73R10746 E
By Parker, Moncrief S.B. No. 1062
Substitute the following for S.B. No. 1062:
By Berlanga C.S.S.B. No. 1062
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the continuation and operation of the Texas State Board
1-3 of Medical Examiners and to the regulation of the practice of
1-4 medicine, including the practice of acupuncture; providing
1-5 penalties.
1-6 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-7 SECTION 1. Section 1.03(a), Medical Practice Act (Article
1-8 4495b, Vernon's Texas Civil Statutes), is amended by amending
1-9 Subdivision (6) to read as follows:
1-10 (6) "Medical peer review committee" or "professional
1-11 review body" means a committee of a health-care entity, the
1-12 governing board of a health-care entity, or the medical staff of a
1-13 health-care entity, provided the committee or medical staff
1-14 operates pursuant to written bylaws that have been approved by the
1-15 policy-making body or the governing board of the health-care entity
1-16 and authorized to evaluate the quality of medical and health-care
1-17 services or the competence of physicians, including those functions
1-18 specified by Section 85.204, Health and Safety Code, and its
1-19 subsequent amendments. Such a committee includes the employees and
1-20 agents of the committee, including assistants, investigators,
1-21 intervenors, attorneys, and any other persons or organizations that
1-22 serve the committee in any capacity.
1-23 SECTION 2. Section 2.03, Medical Practice Act (Article
1-24 4495b, Vernon's Texas Civil Statutes), is amended to read as
2-1 follows:
2-2 Sec. 2.03. Appointment to Board. Members of the board shall
2-3 be appointed by the governor and confirmed by the senate. Any
2-4 vacancy on the board shall be filled by appointment of the
2-5 governor. Any appointment made shall be without regard to race,
2-6 color, disability <creed>, sex, religion, age, or national origin,
2-7 except that a person younger than 18 years of age is not eligible
2-8 for appointment.
2-9 SECTION 3. Section 2.04, Medical Practice Act (Article
2-10 4495b, Vernon's Texas Civil Statutes), is amended to read as
2-11 follows:
2-12 Sec. 2.04. Removal from Office. (a) It is a ground for
2-13 removal from the board if a member:
2-14 (1) does not have at the time of appointment the
2-15 qualifications required by Sections 2.05(a), (b), (c), (d), and (e)
2-16 of this Act;
2-17 (2) does not maintain during service on the board the
2-18 qualifications required by Sections 2.05(a), (b), (c), (d), and (e)
2-19 of this Act;
2-20 (3) violates a prohibition established by Section
2-21 2.05(f), (g), (h), (j), or (k) of this Act;
2-22 (4) cannot discharge the member's duties for a
2-23 substantial part of the term for which the member is appointed
2-24 because of illness or disability; or
2-25 (5) is absent from more than half of the regularly
2-26 scheduled board meetings that the member is eligible to attend
2-27 during a calendar year<, during a member's service on the board,
3-1 the member fails to meet the qualifications set forth in this Act
3-2 for members of the board. The validity of an action of the board
3-3 is not affected by the fact that it was taken when a ground for
3-4 removal of a member of the board existed>.
3-5 (b) The validity of an action of the board is not affected
3-6 by the fact that it is taken when a ground for removal of a board
3-7 member exists <Each member of the board shall be present for at
3-8 least one-half of the regularly scheduled board meetings held each
3-9 year. Failure of a board member to meet this requirement is
3-10 grounds for removal of the member from the board and the removal
3-11 creates a vacancy on the board>.
3-12 (c) If the executive director has knowledge that a potential
3-13 ground for removal exists, the executive director shall notify the
3-14 president of the board of the ground. The president shall then
3-15 notify the governor that a potential ground for removal exists.
3-16 SECTION 4. Section 2.05, Medical Practice Act (Article
3-17 4495b, Vernon's Texas Civil Statutes), is amended by amending
3-18 Subsections (b), (c), (d), (g), (h), and (i) and adding Subsections
3-19 (j), (k), and (l) to read as follows:
3-20 (b) Eight <Nine> members of the board must:
3-21 (1) be learned and eminent physicians licensed to
3-22 practice medicine within this state for at least three years prior
3-23 to appointment and be graduates of a reputable medical school or
3-24 college with a degree of doctor of medicine (M.D.); <and>
3-25 (2) have been actively engaged in the practice of
3-26 medicine for at least five years immediately preceding their
3-27 appointment; and
4-1 (3) have been actively engaged in organized peer
4-2 review at a health care entity for at least three years immediately
4-3 preceding their appointment.
4-4 (c) Three members of the board must:
4-5 (1) be learned and eminent physicians licensed to
4-6 practice medicine within this state for at least three years prior
4-7 to appointment and be graduates of a reputable medical school or
4-8 college with a degree of doctor of osteopathic medicine (D.O.);
4-9 <and>
4-10 (2) have been actively engaged in the practice of
4-11 medicine for at least five years immediately preceding their
4-12 appointment; and
4-13 (3) have been actively engaged in organized peer
4-14 review at a health care entity for at least three years immediately
4-15 preceding their appointment.
4-16 (d) Four <Three> members of the board must be public
4-17 representatives who are not licensed to practice medicine, who are
4-18 not financially involved in any organization subject to the
4-19 regulation of the board, and who are not providers of health care.
4-20 "Provider of health care" means:
4-21 (1) an individual who is a direct provider of health
4-22 care (including but not limited to a dentist, registered nurse,
4-23 licensed vocational nurse, chiropractor, podiatrist, physician
4-24 assistant, psychologist, athletic trainer, physical therapist,
4-25 social psychotherapist, pharmacist, optometrist, hospital
4-26 administrator, or nursing home administrator) in that the
4-27 individual's primary current activity is the provision of health
5-1 care to individuals or the administration of facilities or
5-2 institutions (including but not limited to hospitals, long-term
5-3 care facilities, out-patient facilities, and health maintenance
5-4 organizations) in which such care is provided and, when required by
5-5 law or otherwise, the individual has received professional or other
5-6 training in the provision of such care or in such administration
5-7 and is licensed or certified or holds himself out for such
5-8 provision or administration;
5-9 (2) one who is an indirect provider of health care in
5-10 that the individual holds a fiduciary position with or has a
5-11 fiduciary interest in an entity described below in this
5-12 subdivision; for purposes of this subdivision, a fiduciary position
5-13 or interest as applied to any entity means a position or interest
5-14 with respect to such entity affected with the character of a trust,
5-15 including members of boards of directors and officers, majority
5-16 shareholders, or agents, and receivers (either directly or through
5-17 their spouses) of more than one-tenth of their annual income from
5-18 any one or combination of fees or other compensation for research
5-19 into or instruction in the provision of health-care entities (or
5-20 associations or organizations composed of such entities) engaged
5-21 (or comprised of individuals who are engaged) in the provision of
5-22 health care or in the provision of health care and entities (or
5-23 associations or organizations composed of such entities engaged in
5-24 producing drugs or other such articles);
5-25 (3) one who is a member of the immediate family of an
5-26 individual described in this subsection; for purposes of this
5-27 subsection "immediate family" as applied to any individual includes
6-1 only his parents, spouse, children, brothers, and sisters who
6-2 reside in the same household;
6-3 (4) one who is engaged in or employed by an entity
6-4 issuing any policy or contract of individual or group health
6-5 insurance or hospital or medical service benefits; or
6-6 (5) one who is employed by, on the board of directors
6-7 of, or holds elective office by or under the authority of any unit
6-8 of federal, state, or local government or any organization that
6-9 receives a significant part of its funding from any such unit of
6-10 federal, state, or local government.
6-11 (g) An officer, employee, or paid consultant of a Texas
6-12 trade or professional association in the field of health care may
6-13 not be a member or employee of the board who is exempt from the
6-14 state's position classification plan or is compensated at or above
6-15 the amount prescribed by the General Appropriations Act for step 1,
6-16 salary group 17, of the position classification salary schedule.
6-17 (h) A person who is the spouse of an officer, manager, or
6-18 paid consultant of a Texas trade or professional association in the
6-19 field of health care may not be a board member and may not be a
6-20 board employee who is exempt from the state's position
6-21 classification plan or is compensated at or above the amount
6-22 prescribed by the General Appropriations Act for step 1, salary
6-23 group 17, of the position classification salary schedule.
6-24 (i) For the purposes of this section, a "Texas trade or
6-25 professional association" is a nonprofit, cooperative, and
6-26 voluntarily joined association of business or professional
6-27 competitors in this state designed to assist its members and its
7-1 industry or profession in dealing with mutual business or
7-2 professional problems and in promoting their common interest.
7-3 (j) A person may not serve as a member of the board if the
7-4 person is required to register as a lobbyist under Chapter 305,
7-5 Government Code, and its subsequent amendments, because of the
7-6 person's activities for compensation on behalf of a profession
7-7 related to the operation of the board <A person required to
7-8 register as a lobbyist under Chapter 305, Government Code, by
7-9 virtue of his activities on behalf of a trade or professional
7-10 association in the regulated profession may not act as a member of
7-11 the board>.
7-12 (k) <(h)> A person is ineligible for appointment to the
7-13 board if, at the time of appointment, the person is a stockholder,
7-14 paid full-time faculty member, or a member of the board of trustees
7-15 of a medical school.
7-16 (l) <(i)> All board members must take the official oath.
7-17 SECTION 5. Section 2.07(a), Medical Practice Act (Article
7-18 4495b, Vernon's Texas Civil Statutes), is amended to read as
7-19 follows:
7-20 (a) Not later than December after each regular session of
7-21 the legislature <At the first meeting of the board after each
7-22 biennial appointment>, the governor shall appoint from the members
7-23 of the board a president and the board shall elect from its members
7-24 a <president,> vice-president, secretary-treasurer, and other
7-25 officers as are required, in the opinion of the board, to carry out
7-26 its duties.
7-27 SECTION 6. Section 2.09, Medical Practice Act (Article
8-1 4495b, Vernon's Texas Civil Statutes), is amended by amending
8-2 Subsections (b), (c), (g), (k), (s), and (u) and adding Subsections
8-3 (b-1), (x), (y), (z), and (aa) to read as follows:
8-4 (b) The board shall develop and implement policies that
8-5 clearly define the respective responsibilities of the board and the
8-6 staff of the board. The board shall appoint an executive director
8-7 who shall be its chief executive and administrative officer, who
8-8 shall be charged with the primary responsibility of administering,
8-9 enforcing, and carrying out the provisions of the Medical Practice
8-10 Act under the control and supervision and at the direction of the
8-11 board. The executive director shall hold such position at the
8-12 pleasure of board and may be discharged at any time. The board may
8-13 act under its rules through the executive director, an executive
8-14 committee, or other committee, unless otherwise specified in this
8-15 Act. The executive committee shall be the president,
8-16 vice-president, and secretary-treasurer except where otherwise
8-17 provided in this Act<. Any duty of the secretary-treasurer in this
8-18 Act may be performed by the executive director within the
8-19 discretion of the board. Any reference to secretary-treasurer
8-20 shall have the same meaning as executive director when so
8-21 designated by the board>.
8-22 (b-1) The executive director may employ a chief operating
8-23 officer who shall be primarily responsible for administering,
8-24 implementing, and monitoring systems and necessary measures to
8-25 promote quality and efficiency of ongoing board operations and
8-26 other duties as may be assigned by the executive director. If the
8-27 board appoints an executive director who is not a physician
9-1 licensed to practice in this state, the executive director shall
9-2 appoint a medical director who is a physician licensed to practice
9-3 in this state and who shall be primarily responsible for
9-4 implementing and maintaining policies, systems, and measures
9-5 regarding clinical and professional issues and determinations. The
9-6 chief operating officer or medical director shall act under the
9-7 control and supervision and at the direction of the executive
9-8 director.
9-9 (c) The board may make rules and establish fees as are
9-10 reasonable relating to the granting and extension of expiration
9-11 dates of temporary licenses and the placing of licensees on
9-12 inactive status. The board shall by rule set time limits on the
9-13 periods for which licensees may hold temporary licenses or maintain
9-14 inactive status.
9-15 (g) A person may not serve as a member of the board or act
9-16 as the general counsel to the board if the person is required to
9-17 register as a lobbyist under Chapter 305, Government Code, and its
9-18 subsequent amendments, because of the person's activities for
9-19 compensation on behalf of a profession related to the operation of
9-20 the board <A person who is required personally to register as a
9-21 lobbyist under Chapter 305, Government Code, representing
9-22 physicians, health-care entities, or health-care related
9-23 professions, may not be employed by the board in any capacity>.
9-24 (k) The board <shall establish> by rule shall establish
9-25 reasonable and necessary fees so that the fees, in the aggregate,
9-26 produce sufficient revenue to cover the cost of administering this
9-27 Act. The fees set by the board may be adjusted so that the total
10-1 fees collected shall be sufficient to meet the expenses of
10-2 administering this Act. The board may not set a fee for an amount
10-3 less than the amount of that fee on September 1, 1993 <a reasonable
10-4 charge for those fees not specifically determined but authorized by
10-5 this Act>. The board may not waive collection of any fee or
10-6 penalty. The board shall place all fees received under authority
10-7 of this Act, not otherwise specified, into the medical licensing
10-8 fund. The board is authorized and shall by annual budget determine
10-9 the manner of handling the funds and the purpose, consistent with
10-10 this Act, for which the same may be used. The budgeted expenses
10-11 authorized by the board shall not be a charge upon the general
10-12 revenue of the state nor paid from the general revenue.
10-13 (s)(1) The board shall prepare information of public
10-14 <consumer> interest describing the functions of the board and the
10-15 board's procedures by which complaints are filed with and resolved
10-16 by the board. The board shall make the information available to
10-17 the public and appropriate state agencies.
10-18 (2) The board by rule shall establish methods by which
10-19 the public and licensees of the board are notified of the name,
10-20 mailing address, and telephone number of the board for the purpose
10-21 of directing complaints to the board. The board may provide for
10-22 that notification:
10-23 (A) on each registration form, application, or
10-24 written contract for services of an individual or entity regulated
10-25 under this Act;
10-26 (B) on a sign prominently displayed in the place
10-27 of business of each individual or entity regulated under this Act;
11-1 or
11-2 (C) in a bill for services provided by an
11-3 individual or entity regulated under this Act.
