By: Cain S.B. No. 1699
97S0880/1
A BILL TO BE ENTITLED
AN ACT
1-1 relating to the Texas State Board of Medical Examiners and the
1-2 licensure of physicians; providing penalties.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Section 2.09, Medical Practice Act (Article
1-5 4495b, Vernon's Texas Civil Statutes), is amended by amending
1-6 Subsections (d), (h), (k), and (t) and adding Subsection (bb) to
1-7 read as follows:
1-8 (d) The board shall preserve a record of its proceedings
1-9 which shall be a public record. [The board shall also maintain
1-10 records showing the name, age, place, and duration of residence of
1-11 each applicant, the time spent in medical study in respective
1-12 medical schools, and the years and schools from which degrees were
1-13 granted.] The record shall [also] show whether applicants were
1-14 denied [rejected] or licensed and shall be prima facie evidence of
1-15 all matters contained in the record. A certified copy of those
1-16 permanent records, with the hand and seal of the executive director
1-17 [secretary-treasurer] of the board, shall be admitted in evidence
1-18 in all courts.
1-19 (h) The board may receive criminal records or reports from
1-20 any law enforcement agency or source pertaining to its licensees or
1-21 any applicant for license. The board may [shall] submit to the
1-22 Department of Public Safety a complete set of fingerprints of every
1-23 applicant for a license, and the Department of Public Safety shall
2-1 cause them to be classified and checked against those in their
2-2 fingerprint files and shall [forthwith] certify their findings
2-3 concerning the criminal record of the applicant or shall report the
2-4 lack of a criminal record, as the case may be, to the board. All
2-5 criminal records and reports received from the Department of Public
2-6 Safety shall be for the exclusive use of the board and shall be
2-7 privileged and shall not be released or otherwise disclosed to any
2-8 person or agency by the board except on court order. [Any
2-9 applicant for licensure or any licensee whose license is subject to
2-10 revocation, cancellation, or suspension because of adverse
2-11 information contained in the criminal records or reports shall be
2-12 afforded the opportunity for a hearing before the board prior to
2-13 any action on the application for license or revocation,
2-14 cancellation, or suspension of license.]
2-15 (k) The board by rule shall establish reasonable and
2-16 necessary fees so that the fees, in the aggregate, produce
2-17 sufficient revenue to cover the cost of administering this Act.
2-18 The fees set by the board may be adjusted so that the total fees
2-19 collected shall be sufficient to meet the expenses of administering
2-20 this Act. The board may not set a fee for an amount less than the
2-21 amount of that fee on September 1, 1993. The board may not waive
2-22 collection of any fee or penalty. The board shall place all fees
2-23 received under authority of this Act[, not otherwise specified,
2-24 into the medical licensing fund] in the state treasury. The board
2-25 is authorized and shall by annual budget determine the manner of
3-1 handling the funds and the purpose, consistent with this Act, for
3-2 which the same may be used. The budgeted expenses authorized by
3-3 the board shall be paid out of funds received by the board and are
3-4 not a charge upon the general revenue of the state.
3-5 (t) The board shall on request of a licensee issue
3-6 certification on endorsement of its license to other states and
3-7 charge a reasonable fee for the issuance. The board shall on
3-8 request of a licensee issue certification of state board
3-9 examination grades to the Federation of State Medical Boards of the
3-10 United States and charge a reasonable fee for the issuance.
3-11 (bb) The executive director of the board shall file a surety
3-12 bond with the board. The bond shall be in an amount not less than
3-13 $10,000, be in compliance with the insurance laws of the state, and
3-14 be payable to the state for the use of the state if the executive
3-15 director does not faithfully discharge the duties of the office.
3-16 The board shall pay the premium on the bond.
3-17 SECTION 2. Sections 3.01, 3.02, 3.03, 3.04, and 3.05,
3-18 Medical Practice Act (Article 4495b, Vernon's Texas Civil
3-19 Statutes), are amended to read as follows:
3-20 Sec. 3.01. ANNUAL REGISTRATION OF PHYSICIANS [PRACTITIONERS
3-21 AND INTERNS]. (a) All persons now lawfully qualified to practice
3-22 medicine in this state or hereafter licensed for the practice of
3-23 medicine by the board shall register annually as practitioners with
3-24 the board. The initial annual registration permit shall be issued
3-25 with the license.
4-1 (b) The annual registration permit fee as established by
4-2 board rule shall apply to all physicians licensed by the board,
4-3 whether or not they are practicing within the borders of this
4-4 state, except retired physicians as provided by rules of the board.
4-5 (c) A physician licensed by the board whose only practice is
4-6 voluntary charity care is exempt from the annual registration
4-7 permit fee as provided by rules of the board.
4-8 (d) The board shall mail an annual registration permit
4-9 renewal application to each practitioner at the practitioner's
4-10 last known address according to the records of the board at least
4-11 30 days prior to the expiration date of the annual registration
4-12 permit.
4-13 (e) The board shall provide for a 30-day grace period for
4-14 renewing the annual registration permit from the date of the
4-15 expiration of the annual registration permit.
4-16 (f) A licensee may renew his or her annual registration
4-17 permit by submitting to the board, on or before the expiration date
4-18 of the annual registration permit, the required renewal application
4-19 and renewal fee. Each annual registration permit renewal
4-20 application shall include the name and mailing address of the
4-21 licensee, the place or places where the licensee is engaged in the
4-22 practice of medicine, and other necessary information prescribed by
4-23 the board.
