AN ACT
1-1 relating to the Texas State Board of Medical Examiners and the
1-2 licensure of physicians; appropriating fees and providing
1-3 penalties.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Section 2.09, Medical Practice Act (Article
1-6 4495b, Vernon's Texas Civil Statutes), is amended by amending
1-7 Subsections (d), (h), (k), and (t) and adding Subsection (bb) to
1-8 read as follows:
1-9 (d) The board shall preserve a record of its proceedings
1-10 which shall be a public record. [The board shall also maintain
1-11 records showing the name, age, place, and duration of residence of
1-12 each applicant, the time spent in medical study in respective
1-13 medical schools, and the years and schools from which degrees were
1-14 granted.] The record shall [also] show whether applicants were
1-15 denied [rejected] or licensed and shall be prima facie evidence of
1-16 all matters contained in the record. A certified copy of those
1-17 permanent records, with the hand and seal of the executive director
1-18 [secretary-treasurer] of the board, shall be admitted in evidence
1-19 in all courts.
1-20 (h) The board may receive criminal records or reports from
1-21 any law enforcement agency or source pertaining to its licensees or
1-22 any applicant for license. The board may [shall] submit to the
1-23 Department of Public Safety a complete set of fingerprints of every
1-24 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
2-23 receipts collected [fees received] under authority of this Act[,
2-24 not otherwise specified, into the medical licensing fund] in the
2-25 state treasury. The board is authorized and shall by annual budget
2-26 determine the manner of handling the funds and the purpose,
3-1 consistent with this Act, for which the same may be used. The
3-2 budgeted expenses authorized by the board shall be paid out of
3-3 funds received by the board and are not a charge upon the general
3-4 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 who are hereafter licensed for the
3-23 practice of medicine by the board, shall register annually as
3-24 practitioners with the board. The initial annual registration
3-25 permit shall be issued with the license.
3-26 (b) The annual registration permit fee as established by
4-1 board rule shall apply to all physicians licensed by the board,
4-2 whether or not they are practicing within the borders of this
4-3 state, except retired physicians as provided by rules of the board.
4-4 (c) A physician licensed by the board whose only practice is
4-5 voluntary charity care is exempt from the annual registration
4-6 permit fee as provided by rules of the board.
4-7 (d) The board shall mail an annual registration permit
4-8 renewal application to each practitioner at the practitioner's
4-9 last known address according to the records of the board at least
4-10 30 days prior to the expiration date of the annual registration
4-11 permit.
4-12 (e) The board shall provide for a 30-day grace period for
4-13 renewing the annual registration permit from the date of the
4-14 expiration of the annual registration permit.
4-15 (f) A licensee may renew the annual registration permit by
4-16 submitting to the board, on or before the expiration date of the
4-17 annual registration permit, the required renewal application and
4-18 renewal fee. Each annual registration permit renewal application
4-19 shall include the name and mailing address of the licensee, the
4-20 place or places where the licensee is engaged in the practice of
4-21 medicine, and other necessary information prescribed by the board.
4-22 (g) If the licensee is licensed for the practice of medicine
4-23 by another state, the District of Columbia, a territory of the
4-24 United States, Canada, any other country, or the uniformed services
4-25 of the United States, the renewal application must include a
4-26 description of any investigations the licensee knows are in
5-1 progress and of any sanctions imposed by or disciplinary matters
5-2 pending in the state, district, territory, country, or service.
5-3 (h) On receipt of a renewal application and all required
5-4 fees, the board, after ascertaining, either from the records of the
5-5 board or from other sources considered by it to be reliable, that
5-6 the applicant is a licensed practitioner of medicine in this state,
5-7 shall issue to the licensee an annual registration permit
5-8 certifying that the licensee has filed the renewal application, has
5-9 paid the annual registration permit fee for the year in question,
5-10 and has completed the requirements for annual registration.
5-11 (i) If a licensee's annual registration permit has been
5-12 expired for 90 days or less, the licensee may renew the licensee's
5-13 annual registration permit by submitting to the board the required
5-14 renewal application, renewal fee, and a $50 penalty fee.
5-15 (j) If a licensee's annual registration permit has been
5-16 expired for longer than 90 days but less than one year, the
5-17 licensee may renew the annual registration permit by submitting to
5-18 the board the required renewal application, renewal fee, and a $100
5-19 penalty fee.
5-20 (k) If a licensee's annual registration permit has been
5-21 expired for one year or longer, the license is considered to have
5-22 been canceled, unless an investigation is pending, and the licensee
5-23 may not renew the annual registration permit.
5-24 (l) Each physician whose license is considered canceled may
5-25 obtain a new license by submitting to reexamination and complying
5-26 with the requirements, fees, and procedures for obtaining a
6-1 license. The board may issue a new license without examination to
6-2 a person whose license is considered canceled for less than two
6-3 years.
6-4 (m) The board by rule may adopt a system under which annual
6-5 registration permits expire on various dates during the year. For
6-6 the year in which the expiration date is changed, annual
6-7 registration permit fees shall be prorated. On renewal of the
6-8 annual registration on the new expiration date, the total annual
6-9 registration permit fee is payable.
6-10 (n) The filing of the renewal application, the payment of
6-11 the required fees, and the issuance of the permit shall not entitle
6-12 the holder to practice medicine in Texas unless the holder has been
6-13 previously licensed as a practitioner by the board, as prescribed
6-14 by law, and the license to practice medicine is in full force and
6-15 effect. In any prosecution for the unlawful practice of medicine,
6-16 the annual registration permit required by this Act may not be
6-17 treated as evidence that the holder is lawfully entitled to
6-18 practice medicine.
