By: Duncan S.B. No. 1079

(Zerwas)

A BILL TO BE ENTITLED

AN ACT

relating to the regulation of medical radiologic technology; providing penalties; imposing fees.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 601.002, Occupations Code, is amended by amending Subdivision (3) and adding Subdivisions (5-a), (10-a), and (11-a) to read as follows:

(3) "Department" means the [Texas] Department of State Health Services.

(5-a) "Executive commissioner" means the executive commissioner of the Health and Human Services Commission.

(10-a) "Radiologist" means a physician specializing in radiology certified by or board-eligible for the American Board of Radiology, the American Osteopathic Board of Radiology, the British Royal College of Radiologists, or the Canadian College of Physicians and Surgeons.

(11-a) "Registered radiologist assistant" means an advanced-level medical radiologic technologist, other than a practitioner, who is registered under Chapter 207 as a registered radiologist assistant.

SECTION 2. Subsections (a) and (b), Section 601.056, Occupations Code, are amended to read as follows:

(a) The executive commissioner [board] with the assistance of other appropriate state agencies shall identify by rule radiologic procedures, other than radiologic procedures described by Subsection (c), that are dangerous or hazardous and that may be performed only by a practitioner, [or] a medical radiologic technologist certified under this chapter, or a registered radiologist assistant.

(b) In adopting rules under Subsection (a), the executive commissioner [board] may consider whether the radiologic procedure will be performed by a registered nurse, [or] a licensed physician assistant, or a registered radiologist assistant.

SECTION 3. Subtitle C, Title 3, Occupations Code, is amended by adding Chapter 207 to read as follows:

CHAPTER 207. REGISTERED RADIOLOGIST ASSISTANTS

SUBCHAPTER A. GENERAL PROVISIONS

Sec. 207.001. DEFINITIONS. In this chapter:

(1) "Board" means the Texas Medical Board.

(2) "Radiologist" means a physician specializing in radiology certified by the American Board of Radiology, the American Osteopathic Board of Radiology, the British Royal College of Radiologists, or the Canadian College of Physicians and Surgeons.

(3) "Registered radiologist assistant" means a person who is registered under this chapter as a registered radiologist assistant and who performs a variety of activities under the personal, direct, or general supervision of a radiologist in the areas of patient care, patient management, clinical imaging, and interventional procedures.

SUBCHAPTER B. POWERS AND DUTIES OF BOARD

Sec. 207.051. GENERAL POWERS AND DUTIES. The board shall:

(1) establish qualifications for a registered radiologist assistant to practice in this state;

(2) establish requirements for an examination for registration to practice as a registered radiologist assistant;

(3) establish minimum education and training requirements necessary for registration to practice as a registered radiologist assistant;

(4) prescribe the application form for registration to practice as a registered radiologist assistant; and

(5) develop an approved program of mandatory continuing education and the manner in which attendance at all approved courses, clinics, forums, lectures, programs, or seminars is monitored and recorded.

Sec. 207.052. GIFTS, GRANTS, AND DONATIONS. In addition to any fees paid to the board or money appropriated to the board, the board may receive and accept under this chapter a gift, grant, donation, or other item of value from any source, including the United States or a private source.

Sec. 207.053. ADVISORY COMMITTEE. (a) The registered radiologist assistant advisory committee consists of five members appointed by the president of the board as follows:

(1) four registered radiologist assistant members with at least three years of experience as a registered radiologist assistant, two of whom must be engaged in practice in a clinical setting; and

(2) one radiologist member licensed in this state who supervises a registered radiologist assistant.

(b) Appointments to the advisory committee shall be made without regard to the race, color, disability, sex, religion, age, or national origin of the appointee.

(c) Notwithstanding Subsection (a)(1), the president of the board may appoint to the advisory committee those persons who:

(1) before January 1, 2015, have met the eligibility requirements of Section 207.153 for the three years preceding the date of appointment, regardless of whether the members hold a registration under this chapter; and

(2) before January 1, 2018, hold a registration under this chapter and who have met the eligibility requirements of Section 207.153 for the three years preceding the date of appointment, regardless of whether the members have held a registration under this chapter for the three years preceding the date of appointment.

(d) Subsection (c) and this subsection expire December 31, 2018.

