1-1 By: Capelo (Senate Sponsor - Carona) H.B. No. 1183
1-2 (In the Senate - Received from the House May 7, 2001;
1-3 May 7, 2001, read first time and referred to Committee on Health
1-4 and Human Services; May 11, 2001, reported adversely, with
1-5 favorable Committee Substitute by the following vote: Yeas 7, Nays
1-6 0; May 11, 2001, sent to printer.)
1-7 COMMITTEE SUBSTITUTE FOR H.B. No. 1183 By: Carona
1-8 A BILL TO BE ENTITLED
1-9 AN ACT
1-10 relating to the regulation of surgical assistants; granting
1-11 rulemaking authority; providing an administrative penalty.
1-12 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-13 SECTION 1. Subtitle C, Title 3, Occupations Code, is amended
1-14 by adding Chapter 206 to read as follows:
1-15 CHAPTER 206. SURGICAL ASSISTANTS
1-16 SUBCHAPTER A. GENERAL PROVISIONS
1-17 Sec. 206.001. DEFINITIONS. In this chapter:
1-18 (1) "Advisory committee" means the advisory committee
1-19 created under this chapter.
1-20 (2) "Delegating physician" means a physician who is
1-21 licensed by the medical board either as a doctor of medicine or
1-22 doctor of osteopathic medicine and who delegates, to a licensed
1-23 surgical assistant, surgical assisting and oversees and accepts
1-24 responsibility for that surgical assisting.
1-25 (3) "Direct supervision" means supervision by a
1-26 delegating physician who is physically present and who personally
1-27 directs delegated acts and remains immediately available to
1-28 personally respond to any emergency until the patient is released
1-29 from the operating room or care and has been transferred, as
1-30 determined by medical board rule, to another physician.
1-31 (4) "Executive director" means the executive director
1-32 of the medical board.
1-33 (5) "Medical board" means the Texas State Board of
1-34 Medical Examiners.
1-35 (6) "Surgical assisting" means providing aid under
1-36 direct supervision in exposure, hemostasis, and other
1-37 intraoperative technical functions that assist a physician in
1-38 performing a safe operation with optimal results for the patient,
1-39 including the delegated authority to provide local infiltration or
1-40 the topical application of a local anesthetic at the operation
1-41 site. This term is synonymous with "first assisting."
1-42 Sec. 206.002. APPLICABILITY. (a) A person is not required
1-43 to hold a license under this chapter if the person is:
1-44 (1) a student enrolled in a surgical assistant
1-45 education program approved by the medical board who is assisting in
1-46 a surgical operation that is an integral part of the program of
1-47 study;
1-48 (2) a surgical assistant employed in the service of
1-49 the federal government while performing duties related to that
1-50 employment;
1-51 (3) a person acting under the delegated authority of a
1-52 licensed physician;
1-53 (4) a licensed health care worker acting within the
1-54 scope of the person's license;
1-55 (5) a registered nurse; or
1-56 (6) a licensed physician assistant.
1-57 (b) This chapter does not affect the authority of a licensed
1-58 physician to delegate acts under Subtitle B.
1-59 (Sections 206.003-206.050 reserved for expansion
1-60 SUBCHAPTER B. ADVISORY COMMITTEE
1-61 Sec. 206.051. ADVISORY COMMITTEE. (a) The advisory
1-62 committee is an informal advisory committee to the medical board
1-63 and is not subject to Chapter 2110, Government Code.
1-64 (b) The advisory committee has no independent rulemaking
2-1 authority.
2-2 Sec. 206.052. APPOINTMENT OF ADVISORY COMMITTEE. (a) The
2-3 advisory committee consists of five members appointed by the
2-4 president of the medical board. Each member of the advisory
2-5 committee must be:
2-6 (1) a practicing surgical assistant who has at least
2-7 five years of clinical experience as a surgical assistant; or
2-8 (2) a physician licensed in this state who supervises
2-9 a surgical assistant.
2-10 (b) Appointments to the advisory committee shall be made
2-11 without regard to the race, color, disability, sex, religion, age,
2-12 or national origin of the appointees.
2-13 Sec. 206.053. MEMBERSHIP AND EMPLOYEE RESTRICTIONS. (a) In
2-14 this section, "Texas trade association" means a cooperative and
2-15 voluntarily joined association of business or professional
2-16 competitors in this state designed to assist its members and its
2-17 industry or profession in dealing with mutual business or
2-18 professional problems and in promoting their common interest.
2-19 (b) A person may not be a member of the advisory committee
2-20 if:
2-21 (1) the person is an officer, employee, or paid
2-22 consultant of a Texas trade association in the field of surgical
2-23 assisting; or
2-24 (2) the person's spouse is an officer, manager, or
2-25 paid consultant of a Texas trade association in the field of
2-26 surgical assisting.
2-27 (c) A person may not be a member of the advisory committee
2-28 if the person is required to register as a lobbyist under Chapter
2-29 305, Government Code, because of the person's activities for
2-30 compensation on behalf of a profession related to the field of
2-31 surgical assisting.
2-32 Sec. 206.054. TERMS; VACANCY. (a) Members of the advisory
2-33 committee are appointed for two-year terms. The terms of the
2-34 members expire on February 1 of each odd-numbered year.
2-35 (b) If a vacancy occurs during a member's term, the
2-36 president of the medical board shall appoint a new member to fill
2-37 the unexpired term.
2-38 (c) An advisory committee member may not serve more than two
2-39 consecutive full terms.
2-40 Sec. 206.055. GROUNDS FOR REMOVAL. (a) It is a ground for
2-41 removal from the advisory committee that a member:
2-42 (1) does not have at the time of appointment the
2-43 qualifications required by Section 206.052;
2-44 (2) does not maintain during service on the advisory
2-45 committee the qualifications required by Section 206.052;
2-46 (3) is ineligible for membership under Section
2-47 206.053; or
2-48 (4) cannot, because of illness or disability,
2-49 discharge the member's duties for a substantial part of the
2-50 member's term.
2-51 (b) The validity of an action of the committee is not
2-52 affected by the fact that it is taken when a ground for removal of
2-53 a committee member exists.
2-54 Sec. 206.056. OFFICERS. The president of the medical board
2-55 shall designate biennially a committee member as the presiding
2-56 officer of the advisory committee to serve in that capacity at the
2-57 will of the president.
2-58 Sec. 206.057. PER DIEM. An advisory committee member is not
2-59 entitled to reimbursement for travel expenses or compensation.
2-60 Sec. 206.058. MEETINGS. (a) The advisory committee shall
2-61 meet as requested by the medical board.
2-62 (b) A meeting may be held by telephone conference call.