11-4 (3) The board shall list along with its regular
11-5 telephone number the toll-free telephone number that may be called
11-6 to present a complaint about a health professional if the toll-free
11-7 number is established under other state law <regulatory functions
11-8 of the board and describing the board's procedures by which
11-9 consumer complaints are filed with and resolved by the board>. On
11-10 written request the board shall make information available to the
11-11 general public for a reasonable fee to cover expenses and
11-12 appropriate state agencies including a summary of any previous
11-13 disciplinary orders by the board against a specific physician
11-14 licensed in this state, the date of the order, and the current
11-15 status of the order. The board shall establish an eight-hour
11-16 toll-free telephone number to make the information immediately
11-17 available to any caller if the board is not required to establish a
11-18 toll-free telephone number under other state law.
11-19 (u) The executive director or the executive director's
11-20 designee shall develop an intra-agency career ladder program. The
11-21 program shall require intra-agency posting of all nonentry level
11-22 positions concurrently with any public posting <board shall cause
11-23 to be developed an intraagency career ladder program, one part of
11-24 which shall be the intraagency posting of each job opening with the
11-25 board in a nonentry-level position. The intraagency posting shall
11-26 be made at least 10 days before any public posting>.
11-27 (x) Each board member shall comply with the board member
12-1 training requirements established by any other state agency that is
12-2 given authority to establish the requirements for the board.
12-3 (y) The board shall provide to its members and employees, as
12-4 often as necessary, information regarding their qualifications for
12-5 office or employment under this Act and their responsibilities
12-6 under applicable laws relating to standards of conduct for state
12-7 officers or employees.
12-8 (z) The board shall develop and implement policies that
12-9 provide the public with a reasonable opportunity to appear before
12-10 the board and to speak on any issue under the jurisdiction of the
12-11 board.
12-12 (aa) The board shall prepare and maintain a written plan
12-13 that describes how a person who does not speak English can be
12-14 provided reasonable access to the board's programs. The board
12-15 shall also comply with federal and state laws for program and
12-16 facility accessibility.
12-17 SECTION 7. The Medical Practice Act (Article 4495b, Vernon's
12-18 Texas Civil Statutes) is amended by adding Section 2.10 to read as
12-19 follows:
12-20 Sec. 2.10. EQUAL EMPLOYMENT OPPORTUNITY. (a) The executive
12-21 director or the executive director's designee shall prepare and
12-22 maintain a written policy statement to assure implementation of a
12-23 program of equal employment opportunity under which all personnel
12-24 decisions are made without regard to race, color, disability, sex,
12-25 religion, age, or national origin. The policy statement must
12-26 include:
12-27 (1) personnel policies, including policies relating to
13-1 recruitment, evaluation, selection, appointment, training, and
13-2 promotion of personnel, that are in compliance with requirements of
13-3 the Commission on Human Rights Act (Article 5221k, Vernon's Texas
13-4 Civil Statutes) and its subsequent amendments;
13-5 (2) a comprehensive analysis of the board's work force
13-6 that meets federal and state guidelines;
13-7 (3) procedures by which a determination can be made of
13-8 significant underuse in the board's work force of all persons for
13-9 whom federal or state guidelines encourage a more equitable
13-10 balance; and
13-11 (4) reasonable methods to appropriately address those
13-12 areas of significant underuse.
13-13 (b) A policy statement prepared under Subsection (a) of this
13-14 section must cover an annual period, be updated annually and
13-15 reviewed by the Commission on Human Rights for compliance with
13-16 requirements of the Commission on Human Rights Act (Article 5221k,
13-17 Vernon's Texas Civil Statutes) and its subsequent amendments, and
13-18 be filed with the governor's office.
13-19 (c) The governor's office shall deliver a biennial report to
13-20 the legislature based on the information received under Subsection
13-21 (b) of this section. The report may be made separately or as a
13-22 part of other biennial reports made to the legislature.
13-23 SECTION 8. Sections 3.01(a), (c), (f), (h), and (i), Medical
13-24 Practice Act (Article 4495b, Vernon's Texas Civil Statutes), are
13-25 amended to read as follows:
13-26 (a) All persons now lawfully qualified to practice medicine
13-27 in this state, or who are hereafter licensed for the practice of
14-1 medicine by the board, shall be registered as practitioners with
14-2 the board on or before the first day of January and thereafter
14-3 shall register in like manner annually, on or before the first day
14-4 of January of each succeeding year. Each person so registered with
14-5 the board shall pay, in connection with each annual registration
14-6 and for the receipt hereinafter provided for, a fee established by
14-7 the board which fee shall accompany the application of each person
14-8 for registration. The payment shall be made to the board. Every
14-9 person so registered shall file with the board a written
14-10 application for annual registration, setting forth his name and
14-11 mailing address, the place or places where the applicant is engaged
14-12 in the practice of medicine, and other necessary information
14-13 prescribed by the board. If the person is licensed for the
14-14 practice of medicine by another state, the District of Columbia, a
14-15 territory of the United States, Canada, any other country, or the
14-16 uniformed services of the United States, the application must
14-17 include a description of any investigations the person knows are in
14-18 progress and of any sanctions imposed by or disciplinary matters
14-19 pending in the state, district, territory, country, or service.
14-20 (c)(1) A person may renew an unexpired license by paying to
14-21 the board on or before the expiration date of the license the
14-22 required renewal fee.
14-23 (2) If a person's license has been expired for 90 days
14-24 or less, the person may renew the license by paying to the board
14-25 the required renewal fee and a fee that is one-half of the
14-26 examination fee for the license.
14-27 (3) If a person's license has been expired for longer
15-1 than 90 days but less than one year, the person may renew the
15-2 license by paying to the board all unpaid renewal fees and a fee
15-3 that is equal to the examination fee for the license.
15-4 (4) If a person's license has been expired for one
15-5 year, it is considered to have been canceled, and the person may
15-6 not renew the license. The person may obtain a new license by
15-7 submitting to reexamination and complying with the requirements and
15-8 procedures for obtaining an original license.
15-9 (5) The board may renew without examination an expired
15-10 license of a person who was licensed in this state, moved to
15-11 another state, and is currently licensed and has been in practice
15-12 in the other state for not more than two years preceding
15-13 application. The person must pay to the board a fee that is equal
15-14 to the examination fee for the license. <Failure of any licensee
15-15 to pay the annual license renewal fee on or before the 90th day
15-16 after the date it is due automatically cancels his licensure. Any
15-17 licensee whose license has been canceled because of failure to pay
15-18 the annual license renewal fee may secure reinstatement of his
15-19 license at any time within that license year upon payment of the
15-20 delinquent fee together with a penalty in an amount as the board
15-21 may determine to be reasonable. After expiration of the license
15-22 year for which the license fee was not paid, no license shall be
15-23 reinstated except upon application and satisfaction of other
15-24 conditions as the board may establish and payment of delinquent
15-25 fees and a penalty to be assessed by the board.>
15-26 (f) <In performing its duties as provided in this Act, the
15-27 board may act through the secretary-treasurer of the board. The
16-1 secretary-treasurer is entitled to a salary to be fixed by the
16-2 legislature in its General Appropriations Act for the performance
16-3 of duties under this Act.> The executive director
16-4 <secretary-treasurer> of the board shall file a surety bond with
16-5 the board. The bond shall be in an amount not less than $10,000,
16-6 be in compliance with the insurance laws of the state, and be
16-7 payable to the state for the use of the state if the executive
16-8 director <secretary-treasurer> does not faithfully discharge the
16-9 duties of the office. The board shall pay the premium on the bond.
16-10 <The salary shall be paid out of said medical registration fund and
16-11 shall not be in any way a charge upon the general revenue of the
16-12 state.>
16-13 (h) The <secretary-treasurer or the> executive director
16-14 shall review each application for licensure by examination or
16-15 reciprocity and shall recommend to the board all applicants
16-16 eligible for licensure. The <secretary-treasurer or the> executive
16-17 director also shall report to the board the names of all applicants
16-18 determined to be ineligible for licensure, together with the
16-19 reasons for each recommendation. An applicant deemed ineligible
16-20 for licensure by the <secretary-treasurer or the> executive
16-21 director may request review of such recommendation by a committee
16-22 of the board within 20 days of receipt of such notice, and the
16-23 <secretary-treasurer or the> executive director may refer any
16-24 application to said committee for a recommendation concerning
16-25 eligibility. If the committee finds the applicant ineligible for
16-26 licensure, such recommendation, together with the reasons therefor,
16-27 shall be submitted to the board unless the applicant requests a <an
17-1 appellate> hearing <before a hearing examiner appointed by the
17-2 board> within 20 days of receipt of notice of the committee's
17-3 determination. The hearing shall be before an administrative law
17-4 judge of the State Office of Administrative Hearings and shall
17-5 comply with the Administrative Procedure Act and its subsequent
17-6 amendments and the rules of the State Office of Administrative
17-7 Hearings and the board. The committee may refer any application
17-8 for determination of eligibility to the full board. The board
17-9 shall, after receiving the administrative law judge's proposed
17-10 findings of fact and conclusions of law, determine the eligibility
17-11 of the applicant for licensure <an appellate hearing on its own
17-12 motion. The board may elect to hear any appeal in lieu of
17-13 proceedings before a hearing examiner, and it shall adopt, modify,
17-14 or reject each decision made by a hearing examiner. The board also
17-15 shall adopt, modify, or reject each recommendation of ineligibility
17-16 made by the secretary-treasurer or the executive director or by the
17-17 committee, unless the applicant has requested a timely review of
17-18 the recommendation. Such action by the board shall constitute a
17-19 final administrative decision concerning licensure. Any hearing
17-20 before the board or before a hearing examiner under this subsection
17-21 becomes a contested case under the Administrative Procedure Act>.
17-22 A physician whose application for licensure is denied by the board
17-23 shall receive a written statement<, upon request,> containing the
17-24 reasons for the board's action. All reports received or gathered
17-25 by the board on each applicant are confidential and are not subject
17-26 to disclosure under the Open Records Law. The board may disclose
17-27 such reports to appropriate licensing authorities in other states
18-1 <upon request>.
18-2 (i) At least 30 days before the expiration of a person's
18-3 license, the board shall send written notice of the impending
18-4 license expiration to the person at the licensee's last known
18-5 address according to the records of the board <The board must
18-6 notify each delinquent licensee of his impending license
18-7 cancellation by registered or certified mail sent to the licensee's
18-8 address listed with the board not less than 30 days prior to the
18-9 cancellation. This requirement shall be waived when the licensee
18-10 has requested in writing that his or her license be canceled>.
18-11 SECTION 9. The Medical Practice Act (Article 4495b, Vernon's
18-12 Texas Civil Statutes) is amended by adding Section 3.025 to read as
18-13 follows:
18-14 Sec. 3.025. CONTINUING MEDICAL EDUCATION. (a) The board by
18-15 rule shall adopt, monitor, and enforce a reporting program for
18-16 continuing medical education of licensees. The board shall adopt
18-17 and administer rules:
18-18 (1) requiring the number of hours of continuing
18-19 medical education the board determines appropriate as a
18-20 prerequisite to the annual registration of a licensee under this
18-21 Act;
18-22 (2) requiring at least one-half of the hours of
18-23 continuing medical education required under Subdivision (1) of this
18-24 subsection to be approved by the board after taking into account
18-25 the standards of the American Medical Association for its
18-26 Physician's Recognition Award, the Council on Medical Specialty
18-27 Societies, or the American Osteopathic Association and permitting
19-1 the remaining hours to be composed of self-study or equivalent
19-2 self-directed continuing medical education according to guidelines
19-3 determined by the board; and
19-4 (3) adopting a process to assess a licensee's
19-5 participation in continuing medical education courses.
19-6 (b) A licensee shall be presumed to have complied with this
19-7 section if in the preceding 36 months the licensee becomes board
19-8 certified or recertified in a medical specialty and the medical
19-9 specialty program takes into consideration the standards of the
19-10 American Board of Medical Specialties, the American Medical
19-11 Association, the Advisory Board for Osteopathic Specialists and
19-12 Boards of Certification, or the American Osteopathic Association.
19-13 (c) The board may temporarily exempt a licensee from the
19-14 requirement for continuing medical education for:
19-15 (1) catastrophic illness;
19-16 (2) military service of longer than one year's
19-17 duration outside the state;
19-18 (3) medical practice and residence of longer than one
19-19 year's duration outside the United States; or
19-20 (4) good cause shown on written application of the
19-21 licensee that gives satisfactory evidence to the board that the
19-22 licensee is unable to comply with the requirement for continuing
19-23 medical education.
19-24 (d) A temporary exemption under Subsection (c) of this
19-25 section may not exceed one year but may be renewed annually.
19-26 (e) Subsection (a) of this section does not apply to a
19-27 licensee who is retired and has been exempted by rule from paying
20-1 the annual registration fee.
20-2 (f) This section does not prevent the board from taking
20-3 disciplinary action with respect to a licensee or an applicant for
20-4 a license by requiring additional hours of continuing medical
20-5 education or of specific course subjects.
20-6 SECTION 10. Section 3.03, Medical Practice Act (Article
20-7 4495b, Vernon's Texas Civil Statutes), is amended by amending
20-8 Subsections (a)-(f) to read as follows:
20-9 (a) The board, at its sole discretion and upon payment by an
20-10 applicant of a fee prescribed by the board under this Act, may
20-11 grant a license to practice medicine to any <reputable> physician
20-12 who is a graduate of an acceptable <a reputable> medical college as
20-13 determined by the board and who<:>
20-14 <(1)> is a licensee of another state or Canadian
20-15 province having requirements for physician registration and
20-16 practice substantially equivalent to those established by the laws
20-17 of this state<; or>
20-18 <(2) is qualified by an examination for a certificate
20-19 to practice medicine under a commission in the uniformed services
20-20 of the United States>.