SUBCHAPTER C. PUBLIC INTEREST INFORMATION; COMPLAINT AND

INVESTIGATIVE INFORMATION

Sec. 207.101. PUBLIC PARTICIPATION. (a) The board shall develop and implement policies that provide the public with a reasonable opportunity to appear before the board and speak on any issue relating to registered radiologist assistants.

(b) The executive director of the board shall prepare and maintain a written plan that describes how a person who does not speak English may be provided reasonable access to the board's programs and services under this chapter.

Sec. 207.102. PUBLIC INTEREST INFORMATION. (a) The board shall prepare information of public interest describing the functions of the board and the procedures by which complaints are filed and resolved under this chapter.

(b) The board shall make the information available to the public and appropriate state agencies.

Sec. 207.103. COMPLAINTS. (a) The board by rule shall establish methods by which consumers and service recipients are notified of the name, mailing address, and telephone number of the board for the purpose of directing complaints about registered radiologist assistants to the board.

(b) The board shall list with its regular telephone number any toll-free telephone number established under other state law that may be called to present a complaint about a registered radiologist assistant.

Sec. 207.104. RECORDS OF COMPLAINTS. (a) The board shall maintain a file on each written complaint filed with the board under this chapter. The file must include:

(1) the name of the person who filed the complaint;

(2) the date the complaint is received by the board;

(3) the subject matter of the complaint;

(4) the name of each person contacted in relation to the complaint;

(5) a summary of the results of the review or investigation of the complaint; and

(6) an explanation of the reason the file was closed, if the board closed the file without taking action other than to investigate the complaint.

(b) The board shall provide to the person filing the complaint and to each person who is a subject of the complaint a copy of the board's policies and procedures relating to complaint investigation and resolution. A person who reports a complaint by phone shall be given information on how to file a written complaint.

(c) The board, at least quarterly and until final disposition of the complaint, shall notify the person filing the complaint and each person who is a subject of the complaint of the status of the investigation unless the notice would jeopardize an undercover investigation.

Sec. 207.105. REGISTRATION HOLDER ACCESS TO COMPLAINT INFORMATION. (a) The board shall provide a registration holder who is the subject of a formal complaint filed under this chapter with access to all information in its possession that the board intends to offer into evidence in presenting its case in chief at the contested hearing on the complaint, subject to any other privilege or restriction established by rule, statute, or legal precedent. The board shall provide the information not later than the 45th day after receipt of a written request from the registration holder or the registration holder's counsel, unless good cause is shown for delay.

(b) Notwithstanding Subsection (a), the board is not required to provide:

(1) board investigative reports;

(2) investigative memoranda;

(3) the identity of a nontestifying complainant;

(4) attorney-client communications;

(5) attorney work product; or

(6) other material covered by a privilege recognized by the Texas Rules of Civil Procedure or the Texas Rules of Evidence.

(c) The provision of information does not constitute a waiver of privilege or confidentiality under this chapter or other law.

Sec. 207.106. HEALTH CARE ENTITY REQUEST FOR INFORMATION. On the written request of a health care entity, the board shall provide to the entity:

(1) information about a complaint filed against a registration holder that was resolved after investigation by:

(A) a disciplinary order of the board; or

(B) an agreed settlement; and

(2) the basis of and current status of any complaint under active investigation that has been referred by the executive director of the board or the director's designee for legal action.

Sec. 207.107. CONFIDENTIALITY OF INVESTIGATIVE INFORMATION. A complaint, adverse report, investigation file, or other report, the identity of and reports made by a physician or registered radiologist assistant performing or supervising compliance monitoring for the board, or other investigative information in the possession of or received or gathered by the board, a board employee, or an agent relating to a registration holder, a registration application, or a criminal investigation or proceeding is privileged and confidential and is not subject to discovery, subpoena, or other means of legal compulsion for release to any person other than the board or a board employee or agent involved in registration holder discipline.

Sec. 207.108. PERMITTED DISCLOSURE OF INVESTIGATIVE INFORMATION. (a) Investigative information in the possession of the board, a board employee, or an agent that relates to the discipline of a registration holder may be disclosed to:

(1) a licensing authority in another state or a territory or country in which the registration holder is licensed or registered or has applied for a license or registration; or

(2) a peer review committee reviewing:

(A) an application for privileges; or

(B) the qualifications of the registration holder with respect to retaining privileges.

