1-1 By: Cain S.B. No. 1207
1-2 (In the Senate - Filed March 11, 1999; March 11, 1999, read
1-3 first time and referred to Committee on Health Services;
1-4 April 29, 1999, reported adversely, with favorable Committee
1-5 Substitute by the following vote: Yeas 5, Nays 0; April 29, 1999,
1-6 sent to printer.)
1-7 COMMITTEE SUBSTITUTE FOR S.B. No. 1207 By: Moncrief
1-8 A BILL TO BE ENTITLED
1-9 AN ACT
1-10 relating to the Texas State Board of Medical Examiners and the
1-11 licensure of physicians; appropriating fees and providing
1-12 penalties.
1-13 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-14 SECTION 1. Section 2.09, Medical Practice Act (Article
1-15 4495b, Vernon's Texas Civil Statutes), is amended by amending
1-16 Subsections (d), (h), (k), and (t) and adding Subsection (bb) to
1-17 read as follows:
1-18 (d) The board shall preserve a record of its proceedings
1-19 which shall be a public record. [The board shall also maintain
1-20 records showing the name, age, place, and duration of residence of
1-21 each applicant, the time spent in medical study in respective
1-22 medical schools, and the years and schools from which degrees were
1-23 granted.] The record shall [also] show whether applicants were
1-24 denied [rejected] or licensed and shall be prima facie evidence of
1-25 all matters contained in the record. A certified copy of those
1-26 permanent records, with the hand and seal of the executive director
1-27 [secretary-treasurer] of the board, shall be admitted in evidence
1-28 in all courts.
1-29 (h) The board may receive criminal records or reports from
1-30 any law enforcement agency or source pertaining to its licensees or
1-31 any applicant for license. The board may [shall] submit to the
1-32 Department of Public Safety a complete set of fingerprints of every
1-33 applicant for a license, and the Department of Public Safety shall
1-34 cause them to be classified and checked against those in their
1-35 fingerprint files and shall [forthwith] certify their findings
1-36 concerning the criminal record of the applicant or shall report the
1-37 lack of a criminal record, as the case may be, to the board. All
1-38 criminal records and reports received from the Department of Public
1-39 Safety shall be for the exclusive use of the board and shall be
1-40 privileged and shall not be released or otherwise disclosed to any
1-41 person or agency by the board except on court order. [Any
1-42 applicant for licensure or any licensee whose license is subject to
1-43 revocation, cancellation, or suspension because of adverse
1-44 information contained in the criminal records or reports shall be
1-45 afforded the opportunity for a hearing before the board prior to
1-46 any action on the application for license or revocation,
1-47 cancellation, or suspension of license.]
1-48 (k) The board by rule shall establish reasonable and
1-49 necessary fees so that the fees, in the aggregate, produce
1-50 sufficient revenue to cover the cost of administering this Act.
1-51 The fees set by the board may be adjusted so that the total fees
1-52 collected shall be sufficient to meet the expenses of administering
1-53 this Act. The board may not set a fee for an amount less than the
1-54 amount of that fee on September 1, 1993. The board may not waive
1-55 collection of any fee or penalty. The board shall place all
1-56 receipts collected [fees received] under authority of this Act[,
1-57 not otherwise specified, into the medical licensing fund] in the
1-58 state treasury. The board is authorized and shall by annual budget
1-59 determine the manner of handling the funds and the purpose,
1-60 consistent with this Act, for which the same may be used. The
1-61 budgeted expenses authorized by the board shall be paid out of
1-62 funds received by the board and are not a charge upon the general
1-63 revenue of the state.
1-64 (t) The board shall on request of a licensee issue
2-1 certification on endorsement of its license to other states and
2-2 charge a reasonable fee for the issuance. The board shall on
2-3 request of a licensee issue certification of state board
2-4 examination grades to the Federation of State Medical Boards of the
2-5 United States and charge a reasonable fee for the issuance.
2-6 (bb) The executive director of the board shall file a surety
2-7 bond with the board. The bond shall be in an amount not less than
2-8 $10,000, be in compliance with the insurance laws of the state, and
2-9 be payable to the state for the use of the state if the executive
2-10 director does not faithfully discharge the duties of the office.
2-11 The board shall pay the premium on the bond.
2-12 SECTION 2. Sections 3.01, 3.02, 3.03, 3.04, and 3.05,
2-13 Medical Practice Act (Article 4495b, Vernon's Texas Civil
2-14 Statutes), are amended to read as follows:
2-15 Sec. 3.01. ANNUAL REGISTRATION OF PHYSICIANS [PRACTITIONERS
2-16 AND INTERNS]. (a) All persons now lawfully qualified to practice
2-17 medicine in this state, or who are hereafter licensed for the
2-18 practice of medicine by the board, shall register annually as
2-19 practitioners with the board. The initial annual registration
2-20 permit shall be issued with the license.
2-21 (b) The annual registration permit fee as established by
2-22 board rule shall apply to all physicians licensed by the board,
2-23 whether or not they are practicing within the borders of this
2-24 state, except retired physicians as provided by rules of the board.
2-25 (c) A physician licensed by the board whose only practice is
2-26 voluntary charity care is exempt from the annual registration
2-27 permit fee as provided by rules of the board.
2-28 (d) The board shall mail an annual registration permit
2-29 renewal application to each practitioner at the practitioner's
2-30 last known address according to the records of the board at least
2-31 30 days prior to the expiration date of the annual registration
2-32 permit.
2-33 (e) The board shall provide for a 30-day grace period for
2-34 renewing the annual registration permit from the date of the
2-35 expiration of the annual registration permit.
2-36 (f) A licensee may renew the annual registration permit by
2-37 submitting to the board, on or before the expiration date of the
2-38 annual registration permit, the required renewal application and
2-39 renewal fee. Each annual registration permit renewal application
2-40 shall include the name and mailing address of the licensee, the
2-41 place or places where the licensee is engaged in the practice of
2-42 medicine, and other necessary information prescribed by the board.
