1-1 By: Cain S.B. No. 1699
1-2 (In the Senate - Filed March 14, 1997; March 24, 1997, read
1-3 first time and referred to Committee on Health and Human Services;
1-4 April 18, 1997, reported favorably by the following vote: Yeas 11,
1-5 Nays 0; April 18, 1997, sent to printer.)
1-6 A BILL TO BE ENTITLED
1-7 AN ACT
1-8 relating to the Texas State Board of Medical Examiners and the
1-9 licensure of physicians; providing penalties.
1-10 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-11 SECTION 1. Section 2.09, Medical Practice Act (Article
1-12 4495b, Vernon's Texas Civil Statutes), is amended by amending
1-13 Subsections (d), (h), (k), and (t) and adding Subsection (bb) to
1-14 read as follows:
1-15 (d) The board shall preserve a record of its proceedings
1-16 which shall be a public record. [The board shall also maintain
1-17 records showing the name, age, place, and duration of residence of
1-18 each applicant, the time spent in medical study in respective
1-19 medical schools, and the years and schools from which degrees were
1-20 granted.] The record shall [also] show whether applicants were
1-21 denied [rejected] or licensed and shall be prima facie evidence of
1-22 all matters contained in the record. A certified copy of those
1-23 permanent records, with the hand and seal of the executive director
1-24 [secretary-treasurer] of the board, shall be admitted in evidence
1-25 in all courts.
1-26 (h) The board may receive criminal records or reports from
1-27 any law enforcement agency or source pertaining to its licensees or
1-28 any applicant for license. The board may [shall] submit to the
1-29 Department of Public Safety a complete set of fingerprints of every
1-30 applicant for a license, and the Department of Public Safety shall
1-31 cause them to be classified and checked against those in their
1-32 fingerprint files and shall [forthwith] certify their findings
1-33 concerning the criminal record of the applicant or shall report the
1-34 lack of a criminal record, as the case may be, to the board. All
1-35 criminal records and reports received from the Department of Public
1-36 Safety shall be for the exclusive use of the board and shall be
1-37 privileged and shall not be released or otherwise disclosed to any
1-38 person or agency by the board except on court order. [Any
1-39 applicant for licensure or any licensee whose license is subject to
1-40 revocation, cancellation, or suspension because of adverse
1-41 information contained in the criminal records or reports shall be
1-42 afforded the opportunity for a hearing before the board prior to
1-43 any action on the application for license or revocation,
1-44 cancellation, or suspension of license.]
1-45 (k) The board by rule shall establish reasonable and
1-46 necessary fees so that the fees, in the aggregate, produce
1-47 sufficient revenue to cover the cost of administering this Act.
1-48 The fees set by the board may be adjusted so that the total fees
1-49 collected shall be sufficient to meet the expenses of administering
1-50 this Act. The board may not set a fee for an amount less than the
1-51 amount of that fee on September 1, 1993. The board may not waive
1-52 collection of any fee or penalty. The board shall place all fees
1-53 received under authority of this Act[, not otherwise specified,
1-54 into the medical licensing fund] in the state treasury. The board
1-55 is authorized and shall by annual budget determine the manner of
1-56 handling the funds and the purpose, consistent with this Act, for
1-57 which the same may be used. The budgeted expenses authorized by
1-58 the board shall be paid out of funds received by the board and are
1-59 not a charge upon the general revenue of the state.
1-60 (t) The board shall on request of a licensee issue
1-61 certification on endorsement of its license to other states and
1-62 charge a reasonable fee for the issuance. The board shall on
1-63 request of a licensee issue certification of state board
1-64 examination grades to the Federation of State Medical Boards of the
2-1 United States and charge a reasonable fee for the issuance.
2-2 (bb) The executive director of the board shall file a surety
2-3 bond with the board. The bond shall be in an amount not less than
2-4 $10,000, be in compliance with the insurance laws of the state, and
2-5 be payable to the state for the use of the state if the executive
2-6 director does not faithfully discharge the duties of the office.
2-7 The board shall pay the premium on the bond.
2-8 SECTION 2. Sections 3.01, 3.02, 3.03, 3.04, and 3.05,
2-9 Medical Practice Act (Article 4495b, Vernon's Texas Civil
2-10 Statutes), are amended to read as follows:
2-11 Sec. 3.01. ANNUAL REGISTRATION OF PHYSICIANS [PRACTITIONERS
2-12 AND INTERNS]. (a) All persons now lawfully qualified to practice
2-13 medicine in this state or hereafter licensed for the practice of
2-14 medicine by the board shall register annually as practitioners with
2-15 the board. The initial annual registration permit shall be issued
2-16 with the license.
2-17 (b) The annual registration permit fee as established by
2-18 board rule shall apply to all physicians licensed by the board,
2-19 whether or not they are practicing within the borders of this
2-20 state, except retired physicians as provided by rules of the board.
2-21 (c) A physician licensed by the board whose only practice is
2-22 voluntary charity care is exempt from the annual registration
2-23 permit fee as provided by rules of the board.
2-24 (d) The board shall mail an annual registration permit
2-25 renewal application to each practitioner at the practitioner's
2-26 last known address according to the records of the board at least
2-27 30 days prior to the expiration date of the annual registration
2-28 permit.
2-29 (e) The board shall provide for a 30-day grace period for
2-30 renewing the annual registration permit from the date of the
2-31 expiration of the annual registration permit.
2-32 (f) A licensee may renew his or her annual registration
2-33 permit by submitting to the board, on or before the expiration date
2-34 of the annual registration permit, the required renewal application
2-35 and renewal fee. Each annual registration permit renewal
2-36 application shall include the name and mailing address of the
2-37 licensee, the place or places where the licensee is engaged in the
2-38 practice of medicine, and other necessary information prescribed by
2-39 the board.
