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A BILL TO BE ENTITLED
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AN ACT
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relating to the issuance by the Texas Medical Board of certain |
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licenses to practice medicine and the authority of an insured to |
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select certain license holders under the insured's health policy; |
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requiring an occupational license; authorizing fees. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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ARTICLE 1. SHORT TITLE |
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SECTION 1.001. This Act shall be known as the Decreasing |
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Occupational Certification Timelines, Obstacles, and Regulations |
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(DOCTOR) Act. |
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ARTICLE 2. FOREIGN LICENSE HOLDERS |
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SECTION 2.001. Subchapter C, Chapter 155, Occupations Code, |
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is amended by adding Section 155.1015 to read as follows: |
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Sec. 155.1015. ISSUANCE OF PROVISIONAL LICENSE TO |
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CERTAIN FOREIGN MEDICAL LICENSE HOLDERS WITH OFFERS OF |
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EMPLOYMENT. (a) Upon receiving an application, the board shall |
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issue a provisional license to practice medicine to an applicant |
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who: |
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(1) has been granted a degree of doctor of medicine or |
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a substantially similar degree by a program of medical education |
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that meets eligibility requirements for the applicant to apply for |
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certification by the Educational Commission for Foreign Medical |
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Graduates; |
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(2) has been licensed in good standing to practice |
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medicine in another country in the five years preceding application |
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under this section and is not the subject of any pending |
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disciplinary action before the licensing body; |
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(3) either: |
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(A) has completed a residency or substantially |
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similar postgraduate medical training required by the applicant's |
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country of licensure and has practiced medicine as a licensed |
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physician in that country for at least five years after the |
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completion of the required postgraduate medical training; or |
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(B) if the applicant's country of licensure does |
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not require postgraduate medical training, has practiced as a |
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medical professional performing the duties of a physician in that |
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country for at least five years and has practiced medicine as a |
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licensed physician in that country for at least 10 years after |
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completing medical school; |
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(4) satisfies the examination requirements of Section |
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155.051; |
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(5) has proficiency in the English language; |
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(6) is authorized under federal law to work in the |
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United States; and |
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(7) has been offered employment in this state as a |
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physician by a person who provides health care services in the |
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normal course of business, including a health system, hospital, |
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hospital-based facility, freestanding emergency facility, or |
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urgent care clinic. |
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(b) A provisional license issued under this section expires |
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on the earlier of: |
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(1) the date the board issues the provisional license |
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holder a license under this subtitle or denies the provisional |
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license holder's application for a license under Subsection (c); or |
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(2) the third anniversary of the date the provisional |
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license was issued. |
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(c) Upon receiving an application, the board shall issue a |
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license under this subtitle to the holder of a provisional license |
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under this section if the provisional license holder: |
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(1) will have practiced under the provisional license |
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for at least three years at the time the license will be issued; and |
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(2) has not been and is not currently subject to board |
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investigation or discipline for conduct that occurred while holding |
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the provisional license. |
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ARTICLE 3. MILITARY VETERANS |
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SECTION 3.001. Subchapter C, Chapter 155, Occupations Code, |
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is amended by adding Section 155.108 to read as follows: |
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Sec. 155.108. LICENSE FOR MILITARY VETERAN TO PRACTICE IN |
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CERTAIN AREAS. (a) In this section, "active duty" and "armed |
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forces of the United States" have the meanings assigned by Section |
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55.001. |
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(b) The board shall issue a medical license to practice |
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medicine to an applicant who: |
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(1) is licensed in good standing as a physician in |
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another state; |
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(2) is a veteran of the armed forces of the United |
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States who retired from or otherwise left military service not more |
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than three years before the application date for a license under |
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this section; |
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(3) was, at the time of retiring from or leaving |
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military service: |
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(A) serving on active duty in this state; and |
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(B) authorized as a physician to treat persons |
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enlisted in the armed forces of the United States or veterans; and |
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(4) has passed the Texas medical jurisprudence |
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examination. |
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(c) The board may not issue a license under this section to |
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an applicant who: |
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(1) was discharged or separated from the armed forces |
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of the United States: |
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(A) on the basis of substandard conduct; or |
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(B) for any act of misconduct or moral or |
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professional dereliction; |
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(2) holds a medical license or a license to prescribe, |
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dispense, administer, supply, or sell a controlled substance that: |
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(A) is currently under active investigation; or |
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(B) is or was subject to a disciplinary order or |
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action or to denial by another jurisdiction; or |
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(3) has been convicted of, is on deferred adjudication |
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community supervision or deferred disposition for, or is under |
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active investigation for the commission of: |
