84R19980 TSR-F
 
  By: Bonnen of Galveston H.B. No. 2978
 
  Substitute the following for H.B. No. 2978:
 
  By:  Crownover C.S.H.B. No. 2978
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the licensing and regulation of neurodiagnostic
  technologists; requiring an occupational license; creating an
  offense; providing penalties and authorizing fees.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subtitle K, Title 3, Occupations Code, is
  amended by adding Chapter 606 to read as follows:
  CHAPTER 606. NEURODIAGNOSTIC TECHNOLOGISTS
  SUBCHAPTER A. GENERAL PROVISIONS
         Sec. 606.001.  DEFINITIONS. In this chapter:
               (1)  "Autonomic reflex testing" means a test used to
  measure how autonomic nerves work in controlling involuntary body
  functions, including blood pressure, heart rate, and sweating, in
  response to different maneuvers, such as deep breathing, blowing
  into a mouthpiece, sweating, and lying for several minutes on a
  table that is tilted to a near standing position.
               (2)  "Board" means the Texas Medical Board.
               (3)  "Credentialing organization" means a national
  accrediting organization that administers and awards
  neurodiagnostic technologist credentials, including the:
                     (A)  ABRET Neurodiagnostic Credentialing and
  Accreditation (ABRET);
                     (B)  American Association of Electrodiagnostic
  Technologists (AAET);
                     (C)  American Board of Electrodiagnostic Medicine
  (ABEM); or
                     (D)  Board of Registered Polysomnographic
  Technologists (BRPT).
               (4)  "Direct supervision" means supervision by a
  responsible neurodiagnostic technologist or physician who is
  physically present and immediately available to provide assistance
  and direction while a neurodiagnostic procedure is being performed. 
               (5)  "Electroencephalography" means the recording and
  analysis of the ongoing electrical activity of the brain using a
  digital or analog instrument with a minimum of 16 channels and 21
  electrodes and is used to assist in the diagnosis of epilepsy and
  other neurological symptoms.
               (6)  "Electromyography" means the recording and
  analysis of electrical activity generated by a needle insertion
  into a muscle.
               (7)  "Evoked potentials" means the recording of
  electrical activity from the brain, spinal nerves, or sensory
  receptors that occurs in direct response to auditory, visual, or
  electrical stimulation using surface electrodes and computer
  equipment to average the electrical potentials generated.
               (8)  "Intraoperative monitoring" means the use of a
  neurophysiological monitoring technique during surgery that
  ensures the safety of a patient by:
                     (A)  providing information to the surgeon that
  relates to the integrity of the central and peripheral nervous
  systems; and
                     (B)  using real-time electrographic information
  or stimulus evoked recordings of auditory, visual, somatosensory,
  or motor pathways via surface or subdermal needle electrodes.
               (9)  "License holder" means a person who holds a
  license as a neurodiagnostic technologist under this chapter.
               (10)  "Long-term monitoring" means the prolonged
  recording, by video recording or digital analysis, of the ongoing
  electrical activity of the brain to evaluate and diagnose epilepsy
  and other intermittent or infrequent neurological disturbances.
               (11)  "Nerve conduction study" means a recording
  obtained from electrical stimulation of peripheral nerves using
  surface electrodes and standard equipment with oscilloscopes for
  waveform analysis to evaluate and diagnose a disorder of the
  peripheral nervous system.
               (12)  "Neurodiagnostic student" means a person who is
  enrolled in a neurodiagnostics program.
               (13)  "Neurodiagnostic technologist" means a person
  who holds a license issued under this chapter to:
                     (A)  use specialized equipment to record and
  analyze physiological data and electrical activity from the central
  and peripheral nervous systems; and
                     (B)  perform one or more of the following
  neurodiagnostic procedures under the direct supervision of a
  physician:
                           (i)  electroencephalography;
                           (ii)  evoked potentials;
                           (iii)  continuous electroencephalography
  monitoring;
                           (iv)  intraoperative neuromonitoring;
                           (v)  long-term monitoring;
                           (vi)  nerve conduction studies;
                           (vii)  polysomnography; or
                           (viii)  autonomic reflex testing.