2-43 (g) If the licensee is licensed for the practice of medicine
2-44 by another state, the District of Columbia, a territory of the
2-45 United States, Canada, any other country, or the uniformed services
2-46 of the United States, the renewal application must include a
2-47 description of any investigations the licensee knows are in
2-48 progress and of any sanctions imposed by or disciplinary matters
2-49 pending in the state, district, territory, country, or service.
2-50 (h) On receipt of a renewal application and all required
2-51 fees, the board, after ascertaining, either from the records of the
2-52 board or from other sources considered by it to be reliable, that
2-53 the applicant is a licensed practitioner of medicine in this state,
2-54 shall issue to the licensee an annual registration permit
2-55 certifying that the licensee has filed the renewal application, has
2-56 paid the annual registration permit fee for the year in question,
2-57 and has completed the requirements for annual registration.
2-58 (i) If a licensee's annual registration permit has been
2-59 expired for 90 days or less, the licensee may renew the licensee's
2-60 annual registration permit by submitting to the board the required
2-61 renewal application, renewal fee, and a $50 penalty fee.
2-62 (j) If a licensee's annual registration permit has been
2-63 expired for longer than 90 days but less than one year, the
2-64 licensee may renew the annual registration permit by submitting to
2-65 the board the required renewal application, renewal fee, and a $100
2-66 penalty fee.
2-67 (k) If a licensee's annual registration permit has been
2-68 expired for one year or longer, the license is considered to have
2-69 been canceled, unless an investigation is pending, and the licensee
3-1 may not renew the annual registration permit.
3-2 (l) Each physician whose license is considered canceled may
3-3 obtain a new license by submitting to reexamination and complying
3-4 with the requirements, fees, and procedures for obtaining a
3-5 license. The board may issue a new license without examination to
3-6 a person whose license is considered canceled for less than two
3-7 years.
3-8 (m) The board by rule may adopt a system under which annual
3-9 registration permits expire on various dates during the year. For
3-10 the year in which the expiration date is changed, annual
3-11 registration permit fees shall be prorated. On renewal of the
3-12 annual registration on the new expiration date, the total annual
3-13 registration permit fee is payable.
3-14 (n) The filing of the renewal application, the payment of
3-15 the required fees, and the issuance of the permit shall not entitle
3-16 the holder to practice medicine in Texas unless the holder has been
3-17 previously licensed as a practitioner by the board, as prescribed
3-18 by law, and the license to practice medicine is in full force and
3-19 effect. In any prosecution for the unlawful practice of medicine,
3-20 the annual registration permit required by this Act may not be
3-21 treated as evidence that the holder is lawfully entitled to
3-22 practice medicine.
3-23 (o) Practicing medicine as defined in this Act without an
3-24 annual registration permit for the current year as provided in this
3-25 Act has the same force and effect as and is subject to all
3-26 penalties of practicing medicine without a license [be registered
3-27 as practitioners with the board on or before the first day of
3-28 January and thereafter shall register in like manner annually, on
3-29 or before the first day of January of each succeeding year. Each
3-30 person so registered with the board shall pay, in connection with
3-31 each annual registration and for the receipt hereinafter provided
3-32 for, a fee established by the board which fee shall accompany the
3-33 application of each person for registration. The payment shall be
3-34 made to the board. Every person so registered shall file with the
3-35 board a written application for annual registration, setting forth
3-36 his name and mailing address, the place or places where the
3-37 applicant is engaged in the practice of medicine, and other
3-38 necessary information prescribed by the board. If the person is
3-39 licensed for the practice of medicine by another state, the
3-40 District of Columbia, a territory of the United States, Canada, any
3-41 other country, or the uniformed services of the United States, the
3-42 application must include a description of any investigations the
3-43 person knows are in progress and of any sanctions imposed by or
3-44 disciplinary matters pending in the state, district, territory,
3-45 country, or service.]
3-46 [(b) Physicians not otherwise licensed by the board who are
3-47 participating in graduate medical education training programs
3-48 approved by the board may be issued institutional permits as
3-49 provided by rules of the board. A reasonable fee shall be charged
3-50 and deposited into the medical registration fund. This permit does
3-51 not authorize the performance of medical acts except as the acts
3-52 are performed as a part of graduate medical education programs and
3-53 under the supervision of a licensed practitioner of medicine.]
3-54 [(c)(1) A person may renew an unexpired license by paying to
3-55 the board on or before the expiration date of the license the
3-56 required renewal fee.]
3-57 [(2) If a person's license has been expired for 90
3-58 days or less, the person may renew the license by paying to the
3-59 board the required renewal fee and a fee that is one-half of the
3-60 annual registration fee as established by the board under Section
3-61 3.10(b)(7) of this Act.]
3-62 [(3) If a person's license has been expired for longer
3-63 than 90 days but less than one year, the person may renew the
3-64 license by paying to the board all unpaid renewal fees and a fee
3-65 that is equal to the annual registration fee as established by the
3-66 board under Section 3.10(b)(7) of this Act.]
3-67 [(4) If a person's license has been expired for one
3-68 year, it is considered to have been canceled, unless an
3-69 investigation is pending, and the person may not renew the license.
4-1 The person may obtain a new license by submitting to reexamination
4-2 and complying with the requirements and procedures for obtaining an
4-3 original license.]
4-4 [(5) The board may renew without examination an
4-5 expired license of a person who was licensed in this state, moved
4-6 to another state, and is currently licensed and has been in
4-7 practice in the other state for not more than two years preceding
4-8 application. The person must pay to the board a fee that is equal
4-9 to the examination fee for the license.]