4-24 (g) If the licensee is licensed for the practice of medicine
4-25 by another state, the District of Columbia, a territory of the
5-1 United States, Canada, any other country, or the uniformed services
5-2 of the United States, the renewal application must include a
5-3 description of any investigations the licensee knows are in
5-4 progress and of any sanctions imposed by or disciplinary matters
5-5 pending in the state, district, territory, country, or service.
5-6 (h) On receipt of a renewal application and all required
5-7 fees, the board, after ascertaining, either from the records of the
5-8 board or from other sources considered by it to be reliable, that
5-9 the applicant is a licensed practitioner of medicine in this state,
5-10 shall issue to the licensee an annual registration permit
5-11 certifying that the licensee has filed the renewal application, has
5-12 paid the annual registration permit fee for the year in question,
5-13 and has completed the requirements for annual registration.
5-14 (i) If a licensee's annual registration permit has been
5-15 expired for 90 days or less, the licensee may renew his or her
5-16 annual registration permit by submitting to the board the required
5-17 renewal application, renewal fee, and a $50 penalty fee.
5-18 (j) If a licensee's annual registration permit has been
5-19 expired for longer than 90 days but less than one year, the
5-20 licensee may renew his or her annual registration permit by
5-21 submitting to the board the required renewal application, renewal
5-22 fee, and a $100 penalty fee.
5-23 (k) If a licensee's annual registration permit has been
5-24 expired for one year or longer, his or her license is considered to
5-25 have been canceled, and the licensee may not renew his or her
6-1 annual registration permit.
6-2 (l) Each physician whose license is considered canceled may
6-3 obtain a new license by submitting to reexamination and complying
6-4 with the requirements, fees, and procedures for obtaining a
6-5 license. The board may issue a new license without examination to
6-6 a person whose license is considered canceled for less than two
6-7 years.
6-8 (m) The board by rule may adopt a system under which annual
6-9 registration permits expire on various dates during the year. For
6-10 the year in which the expiration date is changed, annual
6-11 registration permit fees shall be prorated. On renewal of the
6-12 annual registration on the new expiration date, the total annual
6-13 registration permit fee is payable.
6-14 (n) The filing of the renewal application, the payment of
6-15 the required fees, and the issuance of the permit shall not entitle
6-16 the holder to practice medicine in Texas unless the holder has been
6-17 previously licensed as a practitioner by the board, as prescribed
6-18 by law, and the license to practice medicine is in full force and
6-19 effect. In any prosecution for the unlawful practice of medicine,
6-20 the annual registration permit required by this Act may not be
6-21 treated as evidence that the holder is lawfully entitled to
6-22 practice medicine.
6-23 (o) Practicing medicine as defined in this Act without an
6-24 annual registration permit for the current year as provided in this
6-25 Act has the same force and effect as and is subject to all
7-1 penalties of practicing medicine without a license. [All persons
7-2 now lawfully qualified to practice medicine in this state, or who
7-3 are hereafter licensed for the practice of medicine by the board,
7-4 shall be registered as practitioners with the board on or before
7-5 the first day of January and thereafter shall register in like
7-6 manner annually, on or before the first day of January of each
7-7 succeeding year. Each person so registered with the board shall
7-8 pay, in connection with each annual registration and for the
7-9 receipt hereinafter provided for, a fee established by the board
7-10 which fee shall accompany the application of each person for
7-11 registration. The payment shall be made to the board. Every
7-12 person so registered shall file with the board a written
7-13 application for annual registration, setting forth his name and
7-14 mailing address, the place or places where the applicant is engaged
7-15 in the practice of medicine, and other necessary information
7-16 prescribed by the board. If the person is licensed for the
7-17 practice of medicine by another state, the District of Columbia, a
7-18 territory of the United States, Canada, any other country, or the
7-19 uniformed services of the United States, the application must
7-20 include a description of any investigations the person knows are in
7-21 progress and of any sanctions imposed by or disciplinary matters
7-22 pending in the state, district, territory, country, or service.]
7-23 [(b) Physicians not otherwise licensed by the board who are
7-24 participating in graduate medical education training programs
7-25 approved by the board may be issued institutional permits as
8-1 provided by rules of the board. A reasonable fee shall be charged
8-2 and deposited into the medical registration fund. This permit does
8-3 not authorize the performance of medical acts except as the acts
8-4 are performed as a part of graduate medical education programs and
8-5 under the supervision of a licensed practitioner of medicine.]
8-6 [(c)(1) A person may renew an unexpired license by paying to
8-7 the board on or before the expiration date of the license the
8-8 required renewal fee.]
8-9 [(2) If a person's license has been expired for 90
8-10 days or less, the person may renew the license by paying to the
8-11 board the required renewal fee and a fee that is one-half of the
8-12 annual registration fee as established by the board under Section
8-13 3.10(b)(7) of this Act.]
8-14 [(3) If a person's license has been expired for longer
8-15 than 90 days but less than one year, the person may renew the
8-16 license by paying to the board all unpaid renewal fees and a fee
8-17 that is equal to the annual registration fee as established by the
8-18 board under Section 3.10(b)(7) of this Act.]
8-19 [(4) If a person's license has been expired for one
8-20 year, it is considered to have been canceled, unless an
8-21 investigation is pending, and the person may not renew the license.
8-22 The person may obtain a new license by submitting to reexamination
8-23 and complying with the requirements and procedures for obtaining an
8-24 original license.]
8-25 [(5) The board may renew without examination an
9-1 expired license of a person who was licensed in this state, moved
9-2 to another state, and is currently licensed and has been in
9-3 practice in the other state for not more than two years preceding
9-4 application. The person must pay to the board a fee that is equal
9-5 to the examination fee for the license.]