6-19 (o) Practicing medicine as defined in this Act without an
6-20 annual registration permit for the current year as provided in this
6-21 Act has the same force and effect as and is subject to all
6-22 penalties of practicing medicine without a license [be registered
6-23 as practitioners with the board on or before the first day of
6-24 January and thereafter shall register in like manner annually, on
6-25 or before the first day of January of each succeeding year. Each
6-26 person so registered with the board shall pay, in connection with
7-1 each annual registration and for the receipt hereinafter provided
7-2 for, a fee established by the board which fee shall accompany the
7-3 application of each person for registration. The payment shall be
7-4 made to the board. Every person so registered shall file with the
7-5 board a written application for annual registration, setting forth
7-6 his name and mailing address, the place or places where the
7-7 applicant is engaged in the practice of medicine, and other
7-8 necessary information prescribed by the board. If the person is
7-9 licensed for the practice of medicine by another state, the
7-10 District of Columbia, a territory of the United States, Canada, any
7-11 other country, or the uniformed services of the United States, the
7-12 application must include a description of any investigations the
7-13 person knows are in progress and of any sanctions imposed by or
7-14 disciplinary matters pending in the state, district, territory,
7-15 country, or service.]
7-16 [(b) Physicians not otherwise licensed by the board who are
7-17 participating in graduate medical education training programs
7-18 approved by the board may be issued institutional permits as
7-19 provided by rules of the board. A reasonable fee shall be charged
7-20 and deposited into the medical registration fund. This permit does
7-21 not authorize the performance of medical acts except as the acts
7-22 are performed as a part of graduate medical education programs and
7-23 under the supervision of a licensed practitioner of medicine.]
7-24 [(c)(1) A person may renew an unexpired license by paying to
7-25 the board on or before the expiration date of the license the
7-26 required renewal fee.]
8-1 [(2) If a person's license has been expired for 90
8-2 days or less, the person may renew the license by paying to the
8-3 board the required renewal fee and a fee that is one-half of the
8-4 annual registration fee as established by the board under Section
8-5 3.10(b)(7) of this Act.]
8-6 [(3) If a person's license has been expired for longer
8-7 than 90 days but less than one year, the person may renew the
8-8 license by paying to the board all unpaid renewal fees and a fee
8-9 that is equal to the annual registration fee as established by the
8-10 board under Section 3.10(b)(7) of this Act.]
8-11 [(4) If a person's license has been expired for one
8-12 year, it is considered to have been canceled, unless an
8-13 investigation is pending, and the person may not renew the license.
8-14 The person may obtain a new license by submitting to reexamination
8-15 and complying with the requirements and procedures for obtaining an
8-16 original license.]
8-17 [(5) The board may renew without examination an
8-18 expired license of a person who was licensed in this state, moved
8-19 to another state, and is currently licensed and has been in
8-20 practice in the other state for not more than two years preceding
8-21 application. The person must pay to the board a fee that is equal
8-22 to the examination fee for the license.]
8-23 [(6) The board shall provide written notice to each
8-24 practitioner at the practitioner's last known address according to
8-25 the records of the board at least 30 days prior to the expiration
8-26 date of a license and shall provide for a 30-day grace period for
9-1 payment of the annual registration fee from the date of the
9-2 expiration of the license.]
9-3 [(d) Practicing medicine as defined in this Act without an
9-4 annual registration receipt for the current year as provided in
9-5 this Act has the same force and effect as and is subject to all
9-6 penalties of practicing medicine without a license.]
9-7 [(e) On receipt of an application, accompanied by the proper
9-8 registration fee, the board, after ascertaining, either from the
9-9 records of the board or from other sources considered by it to be
9-10 reliable, that the applicant is a licensed practitioner of medicine
9-11 in this state, shall issue to the applicant an annual registration
9-12 receipt certifying that the applicant has filed the application and
9-13 has paid the registration fee for the year in question. The filing
9-14 of the application, the payment of the registration fee, and the
9-15 issuance of the receipt shall not entitle the holder to practice
9-16 medicine in Texas unless he has in fact been previously licensed as
9-17 a practitioner by the board, as prescribed by law, and unless the
9-18 license to practice medicine is in full force and effect. In any
9-19 prosecution for the unlawful practice of medicine the receipt
9-20 showing payment of the annual registration fee required by this Act
9-21 may not be treated as evidence that the holder is lawfully entitled
9-22 to practice medicine.]
9-23 [(f) The executive director of the board shall file a surety
9-24 bond with the board. The bond shall be in an amount not less than
9-25 $10,000, be in compliance with the insurance laws of the state, and
9-26 be payable to the state for the use of the state if the executive
10-1 director does not faithfully discharge the duties of the office.
10-2 The board shall pay the premium on the bond.]
10-3 [(g) The annual registration fee shall apply to all persons
10-4 licensed by the board, whether or not they are practicing within
10-5 the borders of this state, except retired physicians as provided by
10-6 rules of the board. A retired physician licensed by the board
10-7 whose only practice is voluntary charity care is exempt from the
10-8 annual registration fee.]
