82R5053 NC-D
 
  By: Brown H.B. No. 1013
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the powers and duties of the Texas Medical Board.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 152.002(a), Occupations Code, is amended
  to read as follows:
         (a)  The board consists of 19 members appointed by the
  governor with the advice and consent of the senate as follows:
               (1)  twelve members who are learned and eminent
  physicians licensed in this state for at least five [three] years
  before the appointment, nine of whom must be graduates of a
  reputable medical school or college with a degree of doctor of
  medicine (M.D.) and three of whom must be graduates of a reputable
  medical school or college with a degree of doctor of osteopathic
  medicine (D.O.); and
               (2)  seven members who represent the public.
         SECTION 2.  Section 152.003, Occupations Code, is amended by
  adding Subsections (e) and (f) to read as follows:
         (e)  A person may not be a member of the board if the member
  is not in full compliance with Section 572.051, Government Code. A
  person is not in full compliance with that section if the person's
  spouse or anyone related to the person within the second degree by
  consanguinity engages in conduct described by Section 572.051(a),
  Government Code, that would affect or influence the person's
  official conduct, position, powers, or duties as a member of the
  board in a manner prohibited by that section.
         (f)  A member of the board may not participate in any matter
  regarding a license holder if the person or anyone related to the
  person within the second degree by consanguinity receives
  compensation from an entity, other than a medical practice, that
  has a financial interest in common with or adverse to the license
  holder, including an insurance company, health care regulatory
  agency, pharmaceutical company, or medical malpractice attorney.
         SECTION 3.  Section 154.002(a), Occupations Code, is amended
  to read as follows:
         (a)  The board shall prepare:
               (1)  an alphabetical list of the names of the license
  holders;
               (2)  an alphabetical list of the names of the license
  holders by the county in which the license holder's principal place
  of practice is located;
               (3)  a summary of the board's functions;
               (4)  a copy of this subtitle and a list of other laws
  relating to the practice of medicine;
               (5)  a copy of the board's rules;
               (6)  a statistical report each fiscal year to the
  legislature and the public that provides aggregate information
  about all complaints received by the board categorized by type of
  complaint, including administrative, quality of care, medical
  error, substance abuse, other criminal behavior, and the
  disposition of those complaints by category; [and]
               (7)  a list of the names of all persons who served on an
  informal settlement conference panel during the preceding year and
  the number of informal settlement conference panels on which each
  person served; and
               (8)  other information considered appropriate by the
  board.
         SECTION 4.  Section 154.051, Occupations Code, is amended by
  adding Subsection (d) to read as follows:
         (d)  The board may not consider or act on a complaint
  involving care provided more than seven years before the date the
  complaint is filed, unless the care was provided to a minor. If the
  care was provided to a minor, the board may not consider or act on a
  complaint involving the care after the later of:
               (1)  the date the minor is 21 years of age; or
               (2)  the seventh anniversary of the date of care.
         SECTION 5.  Section 154.053, Occupations Code, is amended by
  amending Subsection (a) and adding Subsection (a-1) to read as
  follows:
         (a)  The board shall notify by personal delivery or certified
  mail a physician who is the subject of a complaint filed with the
  board that a complaint has been filed and shall provide [notify] the
  physician with a copy of the [nature of the] complaint without
  redaction unless there is a risk of harm to the public or the notice
  would jeopardize an investigation.  The complaint must include a
  statement of the alleged violation in plain language.
         (a-1)  If a physician rejects a notice by personal delivery
  or certified mail under Subsection (a), the board may send to the
  physician an additional notice of the complaint by first class mail
  that includes notice of the attempted delivery by personal delivery
  or certified mail.
         SECTION 6.  Subchapter B, Chapter 154, Occupations Code, is
  amended by adding Section 154.0535 to read as follows:
         Sec. 154.0535.  REQUIREMENTS FOR CERTAIN COMPLAINTS. (a)
  In this section:
               (1)  "Anonymous complaint" means a complaint that lacks
  sufficient information to identify the source or the name of the
  person who filed the complaint.