2-63 (Sections 206.059-206.100 reserved for expansion
2-64 SUBCHAPTER C. POWERS AND DUTIES OF MEDICAL BOARD
2-65 Sec. 206.101. GENERAL POWERS AND DUTIES. The medical board
2-66 shall:
2-67 (1) establish qualifications for a surgical assistant
2-68 to practice in this state;
2-69 (2) establish requirements for an examination for a
3-1 license to practice as a surgical assistant;
3-2 (3) establish minimum education and training
3-3 requirements necessary for a license to practice as a surgical
3-4 assistant;
3-5 (4) prescribe the application form for a license to
3-6 practice as a surgical assistant; and
3-7 (5) develop an approved program of mandatory
3-8 continuing education and the manner in which attendance at all
3-9 approved courses, clinics, forums, lectures, programs, or seminars
3-10 is monitored and recorded.
3-11 Sec. 206.102. ANNUAL REPORT. (a) The medical board shall
3-12 prepare annually a complete and detailed written report accounting
3-13 for all funds received and disbursed by the medical board under
3-14 this chapter during the preceding fiscal year.
3-15 (b) The annual report must meet the reporting requirements
3-16 applicable to financial reporting provided in the General
3-17 Appropriations Act.
3-18 Sec. 206.103. GIFTS, GRANTS, AND DONATIONS. In addition to
3-19 any fees paid to the medical board or money appropriated to the
3-20 medical board, the medical board may receive and accept under this
3-21 chapter a gift, grant, donation, or other item of value from any
3-22 source, including the United States or a private source.
3-23 (Sections 206.104-206.150 reserved for expansion
3-24 SUBCHAPTER D. PUBLIC INTEREST INFORMATION; COMPLAINT AND
3-25 INVESTIGATIVE INFORMATION
3-26 Sec. 206.151. PUBLIC PARTICIPATION. (a) The medical board
3-27 shall develop and implement policies that provide the public with a
3-28 reasonable opportunity to appear before the medical board and speak
3-29 on any issue relating to surgical assistants.
3-30 (b) The executive director of the medical board shall
3-31 prepare and maintain a written plan that describes how a person who
3-32 does not speak English may be provided reasonable access to the
3-33 medical board's programs and services under this chapter.
3-34 Sec. 206.152. PUBLIC INTEREST INFORMATION. (a) The medical
3-35 board shall prepare information of public interest describing the
3-36 functions of the medical board and the procedures by which
3-37 complaints are filed and resolved under this chapter.
3-38 (b) The medical board shall make the information available
3-39 to the public and appropriate state agencies.
3-40 Sec. 206.153. COMPLAINTS. (a) The medical board by rule
3-41 shall establish methods by which consumers and service recipients
3-42 are notified of the name, mailing address, and telephone number of
3-43 the medical board for the purpose of directing complaints about
3-44 licensed surgical assistants to the medical board.
3-45 (b) The medical board shall list with its regular telephone
3-46 number any toll-free telephone number established under other state
3-47 law that may be called to present a complaint about a licensed
3-48 surgical assistant.
3-49 Sec. 206.154. RECORDS OF COMPLAINTS. (a) The medical board
3-50 shall maintain a file on each written complaint filed with the
3-51 medical board under this chapter. The file must include:
3-52 (1) the name of the person who filed the complaint;
3-53 (2) the date the complaint is received by the medical
3-54 board;
3-55 (3) the subject matter of the complaint;
3-56 (4) the name of each person contacted in relation to
3-57 the complaint;
3-58 (5) a summary of the results of the review or
3-59 investigation of the complaint; and
3-60 (6) an explanation of the reason the file was closed,
3-61 if the medical board closed the file without taking action other
3-62 than to investigate the complaint.
3-63 (b) The medical board shall provide to the person filing the
3-64 complaint and to each person who is a subject of the complaint a
3-65 copy of the medical board's policies and procedures relating to
3-66 complaint investigation and resolution. A person who reports a
3-67 complaint by phone shall be given information on how to file a
3-68 written complaint.
3-69 (c) The medical board, at least quarterly and until final
4-1 disposition of the complaint, shall notify the person filing the
4-2 complaint and each person who is a subject of the complaint of the
4-3 status of the investigation unless the notice would jeopardize an
4-4 undercover investigation.
4-5 Sec. 206.155. LICENSE HOLDER ACCESS TO COMPLAINT
4-6 INFORMATION. (a) The medical board shall provide a license holder
4-7 who is the subject of a formal complaint filed under this chapter
4-8 with access to all information in its possession that the medical
4-9 board intends to offer into evidence in presenting its case in
4-10 chief at the contested hearing on the complaint, subject to any
4-11 other privilege or restriction established by rule, statute, or
4-12 legal precedent. The medical board shall provide the information
4-13 not later than the 30th day after receipt of a written request from
4-14 the license holder or the license holder's counsel, unless good
4-15 cause is shown for delay.
4-16 (b) Notwithstanding Subsection (a), the medical board is not
4-17 required to provide:
4-18 (1) medical board investigative reports;
4-19 (2) investigative memoranda;
4-20 (3) the identity of a nontestifying complainant;
4-21 (4) attorney-client communications;
4-22 (5) attorney work product; or
4-23 (6) other material covered by a privilege recognized
4-24 by the Texas Rules of Civil Procedure or the Texas Rules of
4-25 Evidence.
4-26 (c) The provision of information does not constitute a
4-27 waiver of privilege or confidentiality under this chapter or other
4-28 law.
4-29 Sec. 206.156. HEALTH CARE ENTITY REQUEST FOR INFORMATION. On
4-30 the written request of a health care entity, the medical board
4-31 shall provide to the entity:
4-32 (1) information about a complaint filed against a
4-33 license holder that was resolved after investigation by:
4-34 (A) a disciplinary order of the medical board;
4-35 or
4-36 (B) an agreed settlement; and
4-37 (2) the basis of and current status of any complaint
4-38 under active investigation that has been referred by the executive
4-39 director or the director's designee for legal action.
4-40 Sec. 206.157. CONFIDENTIALITY OF INVESTIGATIVE INFORMATION.
4-41 A complaint, adverse report, investigation file, or other report,
4-42 the identity of and reports made by a physician or surgical
4-43 assistant performing or supervising compliance monitoring for the
4-44 medical board, or other investigative information in the possession
4-45 of or received or gathered by the medical board, medical board
4-46 employee or agent relating to a license holder, a license
4-47 application, or a criminal investigation or proceeding is
4-48 privileged and confidential and is not subject to discovery,
4-49 subpoena, or other means of legal compulsion for release to any
4-50 person other than the medical board or medical board employee or
4-51 agent involved in license holder discipline.
