By Berlanga                                           H.R. No. 1139

         75R16646 PB-D                           

                                 R E S O L U T I O N

 1-1           BE IT RESOLVED by the House of Representatives of the State

 1-2     of Texas, 75th Legislature, Regular Session, 1997, That House Rule

 1-3     13, Section 9(a), be suspended in part as provided by House Rule

 1-4     13, Section 9(f), to enable the conference committee appointed to

 1-5     resolve the differences on House Bill No. 2846 to consider and take

 1-6     action on the following matters:

 1-7           (1)  House Rule 13, Sections 9(a)(3) and (4), are suspended

 1-8     to permit the committee to add text incorporating a new Section in

 1-9     the bill, appropriately numbered, to amend Section 3.10, Medical

1-10     Practice Act (Article 4495b, Vernon's Texas Civil Statutes), to

1-11     read as follows:

1-12           SECTION ____.  Section 3.10, Medical Practice Act (Article

1-13     4495b, Vernon's Texas Civil Statutes), as amended by Chapters 214

1-14     and 862, Acts of the 73rd Legislature, Regular Session, 1993, is

1-15     amended to read as follows:

1-16           Sec. 3.10.  FEES.  (a)  All annual registration fees

1-17     collected by the board shall be placed in the State Treasury to the

1-18     credit of the medical registration fund.  The fees deposited to

1-19     this special fund shall be credited to the appropriations of the

1-20     board and may be spent only as provided by the General

1-21     Appropriations Act, this Act, or other applicable statutes.  Money

1-22     in that fund may be used by the board and under its direction in

1-23     the enforcement of this Act, the prohibition of the unlawful

1-24     practice of medicine, the dissemination of information to prevent

 2-1     the violation of the laws, and the prosecution of those who violate

 2-2     the laws.  All distributions from the fund may be made only upon

 2-3     written approval of the secretary-treasurer of the board or his

 2-4     designated representative, and the comptroller shall upon

 2-5     requisition of the board from time to time draw warrants upon the

 2-6     State Treasurer for the amounts specified in the requisition.

 2-7           (b)  The board may not set, charge, collect, receive, or

 2-8     deposit any of the following fees in excess of:

 2-9                 (1)  for  processing    and   granting   a    license

2-10                        by   reciprocity  to   a  licensee   of

2-11                        another state .................... $1,000 [$700]

2-12                 (2)  for  processing an  application  and

2-13                        administration of a partial  examination  for

2-14                        licensure ........................ $1,000 [$700]

2-15                 (3)  for  processing  an  application and

2-16                        administration  of  a complete examination for

2-17                        licensure ........................ $1,000 [$700]

2-18                 (4)  for processing an application and issuance of a

2-19                        temporary license ......................... $200

2-20                 (5)  for processing an application and issuance of a

2-21                        duplicate license ......................... $200

2-22                 (6)  for processing an application and issuance of a

2-23                        license of reinstatement after a lapse or

2-24                        cancellation of a license ........ $1,000 [$700]

2-25                 (7)  for processing an application and issuance of an

2-26                        annual registration of a licensee ......... $200

2-27                 (8)  for processing and issuance of an institutional

 3-1                        permit for interns, residents, and others in

 3-2                        approved medical training programs ........ $200

 3-3                 (9)  for processing an application and issuance of an

 3-4                        endorsement to other state medical boards . $200

 3-5                 (10)  for  processing and  issuance   of   a   license

 3-6                        or    temporary license   to  a   physician

 3-7                        assistant ................................. $200

 3-8                 (11)  for   processing   and  issuance  of  a permit

 3-9                        to  a   physician  who supervises an

3-10                        acupuncturist ........................... $200. 

3-11           (c) [(b)]  The board may set and collect a sales charge for

3-12     making copies of any paper of record in the office of the board and

3-13     for any printed material published by the board.  The charges shall

3-14     be in amounts considered sufficient to reimburse the board for the

3-15     actual expense.

3-16           (d) [(c)]  The financial transactions of the board are

3-17     subject to audit by the state auditor in accordance with Chapter

3-18     321, Government Code.

3-19           (e) [(d)]  The board shall file annually with the governor

3-20     and the presiding officer of each house of the legislature a

3-21     complete and detailed written report accounting for all funds

3-22     received and disbursed by the board during the preceding fiscal

3-23     year.  The annual report must be in the form and reported in the

3-24     time provided by the General Appropriations Act.