               (2)  "Insurance agent" means a person licensed under
  Chapter 4054, Insurance Code.
               (3)  "Insurer" means an insurance company or other
  entity authorized to engage in the business of insurance under
  Subtitle C, Title 6, Insurance Code.
         (b)  Notwithstanding any confidentiality requirements under
  Chapter 552, Government Code, this subtitle, or rules adopted under
  this subtitle, a complaint filed with the board by an insurance
  agent or insurer against a physician must include the name and
  address of the insurance agent or insurer filing the complaint.  Not
  later than the 15th day after the date the complaint is filed with
  the board, the board shall notify the physician who is the subject
  of the complaint of the name and address of the insurance agent or
  insurer who filed the complaint, unless the notice would jeopardize
  an investigation.
         (c)  The board may not accept anonymous complaints.
         (d)  The board shall adopt rules as necessary to implement
  this section.
         (e)  Failure by an insurance agent or insurer to comply with
  the requirements of Subsection (b) or rules adopted by the board
  under this section constitutes grounds for the imposition of
  sanctions by the commissioner of the Texas Department of Insurance
  under Chapter 82, Insurance Code.  The commissioner of insurance
  may adopt rules to implement this subsection.
         SECTION 7.  Sections 154.056(a), (b), and (e), Occupations
  Code, are amended to read as follows:
         (a)  The board shall adopt rules concerning the
  investigation and review of a complaint filed with the board. The
  rules adopted under this section must:
               (1)  distinguish among categories of complaints and
  give priority to complaints that involve sexual misconduct, quality
  of care, and impaired physician issues;
               (2)  ensure that a complaint is not dismissed without
  appropriate consideration;
               (3)  require that the board be advised of the dismissal
  of a complaint and that a letter be sent to the person who filed the
  complaint and to the physician who was the subject of the complaint
  explaining the action taken on the complaint;
               (4)  ensure that a person who files a complaint has an
  opportunity to explain the allegations made in the complaint;
               (5)  ensure that a physician who is the subject of a
  complaint has at least 45 days after receiving a copy of the
  complaint as provided by Section 154.053(a) to prepare and submit a
  response;
               (6)  prescribe guidelines concerning the categories of
  complaints that require the use of a private investigator and the
  procedures for the board to obtain the services of a private
  investigator;
               (7) [(6)]  provide for an expert physician panel
  authorized under Subsection (e) to assist with complaints and
  investigations relating to medical competency; and
               (8) [(7)]  require the review of reports filed with the
  National Practitioner Data Bank for any report of the termination,
  limitation, suspension, limitation in scope of practice, or
  probation of clinical or hospital staff privileges of a physician
  by:
                     (A)  a hospital;
                     (B)  a health maintenance organization;
                     (C)  an independent practice association;
                     (D)  an approved nonprofit health corporation
  certified under Section 162.001; or
                     (E)  a physician network.
         (b)  The board shall:
               (1)  dispose of each complaint in a timely manner; and
               (2)  establish a schedule for conducting each phase of
  a complaint that is under the control of the board not later than
  the 30th day after the date the physician's time for preparing and
  submitting a response expires [board receives the complaint].
         (e)  The board by rule shall provide for an expert physician
  panel appointed by the board to assist with complaints and
  investigations relating to medical competency by acting as expert
  physician reviewers.  Each member of the expert physician panel
  must be actively practicing [licensed to practice] medicine in this
  state.  The rules adopted under this subsection must include
  provisions governing the composition of the panel, qualifications
  for membership on the panel, length of time a member may serve on
  the panel, grounds for removal from the panel, the avoidance of
  conflicts of interest, including situations in which the affected
  physician and the panel member live or work in the same geographical
  area or are competitors, and the duties to be performed by the
  panel.  The board's rules governing grounds for removal from the
  panel must include providing for the removal of a panel member who
  is repeatedly delinquent in reviewing complaints and in submitting
  reports to the board.  The board's rules governing appointment of
  expert physician panel members to act as expert physician reviewers
  must include a requirement that the board randomly select, to the
  extent permitted by Section 154.058(b) and the conflict of interest
  provisions adopted under this subsection, panel members to review a
  complaint.