2-40 (g) If the licensee is licensed for the practice of medicine
2-41 by another state, the District of Columbia, a territory of the
2-42 United States, Canada, any other country, or the uniformed services
2-43 of the United States, the renewal application must include a
2-44 description of any investigations the licensee knows are in
2-45 progress and of any sanctions imposed by or disciplinary matters
2-46 pending in the state, district, territory, country, or service.
2-47 (h) On receipt of a renewal application and all required
2-48 fees, the board, after ascertaining, either from the records of the
2-49 board or from other sources considered by it to be reliable, that
2-50 the applicant is a licensed practitioner of medicine in this state,
2-51 shall issue to the licensee an annual registration permit
2-52 certifying that the licensee has filed the renewal application, has
2-53 paid the annual registration permit fee for the year in question,
2-54 and has completed the requirements for annual registration.
2-55 (i) If a licensee's annual registration permit has been
2-56 expired for 90 days or less, the licensee may renew his or her
2-57 annual registration permit by submitting to the board the required
2-58 renewal application, renewal fee, and a $50 penalty fee.
2-59 (j) If a licensee's annual registration permit has been
2-60 expired for longer than 90 days but less than one year, the
2-61 licensee may renew his or her annual registration permit by
2-62 submitting to the board the required renewal application, renewal
2-63 fee, and a $100 penalty fee.
2-64 (k) If a licensee's annual registration permit has been
2-65 expired for one year or longer, his or her license is considered to
2-66 have been canceled, and the licensee may not renew his or her
2-67 annual registration permit.
2-68 (l) Each physician whose license is considered canceled may
2-69 obtain a new license by submitting to reexamination and complying
3-1 with the requirements, fees, and procedures for obtaining a
3-2 license. The board may issue a new license without examination to
3-3 a person whose license is considered canceled for less than two
3-4 years.
3-5 (m) The board by rule may adopt a system under which annual
3-6 registration permits expire on various dates during the year. For
3-7 the year in which the expiration date is changed, annual
3-8 registration permit fees shall be prorated. On renewal of the
3-9 annual registration on the new expiration date, the total annual
3-10 registration permit fee is payable.
3-11 (n) The filing of the renewal application, the payment of
3-12 the required fees, and the issuance of the permit shall not entitle
3-13 the holder to practice medicine in Texas unless the holder has been
3-14 previously licensed as a practitioner by the board, as prescribed
3-15 by law, and the license to practice medicine is in full force and
3-16 effect. In any prosecution for the unlawful practice of medicine,
3-17 the annual registration permit required by this Act may not be
3-18 treated as evidence that the holder is lawfully entitled to
3-19 practice medicine.
3-20 (o) Practicing medicine as defined in this Act without an
3-21 annual registration permit for the current year as provided in this
3-22 Act has the same force and effect as and is subject to all
3-23 penalties of practicing medicine without a license. [All persons
3-24 now lawfully qualified to practice medicine in this state, or who
3-25 are hereafter licensed for the practice of medicine by the board,
3-26 shall be registered as practitioners with the board on or before
3-27 the first day of January and thereafter shall register in like
3-28 manner annually, on or before the first day of January of each
3-29 succeeding year. Each person so registered with the board shall
3-30 pay, in connection with each annual registration and for the
3-31 receipt hereinafter provided for, a fee established by the board
3-32 which fee shall accompany the application of each person for
3-33 registration. The payment shall be made to the board. Every
3-34 person so registered shall file with the board a written
3-35 application for annual registration, setting forth his name and
3-36 mailing address, the place or places where the applicant is engaged
3-37 in the practice of medicine, and other necessary information
3-38 prescribed by the board. If the person is licensed for the
3-39 practice of medicine by another state, the District of Columbia, a
3-40 territory of the United States, Canada, any other country, or the
3-41 uniformed services of the United States, the application must
3-42 include a description of any investigations the person knows are in
3-43 progress and of any sanctions imposed by or disciplinary matters
3-44 pending in the state, district, territory, country, or service.]
3-45 [(b) Physicians not otherwise licensed by the board who are
3-46 participating in graduate medical education training programs
3-47 approved by the board may be issued institutional permits as
3-48 provided by rules of the board. A reasonable fee shall be charged
3-49 and deposited into the medical registration fund. This permit does
3-50 not authorize the performance of medical acts except as the acts
3-51 are performed as a part of graduate medical education programs and
3-52 under the supervision of a licensed practitioner of medicine.]
3-53 [(c)(1) A person may renew an unexpired license by paying to
3-54 the board on or before the expiration date of the license the
3-55 required renewal fee.]
3-56 [(2) If a person's license has been expired for 90
3-57 days or less, the person may renew the license by paying to the
3-58 board the required renewal fee and a fee that is one-half of the
3-59 annual registration fee as established by the board under Section
3-60 3.10(b)(7) of this Act.]
3-61 [(3) If a person's license has been expired for longer
3-62 than 90 days but less than one year, the person may renew the
3-63 license by paying to the board all unpaid renewal fees and a fee
3-64 that is equal to the annual registration fee as established by the
3-65 board under Section 3.10(b)(7) of this Act.]
3-66 [(4) If a person's license has been expired for one
3-67 year, it is considered to have been canceled, unless an
3-68 investigation is pending, and the person may not renew the license.
3-69 The person may obtain a new license by submitting to reexamination
4-1 and complying with the requirements and procedures for obtaining an
4-2 original license.]