20-21 (b) An application for a license under this section must be
20-22 in writing and upon a form prescribed by the board. The
20-23 application must be accompanied by:
20-24 (1) a diploma or photograph of a diploma awarded to
20-25 the applicant by an acceptable <a reputable> medical college and a
20-26 certified transcript showing courses and grades <or a certificate,
20-27 license, or commission issued to the applicant by the Medical Corps
21-1 of the uniformed services of the United States>;
21-2 (2) a license or a certified copy of a license to
21-3 practice medicine lawfully issued to the applicant<, on
21-4 examination,> by some other state or a Canadian province that
21-5 requires in its examination the same general degree of fitness
21-6 required by this state and that grants the same reciprocal
21-7 privileges to persons licensed by the board; <or>
21-8 (3) a certification made by <an executive officer of
21-9 the uniformed services of the United States,> the president or
21-10 secretary of the board that issued the license<,> or a duly
21-11 constituted registration office of the state or Canadian province
21-12 that issued the certificate or license, reciting that the
21-13 accompanying certificate or license has not been canceled,
21-14 suspended, or revoked <except by honorable discharge from the
21-15 Medical Corps of the uniformed services of the United States> and
21-16 reciting that the statement of the qualifications made in the
21-17 application for medical license in Texas is true and correct; and
21-18 (4) evidence of a passing grade on an examination
21-19 required by the board.
21-20 (c) Applicants for a license under this section must
21-21 subscribe to an oath in writing before an officer authorized by law
21-22 to administer oaths. The written oath must be a part of the
21-23 application. The application must:
21-24 (1) state that:
21-25 (A) <(1)> the license, certificate, or authority
21-26 under which the applicant has most recently practiced medicine in
21-27 the state or Canadian province from which the applicant is
22-1 transferring to this state <removed> or in the uniformed service in
22-2 which the applicant served is <was at the time of the removal or
22-3 completion of service> in full force and not restricted, canceled,
22-4 suspended, or revoked;
22-5 (B) <(2)> the applicant is the identical person
22-6 to whom the certificate or<,> license<, or commission> and the
22-7 diploma were issued;
22-8 (C) <(3)> no proceeding has been instituted
22-9 against the applicant for the restriction, cancellation,
22-10 suspension, or revocation of the certificate, license, or authority
22-11 to practice medicine in the state, Canadian province, or uniformed
22-12 service of the United States in which it was issued; and
22-13 (D) <(4)> no prosecution is pending against the
22-14 applicant in any state, federal, or Canadian court for any offense
22-15 that under the laws of this state is a felony;
22-16 (2) include a description of any sanctions imposed by
22-17 or disciplinary matters pending in the state or Canadian province
22-18 in which the applicant was or is licensed or certified to practice
22-19 medicine; and
22-20 (3) include evidence of postgraduate training required
22-21 by the board.
22-22 (d) An applicant for a license under this section must <A
22-23 "reputable physician" means one who would> be eligible for
22-24 examination by the board. <A "reputable medical school or college"
22-25 means a medical school or college that was approved by the board at
22-26 the time the applicant's degree was conferred.>
22-27 (e) In addition to other licensure requirements, the board
23-1 may require by rule and regulation that an applicant who is a
23-2 licensee of another state or Canadian province and who is a
23-3 graduate <graduates> of a medical school <schools> located outside
23-4 of the United States and Canada, or the school itself <schools
23-5 themselves>, provide additional information to the board concerning
23-6 the medical school attended prior to approval of the applicant.
23-7 (f) The board may refuse to issue a license to an applicant
23-8 who is a licensee of another state or Canadian province and who
23-9 graduated from a medical school outside of the United States and
23-10 Canada if it finds that the applicant does not possess the
23-11 requisite qualifications to provide the same standard of medical
23-12 care as provided by a licensed physician in this state.
23-13 SECTION 11. The Medical Practice Act (Article 4495b,
23-14 Vernon's Texas Civil Statutes) is amended by adding Section 3.0305
23-15 to read as follows:
23-16 Sec. 3.0305. TEMPORARY LICENSE FOR OUT-OF-STATE
23-17 PRACTITIONERS. (a) On application, the board shall grant a
23-18 temporary license to practice medicine. An applicant for a
23-19 temporary license under this section must:
23-20 (1) have a current, active, and unrestricted license,
23-21 without any pending disciplinary matters, as a physician in another
23-22 state, the District of Columbia, or a territory of the United
23-23 States that has licensing requirements that are substantially
23-24 equivalent to the requirements of this Act;
23-25 (2) have passed a national or other examination
23-26 recognized by the board relating to the practice of medicine; and
23-27 (3) be sponsored by a person licensed by the board
24-1 under this Act with whom the temporary license holder may practice
24-2 under this section.
24-3 (b) An applicant for a temporary license may be excused from
24-4 the requirement of Subsection (a)(3) of this section if the board
24-5 determines that compliance with that subsection constitutes a
24-6 hardship to the applicant.
24-7 (c) A temporary license is valid until the date the board
24-8 approves or denies the temporary license holder's application for a
24-9 license. The board shall issue a license under this Act to the
24-10 holder of a temporary license under this section if:
24-11 (1) the temporary license holder passes the
24-12 examination required by Section 3.05 of this Act;
24-13 (2) the board verifies that the temporary license
24-14 holder has satisfied the academic and experience requirements for a
24-15 license under this Act; and
24-16 (3) the temporary license holder has satisfied any
24-17 other license requirements under this Act.
24-18 (d) The board must assemble the documents and information
24-19 necessary to process a temporary license holder's application for a
24-20 license not later than the 90th day after the date the temporary
24-21 license is issued and complete the processing of the application
24-22 not later than the 90th day after the date the documents and
24-23 information are assembled. If by the 180th day after the date the
24-24 temporary license is issued the board has not completed the
24-25 processing of the application, the board shall review the
24-26 application to determine the cause of the delay.
24-27 SECTION 12. Section 3.04, Medical Practice Act (Article
25-1 4495b, Vernon's Texas Civil Statutes), is amended to read as
25-2 follows:
25-3 Sec. 3.04. Qualification of Licensee. (a) An applicant, to
25-4 be eligible for the examination and issuance of a license, must
25-5 present satisfactory proof to the board that the applicant:
25-6 (1) is at least 21 years of age;
25-7 (2) is of good professional character;
25-8 (3) has completed 60 semester hours of college courses
25-9 other than in medical school, which courses would be acceptable, at
25-10 the time of completion, to The University of Texas for credit on a
25-11 bachelor of arts degree or a bachelor of science degree; and
25-12 (4) is a graduate of an acceptable <a> medical school
25-13 or college that was approved by the board at the time the degree
25-14 was conferred<;> and has completed a one-year program of graduate
25-15 medical training approved by the board.
25-16 (b) The <(5) has successfully completed a one year program
25-17 of graduate medical training approved by the board. In addition to
25-18 other licensure requirements, the board may require by rule and
25-19 regulation that graduates of medical schools located outside the
25-20 United States and Canada comply with other requirements that the
25-21 board considers appropriate, including but not limited to
25-22 additional graduate medical training in the United States, except
25-23 those who qualify for licensure in Section 5.04 of this Act.
25-24 However, the> applicant shall be eligible for examination prior to
25-25 complying with the graduate training requirement of Subsection
25-26 (a)(4) <Subdivision (5) of Subsection (a)> of this section but
25-27 shall not be eligible for the issuance of an unrestricted license
26-1 until the requirements of Subsection (a) of this section <this
26-2 subsection> have been satisfied.
26-3 (c) <(b)> Applications for examination must be made in
26-4 writing, verified by affidavit, filed with the board on forms
26-5 prescribed by the board, and accompanied by documents and a fee as
26-6 the board determines to be reasonable.
26-7 (d) To be recognized by the board for the purposes of this
26-8 subchapter, all allopathic or osteopathic medical education
26-9 instruction taught in the United States must be accredited by an
26-10 accrediting body officially recognized by the United States
26-11 Department of Education and the Council on Postsecondary
26-12 Accreditation as the accrediting body for medical education leading
26-13 to the doctor of medicine degree or the doctor of osteopathy degree
26-14 in the United States.
26-15 (e) The requirements for eligibility for licensure of a
26-16 graduate of an unapproved foreign medical school are set out in
26-17 Section 5.035 of this Act, and the requirements for eligibility for
26-18 licensure of a person who has completed all of the didactic work of
26-19 a foreign medical school but has not graduated from the school
26-20 (Fifth Pathway Program) are set out in Section 5.04 of this Act.
26-21 SECTION 13. Sections 3.05(a), (c), and (e), Medical Practice
26-22 Act (Article 4495b, Vernon's Texas Civil Statutes), are amended to
26-23 read as follows:
26-24 (a) All examinations for license to practice medicine shall
26-25 be conducted in writing in the English language and in a manner as
26-26 to be entirely fair and impartial to all individuals and to every
26-27 school or system of medicine. <All applicants shall be known to
27-1 the examiners only by numbers, without names or other method of
27-2 identification on examination papers by which members of the board
27-3 may be able to identify the applicants or examinees, until after
27-4 the general averages of the examinees' numbers in the class have
27-5 been determined and license granted or refused.> Examinations
27-6 shall be conducted on and cover those subjects generally taught by
27-7 medical schools, a knowledge of which is commonly and generally
27-8 required of candidates for the degree of doctor of medicine or
27-9 doctor of osteopathy conferred by schools or colleges of medicine
27-10 approved by the board, and the examinations shall also be conducted
27-11 on and cover the subject of medical jurisprudence. Examinations
27-12 shall be prepared by a national testing service or prepared by the
27-13 board and validated by qualified independent testing professionals.
27-14 On satisfactory examination conducted as required by this Act under
27-15 rules of the board, applicants may <shall> be granted licenses to
27-16 practice medicine. All questions and answers, with the grades
27-17 attached, shall be preserved for one year in the executive office
27-18 of the board or such other repository as the board by rule may
27-19 direct. All applicants examined at the same time shall be given
27-20 identical questions. All certificates shall be attested by the
27-21 seal of the board. The board in its discretion may give the
27-22 examination for license in two or more parts.
27-23 (c) All applicants for license to practice medicine in this
27-24 state not otherwise licensed under the provisions of law must
27-25 successfully pass a uniform <an> examination approved by the board
27-26 as determined by rule. The board is authorized to adopt and
27-27 enforce all rules of procedure not inconsistent with statutory
28-1 requirements. All applicants shall be given due notice of the date
28-2 and place of the examination<; provided that the partial
28-3 examinations provided for in this Act shall not be disturbed by
28-4 this section>. If any applicant, because of failure to pass the
28-5 required examination, is refused a license, the applicant, at a
28-6 time as the board may fix, shall be permitted to take a subsequent
28-7 examination not more than two additional times <upon any subjects
28-8 required in the original examination> as the board may prescribe on
28-9 the payment of a fee as the board may determine to be reasonable.
28-10 In the event satisfactory grades shall be made on the subjects
28-11 prescribed and taken on the reexamination, the board may grant the
28-12 applicant a license to practice medicine. The board shall
28-13 determine the credit to be given examinees on answers turned in on
28-14 the subjects of complete and partial examination, and its decision
28-15 is final.
28-16 (e) Within 90 <30> days after the day on which an
28-17 examination is administered under this Act, the board shall notify
28-18 each examinee of the results of the examination. However, if an
28-19 examination is graded or reviewed by a national testing service,
28-20 the board shall notify each examinee of the results of the
28-21 examination not later than the 30th day <within four weeks> after
28-22 the date the board receives the results from the testing service.
28-23 If the notice of the examination results will be delayed for longer
28-24 than 90 days after the examination, the board shall notify the
28-25 examinee of the reason for the delay before the 90th day.
28-26 SECTION 14. Section 3.06(d)(5), Medical Practice Act
28-27 (Article 4495b, Vernon's Texas Civil Statutes), is amended by
29-1 adding Paragraph (G) to read as follows:
29-2 (G) An advertisement for a site serving a
29-3 medically underserved population shall include the name and
29-4 business address of the supervising physician for the site.
29-5 SECTION 15. Section 3.06, Medical Practice Act (Article
29-6 4495b, Vernon's Texas Civil Statutes), is amended by adding
29-7 Subsections (g) and (h) to read as follows:
29-8 (g) This Act does not prohibit a nonprofit clinic that is
29-9 operated by a nonprofit hospital or organization and that primarily
29-10 serves a financially indigent population from:
29-11 (1) contracting with a physician to provide services
29-12 at the clinic;
29-13 (2) paying a physician a minimum guarantee to assure
29-14 the physician's availability;
29-15 (3) billing to and collecting from patients as the
29-16 physician's agent the physician's professional fees; or
29-17 (4) retaining any professional fees collected under
29-18 Subdivision (3) of this subsection up to the amount of the minimum
29-19 guarantee fee and a reasonable collection fee.
29-20 (h) In Subsection (g), "financially indigent population"
29-21 means persons meeting Medicaid eligibility requirements or
29-22 uninsured persons who are accepted for care with no obligation to
29-23 pay or with a discounted obligation to pay for services rendered
29-24 based on the clinic's eligibility system.
29-25 SECTION 16. Section 3.08, Medical Practice Act (Article
29-26 4495b, Vernon's Texas Civil Statutes), is amended to read as
29-27 follows:
30-1 Sec. 3.08. Grounds for Refusal to Admit Persons to
30-2 Examination and to Issue License and Renewal License And For
30-3 Disciplinary Action. The board may refuse to admit persons to its
30-4 examinations and to issue a license to practice medicine to any
30-5 person and may take disciplinary action against any person for any
30-6 of the following reasons:
30-7 (1) submission of a false or misleading statement,
30-8 document, or certificate to the board in an application for
30-9 examination or licensure; the presentation to the board of any
30-10 license, certificate, or diploma that was illegally or fraudulently
30-11 obtained; the practice of fraud or deception in taking or passing
30-12 an examination;
30-13 (2) conviction of a crime of the grade of a felony or
30-14 a crime of a lesser degree that involves moral turpitude;
30-15 (3) intemperate use of alcohol or drugs that, in the
30-16 opinion of the board, could endanger the lives of patients;
30-17 (4) unprofessional or dishonorable conduct that is
30-18 likely to deceive or defraud the public or injure the public.