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(A) a felony; or |
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(B) a misdemeanor involving moral turpitude. |
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ARTICLE 4. PHYSICIAN GRADUATES |
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SECTION 4.001. Chapter 155, Occupations Code, is amended by |
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adding Subchapter E to read as follows: |
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SUBCHAPTER E. PHYSICIAN GRADUATE |
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Sec. 155.201. DEFINITIONS. In this subchapter: |
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(1) "Physician graduate" means an individual issued a |
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limited license under this subchapter to practice medicine under a |
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supervising practice agreement with a sponsoring physician. |
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(2) "Sponsoring physician" means a physician who |
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enters into a supervising practice agreement with a physician |
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graduate. |
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(3) "Supervising practice agreement" means an |
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agreement between a sponsoring physician and a physician graduate |
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regarding the supervision by the sponsoring physician of the |
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physician graduate's practice of medicine. |
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Sec. 155.202. RULES. The board shall adopt rules in |
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accordance with this subchapter relating to the licensing and |
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regulation of physician graduates, including rules relating to: |
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(1) procedures and fees for the issuance, term, and |
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renewal of a license under this subchapter, including continuing |
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medical education requirements for renewal of the license; |
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(2) practices and requirements for the supervision of |
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physician graduates; and |
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(3) any other matter necessary to ensure protection of |
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the public, including disciplinary procedures. |
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Sec. 155.203. LICENSE ISSUANCE. Upon receiving an |
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application, the board shall issue a limited license to practice |
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medicine under this subchapter to an applicant who: |
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(1) is a resident of this state and is: |
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(A) a United States citizen or a legal permanent |
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resident; or |
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(B) otherwise authorized under federal law to |
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work in the United States; |
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(2) has proficiency in the English language; |
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(3) has graduated: |
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(A) in the two years preceding the date that the |
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applicant initially applies for a physician graduate license, from: |
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(i) a board-recognized accredited medical |
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school or osteopathic medical school in the United States or |
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Canada; or |
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(ii) a medical school located outside of |
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the United States and Canada that is recognized by the board as |
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acceptable; or |
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(B) if the applicant is licensed in good standing |
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to practice medicine in another country, from a medical school |
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located outside of the United States and Canada that is recognized |
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by the board as acceptable; |
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(4) has passed the first and second components of the |
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United States Medical Licensing Examination or equivalent |
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components of another board-approved licensing examination |
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described by Section 155.0511; |
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(5) is not enrolled in a board-approved postgraduate |
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residency program; |
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(6) has not been and is not currently the subject of |
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disciplinary action by the board or the medical licensing authority |
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of any other jurisdiction; and |
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(7) meets any other requirement prescribed by board |
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rule. |
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Sec. 155.204. FEES. The amount of a fee for the issuance or |
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renewal of a license under this subchapter may not exceed the amount |
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of a fee for the issuance or renewal of a physician assistant |
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license under Chapter 204. |
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Sec. 155.205. SPONSORING PHYSICIAN. (a) A physician is |
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eligible to enter into a supervising practice agreement as a |
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sponsoring physician if the physician: |
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(1) holds a full and unrestricted license to practice |
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medicine issued under this subtitle; |
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(2) has not been and is not currently the subject of |
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disciplinary action by the board or the medical licensing authority |
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of any other jurisdiction; |
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(3) is certified by: |
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(A) a medical specialty member board of the |
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American Board of Medical Specialties; |
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(B) a medical specialty member board of the |
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American Osteopathic Association Bureau of Osteopathic |
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Specialists; |
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(C) the American Board of Oral and Maxillofacial |
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Surgery; or |
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(D) any other medical specialty member board |
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recognized by the Texas Medical Board; and |
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(4) practices medicine in the specialty for which the |
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physician is certified under Subdivision (3). |
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(b) A sponsoring physician who enters into a supervising |
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practice agreement with a physician graduate shall comply with all |
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board rules related to the supervision of physician graduates. |
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(c) The board by rule shall establish the maximum number of |
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physician graduates that a sponsoring physician may supervise under |
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supervising practice agreements. |
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Sec. 155.206. SUPERVISING PRACTICE AGREEMENT REQUIRED. |
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(a) A physician graduate shall enter into a supervising practice |
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agreement with a sponsoring physician. |
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(b) A physician graduate who has not entered into a |
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supervising practice agreement may not practice or attempt to |
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practice medicine. |
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(c) A physician graduate who enters into a supervising |
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practice agreement may practice under the delegation and |
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supervision of another physician if: |
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(1) the sponsoring physician authorizes the practice |
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of the physician graduate under the delegation and supervision of |