4-3 [(5) The board may renew without examination an
4-4 expired license of a person who was licensed in this state, moved
4-5 to another state, and is currently licensed and has been in
4-6 practice in the other state for not more than two years preceding
4-7 application. The person must pay to the board a fee that is equal
4-8 to the examination fee for the license.]
4-9 [(6) The board shall provide written notice to each
4-10 practitioner at the practitioner's last known address according to
4-11 the records of the board at least 30 days prior to the expiration
4-12 date of a license and shall provide for a 30-day grace period for
4-13 payment of the annual registration fee from the date of the
4-14 expiration of the license.]
4-15 [(d) Practicing medicine as defined in this Act without an
4-16 annual registration receipt for the current year as provided in
4-17 this Act has the same force and effect as and is subject to all
4-18 penalties of practicing medicine without a license.]
4-19 [(e) On receipt of an application, accompanied by the proper
4-20 registration fee, the board, after ascertaining, either from the
4-21 records of the board or from other sources considered by it to be
4-22 reliable, that the applicant is a licensed practitioner of medicine
4-23 in this state, shall issue to the applicant an annual registration
4-24 receipt certifying that the applicant has filed the application and
4-25 has paid the registration fee for the year in question. The filing
4-26 of the application, the payment of the registration fee, and the
4-27 issuance of the receipt shall not entitle the holder to practice
4-28 medicine in Texas unless he has in fact been previously licensed as
4-29 a practitioner by the board, as prescribed by law, and unless the
4-30 license to practice medicine is in full force and effect. In any
4-31 prosecution for the unlawful practice of medicine the receipt
4-32 showing payment of the annual registration fee required by this Act
4-33 may not be treated as evidence that the holder is lawfully entitled
4-34 to practice medicine.]
4-35 [(f) The executive director of the board shall file a surety
4-36 bond with the board. The bond shall be in an amount not less than
4-37 $10,000, be in compliance with the insurance laws of the state, and
4-38 be payable to the state for the use of the state if the executive
4-39 director does not faithfully discharge the duties of the office.
4-40 The board shall pay the premium on the bond.]
4-41 [(g) The annual registration fee shall apply to all persons
4-42 licensed by the board, whether or not they are practicing within
4-43 the borders of this state, except retired physicians as provided by
4-44 rules of the board. A retired physician licensed by the board
4-45 whose only practice is voluntary charity care is exempt from the
4-46 annual registration fee.]
4-47 [(h) The executive director shall review each application
4-48 for licensure by examination or reciprocity and shall recommend to
4-49 the board all applicants eligible for licensure. The executive
4-50 director also shall report to the board the names of all applicants
4-51 determined to be ineligible for licensure, together with the
4-52 reasons for each recommendation. An applicant deemed ineligible
4-53 for licensure by the executive director may request review of such
4-54 recommendation by a committee of the board within 20 days of
4-55 receipt of such notice, and the executive director may refer any
4-56 application to said committee for a recommendation concerning
4-57 eligibility. If the committee finds the applicant ineligible for
4-58 licensure, such recommendation, together with the reasons therefor,
4-59 shall be submitted to the board unless the applicant requests a
4-60 hearing within 20 days of receipt of notice of the committee's
4-61 determination. The hearing shall be before an administrative law
4-62 judge of the State Office of Administrative Hearings and shall
4-63 comply with the Administrative Procedure Act and its subsequent
4-64 amendments and the rules of the State Office of Administrative
4-65 Hearings and the board. The committee may refer any application
4-66 for determination of eligibility to the full board. The board
4-67 shall, after receiving the administrative law judge's proposed
4-68 findings of fact and conclusions of law, determine the eligibility
4-69 of the applicant for licensure. A physician whose application for
5-1 licensure is denied by the board shall receive a written statement
5-2 containing the reasons for the board's action. All reports
5-3 received or gathered by the board on each applicant are
5-4 confidential and are not subject to disclosure under the Open
5-5 Records Law. The board may disclose such reports to appropriate
5-6 licensing authorities in other states.]
5-7 Sec. 3.02. INSTITUTIONAL PERMITS [RENEWALS]. Physicians not
5-8 otherwise licensed by the board who are participating in graduate
5-9 medical education training programs approved by the board may be
5-10 issued institutional permits as provided by rules of the board.
5-11 This permit does not authorize the performance of medical acts
5-12 except as the acts are performed as a part of graduate medical
5-13 education training programs and under the supervision of a licensed
5-14 practitioner of medicine. [(a) On application on forms provided
5-15 by the board for this purpose and receipt of renewal fees, licenses
5-16 shall be renewed annually by the board.]
5-17 [(b) The board by rule may adopt a system under which
5-18 registrations expire on various dates during the year. The date
5-19 for license cancellation due to nonpayment shall be adjusted
5-20 accordingly. For the year in which the expiration date is changed,
5-21 registration fees payable on or before January 1 shall be prorated
5-22 on a monthly basis so that each registrant shall pay only that
5-23 portion of the registration fee which is allocable to the number of
5-24 months during which the registration is valid. On renewal of the
5-25 registration on the new expiration date, the total registration fee
5-26 is payable.]
5-27 Sec. 3.03. LICENSURE OF PHYSICIANS [RECIPROCAL AGREEMENTS].
5-28 (a) The board, at its sole discretion, may grant a license to
5-29 practice medicine to any physician who qualifies under this Act.
5-30 (b) An application for a license must be in writing and on
5-31 forms prescribed by the board.
5-32 (c) The application forms must be accompanied by all fees,
5-33 documents, and photographs required by board rule.
5-34 (d) Applicants for a license must subscribe to an oath in
5-35 writing before an officer authorized by law to administer oaths.