10-9 [(h) The executive director shall review each application
10-10 for licensure by examination or reciprocity and shall recommend to
10-11 the board all applicants eligible for licensure. The executive
10-12 director also shall report to the board the names of all applicants
10-13 determined to be ineligible for licensure, together with the
10-14 reasons for each recommendation. An applicant deemed ineligible
10-15 for licensure by the executive director may request review of such
10-16 recommendation by a committee of the board within 20 days of
10-17 receipt of such notice, and the executive director may refer any
10-18 application to said committee for a recommendation concerning
10-19 eligibility. If the committee finds the applicant ineligible for
10-20 licensure, such recommendation, together with the reasons therefor,
10-21 shall be submitted to the board unless the applicant requests a
10-22 hearing within 20 days of receipt of notice of the committee's
10-23 determination. The hearing shall be before an administrative law
10-24 judge of the State Office of Administrative Hearings and shall
10-25 comply with the Administrative Procedure Act and its subsequent
10-26 amendments and the rules of the State Office of Administrative
11-1 Hearings and the board. The committee may refer any application
11-2 for determination of eligibility to the full board. The board
11-3 shall, after receiving the administrative law judge's proposed
11-4 findings of fact and conclusions of law, determine the eligibility
11-5 of the applicant for licensure. A physician whose application for
11-6 licensure is denied by the board shall receive a written statement
11-7 containing the reasons for the board's action. All reports
11-8 received or gathered by the board on each applicant are
11-9 confidential and are not subject to disclosure under the Open
11-10 Records Law. The board may disclose such reports to appropriate
11-11 licensing authorities in other states].
11-12 Sec. 3.02. PHYSICIAN IN TRAINING PERMITS [RENEWALS].
11-13 Physicians not otherwise licensed by the board who are
11-14 participating in graduate medical education training programs
11-15 approved by the board may be issued physician-in-training permits
11-16 as provided by rules of the board. This permit does not authorize
11-17 the performance of medical acts except as the acts are performed as
11-18 part of graduate medical education training programs and under the
11-19 supervision of a licensed practitioner of medicine. The board has
11-20 jurisdiction to discipline a physician whose physician-in-training
11-21 permit has expired if the violation of the law occurred during the
11-22 time that the permit was valid. If an investigation is open when
11-23 the permit expires, the permit shall be executory and the board may
11-24 retain jurisdiction. [(a) On application on forms provided by the
11-25 board for this purpose and receipt of renewal fees, licenses shall
11-26 be renewed annually by the board.]
12-1 [(b) The board by rule may adopt a system under which
12-2 registrations expire on various dates during the year. The date
12-3 for license cancellation due to nonpayment shall be adjusted
12-4 accordingly. For the year in which the expiration date is changed,
12-5 registration fees payable on or before January 1 shall be prorated
12-6 on a monthly basis so that each registrant shall pay only that
12-7 portion of the registration fee which is allocable to the number of
12-8 months during which the registration is valid. On renewal of the
12-9 registration on the new expiration date, the total registration fee
12-10 is payable.]
12-11 Sec. 3.03. LICENSURE OF PHYSICIANS [RECIPROCAL AGREEMENTS].
12-12 (a) The board, at its sole discretion [and upon payment by an
12-13 applicant of a fee prescribed by the board under this Act], may
12-14 grant a license to practice medicine to any physician who qualifies
12-15 under this Act.
12-16 (b) An application for a license must be in writing and on
12-17 forms prescribed by the board. The board may allow or require
12-18 applicants, by board rule, to use the Federation Credentials
12-19 Verification Service offered by the Federation of State Medical
12-20 Boards of the United States.
12-21 (c) The application forms must be accompanied by all fees,
12-22 documents, and photographs required by board rule.
12-23 (d) Applicants for a license must subscribe to an oath in
12-24 writing before an officer authorized by law to administer oaths.
12-25 The written oath is part of the application.
12-26 (e) An applicant is not eligible for a license if:
13-1 (1) the applicant holds a medical license that is
13-2 currently restricted for cause, canceled for cause, suspended for
13-3 cause, or revoked by a state of the United States, a province of
13-4 Canada, or a uniformed service of the United States;
13-5 (2) an investigation or a proceeding is instituted
13-6 against the applicant for the restriction, cancellation,
13-7 suspension, or revocation in a state of the United States, a
13-8 province of Canada, or a uniformed service of the United States; or
13-9 (3) a prosecution is pending against the applicant in
13-10 any state, federal, or Canadian court for any offense that under
13-11 the laws of this state is a felony or a misdemeanor that involves
13-12 moral turpitude.
13-13 (f) An applicant must present satisfactory proof to the
13-14 board that each medical school attended is substantially equivalent
13-15 to a Texas medical school as determined by board rule.
13-16 (g) An applicant who is a graduate of a medical school that
13-17 is located outside the United States and Canada must present
13-18 satisfactory proof to the board that the applicant:
13-19 (1) is a graduate of a school whose curriculum meets
13-20 the requirements for an unapproved medical school as determined by
13-21 a committee of experts selected by the Texas Higher Education
13-22 Coordinating Board;
13-23 (2) has successfully completed three years of graduate
13-24 medical training in the United States or Canada that was approved
13-25 by the board;
13-26 (3) is eligible for licensure to practice medicine in
14-1 the country in which the school is located except for any
14-2 citizenship requirements;
14-3 (4) possesses a valid certificate issued by the
14-4 Educational Commission for Foreign Medical Graduates; and
14-5 (5) has the ability to communicate in the English
14-6 language.