30-19 Unprofessional or dishonorable conduct likely to deceive or defraud
30-20 the public includes but is not limited to the following acts:
30-21 (A) committing any act that is in violation of
30-22 the laws of the State of Texas if the act is connected with the
30-23 physician's practice of medicine. A complaint, indictment, or
30-24 conviction of a law violation is not necessary for the enforcement
30-25 of this provision. Proof of the commission of the act while in the
30-26 practice of medicine or under the guise of the practice of medicine
30-27 is sufficient for action by the board under this section;
31-1 (B) failing to keep complete and accurate
31-2 records of purchases and disposals of drugs listed in Chapter 481,
31-3 Health and Safety Code, or of controlled substances scheduled in
31-4 the Federal Comprehensive Drug Abuse Prevention and Control Act of
31-5 1970, 21 U.S.C.A. Section 801 et seq. (Public Law 91-513). A
31-6 physician shall keep records of his purchases and disposals of
31-7 these drugs to include without limitation the date of purchase, the
31-8 sale or disposal of the drugs by the physician, the name and
31-9 address of the person receiving the drugs, and the reason for the
31-10 disposing or dispensing of the drugs to the person. A failure to
31-11 keep the records for a reasonable time is grounds for revoking,
31-12 canceling, suspending, or probating the license of any practitioner
31-13 of medicine. The board or its representative may enter and inspect
31-14 a physician's place(s) of practice during reasonable business hours
31-15 for the purpose of verifying the correctness of these records and
31-16 of taking inventory of the prescription drugs on hand;
31-17 (C) writing prescriptions for or dispensing to a
31-18 person known to be an abuser <a habitual user> of narcotic drugs,
31-19 controlled substances, or dangerous drugs or to a person who the
31-20 physician should have known was an abuser <a habitual user> of the
31-21 narcotic drugs, controlled substances, or dangerous drugs. This
31-22 provision does not apply to those persons:
31-23 (i) being treated by the physician for
31-24 their narcotic use after the physician notifies the board in
31-25 writing of the name and address of the person being so treated; or
31-26 (ii) who the physician is treating for
31-27 intractable pain under the Intractable Pain Treatment Act (Article
32-1 4495c, Revised Statutes) and its subsequent amendments;
32-2 (D) writing false or fictitious prescriptions
32-3 for dangerous drugs as defined by Chapter 483, Health and Safety
32-4 Code, of controlled substances scheduled in the Texas Controlled
32-5 Substances Act (Chapter 481, Health and Safety Code) <(Article
32-6 4476-15, Vernon's Texas Civil Statutes)>, or of controlled
32-7 substances scheduled in the Federal Comprehensive Drug Abuse
32-8 Prevention and Control Act of 1970, 21 U.S.C.A. Section 801 et
32-9 seq. (Public Law 91-513);
32-10 (E) prescribing or administering a drug or
32-11 treatment that is nontherapeutic in nature or nontherapeutic in the
32-12 manner the drug or treatment is administered or prescribed;
32-13 (F) prescribing, administering, or dispensing in
32-14 a manner not consistent with public health and welfare dangerous
32-15 drugs as defined by Chapter 483, Health and Safety Code, controlled
32-16 substances scheduled in the Texas Controlled Substances Act
32-17 (Chapter 481, Health and Safety Code) <(Article 4476-15, Vernon's
32-18 Texas Civil Statutes)>, or controlled substances scheduled in the
32-19 Federal Comprehensive Drug Abuse Prevention and Control Act of
32-20 1970, 21 U.S.C.A. Section 801 et seq. (Public Law 91-513);
32-21 (G) persistently or <and> flagrantly
32-22 overcharging or overtreating patients;
32-23 (H) failing to supervise adequately the
32-24 activities of those acting under the supervision of the physician;
32-25 or
32-26 (I) delegating professional medical
32-27 responsibility or acts to a person if the delegating physician
33-1 knows or has reason to know that the person is not qualified by
33-2 training, experience, or licensure to perform the responsibility or
33-3 acts;
33-4 (5) violation or attempted violation, direct or
33-5 indirect, of any valid rules issued under this Act, either as a
33-6 principal, accessory, or accomplice;
33-7 (6) use of any advertising statement that is false,
33-8 misleading, or deceptive;
33-9 (7) advertising professional superiority or the
33-10 performance of professional service in a superior manner if the
33-11 advertising is not readily subject to verification;
33-12 (8) purchase, sale, barter, or use or any offer to
33-13 purchase, sell, barter, or use any medical degree, license,
33-14 certificate, diploma, or transcript of license, certificate, or
33-15 diploma in or incident to an application to the board for a license
33-16 to practice medicine;
33-17 (9) altering, with fraudulent intent, any medical
33-18 license, certificate, diploma, or transcript of a medical license,
33-19 certificate, or diploma;
33-20 (10) using any medical license, certificate, diploma,
33-21 or transcript of a medical license, certificate, or diploma that
33-22 has been fraudulently purchased, issued, or counterfeited or that
33-23 has been materially altered;
33-24 (11) impersonating or acting as proxy for another in
33-25 any examination required by this Act for a medical license; or
33-26 engaging in conduct which subverts or attempts to subvert any
33-27 examination process required by this Act for a medical license.
34-1 Conduct which subverts or attempts to subvert the medical licensing
34-2 examination process includes, but is not limited to:
34-3 (A) conduct which violates the security of the
34-4 examination materials, as prescribed by board rules;
34-5 (B) conduct which violates the standard of test
34-6 administration, as prescribed by board rules; or
34-7 (C) conduct which violates the accreditation
34-8 process, as prescribed by board rules;
34-9 (12) impersonating a licensed practitioner or
34-10 permitting or allowing another to use his license or certificate to
34-11 practice medicine in this state for the purpose of diagnosing,
34-12 treating, or offering to treat sick, injured, or afflicted human
34-13 beings;
34-14 (13) employing, directly or indirectly, any person
34-15 whose license to practice medicine has been suspended, canceled, or
34-16 revoked or association in the practice of medicine with any person
34-17 or persons whose license to practice medicine has been suspended,
34-18 canceled, or revoked or any person who has been convicted of the
34-19 unlawful practice of medicine in Texas or elsewhere;
34-20 (14) performing or procuring a criminal abortion or
34-21 aiding or abetting in the procuring of a criminal abortion or
34-22 attempting to perform or procure a criminal abortion or attempting
34-23 to aid or abet the performance or procurement of a criminal
34-24 abortion;
34-25 (15) aiding or abetting, directly or indirectly, the
34-26 practice of medicine by any person, partnership, association, or
34-27 corporation not duly licensed to practice medicine by the board;
35-1 (16) inability to practice medicine with reasonable
35-2 skill and safety to patients by reason of illness, drunkenness,
35-3 excessive use of drugs, narcotics, chemicals, or any other type of
35-4 material or as a result of any mental or physical condition. In
35-5 enforcing this subdivision the board shall, upon probable cause,
35-6 request a physician to submit to a mental or physical examination
35-7 by physicians designated by the board. If the physician refuses to
35-8 submit to the examination, the board shall issue an order requiring
35-9 the physician to show cause why he should not be required to submit
35-10 to the examination and shall schedule a hearing on the order within
35-11 30 days after notice is served on the physician. The physician
35-12 shall be notified by either personal service or certified mail with
35-13 return receipt requested. At the hearing, the physician and his
35-14 attorney are entitled to present any testimony and other evidence
35-15 to show why the physician should not be required to submit to the
35-16 examination. After a complete hearing, the board shall issue an
35-17 order either requiring the physician to submit to the examination
35-18 or withdrawing the request for examination. An appeal from the
35-19 decision of the board shall be taken under the Administrative
35-20 Procedure Act;
35-21 (17) judgment by a court of competent jurisdiction
35-22 that a person licensed to practice medicine is of unsound mind;
35-23 (18) professional failure to practice medicine in an
35-24 acceptable manner consistent with public health and welfare;
35-25 (19) being removed, suspended, or having disciplinary
35-26 action taken by his peers in any professional medical association
35-27 or society, whether the association or society is local, regional,
36-1 state, or national in scope, or being disciplined by a licensed
36-2 hospital or medical staff of a hospital, including removal,
36-3 suspension, limitation of hospital privileges, or other
36-4 disciplinary action, if that action in the opinion of the board was
36-5 based on unprofessional conduct or professional incompetence that
36-6 was likely to harm the public, provided that the board finds that
36-7 the actions were appropriate and reasonably supported by evidence
36-8 submitted to it. The action does not constitute state action on
36-9 the part of the association, society, or hospital medical staff;
36-10 (20) repeated or recurring meritorious health-care
36-11 liability claims that in the opinion of the board evidence
36-12 professional incompetence likely to injure the public; or
36-13 (21) suspension, revocation, <or> restriction, or
36-14 other disciplinary action by another state of a license to practice
36-15 medicine, or disciplinary action by the uniformed services of the
36-16 United States, based upon acts by the licensee similar to acts
36-17 described in this section. A certified copy of the record of the
36-18 state taking the action is conclusive evidence of it.
36-19 SECTION 17. The Medical Practice Act (Article 4495b,
36-20 Vernon's Texas Civil Statutes) is amended by adding Section 3.085
36-21 to read as follows:
36-22 Sec. 3.085. RESTRICTIONS ON BIDDING AND ADVERTISING. (a)
36-23 The board may not adopt rules restricting competitive bidding or
36-24 advertising by a person regulated by the board except to prohibit
36-25 false, misleading, or deceptive practices by the person.
36-26 (b) The board may not include in its rules to prohibit
36-27 false, misleading, or deceptive practices by a person regulated by
37-1 the board a rule that:
37-2 (1) restricts the use of any medium for advertising;
37-3 (2) restricts the person's personal appearance or use
37-4 of the person's voice in an advertisement;
37-5 (3) relates to the size or duration of an
37-6 advertisement by the person; or
37-7 (4) restricts the person's advertisement under a trade
37-8 name.
37-9 SECTION 18. Sections 3.10(b), (c), (d), and (e), Medical
37-10 Practice Act (Article 4495b, Vernon's Texas Civil Statutes), are
37-11 amended to read as follows:
37-12 (b) <The board may not set, charge, collect, receive, or
37-13 deposit any of the following fees in excess of:>
37-14 <(1) for processing and granting a license by
37-15 reciprocity to a licensee of another state.....................$700>
37-16 <(2) for processing an application and
37-17 administration of a partial examination for
37-18 licensure......................................................$700>
37-19 <(3) for processing an application and
37-20 administration of a complete examination for
37-21 licensure......................................................$700>
37-22 <(4) for processing an application and
37-23 issuance of a temporary license................................$200>
37-24 <(5) for processing an application and
37-25 issuance of a duplicate license................................$200>
37-26 <(6) for processing an application and
37-27 issuance of a license of reinstatement after a lapse
38-1 or cancellation of a license...................................$700>
38-2 <(7) for processing an application and
38-3 issuance of an annual registration of a licensee...............$200>
38-4 <(8) for processing and issuance of an
38-5 institutional permit for interns, residents, and
38-6 others in approved medical training programs...................$200>
38-7 <(9) for processing an application and
38-8 issuance of an endorsement to other state medical
38-9 boards.........................................................$200>
38-10 <(10) for processing and issuance of a permit
38-11 to a physician who supervises a physician assistant............$200>
38-12 <(11) for processing and issuance of a permit
38-13 to a physician who supervises an acupuncturist...............$200.>
38-14 <(c)> The board may set and collect a sales charge for
38-15 making copies of any paper of record in the office of the board and
38-16 for any printed material published by the board. The charges shall
38-17 be in amounts considered sufficient to reimburse the board for the
38-18 actual expense.
38-19 (c) <(d)> The financial transactions of the board are
38-20 subject to audit by the state auditor in accordance with Chapter
38-21 321, Government Code.
38-22 (d) The board shall file annually with the governor and the
38-23 presiding officer of each house of the legislature a complete and
38-24 detailed written report accounting for all funds received and
38-25 disbursed by the board during the preceding fiscal year. The
38-26 annual report must be in the form and reported in the time provided
38-27 by the General Appropriations Act <(e) On or before the first day
39-1 of January each year, the board shall file with the governor and
39-2 the presiding officer of each house of the legislature a complete
39-3 and detailed written report accounting for all funds received and
39-4 disbursed by the board during the preceding year>.
39-5 SECTION 19. Section 3.11A, Medical Practice Act (Article
39-6 4495b, Vernon's Texas Civil Statutes), is amended to read as
39-7 follows:
39-8 Sec. 3.11A. Disposition of <Increase in> fees. (a) This
39-9 section applies to each <Each> of the following fees <imposed by or
39-10 under another section of this Act is increased by $200>:
39-11 (1) fee for processing and granting a license by
39-12 reciprocity to a licensee of another state;
39-13 (2) fee for processing an application and
39-14 administration of a partial examination for licensure;
39-15 (3) fee for processing an application and
39-16 administration of a complete examination for licensure;
39-17 (4) fee for processing an application and issuance of
39-18 a license of reinstatement after a lapse or cancellation of a
39-19 license; and
39-20 (5) fee for processing an application and issuance of
39-21 an annual registration of a licensee.
39-22 (b) Of each fee <increase> collected, $50 shall be deposited
39-23 to the credit of the foundation school fund and $150 shall be
39-24 deposited to the credit of the general revenue fund. This
39-25 subsection applies to the disposition of the stated portion of each
39-26 fee <increase> regardless of any other provision of law providing
39-27 for a different disposition of funds.
