legislative appropriation for transportation and
73-25 related expenses incurred for each day that the member engages in
73-26 the business of the board.
73-27 (g) The acupuncture board is subject to the open meetings
74-1 law, the open records law, and the Administrative Procedure Act and
74-2 any subsequent amendments.
74-3 (h) The acupuncture board is subject to Chapter 325,
74-4 Government Code (Texas Sunset Act). Unless continued in existence
74-5 as provided by that chapter, the board is abolished and this
74-6 subchapter expires September 1, 1997.
74-7 Sec. 6.05. POWERS AND DUTIES OF ACUPUNCTURE BOARD.
74-8 (a) Subject to the advice and approval of the medical board, the
74-9 acupuncture board shall:
74-10 (1) establish qualifications for an acupuncturist to
74-11 practice in this state;
74-12 (2) establish minimum educational and training
74-13 requirements necessary for the acupuncture board to recommend that
74-14 the medical board issue a license to practice acupuncture;
74-15 (3) administer an examination that is validated by
74-16 independent testing professionals for a license to practice
74-17 acupuncture;
74-18 (4) develop requirements for licensure by endorsement
74-19 of other states;
74-20 (5) prescribe the application form for a license to
74-21 practice acupuncture;
74-22 (6) make recommendations on applications for licenses
74-23 to practice acupuncture;
74-24 (7) establish a procedure for reporting and processing
74-25 complaints relating to the practice of acupuncture under this
74-26 article;
74-27 (8) establish the requirements for a tutorial program
75-1 for students who have completed at least 48 semester hours of
75-2 college; and
75-3 (9) recommend additional rules as are necessary for
75-4 the administration and enforcement of this subchapter.
75-5 (b) Notwithstanding Subsection (a) of this section, the
75-6 acupuncture board has no independent rulemaking authority.
75-7 Sec. 6.06. LICENSE REQUIRED. A person may not practice
75-8 acupuncture in this state unless the person holds a license to
75-9 practice acupuncture issued by the medical board under this
75-10 subchapter.
75-11 Sec. 6.07. QUALIFICATIONS OF ACUPUNCTURISTS. (a) An
75-12 applicant for a license to practice acupuncture who is not
75-13 otherwise licensed under this subchapter must pass an examination
75-14 approved by the acupuncture board.
75-15 (b) To be eligible for the examination, an applicant must:
75-16 (1) be at least 21 years of age;
75-17 (2) have completed at least 48 semester hours of
75-18 college courses, including basic science courses as determined by
75-19 the advisory board; and
75-20 (3) be a graduate of an acceptable acupuncture school
75-21 whose entrance requirements and course of instruction meet
75-22 standards set by the acupuncture board.
75-23 (c) A reputable acupuncture school must:
75-24 (1) maintain a resident course of instruction
75-25 equivalent to not less than six terms of four months each for a
75-26 total of not less than 1,800 instructional hours;
75-27 (2) provide supervised patient treatment for at least
76-1 two terms of the resident course of instruction;
76-2 (3) maintain a course of instruction in
76-3 anatomy-histology, bacteriology, physiology, symptomatology,
76-4 pathology, meridian and point locations, hygiene, and public
76-5 health; and
76-6 (4) have the necessary teaching force and facilities
76-7 for proper instruction in required subjects.
76-8 (d) In establishing standards for the entrance requirements
76-9 and course of instruction of an acupuncture school, the acupuncture
76-10 board may consider the standards set by the National Accreditation
76-11 Commission for Schools and Colleges of Acupuncture and Oriental
76-12 Medicine.
76-13 (e) The examination shall be conducted on practical and
76-14 theoretical acupuncture and other subjects required by the
76-15 acupuncture board.
76-16 (f) An application for examination must be:
76-17 (1) in writing on a form prescribed by the acupuncture
76-18 board;
76-19 (2) verified by affidavit;
76-20 (3) filed with the executive director of the medical
76-21 board; and
76-22 (4) accompanied by a fee set by the medical board.
76-23 (g) The medical board shall notify all applicants of the
76-24 time and place of the examination.
76-25 (h) The examination may be in writing, by a practical
76-26 demonstration of the applicant's skill, or both, as the acupuncture
76-27 board may require.
77-1 Sec. 6.08. ASSISTANCE BY MEDICAL BOARD. The medical board
77-2 shall provide administrative and clerical employees as necessary to
77-3 enable the acupuncture board to carry out this subchapter.
77-4 Sec. 6.09. FEES. (a) The medical board shall set and
77-5 collect fees in amounts that are reasonable and necessary to cover
77-6 the costs of administering and enforcing this subchapter without
77-7 the use of any other funds generated by the medical board.
77-8 (b) Fees collected by the medical board under this
77-9 subchapter shall be deposited by the medical board in the state
77-10 treasury to the credit of an account in the general revenue fund
77-11 and may be expended to cover the costs of administering and
77-12 enforcing this subchapter. At the end of each fiscal biennium, the
77-13 comptroller shall transfer any surplus money remaining in the
77-14 account to the general revenue fund.