14-7 (h) All medical or osteopathic medical education received by
14-8 the applicant in the United States must be accredited by an
14-9 accrediting body officially recognized by the United States
14-10 Department of Education as the accrediting body for medical
14-11 education leading to the doctor of medicine degree or the doctor of
14-12 osteopathy degree in the United States. This subsection does not
14-13 apply to postgraduate medical education or training.
14-14 (i) An applicant who is unable to comply with the
14-15 requirements of Subsection (h) of this section may be eligible for
14-16 an unrestricted license if the applicant:
14-17 (1) received medical education in a hospital or
14-18 teaching institution sponsoring or participating in a program of
14-19 graduate medical education accredited by the Accreditation Council
14-20 for Graduate Medical Education, the American Osteopathic
14-21 Association, or the board in the same subject as the medical or
14-22 osteopathic medical education as defined by board rule; or
14-23 (2) is specialty board certified by a board approved
14-24 by the American Osteopathic Association or the American Board of
14-25 Medical Specialties.
14-26 (j)(1) The executive director shall review each application
15-1 for licensure and shall recommend to the board all applicants
15-2 eligible for licensure. The executive director also shall report
15-3 to the board the names of all applicants determined to be
15-4 ineligible for licensure, together with the reasons for each
15-5 recommendation.
15-6 (2) An applicant deemed ineligible for licensure by
15-7 the executive director may request review of such recommendation by
15-8 a committee of the board within 20 days of receipt of such notice,
15-9 and the executive director may refer any application to the
15-10 committee for a recommendation concerning eligibility. The
15-11 committee may refer any application for determination of
15-12 eligibility to the full board.
15-13 (3) If the committee finds the applicant ineligible
15-14 for licensure, such recommendation, together with the reasons for
15-15 the recommendation, shall be submitted to the board unless the
15-16 applicant requests a hearing within 20 days of receipt of notice of
15-17 the committee's determination.
15-18 (4) If the applicant requests a hearing, the hearing
15-19 shall be before an administrative law judge of the State Office of
15-20 Administrative Hearings and shall comply with Chapter 2001,
15-21 Government Code, and the rules of the State Office of
15-22 Administrative Hearings and the board.
15-23 (5) The board shall, after receiving the
15-24 administrative law judge's proposed findings of fact and
15-25 conclusions of law, determine the eligibility of the applicant for
15-26 licensure. A physician whose application for licensure is denied
16-1 by the board shall receive a written statement containing the
16-2 reasons for the board's action.
16-3 (k) Examination questions that may be used in the future,
16-4 examinations other than the one taken by the person requesting it,
16-5 and deliberations and records relating to the professional
16-6 character and fitness of applicants are exempted from the open
16-7 meetings law, Chapter 551, Government Code, and the public
16-8 information law, Chapter 552, Government Code.
16-9 (l) All reports received or gathered by the board on each
16-10 applicant are confidential and are not subject to disclosure under
16-11 the public information law, Chapter 552, Government Code. The
16-12 board may disclose such reports to appropriate licensing
16-13 authorities in other states. The board shall report all licensure
16-14 actions to appropriate licensing authorities in other states and to
16-15 the Federation of State Medical Boards of the United States.
16-16 (m) In addition to the requirements prescribed by this Act,
16-17 the board may require applicants to comply with other requirements
16-18 that the board considers appropriate. [is a graduate of an
16-19 acceptable medical college as determined by the board and who is a
16-20 licensee of another state or Canadian province having requirements
16-21 for physician registration and practice substantially equivalent to
16-22 those established by the laws of this state.]
16-23 [(b) An application for a license under this section must be
16-24 in writing and upon a form prescribed by the board. The
16-25 application must be accompanied by:]
16-26 [(1) a diploma or photograph of a diploma awarded to
17-1 the applicant by an acceptable medical college and a certified
17-2 transcript showing courses and grades;]
17-3 [(2) a license or a certified copy of a license to
17-4 practice medicine lawfully issued to the applicant by some other
17-5 state or a Canadian province that requires in its examination the
17-6 same general degree of fitness required by this state and that
17-7 grants the same reciprocal privileges to persons licensed by the
17-8 board;]
17-9 [(3) a certification made by the president or
17-10 secretary of the board that issued the license or a duly
17-11 constituted registration office of the state or Canadian province
17-12 that issued the certificate or license, reciting that the
17-13 accompanying certificate or license has not been canceled,
17-14 suspended, or revoked and reciting that the statement of the
17-15 qualifications made in the application for medical license in Texas
17-16 is true and correct; and]
17-17 [(4) evidence of a passing grade on an examination
17-18 required by the board.]
17-19 [(c) Applicants for a license under this section must
17-20 subscribe to an oath in writing before an officer authorized by law
17-21 to administer oaths. The written oath must be a part of the
17-22 application. The application must:]
17-23 [(1) state that:]
17-24 [(A) the license, certificate, or authority
17-25 under which the applicant has most recently practiced medicine in
17-26 the state or Canadian province from which the applicant is
18-1 transferring to this state or in the uniformed service in which the
18-2 applicant served is in full force and not restricted, canceled,
18-3 suspended, or revoked;]
18-4 [(B) the applicant is the identical person to
18-5 whom the certificate or license and the diploma were issued;]
18-6 [(C) no proceeding has been instituted against
18-7 the applicant for the restriction, cancellation, suspension, or
18-8 revocation of the certificate, license, or authority to practice
18-9 medicine in the state, Canadian province, or uniformed service of
18-10 the United States in which it was issued; and]
18-11 [(D) no prosecution is pending against the
18-12 applicant in any state, federal, or Canadian court for any offense
18-13 that under the laws of this state is a felony;]
18-14 [(2) include a description of any sanctions imposed by
18-15 or disciplinary matters pending in the state or Canadian province
18-16 in which the applicant was or is licensed or certified to practice
18-17 medicine; and]
18-18 [(3) include evidence of postgraduate training
18-19 required by the board.]