5-36 The written oath is a part of the application.
5-37 (e) An applicant may not have:
5-38 (1) a medical license that is currently restricted,
5-39 canceled, suspended, or revoked in a state of the United States, a
5-40 province of Canada, or a uniformed service of the United States;
5-41 (2) an investigation or a proceeding instituted
5-42 against the applicant for the restriction, cancellation,
5-43 suspension, or revocation in a state of the United States, a
5-44 province of Canada, or a uniformed service of the United States; or
5-45 (3) a prosecution pending against the applicant in any
5-46 state, federal, or Canadian court for any offense that under the
5-47 laws of this state is a felony or a misdemeanor that involves moral
5-48 turpitude.
5-49 (f) An applicant must present satisfactory proof to the
5-50 board that each medical school attended is substantially equivalent
5-51 to a Texas medical school as determined by board rule.
5-52 (g) An applicant who is a graduate of a medical school that
5-53 is located outside the United States and Canada must present
5-54 satisfactory proof to the board that the applicant:
5-55 (1) is a graduate of a school whose curriculum meets
5-56 the requirements for an unapproved medical school as determined by
5-57 a committee of experts selected by the Texas Higher Education
5-58 Coordinating Board;
5-59 (2) has successfully completed three years of graduate
5-60 medical training in the United States or Canada that was approved
5-61 by the board;
5-62 (3) is eligible for licensure to practice medicine in
5-63 the country in which the school is located except for any
5-64 citizenship requirements;
5-65 (4) possesses a valid certificate issued by the
5-66 Educational Commission for Foreign Medical Graduates; and
5-67 (5) has the ability to communicate in the English
5-68 language.
5-69 (h) All medical or osteopathic medical education received by
6-1 the applicant in the United States must be accredited by an
6-2 accrediting body officially recognized by the United States
6-3 Department of Education as the accrediting body for medical
6-4 education leading to the doctor of medicine degree or the doctor of
6-5 osteopathy degree in the United States. This subsection does not
6-6 apply to postgraduate medical education or training.
6-7 (i) An applicant who is unable to comply with the
6-8 requirements of Subsection (h) of this section may be eligible for
6-9 an unrestricted license if the applicant:
6-10 (1) received medical education in a hospital or
6-11 teaching institution sponsoring or participating in a program of
6-12 graduate medical education accredited by the Accrediting Council
6-13 for Graduate Medical Education, the American Osteopathic
6-14 Association, or the board in the same subject as the medical or
6-15 osteopathic medical education as defined by board rule; or
6-16 (2) is specialty board certified by a board approved
6-17 by the American Osteopathic Association or the American Board of
6-18 Medical Specialties.
6-19 (j)(1) The executive director shall review each application
6-20 for licensure and shall recommend to the board all applicants
6-21 eligible for licensure. The executive director also shall report
6-22 to the board the names of all applicants determined to be
6-23 ineligible for licensure, together with the reasons for each
6-24 recommendation.
6-25 (2) An applicant deemed ineligible for licensure by
6-26 the executive director may request review of such recommendation by
6-27 a committee of the board within 20 days of receipt of such notice,
6-28 and the executive director may refer any application to the
6-29 committee for a recommendation concerning eligibility.
6-30 (3) If the committee finds the applicant ineligible
6-31 for licensure, such recommendation, together with the reasons for
6-32 the recommendation, shall be submitted to the board unless the
6-33 applicant requests a hearing within 20 days of receipt of notice of
6-34 the committee's determination.
6-35 (A) The hearing shall be before an
6-36 administrative law judge of the State Office of Administrative
6-37 Hearings and shall comply with the Administrative Procedure Act and
6-38 the rules of the State Office of Administrative Hearings and the
6-39 board.
6-40 (B) The committee may refer any application for
6-41 determination of eligibility to the full board.
6-42 (4) The board shall, after receiving the
6-43 administrative law judge's proposed findings of fact and
6-44 conclusions of law, determine the eligibility of the applicant for
6-45 licensure. A physician whose application for licensure is denied
6-46 by the board shall receive a written statement containing the
6-47 reasons for the board's action.
6-48 (k) Examination questions that may be used in the future,
6-49 examinations other than the one taken by the person requesting it,
6-50 and deliberations and records relating to the professional
6-51 character and fitness of applicants are exempted from the open
6-52 meetings law and the open records law.
6-53 (l) All reports received or gathered by the board on each
6-54 applicant are confidential and are not subject to disclosure under
6-55 the open records law. The board may disclose such reports to
6-56 appropriate licensing authorities in other states.
6-57 (m) In addition to the requirements prescribed by this Act,
6-58 the board may require applicants to comply with other requirements
6-59 that the board considers appropriate. [The board, at its sole
6-60 discretion and upon payment by an applicant of a fee prescribed by
6-61 the board under this Act, may grant a license to practice medicine
6-62 to any physician who is a graduate of an acceptable medical college
6-63 as determined by the board and who is a licensee of another state
6-64 or Canadian province having requirements for physician registration
6-65 and practice substantially equivalent to those established by the
6-66 laws of this state.]
6-67 [(b) An application for a license under this section must be
6-68 in writing and upon a form prescribed by the board. The
6-69 application must be accompanied by:]
7-1 [(1) a diploma or photograph of a diploma awarded to
7-2 the applicant by an acceptable medical college and a certified
7-3 transcript showing courses and grades;]
7-4 [(2) a license or a certified copy of a license to
7-5 practice medicine lawfully issued to the applicant by some other
7-6 state or a Canadian province that requires in its examination the
7-7 same general degree of fitness required by this state and that
7-8 grants the same reciprocal privileges to persons licensed by the
7-9 board;]
7-10 [(3) a certification made by the president or
7-11 secretary of the board that issued the license or a duly
7-12 constituted registration office of the state or Canadian province
7-13 that issued the certificate or license, reciting that the
7-14 accompanying certificate or license has not been canceled,
7-15 suspended, or revoked and reciting that the statement of the
7-16 qualifications made in the application for medical license in Texas
7-17 is true and correct; and]
7-18 [(4) evidence of a passing grade on an examination
7-19 required by the board.]
