88R19476 BEE-F
 
  By: Oliverson, Morales of Maverick, Harless H.B. No. 2556
 
  Substitute the following for H.B. No. 2556:
 
  By:  Harless C.S.H.B. No. 2556
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the licensing and regulation of physician graduates and
  the authority of an insured to select a physician graduate under the
  insured's health insurance policy; requiring an occupational
  license; authorizing fees.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Chapter 155, Occupations Code, is amended by
  adding Subchapter E to read as follows:
  SUBCHAPTER E. PHYSICIAN GRADUATE
         Sec. 155.201.  DEFINITIONS. In this subchapter:
               (1)  "Physician graduate" means an individual issued a
  limited license under this subchapter to practice medicine under a
  supervising practice agreement with a sponsoring physician.
               (2)  "Sponsoring physician" means a physician who
  enters into a supervising practice agreement with a physician
  graduate.
               (3)  "Supervising practice agreement" means an
  agreement between a sponsoring physician and a physician graduate
  regarding the supervision by the sponsoring physician of the
  physician graduate's practice of medicine.
         Sec. 155.202.  RULES. The board shall adopt rules in
  accordance with this subchapter relating to the licensing and
  regulation of physician graduates, including rules relating to:
               (1)  procedures and fees for the issuance, term, and
  renewal of a license under this subchapter, including continuing
  medical education requirements for renewal of the license;
               (2)  practices and requirements for the supervision of
  physician graduates; and
               (3)  any other matter necessary to ensure protection of
  the public, including disciplinary procedures.
         Sec. 155.203.  LICENSE ISSUANCE. On application, the board
  shall issue a limited license to practice medicine under this
  subchapter to an applicant who:
               (1)  is a resident of this state and is:
                     (A)  a United States citizen or a legal permanent
  resident; or
                     (B)  otherwise authorized under federal law to
  work in the United States;
               (2)  has proficiency in the English language;
               (3)  has graduated:
                     (A)  in the two years preceding the date that the
  applicant initially applies for a physician graduate license, from:
                           (i)  a board-recognized accredited medical
  school or osteopathic medical school in the United States or
  Canada; or
                           (ii)  a medical school located outside of
  the United States and Canada that is recognized by the board as
  acceptable; or
                     (B)  if the applicant is licensed in good standing
  to practice medicine in another country, from a medical school
  located outside of the United States and Canada that is recognized
  by the board as acceptable;
               (4)  has passed the first and second components of the
  United States Medical Licensing Examination or equivalent
  components of another board-approved licensing examination
  described by Section 155.0511;
               (5)  is not enrolled in a board-approved postgraduate
  residency program; and
               (6)  meets any other requirement prescribed by board
  rule.
         Sec. 155.204.  FEES. The amount of a fee for the issuance or
  renewal of a license under this subchapter may not exceed the amount
  of a fee for the issuance or renewal of a physician assistant
  license under Chapter 204.
         Sec. 155.205.  SPONSORING PHYSICIAN. (a)  A physician is
  eligible to enter into a supervising practice agreement as a
  sponsoring physician if the physician:
               (1)  holds a full and unrestricted license to practice
  medicine issued under this subtitle;
               (2)  has not been and is not currently the subject of
  disciplinary action by the board or the medical licensing authority
  of any other jurisdiction;
               (3)  is certified by a medical specialty member board
  of:
                     (A)  the American Board of Medical Specialties; or
                     (B)  the American Osteopathic Association Bureau
  of Osteopathic Specialists; and
               (4)  practices medicine in the specialty for which the
  physician is certified under Subdivision (3).
         (b)  A sponsoring physician who enters into a supervising
  practice agreement with a physician graduate shall comply with all
  board rules related to the supervision of physician graduates.
         (c)  The board by rule shall establish the maximum number of
  physician graduates that a sponsoring physician may supervise under
  supervising practice agreements.
         Sec. 155.206.  SUPERVISING PRACTICE AGREEMENT REQUIRED. (a)
  A physician graduate shall enter into a supervising practice
  agreement with a sponsoring physician.