(b) If the investigative information in the possession of the board or a board employee or agent indicates a crime may have been committed, the board shall report the information to the proper law enforcement agency. The board shall cooperate with and assist all law enforcement agencies conducting criminal investigations of a registration holder by providing information relevant to the investigation. Confidential information disclosed by the board to a law enforcement agency remains confidential and may not be disclosed by the law enforcement agency except as necessary to further the investigation.

Sec. 207.109. IMMUNITY AND REPORTING REQUIREMENTS. (a) A medical peer review committee in this state, a quality assurance committee in this state, a registered radiologist assistant, a registered radiologist assistant student, or a physician practicing medicine in this state shall report relevant information to the board related to the acts of a registered radiologist assistant in this state if, in that person's opinion, a registered radiologist assistant poses a continuing threat to the public welfare through the person's practice as a registered radiologist assistant. The duty to report under this section may not be nullified through contract.

(b) A person who, without malice, furnishes records, information, or assistance to the board under this section is immune from any civil liability arising from that action in a suit against the person brought by or on behalf of a registered radiologist assistant who is reported under this section.

(c) Sections 160.002, 160.003, 160.006, 160.007, 160.009, 160.013, and 160.014 apply to medical peer review regarding a registered radiologist assistant.

SUBCHAPTER D. REGISTRATION REQUIREMENTS

Sec. 207.151. REGISTRATION REQUIRED. (a) A person may not practice as a registered radiologist assistant unless the person is registered under this chapter.

(b) Unless the person holds a registration under this chapter, a person may not use, in connection with the person's name:

(1) the title "Registered Radiologist Assistant"; or

(2) any other designation that would imply that the person is a registered radiologist assistant.

Sec. 207.152. REGISTRATION APPLICATION. An applicant for registration must:

(1) file a written application with the board on a form prescribed by the board; and

(2) pay the application fee set by the board.

Sec. 207.153. REGISTRATION ELIGIBILITY. To be eligible for a registration, a person must:

(1) be a medical radiologic technologist certified under Chapter 601;

(2) have a baccalaureate degree, postbaccalaureate certificate, or graduate degree from an advanced academic program encompassing a nationally recognized radiologist assistant curriculum that incorporates a radiologist-directed clinical preceptorship;

(3) be certified as a registered radiologist assistant by the American Registry of Radiologic Technologists or be certified as a radiology practitioner assistant by the Certification Board for Radiology Practitioner Assistants; and

(4) be credentialed to provide radiology services under the supervision of a radiologist.

Sec. 207.1535. ELIGIBILITY OF APPLICANT HOLDING OUT-OF-STATE LICENSE. (a) Notwithstanding Section 207.153, a person is eligible for a registration if the person:

(1) was licensed or otherwise registered as a radiologist assistant in another state that has requirements at least as stringent as the requirements of this chapter;

(2) applies for a registration within a period set by the board; and

(3) meets other requirements as determined by the board.

(b) A registration issued under this section must be renewed under Section 207.156.

(c) A registration issued under this section expires on the first anniversary of the date the registration is issued and may not be renewed except as provided by Subsection (b).

Sec. 207.1536. ELIGIBILITY FOR TRANSITIONAL REGISTRATION. (a) Notwithstanding Section 207.153, a person is eligible for a registration if the person:

(1) applies for the registration before September 1, 2017; and

(2) meets the requirements of Section 207.153 other than Section 207.153(2).

(b) A registration issued under the eligibility requirements of this section must be renewed under Section 207.156.

(c) A registration issued under the eligibility requirements of this section expires on September 1, 2018, and may not be renewed except as provided by Subsection (d).

(d) A person who meets the eligibility requirements of Section 207.153 on September 1, 2018, may renew the person's registration. A person who does not meet the eligibility requirements of Section 207.153 on that date may not renew the person's registration and may not practice as a registered radiologist assistant after that date unless the person applies for and obtains a new registration.

(e) This section expires September 1, 2020.

Sec. 207.154. FEES. (a) The board shall set and collect fees in amounts that are reasonable and necessary to cover the costs of administering and enforcing this chapter without the use of any other funds generated by the board.

(b) Fees collected by the board under this chapter shall be deposited by the board in the state treasury to the credit of an account in the general revenue fund and may be spent to cover the costs of administering and enforcing this chapter. At the end of each fiscal biennium, the comptroller shall transfer any surplus money remaining in the account to the general revenue fund.