4-10 [(6) The board shall provide written notice to each
4-11 practitioner at the practitioner's last known address according to
4-12 the records of the board at least 30 days prior to the expiration
4-13 date of a license and shall provide for a 30-day grace period for
4-14 payment of the annual registration fee from the date of the
4-15 expiration of the license.]
4-16 [(d) Practicing medicine as defined in this Act without an
4-17 annual registration receipt for the current year as provided in
4-18 this Act has the same force and effect as and is subject to all
4-19 penalties of practicing medicine without a license.]
4-20 [(e) On receipt of an application, accompanied by the proper
4-21 registration fee, the board, after ascertaining, either from the
4-22 records of the board or from other sources considered by it to be
4-23 reliable, that the applicant is a licensed practitioner of medicine
4-24 in this state, shall issue to the applicant an annual registration
4-25 receipt certifying that the applicant has filed the application and
4-26 has paid the registration fee for the year in question. The filing
4-27 of the application, the payment of the registration fee, and the
4-28 issuance of the receipt shall not entitle the holder to practice
4-29 medicine in Texas unless he has in fact been previously licensed as
4-30 a practitioner by the board, as prescribed by law, and unless the
4-31 license to practice medicine is in full force and effect. In any
4-32 prosecution for the unlawful practice of medicine the receipt
4-33 showing payment of the annual registration fee required by this Act
4-34 may not be treated as evidence that the holder is lawfully entitled
4-35 to practice medicine.]
4-36 [(f) The executive director of the board shall file a surety
4-37 bond with the board. The bond shall be in an amount not less than
4-38 $10,000, be in compliance with the insurance laws of the state, and
4-39 be payable to the state for the use of the state if the executive
4-40 director does not faithfully discharge the duties of the office.
4-41 The board shall pay the premium on the bond.]
4-42 [(g) The annual registration fee shall apply to all persons
4-43 licensed by the board, whether or not they are practicing within
4-44 the borders of this state, except retired physicians as provided by
4-45 rules of the board. A retired physician licensed by the board
4-46 whose only practice is voluntary charity care is exempt from the
4-47 annual registration fee.]
4-48 [(h) The executive director shall review each application
4-49 for licensure by examination or reciprocity and shall recommend to
4-50 the board all applicants eligible for licensure. The executive
4-51 director also shall report to the board the names of all applicants
4-52 determined to be ineligible for licensure, together with the
4-53 reasons for each recommendation. An applicant deemed ineligible
4-54 for licensure by the executive director may request review of such
4-55 recommendation by a committee of the board within 20 days of
4-56 receipt of such notice, and the executive director may refer any
4-57 application to said committee for a recommendation concerning
4-58 eligibility. If the committee finds the applicant ineligible for
4-59 licensure, such recommendation, together with the reasons therefor,
4-60 shall be submitted to the board unless the applicant requests a
4-61 hearing within 20 days of receipt of notice of the committee's
4-62 determination. The hearing shall be before an administrative law
4-63 judge of the State Office of Administrative Hearings and shall
4-64 comply with the Administrative Procedure Act and its subsequent
4-65 amendments and the rules of the State Office of Administrative
4-66 Hearings and the board. The committee may refer any application
4-67 for determination of eligibility to the full board. The board
4-68 shall, after receiving the administrative law judge's proposed
4-69 findings of fact and conclusions of law, determine the eligibility
5-1 of the applicant for licensure. A physician whose application for
5-2 licensure is denied by the board shall receive a written statement
5-3 containing the reasons for the board's action. All reports
5-4 received or gathered by the board on each applicant are
5-5 confidential and are not subject to disclosure under the Open
5-6 Records Law. The board may disclose such reports to appropriate
5-7 licensing authorities in other states].
5-8 Sec. 3.02. PHYSICIAN IN TRAINING PERMITS [RENEWALS].
5-9 Physicians not otherwise licensed by the board who are
5-10 participating in graduate medical education training programs
5-11 approved by the board may be issued physician-in-training permits
5-12 as provided by rules of the board. This permit does not authorize
5-13 the performance of medical acts except as the acts are performed as
5-14 part of graduate medical education training programs and under the
5-15 supervision of a licensed practitioner of medicine. The board has
5-16 jurisdiction to discipline a physician whose physician-in-training
5-17 permit has expired if the violation of the law occurred during the
5-18 time that the permit was valid. If an investigation is open when
5-19 the permit expires, the permit shall be executory and the board may
5-20 retain jurisdiction. [(a) On application on forms provided by the
5-21 board for this purpose and receipt of renewal fees, licenses shall
5-22 be renewed annually by the board.]
5-23 [(b) The board by rule may adopt a system under which
5-24 registrations expire on various dates during the year. The date
5-25 for license cancellation due to nonpayment shall be adjusted
5-26 accordingly. For the year in which the expiration date is changed,
5-27 registration fees payable on or before January 1 shall be prorated
5-28 on a monthly basis so that each registrant shall pay only that
5-29 portion of the registration fee which is allocable to the number of
5-30 months during which the registration is valid. On renewal of the
5-31 registration on the new expiration date, the total registration fee
5-32 is payable.]
5-33 Sec. 3.03. LICENSURE OF PHYSICIANS [RECIPROCAL AGREEMENTS].
5-34 (a) The board, at its sole discretion [and upon payment by an
5-35 applicant of a fee prescribed by the board under this Act], may
5-36 grant a license to practice medicine to any physician who qualifies
5-37 under this Act.
5-38 (b) An application for a license must be in writing and on
5-39 forms prescribed by the board. The board may allow or require
5-40 applicants, by board rule, to use the Federation Credentials
5-41 Verification Service offered by the Federation of State Medical
5-42 Boards of the United States.
5-43 (c) The application forms must be accompanied by all fees,
5-44 documents, and photographs required by board rule.
5-45 (d) Applicants for a license must subscribe to an oath in
5-46 writing before an officer authorized by law to administer oaths.