         (b)  A physician graduate who has not entered into a
  supervising practice agreement may not practice or attempt to
  practice medicine. 
         (c)  A physician graduate who enters into a supervising
  practice agreement may practice under the delegation and
  supervision of another physician if:
               (1)  the sponsoring physician authorizes the practice
  of the physician graduate under the delegation and supervision of
  the other physician in a written document that identifies the other
  physician by name; and
               (2)  the other physician is:
                     (A)  part of the sponsoring physician's physician
  group or facility; and
                     (B)  certified in the same specialty as the
  sponsoring physician by a medical specialty member board of:
                           (i)  the American Board of Medical
  Specialties; or
                           (ii)  the American Osteopathic Association
  Bureau of Osteopathic Specialists.
         (d)  The physician profile under Section 154.006 of a
  sponsoring physician or physician graduate must indicate in the
  manner prescribed by board rule that the sponsoring physician or
  physician graduate has entered into a supervising practice
  agreement.
         Sec. 155.207.  LIMITED PRACTICE BY LICENSE HOLDER. (a) A
  physician graduate may provide only medical services in the
  specialty in which the physician graduate's sponsoring physician is
  certified as described by Section 155.205(a)(3) under supervision
  in accordance with a supervising practice agreement.
         (b)  Before a license holder under this subchapter provides a
  treatment, consultation, or other medical service, the license
  holder must disclose to the patient:
               (1)  that the license holder is a physician graduate;
  and
               (2)  if asked, that the license holder has not
  completed any formal specialized postgraduate or resident
  training.
         (c)  A physician graduate may not prescribe a Schedule II
  controlled substance.
         Sec. 155.208.  LIABILITY OF SUPERVISING PHYSICIAN. A
  sponsoring physician who enters into a supervising practice
  agreement with a physician graduate is responsible at all times for
  the oversight of and is liable for any medical act performed or the
  omission of any medical act by the physician graduate in the
  provision of medical services.
         Sec. 155.209.  IDENTIFICATION REQUIREMENTS; USE OF TITLE.
  (a) The holder of a license issued under this subchapter shall at
  all times while practicing as a physician graduate display a
  personal identification document identifying the license holder as
  a physician graduate. 
         (b)  A physician graduate may use the following titles or
  abbreviations:
               (1)  "doctor"; or
               (2)  "Dr." or "doc."
         Sec. 155.210.  STATUS OF PHYSICIAN GRADUATE. A physician
  graduate license holder is considered a general practitioner for
  purposes of regulations of the federal Centers for Medicare and
  Medicaid Services.
         Sec. 155.211.  LICENSE RENEWAL. The board may not renew a
  license issued under this subchapter unless:
               (1)  the board verifies that the license holder has
  practiced in accordance with this subchapter under a supervising
  practice agreement with a sponsoring physician in the license term
  preceding the application for renewal; and
               (2)  the license  holder satisfies the continuing
  medical education requirements established by board rule.
         Sec. 155.212.  DENIAL, SUSPENSION, OR REVOCATION OF LICENSE.
  The board may deny an application for licensure or suspend or revoke
  a license issued under this subchapter:
               (1)  for any ground provided by Chapter 164 or board
  rule; and
               (2)  in the manner provided by Chapter 164 and board
  rule.
         SECTION 2.  Section 1451.001, Insurance Code, is amended by
  adding Subdivision (16-a) to read as follows:
               (16-a) "Physician graduate" has the meaning assigned
  by Section 155.201, Occupations Code.
         SECTION 3.  Subchapter C, Chapter 1451, Insurance Code, is
  amended by adding Section 1451.129 to read as follows:
         Sec. 1451.129.  SELECTION OF PHYSICIAN GRADUATE. An insured
  may select a physician graduate to provide the services scheduled
  in the health insurance policy that are within the scope of the
  physician graduate's license under Subchapter E, Chapter 155,
  Occupations Code.
         SECTION 4.  Not later than January 1, 2024, the Texas Medical
  Board shall adopt rules as necessary to implement Subchapter E,
  Chapter 155, Occupations Code, as added by this Act.
         SECTION 5.  Section 1451.129, Insurance Code, as added by
  this Act, applies only to a health insurance policy that is
  delivered, issued for delivery, or renewed on or after January 1,
  2024.
         SECTION 6.  This Act takes effect September 1, 2023.