Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services
FROM:
Jerry McGinty, Director, Legislative Budget Board
IN RE:
HB2038 by Oliverson (Relating to the issuance by the Texas Medical Board of certain licenses to practice medicine and the authority of an insured to select certain license holders under the insured ’s health policy; requiring an occupational license; authorizing fees.), Committee Report 2nd House, Substituted
Estimated Two-year Net Impact to General Revenue Related Funds for HB2038, Committee Report 2nd House, Substituted: a positive impact of $39,170 through the biennium ending August 31, 2027.
The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.
General Revenue-Related Funds, Five- Year Impact:
Fiscal Year
Probable Net Positive/(Negative) Impact to General Revenue Related Funds
2026
$19,585
2027
$19,585
2028
$19,585
2029
$19,585
2030
$19,585
All Funds, Five-Year Impact:
Fiscal Year
Probable Savings/(Cost) from General Revenue Fund 1
Probable Revenue Gain/(Loss) from General Revenue Fund 1
Change in Number of State Employees from FY 2025
2026
($173,690)
$193,275
2.0
2027
($173,690)
$193,275
2.0
2028
($173,690)
$193,275
2.0
2029
($173,690)
$193,275
2.0
2030
($173,690)
$193,275
2.0
Fiscal Analysis
The bill would amend the Texas Occupations Code to require the Texas Medical Board (TMB) to issue provisional licenses to practice medicine to certain foreign applicants who have been granted a medical degree, or a similar degree, and have been licensed in good standing in another country. TMB would have the choice to issue either a standard license or another provisional license to a provisional license holder if the licensee meets certain criteria. TMB would not be allowed to issue a license if the foreign applicant is a citizen of a country that is identified as either a national security risk or subject to prohibitions in the International Traffic in Arms Regulations. The provisional licenses would expire two years after the issuance of the provisional license.
The bill would require TMB to issue limited licenses to practice medicine to medical school graduates who have no matched into a residency program and authorizes a fee. these graduates would be able to practice a limited scope of medicine under a supervising practice agreement with a sponsoring physician in counties with a population of less than 100,000.
The bill would take effect September 1, 2025.
Methodology
Based upon analysis provided by the Texas Medical Board (TMB), this estimate assumes that the agency will require 2.0 additional License and Permit Specialist positions ($57,851 each year with $17,309 in estimated benefits) to address the increased amount of licensure applications while maintaining current licensing processing times. This estimate assumes an additional annual cost of $23,370 for equipment and operating expenses related to the additional staffing position.
Based upon analysis provided by TMB and the Comptroller of Public Accounts, this estimate assumes that 200 individuals would apply each year for the foreign applicant provisional license and will pay a one-time application fee of $552 per applicant, resulting in $110,400 in annual revenue to the credit of the General Revenue Fund. Additionally, this estimate assumes that 170 individuals would apply each year for the graduate limited license and would pay a $220 application fee and a $267.50 registration fee for a license term of two years, resulting in annual revenue of $82,875 to the credit of the General Revenue Fund. This estimate assumes there will be no renewal applications and that all graduate limited licensees will enter into a residency program before they would need to renew their limited license.
Local Government Impact
No significant fiscal implication to units of local government is anticipated.
Source Agencies:
304 Comptroller of Public Accounts, 503 Texas Medical Board