5-47 The written oath is part of the application.
5-48 (e) An applicant is not eligible for a license if:
5-49 (1) the applicant holds a medical license that is
5-50 currently restricted for cause, canceled for cause, suspended for
5-51 cause, or revoked by a state of the United States, a province of
5-52 Canada, or a uniformed service of the United States;
5-53 (2) an investigation or a proceeding is instituted
5-54 against the applicant for the restriction, cancellation,
5-55 suspension, or revocation in a state of the United States, a
5-56 province of Canada, or a uniformed service of the United States; or
5-57 (3) a prosecution is pending against the applicant in
5-58 any state, federal, or Canadian court for any offense that under
5-59 the laws of this state is a felony or a misdemeanor that involves
5-60 moral turpitude.
5-61 (f) An applicant must present satisfactory proof to the
5-62 board that each medical school attended is substantially equivalent
5-63 to a Texas medical school as determined by board rule.
5-64 (g) An applicant who is a graduate of a medical school that
5-65 is located outside the United States and Canada must present
5-66 satisfactory proof to the board that the applicant:
5-67 (1) is a graduate of a school whose curriculum meets
5-68 the requirements for an unapproved medical school as determined by
5-69 a committee of experts selected by the Texas Higher Education
6-1 Coordinating Board;
6-2 (2) has successfully completed three years of graduate
6-3 medical training in the United States or Canada that was approved
6-4 by the board;
6-5 (3) is eligible for licensure to practice medicine in
6-6 the country in which the school is located except for any
6-7 citizenship requirements;
6-8 (4) possesses a valid certificate issued by the
6-9 Educational Commission for Foreign Medical Graduates; and
6-10 (5) has the ability to communicate in the English
6-11 language.
6-12 (h) All medical or osteopathic medical education received by
6-13 the applicant in the United States must be accredited by an
6-14 accrediting body officially recognized by the United States
6-15 Department of Education as the accrediting body for medical
6-16 education leading to the doctor of medicine degree or the doctor of
6-17 osteopathy degree in the United States. This subsection does not
6-18 apply to postgraduate medical education or training.
6-19 (i) An applicant who is unable to comply with the
6-20 requirements of Subsection (h) of this section may be eligible for
6-21 an unrestricted license if the applicant:
6-22 (1) received medical education in a hospital or
6-23 teaching institution sponsoring or participating in a program of
6-24 graduate medical education accredited by the Accreditation Council
6-25 for Graduate Medical Education, the American Osteopathic
6-26 Association, or the board in the same subject as the medical or
6-27 osteopathic medical education as defined by board rule; or
6-28 (2) is specialty board certified by a board approved
6-29 by the American Osteopathic Association or the American Board of
6-30 Medical Specialties.
6-31 (j)(1) The executive director shall review each application
6-32 for licensure and shall recommend to the board all applicants
6-33 eligible for licensure. The executive director also shall report
6-34 to the board the names of all applicants determined to be
6-35 ineligible for licensure, together with the reasons for each
6-36 recommendation.
6-37 (2) An applicant deemed ineligible for licensure by
6-38 the executive director may request review of such recommendation by
6-39 a committee of the board within 20 days of receipt of such notice,
6-40 and the executive director may refer any application to the
6-41 committee for a recommendation concerning eligibility. The
6-42 committee may refer any application for determination of
6-43 eligibility to the full board.
6-44 (3) If the committee finds the applicant ineligible
6-45 for licensure, such recommendation, together with the reasons for
6-46 the recommendation, shall be submitted to the board unless the
6-47 applicant requests a hearing within 20 days of receipt of notice of
6-48 the committee's determination.
6-49 (4) If the applicant requests a hearing, the hearing
6-50 shall be before an administrative law judge of the State Office of
6-51 Administrative Hearings and shall comply with Chapter 2001,
6-52 Government Code, and the rules of the State Office of
6-53 Administrative Hearings and the board.
6-54 (5) The board shall, after receiving the
6-55 administrative law judge's proposed findings of fact and
6-56 conclusions of law, determine the eligibility of the applicant for
6-57 licensure. A physician whose application for licensure is denied
6-58 by the board shall receive a written statement containing the
6-59 reasons for the board's action.
6-60 (k) Examination questions that may be used in the future,
6-61 examinations other than the one taken by the person requesting it,
6-62 and deliberations and records relating to the professional
6-63 character and fitness of applicants are exempted from the open
6-64 meetings law, Chapter 551, Government Code, and the public
6-65 information law, Chapter 552, Government Code.
6-66 (l) All reports received or gathered by the board on each
6-67 applicant are confidential and are not subject to disclosure under
6-68 the public information law, Chapter 552, Government Code. The
6-69 board may disclose such reports to appropriate licensing
7-1 authorities in other states. The board shall report all licensure
7-2 actions to appropriate licensing authorities in other states and to
7-3 the Federation of State Medical Boards of the United States.
7-4 (m) In addition to the requirements prescribed by this Act,
7-5 the board may require applicants to comply with other requirements
7-6 that the board considers appropriate. [is a graduate of an
7-7 acceptable medical college as determined by the board and who is a
7-8 licensee of another state or Canadian province having requirements
7-9 for physician registration and practice substantially equivalent to
7-10 those established by the laws of this state.]
7-11 [(b) An application for a license under this section must be
7-12 in writing and upon a form prescribed by the board. The
7-13 application must be accompanied by:]
7-14 [(1) a diploma or photograph of a diploma awarded to
7-15 the applicant by an acceptable medical college and a certified
7-16 transcript showing courses and grades;]
7-17 [(2) a license or a certified copy of a license to
7-18 practice medicine lawfully issued to the applicant by some other
7-19 state or a Canadian province that requires in its examination the
7-20 same general degree of fitness required by this state and that
7-21 grants the same reciprocal privileges to persons licensed by the
7-22 board;]
7-23 [(3) a certification made by the president or
7-24 secretary of the board that issued the license or a duly
7-25 constituted registration office of the state or Canadian province
7-26 that issued the certificate or license, reciting that the
7-27 accompanying certificate or license has not been canceled,
7-28 suspended, or revoked and reciting that the statement of the
7-29 qualifications made in the application for medical license in Texas
7-30 is true and correct; and]
7-31 [(4) evidence of a passing grade on an examination
7-32 required by the board.]
