AN ACT
relating to the regulation and enforcement of the practice of
medicine by the Texas State Board of Medical Examiners; providing a
criminal penalty.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subdivision (2), Subsection (a), Section 151.002,
Occupations Code, is amended to read as follows:
(2) "Continuing threat to the public welfare" means a
real [and present] danger to the health of a physician's patients or
to the public from the acts or omissions of the physician caused
through the physician's lack of competence, impaired status, or
failure to care adequately for the physician's patients, as
determined by:
(A) the board;
(B) a medical peer review committee in this state;
(C) a physician licensed to practice medicine in
this state or otherwise lawfully practicing medicine
in this state;
(D) a physician engaged in graduate medical education or training; or
(E) a medical student.
SECTION 2. Subsection (d), Section 153.051, Occupations
Code, is amended to read as follows:
(d) The board may not set, charge, collect, receive, or
deposit any of the following fees in excess of:
(1) $900 for a license;
(2) $400 [$200] for a first [annual] registration permit;
(3) $200 for a temporary license;
(4) $400 [$200] for renewal of a [an annual] registration permit;
(5) $200 for a physician-in-training permit;
(6) $600 [$300] for the processing of an application and
the issuance of a [an annual] registration for anesthesia
in an outpatient setting;
(7) $200 for an endorsement to other state medical boards;
(8) $200 for a duplicate license; or
(9) $700 for a reinstated license after cancellation for cause.
SECTION 3. Section 153.053, Occupations Code, is amended to
read as follows:
Sec. 153.053. SURCHARGE FOR CERTAIN FEES.
(a) The board shall collect a fee [an additional $200] surcharge
as follows [for each of the following fees]:
(1) $200 for the license fee;
(2) $400 for the first [annual] registration permit;
(3) $400 for renewal of a [annual] registration
permit; and
(4) $200 for reinstatement of a license after
cancellation for cause.
(b) Of each surcharge collected under Subsections (a)(1)
and (4), the board shall deposit $50 to the credit of the foundation
school fund and $150 to the credit of the general revenue fund.
(c) Of each surcharge collected under Subsections (a)(2)
and (3), the board shall deposit $100 to the credit of the
foundation school fund and $300 to the credit of the general
revenue fund.
SECTION 4. Subchapter B, Chapter 153, Occupations Code, is
amended by adding Section 153.0535 to read as follows:
Sec. 153.0535. SURCHARGE FOR REGISTRATION PERMIT. (a) The
board shall collect an additional $80 surcharge for each of the
following fees:
(1) first registration permit; and
(2) renewal of a registration permit.
(b) The board shall deposit each surcharge collected to the
credit of the public assurance account. The public assurance
account is an account in the general revenue fund that shall be
appropriated only to the board to pay for the board's enforcement
program, including the expert physician panel.
SECTION 5. Subchapter B, Chapter 153, Occupations Code, is
amended by adding Section 153.056 to read as follows:
Sec. 153.056. REPORT ON PENDING COMPLAINTS. The board
shall include with its annual financial report information
regarding any investigations that remain pending after one year,
including the reasons the investigations remain pending.
Information in the report under this section may not identify a
patient for any purpose unless proper consent to the release is
given by the patient.
SECTION 6. Subsection (a), Section 154.002, Occupations
Code, is amended to read as follows:
(a) The board shall prepare:
(1) an alphabetical list of the names of the license
holders;
(2) an alphabetical list of the names of the license
holders by the county in which the license holder's principal place
of practice is located;
(3) a summary of the board's functions;
(4) a copy of this subtitle and a list of other laws
relating to the practice of medicine;
(5) a copy of the board's rules; [and]
(6) a statistical report each fiscal year to the
legislature and the public that provides aggregate information
about all complaints received by the board categorized by type of
complaint, including administrative, quality of care, medical
error, substance abuse, other criminal behavior, and the
disposition of those complaints by category; and
(7) other information considered appropriate by the
board.
SECTION 7. Section 154.006, Occupations Code, is amended by
amending Subsections (a), (b), and (g) and adding Subsections (i)
and (j) to read as follows:
(a) The board shall create a profile of each physician
licensed under this subtitle. The profile must:
(1) include the information required by Subsection
(b); and
(2) be compiled in a format that makes [permits the
board to make] the information contained in the profile easily
available to the public.