9-6 [(6) The board shall provide written notice to each
9-7 practitioner at the practitioner's last known address according to
9-8 the records of the board at least 30 days prior to the expiration
9-9 date of a license and shall provide for a 30-day grace period for
9-10 payment of the annual registration fee from the date of the
9-11 expiration of the license.]
9-12 [(d) Practicing medicine as defined in this Act without an
9-13 annual registration receipt for the current year as provided in
9-14 this Act has the same force and effect as and is subject to all
9-15 penalties of practicing medicine without a license.]
9-16 [(e) On receipt of an application, accompanied by the proper
9-17 registration fee, the board, after ascertaining, either from the
9-18 records of the board or from other sources considered by it to be
9-19 reliable, that the applicant is a licensed practitioner of medicine
9-20 in this state, shall issue to the applicant an annual registration
9-21 receipt certifying that the applicant has filed the application and
9-22 has paid the registration fee for the year in question. The filing
9-23 of the application, the payment of the registration fee, and the
9-24 issuance of the receipt shall not entitle the holder to practice
9-25 medicine in Texas unless he has in fact been previously licensed as
10-1 a practitioner by the board, as prescribed by law, and unless the
10-2 license to practice medicine is in full force and effect. In any
10-3 prosecution for the unlawful practice of medicine the receipt
10-4 showing payment of the annual registration fee required by this Act
10-5 may not be treated as evidence that the holder is lawfully entitled
10-6 to practice medicine.]
10-7 [(f) The executive director of the board shall file a surety
10-8 bond with the board. The bond shall be in an amount not less than
10-9 $10,000, be in compliance with the insurance laws of the state, and
10-10 be payable to the state for the use of the state if the executive
10-11 director does not faithfully discharge the duties of the office.
10-12 The board shall pay the premium on the bond.]
10-13 [(g) The annual registration fee shall apply to all persons
10-14 licensed by the board, whether or not they are practicing within
10-15 the borders of this state, except retired physicians as provided by
10-16 rules of the board. A retired physician licensed by the board
10-17 whose only practice is voluntary charity care is exempt from the
10-18 annual registration fee.]
10-19 [(h) The executive director shall review each application
10-20 for licensure by examination or reciprocity and shall recommend to
10-21 the board all applicants eligible for licensure. The executive
10-22 director also shall report to the board the names of all applicants
10-23 determined to be ineligible for licensure, together with the
10-24 reasons for each recommendation. An applicant deemed ineligible
10-25 for licensure by the executive director may request review of such
11-1 recommendation by a committee of the board within 20 days of
11-2 receipt of such notice, and the executive director may refer any
11-3 application to said committee for a recommendation concerning
11-4 eligibility. If the committee finds the applicant ineligible for
11-5 licensure, such recommendation, together with the reasons therefor,
11-6 shall be submitted to the board unless the applicant requests a
11-7 hearing within 20 days of receipt of notice of the committee's
11-8 determination. The hearing shall be before an administrative law
11-9 judge of the State Office of Administrative Hearings and shall
11-10 comply with the Administrative Procedure Act and its subsequent
11-11 amendments and the rules of the State Office of Administrative
11-12 Hearings and the board. The committee may refer any application
11-13 for determination of eligibility to the full board. The board
11-14 shall, after receiving the administrative law judge's proposed
11-15 findings of fact and conclusions of law, determine the eligibility
11-16 of the applicant for licensure. A physician whose application for
11-17 licensure is denied by the board shall receive a written statement
11-18 containing the reasons for the board's action. All reports received
11-19 or gathered by the board on each applicant are confidential and are
11-20 not subject to disclosure under the Open Records Law. The board
11-21 may disclose such reports to appropriate licensing authorities in
11-22 other states.]
11-23 Sec. 3.02. INSTITUTIONAL PERMITS [RENEWALS]. Physicians not
11-24 otherwise licensed by the board who are participating in graduate
11-25 medical education training programs approved by the board may be
12-1 issued institutional permits as provided by rules of the board.
12-2 This permit does not authorize the performance of medical acts
12-3 except as the acts are performed as a part of graduate medical
12-4 education training programs and under the supervision of a licensed
12-5 practitioner of medicine. [(a) On application on forms provided
12-6 by the board for this purpose and receipt of renewal fees, licenses
12-7 shall be renewed annually by the board.]
12-8 [(b) The board by rule may adopt a system under which
12-9 registrations expire on various dates during the year. The date
12-10 for license cancellation due to nonpayment shall be adjusted
12-11 accordingly. For the year in which the expiration date is changed,
12-12 registration fees payable on or before January 1 shall be prorated
12-13 on a monthly basis so that each registrant shall pay only that
12-14 portion of the registration fee which is allocable to the number of
12-15 months during which the registration is valid. On renewal of the
12-16 registration on the new expiration date, the total registration fee
12-17 is payable.]
12-18 Sec. 3.03. LICENSURE OF PHYSICIANS [RECIPROCAL AGREEMENTS].
12-19 (a) The board, at its sole discretion, may grant a license to
12-20 practice medicine to any physician who qualifies under this Act.
12-21 (b) An application for a license must be in writing and on
12-22 forms prescribed by the board.
12-23 (c) The application forms must be accompanied by all fees,
12-24 documents, and photographs required by board rule.
12-25 (d) Applicants for a license must subscribe to an oath in
13-1 writing before an officer authorized by law to administer oaths.
13-2 The written oath is a part of the application.