7-33 [(c) Applicants for a license under this section must
7-34 subscribe to an oath in writing before an officer authorized by law
7-35 to administer oaths. The written oath must be a part of the
7-36 application. The application must:]
7-37 [(1) state that:]
7-38 [(A) the license, certificate, or authority
7-39 under which the applicant has most recently practiced medicine in
7-40 the state or Canadian province from which the applicant is
7-41 transferring to this state or in the uniformed service in which the
7-42 applicant served is in full force and not restricted, canceled,
7-43 suspended, or revoked;]
7-44 [(B) the applicant is the identical person to
7-45 whom the certificate or license and the diploma were issued;]
7-46 [(C) no proceeding has been instituted against
7-47 the applicant for the restriction, cancellation, suspension, or
7-48 revocation of the certificate, license, or authority to practice
7-49 medicine in the state, Canadian province, or uniformed service of
7-50 the United States in which it was issued; and]
7-51 [(D) no prosecution is pending against the
7-52 applicant in any state, federal, or Canadian court for any offense
7-53 that under the laws of this state is a felony;]
7-54 [(2) include a description of any sanctions imposed by
7-55 or disciplinary matters pending in the state or Canadian province
7-56 in which the applicant was or is licensed or certified to practice
7-57 medicine; and]
7-58 [(3) include evidence of postgraduate training
7-59 required by the board.]
7-60 [(d) An applicant for a license under this section must be
7-61 eligible for examination by the board.]
7-62 [(e) In addition to other licensure requirements, the board
7-63 may require by rule and regulation that an applicant who is a
7-64 licensee of another state or Canadian province and who is a
7-65 graduate of a medical school located outside of the United States
7-66 and Canada, or the school itself, provide additional information to
7-67 the board concerning the medical school attended prior to approval
7-68 of the applicant.]
7-69 [(f) The board may refuse to issue a license to an applicant
8-1 who is a licensee of another state or Canadian province and who
8-2 graduated from a medical school outside of the United States and
8-3 Canada if it finds that the applicant does not possess the
8-4 requisite qualifications to provide the same standard of medical
8-5 care as provided by a licensed physician in this state.]
8-6 [(g) In addition to the requirements prescribed by this
8-7 section, the board may require applicants to comply with other
8-8 requirements that the board considers appropriate.]
8-9 [(h) The board may not refuse to issue a license to an
8-10 applicant under Subsection (f) of this section if the applicant:]
8-11 [(1) for the preceding five years has been a licensee
8-12 of another state or a Canadian province;]
8-13 [(2) is not the subject of a sanction imposed by or
8-14 disciplinary matter pending in any state or Canadian province in
8-15 which the applicant is licensed to practice medicine; and]
8-16 [(3) is either specialty board certified by a board
8-17 that is a member of the American Board of Medical Specialties or a
8-18 specialty board approved by the American Osteopathic Association or
8-19 successfully passes an examination that the board shall determine
8-20 by rule.]
8-21 Sec. 3.04. QUALIFICATIONS OF LICENSEES [QUALIFICATION OF
8-22 LICENSEE]. [(a)] An applicant, to be eligible for [the
8-23 examination and] issuance of a license, must present satisfactory
8-24 proof to the board that the applicant:
8-25 (1) is at least 21 years of age;
8-26 (2) is of good professional character and has not
8-27 violated Section 3.08 of this Act;
8-28 (3) has completed:
8-29 (A) 60 semester hours of college courses other
8-30 than in medical school that are[, which courses would be]
8-31 acceptable[, at the time of completion,] to The University of Texas
8-32 at Austin for credit on a bachelor of arts degree or a bachelor of
8-33 science degree;
8-34 (B) the entire primary, secondary, and
8-35 premedical education required in the country of medical school
8-36 graduation, if the medical school is located outside the United
8-37 States or Canada; or
8-38 (C) substantially equivalent courses as
8-39 determined by board rule; [and]
8-40 (4) is a graduate of a [an acceptable] medical [or
8-41 osteopathic] school located inside the United States or Canada and
8-42 [or college that was] approved by the board who [at the time the
8-43 degree was conferred and] has successfully completed one year [a
8-44 one year program] of graduate medical training approved by the
8-45 board in the United States or Canada or is a graduate of a medical
8-46 school located outside the United States or Canada who has
8-47 successfully completed three years of graduate medical training
8-48 approved by the board in the United States or Canada;
8-49 (5) has successfully passed within three attempts an
8-50 examination accepted or administered by the board; and
8-51 (6) has successfully passed a Texas medical
8-52 jurisprudence examination as determined by board rule.
8-53 [(b) The applicant shall be eligible for examination prior
8-54 to complying with the graduate training requirement of Subsection
8-55 (a)(4) of this section but shall not be eligible for the issuance
8-56 of an unrestricted license until the requirements of Subsection (a)
8-57 of this section have been satisfied.]
8-58 [(c) Applications for examination must be made in writing,
8-59 verified by affidavit, filed with the board on forms prescribed by
8-60 the board, and accompanied by documents and a fee as the board
8-61 determines to be reasonable.]
8-62 [(d) To be recognized by the board for the purposes of this
8-63 subchapter, all medical or osteopathic medical education received
8-64 by the applicant in the United States must be accredited by an
8-65 accrediting body officially recognized by the United States
8-66 Department of Education as the accrediting body for medical
8-67 education leading to the doctor of medicine degree or the doctor of
8-68 osteopathy degree in the United States. This subsection does not
8-69 apply to postgraduate medical education or training.]