         SECTION 8.  Section 154.0561, Occupations Code, is amended
  by adding Subsections (a-1) and (e) to read as follows:
         (a-1)  Before the complaint is reviewed, the board must
  redact all information that identifies the physician who is the
  subject of the complaint, the patient, and the person filing the
  complaint.
         (e)  The board shall deliver a copy of the preliminary and
  final reports to the physician who is the subject of the review.
  Before delivering the reports to the physician, the board shall
  redact information identifying the expert physicians from the
  reports.
         SECTION 9.  Section 154.058(b), Occupations Code, is amended
  to read as follows:
         (b)  If the initial review under Subsection (a) indicates
  that an act by a physician falls below an acceptable standard of
  care, the complaint shall be reviewed by an expert physician panel
  authorized under Section 154.056(e) consisting of physicians who
  have an active practice in the same specialty as the physician who
  is the subject of the complaint or in another specialty that is
  similar to the physician's specialty.
         SECTION 10.  Section 164.001, Occupations Code, is amended
  by adding Subsections (k) and (l) to read as follows:
         (k)  A license holder may practice medicine in a manner
  taught in a course currently accredited by the Accreditation
  Council for Continuing Medical Education, the American Medical
  Association, or the American Osteopathic Association.
         (l)  The board may not direct a physician in the practice of
  medicine, except by ordering that a physician not engage in a
  practice that causes actual harm or an imminent risk of harm to a
  patient.
         SECTION 11.  Section 164.003, Occupations Code, is amended
  by adding Subsection (i) to read as follows:
         (i)  On request by a physician under review, the board shall
  make a recording of the informal settlement conference proceeding.
  The recording is a part of the investigative file and may not be
  released to a third party unless authorized under this subtitle.
         SECTION 12.  Section 164.0031(a), Occupations Code, is
  amended to read as follows:
         (a)  In an informal meeting under Section 164.003 or an
  informal hearing under Section 164.103, at least two panelists
  shall be randomly appointed to determine whether an informal
  disposition is appropriate.  At least one of the panelists must be a
  physician.
         SECTION 13.  Sections 164.007(a) and (a-1), Occupations
  Code, are amended to read as follows:
         (a)  The board by rule shall adopt procedures governing
  formal disposition of a contested case under Chapter 2001,
  Government Code. A formal hearing shall be conducted by an
  administrative law judge employed by the State Office of
  Administrative Hearings. After receiving the administrative law
  judge's findings of fact and conclusions of law, the board shall
  dispose of the contested case by issuing a final order based on the
  administrative law judge's findings of fact and conclusions of law
  [determine the charges on the merits].
         (a-1)  Notwithstanding Section 2001.058(e), Government
  Code, the [The] board may not change a finding of fact or conclusion
  of law or vacate or modify an order of the administrative law judge.
  The board may obtain judicial review of any finding of fact or
  conclusion of law issued by the administrative law judge as
  provided by Section 2001.058(f)(5), Government Code. For each
  case, the board has the sole authority and discretion to determine
  the appropriate action or sanction, and the administrative law
  judge may not make any recommendation regarding the appropriate
  action or sanction [only if the board makes a determination
  required by Section 2001.058(e), Government Code].
         SECTION 14.  Section 164.009, Occupations Code, is amended
  to read as follows:
         Sec. 164.009.  JUDICIAL REVIEW. (a) A person whose license
  to practice medicine has been revoked or who is subject to other
  disciplinary action by the board may appeal to a Travis County
  district court not later than the 30th day after the date the board
  decision is final.