18-20 [(d) An applicant for a license under this section must be
18-21 eligible for examination by the board.]
18-22 [(e) In addition to other licensure requirements, the board
18-23 may require by rule and regulation that an applicant who is a
18-24 licensee of another state or Canadian province and who is a
18-25 graduate of a medical school located outside of the United States
18-26 and Canada, or the school itself, provide additional information to
19-1 the board concerning the medical school attended prior to approval
19-2 of the applicant.]
19-3 [(f) The board may refuse to issue a license to an applicant
19-4 who is a licensee of another state or Canadian province and who
19-5 graduated from a medical school outside of the United States and
19-6 Canada if it finds that the applicant does not possess the
19-7 requisite qualifications to provide the same standard of medical
19-8 care as provided by a licensed physician in this state.]
19-9 [(g) In addition to the requirements prescribed by this
19-10 section, the board may require applicants to comply with other
19-11 requirements that the board considers appropriate.]
19-12 [(h) The board may not refuse to issue a license to an
19-13 applicant under Subsection (f) of this section if the applicant:]
19-14 [(1) for the preceding five years has been a licensee
19-15 of another state or a Canadian province;]
19-16 [(2) is not the subject of a sanction imposed by or
19-17 disciplinary matter pending in any state or Canadian province in
19-18 which the applicant is licensed to practice medicine; and]
19-19 [(3) is either specialty board certified by a board
19-20 that is a member of the American Board of Medical Specialties or a
19-21 specialty board approved by the American Osteopathic Association or
19-22 successfully passes an examination that the board shall determine
19-23 by rule.]
19-24 Sec. 3.04. QUALIFICATIONS OF LICENSEES [QUALIFICATION OF
19-25 LICENSEE]. [(a)] An applicant, to be eligible for [the
19-26 examination and] issuance of a license, must present satisfactory
20-1 proof to the board that the applicant:
20-2 (1) is at least 21 years of age;
20-3 (2) is of good professional character and has not
20-4 violated Section 3.08 of this Act;
20-5 (3) has completed:
20-6 (A) 60 semester hours of college courses other
20-7 than in medical school that are[, which courses would be]
20-8 acceptable[, at the time of completion,] to The University of Texas
20-9 at Austin for credit on a bachelor of arts degree or a bachelor of
20-10 science degree;
20-11 (B) the entire primary, secondary, and
20-12 premedical education required in the country of medical school
20-13 graduation, if the medical school is located outside the United
20-14 States or Canada; or
20-15 (C) substantially equivalent courses as
20-16 determined by board rule; [and]
20-17 (4) is a graduate of a [an acceptable] medical [or
20-18 osteopathic] school located inside the United States or Canada and
20-19 [or college that was] approved by the board who [at the time the
20-20 degree was conferred and] has successfully completed one year [a
20-21 one year program] of graduate medical training approved by the
20-22 board in the United States or Canada or is a graduate of a medical
20-23 school located outside the United States or Canada who has
20-24 successfully completed three years of graduate medical training
20-25 approved by the board in the United States or Canada;
20-26 (5) has successfully passed within three attempts an
21-1 examination accepted or administered by the board, except as
21-2 provided by Sections 3.05(k) and (l) of this Act; and
21-3 (6) has successfully passed a Texas medical
21-4 jurisprudence examination as determined by board rule.
21-5 [(b) The applicant shall be eligible for examination prior
21-6 to complying with the graduate training requirement of Subsection
21-7 (a)(4) of this section but shall not be eligible for the issuance
21-8 of an unrestricted license until the requirements of Subsection (a)
21-9 of this section have been satisfied.]
21-10 [(c) Applications for examination must be made in writing,
21-11 verified by affidavit, filed with the board on forms prescribed by
21-12 the board, and accompanied by documents and a fee as the board
21-13 determines to be reasonable.]
21-14 [(d) To be recognized by the board for the purposes of this
21-15 subchapter, all medical or osteopathic medical education received
21-16 by the applicant in the United States must be accredited by an
21-17 accrediting body officially recognized by the United States
21-18 Department of Education as the accrediting body for medical
21-19 education leading to the doctor of medicine degree or the doctor of
21-20 osteopathy degree in the United States. This subsection does not
21-21 apply to postgraduate medical education or training.]
21-22 [(f) An applicant who is unable to comply with the
21-23 requirements of Subsection (d) of this section is eligible for an
21-24 unrestricted license if the applicant:]
21-25 [(1) received such medical education in a hospital or
21-26 teaching institution sponsoring or participating in a program of
22-1 graduate medical education accredited by the Accrediting Council
22-2 for Graduate Medical Education, the American Osteopathic
22-3 Association, or the Texas State Board of Medical Examiners in the
22-4 same subject as the medical or osteopathic medical education if the
22-5 hospital or teaching institution has an agreement with the
22-6 applicant's school; or]
22-7 [(2) is specialty board certified by a board approved
22-8 by the American Osteopathic Association or the American Board of
22-9 Medical Specialties.]