13-3 (e) An applicant may not have:
13-4 (1) a medical license that is currently restricted,
13-5 canceled, suspended, or revoked in a state of the United States, a
13-6 province of Canada, or a uniformed service of the United States;
13-7 (2) an investigation or a proceeding instituted
13-8 against the applicant for the restriction, cancellation,
13-9 suspension, or revocation in a state of the United States, a
13-10 province of Canada, or a uniformed service of the United States; or
13-11 (3) a prosecution pending against the applicant in any
13-12 state, federal, or Canadian court for any offense that under the
13-13 laws of this state is a felony or a misdemeanor that involves moral
13-14 turpitude.
13-15 (f) An applicant must present satisfactory proof to the
13-16 board that each medical school attended is substantially equivalent
13-17 to a Texas medical school as determined by board rule.
13-18 (g) An applicant who is a graduate of a medical school that
13-19 is located outside the United States and Canada must present
13-20 satisfactory proof to the board that the applicant:
13-21 (1) is a graduate of a school whose curriculum meets
13-22 the requirements for an unapproved medical school as determined by
13-23 a committee of experts selected by the Texas Higher Education
13-24 Coordinating Board;
13-25 (2) has successfully completed three years of graduate
14-1 medical training in the United States or Canada that was approved
14-2 by the board;
14-3 (3) is eligible for licensure to practice medicine in
14-4 the country in which the school is located except for any
14-5 citizenship requirements;
14-6 (4) possesses a valid certificate issued by the
14-7 Educational Commission for Foreign Medical Graduates; and
14-8 (5) has the ability to communicate in the English
14-9 language.
14-10 (h) All medical or osteopathic medical education received by
14-11 the applicant in the United States must be accredited by an
14-12 accrediting body officially recognized by the United States
14-13 Department of Education as the accrediting body for medical
14-14 education leading to the doctor of medicine degree or the doctor of
14-15 osteopathy degree in the United States. This subsection does not
14-16 apply to postgraduate medical education or training.
14-17 (i) An applicant who is unable to comply with the
14-18 requirements of Subsection (h) of this section may be eligible for
14-19 an unrestricted license if the applicant:
14-20 (1) received medical education in a hospital or
14-21 teaching institution sponsoring or participating in a program of
14-22 graduate medical education accredited by the Accrediting Council
14-23 for Graduate Medical Education, the American Osteopathic
14-24 Association, or the board in the same subject as the medical or
14-25 osteopathic medical education as defined by board rule; or
15-1 (2) is specialty-board certified by a board approved
15-2 by the American Osteopathic Association or the American Board of
15-3 Medical Specialties.
15-4 (j)(1) The executive director shall review each application
15-5 for licensure and shall recommend to the board all applicants
15-6 eligible for licensure. The executive director also shall report
15-7 to the board the names of all applicants determined to be
15-8 ineligible for licensure, together with the reasons for each
15-9 recommendation.
15-10 (2) An applicant deemed ineligible for licensure by
15-11 the executive director may request review of such recommendation by
15-12 a committee of the board within 20 days of receipt of such notice,
15-13 and the executive director may refer any application to the
15-14 committee for a recommendation concerning eligibility.
15-15 (3) If the committee finds the applicant ineligible
15-16 for licensure, such recommendation, together with the reasons for
15-17 the recommendation, shall be submitted to the board unless the
15-18 applicant requests a hearing within 20 days of receipt of notice of
15-19 the committee's determination.
15-20 (A) The hearing shall be before an
15-21 administrative law judge of the State Office of Administrative
15-22 Hearings and shall comply with the Administrative Procedure Act and
15-23 the rules of the State Office of Administrative Hearings and the
15-24 board.
15-25 (B) The committee may refer any application for
16-1 determination of eligibility to the full board.
16-2 (4) The board shall, after receiving the
16-3 administrative law judge's proposed findings of fact and
16-4 conclusions of law, determine the eligibility of the applicant for
16-5 licensure. A physician whose application for licensure is denied
16-6 by the board shall receive a written statement containing the
16-7 reasons for the board's action.
16-8 (k) Examination questions that may be used in the future,
16-9 examinations other than the one taken by the person requesting it,
16-10 and deliberations and records relating to the professional
16-11 character and fitness of applicants are exempted from the open
16-12 meetings law and the open records law.
16-13 (l) All reports received or gathered by the board on each
16-14 applicant are confidential and are not subject to disclosure under
16-15 the open records law. The board may disclose such reports to
16-16 appropriate licensing authorities in other states.
16-17 (m) In addition to the requirements prescribed by this Act,
16-18 the board may require applicants to comply with other requirements
16-19 that the board considers appropriate. [The board, at its sole
16-20 discretion and upon payment by an applicant of a fee prescribed by
16-21 the board under this Act, may grant a license to practice medicine
16-22 to any physician who is a graduate of an acceptable medical college
16-23 as determined by the board and who is a licensee of another state
16-24 or Canadian province having requirements for physician registration
16-25 and practice substantially equivalent to those established by the
17-1 laws of this state.]
17-2 [(b) An application for a license under this section must be
17-3 in writing and upon a form prescribed by the board. The
17-4 application must be accompanied by:]
17-5 [(1) a diploma or photograph of a diploma awarded to
17-6 the applicant by an acceptable medical college and a certified
17-7 transcript showing courses and grades;]
17-8 [(2) a license or a certified copy of a license to
17-9 practice medicine lawfully issued to the applicant by some other
17-10 state or a Canadian province that requires in its examination the
17-11 same general degree of fitness required by this state and that
17-12 grants the same reciprocal privileges to persons licensed by the
17-13 board;]
17-14 [(3) a certification made by the president or
17-15 secretary of the board that issued the license or a duly
17-16 constituted registration office of the state or Canadian province
17-17 that issued the certificate or license, reciting that the
17-18 accompanying certificate or license has not been canceled,
17-19 suspended, or revoked and reciting that the statement of the
17-20 qualifications made in the application for medical license in Texas
17-21 is true and correct; and]
17-22 [(4) evidence of a passing grade on an examination
17-23 required by the board.]