4-52 Sec. 206.158. PERMITTED DISCLOSURE OF INVESTIGATIVE
4-53 INFORMATION. (a) Investigative information in the possession of
4-54 the medical board, medical board employee, or agent that relates to
4-55 the discipline of a license holder may be disclosed to:
4-56 (1) a licensing authority in another state or a
4-57 territory or country in which the license holder is licensed or
4-58 has applied for a license; or
4-59 (2) a peer review committee reviewing:
4-60 (A) an application for privileges; or
4-61 (B) the qualifications of the license holder
4-62 with respect to retaining privileges.
4-63 (b) If the investigative information in the possession of
4-64 the medical board or a medical board employee or agent indicates a
4-65 crime may have been committed, the medical board shall report the
4-66 information to the proper law enforcement agency. The medical
4-67 board shall cooperate with and assist all law enforcement agencies
4-68 conducting criminal investigations of a license holder by providing
4-69 information relevant to the investigation. Confidential
5-1 information disclosed by the medical board to a law enforcement
5-2 agency remains confidential and may not be disclosed by the law
5-3 enforcement agency except as necessary to further the
5-4 investigation.
5-5 Sec. 206.159. IMMUNITY AND REPORTING REQUIREMENTS. (a) A
5-6 medical peer review committee in this state, a quality assurance
5-7 committee in this state, a surgical assistant, a surgical assistant
5-8 student, a physician practicing medicine in this state, or any
5-9 person usually present in an operating room, including a nurse or
5-10 surgical technologist, shall report relevant information to the
5-11 advisory committee related to the acts of a surgical assistant in
5-12 this state if, in that person's opinion, a surgical assistant poses
5-13 a continuing threat to the public welfare through the person's
5-14 practice as a surgical assistant. The duty to report under this
5-15 section may not be nullified through contract.
5-16 (b) A person who, without malice, furnishes records,
5-17 information, or assistance to the advisory committee under this
5-18 section is immune from any civil liability arising from that action
5-19 in a suit against the person brought by or on behalf of a surgical
5-20 assistant who is reported under this section.
5-21 (c) Sections 160.002, 160.003, 160.006, 160.007, 160.009,
5-22 160.013, and 160.014 apply to medical peer review regarding a
5-23 licensed surgical assistant.
5-24 (Sections 206.160-206.200 reserved for expansion
5-25 SUBCHAPTER E. LICENSE REQUIREMENTS
5-26 Sec. 206.201. LICENSE REQUIRED. (a) Except as provided by
5-27 Section 206.002, a person may not practice as a surgical assistant
5-28 unless the person is licensed under this chapter.
5-29 (b) Unless the person holds a license under this chapter, a
5-30 person may not use, in connection with the person's name:
5-31 (1) the title "Licensed Surgical Assistant"; or
5-32 (2) any other designation that would imply that the
5-33 person is a licensed surgical assistant.
5-34 Sec. 206.202. LICENSE APPLICATION. An applicant for a
5-35 license must:
5-36 (1) file a written application with the medical board
5-37 on a form prescribed by the medical board; and
5-38 (2) pay the application fee set by the medical board.
5-39 Sec. 206.203. LICENSE ELIGIBILITY. (a) Except as provided
5-40 by Section 206.206, to be eligible for a license, a person must:
5-41 (1) be of good moral character;
5-42 (2) have not been convicted of a felony or a crime
5-43 involving moral turpitude;
5-44 (3) not use drugs or alcohol to an extent that affects
5-45 the applicant's professional competency;
5-46 (4) not have had a license or certification revoked by
5-47 a licensing agency or by a certifying professional organization;
5-48 and
5-49 (5) not have engaged in fraud or deceit in applying
5-50 for a license under this chapter.
5-51 (b) In addition to meeting the requirements of Subsection
5-52 (a), a person must:
5-53 (1) pass the examination required by Section 206.204;
5-54 (2) hold at least an associate's degree based on
5-55 completion of an educational program that is substantially
5-56 equivalent to the education required for a registered nurse or
5-57 physician assistant who specializes in surgical assisting;
5-58 (3) demonstrate to the satisfaction of the medical
5-59 board the completion of full-time work experience performed in this
5-60 country under the direct supervision of a physician licensed in
5-61 this country and consisting of at least 2,000 hours of performance
5-62 as an assistant in surgical procedures for the three years
5-63 preceding the date of application; and
5-64 (4) possess a current certification by a national
5-65 certifying body approved by the medical board.
5-66 (c) A degree program described by Subsection (b)(2) must
5-67 contain a clinical component and must include courses in anatomy,
5-68 physiology, basic pharmacology, aseptic techniques, operative
5-69 procedures, chemistry, microbiology, and pathophysiology.
6-1 Sec. 206.204. EXAMINATION. An applicant for a surgical
6-2 assistant license must pass a surgical assistant examination
6-3 approved by the medical board. Any written portion of the
6-4 examination must be validated by an independent testing
6-5 professional.
6-6 Sec. 206.205. SPECIAL ELIGIBILITY FOR LICENSE. (a) A person
6-7 who is otherwise eligible for a license under Section 206.203 is
6-8 not required to take the examination required by Section
6-9 206.203(b)(1) if the person:
6-10 (1) passed a surgical assistant examination required
6-11 for certification under Section 206.203(b)(4) that the medical
6-12 board determines is substantially equivalent to the examination
6-13 required by the medical board under this chapter; and
6-14 (2) applies for a license under this section before
6-15 September 1, 2002.
6-16 (b) A person who is otherwise eligible for a license under
6-17 Section 206.203 is not required to meet the educational
6-18 requirements under Section 206.203(b)(2) if the person applies for
6-19 a license under this section before September 1, 2002, and:
6-20 (1) will complete before the third anniversary of the
6-21 date the license is issued under this subsection the following
6-22 academic courses approved by the medical board:
6-23 (A) anatomy;
6-24 (B) physiology;
6-25 (C) basic pharmacology;
6-26 (D) aseptic techniques;
6-27 (E) operative procedures;
6-28 (F) chemistry; and
6-29 (G) microbiology; or
6-30 (2) has been continuously certified after September
6-31 30, 1995, as a surgical assistant by a national certifying body
6-32 approved by the medical board and has practiced full-time as a
6-33 surgical assistant under the direct supervision of a physician
6-34 licensed in this country.
6-35 (c) A license issued under Subsection (b)(1) may not be
6-36 renewed after the third anniversary of the date of issuance unless
6-37 the license holder completes the academic courses described by
6-38 Subsection (b)(1).