22-10 [(g) In addition to the other requirements of this section,
22-11 an applicant who is a graduate of a medical school that is located
22-12 outside the United States and Canada and that was not approved by
22-13 the board at the time the degree was conferred must, in order to be
22-14 eligible for the issuance of a license, present satisfactory proof
22-15 to the board that the applicant:]
22-16 [(1) is a graduate of a school whose curriculum meets
22-17 the requirements for an unapproved medical school as determined by
22-18 a committee of experts selected by the Texas Higher Education
22-19 Coordinating Board;]
22-20 [(2) has successfully completed three years of
22-21 graduate medical training in the United States or Canada that was
22-22 approved by the board on the date the training was completed;]
22-23 [(3) is eligible for licensure to practice medicine in
22-24 the country in which the school is located;]
22-25 [(4) possesses a valid certificate issued by the
22-26 Educational Commission for Foreign Medical Graduates;]
23-1 [(5) has the ability to communicate in the English
23-2 language; and]
23-3 [(6) has passed the examination required by the board
23-4 of all applicants for license as required by Section 3.05 of this
23-5 Act.]
23-6 [(h) The board by rule may establish alternate educational
23-7 prerequisites to those required by Subsection (a)(3) of this
23-8 section for an applicant who graduated from an unapproved medical
23-9 school located outside the United States and Canada.]
23-10 [(i) In addition to other licensure requirements, the board,
23-11 before approving the applicant, may require by rule that a graduate
23-12 of an unapproved medical school located outside the United States
23-13 and Canada or the school of which the person is a graduate provide
23-14 additional information to the board concerning the school.]
23-15 [(j) The board may refuse to issue a license to an applicant
23-16 who graduated from an unapproved medical school located outside the
23-17 United States and Canada if it finds that:]
23-18 [(1) the applicant does not possess the requisite
23-19 qualifications to provide the same standard of medical care as
23-20 provided by a physician licensed in this state; or]
23-21 [(2) the applicant failed to provide the board
23-22 evidence to establish that the applicant completed medical
23-23 education or professional training substantially equivalent to that
23-24 provided by a medical school in this state.]
23-25 Sec. 3.05. EXAMINATIONS ACCEPTED OR ADMINISTERED
23-26 [EXAMINATION]. (a) The board may administer or accept the
24-1 following examinations for licensure as determined by rule:
24-2 (1) a state board licensing examination;
24-3 (2) the Medical Council of Canada Examination (LMCC)
24-4 or its successor;
24-5 (3) the National Board of Osteopathic Medical
24-6 Examiners (NBOME) examination or its successor;
24-7 (4) the National Board of Medical Examiners (NBME)
24-8 examination or its successor;
24-9 (5) the Federation Licensing Examination (FLEX) with a
24-10 weighted average in one sitting before June, 1985;
24-11 (6) the Federation Licensing Examination (FLEX) after
24-12 May, 1985;
24-13 (7) the United States Medical Licensing Examination
24-14 (USMLE) or its successor; or
24-15 (8) a combination of the National Board of Osteopathic
24-16 Medical Examiners examination and the Federation Licensing
24-17 Examination after May, 1985, or of the United States Medical
24-18 Licensing Examination, the Federation Licensing Examination after
24-19 May, 1985, and the National Board of Medical Examiners examination,
24-20 as determined by board rule.
24-21 (b) All examinations used by the board for licensure
24-22 [license] to practice medicine shall be [conducted] in writing in
24-23 the English language and shall [in a manner as to] be entirely fair
24-24 and impartial to all individuals and to every school or system of
24-25 medicine. Applicants who wish to request reasonable accommodations
24-26 due to a disability shall submit the request on filing the
25-1 application.
25-2 (c) Examinations shall include [be conducted on and cover
25-3 those] subjects generally taught by medical schools, a knowledge of
25-4 which is commonly and generally required of candidates for the
25-5 degree of doctor of medicine or doctor of osteopathy conferred by
25-6 schools in Texas.
25-7 (d) The board shall administer the Texas medical
25-8 jurisprudence examination to all applicants.
25-9 (e) The minimum passing grade for all examinations used by
25-10 the board shall be determined by rule.
25-11 (f) Examinations administered to evaluate basic medical
25-12 knowledge and clinical competency shall be prepared by a national
25-13 testing service or the board and validated by qualified independent
25-14 testing professionals.
25-15 (g) All questions, answers, and grades shall be preserved
25-16 for one year as the board may direct by rule.
25-17 (h) All applicants shall be given due notice of the date and
25-18 place of the examination if administered by the board.
25-19 (i) Within 120 days after the day on which an examination is
25-20 administered by the board, each examinee shall be notified of the
25-21 results of the examination. However, if an examination is graded
25-22 or reviewed by a national testing service, the board shall notify
25-23 each examinee of the results of the examination not later than 30
25-24 days after the date the board receives the results from the testing
25-25 service.
25-26 (j) Except as provided by Subsection (m) of this section,
26-1 all parts of the Medical Council of Canada Examination, the
26-2 National Board of Osteopathic Medical Examiners examination, the
26-3 National Board of Medical Examiners examination, the Federation
26-4 Licensing Examination after May, 1985, and the United States
26-5 Medical Licensing Examination must be passed within seven years.
26-6 (k) An applicant must pass each part of an examination
26-7 within three attempts, except that an applicant who has passed all
26-8 but one part of an examination within three attempts may take the
26-9 remaining part of the examination one additional time.