(c) All money paid to the board under this chapter is subject to Subchapter F, Chapter 404, Government Code.

Sec. 207.155. ISSUANCE AND RENEWAL OF REGISTRATION. The board shall issue a registered radiologist assistant registration in this state to a person who meets the requirements of this chapter and the rules adopted under this chapter.

Sec. 207.156. REGISTRATION RENEWAL. (a) The board by rule shall provide for the annual renewal of a registered radiologist assistant registration.

(b) The board by rule may adopt a system under which registrations expire on various dates during the year. For the year in which the registration expiration date is changed, registration fees shall be prorated on a monthly basis so that each registration holder pays only that portion of the registration fee that is allocable to the number of months during which the registration is valid. On renewal of the registration on the new expiration date, the total registration renewal fee is payable.

Sec. 207.157. NOTICE OF REGISTRATION RENEWAL. At least 30 days before the expiration of a person's registration, the board shall send written notice of the impending registration expiration to the person at the registration holder's last known address according to the records of the board.

Sec. 207.158. PROCEDURE FOR RENEWAL. (a) A person who is otherwise eligible to renew a registration may renew an unexpired registration by paying the required renewal fee to the board before the expiration date of the registration. A person whose registration has expired may not engage in activities that require a registration until the registration has been renewed under this section.

(b) If the person's registration has been expired for 90 days or less, the person may renew the registration by paying to the board one and one-half times the required renewal fee.

(c) If the person's registration has been expired for longer than 90 days but less than one year, the person may renew the registration by paying to the board two times the required renewal fee.

(d) If the person's registration has been expired for one year or longer, the person may not renew the registration. The person may obtain a new registration by complying with the requirements and procedures for obtaining an original registration.

Sec. 207.159. REGISTRATION HOLDER INFORMATION. (a) Each registration holder shall file with the board:

(1) the registration holder's mailing address;

(2) the address of the registration holder's residence;

(3) the mailing address of each of the registration holder's offices; and

(4) the address for the location of each of the registration holder's offices if that address is different from the office's mailing address.

(b) A registration holder shall:

(1) notify the board of a change of the registration holder's residence or business address; and

(2) provide the board with the registration holder's new address not later than the 30th day after the date the address change occurs.

SUBCHAPTER E. SCOPE OF PRACTICE

Sec. 207.201. SCOPE OF PRACTICE. (a) The board shall adopt rules to determine the scope of practice of a registered radiologist assistant. The board shall consider guidelines adopted by the American College of Radiology, the American Society of Radiologic Technologists, and the American Registry of Radiologic Technologists in adopting rules under this subsection.

(b) The practice of a registered radiologist assistant may be performed in any place authorized by a delegating radiologist, including a clinic, hospital, health care center, or other institutional setting.

Sec. 207.202. ESTABLISHMENT OF CERTAIN FUNCTIONS AND STANDARDS. A registered radiologist assistant and the registered radiologist assistant's delegating radiologist shall ensure that:

(1) the registered radiologist assistant's scope of function is identified;

(2) the delegation of medical tasks is appropriate to the registered radiologist assistant's level of competence;

(3) the relationship between the registered radiologist assistant and the delegating radiologist and the access of the registered radiologist assistant to the delegating radiologist are defined; and

(4) a process is established for evaluating the registered radiologist assistant's performance.

Sec. 207.203. SUPERVISION OF REGISTERED RADIOLOGIST ASSISTANTS. (a) In this section:

(1) "Direct supervision" means supervision provided by a radiologist who is present in the same area or an area adjacent to the area where a registered radiologist assistant performs a procedure and who is immediately available to provide assistance and direction during the performance of the procedure.

(2) "General supervision" means supervision provided by a radiologist who provides overall direction and control of a registered radiologist assistant's performance of a procedure but who is not required to be present during the performance of the procedure.

(3) "Personal supervision" means supervision provided by a radiologist who is present in the room where a registered radiologist assistant performs a procedure.

(b) The board by rule shall establish guidelines for general supervision, direct supervision, and personal supervision of a registered radiologist assistant.

(c) A supervising radiologist shall determine whether to provide general supervision, direct supervision, or personal supervision of a registered radiologist assistant performing a procedure based on the registered radiologist assistant's technical ability, the procedure, the patient's history and clinical presentation, and other relevant factors.