17-24 [(c) Applicants for a license under this section must
17-25 subscribe to an oath in writing before an officer authorized by law
18-1 to administer oaths. The written oath must be a part of the
18-2 application. The application must:]
18-3 [(1) state that:]
18-4 [(A) the license, certificate, or authority
18-5 under which the applicant has most recently practiced medicine in
18-6 the state or Canadian province from which the applicant is
18-7 transferring to this state or in the uniformed service in which the
18-8 applicant served is in full force and not restricted, canceled,
18-9 suspended, or revoked;]
18-10 [(B) the applicant is the identical person to
18-11 whom the certificate or license and the diploma were issued;]
18-12 [(C) no proceeding has been instituted against
18-13 the applicant for the restriction, cancellation, suspension, or
18-14 revocation of the certificate, license, or authority to practice
18-15 medicine in the state, Canadian province, or uniformed service of
18-16 the United States in which it was issued; and]
18-17 [(D) no prosecution is pending against the
18-18 applicant in any state, federal, or Canadian court for any offense
18-19 that under the laws of this state is a felony;]
18-20 [(2) include a description of any sanctions imposed by
18-21 or disciplinary matters pending in the state or Canadian province
18-22 in which the applicant was or is licensed or certified to practice
18-23 medicine; and]
18-24 [(3) include evidence of postgraduate training
18-25 required by the board.]
19-1 [(d) An applicant for a license under this section must be
19-2 eligible for examination by the board.]
19-3 [(e) In addition to other licensure requirements, the board
19-4 may require by rule and regulation that an applicant who is a
19-5 licensee of another state or Canadian province and who is a
19-6 graduate of a medical school located outside of the United States
19-7 and Canada, or the school itself, provide additional information to
19-8 the board concerning the medical school attended prior to approval
19-9 of the applicant.]
19-10 [(f) The board may refuse to issue a license to an applicant
19-11 who is a licensee of another state or Canadian province and who
19-12 graduated from a medical school outside of the United States and
19-13 Canada if it finds that the applicant does not possess the
19-14 requisite qualifications to provide the same standard of medical
19-15 care as provided by a licensed physician in this state.]
19-16 [(g) In addition to the requirements prescribed by this
19-17 section, the board may require applicants to comply with other
19-18 requirements that the board considers appropriate.]
19-19 [(h) The board may not refuse to issue a license to an
19-20 applicant under Subsection (f) of this section if the applicant:]
19-21 [(1) for the preceding five years has been a licensee
19-22 of another state or a Canadian province;]
19-23 [(2) is not the subject of a sanction imposed by or
19-24 disciplinary matter pending in any state or Canadian province in
19-25 which the applicant is licensed to practice medicine; and]
20-1 [(3) is either specialty board certified by a board
20-2 that is a member of the American Board of Medical Specialties or a
20-3 specialty board approved by the American Osteopathic Association or
20-4 successfully passes an examination that the board shall determine
20-5 by rule.]
20-6 Sec. 3.04. QUALIFICATIONS OF LICENSEES [QUALIFICATION OF
20-7 LICENSEE]. (a) An applicant, to be eligible for issuance of a
20-8 license, must present satisfactory proof to the board that the
20-9 applicant:
20-10 (1) is at least 21 years of age;
20-11 (2) is of good professional character and has not
20-12 violated Section 3.08 of this Act;
20-13 (3) has completed:
20-14 (A) 60 semester hours of college courses other
20-15 than in medical school that are acceptable to The University of
20-16 Texas at Austin for credit on a bachelor of arts degree or a
20-17 bachelor of science degree;
20-18 (B) the entire primary, secondary, and
20-19 premedical education required in the country of medical school
20-20 graduation, if the medical school is located outside the United
20-21 States or Canada; or
20-22 (C) substantially equivalent courses as
20-23 determined by board rule;
20-24 (4) is a graduate of a medical school located inside
20-25 the United States or Canada and approved by the board who has
21-1 successfully completed one year of graduate medical training
21-2 approved by the board in the United States or Canada or is a
21-3 graduate of a medical school located outside the United States or
21-4 Canada who has successfully completed three years of graduate
21-5 medical training approved by the board in the United States or
21-6 Canada;
21-7 (5) has successfully passed within three attempts each
21-8 part of a uniform medical licensing examination; and
21-9 (6) has passed the Texas medical jurisprudence
21-10 examination as determined by board rule. [An applicant, to be
21-11 eligible for the examination and issuance of a license, must
21-12 present satisfactory proof to the board that the applicant:]
21-13 [(1) is at least 21 years of age;]
21-14 [(2) is of good professional character;]
21-15 [(3) has completed 60 semester hours of college
21-16 courses other than in medical school, which courses would be
21-17 acceptable, at the time of completion, to The University of Texas
21-18 for credit on a bachelor of arts degree or a bachelor of science
21-19 degree; and]
21-20 [(4) is a graduate of an acceptable medical or
21-21 osteopathic school or college that was approved by the board at the
21-22 time the degree was conferred and has completed a one-year program
21-23 of graduate medical training approved by the board.]
21-24 [(b) The applicant shall be eligible for examination prior
21-25 to complying with the graduate training requirement of Subsection
22-1 (a)(4) of this section but shall not be eligible for the issuance
22-2 of an unrestricted license until the requirements of Subsection (a)
22-3 of this section have been satisfied.]