(b) A profile must contain the following information on each
physician:
(1) the name of each medical school attended and the
dates of:
(A) graduation; or
(B) Fifth Pathway designation and completion of
the Fifth Pathway Program;
(2) a description of all graduate medical education in
the United States or Canada;
(3) any specialty certification held by the physician
and issued by a medical licensing board that is a member of the
American Board of Medical Specialties or the Bureau of Osteopathic
Specialists;
(4) the number of years the physician has actively
practiced medicine in:
(A) the United States or Canada; and
(B) this state;
(5) the name of each hospital in this state in which
the physician has privileges;
(6) the physician's primary practice location;
(7) the type of language translating services,
including translating services for a person with impairment of
hearing, that the physician provides at the physician's primary
practice location;
(8) whether the physician participates in the Medicaid
program;
(9) a description of any conviction for a felony, a
Class A or Class B misdemeanor, or a Class C misdemeanor involving
moral turpitude [during the 10-year period preceding the date of
the profile];
(10) a description of any charges reported to the
board [during the 10-year period preceding the date of the profile]
to which the physician has pleaded no contest, for which the
physician is the subject of deferred adjudication or pretrial
diversion, or in which sufficient facts of guilt were found and the
matter was continued by a court;
(11) a description of any disciplinary action against
the physician by the board [during the 10-year period preceding the
date of the profile];
(12) a description of any disciplinary action against
the physician by a medical licensing board of another state [during
the 10-year period preceding the date of the profile];
(13) a description of the final resolution taken by
the board on medical malpractice claims or complaints required to
be opened by the board under Section 164.201;
(14) whether the physician's patient service areas are
accessible to disabled persons, as defined by federal law; [and]
(15) a description of any formal complaint against the
physician initiated and filed under Section 164.005 and the status
of the complaint; and
(16) a description of any medical malpractice claim
against the physician, not including a description of any offers by
the physician to settle the claim, for which the physician was found
liable, a jury awarded monetary damages to the claimant, and the
award has been determined to be final and not subject to further
appeal.
(g) The board shall update the information contained in a
physician's profile annually, except that information provided
under Subsection (i) shall be updated not later than the 10th
working day after the date the formal complaint is filed or the
board's order is issued. The board shall adopt a form that allows a
physician to update information contained in a physician's profile.
The form shall be made available on the Internet and in other
formats as prescribed by board rule. The board may adopt rules
concerning the type and content of additional information that may
be included in a physician's profile.
(i) In addition to the information required by Subsection
(b), a profile must contain the text of a formal complaint filed
under Section 164.005 against the physician or of a board order
related to the formal complaint.
(j) Information included in a physician's profile under
Subsections (b) and (i) may not include any patient identifying
information.
SECTION 8. Section 154.054, Occupations Code, is amended to
read as follows:
Sec. 154.054. COMPLAINT INFORMATION TO HEALTH CARE ENTITY.
On written request, the board shall provide information to a health
care entity regarding:
(1) a complaint filed against a license 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 assigned by the executive
director to a person authorized by the board to pursue legal action.
SECTION 9. Section 154.056, Occupations Code, is amended by
amending Subsection (a) and adding Subsections (e) and (f) to read
as follows:
(a) The board shall adopt rules concerning the
investigation and review of a complaint filed with the board. The
rules adopted under this section must:
(1) distinguish among categories of complaints and
give priority to complaints that involve sexual misconduct, quality
of care, and impaired physician issues;
(2) ensure that a complaint is not dismissed without
appropriate consideration;
(3) require that the board be advised of the dismissal
of a complaint and that a letter be sent to the person who filed the
complaint and to the physician who was the subject of the complaint
explaining the action taken on the complaint;
(4) ensure that a person who files a complaint has an
opportunity to explain the allegations made in the complaint; [and]
(5) prescribe guidelines concerning the categories of
complaints that require the use of a private investigator and the
procedures for the board to obtain the services of a private
investigator;
(6) provide for an expert physician panel authorized
under Subsection (e) to assist with complaints and investigations
relating to medical competency; and
(7) require the review of reports filed with the
National Practitioner Data Bank for any report of the termination,
limitation, suspension, limitation in scope of practice, or
probation of clinical or hospital staff privileges of a physician
by:
(A) a hospital;
(B) a health maintenance organization;
(C) an independent practice association;
(D) an approved nonprofit health corporation
certified under Section 162.001; or
(E) a physician network.
(e) The board by rule shall provide for an expert physician
panel appointed by the board to assist with complaints and
investigations relating to medical competency. Each member of an
expert physician panel must be licensed to practice medicine in
this state. The rules adopted under this subsection must include
provisions governing the composition of the panel, qualifications
for membership on the panel, and the duties to be performed by the
panel.