7-20 [(c) Applicants for a license under this section must
7-21 subscribe to an oath in writing before an officer authorized by law
7-22 to administer oaths. The written oath must be a part of the
7-23 application. The application must:]
7-24 [(1) state that:]
7-25 [(A) the license, certificate, or authority
7-26 under which the applicant has most recently practiced medicine in
7-27 the state or Canadian province from which the applicant is
7-28 transferring to this state or in the uniformed service in which the
7-29 applicant served is in full force and not restricted, canceled,
7-30 suspended, or revoked;]
7-31 [(B) the applicant is the identical person to
7-32 whom the certificate or license and the diploma were issued;]
7-33 [(C) no proceeding has been instituted against
7-34 the applicant for the restriction, cancellation, suspension, or
7-35 revocation of the certificate, license, or authority to practice
7-36 medicine in the state, Canadian province, or uniformed service of
7-37 the United States in which it was issued; and]
7-38 [(D) no prosecution is pending against the
7-39 applicant in any state, federal, or Canadian court for any offense
7-40 that under the laws of this state is a felony;]
7-41 [(2) include a description of any sanctions imposed by
7-42 or disciplinary matters pending in the state or Canadian province
7-43 in which the applicant was or is licensed or certified to practice
7-44 medicine; and]
7-45 [(3) include evidence of postgraduate training
7-46 required by the board.]
7-47 [(d) An applicant for a license under this section must be
7-48 eligible for examination by the board.]
7-49 [(e) In addition to other licensure requirements, the board
7-50 may require by rule and regulation that an applicant who is a
7-51 licensee of another state or Canadian province and who is a
7-52 graduate of a medical school located outside of the United States
7-53 and Canada, or the school itself, provide additional information to
7-54 the board concerning the medical school attended prior to approval
7-55 of the applicant.]
7-56 [(f) The board may refuse to issue a license to an applicant
7-57 who is a licensee of another state or Canadian province and who
7-58 graduated from a medical school outside of the United States and
7-59 Canada if it finds that the applicant does not possess the
7-60 requisite qualifications to provide the same standard of medical
7-61 care as provided by a licensed physician in this state.]
7-62 [(g) In addition to the requirements prescribed by this
7-63 section, the board may require applicants to comply with other
7-64 requirements that the board considers appropriate.]
7-65 [(h) The board may not refuse to issue a license to an
7-66 applicant under Subsection (f) of this section if the applicant:]
7-67 [(1) for the preceding five years has been a licensee
7-68 of another state or a Canadian province;]
7-69 [(2) is not the subject of a sanction imposed by or
8-1 disciplinary matter pending in any state or Canadian province in
8-2 which the applicant is licensed to practice medicine; and]
8-3 [(3) is either specialty board certified by a board
8-4 that is a member of the American Board of Medical Specialties or a
8-5 specialty board approved by the American Osteopathic Association or
8-6 successfully passes an examination that the board shall determine
8-7 by rule.]
8-8 Sec. 3.04. QUALIFICATIONS OF LICENSEES [QUALIFICATION OF
8-9 LICENSEE]. An applicant, to be eligible for issuance of a license,
8-10 must present satisfactory proof to the board that the applicant:
8-11 (1) is at least 21 years of age;
8-12 (2) is of good professional character and has not
8-13 violated Section 3.08 of this Act;
8-14 (3) has completed:
8-15 (A) 60 semester hours of college courses other
8-16 than in medical school that are acceptable to The University of
8-17 Texas at Austin for credit on a bachelor of arts degree or a
8-18 bachelor of science degree;
8-19 (B) the entire primary, secondary, and
8-20 premedical education required in the country of medical school
8-21 graduation, if the medical school is located outside the United
8-22 States or Canada; or
8-23 (C) substantially equivalent courses as
8-24 determined by board rule;
8-25 (4) is a graduate of a medical school located inside
8-26 the United States or Canada and approved by the board who has
8-27 successfully completed one year of graduate medical training
8-28 approved by the board in the United States or Canada or is a
8-29 graduate of a medical school located outside the United States or
8-30 Canada who has successfully completed three years of graduate
8-31 medical training approved by the board in the United States or
8-32 Canada;
8-33 (5) has successfully passed within three attempts each
8-34 part of a uniform medical licensing examination; and
8-35 (6) has passed the Texas medical jurisprudence
8-36 examination as determined by board rule. [(a) An applicant, to be
8-37 eligible for the examination and issuance of a license, must
8-38 present satisfactory proof to the board that the applicant:]
8-39 [(1) is at least 21 years of age;]
8-40 [(2) is of good professional character;]
8-41 [(3) has completed 60 semester hours of college
8-42 courses other than in medical school, which courses would be
8-43 acceptable, at the time of completion, to The University of Texas
8-44 for credit on a bachelor of arts degree or a bachelor of science
8-45 degree; and]
8-46 [(4) is a graduate of an acceptable medical or
8-47 osteopathic school or college that was approved by the board at the
8-48 time the degree was conferred and has completed a one-year program
8-49 of graduate medical training approved by the board.]