22-4 [(c) Applications for examination must be made in writing,
22-5 verified by affidavit, filed with the board on forms prescribed by
22-6 the board, and accompanied by documents and a fee as the board
22-7 determines to be reasonable.]
22-8 [(d) To be recognized by the board for the purposes of this
22-9 subchapter, all medical or osteopathic medical education received
22-10 by the applicant in the United States must be accredited by an
22-11 accrediting body officially recognized by the United States
22-12 Department of Education as the accrediting body for medical
22-13 education leading to the doctor of medicine degree or the doctor of
22-14 osteopathy degree in the United States. This subsection does not
22-15 apply to postgraduate medical education or training.]
22-16 [(f) An applicant who is unable to comply with the
22-17 requirements of Subsection (d) of this section is eligible for an
22-18 unrestricted license if the applicant:]
22-19 [(1) received such medical education in a hospital or
22-20 teaching institution sponsoring or participating in a program of
22-21 graduate medical education accredited by the Accrediting Council
22-22 for Graduate Medical Education, the American Osteopathic
22-23 Association, or the Texas State Board of Medical Examiners in the
22-24 same subject as the medical or osteopathic medical education if the
22-25 hospital or teaching institution has an agreement with the
23-1 applicant's school; or]
23-2 [(2) is specialty board certified by a board approved
23-3 by the American Osteopathic Association or the American Board of
23-4 Medical Specialties.]
23-5 [(g) In addition to the other requirements of this section,
23-6 an applicant who is a graduate of a medical school that is located
23-7 outside the United States and Canada and that was not approved by
23-8 the board at the time the degree was conferred must, in order to be
23-9 eligible for the issuance of a license, present satisfactory proof
23-10 to the board that the applicant:]
23-11 [(1) is a graduate of a school whose curriculum meets
23-12 the requirements for an unapproved medical school as determined by
23-13 a committee of experts selected by the Texas Higher Education
23-14 Coordinating Board;]
23-15 [(2) has successfully completed three years of
23-16 graduate medical training in the United States or Canada that was
23-17 approved by the board on the date the training was completed;]
23-18 [(3) is eligible for licensure to practice medicine in
23-19 the country in which the school is located;]
23-20 [(4) possesses a valid certificate issued by the
23-21 Educational Commission for Foreign Medical Graduates;]
23-22 [(5) has the ability to communicate in the English
23-23 language; and]
23-24 [(6) has passed the examination required by the board
23-25 of all applicants for license as required by Section 3.05 of this
24-1 Act.]
24-2 [(h) The board by rule may establish alternate educational
24-3 prerequisites to those required by Subsection (a)(3) of this
24-4 section for an applicant who graduated from an unapproved medical
24-5 school located outside the United States and Canada.]
24-6 [(i) In addition to other licensure requirements, the board,
24-7 before approving the applicant, may require by rule that a graduate
24-8 of an unapproved medical school located outside the United States
24-9 and Canada or the school of which the person is a graduate provide
24-10 additional information to the board concerning the school.]
24-11 [(j) The board may refuse to issue a license to an applicant
24-12 who graduated from an unapproved medical school located outside the
24-13 United States and Canada if it finds that:]
24-14 [(1) the applicant does not possess the requisite
24-15 qualifications to provide the same standard of medical care as
24-16 provided by a physician licensed in this state; or]
24-17 [(2) the applicant failed to provide the board
24-18 evidence to establish that the applicant completed medical
24-19 education or professional training substantially equivalent to that
24-20 provided by a medical school in this state.]
24-21 Sec. 3.05. EXAMINATIONS ACCEPTED OR ADMINISTERED
24-22 [EXAMINATION]. (a) The board may administer or accept the
24-23 following examinations for licensure as determined by rule:
24-24 (1) a state board licensing examination;
24-25 (2) National Board of Osteopathic Medical Examiners
25-1 (NBOME) examination or its successor;
25-2 (3) National Board of Medical Examiners (NBME)
25-3 examination or its successor;
25-4 (4) Federation Licensing Examination (FLEX) with a
25-5 weighted average in one sitting before June, 1985;
25-6 (5) Federation Licensing Examination (FLEX) after May,
25-7 1985;
25-8 (6) United States Medical Licensing Examination
25-9 (USMLE); or
25-10 (7) a combination of the above examinations if passed
25-11 prior to 1998 as determined by board rule.
25-12 (b) All examinations used by the board for license to
25-13 practice medicine shall be in writing in the English language and
25-14 shall be entirely fair and impartial to all individuals and to
25-15 every school or system of medicine. Applicants who wish to request
25-16 reasonable accommodations due to a disability shall submit the
25-17 request on filing the application.
25-18 (c) Examinations shall include subjects generally taught by
25-19 medical schools, a knowledge of which is commonly and generally
25-20 required of candidates for the degree of doctor of medicine or
25-21 doctor of osteopathy conferred by schools in Texas.
25-22 (d) The board shall also administer the Texas medical
25-23 jurisprudence examination to all applicants.
25-24 (e) The minimum passing grade for all examinations used by
25-25 the board shall be determined by rule.
26-1 (f) Examinations administered to evaluate basic medical
26-2 knowledge and clinical competency shall be prepared by a national
26-3 testing service or the board and validated by qualified independent
26-4 testing professionals.
26-5 (g) All questions, answers, and grades shall be preserved
26-6 for one year as the board may direct by rule.
26-7 (h) All applicants shall be given due notice of the date and
26-8 place of the examination if administered by the board.
