LEGISLATIVE BUDGET BOARD
                              Austin, Texas
                                     
                    FISCAL NOTE, 76th Regular Session
  
                              April 20, 1999
  
  
          TO:  Honorable Patricia Gray, Chair, House Committee on Public
               Health
  
        FROM:  John Keel, Director, Legislative Budget Board
  
       IN RE:  HB3217  by McCall (Relating to the regulation of the
               practice of medicine.), As Introduced
  
**************************************************************************
*  Estimated Two-year Net Impact to General Revenue Related Funds for    *
*  HB3217, As Introduced:  negative impact of $(23,791,500) through      *
*  the biennium ending August 31, 2001.                                  *
*                                                                        *
*  The bill would make no appropriation but could provide the legal      *
*  basis for an appropriation of funds to implement the provisions of    *
*  the bill.                                                             *
**************************************************************************
  
General Revenue-Related Funds, Five-Year Impact:
  
          ****************************************************
          *  Fiscal Year  Probable Net Positive/(Negative)   *
          *               Impact to General Revenue Related  *
          *                             Funds                *
          *       2000                        $(11,805,750)  *
          *       2001                         (11,985,750)  *
          *       2002                         (12,169,750)  *
          *       2003                         (12,311,750)  *
          *       2004                         (12,452,750)  *
          ****************************************************
  
All Funds, Five-Year Impact:
  
**************************************************************************
*Fiscal    Probable Revenue     Probable Revenue     Probable Revenue    *
* Year     Gain/(Loss) from   Gain/(Loss) from New   Gain/(Loss) from    *
*        General Revenue Fund    - GR Dedicated      Foundation School   *
*                0001                                      Fund          *
*                                                          0193          *
*  2000          $(11,562,000)           $8,643,000           $(243,750) *
*  2001           (11,742,000)            8,773,000            (243,750) *
*  2002           (11,926,000)            8,904,000            (243,750) *
*  2003           (12,068,000)            8,993,000            (243,750) *
*  2004           (12,209,000)            9,083,000            (243,750) *
**************************************************************************
  
Fiscal Analysis
  
The bill would amend the Medical Practices Act by creating a single fee
for a license and first annual registration permit, and by repealing
current provisions for temporary out-of-state and reciprocity licenses.
Under current law, a person must pay a license fee and a registration fee
in addition to a surcharge for both fees in order to become a licensed
physician.  The bill would clarify that $50 from each surcharge fee would
be deposited to the credit of the Foundation School Fund and that $150
would be deposited in the General Revenue Fund.  The bill would also
create a dedicated general revenue account for all revenue collected by
the Board of Medical Examiners (BME) and would allow funds in the account
only to be spent for the enforcement of the act.

The bill would take effect September 1, 1999.
  
  
Methodology
  
The bill would impact revenues generated from surcharges applied to
licensing and registration fees paid by new physicians.  Under current
law, a person must pay a license fee of $800 ($600 with a $200 surcharge)
to become a licensed physician in addition to a registration fee of $310
($110 with a $200 surcharge) to register the license in order to
practice.  Under the provisions of the bill, new physicians would pay
$910 instead of $1,110 to be licensed and receive a first annual
registration.  A net loss to the General Revenue Fund and the Foundation
School Fund would be realized equivalent to the portion of the surcharge
that would be eliminated by the bill.

The bill would reduce the General Revenue Fund by the amount of revenue
that the BME would generate in  fiscal year 2000 and following years as
a result of creating a new general revenue dedicated account.  The
Comptroller estimates that the BME would generate $8,643,029 in first
year and $8,772,674 in the subsequent year in the 2000-01 Biennial
Revenue Estimate.  In addition, the Comptroller estimates that a loss of
approximately $3 million to the General Revenue Fund each fiscal year
would be realized as a result of the bill eliminating temporary
out-of-state and reciprocity licenses.  It is assumed that similar
revenues would be generated in each following year and that the BME
would adopt rules necessary to implement the provisions of the bill.
  
  
Local Government Impact
  
No significant fiscal implication to units of local government is
anticipated.
  
  
Source Agencies:   405   Department of Public Safety, 308   State
                   Auditor's Office, 360   State Office of
                   Administrative Hearings, 503   Board of Medical
                   Examiners, 304   Comptroller of Public Accounts, 781
                   Higher Education Coordinating Board
LBB Staff:         JK, TH, RT, MW