77-15 Sec. 6.10. ISSUANCE OF LICENSE. (a) After consulting the
77-16 acupuncture board, the medical board shall issue a license to
77-17 practice acupuncture in this state to a person who meets the
77-18 requirements of this subchapter and the rules adopted under this
77-19 subchapter.
77-20 (b) The medical board shall by rule provide for the annual
77-21 renewal of a license to practice acupuncture.
77-22 Sec. 6.11. DENIAL OF LICENSE; DISCIPLINE OF LICENSE HOLDER.
77-23 (a) A license to practice acupuncture may be denied or, after
77-24 notice and hearing, suspended, probated, or revoked if the
77-25 applicant for a license or the holder of a license:
77-26 (1) uses drugs or intoxicating liquors to an extent
77-27 that affects the person's professional competence;
78-1 (2) obtains or attempts to obtain a license by fraud
78-2 or deception;
78-3 (3) is adjudged mentally incompetent by a court of
78-4 competent jurisdiction;
78-5 (4) practices acupuncture in a manner detrimental to
78-6 the public health and welfare;
78-7 (5) violates this subchapter or a rule adopted under
78-8 this subchapter;
78-9 (6) is convicted of a felony or a crime involving
78-10 moral turpitude; or
78-11 (7) holds himself out as a physician or surgeon or any
78-12 combination or derivative of those terms unless the person is also
78-13 licensed by the medical board as a physician or surgeon.
78-14 (b) Except as provided by Subsection (c) of this section, a
78-15 license to practice acupuncture shall be denied or, after notice
78-16 and hearing, revoked if the holder of a license has performed
78-17 acupuncture on a person who was not evaluated by a physician or
78-18 dentist, as appropriate, for the condition being treated within six
78-19 months before the date acupuncture was performed.
78-20 (c) The holder of a license may perform acupuncture on a
78-21 person who was referred by a doctor licensed to practice
78-22 chiropractic by the Texas Board of Chiropractic Examiners if the
78-23 licensee commences the treatment within 30 days of the date of the
78-24 referral. The licensee shall refer the person to a physician after
78-25 performing acupuncture 20 times or for 30 days, whichever occurs
78-26 first, if no substantial improvement occurs in the person's
78-27 condition for which the referral was made.
79-1 (d) The holder of a license must obtain reasonable
79-2 documentation that the evaluation required by Subsection (b) of
79-3 this section has taken place. If the licensee is unable to
79-4 determine that an evaluation has taken place, the licensee must
79-5 obtain a written statement signed by the person on a form
79-6 prescribed by the acupuncture board that states that the person has
79-7 been evaluated by a physician within the prescribed time frame.
79-8 The form shall contain a clear statement that the person should be
79-9 evaluated by a physician for the condition being treated by the
79-10 licensee.
79-11 (e) The medical board with advice from the acupuncture board
79-12 by rule may modify the requirement of the time frame or the scope
79-13 of the evaluation under Subsection (b) of this section.
79-14 (f) The medical board with advice from the acupuncture board
79-15 by rule may modify the requirement of the time frame for
79-16 commencement of treatment after referral by a chiropractor or the
79-17 number of treatments or days before referral to a physician is
79-18 required under Subsection (c) of this section.
79-19 (g) Notwithstanding Subsections (b) and (c) of this section,
79-20 an acupuncturist holding a current and valid license may without a
79-21 referral from a physician, dentist, or chiropractor perform
79-22 acupuncture on a person for smoking addiction, weight loss, or, as
79-23 established by the medical board with advice from the acupuncture
79-24 board by rule, substance abuse.
79-25 Sec. 6.12. OFFENSE. (a) A person commits an offense if the
79-26 person violates Section 6.06 of this Act.
79-27 (b) An offense under Subsection (a) of this section is a
80-1 Class A misdemeanor.
80-2 (c) Each day of a violation constitutes a separate offense.
80-3 Sec. 6.13. INJUNCTIVE RELIEF; CIVIL PENALTY. (a) The
80-4 medical board, the attorney general, or a district or county
80-5 attorney may bring a civil action to compel compliance with this
80-6 subchapter or to enforce a rule adopted under this subchapter.
80-7 (b) In addition to injunctive relief or any other remedy
80-8 provided by law, a person who violates this subchapter or a rule
80-9 adopted under this subchapter is liable to the state for a civil
80-10 penalty in an amount not to exceed $2,000 for each violation. Each
80-11 day a violation continues or occurs is a separate violation for
80-12 purposes of imposing a civil penalty. The attorney general, at the
80-13 request of the medical board or on the attorney general's own
80-14 initiative, may bring a civil action to collect a civil penalty
80-15 under this subsection. A civil penalty recovered shall be
80-16 deposited to the credit of the general revenue fund.