26-9 (i) Within 120 days after the day on which an examination is
26-10 administered by the board, each examinee shall be notified of the
26-11 results of the examination. However, if an examination is graded
26-12 or reviewed by a national testing service, the board shall notify
26-13 each examinee of the results of the examination not later than 30
26-14 days after the date the board receives the results from the testing
26-15 service. If the notice of the examination results will be delayed
26-16 for longer than 90 days after the examination, the board shall
26-17 notify the examinee of the reason for the delay within the 90 days.
26-18 [All examinations for license to practice medicine shall be
26-19 conducted in writing in the English language and in a manner as to
26-20 be entirely fair and impartial to all individuals and to every
26-21 school or system of medicine. Examinations shall be conducted on
26-22 and cover those subjects generally taught by medical schools, a
26-23 knowledge of which is commonly and generally required of candidates
26-24 for the degree of doctor of medicine or doctor of osteopathy
26-25 conferred by schools or colleges of medicine approved by the board,
27-1 and the examinations shall also be conducted on and cover the
27-2 subject of medical jurisprudence. Examinations shall be prepared
27-3 by a national testing service or prepared by the board and
27-4 validated by qualified independent testing professionals. On
27-5 satisfactory examination conducted as required by this Act under
27-6 rules of the board, applicants may be granted licenses to practice
27-7 medicine. All questions and answers, with the grades attached,
27-8 shall be preserved for one year in the executive office of the
27-9 board or such other repository as the board by rule may direct.
27-10 All applicants examined at the same time shall be given identical
27-11 questions. All certificates shall be attested by the seal of the
27-12 board. The board in its discretion may give the examination for
27-13 license in two or more parts.]
27-14 [(b) In addition to the requirements prescribed by this Act,
27-15 the board may require applicants to comply with other requirements
27-16 that the board considers appropriate and establish reasonable fees
27-17 for examination.]
27-18 [(c) All applicants for license to practice medicine in this
27-19 state not otherwise licensed under the provisions of law must
27-20 successfully pass a uniform examination approved by the board as
27-21 determined by rule. The board is authorized to adopt and enforce
27-22 all rules of procedure not inconsistent with statutory
27-23 requirements. All applicants shall be given due notice of the date
27-24 and place of the examination. If any applicant, because of failure
27-25 to pass the required examination, is refused a license, the
28-1 applicant, at a time as the board may fix, shall be permitted to
28-2 take a subsequent examination not more than two additional times as
28-3 the board may prescribe on the payment of a fee as the board may
28-4 determine to be reasonable. In the event satisfactory grades shall
28-5 be made on the subjects prescribed and taken on the reexamination,
28-6 the board may grant the applicant a license to practice medicine.
28-7 The board shall determine the credit to be given examinees on
28-8 answers turned in on the subjects of complete and partial
28-9 examination, and its decision is final.]
28-10 [(d) Examination questions that may be used in the future,
28-11 examinations other than the one taken by the person requesting it,
28-12 and deliberations and records relating to the professional
28-13 character and fitness of applicants are exempted from the Open
28-14 Meetings Law and the Open Records Law. The records, however, shall
28-15 be disclosed to individual applicants upon written request, unless
28-16 the person supplying the information to the board requests that it
28-17 not be disclosed.]
28-18 [(e) Within 90 days after the day on which an examination is
28-19 administered under this Act, the board shall notify each examinee
28-20 of the results of the examination. However, if an examination is
28-21 graded or reviewed by a national testing service, the board shall
28-22 notify each examinee of the results of the examination not later
28-23 than the 30th day after the date the board receives the results
28-24 from the testing service. If the notice of the examination results
28-25 will be delayed for longer than 90 days after the examination, the
29-1 board shall notify the examinee of the reason for the delay before
29-2 the 90th day.]
29-3 [(f) If requested in writing by a person who fails the
29-4 examination administered under this Act, the board shall furnish
29-5 the person with a summarized analysis of the person's performance
29-6 on the examination consisting of the person's score on each portion
29-7 of the examination.]
29-8 SECTION 3. Section 3.10, Medical Practice Act (Article
29-9 4495b, Vernon's Texas Civil Statutes), as amended by Chapters 214
29-10 and 862, Acts of the 73rd Legislature, 1993, is amended to read as
29-11 follows:
29-12 Sec. 3.10. FEES. (a) All fees collected by the board shall
29-13 be placed in the state treasury. The fees deposited shall be
29-14 credited to the appropriations of the board and may be spent only
29-15 as provided by the General Appropriations Act, this Act, or other
29-16 applicable statutes. Money may be used by the board and under its
29-17 direction in the enforcement of this Act, the prohibition of the
29-18 unlawful practice of medicine, the dissemination of information to
29-19 prevent the violation of the laws, and the prosecution of those who
29-20 violate the laws. All distributions may be made only on written
29-21 approval of the executive director of the board or his designated
29-22 representative.
29-23 (b) The board may not set, charge, collect, receive, or
29-24 deposit any of the following fees in excess of:
29-25 (1) License and first annual registration........ $900
30-1 (2) Temporary license............................ $200
30-2 (3) Renewal of annual registration............... $200
30-3 (4) Institutional permit......................... $200
30-4 (5) Endorsement to other state medical boards.... $200
30-5 (6) Duplicate license............................ $200
30-6 (7) Reinstated license after cancellation for cause
30-7 ............................................................. $700.
30-8 (c) The board may set and collect a sales charge for making
30-9 copies of records in the office of the board and for any material
30-10 published by the board. The charges shall be in amounts considered
30-11 sufficient to reimburse the board for the actual expense.