6-39 Sec. 206.206. TEMPORARY LICENSE. (a) The medical board
6-40 may, through the executive director, issue a temporary license to
6-41 an applicant who:
6-42 (1) submits an application on a form prescribed by the
6-43 medical board;
6-44 (2) has passed an examination required by the medical
6-45 board relating to the practice of surgical assisting;
6-46 (3) pays the appropriate fee set by the medical board;
6-47 (4) if licensed in another state, is licensed in good
6-48 standing; and
6-49 (5) meets all the qualifications for a license under
6-50 this chapter and is waiting for the next scheduled meeting of the
6-51 medical board for the license to be issued.
6-52 (b) A temporary license is valid until the 100th day after
6-53 the date issued and may be extended until the 130th day after the
6-54 date issued.
6-55 Sec. 206.207. ASSISTANCE BY MEDICAL BOARD. The medical
6-56 board shall provide administrative and clerical employees as
6-57 necessary to administer this subchapter.
6-58 Sec. 206.208. FEES. (a) The medical board shall set and
6-59 collect fees in amounts that are reasonable and necessary to cover
6-60 the costs of administering and enforcing this chapter without the
6-61 use of any other funds generated by the medical board.
6-62 (b) Fees collected by the medical board under this chapter
6-63 shall be deposited by the medical board in the state treasury to
6-64 the credit of an account in the general revenue fund and may be
6-65 spent to cover the costs of administering and enforcing this
6-66 chapter. At the end of each fiscal biennium, the comptroller shall
6-67 transfer any surplus money remaining in the account to the general
6-68 revenue fund.
6-69 (c) All money paid to the medical board under this chapter
7-1 is subject to Subchapter F, Chapter 404, Government Code.
7-2 Sec. 206.209. ISSUANCE AND RENEWAL OF LICENSE. The medical
7-3 board shall issue a surgical assistant license in this state to a
7-4 person who meets the requirements of this chapter and the rules
7-5 adopted under this chapter.
7-6 Sec. 206.210. LICENSE RENEWAL. (a) The medical board by
7-7 rule shall provide for the annual renewal of a surgical assistant
7-8 license.
7-9 (b) The medical board by rule may adopt a system under which
7-10 licenses expire on various dates during the year. For the year in
7-11 which the license expiration date is changed, license fees shall be
7-12 prorated on a monthly basis so that each license holder pays only
7-13 that portion of the license fee that is allocable to the number of
7-14 months during which the license is valid. On renewal of the license
7-15 on the new expiration date, the total license renewal fee is
7-16 payable.
7-17 Sec. 206.211. NOTICE OF LICENSE RENEWAL. At least 30 days
7-18 before the expiration of a person's license, the medical board
7-19 shall send written notice of the impending license expiration to
7-20 the person at the license holder's last known address according to
7-21 the records of the medical board.
7-22 Sec. 206.212. PROCEDURE FOR RENEWAL. (a) A person who is
7-23 otherwise eligible to renew a license may renew an unexpired
7-24 license by paying the required renewal fee to the medical board
7-25 before the expiration date of the license. A person whose license
7-26 has expired may not engage in activities that require a license
7-27 until the license has been renewed under this section.
7-28 (b) If the person's license has been expired for 90 days or
7-29 less, the person may renew the license by paying to the medical
7-30 board one and one-half times the required renewal fee.
7-31 (c) If the person's license has been expired for longer than
7-32 90 days but less than one year, the person may renew the license by
7-33 paying to the medical board two times the required renewal fee.
7-34 (d) If the person's license has been expired for one year or
7-35 longer, the person may not renew the license. The person may
7-36 obtain a new license by complying with the requirements and
7-37 procedures for obtaining an original license.
7-38 Sec. 206.213. RENEWAL OF EXPIRED LICENSE BY OUT-OF-STATE
7-39 PRACTITIONER. (a) If the person was licensed as a surgical
7-40 assistant in this state, moved to another state, and is currently
7-41 licensed as a surgical assistant and has been in practice as a
7-42 surgical assistant in the other state for the two years preceding
7-43 application, the person may renew an expired surgical assistant
7-44 license without reexamination.
7-45 (b) The person must pay to the medical board a fee that is
7-46 equal to two times the required renewal fee for the license.
7-47 Sec. 206.214. LICENSE HOLDER INFORMATION. (a) Each license
7-48 holder shall file with the medical board:
7-49 (1) the license holder's mailing address;
7-50 (2) the address of the license holder's residence;
7-51 (3) the mailing address of each of the license
7-52 holder's offices; and
7-53 (4) the address for the location of each of the
7-54 license holder's offices if that address is different from the
7-55 office's mailing address.
7-56 (b) A license holder shall:
7-57 (1) notify the medical board of a change of the
7-58 license holder's residence or business address; and
7-59 (2) provide the medical board with the license
7-60 holder's new address not later than the 30th day after the date the
7-61 address change occurs.
7-62 (Sections 206.215-206.250 reserved for expansion
7-63 SUBCHAPTER F. SCOPE OF PRACTICE
7-64 Sec. 206.251. SCOPE OF PRACTICE. (a) The practice of a
7-65 surgical assistant is limited to surgical assisting performed under
7-66 the direct supervision of a physician who delegated the acts.
7-67 (b) The practice of a surgical assistant may be performed in
7-68 any place authorized by a delegating licensed physician, including
7-69 a clinic, hospital, ambulatory surgical center, or other
8-1 institutional setting.
8-2 Sec. 206.252. SERVICE CONTRACTS. This chapter does not:
8-3 (1) limit the employment arrangement of a surgical
8-4 assistant licensed under this chapter;
8-5 (2) require a surgeon or hospital to contract with a
8-6 surgical assistant;
8-7 (3) authorize a health maintenance organization,
8-8 preferred provider organization, or health benefit plan to require
8-9 a surgeon to contract with a surgical assistant; or
8-10 (4) require a hospital to use a licensed surgical
8-11 assistant for surgical assisting.
8-12 Sec. 206.253. CERTAIN PROHIBITED PRACTICES. (a) This
8-13 chapter does not authorize a person who holds a license issued
8-14 under this chapter to engage in the practice of:
8-15 (1) medicine, as defined by Subtitle B, Title 3,
8-16 Occupations Code;
8-17 (2) professional nursing, as defined by Chapter 301,
8-18 Occupations Code; or
8-19 (3) nursing, as defined by Chapter 302, Occupations
8-20 Code.
8-21 (b) A health maintenance organization, preferred provider
8-22 organization, or health benefit plan may not require a registered
8-23 nurse or physician assistant to be licensed as a surgical assistant
8-24 as a condition for reimbursement.
8-25 (c) A clinic, hospital, ambulatory surgical center, or other
8-26 facility may not require a registered nurse or physician assistant
8-27 to be licensed as a surgical assistant as a condition for assisting
8-28 at surgery at the facility.