Sec. 207.204. PROHIBITED PRACTICES. A registered radiologist assistant may not:

(1) interpret an image;

(2) make a diagnosis; or

(3) prescribe a medication or therapy.

SUBCHAPTER F. DISCIPLINARY PROCEEDINGS

Sec. 207.251. DISCIPLINARY ACTIONS BY THE BOARD. (a) On a determination that an applicant or registration holder committed an act described by Section 207.252, 207.253, or 207.254, the board by order may take any of the following actions:

(1) deny the person's registration application or revoke the person's registration;

(2) require the person to participate in a program of education or counseling prescribed by the board;

(3) stay enforcement of an order and place the person on probation;

(4) require the person to complete additional training;

(5) suspend, limit, or restrict the person's registration, including:

(A) limiting the practice of the person to, or excluding from the person's practice, one or more specified activities of radiologist assisting; or

(B) stipulating periodic board review;

(6) assess an administrative penalty against the person as provided by Section 207.301;

(7) order the person to perform public service; or

(8) administer a public reprimand.

(b) If the board stays enforcement of an order and places a person on probation, the board retains the right to vacate the probationary stay and enforce the original order for noncompliance with the terms of probation or impose any other remedial measure or sanction authorized by this section.

(c) The board may restore or reissue a registration or remove any disciplinary or corrective measure that the board has imposed.

Sec. 207.252. CONDUCT RELATED TO FRAUD OR MISREPRESENTATION. The board may take action under Section 207.251 against an applicant or registration holder who:

(1) fraudulently or deceptively obtains or attempts to obtain a registration;

(2) fraudulently or deceptively uses a registration;

(3) falsely represents that the person is a radiologist;

(4) acts in an unprofessional or dishonorable manner that is likely to deceive, defraud, or injure the public;

(5) fraudulently alters any registered radiologist assistant registration, certificate, or diploma;

(6) uses any registered radiologist assistant registration, certificate, or diploma that has been fraudulently purchased, issued, or counterfeited or that has been materially altered;

(7) directly or indirectly aids or abets the practice as a registered radiologist assistant by any person not registered by the board to practice as a registered radiologist assistant; or

(8) unlawfully advertises in a false, misleading, or deceptive manner as defined by Section 101.201.

Sec. 207.253. CONDUCT RELATED TO VIOLATION OF LAW. The board may take action under Section 207.251 against an applicant or registration holder who:

(1) violates this chapter or a rule adopted under this chapter;

(2) is convicted of a felony, placed on deferred adjudication, or placed in a pretrial diversion program; or

(3) violates state law if the violation is connected with practice as a registered radiologist assistant.

Sec. 207.254. CONDUCT INDICATING LACK OF FITNESS. (a) The board may take action under Section 207.251 against an applicant or registration holder who:

(1) habitually uses drugs or intoxicating liquors to the extent that, in the board's opinion, the person cannot safely perform as a registered radiologist assistant;

(2) has been adjudicated as mentally incompetent;

(3) has a mental or physical condition that renders the person unable to safely perform as a registered radiologist assistant;

(4) has committed an act of moral turpitude;

(5) has failed to practice as a registered radiologist assistant in an acceptable manner consistent with public health and welfare;

(6) has had the person's registration or other authorization to practice as a registered radiologist assistant suspended, revoked, or restricted;

(7) has had other disciplinary action taken by another state or by the uniformed services of the United States regarding practice as a registered radiologist assistant;

(8) is removed or suspended from, or has disciplinary action taken by the person's peers in, any professional association or society or is being disciplined by a licensed hospital or medical staff of a hospital, including removal, suspension, limitation of privileges, or other disciplinary action, if that action, in the opinion of the board, was based on unprofessional conduct or professional incompetence that was likely to harm the public;

(9) has repeated or recurring meritorious health care liability claims that, in the board's opinion, are evidence of professional incompetence likely to harm the public; or

(10) sexually abuses or exploits another person during the registration holder's practice as a registered radiologist assistant.

(b) For the purpose of Subsection (a)(7), a certified copy of the record of the state or uniformed services of the United States taking the action constitutes conclusive evidence of that action.

(c) An action described by Subsection (a)(8) does not constitute state action on the part of the association, society, or hospital medical staff.