8-50 [(b) The applicant shall be eligible for examination prior
8-51 to complying with the graduate training requirement of Subsection
8-52 (a)(4) of this section but shall not be eligible for the issuance
8-53 of an unrestricted license until the requirements of Subsection (a)
8-54 of this section have been satisfied.]
8-55 [(c) Applications for examination must be made in writing,
8-56 verified by affidavit, filed with the board on forms prescribed by
8-57 the board, and accompanied by documents and a fee as the board
8-58 determines to be reasonable.]
8-59 [(d) To be recognized by the board for the purposes of this
8-60 subchapter, all medical or osteopathic medical education received
8-61 by the applicant in the United States must be accredited by an
8-62 accrediting body officially recognized by the United States
8-63 Department of Education as the accrediting body for medical
8-64 education leading to the doctor of medicine degree or the doctor of
8-65 osteopathy degree in the United States. This subsection does not
8-66 apply to postgraduate medical education or training.]
8-67 [(f) An applicant who is unable to comply with the
8-68 requirements of Subsection (d) of this section is eligible for an
8-69 unrestricted license if the applicant:]
9-1 [(1) received such medical education in a hospital or
9-2 teaching institution sponsoring or participating in a program of
9-3 graduate medical education accredited by the Accrediting Council
9-4 for Graduate Medical Education, the American Osteopathic
9-5 Association, or the Texas State Board of Medical Examiners in the
9-6 same subject as the medical or osteopathic medical education if the
9-7 hospital or teaching institution has an agreement with the
9-8 applicant's school; or]
9-9 [(2) is specialty board certified by a board approved
9-10 by the American Osteopathic Association or the American Board of
9-11 Medical Specialties.]
9-12 [(g) In addition to the other requirements of this section,
9-13 an applicant who is a graduate of a medical school that is located
9-14 outside the United States and Canada and that was not approved by
9-15 the board at the time the degree was conferred must, in order to be
9-16 eligible for the issuance of a license, present satisfactory proof
9-17 to the board that the applicant:]
9-18 [(1) is a graduate of a school whose curriculum meets
9-19 the requirements for an unapproved medical school as determined by
9-20 a committee of experts selected by the Texas Higher Education
9-21 Coordinating Board;]
9-22 [(2) has successfully completed three years of
9-23 graduate medical training in the United States or Canada that was
9-24 approved by the board on the date the training was completed;]
9-25 [(3) is eligible for licensure to practice medicine in
9-26 the country in which the school is located;]
9-27 [(4) possesses a valid certificate issued by the
9-28 Educational Commission for Foreign Medical Graduates;]
9-29 [(5) has the ability to communicate in the English
9-30 language; and]
9-31 [(6) has passed the examination required by the board
9-32 of all applicants for license as required by Section 3.05 of this
9-33 Act.]
9-34 [(h) The board by rule may establish alternate educational
9-35 prerequisites to those required by Subsection (a)(3) of this
9-36 section for an applicant who graduated from an unapproved medical
9-37 school located outside the United States and Canada.]
9-38 [(i) In addition to other licensure requirements, the board,
9-39 before approving the applicant, may require by rule that a graduate
9-40 of an unapproved medical school located outside the United States
9-41 and Canada or the school of which the person is a graduate provide
9-42 additional information to the board concerning the school.]
9-43 [(j) The board may refuse to issue a license to an applicant
9-44 who graduated from an unapproved medical school located outside the
9-45 United States and Canada if it finds that:]
9-46 [(1) the applicant does not possess the requisite
9-47 qualifications to provide the same standard of medical care as
9-48 provided by a physician licensed in this state; or]
9-49 [(2) the applicant failed to provide the board
9-50 evidence to establish that the applicant completed medical
9-51 education or professional training substantially equivalent to that
9-52 provided by a medical school in this state.]
9-53 Sec. 3.05. EXAMINATIONS ACCEPTED OR ADMINISTERED
9-54 [EXAMINATION]. (a) The board may administer or accept the
9-55 following examinations for licensure as determined by rule:
9-56 (1) a state board licensing examination;
9-57 (2) the National Board of Osteopathic Medical
9-58 Examiners (NBOME) examination or its successor;
9-59 (3) the National Board of Medical Examiners (NBME)
9-60 examination or its successor;
9-61 (4) the Federation Licensing Examination (FLEX) with a
9-62 weighted average in one sitting before June, 1985;
9-63 (5) the Federation Licensing Examination (FLEX) after
9-64 May, 1985;
9-65 (6) the United States Medical Licensing Examination
9-66 (USMLE); or
9-67 (7) a combination of the above examinations if passed
9-68 prior to 1998 as determined by board rule.
9-69 (b) All examinations used by the board for licensure to
10-1 practice medicine shall be in writing in the English language and
10-2 shall be entirely fair and impartial to all individuals and to
10-3 every school or system of medicine. Applicants who wish to request
10-4 reasonable accommodations due to a disability shall submit the
10-5 request on filing the application.
10-6 (c) Examinations shall include subjects generally taught by
10-7 medical schools, a knowledge of which is commonly and generally
10-8 required of candidates for the degree of doctor of medicine or
10-9 doctor of osteopathy conferred by schools in Texas.
10-10 (d) The board shall also administer the Texas medical
10-11 jurisprudence examination to all applicants.
10-12 (e) The minimum passing grade for all examinations used by
10-13 the board shall be determined by rule.
10-14 (f) Examinations administered to evaluate basic medical
10-15 knowledge and clinical competency shall be prepared by a national
10-16 testing service or the board and validated by qualified independent
10-17 testing professionals.
10-18 (g) All questions, answers, and grades shall be preserved
10-19 for one year as the board may direct by rule.
10-20 (h) All applicants shall be given due notice of the date and
10-21 place of the examination if administered by the board.