40-1 SECTION 20. Section 4.01, Medical Practice Act (Article
40-2 4495b, Vernon's Texas Civil Statutes), is amended to read as
40-3 follows:
40-4 Sec. 4.01. Grounds for Cancellation, Revocation, Suspension,
40-5 and Probation of License. (a) The board shall, except for good
40-6 cause shown, revoke or suspend a license, place on probation a
40-7 person whose license has been suspended, or reprimand a licensee
40-8 for a violation of this Act or a rule of the board <Except as
40-9 provided herein, the board may cancel, revoke, or suspend the
40-10 license of any practitioner of medicine or impose any other
40-11 authorized means of discipline upon proof of the violation of this
40-12 Act in any respect> or for any cause for which the board is
40-13 authorized to refuse to admit persons to its examination and to
40-14 issue a license and renewal license, including an initial
40-15 conviction or the initial finding of the trier of fact of guilt of
40-16 a felony or misdemeanor involving moral turpitude.
40-17 (b) On proof that a practitioner of medicine has been
40-18 initially convicted of a felony or the initial finding of the trier
40-19 of fact of guilt of a felony under Chapter 481, Health and Safety
40-20 Code, Section 485.033, Health and Safety Code, Chapter 483, Health
40-21 and Safety Code, or the Federal Comprehensive Drug Abuse Prevention
40-22 and Control Act of 1970, 21 U.S.C.A. Section 801 et seq. (Public
40-23 Law 91-513), the board shall suspend the practitioner's license.
40-24 On the practitioner's final conviction for such a felony offense,
40-25 the board shall revoke the practitioner's license.
40-26 (c) The board shall suspend the license of a practitioner
40-27 who is serving a prison term in a state or federal penitentiary
41-1 during his incarceration regardless of the offense.
41-2 SECTION 21. Section 4.04, Medical Practice Act (Article
41-3 4495b, Vernon's Texas Civil Statutes), is redesignated as Section
41-4 4.02 and amended to read as follows:
41-5 Sec. 4.02 <4.04>. COMPLAINT; INVESTIGATION. (a) Any
41-6 person, including a partnership, association, corporation, or other
41-7 entity, may file a complaint against a licensee with the board, or
41-8 the board may file a complaint on its own initiative. The board
41-9 shall adopt rules concerning the investigation of a complaint filed
41-10 with the board. The rules adopted under this subsection shall:
41-11 (1) distinguish between categories of complaints;
41-12 (2) ensure that complaints are not dismissed without
41-13 appropriate consideration;
41-14 (3) require that the board be advised of a complaint
41-15 that is dismissed and that a letter be sent to the person who filed
41-16 the complaint explaining the action taken on the dismissed
41-17 complaint;
41-18 (4) ensure that the person who filed the complaint has
41-19 an opportunity to explain the allegations made in the complaint;
41-20 and
41-21 (5) prescribe guidelines concerning the categories of
41-22 complaints that require the use of a private investigator and the
41-23 procedures for the board to obtain the services of a private
41-24 investigator.
41-25 (b) The board shall keep an information file about each
41-26 complaint filed with the board. The board's information file shall
41-27 be kept current and contain a record for each complaint of:
42-1 (1) potential witnesses contacted in relation to the
42-2 complaint;
42-3 (2) a summary of findings made at each step of the
42-4 complaint process;
42-5 (3) an explanation of the legal basis and reason for a
42-6 complaint that is dismissed; and
42-7 (4) other relevant information.
42-8 (c) If a written complaint is filed with the board that the
42-9 board has authority to resolve, the board, at least as frequently
42-10 as quarterly and until final disposition of the complaint, shall
42-11 notify the parties to the complaint of the status of the complaint
42-12 unless the notice would jeopardize an investigation.
42-13 (d) The board by rule shall adopt a form to standardize
42-14 information concerning complaints made to the board. The board by
42-15 rule shall prescribe information to be provided to a person when
42-16 the person files a complaint with the board.
42-17 (e) The board shall provide reasonable assistance to a
42-18 person who wishes to file a complaint with the board.
42-19 (f) Except as otherwise provided by this section, all
42-20 investigations shall be conducted by the board or persons
42-21 authorized by the board to conduct them. The board may commission
42-22 investigators as peace officers for the purpose of enforcing this
42-23 Act. However, investigators of the board so commissioned as peace
42-24 officers may not carry a firearm or exercise arrest powers. Each
42-25 complaint against a physician which requires a determination of
42-26 medical competency shall be reviewed by a board member, consultant,
42-27 or employee with medical background considered sufficient by the
43-1 board.
43-2 (g) <(b)> Unless it would jeopardize an investigation, the
43-3 board shall notify the physician that a complaint has been filed
43-4 and the nature of the complaint. The board shall make a
43-5 preliminary investigation of the complaint. The first
43-6 consideration of the board shall be whether the physician
43-7 constitutes a continuing threat to the public welfare.
43-8 (h) The board may, unless precluded by the law or this Act,
43-9 make a disposition of any complaint or matter relating to this Act,
43-10 or of any contested case by stipulation, agreed settlement, or
43-11 consent order. The board shall dispose of a complaint, contested
43-12 case, or other matter in writing, and if appropriate, the physician
43-13 shall sign the writing. An agreed disposition is a disciplinary
43-14 order for purposes of reporting under this Act and of
43-15 administrative hearings and proceedings by state and federal
43-16 regulatory agencies regarding the practice of medicine. An agreed
43-17 disposition is a public record.
43-18 (i) In civil or criminal litigation, an agreed disposition
43-19 is a settlement agreement under Rule 408, Texas Rules of Civil
43-20 Evidence, and Rule 408, Texas Rules of Criminal Evidence. This
43-21 subsection does not apply to a licensee who has previously entered
43-22 into an agreed disposition with the board of a different
43-23 disciplinary matter or whose license the board is seeking to
43-24 revoke.
43-25 (j) The board shall adopt such rules as are appropriate to
43-26 carry out this section <such disposition. Such disposition shall
43-27 be considered a disciplinary order>.
44-1 (k) The board shall dispose of all complaints in a timely
44-2 manner. The board shall establish a schedule for conducting each
44-3 phase of a complaint that is under the control of the board not
44-4 later than the 30th day after the date the complaint is received by
44-5 the board. The schedule shall be kept in the information file for
44-6 the complaint and all parties shall be notified of the projected
44-7 time requirements for pursuing the complaint. A change in the
44-8 schedule must be noted in the complaint information file, and all
44-9 parties to the complaint must be notified not later than the 14th
44-10 day after the date the change is made unless the notice would
44-11 jeopardize an investigation.
44-12 (l) The executive director of the board shall notify the
44-13 board of a complaint that extends beyond the time prescribed by the
44-14 board for resolving the complaint so that the board may take
44-15 necessary action on the complaint.
44-16 (m) Except in the case of a suspension under Section 4.13 of
44-17 this Act or in accordance with the terms of an agreement between
44-18 the board and a licensee, no revocation, suspension, involuntary
44-19 modification, or disciplinary action relating to a license is
44-20 effective unless, before board proceedings are instituted:
44-21 (1) the board has served notice, in a manner
44-22 consistent with the requirements for service under Subsection (g)
44-23 of this section, to the physician of the facts or conduct alleged
44-24 to warrant the intended action; and
44-25 (2) the physician was given an opportunity to show
44-26 compliance with all requirements of law for the retention of the
44-27 license either in writing or through personal appearance at an
45-1 informal meeting with one or more representatives of the board, at
45-2 the option of the licensee.
45-3 (n) If the licensee exercises the option to personally
45-4 appear at an informal meeting with one or more representatives of
45-5 the board and the informal meeting is held, the staff of the board
45-6 and the representatives of the board shall be subject to the ex
45-7 parte provisions of the Administrative Procedure Act with regard to
45-8 subsequent contacts with board members and administrative law
45-9 judges concerning the case.
45-10 SECTION 22. The Medical Practice Act (Article 4495b,
45-11 Vernon's Texas Civil Statutes) is amended by adding Section 4.025
45-12 to read as follows:
45-13 Sec. 4.025. INFORMAL PROCEEDINGS. (a) The board by rule
45-14 shall adopt procedures governing:
45-15 (1) informal disposition of a contested case under
45-16 Section 13(e), Administrative Procedure Act, and its subsequent
45-17 amendments; and
45-18 (2) informal proceedings held in compliance with
45-19 Section 18(c), Administrative Procedure Act, and its subsequent
45-20 amendments.
45-21 (b) Rules adopted under this section must provide the
45-22 complainant and the licensee an opportunity to be heard and must
45-23 require the presence of the board's legal counsel or a
45-24 representative of the office of the attorney general to advise the
45-25 board or board's employees.
45-26 SECTION 23. Section 4.02, Medical Practice Act (Article
45-27 4495b, Vernon's Texas Civil Statutes), is redesignated as Section
46-1 4.03 and amended to read as follows:
46-2 Sec. 4.03 <4.02>. Initiation of Charges. (a) Proceedings,
46-3 unless otherwise specified, under this Act or other applicable law
46-4 and charges against a licensee may be instituted by a duly
46-5 authorized representative of the board <on its own initiative or by
46-6 any person>. Charges must be in writing and on sworn affidavit
46-7 filed with the records custodian or assistant records custodian of
46-8 the board detailing the nature of the charges as required by this
46-9 Act or other applicable law. The president or an authorized <his>
46-10 designee shall <set a time and place for a hearing and shall> cause
46-11 a copy of the charges<, together with a notice of the time and
46-12 place fixed for the hearing> to be served on the respondent or the
46-13 respondent's counsel of record.
46-14 (b) The president or designee shall notify the State Office
46-15 of Administrative Hearings of a formal complaint.
46-16 (c) A formal complaint shall be in writing and shall allege
46-17 with reasonable certainty the specific act or acts relied on by the
46-18 agency to constitute a violation of a specific statute or rule.
46-19 The formal complaint shall be specific enough to enable a person of
46-20 common understanding to know what is meant by the formal complaint
46-21 and shall contain a degree of certainty that will give the person
46-22 who is the subject of the formal complaint notice of the particular
46-23 act or acts alleged to be a violation of a specific statute or
46-24 rule.
46-25 (d) The board shall adopt reasonable rules to promote
46-26 discovery by all parties to contested cases.
46-27 (e) In this section, "formal complaint" means a written
47-1 statement made by a credible person under oath that is filed and
47-2 presented by a representative of the board charging a person with
47-3 having committed an act or acts that if proven could affect the
47-4 legal rights or privileges of a licensee or other person under the
47-5 jurisdiction of the board.
47-6 SECTION 24. Section 4.03, Medical Practice Act (Article
47-7 4495b, Vernon's Texas Civil Statutes), is redesignated as Section
47-8 4.04 and amended to read as follows:
47-9 Sec. 4.04 <4.03>. Notice. (a) Service of process notifying
47-10 the respondent of <the time and place of> a hearing about <and the
47-11 nature of> the charges against the person shall be made in
47-12 accordance with the requirements of the Administrative Procedure
47-13 Act and its subsequent amendments <person or by mail. Notice shall
47-14 be sufficient if made in person or if sent by registered or
47-15 certified mail to the person charged at the address shown in the
47-16 board files or on his most recent application for registration or
47-17 renewal, no later than 10 days before the hearing>.
47-18 (b) If service of notice as prescribed by Subsection (a) of
47-19 this section is impossible or cannot be effected, the board shall
47-20 cause to be published once a week for two successive weeks a notice
47-21 of the hearing in a newspaper published in the county of the last
47-22 known place of practice in Texas of the person, if known. If the
47-23 licensee is not currently practicing in Texas as evidenced by
47-24 information in the board files, or if the last county of practice
47-25 is unknown, publication shall be in a newspaper in Travis County.
47-26 When publication of notice is used, the date of hearing may not be
47-27 less than 10 days after the date of the last publication of notice.
48-1 SECTION 25. Section 4.05, Medical Practice Act (Article
48-2 4495b, Vernon's Texas Civil Statutes), is amended to read as
48-3 follows:
48-4 Sec. 4.05. Hearings, Rules. (a) The <president of the>
48-5 board by rule shall adopt procedures governing formal disposition
48-6 of a contested case under the Administrative Procedure Act and its
48-7 subsequent amendments. A formal hearing shall be conducted by an
48-8 administrative law judge employed by the State Office of
48-9 Administrative Hearings <designate one of the following alternative
48-10 procedures for the conduct of each individual contested case in a
48-11 disciplinary matter:>
48-12 <(1) a hearing before the board itself where a quorum
48-13 of the board shall be present for the hearing and decision at the
48-14 conclusion of the hearing;>
48-15 <(2) a hearing committee appointed by the president of
48-16 the board, provided that the hearing committee shall be composed of
48-17 not less than three members of the board and the composition of
48-18 such committee shall be consistent with the provisions of Sections
48-19 2.08 and 2.09 of this Act; or>
48-20 <(3) a hearing before a hearing examiner appointed by
48-21 the board to conduct a hearing and to prepare and submit to the
48-22 board for action a proposal for decision as provided in the
48-23 Administrative Procedure and Texas Register Act (Article 6252-13a,
48-24 Vernon's Texas Civil Statutes).>
48-25 <Any individual conducting a hearing under this subchapter is
48-26 empowered to administer oaths and to receive evidence at the
48-27 hearing and shall report the hearing as prescribed by board rules>.
49-1 Notwithstanding any other provision of this Act or other law, the
49-2 board may, in its sole discretion, employ, retain, and compensate
49-3 such attorneys, consultants, and other professionals as it deems
49-4 necessary and appropriate to serve as <hearing examiners,> board
49-5 consultants or<,> special counsel to prosecute on behalf of the
49-6 hearings division and investigating division such complaints as are
49-7 filed with the board, court reporters, and other staff deemed
49-8 necessary or appropriate by the board to prepare for or represent
49-9 the board in <conduct> the hearings authorized by this section.
49-10 <All hearings conducted under this subchapter by the board shall
49-11 comply with the provisions of the Administrative Procedure Act and
49-12 the board's rules.>
49-13 (b) <The licensee shall have the right to produce witnesses
49-14 or evidence on the person's behalf, to cross-examine witnesses, and
49-15 to have subpoenas issued by the board to be served at the
49-16 licensee's expense.>
49-17 <(c)> The board shall, after receiving the administrative
49-18 law judge's findings of fact and conclusions of law <the hearing>,
49-19 determine the charges upon their merits.