(f) In the board rules adopted under Subsection (a)(3), the
board shall require that the letter informing the person who filed
the complaint of the dismissal of the complaint include an
explanation of the reason the complaint was dismissed.
SECTION 10. Section 154.058, Occupations Code, is amended
to read as follows:
Sec. 154.058. DETERMINATION OF MEDICAL COMPETENCY.
(a) Each complaint against a physician that requires a
determination of medical competency shall be reviewed initially by
a board member, consultant, or employee with a medical background
considered sufficient by the board.
(b) If the initial review under Subsection (a) indicates
that an act by a physician falls below an acceptable standard of
care, the complaint shall be reviewed by an expert physician panel
authorized under Section 154.056(e) consisting of physicians who
practice in the same specialty as the physician who is the subject
of the complaint or in another specialty that is similar to the
physician's specialty.
(c) The expert physician panel shall report in writing the
panel's determinations based on the review of the complaint under
Subsection (b). The report must specify the standard of care that
applies to the facts that are the basis of the complaint and the
clinical basis for the panel's determinations, including any
reliance on peer-reviewed journals, studies, or reports.
SECTION 11. The heading to Chapter 156, Occupations Code,
is amended to read as follows:
CHAPTER 156. REGISTRATION OF PHYSICIANS [LICENSE RENEWAL]
SECTION 12. Section 156.001, Occupations Code, is amended
to read as follows:
Sec. 156.001. [ANNUAL] REGISTRATION REQUIREMENTS AND
PROCEDURES [REQUIRED; REGISTRATION PROCEDURE]. (a) Each person
licensed to practice medicine in this state must register with the
board every two years [annually]. The initial [annual]
registration permit shall be issued with the license and expires on
the last day of the birth month of the license holder.
(b) Except as provided by Section 156.002, the application
for registration must be accompanied by a [an annual] registration
permit fee in an amount set by the board regardless of whether the
person is practicing medicine in this state.
(c) A license holder may renew the [annual] registration
permit by submitting to the board, on or before the expiration date
of the [annual] registration permit, the required renewal
application and registration renewal fee. Each [annual]
registration permit renewal application must include:
(1) the license holder's name, [and] mailing address,
and, if one is available, address for receipt of electronic mail;
(2) the primary place [or places] at which the license
holder is engaged in the practice of medicine; and
(3) other necessary information as prescribed by [the]
board rule.
(d) If the license holder [person] is licensed to practice
medicine by another state or country or by the uniformed services of
the United States, the registration renewal application must
include a description of any investigation the license holder
[person] knows is in progress and any sanction imposed by or
disciplinary matter pending in the state, country, or service
regarding the license holder [person].
SECTION 13. Section 156.002, Occupations Code, is amended
to read as follows:
Sec. 156.002. EXEMPTION FOR CERTAIN PHYSICIANS. (a) The
board by rule may exempt a retired physician from the [annual]
registration permit fee requirement.
(b) A physician licensed by the board whose only practice is
voluntary charity care, as defined by board rule, is exempt from the
[annual] registration permit fee requirement.
SECTION 14. Section 156.003, Occupations Code, is amended
to read as follows:
Sec. 156.003. STAGGERED RENEWAL SYSTEM. (a) The board by
rule may adopt a system under which [annual] registration permits
expire on various dates during the two-year registration period
[year].
(b) For the registration period [year] in which the
expiration date is changed, [annual] registration permit fees shall
be prorated. On renewal of the registration on the new expiration
date, the total [annual] registration permit fee is payable.
SECTION 15. Section 156.004, Occupations Code, is amended
to read as follows:
Sec. 156.004. NOTICE OF EXPIRATION. The board shall send a
[mail an annual] registration permit renewal application notice to
each physician at the physician's last known address according to
the board's records at least 30 days before the expiration date of
the [annual] registration permit. The board shall provide for a
30-day grace period for renewing the [annual] registration permit
from the date of the expiration of the permit.
SECTION 16. Section 156.005, Occupations Code, is amended
to read as follows:
Sec. 156.005. RENEWAL OF CERTAIN REGISTRATION PERMITS.
(a) If a person's [annual] registration permit has been expired
for 90 days or less, the person may renew the permit by submitting
to the board the required registration renewal application, the
registration renewal fee, and a $75 [$50] penalty fee.
(b) If the person's [annual] registration permit has been
expired for longer than 90 days but less than one year, the person
may renew the permit by submitting to the board the required
registration renewal application, the registration renewal fee,
and a $150 [$100] penalty fee.