8-29 Sec. 206.254. ESTABLISHMENT OF CERTAIN FUNCTIONS AND
8-30 STANDARDS. A surgical assistant and the surgical assistant's
8-31 delegating physician shall ensure that:
8-32 (1) the surgical assistant's scope of function is
8-33 identified;
8-34 (2) the delegation of medical tasks is appropriate to
8-35 the surgical assistant's level of competence;
8-36 (3) the relationship between the surgical assistant
8-37 and the delegating physician and the access of the surgical
8-38 assistant to the delegating physician are defined; and
8-39 (4) a process is established for evaluating the
8-40 surgical assistant's performance.
8-41 (Sections 206.255-206.300 reserved for expansion
8-42 SUBCHAPTER G. DISCIPLINARY PROCEEDINGS
8-43 Sec. 206.301. DISCIPLINARY ACTIONS BY THE MEDICAL BOARD. (a)
8-44 Except as provided by Section 206.305, on a determination that an
8-45 applicant or license holder committed an act described by Section
8-46 206.302, 206.303, or 206.304, the medical board by order shall take
8-47 any of the following actions:
8-48 (1) deny the person's license application or revoke
8-49 the person's license;
8-50 (2) require the person to submit to the care,
8-51 counseling, or treatment of a health care practitioner designated
8-52 by the medical board;
8-53 (3) stay enforcement of an order and place the person
8-54 on probation;
8-55 (4) require the person to complete additional
8-56 training;
8-57 (5) suspend, limit, or restrict the person's license,
8-58 including:
8-59 (A) limiting the practice of the person to, or
8-60 excluding from the person's practice, one or more specified
8-61 activities of surgical assisting; or
8-62 (B) stipulating periodic medical board review;
8-63 (6) assess an administrative penalty against the
8-64 person as provided by Section 206.351;
8-65 (7) order the person to perform public service; or
8-66 (8) administer a public reprimand.
8-67 (b) If the medical board stays enforcement of an order and
8-68 places a person on probation, the medical board retains the right
8-69 to vacate the probationary stay and enforce the original order for
9-1 noncompliance with the terms of probation or impose any other
9-2 remedial measure or sanction authorized by this section.
9-3 (c) The medical board may restore or reissue a license or
9-4 remove any disciplinary or corrective measure that the medical
9-5 board has imposed.
9-6 Sec. 206.302. CONDUCT RELATED TO FRAUD OR MISREPRESENTATION.
9-7 The medical board may take action under Section 206.301 against an
9-8 applicant or license holder who:
9-9 (1) fraudulently or deceptively obtains or attempts to
9-10 obtain a license;
9-11 (2) fraudulently or deceptively uses a license;
9-12 (3) falsely represents that the person is a physician;
9-13 (4) acts in an unprofessional or dishonorable manner
9-14 that is likely to deceive, defraud, or injure the public;
9-15 (5) fraudulently alters any surgical assistant
9-16 license, certificate, or diploma;
9-17 (6) uses any surgical assistant license, certificate,
9-18 or diploma that has been fraudulently purchased, issued, or
9-19 counterfeited or that has been materially altered;
9-20 (7) directly or indirectly aids or abets the practice
9-21 as a surgical assistant by any person not licensed by the medical
9-22 board to practice as a surgical assistant; or
9-23 (8) unlawfully advertises in a false, misleading, or
9-24 deceptive manner as defined by Section 101.201.
9-25 Sec. 206.303. CONDUCT RELATED TO VIOLATION OF LAW. (a) The
9-26 medical board may take action under Section 206.301 against an
9-27 applicant or license holder who:
9-28 (1) violates this chapter or a rule adopted under this
9-29 chapter;
9-30 (2) is convicted of a felony, placed on deferred
9-31 adjudication, or placed in a pretrial diversion program; or
9-32 (3) violates state law if the violation is connected
9-33 with practice as a surgical assistant.
9-34 (b) A complaint, indictment, or conviction of a law
9-35 violation is not necessary for the medical board to act under
9-36 Subsection (a)(3). Proof of the commission of the act while in
9-37 practice as a surgical assistant or under the guise of practice as
9-38 a surgical assistant is sufficient for action by the medical board.
9-39 Sec. 206.304. CONDUCT INDICATING LACK OF FITNESS. (a) The
9-40 medical board may take action under Section 206.301 against an
9-41 applicant or license holder who:
9-42 (1) habitually uses drugs or intoxicating liquors to
9-43 the extent that, in the medical board's opinion, the person cannot
9-44 safely perform as a surgical assistant;
9-45 (2) has been adjudicated as mentally incompetent;
9-46 (3) has a mental or physical condition that renders
9-47 the person unable to safely perform as a surgical assistant;
9-48 (4) has committed an act of moral turpitude;
9-49 (5) has failed to practice as a surgical assistant in
9-50 an acceptable manner consistent with public health and welfare;
9-51 (6) has had the person's license or other
9-52 authorization to practice as a surgical assistant suspended,
9-53 revoked, or restricted;
9-54 (7) has had other disciplinary action taken by another
9-55 state or by the uniformed services of the United States regarding
9-56 practice as a surgical assistant;
9-57 (8) is removed or suspended or has disciplinary action
9-58 taken by the person's peers in any professional association or
9-59 society or is being disciplined by a licensed hospital or medical
9-60 staff of a hospital, including removal, suspension, limitation of
9-61 privileges, or other disciplinary action, if that action, in the
9-62 opinion of the medical board, was based on unprofessional conduct
9-63 or professional incompetence that was likely to harm the public;
9-64 (9) has repeated or recurring meritorious health care
9-65 liability claims that, in the medical board's opinion, are evidence
9-66 of professional incompetence likely to harm the public; or
9-67 (10) sexually abuses or exploits another person during
9-68 the license holder's practice as a surgical assistant.
9-69 (b) For the purpose of Subsection (a)(7), a certified copy
10-1 of the record of the state or uniformed services of the United
10-2 States taking the action constitutes conclusive evidence of that
10-3 action.
10-4 (c) An action described by Subsection (a)(8) does not
10-5 constitute state action on the part of the association, society, or
10-6 hospital medical staff.