49-20 (c) <(d)> All complaints, adverse reports, investigation
49-21 files, other investigation reports, and other investigative
49-22 information in the possession of, received or gathered by the board
49-23 or its employees or agents relating to a licensee, an application
49-24 for license, or a criminal investigation or proceedings are
49-25 privileged and confidential and are not subject to discovery,
49-26 subpoena, or other means of legal compulsion for their release to
49-27 anyone other than the board or its employees or agents involved in
50-1 licensee discipline. Not later than 30 days after receiving a
50-2 written request from a licensee who is the subject of a formal
50-3 complaint initiated and filed under Section 4.03 of this Act or
50-4 from the licensee's counsel of record and subject to any other
50-5 privileges or restrictions set forth by rule, statute, or legal
50-6 precedent, and unless good cause is shown for delay, the board
50-7 shall provide the licensee with access to all information in its
50-8 possession that the board intends to offer into evidence in
50-9 presenting its case in chief at the contested hearing on the
50-10 complaint. However, the board is not required to provide board
50-11 investigative reports or investigative memoranda, the identity of
50-12 nontestifying complainants, attorney-client communications,
50-13 attorney-work product, or other materials covered by a privilege as
50-14 recognized by the Texas Rules of Civil Procedure or the Texas Rules
50-15 of Civil Evidence. The furnishing of information shall not
50-16 constitute a waiver of privilege or confidentiality under this
50-17 section, this Act, or other applicable law. Investigative
50-18 <However, investigative> information in the possession of the board
50-19 or its employees or agents which relates to licensee discipline may
50-20 be disclosed to the appropriate licensing authority in another
50-21 state, the District of Columbia, or a territory or country in which
50-22 the licensee is licensed or has applied for a license, or to a peer
50-23 review committee reviewing an application for privileges or the
50-24 qualifications of the licensee with respect to retaining
50-25 privileges. If the investigative information in the possession of
50-26 the board or its employees or agents indicates a crime may have
50-27 been committed, the information shall be reported to the proper law
51-1 enforcement agency. The board shall cooperate and assist all law
51-2 enforcement agencies conducting criminal investigations of
51-3 licensees by providing information which is relevant to the
51-4 criminal investigation to the investigating agency. Any
51-5 information disclosed by the board to an investigative agency shall
51-6 remain confidential and shall not be disclosed by the investigating
51-7 agency except as necessary to further the investigation. The board
51-8 shall provide information upon the written request of a health-care
51-9 entity about a complaint filed against a licensee that was resolved
51-10 after investigation by a disciplinary order of the board or by an
51-11 agreed settlement and the basis of and current status of any
51-12 complaint under active investigation. The board shall keep
51-13 information on file about each complaint filed with the board,
51-14 consistent with this Act. If a written complaint is filed with the
51-15 board relating to a person licensed by the board, the board, at
51-16 least as often as quarterly and until final determination of the
51-17 action to be taken relative to the complaint, shall notify the
51-18 parties to the complaint <complaining party> consistent with this
51-19 Act of the status of the complaint unless the notice would
51-20 jeopardize an active investigation.
51-21 (d) <(e)> The board in its discretion may accept the
51-22 voluntary surrender of a license. No license may be returned
51-23 unless the board determines, under rules established by it, that
51-24 the licensee is competent to resume practice.
51-25 SECTION 26. Section 4.10, Medical Practice Act (Article
51-26 4495b, Vernon's Texas Civil Statutes), is amended to read as
51-27 follows:
52-1 Sec. 4.10. Petition for Reinstatement. (a) Upon
52-2 application, the board may reissue a license to practice medicine
52-3 to a person whose license has been canceled, revoked, or suspended,
52-4 but the application, in the case of revocation, may not be made
52-5 prior to one year after the revocation was issued or became final
52-6 and must be made upon payment of the fees as established by the
52-7 board and in the manner and form and under the conditions as the
52-8 board may require. Further, the board may not reinstate or reissue
52-9 a license to a person whose license has been canceled, revoked, or
52-10 suspended because of a felony conviction under Chapter 481, Health
52-11 and Safety Code, Section 485.033, Health and Safety Code, Chapter
52-12 483, Health and Safety Code, or the Federal Comprehensive Drug
52-13 Abuse Prevention and Control Act of 1970, 21 U.S.C.A. Section 801
52-14 et seq. (Public Law 91-513), except on an express determination
52-15 based on substantial evidence contained in an investigative report
52-16 indicating that the reinstatement or reissue of the license is in
52-17 the best interests of the public and of the person whose license
52-18 has been canceled, revoked, or suspended.
52-19 (b) A decision by the board to deny an application to
52-20 reinstate or reissue a license is subject to judicial review in the
52-21 manner provided by Section 4.09 of this Act.
52-22 SECTION 27. Section 4.11, Medical Practice Act (Article
52-23 4495b, Vernon's Texas Civil Statutes), is amended to read as
52-24 follows:
52-25 Sec. 4.11. Monitoring of License Holder; Probation.
52-26 (a) The board by rule shall develop a system for monitoring the
52-27 compliance with the requirements of this Act of license holders who
53-1 are the subject of disciplinary action. Rules adopted under this
53-2 section shall include procedures for monitoring a license holder
53-3 who is ordered by the board to perform certain acts to ascertain
53-4 that the license holder performs the required acts and to identify
53-5 and monitor license holders who are the subject of disciplinary
53-6 action and who present a continuing threat to the public welfare
53-7 through the practice of medicine.
53-8 (b) The board upon majority vote may provide that the order
53-9 canceling, revoking, or suspending a license or imposing any other
53-10 method of discipline be probated so long as the probationer
53-11 conforms to the orders, conditions, and rules that the board may
53-12 set out as the terms of probation. However, the board may not
53-13 grant probation to a person whose license has been canceled,
53-14 revoked, or suspended because of a felony conviction under Chapter
53-15 481, Health and Safety Code, Section 485.033, Health and Safety
53-16 Code, Chapter 483, Health and Safety Code, or the Federal
53-17 Comprehensive Drug Abuse Prevention and Control Act of 1970, 21
53-18 U.S.C.A. Section 801 et seq. (Public Law 91-513), except on an
53-19 express determination, based on substantial evidence, that the
53-20 grant of probation is in the best interests of the public and of
53-21 the person whose license has been suspended, revoked, or canceled.
53-22 The board, at the time of probation, shall set out the period of
53-23 time that constitutes the probationary period. The board may not
53-24 grant probation to a physician who poses, through the practice of
53-25 medicine, a continuing threat to the public welfare.
53-26 (c) <(b)> The board may at any time while a license holder
53-27 <the probationer> remains on probation, with adequate grounds being
54-1 shown, cause <hold> a hearing to be held and, upon proof of a
54-2 violation of the order <majority vote>, rescind the probation and
54-3 enforce the board's original action and may impose any disciplinary
54-4 action permitted under Section 4.12 of this Act in addition to or
54-5 in lieu of enforcing the original order. The board <and> shall
54-6 revoke or suspend a probationer's license <do so> if the board
54-7 determines that the probationer poses, through the practice of
54-8 medicine, a continuing threat to the public welfare.
54-9 (d) <(c)> The hearing to rescind the probation shall be
54-10 governed by the same provisions as are set forth in this subchapter
54-11 for other charges.
54-12 SECTION 28. Section 4.12, Medical Practice Act (Article
54-13 4495b, Vernon's Texas Civil Statutes), is amended to read as
54-14 follows:
54-15 Sec. 4.12. Methods of Discipline. (a) Except as otherwise
54-16 provided in Section 4.01, if the board finds any person to have
54-17 committed any of the acts set forth in Section 3.08 of this Act, it
54-18 shall enter an order imposing one or more of the following:
54-19 (1) deny the person's application for a license or
54-20 other authorization to practice medicine;
54-21 (2) administer a public reprimand;
54-22 (3) suspend, limit, or restrict the person's license
54-23 or other authorization to practice medicine, including limiting the
54-24 practice of the person to or by the exclusion of one or more
54-25 specified activities of medicine or stipulating periodic board
54-26 review;
54-27 (4) revoke the person's license or other authorization
55-1 to practice medicine;
55-2 (5) require the person to submit to care, counseling,
55-3 or treatment of physicians designated by the board as a condition
55-4 for the initial, continued, or renewal of a license or other
55-5 authorization to practice medicine;
55-6 (6) require the person to participate in a program of
55-7 education or counseling prescribed by the board;
55-8 (7) require the person to practice under the direction
55-9 of a physician designated by the board for a specified period of
55-10 time; <or>
55-11 (8) require the person to perform public service
55-12 considered appropriate by the board; or
55-13 (9) assess an administrative penalty against the
55-14 person as provided by Section 4.125 of this Act.
55-15 (b) Providing however, if the board determines that, through
55-16 the practice of medicine, the physician poses a continuing threat
55-17 to the public welfare, it shall revoke, suspend or deny the
55-18 license.
55-19 (c) In addition to the other disciplinary actions authorized
55-20 by this section, the board may issue a written reprimand to a
55-21 license holder who violates this Act or require that a license
55-22 holder who violates this Act participate in continuing education
55-23 programs. The board shall specify the continuing education
55-24 programs that may be attended and the number of hours that must be
55-25 completed by an individual license holder to fulfill the
55-26 requirements of this subsection.
55-27 (d) If a license suspension is probated, the board may
56-1 require the license holder to:
56-2 (1) report regularly to the board on matters that are
56-3 the basis of the probation;
56-4 (2) limit practice to the areas prescribed by the
56-5 board; or
56-6 (3) continue or review continuing professional
56-7 education until the license holder attains a degree of skill
56-8 satisfactory to the board in those areas that are the basis of the
56-9 probation.
56-10 (e) The schedule of sanctions adopted by the board by rule
56-11 shall be used by the State Office of Administrative Hearings for
56-12 any sanction imposed as the result of a hearing conducted by that
56-13 office.
56-14 SECTION 29. The Medical Practice Act (Article 4495b,
56-15 Vernon's Texas Civil Statutes) is amended by adding Section 4.125
56-16 to read as follows:
56-17 Sec. 4.125. ADMINISTRATIVE PENALTY. (a) The board by order
56-18 may impose an administrative penalty against a person licensed or
56-19 regulated under this Act who violates this Act or a rule or order
56-20 adopted under this Act.
56-21 (b) The penalty for a violation may be in an amount not to
56-22 exceed $5,000. Each day a violation continues or occurs is a
56-23 separate violation for purposes of imposing a penalty.
56-24 (c) The amount of the penalty shall be based on:
56-25 (1) the seriousness of the violation, including the
56-26 nature, circumstances, extent, and gravity of any prohibited acts,
56-27 and the hazard or potential hazard created to the health, safety,
57-1 or economic welfare of the public;
57-2 (2) the economic harm to property or the environment
57-3 caused by the violation;
57-4 (3) the history of previous violations;
57-5 (4) the amount necessary to deter future violations;
57-6 (5) efforts to correct the violation; and
57-7 (6) any other matter that justice may require.
57-8 (d) The board by rule shall prescribe the procedure by which
57-9 it may impose an administrative penalty.
57-10 (e) All proceedings under this section are subject to the
57-11 Administrative Procedure Act and its subsequent amendments.
57-12 (f) If the board by order finds that a violation has
57-13 occurred and imposes an administrative penalty, the board shall
57-14 give notice to the person of the board's order. The notice must
57-15 include a statement of the right of the person to judicial review
57-16 of the order.
57-17 (g) Within 30 days after the date the board's order imposing
57-18 the penalty is final as provided by Section 16(c), Administrative
57-19 Procedure Act, and its subsequent amendments, the person shall:
57-20 (1) pay the amount of the penalty;
57-21 (2) pay the amount of the penalty and file a petition
57-22 for judicial review contesting the occurrence of the violation, the
57-23 amount of the penalty, or both the occurrence of the violation and
57-24 the amount of the penalty; or
57-25 (3) without paying the amount of the penalty, file a
57-26 petition for judicial review contesting the occurrence of the
57-27 violation, the amount of the penalty, or both the occurrence of the
58-1 violation and the amount of the penalty.
58-2 (h) Within the 30-day period, a person who acts under
58-3 Subsection (g)(3) of this section may:
58-4 (1) stay enforcement of the penalty by:
58-5 (A) paying the amount of the penalty to the
58-6 court for placement in an escrow account; or
58-7 (B) giving to the court a supersedeas bond that
58-8 is approved by the court for the amount of the penalty and that is
58-9 effective until all judicial review of the board's order is final;
58-10 or
58-11 (2) request the court to stay enforcement of the
58-12 penalty by:
58-13 (A) filing with the court a sworn affidavit of
58-14 the person stating that the person is financially unable to pay the
58-15 amount of the penalty and is financially unable to give the
58-16 supersedeas bond; and
58-17 (B) giving a copy of the affidavit to the
58-18 executive director by certified mail.
58-19 (i) An executive director who receives a copy of an
58-20 affidavit under Subsection (h)(2) of this section may file with the
58-21 court, within five days after the date the copy is received, a
58-22 contest to the affidavit. The court shall hold a hearing on the
58-23 facts alleged in the affidavit as soon as practicable and shall
58-24 stay the enforcement of the penalty on finding that the alleged
58-25 facts are true. The person who files an affidavit has the burden
58-26 of proving that the person is financially unable to pay the amount
58-27 of the penalty and to give a supersedeas bond.
59-1 (j) If the person does not pay the amount of the penalty and
59-2 the enforcement of the penalty is not stayed, the executive
59-3 director may refer the matter to the attorney general for
59-4 collection of the amount of the penalty.
59-5 (k) If on appeal the court sustains the occurrence of the
59-6 violation, the court may uphold or reduce the amount of the penalty
59-7 and order the person to pay the full or reduced amount of the
59-8 penalty. If the court does not sustain the occurrence of the
59-9 violation, the court shall order that no penalty is owed.