9-1 [(f) An applicant who is unable to comply with the
9-2 requirements of Subsection (d) of this section is eligible for an
9-3 unrestricted license if the applicant:]
9-4 [(1) received such medical education in a hospital or
9-5 teaching institution sponsoring or participating in a program of
9-6 graduate medical education accredited by the Accrediting Council
9-7 for Graduate Medical Education, the American Osteopathic
9-8 Association, or the Texas State Board of Medical Examiners in the
9-9 same subject as the medical or osteopathic medical education if the
9-10 hospital or teaching institution has an agreement with the
9-11 applicant's school; or]
9-12 [(2) is specialty board certified by a board approved
9-13 by the American Osteopathic Association or the American Board of
9-14 Medical Specialties.]
9-15 [(g) In addition to the other requirements of this section,
9-16 an applicant who is a graduate of a medical school that is located
9-17 outside the United States and Canada and that was not approved by
9-18 the board at the time the degree was conferred must, in order to be
9-19 eligible for the issuance of a license, present satisfactory proof
9-20 to the board that the applicant:]
9-21 [(1) is a graduate of a school whose curriculum meets
9-22 the requirements for an unapproved medical school as determined by
9-23 a committee of experts selected by the Texas Higher Education
9-24 Coordinating Board;]
9-25 [(2) has successfully completed three years of
9-26 graduate medical training in the United States or Canada that was
9-27 approved by the board on the date the training was completed;]
9-28 [(3) is eligible for licensure to practice medicine in
9-29 the country in which the school is located;]
9-30 [(4) possesses a valid certificate issued by the
9-31 Educational Commission for Foreign Medical Graduates;]
9-32 [(5) has the ability to communicate in the English
9-33 language; and]
9-34 [(6) has passed the examination required by the board
9-35 of all applicants for license as required by Section 3.05 of this
9-36 Act.]
9-37 [(h) The board by rule may establish alternate educational
9-38 prerequisites to those required by Subsection (a)(3) of this
9-39 section for an applicant who graduated from an unapproved medical
9-40 school located outside the United States and Canada.]
9-41 [(i) In addition to other licensure requirements, the board,
9-42 before approving the applicant, may require by rule that a graduate
9-43 of an unapproved medical school located outside the United States
9-44 and Canada or the school of which the person is a graduate provide
9-45 additional information to the board concerning the school.]
9-46 [(j) The board may refuse to issue a license to an applicant
9-47 who graduated from an unapproved medical school located outside the
9-48 United States and Canada if it finds that:]
9-49 [(1) the applicant does not possess the requisite
9-50 qualifications to provide the same standard of medical care as
9-51 provided by a physician licensed in this state; or]
9-52 [(2) the applicant failed to provide the board
9-53 evidence to establish that the applicant completed medical
9-54 education or professional training substantially equivalent to that
9-55 provided by a medical school in this state.]
9-56 Sec. 3.05. EXAMINATIONS ACCEPTED OR ADMINISTERED
9-57 [EXAMINATION]. (a) The board may administer or accept the
9-58 following examinations for licensure as determined by rule:
9-59 (1) a state board licensing examination;
9-60 (2) the Medical Council of Canada Examination (LMCC)
9-61 or its successor;
9-62 (3) the National Board of Osteopathic Medical
9-63 Examiners (NBOME) examination or its successor;
9-64 (4) the National Board of Medical Examiners (NBME)
9-65 examination or its successor;
9-66 (5) the Federation Licensing Examination (FLEX) with a
9-67 weighted average in one sitting before June, 1985;
9-68 (6) the Federation Licensing Examination (FLEX) after
9-69 May, 1985;
10-1 (7) the United States Medical Licensing Examination
10-2 (USMLE) or its successor; or
10-3 (8) a combination of the National Board of Osteopathic
10-4 Medical Examiners examination and the Federation Licensing
10-5 Examination after May, 1985, or of the United States Medical
10-6 Licensing Examination, the Federation Licensing Examination after
10-7 May, 1985, and the National Board of Medical Examiners examination,
10-8 as determined by board rule.
10-9 (b) All examinations used by the board for licensure
10-10 [license] to practice medicine shall be [conducted] in writing in
10-11 the English language and shall [in a manner as to] be entirely fair
10-12 and impartial to all individuals and to every school or system of
10-13 medicine. Applicants who wish to request reasonable accommodations
10-14 due to a disability shall submit the request on filing the
10-15 application.
10-16 (c) Examinations shall include [be conducted on and cover
10-17 those] subjects generally taught by medical schools, a knowledge of
10-18 which is commonly and generally required of candidates for the
10-19 degree of doctor of medicine or doctor of osteopathy conferred by
10-20 schools in Texas.
10-21 (d) The board shall administer the Texas medical
10-22 jurisprudence examination to all applicants.
10-23 (e) The minimum passing grade for all examinations used by
10-24 the board shall be determined by rule.
10-25 (f) Examinations administered to evaluate basic medical
10-26 knowledge and clinical competency shall be prepared by a national
10-27 testing service or the board and validated by qualified independent
10-28 testing professionals.
10-29 (g) All questions, answers, and grades shall be preserved
10-30 for one year as the board may direct by rule.
10-31 (h) All applicants shall be given due notice of the date and
10-32 place of the examination if administered by the board.
10-33 (i) Within 120 days after the day on which an examination is
10-34 administered by the board, each examinee shall be notified of the
10-35 results of the examination. However, if an examination is graded
10-36 or reviewed by a national testing service, the board shall notify
10-37 each examinee of the results of the examination not later than 30
10-38 days after the date the board receives the results from the testing
10-39 service.