10-7 Sec. 206.305. REHABILITATION ORDER. The medical board,
10-8 through an agreed order or after a contested case proceeding, may
10-9 impose a rehabilitation order on an applicant, as a prerequisite
10-10 for issuing a license, or on a license holder based on:
10-11 (1) the person's intemperate use of drugs or alcohol
10-12 directly resulting from habituation or addiction caused by medical
10-13 care or treatment provided by a physician;
10-14 (2) the person's intemperate use of drugs or alcohol
10-15 during the five years preceding the date of the report that could
10-16 adversely affect the person's ability to safely practice as a
10-17 surgical assistant, if the person:
10-18 (A) reported the use; and
10-19 (B) has not previously been the subject of a
10-20 substance abuse related order of the medical board;
10-21 (3) a judgment by a court that the person is of
10-22 unsound mind; or
10-23 (4) the results of a mental or physical examination,
10-24 or an admission by the person, indicating that the person suffers
10-25 from a potentially dangerous limitation or an inability to practice
10-26 as a surgical assistant with reasonable skill and safety because of
10-27 illness or any other physical or mental condition.
10-28 Sec. 206.306. EFFECT OF REHABILITATION ORDER. (a) A
10-29 rehabilitation order imposed under Section 206.305 is a
10-30 nondisciplinary private order. If entered into by agreement, the
10-31 order is an agreed disposition or settlement agreement for purposes
10-32 of civil litigation and is exempt from Chapter 552, Government
10-33 Code.
10-34 (b) The rehabilitation order must contain findings of fact
10-35 and conclusions of law. The order may impose a license revocation
10-36 or suspension, a period of probation or restriction, or any other
10-37 sanction authorized by this chapter or agreed to by the medical
10-38 board and the person subject to the order.
10-39 (c) A violation of a rehabilitation order may result in
10-40 disciplinary action under this chapter or under the terms of the
10-41 agreed order.
10-42 (d) A violation of a rehabilitation order is grounds for
10-43 disciplinary action based on:
10-44 (1) unprofessional or dishonorable conduct; or
10-45 (2) any provision of this chapter that applies to the
10-46 conduct that resulted in the violation.
10-47 Sec. 206.307. AUDIT OF REHABILITATION ORDER. (a) The
10-48 medical board shall maintain a rehabilitation order imposed under
10-49 Section 206.305 in a confidential file. The file is subject to an
10-50 independent audit by the state auditor or a private auditor with
10-51 whom the board contracts to perform the audit to ensure that only
10-52 qualified license holders are subject to rehabilitation orders.
10-53 (b) An audit may be performed at any time at the direction
10-54 of the medical board. The medical board shall ensure that an audit
10-55 is performed at least once in each three-year period.
10-56 (c) The audit results are a matter of public record and
10-57 shall be reported in a manner that maintains the confidentiality of
10-58 each license holder who is the subject of a rehabilitation order.
10-59 Sec. 206.308. SUBPOENA. (a) The executive director, the
10-60 director's designee, or the secretary-treasurer of the board may
10-61 issue a subpoena or subpoena duces tecum:
10-62 (1) to conduct an investigation or a contested case
10-63 proceeding related to:
10-64 (A) alleged misconduct by a surgical assistant;
10-65 (B) an alleged violation of this chapter or
10-66 another law related to the practice of a surgical assistant; or
10-67 (C) the provision of health care under this
10-68 chapter;
10-69 (2) for purposes of determining whether to issue,
11-1 suspend, restrict, or revoke a license under this chapter; or
11-2 (3) for purposes of determining whether to issue or
11-3 deny a license under this chapter.
11-4 (b) Failure to timely comply with a subpoena issued under
11-5 this section is a ground for:
11-6 (1) disciplinary action by the medical board or
11-7 another licensing or regulatory agency with jurisdiction over the
11-8 person subject to the subpoena; and
11-9 (2) denial of a license application.
11-10 Sec. 206.309. PROTECTION OF PATIENT IDENTITY. In a
11-11 disciplinary investigation or proceeding conducted under this
11-12 chapter, the medical board shall protect the identity of each
11-13 patient whose medical records are examined and used in a public
11-14 proceeding unless the patient:
11-15 (1) testifies in the public proceeding; or
11-16 (2) submits a written release in regard to the
11-17 patient's records or identity.
11-18 Sec. 206.310. RULES FOR DISCIPLINARY PROCEEDINGS. Rules of
11-19 practice adopted under this chapter by the medical board under
11-20 Section 2001.004, Government Code, applicable to the proceedings
11-21 for a disciplinary action may not conflict with rules adopted by
11-22 the State Office of Administrative Hearings.
11-23 Sec. 206.311. REQUIRED SUSPENSION OF INCARCERATED SURGICAL
11-24 ASSISTANT. Regardless of the offense, the medical board shall
11-25 suspend the license of a surgical assistant serving a prison term
11-26 in a state or federal penitentiary during the term of the
11-27 incarceration.
11-28 Sec. 206.312. TEMPORARY SUSPENSION. (a) The president of
11-29 the medical board, with medical board approval, shall appoint a
11-30 three-member disciplinary panel consisting of medical board members
11-31 to determine whether a surgical assistant's license should be
11-32 temporarily suspended.
11-33 (b) If the disciplinary panel determines from the evidence
11-34 or information presented to the panel that a person licensed to
11-35 practice as a surgical assistant would, by the person's
11-36 continuation in practice, constitute a continuing threat to the
11-37 public welfare, the disciplinary panel shall temporarily suspend
11-38 the license of that person.
11-39 (c) A license may be suspended under this section without
11-40 notice or hearing on the complaint if:
11-41 (1) institution of proceedings for a hearing before
11-42 the medical board is initiated simultaneously with the temporary
11-43 suspension; and
11-44 (2) a hearing is held under Chapter 2001, Government
11-45 Code, and this chapter as soon as possible.
11-46 (d) Notwithstanding Chapter 551, Government Code, the
11-47 disciplinary panel may hold a meeting by telephone conference call
11-48 if immediate action is required and convening the disciplinary
11-49 panel at one location is inconvenient for any member of the panel.
11-50 (Sections 206.313-206.350 reserved for expansion
11-51 SUBCHAPTER H. ADMINISTRATIVE PENALTY
11-52 Sec. 206.351. ADMINISTRATIVE PENALTY. (a) The medical board
11-53 by order may impose an administrative penalty against a person
11-54 licensed under this chapter who violates this chapter or a rule or
11-55 order adopted under this chapter.
11-56 (b) The penalty may be in an amount not to exceed $5,000.
11-57 Each day a violation continues or occurs is a separate violation
11-58 for purposes of imposing a penalty.