59-10 (l) When the judgment of the court becomes final, the court
59-11 shall proceed under this subsection. If the person paid the amount
59-12 of the penalty and if that amount is reduced or is not upheld by
59-13 the court, the court shall order that the appropriate amount plus
59-14 accrued interest be remitted to the person. The rate of the
59-15 interest is the rate charged on loans to depository institutions by
59-16 the New York Federal Reserve Bank, and the interest shall be paid
59-17 for the period beginning on the date the penalty was paid and
59-18 ending on the date the penalty is remitted. If the person gave a
59-19 supersedeas bond and if the amount of the penalty is not upheld by
59-20 the court, the court shall order the release of the bond. If the
59-21 person gave a supersedeas bond and if the amount of the penalty is
59-22 reduced, the court shall order the release of the bond after the
59-23 person pays the amount.
59-24 (m) A penalty collected under this section shall be remitted
59-25 to the comptroller for deposit in the general revenue fund.
59-26 SECTION 30. The Medical Practice Act (Article 4495b,
59-27 Vernon's Texas Civil Statutes) is amended by adding Section 4.126
60-1 to read as follows:
60-2 Sec. 4.126. CIVIL PENALTY. (a) If it appears that a person
60-3 is in violation of or is threatening to violate this Act or a rule
60-4 or order adopted by the board, the attorney general may institute
60-5 an action for a civil penalty of $1,000 for each violation. Each
60-6 day of a violation shall constitute a separate violation.
60-7 (b) A civil action filed under this section by the attorney
60-8 general must be filed in a district court in Travis County or the
60-9 county in which the violation occurred.
60-10 (c) The attorney general may recover reasonable expenses
60-11 incurred in obtaining a civil penalty under this section, including
60-12 court costs, reasonable attorney's fees, investigative costs,
60-13 witness fees, and deposition expenses.
60-14 (d) A civil penalty recovered in an action by the attorney
60-15 general under this section shall be deposited in the general
60-16 revenue fund.
60-17 SECTION 31. Section 4.13, Medical Practice Act (Article
60-18 4495b, Vernon's Texas Civil Statutes), is amended to read as
60-19 follows:
60-20 Sec. 4.13. Temporary Suspension of License. (a) The
60-21 president of the board, with the approval of the board, shall
60-22 appoint a three-member disciplinary panel consisting of members of
60-23 the board for the purpose of determining whether a person's license
60-24 to practice medicine in this state should be temporarily suspended
60-25 under this section.
60-26 (b) If the disciplinary panel <executive committee of the
60-27 board> determines from the evidence or information presented to it
61-1 that a person licensed to practice medicine in this state by his
61-2 continuation in practice would constitute a continuing threat to
61-3 the public welfare, the disciplinary panel <executive committee of
61-4 the board> shall temporarily suspend the license of that person.
61-5 (c) The license may be suspended under this section without
61-6 notice or hearing on the complaint, provided institution of
61-7 proceedings for a hearing before the board is initiated
61-8 simultaneously with the temporary suspension and provided that a
61-9 hearing is held as soon as can be accomplished under the
61-10 Administrative Procedure Act and this Act.
61-11 (d) Notwithstanding the open meetings law, Chapter 271, Acts
61-12 of the 60th Legislature, Regular Session, 1967 (Article 6252-17,
61-13 Vernon's Texas Civil Statutes), the disciplinary panel may hold a
61-14 meeting by telephone conference call if immediate action is
61-15 required and the convening at one location of the disciplinary
61-16 panel is inconvenient for any member of the disciplinary panel.
61-17 SECTION 32. Subchapter E, Medical Practice Act (Article
61-18 4495b, Vernon's Texas Civil Statutes), is amended by adding Section
61-19 5.035 to read as follows:
61-20 Sec. 5.035. GRADUATES OF UNAPPROVED FOREIGN MEDICAL SCHOOLS.
61-21 (a) An applicant who is a graduate of a medical school that is
61-22 located outside the United States and Canada and that was not
61-23 approved by the board at the time the degree was conferred, to be
61-24 eligible for the issuance of a license, must present satisfactory
61-25 proof to the board that the applicant:
61-26 (1) meets the requirements set out in Sections
61-27 3.04(a)(1), (2), and (3) of this Act;
62-1 (2) is a graduate of a school whose curriculum meets
62-2 the requirements for an unapproved medical school as determined by
62-3 a committee of experts selected by the Texas Higher Education
62-4 Coordinating Board;
62-5 (3) has successfully completed three years of graduate
62-6 medical training in the United States or Canada that was approved
62-7 by the board on the date the training was completed;
62-8 (4) is eligible for licensure to practice medicine in
62-9 the country in which the school is located;
62-10 (5) possesses a valid certificate issued by the
62-11 Educational Commission for Foreign Medical Graduates;
62-12 (6) has the ability to communicate in the English
62-13 language; and
62-14 (7) has passed the examination required by the board
62-15 of all applicants for license as required by Section 3.05 of this
62-16 Act.
62-17 (b) In addition to other licensure requirements, the board
62-18 may require by rule that a graduate of an unapproved medical school
62-19 located outside the United States and Canada or the school of which
62-20 the person is a graduate provide additional information to the
62-21 board concerning the school before approving the applicant.
62-22 (c) The board may refuse to issue a license to an applicant
62-23 who graduated from an unapproved medical school located outside the
62-24 United States and Canada if it finds that the applicant does not
62-25 possess the requisite qualifications to provide the same standard
62-26 of medical care as provided by a physician licensed in this state.
62-27 (d) The board may refuse to issue a license to an applicant
63-1 who graduated from an unapproved medical school located outside the
63-2 United States and Canada if the applicant fails to provide the
63-3 board evidence to establish that the applicant completed medical
63-4 education or professional training substantially equivalent to that
63-5 provided by a medical school in this state.
63-6 SECTION 33. Section 5.04, Medical Practice Act, is amended
63-7 to read as follows:
63-8 Sec. 5.04. FIFTH PATHWAY FOR FOREIGN MEDICAL SCHOOL
63-9 STUDENTS. (a) An applicant <Notwithstanding any other provision
63-10 of law, an individual> who has been a student of a foreign medical
63-11 school, to be eligible for the issuance of a license, must present
63-12 satisfactory proof to the board that the applicant <is eligible for
63-13 licensure to practice medicine in this state if he>:
63-14 (1) meets the requirements set out in Sections
63-15 3.04(a)(1), (2), and (3) of this Act;
63-16 (2) has studied medicine in an acceptable <a
63-17 reputable> medical school as defined by the board located outside
63-18 the United States and Canada;
63-19 (3) <(2)> has completed all of the didactic work of
63-20 the foreign medical school but has not graduated from the school;
63-21 (4) <(3)> has attained a score satisfactory to a
63-22 medical school in the United States approved by the Liaison
63-23 Committee on Medical Education on a qualifying examination and has
63-24 satisfactorily completed one academic year of supervised clinical
63-25 training for foreign medical students as defined by the American
63-26 Medical Association Council on Medical Education (Fifth Pathway
63-27 Program) under the direction of the medical school in the United
64-1 States;
64-2 (5) <(4)> has attained a passing score on the
64-3 Educational Commission <Council> for Foreign Medical Graduates
64-4 examination, or other examination, if required by the board; <and>
64-5 (6) has successfully completed three years of graduate
64-6 medical training in the United States or Canada that was approved
64-7 by the board on the date the training was completed; and
64-8 (7) <(5)> has passed the examination required by the
64-9 board of all applicants for license as required by Section 3.05 of
64-10 this Act.
64-11 (b) Satisfaction of the requirements of Subsection (a) of
64-12 this section are in lieu of the completion of any requirements of
64-13 the foreign medical school beyond completion of the didactic work,
64-14 and no other medical education requirements shall be a condition of
64-15 licensure to practice medicine in this state.
64-16 (c) Satisfaction of the requirements specified in Subsection
64-17 (a) of this section shall be in lieu of certification by the
64-18 Educational Commission <Council> for Foreign Medical Graduates, and
64-19 the certification is not a condition of licensure to practice
64-20 medicine in this state for candidates who have completed the
64-21 requirements of Subsection (a) of this section.
64-22 (d) A hospital that is licensed by this state, that is
64-23 operated by the state or a political subdivision of the state, or
64-24 that receives state financial assistance, directly or indirectly,
64-25 may not require an individual who has been a student of a foreign
64-26 medical school but has not graduated from the school to satisfy any
64-27 requirements other than those contained in <Subdivisions (1), (2),
65-1 (3), and (4) of> Subsection (a) of this section prior to commencing
65-2 an internship or residency.
65-3 (e) A document granted by a medical school located outside
65-4 the United States issued after the completion of all the didactic
65-5 work of the foreign medical school shall, on certification by the
65-6 medical school in the United States in which the training was
65-7 received of satisfactory completion by the person to whom the
65-8 document was issued of the requirements listed in Subdivision (4)
65-9 <(3)> of Subsection (a) of this section, be considered the
65-10 equivalent of a degree of doctor of medicine or doctor of
65-11 osteopathy for purposes of licensure.
65-12 SECTION 34. Section 5.08(k), Medical Practice Act (Article
65-13 4495b, Vernon's Texas Civil Statutes), is amended to read as
65-14 follows:
65-15 (k) A physician shall furnish copies of medical records
65-16 requested, or a summary or narrative of the records, pursuant to a
65-17 written consent for release of the information as provided by
65-18 Subsection (j) of this section, except if the physician determines
65-19 that access to the information would be harmful to the physical,
65-20 mental, or emotional health of the patient, and the physician may
65-21 delete confidential information about another person who has not
65-22 consented to the release. The information shall be furnished by
65-23 the physician within 30 days after the date of receipt of the
65-24 request <a reasonable period of time> and reasonable fees for
65-25 furnishing the information shall be paid by the patient or someone
65-26 on his behalf. If the physician denies the request, in whole or in
65-27 part, the physician shall furnish the patient a written statement,
66-1 signed and dated, stating the reason for the denial. A copy of the
66-2 statement denying the request shall be placed in the patient's
66-3 medical records. In this subsection, "medical records" means any
66-4 records pertaining to the history, diagnosis, treatment, or
66-5 prognosis of the patient.
66-6 SECTION 35. Section 5.10, Medical Practice Act (Article
66-7 4495b, Vernon's Texas Civil Statutes), is amended to read as
66-8 follows:
66-9 Sec. 5.10. Sunset provision. The Texas State Board of
66-10 Medical Examiners is subject to Chapter 325, Government Code (Texas
66-11 Sunset Act). Unless continued in existence as provided by that
66-12 chapter, the board is abolished and this Act expires September 1,
66-13 2005 <1993>.
66-14 SECTION 36. The Medical Practice Act (Article 4495b,
66-15 Vernon's Texas Civil Statutes) is amended by adding Subchapter F to
66-16 read as follows:
66-17 SUBCHAPTER F. ACUPUNCTURE PRACTICE
66-18 Sec. 6.01. LEGISLATIVE FINDINGS AND PURPOSE. The
66-19 legislature finds that:
66-20 (1) the review and establishment of statewide
66-21 standards for the training, education, and discipline of persons
66-22 performing acupuncture are in the public interest; and
66-23 (2) the health, safety, and welfare of the people of
66-24 this state are best served by an orderly system of regulating the
66-25 practice of acupuncture.
66-26 Sec. 6.02. DEFINITIONS. In this subchapter:
66-27 (1) "Acupuncture" means:
67-1 (A) the insertion of an acupuncture needle and
67-2 the application of moxibustion to specific areas of the human body
67-3 as a primary mode of therapy to treat and mitigate a human
67-4 condition; and
67-5 (B) the administration of thermal or electrical
67-6 treatments or the recommendation of dietary guidelines, therapeutic
67-7 exercise, or dietary or herbal supplements in conjunction with the
67-8 treatment described by Paragraph (A) of this subdivision.
67-9 (2) "Acupuncturist" means a person who practices
67-10 acupuncture.
67-11 (3) "Acupuncture board" means the Texas State Board of
67-12 Acupuncture Examiners.
67-13 (4) "Chiropractor" means a licensee of the Texas Board
67-14 of Chiropractic Examiners.
67-15 (5) "Executive director" means the executive director
67-16 of the Texas State Board of Medical Examiners.
67-17 (6) "Medical board" means the Texas State Board of
67-18 Medical Examiners.
67-19 (7) "Physician" means a licensee of the Texas State
67-20 Board of Medical Examiners.
67-21 Sec. 6.03. EXEMPTION; LIMITATION. (a) This subchapter does
67-22 not apply to a health care professional licensed under another
67-23 subchapter of this Act or another statute of this state and acting
67-24 within the scope of the license.
67-25 (b) This subchapter does not:
67-26 (1) limit the practice of medicine by a physician or
67-27 permit the unauthorized practice of medicine; or
68-1 (2) permit a person to dispense, administer, or supply
68-2 any controlled substance, narcotic, or dangerous drug if the person
68-3 is not otherwise authorized by law to do so.
68-4 Sec. 6.04. ACUPUNCTURE BOARD. (a) The Texas State Board of
68-5 Acupuncture Examiners is composed of nine members appointed by the
68-6 governor as follows:
68-7 (1) four acupuncturists who have at least five years
68-8 of experience in the practice of acupuncture in this state and are
68-9 not licensed in this state as physicians;
68-10 (2) two physicians who are licensed in this state and
68-11 are experienced in the practice of acupuncture; and
68-12 (3) three members of the general public who are not
68-13 licensed or trained in a health care profession and who represent
68-14 the public.
68-15 (b) The following persons may not serve on the acupuncture
68-16 board:
68-17 (1) a person who is required to register as a lobbyist
68-18 under Chapter 305, Government Code, and its subsequent amendments;
68-19 and
68-20 (2) a person who is currently employed by or serving
68-21 as president, vice-president, secretary, or treasurer of a
68-22 statewide or national organization incorporated for the purpose of
68-23 representing a health care profession in this state or the United
68-24 States.
68-25 (c) Members of the acupuncture board hold office for
68-26 staggered terms of six years, with three members' terms expiring
68-27 January 31 of each odd-numbered year.
69-1 (d) The governor shall designate a presiding officer of the
69-2 acupuncture board from the members of the acupuncture board.
69-3 (e) A vacancy on the acupuncture board shall be filled by
69-4 appointment of the governor.