10-22 (i) Within 120 days after the day on which an examination is
10-23 administered by the board, each examinee shall be notified of the
10-24 results of the examination. However, if an examination is graded
10-25 or reviewed by a national testing service, the board shall notify
10-26 each examinee of the results of the examination not later than 30
10-27 days after the date the board receives the results from the testing
10-28 service. If the notice of the examination results will be delayed
10-29 for longer than 90 days after the examination, the board shall
10-30 notify the examinee of the reason for the delay within the 90 days.
10-31 [All examinations for license to practice medicine shall be
10-32 conducted in writing in the English language and in a manner as to
10-33 be entirely fair and impartial to all individuals and to every
10-34 school or system of medicine. Examinations shall be conducted on
10-35 and cover those subjects generally taught by medical schools, a
10-36 knowledge of which is commonly and generally required of candidates
10-37 for the degree of doctor of medicine or doctor of osteopathy
10-38 conferred by schools or colleges of medicine approved by the board,
10-39 and the examinations shall also be conducted on and cover the
10-40 subject of medical jurisprudence. Examinations shall be prepared
10-41 by a national testing service or prepared by the board and
10-42 validated by qualified independent testing professionals. On
10-43 satisfactory examination conducted as required by this Act under
10-44 rules of the board, applicants may be granted licenses to practice
10-45 medicine. All questions and answers, with the grades attached,
10-46 shall be preserved for one year in the executive office of the
10-47 board or such other repository as the board by rule may direct.
10-48 All applicants examined at the same time shall be given identical
10-49 questions. All certificates shall be attested by the seal of the
10-50 board. The board in its discretion may give the examination for
10-51 license in two or more parts.]
10-52 [(b) In addition to the requirements prescribed by this Act,
10-53 the board may require applicants to comply with other requirements
10-54 that the board considers appropriate and establish reasonable fees
10-55 for examination.]
10-56 [(c) All applicants for license to practice medicine in this
10-57 state not otherwise licensed under the provisions of law must
10-58 successfully pass a uniform examination approved by the board as
10-59 determined by rule. The board is authorized to adopt and enforce
10-60 all rules of procedure not inconsistent with statutory
10-61 requirements. All applicants shall be given due notice of the date
10-62 and place of the examination. If any applicant, because of failure
10-63 to pass the required examination, is refused a license, the
10-64 applicant, at a time as the board may fix, shall be permitted to
10-65 take a subsequent examination not more than two additional times as
10-66 the board may prescribe on the payment of a fee as the board may
10-67 determine to be reasonable. In the event satisfactory grades shall
10-68 be made on the subjects prescribed and taken on the reexamination,
10-69 the board may grant the applicant a license to practice medicine.
11-1 The board shall determine the credit to be given examinees on
11-2 answers turned in on the subjects of complete and partial
11-3 examination, and its decision is final.]
11-4 [(d) Examination questions that may be used in the future,
11-5 examinations other than the one taken by the person requesting it,
11-6 and deliberations and records relating to the professional
11-7 character and fitness of applicants are exempted from the Open
11-8 Meetings Law and the Open Records Law. The records, however, shall
11-9 be disclosed to individual applicants upon written request, unless
11-10 the person supplying the information to the board requests that it
11-11 not be disclosed.]
11-12 [(e) Within 90 days after the day on which an examination is
11-13 administered under this Act, the board shall notify each examinee
11-14 of the results of the examination. However, if an examination is
11-15 graded or reviewed by a national testing service, the board shall
11-16 notify each examinee of the results of the examination not later
11-17 than the 30th day after the date the board receives the results
11-18 from the testing service. If the notice of the examination results
11-19 will be delayed for longer than 90 days after the examination, the
11-20 board shall notify the examinee of the reason for the delay before
11-21 the 90th day.]
11-22 [(f) If requested in writing by a person who fails the
11-23 examination administered under this Act, the board shall furnish
11-24 the person with a summarized analysis of the person's performance
11-25 on the examination consisting of the person's score on each portion
11-26 of the examination.]
11-27 SECTION 3. Section 3.10, Medical Practice Act (Article
11-28 4495b, Vernon's Texas Civil Statutes), as amended by Chapters 214
11-29 and 862, Acts of the 73rd Legislature, 1993, is amended to read as
11-30 follows:
11-31 Sec. 3.10. FEES. (a) All fees collected by the board shall
11-32 be placed in the state treasury. The fees deposited shall be
11-33 credited to the appropriations of the board and may be spent only
11-34 as provided by the General Appropriations Act, this Act, or other
11-35 applicable statutes. Money may be used by the board and under its
11-36 direction in the enforcement of this Act, the prohibition of the
11-37 unlawful practice of medicine, the dissemination of information to
11-38 prevent the violation of the laws, and the prosecution of those who
11-39 violate the laws. All distributions may be made only on written
11-40 approval of the executive director of the board or his designated
11-41 representative.
11-42 (b) The board may not set, charge, collect, receive, or
11-43 deposit any of the following fees in excess of:
11-44 (1) License and first annual registration........ $900
11-45 (2) Temporary license............................ $200
11-46 (3) Renewal of annual registration............... $200
11-47 (4) Institutional permit......................... $200
11-48 (5) Endorsement to other state medical
11-49 boards........................................................ $200
11-50 (6) Duplicate license............................ $200
11-51 (7) Reinstated license after cancellation
11-52 for cause.................................................... $700.
11-53 (c) The board may set and collect a sales charge for making
11-54 copies of records in the office of the board and for any material
11-55 published by the board. The charges shall be in amounts considered
11-56 sufficient to reimburse the board for the actual expense.