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the other physician in a written document that identifies the other |
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physician by name; and |
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(2) the other physician is: |
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(A) part of the sponsoring physician's physician |
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group or facility; and |
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(B) certified in the same specialty as the |
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sponsoring physician by: |
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(i) a medical specialty member board of the |
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American Board of Medical Specialties; |
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(ii) a medical specialty member board of |
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the American Osteopathic Association Bureau of Osteopathic |
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Specialists; |
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(iii) the American Board of Oral and |
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Maxillofacial Surgery; or |
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(iv) any other medical specialty member |
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board recognized by the Texas Medical Board. |
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(d) The physician profile under Section 154.006 of a |
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sponsoring physician or physician graduate must indicate in the |
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manner prescribed by board rule that the sponsoring physician or |
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physician graduate has entered into a supervising practice |
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agreement. |
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Sec. 155.207. LIMITED PRACTICE BY LICENSE HOLDER. (a) A |
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physician graduate may provide only medical services in the |
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specialty in which the physician graduate's sponsoring physician is |
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certified as described by Section 155.205(a)(3) under supervision |
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in accordance with a supervising practice agreement. |
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(b) Before a license holder under this subchapter provides a |
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treatment, consultation, or other medical service, the license |
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holder must disclose to the patient: |
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(1) that the license holder is a physician graduate; |
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and |
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(2) that the license holder has not completed any |
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formal specialized postgraduate or resident training. |
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Sec. 155.208. LIABILITY OF SUPERVISING PHYSICIAN. A |
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sponsoring physician who enters into a supervising practice |
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agreement with a physician graduate retains legal responsibility |
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for a physician graduate's patient care activities, including the |
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provision of care and treatment to a patient in a health care |
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facility. |
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Sec. 155.209. IDENTIFICATION REQUIREMENTS; USE OF TITLE. |
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(a) The holder of a license issued under this subchapter shall at |
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all times while practicing as a physician graduate display a |
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personal identification document identifying the license holder as |
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a physician graduate. |
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(b) A physician graduate may use the following titles or |
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abbreviations: |
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(1) "doctor"; or |
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(2) "Dr." or "doc." |
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Sec. 155.210. STATUS OF PHYSICIAN GRADUATE. A physician |
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graduate license holder is considered a general practitioner for |
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purposes of regulations of the federal Centers for Medicare and |
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Medicaid Services. |
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Sec. 155.211. LICENSE RENEWAL. The board may not renew a |
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license issued under this subchapter unless: |
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(1) the board verifies that the license holder has |
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practiced in accordance with this subchapter under a supervising |
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practice agreement with a sponsoring physician in the license term |
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preceding the application for renewal; and |
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(2) the license holder satisfies the continuing |
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medical education requirements established by board rule. |
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Sec. 155.212. DENIAL, SUSPENSION, OR REVOCATION OF LICENSE. |
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The board may deny an application for licensure or suspend or revoke |
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a license issued under this subchapter: |
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(1) for any ground provided by Chapter 164 or board |
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rule; and |
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(2) in the manner provided by Chapter 164 and board |
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rule. |
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SECTION 4.002. Section 1451.001, Insurance Code, is amended |
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by adding Subdivision (16-a) to read as follows: |
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(16-a) "Physician graduate" has the meaning assigned |
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by Section 155.201, Occupations Code. |
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SECTION 4.003. Subchapter C, Chapter 1451, Insurance Code, |
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is amended by adding Section 1451.129 to read as follows: |
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Sec. 1451.129. SELECTION OF PHYSICIAN GRADUATE. An insured |
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may select a physician graduate to provide the services scheduled |
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in the health insurance policy that are within the scope of the |
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physician graduate's license under Subchapter E, Chapter 155, |
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Occupations Code. |
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SECTION 4.004. Section 1451.129, Insurance Code, as added |
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by this Act, applies only to a health insurance policy that is |
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delivered, issued for delivery, or renewed on or after January 1, |
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2026. |
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ARTICLE 5. RULEMAKING |
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SECTION 5.001. (a) Not later than January 1, 2026, the |
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Texas Medical Board shall adopt rules as necessary to implement the |
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following provisions of the Occupations Code, as added by this Act: |
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(1) Sections 155.1015 and 155.108; and |
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(2) Subchapter E, Chapter 155. |
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(b) In adopting rules under Subsection (a) of |
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this section, the Texas Medical Board shall develop a process to |
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create a "whitelist" of countries whose licensure requirements |
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include residency or a substantially similar postgraduate medical |
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training under Section 155.1015(a)(3)(A), Occupations Code, as |
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added by this Act. The process must include a review by the Texas |
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Medical Board of at least 10 countries per year for inclusion on the |
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whitelist, and if after the review a country is not included, the |
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Texas Medical Board must identify, with specificity, the aspects of |
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the country's requirements that caused the country to not be |
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included. |
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ARTICLE 6. EFFECTIVE DATE |
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SECTION 6.001. This Act takes effect September 1, 2025. |