(c) If the person's [annual] registration permit has been
expired for one year or longer, the person's license is
automatically [considered to have been] canceled, unless an
investigation is pending, and the person may not renew the [annual]
registration permit.
(d) A physician whose license is automatically [considered]
canceled may obtain a new license by [submitting to reexamination
and] complying with the requirements, fees, and procedures for
obtaining a new license. The board may issue a new license without
examination to a person whose license is automatically [considered]
canceled for less than two years.
SECTION 17. Section 156.007, Occupations Code, is amended
to read as follows:
Sec. 156.007. ISSUANCE OF [ANNUAL] REGISTRATION PERMIT.
(a) On receipt of a registration renewal application and all
required fees, the board, after ascertaining from the records of
the board or from other sources considered reliable by the board
that the applicant is a physician in this state and meets all other
requirements for registration, shall issue to the applicant a [an
annual] registration permit certifying that the applicant has filed
the application, has paid the [annual] registration permit fee for
the registration period [year], and has completed the requirements
for [annual] registration.
(b) The filing of the registration renewal application, the
payment of the required fees, and the issuance of the permit do
[does] not entitle the permit holder to practice medicine in this
state unless:
(1) the permit holder has been previously licensed as
a physician by the board, as prescribed by law; [and]
(2) the license to practice medicine is in effect;
(3) the permit holder has met the continuing medical
education requirements; and
(4) the permit holder has submitted a current complete
physician profile.
SECTION 18. Section 156.008, Occupations Code, is amended
to read as follows:
Sec. 156.008. PRACTICING MEDICINE WITHOUT [ANNUAL]
REGISTRATION PROHIBITED. (a) Practicing medicine after the
expiration of the 30-day grace period under Section 156.004
following expiration of a [an annual] registration permit that has
not been renewed for the current registration period [year] as
provided by this subchapter has the same effect as, and is subject
to all penalties of, practicing medicine without a license.
(b) In a prosecution for the unlawful practice of medicine,
the receipt showing payment of the [annual] registration fee
required by this chapter does not constitute evidence that the
receipt holder is lawfully entitled to practice medicine.
SECTION 19. Section 156.009, Occupations Code, is amended
to read as follows:
Sec. 156.009. INACTIVE STATUS. The board may adopt rules
and set reasonable fees relating to placing license holders on
inactive status. [The board by rule shall set a time limit for the
period during which a license holder may remain on inactive
status.]
SECTION 20. Subsections (a) and (d), Section 156.051,
Occupations Code, are amended to read as follows:
(a) The board by rule shall adopt, monitor, and enforce a
reporting program for the continuing medical education of license
holders. The board shall adopt and administer rules that:
(1) establish the number of hours of continuing
medical education the board determines appropriate as a
prerequisite to the [annual] registration of a license under this
subtitle;
(2) require at least one-half of the hours of
continuing medical education established under Subdivision (1) to
be board approved; and
(3) adopt a process to assess a license holder's
participation in continuing medical education courses.
(d) This section does not apply to a license holder who is
[retired and is] exempt by rule from paying the [annual]
registration fee under Section 156.002(a).
SECTION 21. Section 156.052, Occupations Code, is amended
to read as follows:
Sec. 156.052. PRESUMPTION OF COMPLIANCE FOR CERTAIN LICENSE
HOLDERS. A license holder is presumed to be in compliance with the
requirements of this subchapter if, during the 36 months preceding
the date of the required [annual] registration, the license holder
becomes board certified or recertified by [in] a [medical]
specialty board approved by [and that medical specialty program
considers the standards of:
[(1)] the American Board of Medical Specialties[;
[(2) the American Medical Association;
[(3) the Advisory Board for Osteopathic Specialists
and Boards of Certification;] or
[(4)] the American Osteopathic Association Bureau of
Osteopathic Specialists.
SECTION 22. Section 156.053, Occupations Code, is amended
to read as follows:
Sec. 156.053. TEMPORARY EXEMPTION. (a) The board may
temporarily exempt a license holder from the continuing medical
education requirement on the basis of [for]:
(1) catastrophic illness;
(2) military service outside this state for longer
than one year;
(3) medical practice and residence outside the United
States for longer than one year; or
(4) good cause shown on the written application of the
license holder that provides evidence satisfactory to the board
that the license holder is unable to comply with the requirement.
(b) A temporary exemption granted under Subsection (a) may
not exceed one year but may be renewed [annually].