30-12 (d) The financial transactions of the board are subject to
30-13 audit by the state auditor in accordance with Chapter 321,
30-14 Government Code.
30-15 (e) The board shall file annually with the governor and the
30-16 presiding officer of each house of the legislature a complete and
30-17 detailed written report accounting for all funds received and
30-18 disbursed by the board during the preceding fiscal year. The
30-19 annual report must be in the form and reported in the time provided
30-20 by the General Appropriations Act. [All annual registration fees
30-21 collected by the board shall be placed in the State Treasury to the
30-22 credit of the medical registration fund. The fees deposited to
30-23 this special fund shall be credited to the appropriations of the
30-24 board and may be spent only as provided by the General
30-25 Appropriations Act, this Act, or other applicable statutes. Money
31-1 in that fund may be used by the board and under its direction in
31-2 the enforcement of this Act, the prohibition of the unlawful
31-3 practice of medicine, the dissemination of information to prevent
31-4 the violation of the laws, and the prosecution of those who violate
31-5 the laws. All distributions from the fund may be made only upon
31-6 written approval of the secretary-treasurer of the board or his
31-7 designated representative, and the comptroller shall upon
31-8 requisition of the board from time to time draw warrants upon the
31-9 State Treasurer for the amounts specified in the requisition.]
31-10 [(b) The board may not set, charge, collect, receive, or
31-11 deposit any of the following fees in excess of:]
31-12 [(1) for processing and granting a license by
31-13 reciprocity to a licensee of another state.................... $700]
31-14 [(2) for processing an application and administration
31-15 of a partial examination for licensure........................ $700]
31-16 [(3) for processing an application and administration
31-17 of a complete examination for licensure....................... $700]
31-18 [(4) for processing an application and issuance of a
31-19 temporary license............................................. $200]
31-20 [(5) for processing an application and issuance of a
31-21 duplicate license............................................. $200]
31-22 [(6) for processing an application and issuance of a
31-23 license of reinstatement after a lapse or cancellation of a license
31-24 .............................................................. $700]
31-25 [(7) for processing an application and issuance of an
32-1 annual registration of a licensee............................. $200]
32-2 [(8) for processing and issuance of an institutional
32-3 permit for interns, residents, and others in approved medical
32-4 training programs............................................. $200]
32-5 [(9) for processing an application and issuance of an
32-6 endorsement to other state medical boards..................... $200]
32-7 [(10) for processing and issuance of a license or
32-8 temporary license to a physician assistant.................... $200]
32-9 [(11) for processing and issuance of a permit to a
32-10 physician who supervises an acupuncturist.................... $200.]
32-11 [(b) The board may set and collect a sales charge for making
32-12 copies of any paper of record in the office of the board and for
32-13 any printed material published by the board. The charges shall be
32-14 in amounts considered sufficient to reimburse the board for the
32-15 actual expense.]
32-16 [(c) The financial transactions of the board are subject to
32-17 audit by the state auditor in accordance with Chapter 321,
32-18 Government Code.]
32-19 [(d) The board shall file annually with the governor and the
32-20 presiding officer of each house of the legislature a complete and
32-21 detailed written report accounting for all funds received and
32-22 disbursed by the board during the preceding fiscal year. The
32-23 annual report must be in the form and reported in the time provided
32-24 by the General Appropriations Act.]
32-25 SECTION 4. Section 3.11A, Medical Practice Act (Article
33-1 4495b, Vernon's Texas Civil Statutes), is amended to read as
33-2 follows:
33-3 Sec. 3.11A. DISPOSITION OF FEES. (a) An additional $200
33-4 surcharge shall apply to each of the following fees:
33-5 (1) license fees;
33-6 (2) renewal of annual registration fees; and
33-7 (3) reinstated license fees after cancellation.
33-8 (b) Of each surcharge collected, $50 shall be deposited to
33-9 the credit of the foundation school fund and $150 shall be
33-10 deposited to the credit of the general revenue fund. This
33-11 subsection applies to the disposition of the stated portion of each
33-12 fee regardless of any other provision of law providing for a
33-13 different disposition of funds. [This section applies to each of
33-14 the following fees:]
33-15 [(1) fee for processing and granting a license by
33-16 reciprocity to a licensee of another state;]
33-17 [(2) fee for processing an application and
33-18 administration of a partial examination for licensure;]
33-19 [(3) fee for processing an application and
33-20 administration of a complete examination for licensure;]
33-21 [(4) fee for processing an application and issuance of
33-22 a license of reinstatement after a lapse or cancellation of a
33-23 license; and]
33-24 [(5) fee for processing an application and issuance of
33-25 an annual registration of a licensee.]
34-1 [(b) Of each fee collected, $50 shall be deposited to the
34-2 credit of the foundation school fund and $150 shall be deposited to
34-3 the credit of the general revenue fund. This subsection applies to
34-4 the disposition of the stated portion of each fee regardless of any
34-5 other provision of law providing for a different disposition of
34-6 funds.]
34-7 SECTION 5. Section 2.10, as added by Section 1.04, Chapter
34-8 36, Acts of the 73rd Legislature, 1993, and Sections 3.0305 and
34-9 3.031, Medical Practice Act (Article 4495b, Vernon's Texas Civil
34-10 Statutes), are repealed.
34-11 SECTION 6. The importance of this legislation and the
34-12 crowded condition of the calendars in both houses create an
34-13 emergency and an imperative public necessity that the
34-14 constitutional rule requiring bills to be read on three several
34-15 days in each house be suspended, and this rule is hereby suspended,
34-16 and that this Act take effect and be in force from and after its
34-17 passage, and it is so enacted.