69-5 (f) A member of the acupuncture board may not receive
69-6 compensation for service on the board but is entitled to receive a
69-7 per diem as set by legislative appropriation for transportation and
69-8 related expenses incurred for each day that the member engages in
69-9 the business of the board.
69-10 (g) The acupuncture board is subject to the open meetings
69-11 law, the open records law, and the Administrative Procedure Act and
69-12 any subsequent amendments.
69-13 (h) The acupuncture board is subject to Chapter 325,
69-14 Government Code (Texas Sunset Act). Unless continued in existence
69-15 as provided by that chapter, the board is abolished and this
69-16 subchapter expires September 1, 1997.
69-17 Sec. 6.05. POWERS AND DUTIES OF ACUPUNCTURE BOARD. (a)
69-18 Subject to the advice and approval of the medical board, the
69-19 acupuncture board shall:
69-20 (1) establish qualifications for an acupuncturist to
69-21 practice in this state;
69-22 (2) establish minimum educational and training
69-23 requirements necessary for the acupuncture board to recommend that
69-24 the medical board issue a license to practice acupuncture;
69-25 (3) administer an examination that is validated by
69-26 independent testing professionals for a license to practice
69-27 acupuncture;
70-1 (4) develop requirements for licensure by endorsement
70-2 of other states;
70-3 (5) prescribe the application form for a license to
70-4 practice acupuncture;
70-5 (6) make recommendations on applications for licenses
70-6 to practice acupuncture;
70-7 (7) establish a procedure for reporting and processing
70-8 complaints relating to the practice of acupuncture under this
70-9 article;
70-10 (8) establish the requirements for a tutorial program
70-11 for students who have completed at least 48 semester hours of
70-12 college; and
70-13 (9) recommend additional rules as are necessary for
70-14 the administration and enforcement of this subchapter.
70-15 (b) Notwithstanding Subsection (a) of this section, the
70-16 acupuncture board has no independent rulemaking authority.
70-17 Sec. 6.06. LICENSE REQUIRED. A person may not practice
70-18 acupuncture in this state unless the person holds a license to
70-19 practice acupuncture issued by the medical board under this
70-20 subchapter.
70-21 Sec. 6.07. QUALIFICATIONS OF ACUPUNCTURISTS. (a) An
70-22 applicant for a license to practice acupuncture who is not
70-23 otherwise licensed under this subchapter must pass an examination
70-24 approved by the acupuncture board.
70-25 (b) To be eligible for the examination, an applicant must:
70-26 (1) be at least 21 years of age;
70-27 (2) have completed at least 48 semester hours of
71-1 college courses, including basic science courses as determined by
71-2 the advisory board; and
71-3 (3) be a graduate of an acceptable acupuncture school
71-4 whose entrance requirements and course of instruction meet
71-5 standards set by the acupuncture board.
71-6 (c) A reputable acupuncture school must:
71-7 (1) maintain a resident course of instruction
71-8 equivalent to not less than six terms of four months each for a
71-9 total of not less than 1,800 instructional hours;
71-10 (2) provide supervised patient treatment for at least
71-11 two terms of the resident course of instruction;
71-12 (3) maintain a course of instruction in
71-13 anatomy-histology, bacteriology, physiology, symptomatology,
71-14 pathology, meridian and point locations, hygiene, and public
71-15 health; and
71-16 (4) have the necessary teaching force and facilities
71-17 for proper instruction in required subjects.
71-18 (d) In establishing standards for the entrance requirements
71-19 and course of instruction of an acupuncture school, the acupuncture
71-20 board may consider the standards set by the National Accreditation
71-21 Commission for Schools and Colleges of Acupuncture and Oriental
71-22 Medicine.
71-23 (e) The examination shall be conducted on practical and
71-24 theoretical acupuncture and other subjects required by the
71-25 acupuncture board.
71-26 (f) An application for examination must be:
71-27 (1) in writing on a form prescribed by the acupuncture
72-1 board;
72-2 (2) verified by affidavit;
72-3 (3) filed with the executive director of the medical
72-4 board; and
72-5 (4) accompanied by a fee set by the medical board.
72-6 (g) The medical board shall notify all applicants of the
72-7 time and place of the examination.
72-8 (h) The examination may be in writing, by a practical
72-9 demonstration of the applicant's skill, or both, as the acupuncture
72-10 board may require.
72-11 Sec. 6.08. ASSISTANCE BY MEDICAL BOARD. The medical board
72-12 shall provide administrative and clerical employees as necessary to
72-13 enable the acupuncture board to carry out this subchapter.
72-14 Sec. 6.09. FEES. (a) The medical board shall set and
72-15 collect fees in amounts that are reasonable and necessary to cover
72-16 the costs of administering and enforcing this subchapter without
72-17 the use of any other funds generated by the medical board.
72-18 (b) Fees collected by the medical board under this
72-19 subchapter shall be deposited by the medical board in the state
72-20 treasury to the credit of an account in the general revenue fund
72-21 and may be expended to cover the costs of administering and
72-22 enforcing this subchapter. At the end of each fiscal biennium, the
72-23 comptroller shall transfer any surplus money remaining in the
72-24 account to the general revenue fund.
72-25 Sec. 6.10. ISSUANCE OF LICENSE. (a) After consulting the
72-26 acupuncture board, the medical board shall issue a license to
72-27 practice acupuncture in this state to a person who meets the
73-1 requirements of this subchapter and the rules adopted under this
73-2 subchapter.
73-3 (b) The medical board shall by rule provide for the annual
73-4 renewal of a license to practice acupuncture.
73-5 Sec. 6.11. DENIAL OF LICENSE; DISCIPLINE OF LICENSE HOLDER.
73-6 (a) A license to practice acupuncture may be denied or, after
73-7 notice and hearing, suspended, probated, or revoked if the
73-8 applicant for a license or the holder of a license:
73-9 (1) uses drugs or intoxicating liquors to an extent
73-10 that affects the person's professional competence;
73-11 (2) obtains or attempts to obtain a license by fraud
73-12 or deception;
73-13 (3) is adjudged mentally incompetent by a court of
73-14 competent jurisdiction;
73-15 (4) practices acupuncture in a manner detrimental to
73-16 the public health and welfare;
73-17 (5) violates this subchapter or a rule adopted under
73-18 this subchapter;
73-19 (6) is convicted of a felony or a crime involving
73-20 moral turpitude; or
73-21 (7) holds himself out as a physician or surgeon or any
73-22 combination or derivative of those terms unless the person is also
73-23 licensed by the medical board as a physician or surgeon.
73-24 (b) Except as provided by Subsection (c) of this section, a
73-25 license to practice acupuncture shall be denied or, after notice
73-26 and hearing, revoked if the holder of a license has performed
73-27 acupuncture on a person who was not evaluated by a physician or
74-1 dentist, as appropriate, for the condition being treated within six
74-2 months before the date acupuncture was performed.
74-3 (c) The holder of a license may perform acupuncture on a
74-4 person who was referred by a doctor licensed to practice
74-5 chiropractic by the Texas Board of Chiropractic Examiners if the
74-6 licensee commences the treatment within 30 days of the date of the
74-7 referral. The licensee shall refer the person to a physician after
74-8 performing acupuncture 20 times or for 30 days, whichever occurs
74-9 first, if no substantial improvement occurs in the person's
74-10 condition for which the referral was made.
74-11 (d) The holder of a license must obtain reasonable
74-12 documentation that the evaluation required by Subsection (b) of
74-13 this section has taken place. If the licensee is unable to
74-14 determine that an evaluation has taken place, the licensee must
74-15 obtain a written statement signed by the person on a form
74-16 prescribed by the acupuncture board that states that the person has
74-17 been evaluated by a physician within the prescribed time frame.
74-18 The form shall contain a clear statement that the person should be
74-19 evaluated by a physician for the condition being treated by the
74-20 licensee.
74-21 (e) The medical board with advice from the acupuncture board
74-22 by rule may modify the requirement of the time frame or the scope
74-23 of the evaluation under Subsection (b) of this section.
74-24 (f) The medical board with advice from the acupuncture board
74-25 by rule may modify the requirement of the time frame for
74-26 commencement of treatment after referral by a chiropractor or the
74-27 number of treatments or days before referral to a physician is
75-1 required under Subsection (c) of this section.
75-2 (g) Notwithstanding Subsections (b) and (c) of this section,
75-3 an acupuncturist holding a current and valid license may without a
75-4 referral from a physician, dentist, or chiropractor perform
75-5 acupuncture on a person for smoking addiction, weight loss, or, as
75-6 established by the medical board with advice from the acupuncture
75-7 board by rule, substance abuse.
75-8 Sec. 6.12. OFFENSE. (a) A person commits an offense if the
75-9 person violates Section 6.06 of this Act.
75-10 (b) An offense under Subsection (a) of this section is a
75-11 Class A misdemeanor.
75-12 (c) Each day of a violation constitutes a separate offense.
75-13 Sec. 6.13. INJUNCTIVE RELIEF; CIVIL PENALTY. (a) The
75-14 medical board, the attorney general, or a district or county
75-15 attorney may bring a civil action to compel compliance with this
75-16 subchapter or to enforce a rule adopted under this subchapter.
75-17 (b) In addition to injunctive relief or any other remedy
75-18 provided by law, a person who violates this subchapter or a rule
75-19 adopted under this subchapter is liable to the state for a civil
75-20 penalty in an amount not to exceed $2,000 for each violation. Each
75-21 day a violation continues or occurs is a separate violation for
75-22 purposes of imposing a civil penalty. The attorney general, at the
75-23 request of the medical board or on the attorney general's own
75-24 initiative, may bring a civil action to collect a civil penalty
75-25 under this subsection. A civil penalty recovered shall be
75-26 deposited to the credit of the general revenue fund.
75-27 Sec. 6.14. AUTOMATIC LICENSURE. (a) With the approval of
76-1 the medical board, the acupuncture board shall establish
76-2 appropriate and reasonable requirements to determine those persons
76-3 practicing acupuncture on the effective date of this subchapter who
76-4 are eligible for immediate approval for a license to practice
76-5 acupuncture under this section.
76-6 (b) This section only applies to a person who meets the
76-7 requirements for immediate licensure under this section and who
76-8 applies for immediate approval on or before June 1, 1994.
76-9 (c) This section expires June 2, 1994.
76-10 SECTION 37. (a) As soon as possible on or after the
76-11 effective date of this Act, the governor shall appoint 15 new
76-12 members to the Texas State Board of Medical Examiners in accordance
76-13 with Section 2.05, Medical Practice Act (Article 4495b, Vernon's
76-14 Texas Civil Statutes), as amended by this Act. In making the
76-15 appointments, the governor shall designate five members for terms
76-16 expiring April 13, 1995, five members for terms expiring April 13,
76-17 1997, and five members for terms expiring April 13, 1999. The
76-18 members appointed under this subsection may not perform the
76-19 functions of the board until the day after the date a majority of
76-20 the new members take office.
76-21 (b) Until the date the new members of the Texas State Board
76-22 of Medical Examiners may begin performing the functions of the
76-23 board under Subsection (a) of this section, the members serving on
76-24 the board immediately before the effective date of this Act shall
76-25 continue to carry out the functions of the board. On the date the
76-26 new members may begin performing the functions of the board, the
76-27 offices of the members serving immediately before the effective
77-1 date of this Act are abolished.
77-2 (c) The changes in law made by this Act in the
77-3 qualifications of, and the prohibitions applying to, members of the
77-4 Texas State Board of Medical Examiners do not affect the
77-5 entitlement of a member serving on the board immediately before the
77-6 effective date of this Act to continue to carry out the functions
77-7 of the board for the period prescribed by Subsection (b) of this
77-8 section. The changes in law apply only to a member appointed on or
77-9 after the effective date of this Act. This Act does not prohibit a
77-10 person who is a member of the board on the effective date of this
77-11 Act from being reappointed to the board if the person has the
77-12 qualifications required for a member under the Medical Practice Act
77-13 (Article 4495b, Vernon's Texas Civil Statutes), as amended by this
77-14 Act.
77-15 (d) The changes in law made by this Act relating to an
77-16 administrative penalty or civil penalty apply only to a violation
77-17 of the Medical Practice Act (Article 4495b, Vernon's Texas Civil
77-18 Statutes) or a rule or order adopted by the Texas State Board of
77-19 Medical Examiners that occurs on or after the effective date of
77-20 this Act. A violation occurs on or after the effective date of
77-21 this Act only if each element of the violation occurs on or after
77-22 that date. A violation that occurs before the effective date of
77-23 this Act is governed by the law in effect on the date the violation
77-24 occurred, and the former law is continued in effect for that
77-25 purpose.
77-26 (e) A person is not required to obtain a license to practice
77-27 acupuncture under Subchapter F, Medical Practice Act (Article
78-1 4495b, Vernon's Texas Civil Statutes), as added by this Act, until
78-2 June 1, 1994.
78-3 (f) The Texas State Board of Medical Examiners shall adopt
78-4 rules under Subchapter F, Medical Practice Act (Article 4495b,
78-5 Vernon's Texas Civil Statutes), as added by this Act, not later
78-6 than February 1, 1994.
78-7 (g) Not later than January 1, 1994, the governor shall make
78-8 initial appointments to the Texas State Board of Acupuncture
78-9 Examiners and shall designate three members for terms expiring
78-10 January 31, 1995, three members for terms expiring January 31,
78-11 1997, and three members for terms expiring January 31, 1999.
78-12 (h) Notwithstanding other provisions of this Act, Sections
78-13 6.06 and 6.12 of the Medical Practice Act (Article 4495b, Vernon's
78-14 Texas Civil Statutes), as added by this Act, take effect June 1,
78-15 1994.
78-16 SECTION 38. This Act takes effect September 1, 1993.
78-17 SECTION 39. The importance of this legislation and the
78-18 crowded condition of the calendars in both houses create an
78-19 emergency and an imperative public necessity that the
78-20 constitutional rule requiring bills to be read on three several
78-21 days in each house be suspended, and this rule is hereby suspended.