3-25           Explanation:  This change is necessary to increase certain

3-26     fees assessed by the Texas State Board of Medical  Examiners to

3-27     levels that cover the administrative costs of that agency in

 4-1     providing the affected services.

 4-2           (2)  House Rule 13, Sections 9(a)(3) and (4), are suspended

 4-3     to permit the committee to add text incorporating a new Section in

 4-4     the bill, appropriately numbered, to amend the Medical Practice Act

 4-5     (Article 4495b, Vernon's Texas Civil Statutes) to add a new Section

 4-6     5.11 to read as follows:

 4-7           SECTION _____.  Subchapter E, Medical Practice Act (Article

 4-8     4495b, Vernon's Texas Civil  Statutes), is amended by adding

 4-9     Section 5.11 to read as follows:

4-10           Sec. 5.11.  PHYSICIAN PROFILES.  (a)  The board shall create

4-11     a profile of each physician licensed under this Act.  The profile

4-12     must:

4-13                 (1)  include the information required by Subsection (b)

4-14     of this section; and

4-15                 (2)  be compiled in a format that permits the board to

4-16     make the information contained in the profile available to the

4-17     public.

4-18           (b)  A profile must contain the following information on each

4-19     physician:

4-20                 (1)  the name of each medical school attended and the

4-21     dates of graduation;

4-22                 (2)  a description of any graduate medical education;

4-23                 (3)  any specialty certification recognized by the

4-24     board and held by the physician;

4-25                 (4)  the number of years the physician has practiced

4-26     medicine;

4-27                 (5)  the name of each hospital in which the physician

 5-1     has privileges;

 5-2                 (6)  the physician's primary practice location;

 5-3                 (7)  whether the physician provides any language

 5-4     translating services, including translating services for a person

 5-5     with impairment of hearing, at the physician's primary practice

 5-6     location;

 5-7                 (8)  whether the physician participates in the Medicaid

 5-8     program;

 5-9                 (9)  a description of any conviction for an offense

5-10     constituting a felony or a serious misdemeanor that reflects

5-11     adversely on the physician's clinical competence to practice

5-12     medicine in an acceptable manner consistent with the public health

5-13     and welfare or affects adversely:

5-14                       (A)  the physician's ability to practice medicine

5-15     in an acceptable manner consistent with the public health and

5-16     welfare, as determined by board rule, during the 10-year period

5-17     preceding the date of the profile; or

5-18                       (B)  the safety of the physician's patients;

5-19                 (10)  a description of any charges reported to the

5-20     board under Section 5.07(a) of this Act during the 10-year period

5-21     preceding the date of the profile to which the physician has

5-22     pleaded no contest or in which sufficient facts of guilt were found

5-23     and the matter was continued by a court of competent jurisdiction;

5-24                 (11)  a description of any final disciplinary action

5-25     against the physician by the board during the 10-year period

5-26     preceding the date of the profile;

5-27                 (12)  a description of any final disciplinary action

 6-1     against the physician by a medical licensing board of another state

 6-2     during the 10-year period preceding the date of the profile;

 6-3                 (13)  a description of any revocation of or involuntary

 6-4     restriction of longer than 30 days on the physician's hospital

 6-5     privileges, after notice and hearing, imposed by the hospital's

 6-6     governing body or other hospital official that was based on

 6-7     clinical quality of patient care during the 10-year period

 6-8     preceding the date of the profile;

 6-9                 (14)  a description of any resignation from or

6-10     nonrenewal of medical staff membership or restriction on hospital

6-11     privileges of longer than 30 days that was based on clinical

6-12     quality of patient care imposed as a settlement of a pending

6-13     disciplinary proceeding during the 10-year period preceding the

6-14     date of the profile;

6-15                 (15)  a description of the type of allegation and of

6-16     each review action taken by the board as the result of opening a

6-17     complaint regarding a physician against whom three or more

6-18     malpractice claims were reported under Section 5.05 of this Act in

6-19     a five-year period; and

6-20                 (16)  whether the physician's patient service areas are

6-21     accessible to disabled persons, as defined by federal law.