SECTION 23. Subsection (a), Section 160.052, Occupations
Code, is amended to read as follows:
(a) Each insurer shall submit to the board the report or
other information described by Section 160.053 at the time
prescribed. The insurer shall provide the report or information
with respect to:
(1) a [notice of claim letter or] complaint filed
against an insured in a court, if the [notice of claim letter or]
complaint seeks damages relating to the insured's conduct in
providing or failing to provide a medical or health care service;
and
(2) settlement of a claim without the filing of a
lawsuit or settlement of a lawsuit made on behalf of the insured
involving damages relating to the insured's conduct in providing or
failing to provide a medical or health care service.
SECTION 24. Section 160.053, Occupations Code, is amended
to read as follows:
Sec. 160.053. CONTENTS OF REPORT; ADDITIONAL INFORMATION.
(a) Not later than the 30th day after the date an insurer receives
from an insured a [notice of claim letter or] complaint filed in a
lawsuit, a settlement of a claim without the filing of a lawsuit, or
a settlement of a lawsuit against the [from an] insured, the insurer
shall furnish to the board:
(1) the name of the insured and the insured's Texas
medical license number;
(2) the policy number; [and]
(3) a copy of the [notice of claim letter or] complaint
or settlement; and
(4) a copy of any expert report filed under Section
13.01, Medical Liability and Insurance Improvement Act of Texas
(Article 4590i, Vernon's Texas Civil Statutes).
(b) The board, in consultation with the commissioner, shall
adopt rules for reporting additional information as the board
requires. In adopting the rules, the board shall consider other
claim reports required under state and federal statutes in
determining the information to be reported, form of the report, and
frequency of reporting. The rules adopted by the board under this
subsection must require that the following additional [Additional]
information be reported [the board requires may include]:
(1) the date of a judgment, dismissal, or settlement;
(2) whether an appeal has been taken and by which
party; and
(3) the amount of the settlement or judgment against
the insured.
SECTION 25. Subsection (a), Section 162.104, Occupations
Code, is amended to read as follows:
(a) The board shall require each physician who administers
anesthesia or performs a surgical procedure for which anesthesia
services are provided in an outpatient setting to [annually]
register with the board on a form prescribed by the board and to pay
a fee to the board in an amount established by the board.
SECTION 26. Section 164.001, Occupations Code, is amended
by adding Subsections (f) through (i) to read as follows:
(f) The board by rule shall adopt a schedule of the
disciplinary sanctions that the board may impose under this
subchapter. In adopting the schedule of sanctions, the board shall
ensure that the severity of the sanction imposed is appropriate to
the type of violation or conduct that is the basis for disciplinary
action.
(g) In determining the appropriate disciplinary action,
including the amount of any administrative penalty to assess, the
board shall consider whether the person:
(1) is being disciplined for multiple violations of
this subtitle or a rule or order adopted under this subtitle; or
(2) has previously been the subject of disciplinary
action by the board.
(h) In the case of a person described by:
(1) Subsection (g)(1), the board shall consider taking
a more severe disciplinary action, including revocation of the
person's license, than the disciplinary action that would be taken
for a single violation; and
(2) Subsection (g)(2), the board shall consider
revoking the person's license if the person has repeatedly been the
subject of disciplinary action by the board.
(i) If the board chooses not to revoke the license of a
person described by Subsection (g)(2), the board shall consider
taking a more severe disciplinary action than the disciplinary
action previously taken.
SECTION 27. Section 164.003, Occupations Code, is amended
by amending Subsection (b) and adding Subsection (e) to read as
follows:
(b) Rules adopted under this section must require that:
(1) an informal meeting in compliance with Section
2001.054, Government Code, be scheduled not later than the 180th
day after the date the complaint is filed with the board under
Section 154.051, unless good cause is shown by the board for
scheduling the informal meeting after that date;
(2) the board give notice to the license holder of the
time and place of the meeting not later than the 30th day before the
date the meeting is held;
(3) the complainant and the license holder be provided
an opportunity to be heard;
(4) [(2)] the board's legal counsel or a
representative of the attorney general be present to advise the
board or the board's staff; and
(5) [(3)] a member of the board's staff at the meeting
present to the board's representative the facts the staff
reasonably believes it could prove by competent evidence or
qualified witnesses at a hearing.
(e) If the license holder has previously been the subject of
disciplinary action by the board, the board shall schedule the
informal meeting as soon as practicable but not later than the
deadline prescribed by Subsection (b)(1).
