BILL ANALYSIS



C.S.H.B. 2669
By: Crabb
04-13-95
Committee Report (Substituted)


BACKGROUND

Currently, the Texas State Board of Medical Examiners (Board) has
no authority to regulate out-of-state physicians who use electronic
telecommunication technologies to practice medicine in Texas. An
out-of-state radiologist, for example, can use this technology to
read radiological films of Texas patients. Patients receiving such
care are not protected by the licensing and regulation that the
Board requires of in-state physicians, and the Board has no
authority to evaluate the qualifications of or to monitor the
standards of practice of these physicians.

PURPOSE

H.B. 2669 gives the Texas State Board of Medical Examiners the
authority to regulate out-of-state physicians who use an electronic
medium to practice medicine in Texas.

RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not expressly
grant any additional rulemaking authority to a state officer,
department, agency or institution.

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Section 3.06(b), Medical Practice Act, (Article
           4495b, Vernon's Texas Civil Statutes), to include an
           out-of-state physician who is consulting in Texas with
           state licensed physicians among the persons to which
           this Act does not apply. Provides that a physician who
           is exempt may not have an office or location in the
           state used for medical treatment of patients.

SECTION 2. Adds Section 3.06(i) to the Medical Practice Act,
(Article 4495b, V.T.C.S.), 
           providing that a person who is physically located in
           another jurisdiction using any medium, including an
           electronic medium, to perform an act in this state,
           including patient care initiated in this state, taking
           an X-ray, or preparing pathological material for
           examination and therefore affecting the diagnosis or
           treatment of a patient, is engaged in the practice of
           medicine in this state and is subject to this Act and
           regulation by the Board. Establishes that this
           Subsection does not apply to a medical specialist
           located in another jurisdiction and providing occasional
           or episodic consultation services on request to a person
           licensed in this state who practices the same medical
           specialty.

SECTION 3. Emergency clause.
           Effective upon passage.

COMPARISON OF ORIGINAL TO SUBSTITUTE

The Substitute for H.B. 2669 clarifies the bill in Section 3.06(i),
Medical Practice Act, Article 4495b, V.T.C.S., by specifying that
this applies to a person using any medium, not just an electronic
medium, and that this applies to patient care service initiated in
this state affecting the diagnosis or treatment of the patient.
Specifies the medical practices affected by this, including taking
an X-ray or preparing pathological material for examination, and
that this subsection does not apply to the act of a medical
specialist located in another jurisdiction providing occasional or
episodic consultation services to a person licensed in this state
who practices the same medical specialty.

SUMMARY OF COMMITTEE ACTION

H.B. 2669 was considered by the Public Health Committee in a public
hearing on April 11, 1995. The committee considered a complete
substitute for the bill. The substitute was adopted without 
objection.

The following persons testified for the bill:

Representative Crabb, author of the bill.
Thomas Michael Wheeler, representing the Texas Society of
Pathologists.
Charles W. Yeats, Jr., representing self and Texas Radiological
Society.

The bill was reported favorably as substituted, with the
recommendation that it do pass and be printed, by a record vote of
5 Ayes, 0 Nays, 0 PNV, AND 4 Absent.