11-57 (d) The financial transactions of the board are subject to
11-58 audit by the state auditor in accordance with Chapter 321,
11-59 Government Code.
11-60 (e) The board shall file annually with the governor and the
11-61 presiding officer of each house of the legislature a complete and
11-62 detailed written report accounting for all funds received and
11-63 disbursed by the board during the preceding fiscal year. The
11-64 annual report must be in the form and reported in the time provided
11-65 by the General Appropriations Act. [All annual registration fees
11-66 collected by the board shall be placed in the State Treasury to the
11-67 credit of the medical registration fund. The fees deposited to
11-68 this special fund shall be credited to the appropriations of the
11-69 board and may be spent only as provided by the General
12-1 Appropriations Act, this Act, or other applicable statutes. Money
12-2 in that fund may be used by the board and under its direction in
12-3 the enforcement of this Act, the prohibition of the unlawful
12-4 practice of medicine, the dissemination of information to prevent
12-5 the violation of the laws, and the prosecution of those who violate
12-6 the laws. All distributions from the fund may be made only upon
12-7 written approval of the secretary-treasurer of the board or his
12-8 designated representative, and the comptroller shall upon
12-9 requisition of the board from time to time draw warrants upon the
12-10 State Treasurer for the amounts specified in the requisition.]
12-11 [(b) The board may not set, charge, collect, receive, or
12-12 deposit any of the following fees in excess of:]
12-13 [(1) for processing and granting a license
12-14 by reciprocity to a licensee of another state................. $700]
12-15 [(2) for processing an application and
12-16 administration of a partial examination for licensure......... $700]
12-17 [(3) for processing an application and
12-18 administration of a complete examination for licensure........ $700]
12-19 [(4) for processing an application and
12-20 issuance of a temporary license............................... $200]
12-21 [(5) for processing an application and
12-22 issuance of a duplicate license............................... $200]
12-23 [(6) for processing an application and
12-24 issuance of a license of reinstatement after a lapse or
12-25 cancellation of a license..................................... $700]
12-26 [(7) for processing an application and
12-27 issuance of an annual registration of a licensee.............. $200]
12-28 [(8) for processing and issuance of an
12-29 institutional permit for interns, residents, and others
12-30 in approved medical training programs......................... $200]
12-31 [(9) for processing an application and
12-32 issuance of an endorsement to other state medical boards...... $200]
12-33 [(10) for processing and issuance of a
12-34 license or temporary license to a physician assistant......... $200]
12-35 [(11) for processing and issuance of a
12-36 permit to a physician who supervises an acupuncturist........ $200.]
12-37 [(b) The board may set and collect a sales charge for making
12-38 copies of any paper of record in the office of the board and for
12-39 any printed material published by the board. The charges shall be
12-40 in amounts considered sufficient to reimburse the board for the
12-41 actual expense.]
12-42 [(c) The financial transactions of the board are subject to
12-43 audit by the state auditor in accordance with Chapter 321,
12-44 Government Code.]
12-45 [(d) The board shall file annually with the governor and the
12-46 presiding officer of each house of the legislature a complete and
12-47 detailed written report accounting for all funds received and
12-48 disbursed by the board during the preceding fiscal year. The
12-49 annual report must be in the form and reported in the time provided
12-50 by the General Appropriations Act.]
12-51 SECTION 4. Section 3.11A, Medical Practice Act (Article
12-52 4495b, Vernon's Texas Civil Statutes), is amended to read as
12-53 follows:
12-54 Sec. 3.11A. DISPOSITION OF FEES. (a) An additional $200
12-55 surcharge shall apply to each of the following fees:
12-56 (1) license fees;
12-57 (2) renewal of annual registration fees; and
12-58 (3) reinstated license fees after cancellation.
12-59 (b) Of each surcharge collected, $50 shall be deposited to
12-60 the credit of the foundation school fund and $150 shall be
12-61 deposited to the credit of the general revenue fund. This
12-62 subsection applies to the disposition of the stated portion of each
12-63 fee regardless of any other provision of law providing for a
12-64 different disposition of funds. [This section applies to each of
12-65 the following fees:]
12-66 [(1) fee for processing and granting a license by
12-67 reciprocity to a licensee of another state;]
12-68 [(2) fee for processing an application and
12-69 administration of a partial examination for licensure;]
13-1 [(3) fee for processing an application and
13-2 administration of a complete examination for licensure;]
13-3 [(4) fee for processing an application and issuance of
13-4 a license of reinstatement after a lapse or cancellation of a
13-5 license; and]
13-6 [(5) fee for processing an application and issuance of
13-7 an annual registration of a licensee.]
13-8 [(b) Of each fee collected, $50 shall be deposited to the
13-9 credit of the foundation school fund and $150 shall be deposited to
13-10 the credit of the general revenue fund. This subsection applies to
13-11 the disposition of the stated portion of each fee regardless of any
13-12 other provision of law providing for a different disposition of
13-13 funds.]
13-14 SECTION 5. Section 2.10, as added by Section 1.04, Chapter
13-15 36, Acts of the 73rd Legislature, 1993, and Sections 3.0305 and
13-16 3.031, Medical Practice Act (Article 4495b, Vernon's Texas Civil
13-17 Statutes), are repealed.
13-18 SECTION 6. The importance of this legislation and the
13-19 crowded condition of the calendars in both houses create an
13-20 emergency and an imperative public necessity that the
13-21 constitutional rule requiring bills to be read on three several
13-22 days in each house be suspended, and this rule is hereby suspended,
13-23 and that this Act take effect and be in force from and after its
13-24 passage, and it is so enacted.
13-25 * * * * *