Sec. 207.255. SUBPOENA. (a) The executive director of the board, the director's designee, or the secretary-treasurer of the board may issue a subpoena or subpoena duces tecum:

(1) to conduct an investigation or a contested case proceeding related to:

(A) alleged misconduct by a registered radiologist assistant;

(B) an alleged violation of this chapter or another law related to the practice of a registered radiologist assistant; or

(C) the provision of health care under this chapter; or

(2) for purposes of determining whether to issue, deny, suspend, restrict, or revoke a registration under this chapter.

(b) Failure to timely comply with a subpoena issued under this section is a ground for:

(1) disciplinary action by the board or another licensing or regulatory agency with jurisdiction over the person subject to the subpoena; and

(2) denial of a registration application.

Sec. 207.256. PROTECTION OF PATIENT IDENTITY. In a disciplinary investigation or proceeding conducted under this chapter, the board shall protect the identity of each patient whose medical records are examined and used in a public proceeding unless the patient:

(1) testifies in the public proceeding; or

(2) submits a written release in regard to the patient's records or identity.

Sec. 207.257. RULES FOR DISCIPLINARY PROCEEDINGS. Rules of practice adopted under this chapter by the board under Section 2001.004, Government Code, applicable to the proceedings for a disciplinary action may not conflict with rules adopted by the State Office of Administrative Hearings.

Sec. 207.258. REQUIRED SUSPENSION OF INCARCERATED REGISTERED RADIOLOGIST ASSISTANT. Regardless of the offense, the board shall suspend the registration of a registered radiologist assistant serving a prison term in a state or federal penitentiary during the term of the incarceration.

Sec. 207.259. TEMPORARY SUSPENSION. (a) The president of the board, with board approval, shall appoint a three-member disciplinary panel consisting of board members to determine whether a registered radiologist assistant's registration should be temporarily suspended.

(b) If the disciplinary panel determines from the evidence or information presented to the panel that a person registered to practice as a registered radiologist assistant would, by the person's continuation in practice, constitute a continuing threat to the public welfare, the disciplinary panel shall temporarily suspend the registration of that person.

(c) A registration may be suspended under this section without notice or hearing on the complaint if:

(1) institution of proceedings for a hearing before the board is initiated simultaneously with the temporary suspension; and

(2) a hearing is held under Chapter 2001, Government Code, and this chapter as soon as possible.

(d) Notwithstanding Chapter 551, Government Code, the disciplinary panel may hold a meeting by telephone conference call if immediate action is required and convening the disciplinary panel at one location is inconvenient for any member of the panel.

SUBCHAPTER G. ADMINISTRATIVE PENALTY

Sec. 207.301. ADMINISTRATIVE PENALTY. (a) The board by order may impose an administrative penalty against a person registered under this chapter who violates this chapter or a rule or order adopted under this chapter.

(b) The penalty may be in an amount not to exceed $5,000. Each day a violation continues or occurs is a separate violation for purposes of imposing a penalty.

(c) The board shall base the amount of the penalty on:

(1) the severity of patient harm;

(2) the severity of economic harm to any person;

(3) the severity of any environmental harm;

(4) the increased potential for harm to the public;

(5) any attempted concealment of misconduct;

(6) any premeditated or intentional misconduct;

(7) the motive for the violation;

(8) any prior misconduct of a similar or related nature;

(9) the registration holder's disciplinary history;

(10) any prior written warnings or written admonishments from any government agency or official regarding statutes or rules relating to the misconduct;

(11) whether the violation is of a board order;

(12) the person's failure to implement remedial measures to correct or mitigate harm from the misconduct;

(13) the person's lack of rehabilitative potential or likelihood of future misconduct of a similar nature;

(14) any relevant circumstances increasing the seriousness of the misconduct; and

(15) any other matter that justice may require.

(d) The board by rule shall prescribe the procedures by which it may impose an administrative penalty. A proceeding under this section is subject to Chapter 2001, Government Code.

(e) If the board by order determines that a violation has occurred and imposes an administrative penalty, the board shall give notice to the person of the order. The notice must include a statement of the person's right to judicial review of the order.

SECTION 4. Not later than January 1, 2014, the Texas Medical Board shall adopt the rules and procedures necessary to administer Chapter 207, Occupations Code, as added by this Act.

SECTION 5. Notwithstanding Chapter 207, Occupations Code, as added by this Act, a registered radiologist assistant is not required to hold a registration under that chapter to practice as a registered radiologist assistant in this state before September 1, 2014.

SECTION 6. This Act takes effect September 1, 2013.