80-17 Sec. 6.14. AUTOMATIC LICENSURE. (a) With the approval of
80-18 the medical board, the acupuncture board shall establish
80-19 appropriate and reasonable requirements to determine those persons
80-20 practicing acupuncture on the effective date of this subchapter who
80-21 are eligible for immediate approval for a license to practice
80-22 acupuncture under this section.
80-23 (b) This section only applies to a person who meets the
80-24 requirements for immediate licensure under this section and who
80-25 applies for immediate approval on or before June 1, 1994.
80-26 (c) This section expires June 2, 1994.
80-27 SECTION 38. Subsection (a), Section 19, Texas Medical
81-1 Physics Practice Act (Article 4512n, Vernon's Texas Civil
81-2 Statutes), is amended to read as follows:
81-3 (a) The board may issue a license to practice medical
81-4 physics in this state, without an examination, to a person who,
81-5 before September 1, 1994, is a resident of this state and:
81-6 (1) has an earned bachelor's, master's, or doctoral
81-7 degree from an accredited college or university that signifies the
81-8 completion of courses approved by the board in physics, medical
81-9 physics, biophysics, radiological physics, medical health physics,
81-10 or nuclear engineering and demonstrated to the board's satisfaction
81-11 the completion of at least two years of full-time work experience
81-12 in the five years preceding January 1, 1993, <the effective date of
81-13 this Act> in the medical physics specialty for which application is
81-14 made; or
81-15 (2) has completed a training course approved by the
81-16 board in physics, medical physics, biophysics, radiological
81-17 physics, or medical health physics and demonstrated to the board's
81-18 satisfaction the completion of at least 10 years of full-time work
81-19 experience in the 12 years preceding January 1, 1993, <the
81-20 effective date of this Act> in the medical physics specialty for
81-21 which application is made.
81-22 SECTION 39. (a) As soon as possible on or after the
81-23 effective date of this Act, the governor shall appoint three new
81-24 public members to the Texas State Board of Medical Examiners to
81-25 achieve the membership plan established by Section 2.05, Medical
81-26 Practice Act (Article 4495b, Vernon's Texas Civil Statutes), as
81-27 amended by this Act. In making the appointments, the governor
82-1 shall designate one new member for a term expiring April 13, 1995,
82-2 one new member for a term expiring April 13, 1997, and one new
82-3 member for a term expiring April 13, 1999.
82-4 (b) The changes in law made by this Act in the
82-5 qualifications of, and the prohibitions applying to, members of the
82-6 Texas State Board of Medical Examiners do not affect the
82-7 entitlement of a member serving on the board immediately before the
82-8 effective date of this Act to continue to carry out the functions
82-9 of the board for the remainder of the member's term. The changes
82-10 in law apply only to a member appointed on or after the effective
82-11 date of this Act. This Act does not prohibit a person who is a
82-12 member of the board on the effective date of this Act from being
82-13 reappointed to the board if the person has the qualifications
82-14 required for a member under the Medical Practice Act (Article
82-15 4495b, Vernon's Texas Civil Statutes), as amended by this Act.
82-16 (c) The changes in law made by this Act relating to an
82-17 administrative penalty or civil penalty apply only to a violation
82-18 of the Medical Practice Act (Article 4495b, Vernon's Texas Civil
82-19 Statutes) or a rule or order adopted by the Texas State Board of
82-20 Medical Examiners that occurs on or after the effective date of
82-21 this Act. A violation occurs on or after the effective date of
82-22 this Act only if each element of the violation occurs on or after
82-23 that date. A violation that occurs before the effective date of
82-24 this Act is governed by the law in effect on the date the violation
82-25 occurred, and the former law is continued in effect for that
82-26 purpose.
82-27 (d) A person is not required to obtain a license to practice
83-1 acupuncture under Subchapter F, Medical Practice Act (Article
83-2 4495b, Vernon's Texas Civil Statutes), as added by this Act, until
83-3 June 1, 1994.
83-4 (e) The Texas State Board of Medical Examiners shall adopt
83-5 rules under Subchapter F, Medical Practice Act (Article 4495b,
83-6 Vernon's Texas Civil Statutes), as added by this Act, not later
83-7 than February 1, 1994.
83-8 (f) Not later than January 1, 1994, the governor shall make
83-9 initial appointments to the Texas State Board of Acupuncture
83-10 Examiners and shall designate three members for terms expiring
83-11 January 31, 1995, three members for terms expiring January 31,
83-12 1997, and three members for terms expiring January 31, 1999.
83-13 (g) Notwithstanding other provisions of this Act, Sections
83-14 6.06 and 6.12 of the Medical Practice Act (Article 4495b, Vernon's
83-15 Texas Civil Statutes), as added by this Act, take effect June 1,
83-16 1994.
83-17 SECTION 40. This Act takes effect September 1, 1993.
83-18 SECTION 41. The importance of this legislation and the
83-19 crowded condition of the calendars in both houses create an
83-20 emergency and an imperative public necessity that the
83-21 constitutional rule requiring bills to be read on three several
83-22 days in each house be suspended, and this rule is hereby suspended.