               (14)  "Polysomnography" means the recording of the
  biophysiological changes that occur during sleep by monitoring the
  ongoing electrical activity of the brain, eye movements, muscle
  activity, heart rhythm, and respiratory effort to diagnose and
  treat sleep disorders.
         Sec. 606.002.  EXEMPTIONS. This chapter does not apply to:
               (1)  a physician licensed in this state;
               (2)  a person performing a neurodiagnostic procedure:
                     (A)  for research if the results of the procedure
  are not used to diagnose or treat a patient;
                     (B)  as a neurodiagnostic student under the direct
  supervision of a neurodiagnostic technologist or physician; or
                     (C)  as an employee under the direct supervision
  of a physician as part of the employee's job training; or
               (3)  a faculty member of an accredited school or
  university with a neurodiagnostics, allied health, or health
  education program.
  SUBCHAPTER B. POWERS AND DUTIES OF BOARD
         Sec. 606.051.  GENERAL POWERS AND DUTIES; RULES. (a) The
  board shall administer and enforce this chapter.
         (b)  The board shall adopt rules necessary to implement this
  chapter.
         Sec. 606.052.  FEES. (a) The board by rule shall establish
  reasonable and necessary fees in amounts sufficient to cover the
  costs of administering and enforcing this chapter.
         (b)  The board may increase the fee for the issuance or
  renewal of a license as necessary to cover the costs of enforcing
  this chapter in an amount not to exceed $1,000.
  SUBCHAPTER C. LICENSE REQUIREMENTS
         Sec. 606.101.  LICENSE REQUIRED. (a) A person may not act
  as or offer to act as a neurodiagnostic technologist unless the
  person holds a license issued under this chapter.
         (b)  A person who is not licensed under this chapter, or
  whose license has been suspended or revoked, may not:
               (1)  use the word "neurodiagnostic" on a sign, name
  tag, or any form of advertising unless the person is expressly
  exempt from the licensing requirements of this chapter;
               (2)  use in connection with the person's practice any
  abbreviations or credentials indicating or implying that the person
  is a neurodiagnostic technologist; or
               (3)  directly or by implication represent in any way
  that the person is a neurodiagnostic technologist.
         (c)  A license:
               (1)  is valid only with respect to the person named on
  the license; and
               (2)  authorizes the license holder to engage in the
  neurodiagnostic procedure for which the license holder has a
  credential issued by a credentialing organization.
         (d)  A license issued under this chapter is not transferable
  or assignable.
         Sec. 606.102.  LICENSING APPLICATION. (a) An applicant for
  a license must:
               (1)  apply to the board on a form prescribed by the
  board and under rules adopted by the board;
               (2)  submit with the application a nonrefundable
  application fee in an amount set by the board; and
               (3)  pass a credentialing organization examination
  administered or accepted by the board.
         (b)  The board by rule shall specify the information that
  must be included on an application submitted to the board. The
  rules must require:
               (1)  each application to include the name and address
  of the applicant; and 
               (2)  each applicant for a license by examination to
  present satisfactory evidence to the board that the applicant is:
                     (A)  at least 18 years of age; and
                     (B)  of good moral character.
         Sec. 606.103.  EXAMINATIONS ADMINISTERED OR ACCEPTED BY
  BOARD. The board may administer or accept for licensing a
  credentialing organization examination as determined by rule.
         Sec. 606.1031.  REDUCED LICENSE REQUIREMENTS. (a) A person
  who applies for a license under this chapter not later than June 1,
  2016, is exempt from the examination required under this chapter if
  the person presents satisfactory evidence to the board that the
  person:
               (1)  holds unexpired credentials issued by a
  credentialing organization; or 
               (2)  actively performs neurodiagnostic procedures.
         (b)  Satisfactory evidence under Subsection (a)(2) must be
  in the form of a signed letter submitted by the employer or
  supervising physician of the applicant.
         (c)  A person who qualifies under this section for an
  exemption from the requirement to take the examination required
  under this chapter must comply with all other requirements under
  this chapter for issuance of a license.
         (d)  This section expires June 1, 2017.
         Sec. 606.104.  TEMPORARY LICENSES. (a) The board may adopt
  rules and set fees relating to granting temporary licenses.