26-10 (l) Notwithstanding Subsection (k) of this section, an
26-11 applicant is considered to have satisfied the requirements of this
26-12 section if the applicant:
26-13 (1) passed all but one part of an examination approved
26-14 by the board within three attempts and passed the remaining part of
26-15 the examination within five attempts;
26-16 (2) is specialty board certified by a specialty board
26-17 that:
26-18 (A) is a member of the American Board of Medical
26-19 Specialties; or
26-20 (B) is approved by the American Osteopathic
26-21 Association; and
26-22 (3) completed in this state an additional two years of
26-23 postgraduate medical training approved by the board.
26-24 (m) An applicant who is a graduate of a program designed to
26-25 lead to both a doctor of philosophy degree and a doctor of medicine
26-26 degree or doctor of osteopathy degree must pass each part of an
27-1 examination described by Subsection (a)(2), (3), (4), (6), or (7)
27-2 of this section not later than the second anniversary of the date
27-3 the applicant was awarded a doctor of medicine degree or doctor of
27-4 osteopathy degree. [or colleges of medicine approved by the board,
27-5 and the examinations shall also be conducted on and cover the
27-6 subject of medical jurisprudence. Examinations shall be prepared
27-7 by a national testing service or prepared by the board and
27-8 validated by qualified independent testing professionals. On
27-9 satisfactory examination conducted as required by this Act under
27-10 rules of the board, applicants may be granted licenses to practice
27-11 medicine. All questions and answers, with the grades attached,
27-12 shall be preserved for one year in the executive office of the
27-13 board or such other repository as the board by rule may direct.
27-14 All applicants examined at the same time shall be given identical
27-15 questions. All certificates shall be attested by the seal of the
27-16 board. The board in its discretion may give the examination for
27-17 license in two or more parts.]
27-18 [(b) In addition to the requirements prescribed by this Act,
27-19 the board may require applicants to comply with other requirements
27-20 that the board considers appropriate and establish reasonable fees
27-21 for examination.]
27-22 [(c) All applicants for license to practice medicine in this
27-23 state not otherwise licensed under the provisions of law must
27-24 successfully pass a uniform examination approved by the board as
27-25 determined by rule. The board is authorized to adopt and enforce
27-26 all rules of procedure not inconsistent with statutory
28-1 requirements. All applicants shall be given due notice of the date
28-2 and place of the examination. If any applicant, because of failure
28-3 to pass the required examination, is refused a license, the
28-4 applicant, at a time as the board may fix, shall be permitted to
28-5 take a subsequent examination not more than two additional times as
28-6 the board may prescribe on the payment of a fee as the board may
28-7 determine to be reasonable. In the event satisfactory grades shall
28-8 be made on the subjects prescribed and taken on the reexamination,
28-9 the board may grant the applicant a license to practice medicine.
28-10 The board shall determine the credit to be given examinees on
28-11 answers turned in on the subjects of complete and partial
28-12 examination, and its decision is final.]
28-13 [(d) Examination questions that may be used in the future,
28-14 examinations other than the one taken by the person requesting it,
28-15 and deliberations and records relating to the professional
28-16 character and fitness of applicants are exempted from the Open
28-17 Meetings Law and the Open Records Law. The records, however, shall
28-18 be disclosed to individual applicants upon written request, unless
28-19 the person supplying the information to the board requests that it
28-20 not be disclosed.]
28-21 [(e) Within 90 days after the day on which an examination is
28-22 administered under this Act, the board shall notify each examinee
28-23 of the results of the examination. However, if an examination is
28-24 graded or reviewed by a national testing service, the board shall
28-25 notify each examinee of the results of the examination not later
28-26 than the 30th day after the date the board receives the results
29-1 from the testing service. If the notice of the examination results
29-2 will be delayed for longer than 90 days after the examination, the
29-3 board shall notify the examinee of the reason for the delay before
29-4 the 90th day.]
29-5 [(f) If requested in writing by a person who fails the
29-6 examination administered under this Act, the board shall furnish
29-7 the person with a summarized analysis of the person's performance
29-8 on the examination consisting of the person's score on each portion
29-9 of the examination.]
29-10 SECTION 3. Section 3.10, Medical Practice Act (Article
29-11 4495b, Vernon's Texas Civil Statutes), as amended by Chapters 214
29-12 and 862, Acts of the 73rd Legislature, Regular Session, 1993, is
29-13 amended to read as follows:
29-14 Sec. 3.10. FEES. (a) All receipts collected by the board
29-15 shall be placed in the state treasury and may be spent only as
29-16 provided by the General Appropriations Act, this Act, or other
29-17 applicable law for the enforcement of this Act, the prohibition of
29-18 the unlawful practice of medicine, the dissemination of information
29-19 to prevent the violation of the laws, and the prosecution of those
29-20 who violate the laws. All distributions may be made only on
29-21 written approval of the executive director of the board or his
29-22 designated 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...................................... $900
29-26 (2) First annual registration permit............. $200
30-1 (3) Temporary license............................ $200
30-2 (4) Renewal of annual registration permit........ $200
30-3 (5) Physician-in-training permit................. $200
30-4 (6) Endorsement to other state medical
30-5 boards........................................................ $200
30-6 (7) Duplicate license............................ $200
30-7 (8) Reinstated license after cancellation
30-8 for cause.................................................... $700.
30-9 (c) The board may set and collect a sales charge for making
30-10 copies of records in the office of the board and for any material
30-11 published by the board.