SECTION 28. Subchapter A, Chapter 164, Occupations Code, is
amended by adding Section 164.0035 to read as follows:
Sec. 164.0035. DISMISSAL OF BASELESS COMPLAINT. If, during
the 180-day period prescribed by Section 164.003(b)(1), the board
determines that the complaint is a baseless or unfounded complaint,
the board shall dismiss the complaint and include a statement in the
records of the complaint that the reason for the dismissal is
because the complaint was baseless or unfounded. The board shall
adopt rules that establish criteria for determining that a
complaint is baseless or unfounded.
SECTION 29. Section 164.010, Occupations Code, is amended
by adding Subsection (c) to read as follows:
(c) The board shall immediately investigate:
(1) a violation of a disciplinary order by a license
holder described by Subsection (a); or
(2) a complaint filed against a license holder
described by Subsection (a).
SECTION 30. Subsection (c), Section 164.011, Occupations
Code, is amended to read as follows:
(c) A stay or injunction may not be granted if the license
holder's continued practice presents a danger to the public. A stay
or injunction may not be granted for a term that exceeds 120 days.
SECTION 31. Section 164.051, Occupations Code, is amended
by amending Subsections (a) and (c) and adding Subsection (d) to
read as follows:
(a) The board may refuse to admit a person to its
examination or refuse to issue a license to practice medicine and
may take disciplinary action against a person if the person:
(1) commits an act prohibited under Section 164.052;
(2) is convicted of, or is placed on deferred
adjudication community supervision or deferred disposition for:
(A) a felony; or
(B) a misdemeanor involving moral turpitude;
(3) commits or attempts to commit a direct or indirect
violation of a rule adopted under this subtitle, either as a
principal, accessory, or accomplice;
(4) is unable to practice medicine with reasonable
skill and safety to patients because of:
(A) illness;
(B) drunkenness;
(C) excessive use of drugs, narcotics,
chemicals, or another substance; or
(D) a mental or physical condition;
(5) is found by a court judgment to be of unsound mind;
(6) fails to practice medicine in an acceptable
professional manner consistent with public health and welfare;
(7) is removed, suspended, or is subject to
disciplinary action taken by the person's peers in a local,
regional, state, or national professional medical association or
society, or is disciplined by a licensed hospital or medical staff
of a hospital, including removal, suspension, limitation of
hospital privileges, or other disciplinary action, if the board
finds that the action:
(A) was based on unprofessional conduct or
professional incompetence that was likely to harm the public; and
(B) was appropriate and reasonably supported by
evidence submitted to the board;
(8) is subject to repeated or recurring meritorious
health care liability claims that in the board's opinion evidence
professional incompetence likely to injure the public; or
(9) except as provided by Subsection (d), holds a
license to practice medicine subject to disciplinary action by
another state, or subject to disciplinary action by the uniformed
services of the United States, based on acts by the person that are
prohibited under Section 164.052 or are similar to acts described
by this subsection.
(c) A certified copy of the record of another state that
takes action described by Subsection (a)(9) or (d) is conclusive
evidence of that action.
(d) The board shall revoke a license issued under this
subtitle if the license holder held a license to practice medicine
in another state that has been revoked by the licensing authority in
that state.
SECTION 32. Subsection (a), Section 164.053, Occupations
Code, is amended to read as follows:
(a) For purposes of Section 164.052(a)(5), unprofessional
or dishonorable conduct likely to deceive or defraud the public
includes conduct in which a physician:
(1) commits an act that violates any [the laws of this]
state or federal law if the act is connected with the physician's
practice of medicine;
(2) fails to keep complete and accurate records of
purchases and disposals of:
(A) drugs listed in Chapter 481, Health and
Safety Code; or
(B) controlled substances scheduled in the
Comprehensive Drug Abuse Prevention and Control Act of 1970 (21
U.S.C. Section 801 et seq.);
(3) writes prescriptions for or dispenses to a person
who:
(A) is known to be an abuser of narcotic drugs,
controlled substances, or dangerous drugs; or
(B) the physician should have known was an abuser
of narcotic drugs, controlled substances, or dangerous drugs;
(4) writes false or fictitious prescriptions for:
(A) dangerous drugs as defined by Chapter 483,
Health and Safety Code; or
(B) controlled substances scheduled in Chapter
481, Health and Safety Code, or the Comprehensive Drug Abuse
Prevention and Control Act of 1970 (21 U.S.C. Section 801 et seq.);
(5) prescribes or administers a drug or treatment that
is nontherapeutic in nature or nontherapeutic in the manner the
drug or treatment is administered or prescribed;
(6) prescribes, administers, or dispenses in a manner
inconsistent with public health and welfare:
(A) dangerous drugs as defined by Chapter 483,
Health and Safety Code; or
(B) controlled substances scheduled in Chapter
481, Health and Safety Code, or the Comprehensive Drug Abuse
Prevention and Control Act of 1970 (21 U.S.C. Section 801 et seq.);
(7) violates Section 311.0025, Health and Safety Code;
(8) fails to supervise adequately the activities of
those acting under the supervision of the physician; or
(9) delegates professional medical responsibility or
acts to a person if the delegating physician knows or has reason to
know that the person is not qualified by training, experience, or
licensure to perform the responsibility or acts.