         (b)  A temporary license under this chapter expires on the
  second anniversary of the date the temporary license is issued or
  the date the applicant presents satisfactory evidence to the board
  that the applicant has passed the examination required under this
  chapter, whichever date occurs first.
         (c)  The board by rule may extend the expiration date of a
  temporary license by not more than an additional 12 months.
  SUBCHAPTER D. LICENSE RENEWAL
         Sec. 606.151.  LICENSE RENEWAL. (a) A license is valid for
  two years from the date of issuance and may be renewed biennially.
         (b)  The board by rule may adopt a system under which
  licenses expire on various dates during the year.
         (c)  A person may renew an unexpired license by paying the
  required renewal fee to the board before the license expiration
  date.
         (d)  To renew a license under this chapter, a person must
  submit proof satisfactory to the board that the person has:
               (1)  maintained the appropriate credentials issued by a
  credentialing organization; and 
               (2)  complied with the continuing education
  requirements prescribed by the board.
         Sec. 606.152.  CONTINUING EDUCATION. (a) The board shall
  establish for the renewal of a license or temporary license uniform
  continuing education requirements of not less than 24 continuing
  education hours for each renewal period. 
         (b)  The board shall adopt a procedure to assess a license
  holder's participation in continuing education programs.
  SUBCHAPTER E. PRACTICE BY LICENSE HOLDER
         Sec. 606.201.  ADVERTISING. (a)  A license holder shall
  include the license holder's license number in each advertisement.
         (b)  A person who advertises that the person is a
  neurodiagnostic technologist is presumed to be engaging in conduct
  regulated by this chapter.
  SUBCHAPTER F. PROHIBITED PRACTICES AND ENFORCEMENT PROVISIONS
         Sec. 606.251.  PROHIBITED PRACTICES. (a) A license holder
  may not engage in a neurodiagnostic procedure for which the license
  holder does not hold the proper credential issued by a
  credentialing organization.
         (b)  A license holder may not:
               (1)  interpret neurodiagnostic data, including making
  a determination of normal or abnormal findings and identifying the
  presence, absence, type, severity, or likelihood of an illness,
  injury, or other condition;
               (2)  provide clinical correlation of data, including
  making statements about the meaning of test results based on a
  person's symptoms, medical history, physical examination, or other
  clinical test results;
               (3)  perform needle insertion electromyography in a
  clinical setting; or
               (4)  meet with a patient except under the direct
  supervision of a physician.
         Sec. 606.252.  INVESTIGATION OF COMPLAINTS. (a) The board
  shall investigate any complaint alleging that a violation of this
  chapter or a rule or order adopted under this chapter has occurred.
         (b)  A complaint must be filed in a manner prescribed by the
  board.
         Sec. 606.253.  SANCTIONS. The board may impose sanctions
  under this chapter in the same manner as provided by Chapter 164 for
  imposition of sanctions against a physician.
  SUBCHAPTER G. PENALTIES
         Sec. 606.301.  ADMINISTRATIVE PENALTY. The board may impose
  an administrative penalty on a person under this chapter in the same
  manner as provided by Subchapter A, Chapter 165, against a
  physician, regardless of whether the person holds a license under
  this chapter, if the person violates this chapter or a rule or order
  adopted under this chapter.
         Sec. 606.302.  CRIMINAL PENALTY. (a) A person commits an
  offense if the person violates this chapter.
         (b)  An offense under this section is a Class A misdemeanor.
         SECTION 2.  Not later than February 1, 2016, the Texas
  Medical Board shall adopt rules and forms necessary to implement
  Chapter 606, Occupations Code, as added by this Act.
         SECTION 3.  The Texas Medical Board shall issue a
  neurodiagnostic technologist license under Chapter 606,
  Occupations Code, as added by this Act, to an applicant who:
               (1)  applies for a license under this section not later
  than June 1, 2016;
               (2)  submits to the board the information required by
  rule;
               (3)  meets the requirements of Section 606.1031,
  Occupations Code, as added by this Act; and
               (4)  pays the application fee established by the board.
         SECTION 4.  (a) Except as provided by Subsection (b) of this
  section, this Act takes effect September 1, 2015.
         (b)  Section 606.101 and Subchapter G, Chapter 606,
  Occupations Code, as added by this Act, take effect September 1,
  2016.