6-22           (c)  Information required to be included under Subsection (b)

6-23     of this section that is not maintained by the board in the ordinary

6-24     course of the board's duties shall be obtained from a physician at

6-25     the time the physician renews the physician's license.  In

6-26     requesting information from the physician, the board shall inform

6-27     the physician that compliance with the request for information is

 7-1     mandatory, inform the physician of the date the information will be

 7-2     made available to the public, and instruct the physician of the

 7-3     requirements under Subsection (f) of this section for the physician

 7-4     to obtain a copy of the physician's profile to make corrections.

 7-5           (d)  This section does not prevent the board from providing

 7-6     explanatory information regarding the significance of categories in

 7-7     which malpractice settlements are reported.

 7-8           (e)  A pending malpractice claim, other than a claim

 7-9     disclosed under Subsection (b)(15) of this section, may not be

7-10     disclosed to the public by the board.  This subsection does not

7-11     prevent the board from investigating and disciplining a physician

7-12     on the basis of a pending medical malpractice claim.

7-13           (f)  The board shall provide an individual physician with a

7-14     copy of the physician's profile if the physician requests a copy at

7-15     the time the physician renews the physician's license.  If a copy

7-16     is requested by a physician the board shall provide the physician

7-17     one month from the date the copy is provided to the physician to

7-18     correct factual errors in the physician's profile.

7-19           (g)  The board shall update the information contained in a

7-20     physician's profile annually.  The board shall adopt a form that

7-21     allows a physician to update information contained in a physician's

7-22     profile or to provide additional information to be included in the

7-23     profile.  The form shall be made available electronically and on

7-24     the Internet.  A physician may update information  in the

7-25     physician's profile or provide additional information for the

7-26     profile at any time.  The board may assess a fee to be paid by the

7-27     physician to update the physician's profile at a time other than

 8-1     the board's annual update and a fee to cover the costs of including

 8-2     additional information in the profile not required by the board.

 8-3     The board may adopt rules concerning the type and content of

 8-4     additional information that may be included in a physician's

 8-5     profile.

 8-6           (h)  The board shall adopt rules as necessary to implement

 8-7     this section.

 8-8           Explanation:  This change is necessary to authorize the Texas

 8-9     State Board of Medical Examiners to establish a physician profiling

8-10     system to improve the efficiency of that agency in regulating the

8-11     practice of medicine in this state.

8-12           (3)  House Rule 13, Sections 9(a)(3) and (4), are suspended

8-13     to permit the committee to add text incorporating transitional

8-14     material in the bill to implement the amendment to  Section 3.10,

8-15     Medical Practice Act (Article 4495b, Vernon's Texas Civil Statutes)

8-16     and the addition of Section 5.11, Medical Practice Act (Article

8-17     4495b, Vernon's Texas Civil Statutes), to read as follows:

8-18           (b)  Section 3.10, Medical Practice Act (Article 4495b,

8-19     Vernon's Texas Civil Statutes), as amended by this Act, applies

8-20     only to a fee assessed for a license application, license issuance,

8-21     or license examination occurring on or after the effective date of

8-22     this  Act.

8-23           (c)  The Texas State Board of Medical Examiners shall adopt

8-24     rules under Section 5.11, Medical Practice Act (Article 4495b,

8-25     Vernon's Texas Civil Statutes), as added by this Act, not later

8-26     than January 1, 1998.  The board shall make the initial physician

8-27     profiles required under that section available to the public not

 9-1     later than June 1, 1999.

 9-2           (d)  The Texas State Board of Medical Examiners shall raise

 9-3     fees prescribed by the board in an amount not to exceed $15 for

 9-4     each fiscal year in the 1998-1999 biennium and not to exceed $10

 9-5     for each fiscal year in the 2000-2001 biennium for each physician

 9-6     licensed by the board to cover the costs of administering the

 9-7     changes in law made by this Act.  The board shall reduce any fees

 9-8     raised under this subsection not later than the second anniversary

 9-9     of the date the initial physician profiles required under Section

9-10     5.11, Medical Practice Act (Article 4495b, Vernon's Texas Civil

9-11     Statutes), as added by this Act, are made available to the public

9-12     to the extent the increase in fee amounts was necessary to cover

9-13     the initial costs incurred by the board in establishing a physician

9-14     profile system.

9-15           Explanation:  This change is necessary to clarify the

9-16     implementation of the new fee increases and physician profiling

9-17     system adopted under the amendments to the Medical Practice Act

9-18     (Article 4495b, Vernon's Texas Civil Statutes).