SECTION 33. Section 164.057, Occupations Code, is amended
to read as follows:
Sec. 164.057. REQUIRED SUSPENSION OR REVOCATION OF LICENSE
FOR CERTAIN [FELONY] OFFENSES. (a) The board shall suspend a
physician's license on proof that the physician has been:
(1) initially convicted of:
(A) a felony;
(B) a misdemeanor under Chapter 22, Penal Code,
other than a misdemeanor punishable by fine only;
(C) a misdemeanor on conviction of which a
defendant is required to register as a sex offender under Chapter
62, Code of Criminal Procedure;
(D) a misdemeanor under Section 25.07, Penal
Code; or
(E) a misdemeanor under Section 25.071, Penal
Code; or
(2) subject to an initial finding by the trier of fact
of guilt of a felony under:
(A) [(1)] Chapter 481 or 483, Health and Safety
Code;
(B) [(2)] Section 485.033, Health and Safety
Code; or
(C) [(3)] the Comprehensive Drug Abuse
Prevention and Control Act of 1970 (21 U.S.C. Section 801 et seq.).
(b) On final conviction for an offense [a felony] described
by Subsection (a), the board shall revoke the physician's license.
SECTION 34. Section 164.059, Occupations Code, is amended
to read as follows:
Sec. 164.059. TEMPORARY SUSPENSION OR RESTRICTION OF
LICENSE. (a) The president of the board[, with board approval,]
shall appoint a three-member disciplinary panel consisting of board
members to determine whether a person's license to practice
medicine should be temporarily suspended or restricted.
(b) If the disciplinary panel determines from the evidence
[or information] presented to the panel that a person licensed to
practice medicine would, by the person's continuation in practice,
constitute a continuing threat to the public welfare, the
disciplinary panel shall temporarily suspend or restrict the
license of that person.
(c) A license may be suspended or restricted by a
disciplinary panel under this section without notice or hearing [on
the complaint] if:
(1) the board immediately provides notice of the
suspension or restriction to the license holder; and
(2) [institution of proceedings for] a hearing on the
temporary suspension or restriction before a disciplinary panel of
the board is scheduled for the earliest possible date after 10 days'
notice of hearing [initiated simultaneously with the temporary
suspension; and
[(2) a hearing is held under Chapter 2001, Government
Code, and this subtitle 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 of the panel at one
location is inconvenient for any member of the disciplinary panel.
(e) After the hearing before the disciplinary panel
described by Subsection (c), if the disciplinary panel affirms the
temporary suspension or restriction of the license holder's
license, the board shall schedule an informal compliance meeting
that meets the requirements of Section 2001.054(c), Government
Code, and Section 164.004 of this code to be held as soon as
practicable, unless the license holder waives the informal meeting
or an informal meeting has already been held with regard to the
issues that are the basis for the temporary suspension or
restriction.
(f) If the license holder is unable to show compliance at
the informal meeting described by Subsection (e) regarding the
issues that are the basis for the temporary suspension or
restriction, a board representative shall file a formal complaint
under Section 164.005 as soon as practicable.
(g) If, after the hearing described by Subsection (c), the
disciplinary panel does not temporarily suspend or restrict the
license holder's license, the facts that were the basis for the
temporary suspension or restriction may not be the sole basis of
another proceeding to temporarily suspend or restrict the license
holder's license. The board may use those same facts in a
subsequent investigation to obtain new information that may be the
basis for the temporary suspension or restriction of the license
holder's license. For purposes of this subsection, facts that are
the basis for the temporary suspension or restriction of a license
holder's license include facts presented to the disciplinary panel
and facts presented by the board or a representative of the board at
the time evidence was presented to the disciplinary panel.