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
30-26 in that fund may be used by the board and under its direction in
31-1 the enforcement of this Act, the prohibition of the unlawful
31-2 practice of medicine, the dissemination of information to prevent
31-3 the violation of the laws, and the prosecution of those who violate
31-4 the laws. All distributions from the fund may be made only upon
31-5 written approval of the secretary-treasurer of the board or his
31-6 designated representative, and the comptroller shall upon
31-7 requisition of the board from time to time draw warrants upon the
31-8 fund for the amounts specified in the requisition.]
31-9 [(b) The board may not set, charge, collect, receive, or
31-10 deposit any of the following fees in excess of:]
31-11 [(1) for processing and granting a license
31-12 by reciprocity to a licensee of another state................. $700]
31-13 [(2) for processing an application and
31-14 administration of a partial examination for licensure......... $700]
31-15 [(3) for processing an application and
31-16 administration of a complete examination for licensure........ $700]
31-17 [(4) for processing an application and
31-18 issuance of a temporary license............................... $200]
31-19 [(5) for processing an application and
31-20 issuance of a duplicate license............................... $200]
31-21 [(6) for processing an application and
31-22 issuance of a license of reinstatement after a lapse or
31-23 cancellation of a license..................................... $700]
31-24 [(7) for processing an application and
31-25 issuance of an annual registration of a licensee.............. $200]
31-26 [(8) for processing and issuance of an
32-1 institutional permit for interns, residents, and others
32-2 in approved medical training programs......................... $200]
32-3 [(9) for processing an application and
32-4 issuance of an endorsement to other state medical boards...... $200]
32-5 [(10) for processing and issuance of a
32-6 license or temporary license to a physician assistant......... $200]
32-7 [(11) for processing and issuance of a
32-8 permit to a physician who supervises an acupuncturist........ $200.]
32-9 [(b) The board may set and collect a sales charge for making
32-10 copies of any paper of record in the office of the board and for
32-11 any printed material published by the board. The charges shall be
32-12 in amounts considered sufficient to reimburse the board for the
32-13 actual expense.]
32-14 [(c) The financial transactions of the board are subject to
32-15 audit by the state auditor in accordance with Chapter 321,
32-16 Government Code.]
32-17 [(d) The board shall file annually with the governor and the
32-18 presiding officer of each house of the legislature a complete and
32-19 detailed written report accounting for all funds received and
32-20 disbursed by the board during the preceding fiscal year. The
32-21 annual report must be in the form and reported in the time provided
32-22 by the General Appropriations Act.]
32-23 SECTION 4. Section 3.11A, Medical Practice Act (Article
32-24 4495b, Vernon's Texas Civil Statutes), is amended to read as
32-25 follows:
32-26 Sec. 3.11A. SURCHARGE; DISPOSITION [OF FEES]. (a) An
33-1 additional $200 surcharge shall apply to each of the following:
33-2 (1) license;
33-3 (2) first annual registration permit;
33-4 (3) renewal of annual registration permit; and
33-5 (4) reinstated license after cancellation for cause.
33-6 [This section applies to each of the following fees:]
33-7 [(1) fee for processing and granting a license by
33-8 reciprocity to a licensee of another state;]
33-9 [(2) fee for processing an application and
33-10 administration of a partial examination for licensure;]
33-11 [(3) fee for processing an application and
33-12 administration of a complete examination for licensure;]
33-13 [(4) fee for processing an application and issuance of
33-14 a license of reinstatement after a lapse or cancellation of a
33-15 license; and]
33-16 [(5) fee for processing an application and issuance of
33-17 an annual registration of a licensee.]
33-18 (b) Of each surcharge [fee] collected, $50 shall be
33-19 deposited to the credit of the foundation school fund and $150
33-20 shall be deposited to the credit of the general revenue fund. This
33-21 subsection applies to the disposition of the stated portion of each
33-22 fee regardless of any other provision of law providing for a
33-23 different disposition of funds.
33-24 SECTION 5. Section 2.10, as added by Section 1.04, Chapter
33-25 36, Acts of the 73rd Legislature, Regular Session, 1993, and
33-26 Sections 3.0305 and 3.031, Medical Practice Act (Article 4495b,
S.B. No. 1207
34-1 Vernon's Texas Civil Statutes), are repealed.
34-2 SECTION 6. The importance of this legislation and the
34-3 crowded condition of the calendars in both houses create an
34-4 emergency and an imperative public necessity that the
34-5 constitutional rule requiring bills to be read on three several
34-6 days in each house be suspended, and this rule is hereby suspended,
34-7 and that this Act take effect and be in force from and after its
34-8 passage, and it is so enacted.
________________________________ ________________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 1207 passed the Senate on
May 10, 1999, by the following vote: Yeas 30, Nays 0;
May 20, 1999, Senate refused to concur in House amendments and
requested appointment of Conference Committee; May 24, 1999, House
granted request of the Senate; May 29, 1999, Senate adopted
Conference Committee Report by the following vote: Yeas 30,
Nays 0.
_______________________________
Secretary of the Senate
I hereby certify that S.B. No. 1207 passed the House, with
amendments, on May 13, 1999, by a non-record vote; May 24, 1999,
House granted request of the Senate for appointment of Conference
Committee; May 27, 1999, House adopted Conference Committee Report
by a non-record vote.
_______________________________
Chief Clerk of the House
Approved:
________________________________
Date
________________________________
Governor