11-59 (c) The medical board shall base the amount of the penalty
11-60 on:
11-61 (1) the severity of patient harm;
11-62 (2) the severity of economic harm to any person;
11-63 (3) the severity of any environmental harm;
11-64 (4) the increased potential for harm to the public;
11-65 (5) any attempted concealment of misconduct;
11-66 (6) any premeditated or intentional misconduct;
11-67 (7) the motive for the violation;
11-68 (8) any prior misconduct of a similar or related
11-69 nature;
12-1 (9) the license holder's disciplinary history;
12-2 (10) any prior written warnings or written
12-3 admonishments from any government agency or official regarding
12-4 statutes or rules relating to the misconduct;
12-5 (11) whether the violation is of a board order;
12-6 (12) the person's failure to implement remedial
12-7 measures to correct or mitigate harm from the misconduct;
12-8 (13) the person's lack of rehabilitative potential or
12-9 likelihood of future misconduct of a similar nature;
12-10 (14) any relevant circumstances increasing the
12-11 seriousness of the misconduct; and
12-12 (15) any other matter that justice may require.
12-13 (d) The medical board by rule shall prescribe the procedures
12-14 by which it may impose an administrative penalty. A proceeding
12-15 under this section is subject to Chapter 2001, Government Code.
12-16 (e) If the medical board by order determines that a
12-17 violation has occurred and imposes an administrative penalty, the
12-18 medical board shall give notice to the person of the order. The
12-19 notice must include a statement of the person's right to judicial
12-20 review of the order.
12-21 SECTION 2. Subsection (B), Section 2, Chapter 397, Acts of
12-22 the 54th Legislature, Regular Session, 1955 (Article 3.70-2,
12-23 Vernon's Texas Insurance Code), is amended to read as follows:
12-24 (B) No policy of accident and sickness insurance shall make
12-25 benefits contingent upon treatment or examination by a particular
12-26 practitioner or by particular practitioners of the healing arts
12-27 hereinafter designated unless such policy contains a provision
12-28 designating the practitioner or practitioners who will be
12-29 recognized by the insurer and those who will not be recognized by
12-30 the insurer. Such provision may be located in the "Exceptions" or
12-31 "Exceptions and Reductions" provisions, or elsewhere in the policy,
12-32 or by endorsement attached to the policy, at the insurer's option.
12-33 In designating the practitioners who will and will not be
12-34 recognized, such provision shall use the following terms: Doctor
12-35 of Medicine, Doctor of Osteopathy, Doctor of Dentistry, Doctor of
12-36 Chiropractic, Doctor of Optometry, Doctor of Podiatry, Licensed
12-37 Audiologist, Licensed Speech-language Pathologist, Doctor in
12-38 Psychology, Licensed Master Social Worker--Advanced Clinical
12-39 Practitioner, Licensed Dietitian, Licensed Professional Counselor,
12-40 Licensed Marriage and Family Therapist, Licensed Chemical
12-41 Dependency Counselor, Licensed Hearing Instrument Fitter and
12-42 Dispenser, Advanced Practice Nurse, Physician Assistant, Licensed
12-43 Occupational Therapist, Licensed Physical Therapist, Licensed
12-44 Acupuncturist, [and] Licensed Psychological Associate, and Licensed
12-45 Surgical Assistant.
12-46 For purposes of this Act, such designations shall have the
12-47 following meanings:
12-48 Doctor of Medicine: One licensed by the Texas State Board of
12-49 Medical Examiners on the basis of the degree "Doctor of Medicine";
12-50 Doctor of Osteopathy: One licensed by the Texas State Board
12-51 of Medical Examiners on the basis of the degree of "Doctor of
12-52 Osteopathy";
12-53 Doctor of Dentistry: One licensed by the State Board of
12-54 Dental Examiners;
12-55 Doctor of Chiropractic: One licensed by the Texas Board of
12-56 Chiropractic Examiners;
12-57 Doctor of Optometry: One licensed by the Texas Optometry
12-58 Board;
12-59 Doctor of Podiatry: One licensed by the Texas State Board of
12-60 Podiatric Medical Examiners;
12-61 Licensed Audiologist: One with a master's or doctorate
12-62 degree in audiology from an accredited college or university and
12-63 who is licensed as an audiologist by the State Board of Examiners
12-64 for Speech-Language Pathology and Audiology;
12-65 Licensed Speech-language Pathologist: One with a master's or
12-66 doctorate degree in speech pathology or speech-language pathology
12-67 from an accredited college or university and who is licensed as a
12-68 speech-language pathologist by the State Board of Examiners for
12-69 Speech-Language Pathology and Audiology;
13-1 Doctor in Psychology: One licensed by the Texas State Board
13-2 of Examiners of Psychologists and certified as a Health Service
13-3 Provider;
13-4 Licensed Master Social Worker--Advanced Clinical
13-5 Practitioner: One licensed by the Texas State Board of Social
13-6 Worker Examiners as a Licensed Master Social Worker with the order
13-7 of recognition of Advanced Clinical Practitioner;
13-8 Licensed Dietitian: One licensed by the Texas State Board of
13-9 Examiners of Dietitians;
13-10 Licensed Professional Counselor: One licensed by the Texas
13-11 State Board of Examiners of Professional Counselors;
13-12 Licensed Marriage and Family Therapist: One licensed by the
13-13 Texas State Board of Examiners of Marriage and Family Therapists;
13-14 Licensed Chemical Dependency Counselor: One licensed by the
13-15 Texas Commission on Alcohol and Drug Abuse;
13-16 Licensed Hearing Instrument Fitter and Dispenser: One
13-17 licensed by the State Committee of Examiners in the Fitting and
13-18 Dispensing of Hearing Instruments;
13-19 Advanced Practice Nurse: One licensed by the Board of Nurse
13-20 Examiners as a registered nurse and recognized by that board as an
13-21 advanced practice nurse;
13-22 Physician Assistant: One licensed by the Texas State Board
13-23 of Physician Assistant Examiners;
13-24 Licensed Occupational Therapist: One licensed by the Texas
13-25 Board of Occupational Therapy Examiners;
13-26 Licensed Physical Therapist: One licensed by the Texas Board
13-27 of Physical Therapy Examiners;
13-28 Licensed Acupuncturist: One licensed by the Texas State
13-29 Board of Medical Examiners as an acupuncturist; [and]
13-30 Licensed Psychological Associate: One licensed by the Texas
13-31 State Board of Examiners of Psychologists and practicing under the
13-32 supervision of a licensed psychologist; and
13-33 Licensed Surgical Assistant: One licensed by the Texas State
13-34 Board of Medical Examiners as a surgical assistant.
13-35 SECTION 3. Section 1, Article 21.52, Insurance Code, is
13-36 amended by adding Subsection (u) to read as follows:
13-37 (u) "Surgical assistant" means a person licensed by the
13-38 Texas State Board of Medical Examiners as a surgical assistant.