         (b)  A person whose license to practice medicine has been
  revoked is entitled to a jury trial in a district court in Travis
  County.
         SECTION 15.  Section 164.053(a), Occupations Code, is
  amended to read as follows:
         (a)  For purposes of Section 164.052(a)(5), unprofessional
  or dishonorable conduct likely to deceive or defraud the public
  includes conduct in which a physician:
               (1)  commits an act that violates any state or federal
  law if the act is connected with the physician's practice of
  medicine;
               (2)  fails to keep complete and accurate records of
  purchases and disposals of:
                     (A)  drugs listed in Chapter 481, Health and
  Safety Code; or
                     (B)  controlled substances scheduled in the
  Comprehensive Drug Abuse Prevention and Control Act of 1970 (21
  U.S.C. Section 801 et seq.);
               (3)  writes prescriptions for or dispenses to a person
  who:
                     (A)  is known to be an abuser of narcotic drugs,
  controlled substances, or dangerous drugs; or
                     (B)  the physician should have known was an abuser
  of narcotic drugs, controlled substances, or dangerous drugs;
               (4)  writes false or fictitious prescriptions for:
                     (A)  dangerous drugs as defined by Chapter 483,
  Health and Safety Code; or
                     (B)  controlled substances scheduled in Chapter
  481, Health and Safety Code, or the Comprehensive Drug Abuse
  Prevention and Control Act of 1970 (21 U.S.C. Section 801 et seq.);
               (5)  prescribes or administers a drug or treatment that
  is nontherapeutic in nature or nontherapeutic in the manner the
  drug or treatment is administered or prescribed and has the
  likelihood of harm to a patient;
               (6)  prescribes, administers, or dispenses in a manner
  inconsistent with public health and welfare:
                     (A)  dangerous drugs as defined by Chapter 483,
  Health and Safety Code; or
                     (B)  controlled substances scheduled in Chapter
  481, Health and Safety Code, or the Comprehensive Drug Abuse
  Prevention and Control Act of 1970 (21 U.S.C. Section 801 et seq.);
               (7)  violates Section 311.0025, Health and Safety Code;
               (8)  fails to supervise adequately the activities of
  those acting under the supervision of the physician; or
               (9)  delegates professional medical responsibility or
  acts to a person if the delegating physician knows or has reason to
  know that the person is not qualified by training, experience, or
  licensure to perform the responsibility or acts.
         SECTION 16.  The changes in law made by this Act by the
  amendment of Sections 152.002(a) and 152.003, Occupations Code,
  apply only to a person appointed to the Texas Medical Board on or
  after the effective date of this Act.  A person appointed before the
  effective date of this Act is governed by the law in effect on the
  date the appointment is made, and the former law is continued in
  effect for that purpose.
         SECTION 17.  The changes in law made by this Act relating to
  the Texas Medical Board's complaint procedures apply only to a
  complaint filed on or after the effective date of this Act.  A
  complaint filed before the effective date of this Act is governed by
  the law in effect on the date the complaint is filed, and the former
  law is continued in effect for that purpose.
         SECTION 18.  The changes in law made by this Act relating to
  the Texas Medical Board's disciplinary authority apply only to
  conduct that occurs on or after the effective date of this Act.
  Conduct that occurs before the effective date of this Act is
  governed by the law in effect on the date the conduct occurs, and
  the former law is continued in effect for that purpose.
         SECTION 19.  Sections 164.007(a) and (a-1), Occupations
  Code, as amended by this Act, apply only to a contested case for
  which an administrative law judge employed by the State Office of
  Administrative Hearings issues written findings of fact and
  conclusions of law on or after the effective date of this Act. A
  contested case for which an administrative law judge employed by
  the State Office of Administrative Hearings issues written findings
  of fact and conclusions of law before the effective date of this Act
  is governed by the law in effect on the date the findings of fact and
  conclusions of law were issued, and the former law is continued in
  effect for that purpose.
         SECTION 20.  This Act takes effect September 1, 2011.