10-40 (j) Except as provided by Subsection (m) of this section,
10-41 all parts of the Medical Council of Canada Examination, the
10-42 National Board of Osteopathic Medical Examiners examination, the
10-43 National Board of Medical Examiners examination, the Federation
10-44 Licensing Examination after May, 1985, and the United States
10-45 Medical Licensing Examination must be passed within seven years.
10-46 (k) An applicant must pass each part of an examination
10-47 within three attempts, except that an applicant who has passed all
10-48 but one part of an examination within three attempts may take the
10-49 remaining part of the examination one additional time.
10-50 (l) Notwithstanding Subsection (k) of this section, an
10-51 applicant is considered to have satisfied the requirements of this
10-52 section if the applicant:
10-53 (1) passed all but one part of an examination approved
10-54 by the board before September 1, 1993, within three attempts and
10-55 passed the remaining part of the examination within five attempts;
10-56 (2) is specialty board certified by:
10-57 (A) a board that is a member of the American
10-58 Board of Medical Specialties; or
10-59 (B) a specialty board approved by the American
10-60 Osteopathic Association;
10-61 (3) enrolled before September 1, 1993, in a
10-62 postgraduate medical training program in this state approved by the
10-63 board; and
10-64 (4) completed two years of postgraduate medical
10-65 training in this state approved by the board.
10-66 (m) An applicant who is a graduate of a program designed to
10-67 lead to both a doctor of philosophy degree and a doctor of medicine
10-68 degree or doctor of osteopathy degree must pass each part of an
10-69 examination described by Subsection (a)(2), (3), (4), (6), or (7)
11-1 of this section not later than the second anniversary of the date
11-2 the applicant was awarded a doctor of medicine degree or doctor of
11-3 osteopathy degree. [or colleges of medicine approved by the board,
11-4 and the examinations shall also be conducted on and cover the
11-5 subject of medical jurisprudence. Examinations shall be prepared
11-6 by a national testing service or prepared by the board and
11-7 validated by qualified independent testing professionals. On
11-8 satisfactory examination conducted as required by this Act under
11-9 rules of the board, applicants may be granted licenses to practice
11-10 medicine. All questions and answers, with the grades attached,
11-11 shall be preserved for one year in the executive office of the
11-12 board or such other repository as the board by rule may direct.
11-13 All applicants examined at the same time shall be given identical
11-14 questions. All certificates shall be attested by the seal of the
11-15 board. The board in its discretion may give the examination for
11-16 license in two or more parts.]
11-17 [(b) In addition to the requirements prescribed by this Act,
11-18 the board may require applicants to comply with other requirements
11-19 that the board considers appropriate and establish reasonable fees
11-20 for examination.]
11-21 [(c) All applicants for license to practice medicine in this
11-22 state not otherwise licensed under the provisions of law must
11-23 successfully pass a uniform examination approved by the board as
11-24 determined by rule. The board is authorized to adopt and enforce
11-25 all rules of procedure not inconsistent with statutory
11-26 requirements. All applicants shall be given due notice of the date
11-27 and place of the examination. If any applicant, because of failure
11-28 to pass the required examination, is refused a license, the
11-29 applicant, at a time as the board may fix, shall be permitted to
11-30 take a subsequent examination not more than two additional times as
11-31 the board may prescribe on the payment of a fee as the board may
11-32 determine to be reasonable. In the event satisfactory grades shall
11-33 be made on the subjects prescribed and taken on the reexamination,
11-34 the board may grant the applicant a license to practice medicine.
11-35 The board shall determine the credit to be given examinees on
11-36 answers turned in on the subjects of complete and partial
11-37 examination, and its decision is final.]
11-38 [(d) Examination questions that may be used in the future,
11-39 examinations other than the one taken by the person requesting it,
11-40 and deliberations and records relating to the professional
11-41 character and fitness of applicants are exempted from the Open
11-42 Meetings Law and the Open Records Law. The records, however, shall
11-43 be disclosed to individual applicants upon written request, unless
11-44 the person supplying the information to the board requests that it
11-45 not be disclosed.]
11-46 [(e) Within 90 days after the day on which an examination is
11-47 administered under this Act, the board shall notify each examinee
11-48 of the results of the examination. However, if an examination is
11-49 graded or reviewed by a national testing service, the board shall
11-50 notify each examinee of the results of the examination not later
11-51 than the 30th day after the date the board receives the results
11-52 from the testing service. If the notice of the examination results
11-53 will be delayed for longer than 90 days after the examination, the
11-54 board shall notify the examinee of the reason for the delay before
11-55 the 90th day.]
11-56 [(f) If requested in writing by a person who fails the
11-57 examination administered under this Act, the board shall furnish
11-58 the person with a summarized analysis of the person's performance
11-59 on the examination consisting of the person's score on each portion
11-60 of the examination.]
11-61 SECTION 3. Section 3.10, Medical Practice Act (Article
11-62 4495b, Vernon's Texas Civil Statutes), as amended by Chapters 214
11-63 and 862, Acts of the 73rd Legislature, Regular Session, 1993, is
11-64 amended to read as follows:
11-65 Sec. 3.10. FEES. (a) All receipts collected by the board
11-66 shall be placed in the state treasury and may be spent only as
11-67 provided by the General Appropriations Act, this Act, or other
11-68 applicable law for the enforcement of this Act, the prohibition of
11-69 the unlawful practice of medicine, the dissemination of information
12-1 to prevent the violation of the laws, and the prosecution of those
12-2 who violate the laws. All distributions may be made only on
12-3 written approval of the executive director of the board or his
12-4 designated representative.