13-39 SECTION 4. Section 3(a), Article 21.52, Insurance Code, as
13-40 amended by Chapters 428 and 888, Acts of the 76th Legislature,
13-41 Regular Session, 1999, is amended to read as follows:
13-42 (a) Any person who is issued, who is a party to, or who is a
13-43 beneficiary under any health insurance policy delivered, renewed,
13-44 or issued for delivery in this state by any insurance company,
13-45 association, or organization to which this article applies may
13-46 select:
13-47 (1) a licensed doctor of podiatric medicine, a
13-48 licensed dentist, or a doctor of chiropractic to perform the
13-49 medical or surgical services or procedures scheduled in the policy
13-50 which fall within the scope of the license of that practitioner;
13-51 (2) a licensed doctor of optometry to perform the
13-52 services or procedures scheduled in the policy which fall within
13-53 the scope of the license of that doctor of optometry;
13-54 (3) an occupational therapist to provide the services
13-55 scheduled in the policy which fall within the scope of the license
13-56 of that occupational therapist;
13-57 (4) a physical therapist to provide the services
13-58 scheduled in the policy which fall within the scope of the license
13-59 of that physical therapist;
13-60 (5) a licensed audiologist to measure hearing for the
13-61 purpose of determining the presence or extent of a hearing loss and
13-62 to provide aural rehabilitation services to a person with a hearing
13-63 loss if those services or procedures are scheduled in the policy;
13-64 (6) a licensed speech-language pathologist to evaluate
13-65 speech and language and to provide habilitative and rehabilitative
13-66 services to restore speech or language loss or to correct a speech
13-67 or language impairment if those services or procedures are
13-68 scheduled in the policy;
13-69 (7) a licensed master social worker--advanced clinical
14-1 practitioner to provide the services that fall within the scope of
14-2 the license of such certified practitioner and which are specified
14-3 as services within the terms of the policy of insurance, including
14-4 the provision of direct, diagnostic, preventive, or clinical
14-5 services to individuals, families, and groups whose functioning is
14-6 threatened or affected by social or psychological stress or health
14-7 impairment, if those services or procedures are scheduled in the
14-8 policy;
14-9 (8) a licensed dietitian including a provisional
14-10 licensed dietitian under a licensed dietitian's supervision to
14-11 provide the services that fall within the scope of the license of
14-12 that dietitian if those services are scheduled in the policy;
14-13 (9) a licensed professional counselor to provide the
14-14 services that fall within the scope of the license of that
14-15 professional if those services are scheduled in the policy;
14-16 (10) a licensed marriage and family therapist to
14-17 provide the services that fall within the scope of the license of
14-18 that professional if those services are scheduled in the policy;
14-19 (11) a psychologist to perform the services or
14-20 procedures scheduled in the policy that fall within the scope of
14-21 the license of that psychologist;
14-22 (12) a licensed chemical dependency counselor to
14-23 perform the services or procedures scheduled in the policy that
14-24 fall within the scope of the license of that practitioner;
14-25 (13) [(12)] a licensed acupuncturist to perform the
14-26 services or procedures scheduled in the policy that fall within the
14-27 scope of the license of that practitioner;
14-28 (14) [(13)] an advanced practice nurse to provide the
14-29 services scheduled in the policy that fall within the scope of the
14-30 license of that practitioner;
14-31 (15) [(14)] a physician assistant to provide the
14-32 services scheduled in the policy that fall within the scope of the
14-33 license of that practitioner;
14-34 (16) [(15)] a licensed hearing instrument fitter and
14-35 dispenser to provide the services or procedures scheduled in the
14-36 policy that fall within the scope of the license of that
14-37 practitioner;
14-38 (17) a licensed surgical assistant to provide the
14-39 services or procedures scheduled in the policy that fall within the
14-40 scope of the license of that practitioner; or
14-41 (18) [(16)] a licensed psychological associate to
14-42 provide the services that fall within the scope of the license of
14-43 that professional if those services are scheduled in the policy.
14-44 SECTION 5. Section 3(d), Article 21.52, Insurance Code, is
14-45 amended to read as follows:
14-46 (d) There shall not be any classification, differentiation,
14-47 or other discrimination in the payment schedule or the payment
14-48 provisions in a health insurance policy, nor in the amount or
14-49 manner of payment or reimbursement thereunder, between scheduled
14-50 services or procedures when performed by a doctor of podiatric
14-51 medicine, a doctor of optometry, a doctor of chiropractic, a
14-52 licensed dentist, an occupational therapist, a physical therapist,
14-53 a licensed audiologist, a licensed speech-language pathologist, a
14-54 licensed master social worker--advanced clinical practitioner, a
14-55 licensed dietitian, a licensed professional counselor, a licensed
14-56 marriage and family therapist, a psychologist, a licensed
14-57 psychological associate, a licensed chemical dependency counselor,
14-58 an advanced practice nurse to provide the services scheduled in the
14-59 policy, a physician assistant to provide the services scheduled in
14-60 the policy, a licensed acupuncturist, or a licensed hearing
14-61 instrument fitter and dispenser which fall within the scope of that
14-62 practitioner's license or certification and the same services or
14-63 procedures when performed by any other practitioner of the healing
14-64 arts whose services or procedures are covered by the policy.
14-65 However, a health insurance policy may provide for a different
14-66 amount of payment or reimbursement for scheduled services or
14-67 procedures when performed by an advanced practice nurse, licensed
14-68 surgical assistant, or physician assistant provided the
14-69 reimbursement methodology used to calculate the payment for the
15-1 service or procedure is the same methodology used to calculate the
15-2 payment when the service or procedure is provided by a physician.
15-3 SECTION 6. (a) Notwithstanding Section 206.201 and
15-4 Subchapter H, Chapter 206, Occupations Code, as added by this Act,
15-5 a person is not required to obtain a license under Chapter 206,
15-6 Occupations Code, as added by this Act, until September 1, 2002.
15-7 (b) The Texas State Board of Medical Examiners shall adopt
15-8 rules under Chapter 206, Occupations Code, as added by this Act,
15-9 not later than January 1, 2002.
15-10 SECTION 7. Section 2, Chapter 397, Acts of the 54th
15-11 Legislature, Regular Session, 1955 (Article 3.70-2, Vernon's Texas
15-12 Insurance Code), and Article 21.52, Insurance Code, as amended by
15-13 this Act, apply only to an insurance policy, contract, or evidence
15-14 of coverage delivered, issued for delivery, or renewed on or after
15-15 January 1, 2003. A policy, contract, or evidence of coverage
15-16 delivered, issued for delivery, or renewed before January 1, 2003,
15-17 is governed by the law as it existed immediately before the
15-18 effective date of this Act, and that law is continued in effect for
15-19 that purpose.
15-20 SECTION 8. This Act takes effect September 1, 2001.
15-21 * * * * *