12-5 (b) The board may not set, charge, collect, receive, or
12-6 deposit any of the following fees in excess of:
12-7 (1) License...................................... $900
12-8 (2) First annual registration permit............. $200
12-9 (3) Temporary license............................ $200
12-10 (4) Renewal of annual registration permit........ $200
12-11 (5) Physician-in-training permit................. $200
12-12 (6) Endorsement to other state medical
12-13 boards........................................................ $200
12-14 (7) Duplicate license............................ $200
12-15 (8) Reinstated license after cancellation
12-16 for cause.................................................... $700.
12-17 (c) The board may set and collect a sales charge for making
12-18 copies of records in the office of the board and for any material
12-19 published by the board.
12-20 (d) The financial transactions of the board are subject to
12-21 audit by the state auditor in accordance with Chapter 321,
12-22 Government Code.
12-23 (e) The board shall file annually with the governor and the
12-24 presiding officer of each house of the legislature a complete and
12-25 detailed written report accounting for all funds received and
12-26 disbursed by the board during the preceding fiscal year. The
12-27 annual report must be in the form and reported in the time provided
12-28 by the General Appropriations Act. [All annual registration fees
12-29 collected by the board shall be placed in the State Treasury to the
12-30 credit of the medical registration fund. The fees deposited to
12-31 this special fund shall be credited to the appropriations of the
12-32 board and may be spent only as provided by the General
12-33 Appropriations Act, this Act, or other applicable statutes. Money
12-34 in that fund may be used by the board and under its direction in
12-35 the enforcement of this Act, the prohibition of the unlawful
12-36 practice of medicine, the dissemination of information to prevent
12-37 the violation of the laws, and the prosecution of those who violate
12-38 the laws. All distributions from the fund may be made only upon
12-39 written approval of the secretary-treasurer of the board or his
12-40 designated representative, and the comptroller shall upon
12-41 requisition of the board from time to time draw warrants upon the
12-42 fund for the amounts specified in the requisition.]
12-43 [(b) The board may not set, charge, collect, receive, or
12-44 deposit any of the following fees in excess of:]
12-45 [(1) for processing and granting a license
12-46 by reciprocity to a licensee of another state................. $700]
12-47 [(2) for processing an application and
12-48 administration of a partial examination for licensure......... $700]
12-49 [(3) for processing an application and
12-50 administration of a complete examination for licensure........ $700]
12-51 [(4) for processing an application and
12-52 issuance of a temporary license............................... $200]
12-53 [(5) for processing an application and
12-54 issuance of a duplicate license............................... $200]
12-55 [(6) for processing an application and
12-56 issuance of a license of reinstatement after a lapse or
12-57 cancellation of a license..................................... $700]
12-58 [(7) for processing an application and
12-59 issuance of an annual registration of a licensee.............. $200]
12-60 [(8) for processing and issuance of an
12-61 institutional permit for interns, residents, and others
12-62 in approved medical training programs......................... $200]
12-63 [(9) for processing an application and
12-64 issuance of an endorsement to other state medical boards...... $200]
12-65 [(10) for processing and issuance of a
12-66 license or temporary license to a physician assistant......... $200]
12-67 [(11) for processing and issuance of a
12-68 permit to a physician who supervises an acupuncturist........ $200.]
12-69 [(b) The board may set and collect a sales charge for making
13-1 copies of any paper of record in the office of the board and for
13-2 any printed material published by the board. The charges shall be
13-3 in amounts considered sufficient to reimburse the board for the
13-4 actual expense.]
13-5 [(c) The financial transactions of the board are subject to
13-6 audit by the state auditor in accordance with Chapter 321,
13-7 Government Code.]
13-8 [(d) The board shall file annually with the governor and the
13-9 presiding officer of each house of the legislature a complete and
13-10 detailed written report accounting for all funds received and
13-11 disbursed by the board during the preceding fiscal year. The
13-12 annual report must be in the form and reported in the time provided
13-13 by the General Appropriations Act.]
13-14 SECTION 4. Section 3.11A, Medical Practice Act (Article
13-15 4495b, Vernon's Texas Civil Statutes), is amended to read as
13-16 follows:
13-17 Sec. 3.11A. SURCHARGE; DISPOSITION [OF FEES]. (a) An
13-18 additional $200 surcharge shall apply to each of the following:
13-19 (1) license;
13-20 (2) first annual registration permit;
13-21 (3) renewal of annual registration permit; and
13-22 (4) reinstated license after cancellation for cause.
13-23 [This section applies to each of the following fees:]
13-24 [(1) fee for processing and granting a license by
13-25 reciprocity to a licensee of another state;]
13-26 [(2) fee for processing an application and
13-27 administration of a partial examination for licensure;]
13-28 [(3) fee for processing an application and
13-29 administration of a complete examination for licensure;]
13-30 [(4) fee for processing an application and issuance of
13-31 a license of reinstatement after a lapse or cancellation of a
13-32 license; and]
13-33 [(5) fee for processing an application and issuance of
13-34 an annual registration of a licensee.]
13-35 (b) Of each surcharge [fee] collected, $50 shall be
13-36 deposited to the credit of the foundation school fund and $150
13-37 shall be deposited to the credit of the general revenue fund. This
13-38 subsection applies to the disposition of the stated portion of each
13-39 fee regardless of any other provision of law providing for a
13-40 different disposition of funds.
13-41 SECTION 5. Section 2.10, as added by Section 1.04, Chapter
13-42 36, Acts of the 73rd Legislature, Regular Session, 1993, and
13-43 Sections 3.0305 and 3.031, Medical Practice Act (Article 4495b,
13-44 Vernon's Texas Civil Statutes), are repealed.
13-45 SECTION 6. The importance of this legislation and the
13-46 crowded condition of the calendars in both houses create an
13-47 emergency and an imperative public necessity that the
13-48 constitutional rule requiring bills to be read on three several
13-49 days in each house be suspended, and this rule is hereby suspended,
13-50 and that this Act take effect and be in force from and after its
13-51 passage, and it is so enacted.
13-52 * * * * *