SECTION 35. Subsection (c), Section 164.060, Occupations
Code, is amended to read as follows:
(c) If the board, during its review of a complaint against a
physician, discovers an act or omission that may constitute a
felony, a misdemeanor involving moral turpitude, a violation of
state or federal narcotics or controlled substance laws, [or] an
offense involving fraud or abuse under the Medicare or Medicaid
programs, or a violation of the workers' compensation laws under
Subtitle A, Title 5, Labor Code, the board shall immediately report
that act or omission to the appropriate prosecuting and regulatory
authorities [authority].
SECTION 36. Section 164.201, Occupations Code, is amended
to read as follows:
Sec. 164.201. REVIEW BY BOARD IF THREE OR MORE MALPRACTICE
CLAIMS. The board shall review the medical competency of
[information relating to] a physician against whom three or more
expert reports under Section 13.01, Medical Liability and Insurance
Improvement Act of Texas (Article 4590i, Vernon's Texas Civil
Statutes), have been filed in three separate lawsuits [malpractice
claims have been reported under Subchapter B, Chapter 154,] within
a five-year period in the same manner as if a complaint against the
physician had been made to the board under Section 154.051.
SECTION 37. Subsection (c), Section 165.152, Occupations
Code, is amended to read as follows:
(c) An offense under Subsection (a) is a [Class A
misdemeanor, except that if it is shown in the trial of the offense
that the defendant has previously been convicted under Subsection
(a), the offense is a] felony of the third degree.
SECTION 38. Subchapter B, Chapter 408, Labor Code, is
amended by adding Section 408.030 to read as follows:
Sec. 408.030. REPORTS OF PHYSICIAN VIOLATIONS. If the
commission discovers an act or omission by a physician that may
constitute a felony, a misdemeanor involving moral turpitude, a
violation of a state or federal narcotics or controlled substance
law, an offense involving fraud or abuse under the Medicare or
Medicaid program, or a violation of this subtitle, the commission
shall immediately report that act or omission to the Texas State
Board of Medical Examiners.
SECTION 39. (a) This Act takes effect immediately if it
receives a vote of two-thirds of all the members elected to each
house, as provided by Section 39, Article III, Texas Constitution.
If this Act does not receive the vote necessary for immediate
effect, this Act takes effect September 1, 2003.
(b) The Texas State Board of Medical Examiners shall adopt
rules required by Subsection (f), Section 164.001, Occupations
Code, as added by this Act, not later than January 1, 2004.
(c) The change in law made by this Act by the amendment of
Section 164.051, Occupations Code, applies to a physician whose
license to practice medicine in another state was revoked on,
before, or after the effective date of this Act.
(d) The change in law made by this Act by the amendment of
Section 164.057, Occupations Code, applies only to a person who is
initially convicted of an offense on or after the effective date of
this Act. A person initially convicted of an offense before that
date is governed by the law in effect on the date the conviction
occurred, and the former law is continued in effect for that
purpose.
SECTION 40. (a) The changes in law made by this Act
relating to the biennial registration of physicians apply to a
person who files with the Texas State Board of Medical Examiners an
application for registration under Chapter 156, Occupations Code,
as amended by this Act, on or after January 1, 2005. A person who
files an application before that date is governed by the law in
effect on the date the application was filed, and the former law is
continued in effect for that purpose.
(b) The Texas State Board of Medical Examiners may adopt a
staggered registration system as provided by Section 156.003,
Occupations Code, as amended by this Act, on or after September 1,
2004.
(c) The Texas State Board of Medical Examiners shall adopt
the rules required by Chapter 156, Occupations Code, as amended by
this Act, not later than December 1, 2003.
SECTION 41. The change in law made by this Act by the
enactment of Section 153.0535, Occupations Code, applies to a
registration permit fee that becomes due on or after January 1,
2004. A registration permit fee that becomes due before that date
is governed by the law in effect on the date the fee became due, and
the former law is continued in effect for that purpose.
SECTION 42. Subsection (a), Section 160.052, and Subsection
(a), Section 160.053, Occupations Code, as amended by this Act,
apply only to a settlement entered into on or after the effective
date of this Act. A settlement entered into before the effective
date of this Act is governed by the law as it existed on the date the
settlement was entered into, and that law is continued in effect for
that purpose.
SECTION 43. The change in law made by this Act by the
amendment of Subsection (c), Section 165.152, Occupations Code,
applies only to an offense committed on or after the effective date
of this Act. An offense committed before the effective date of this
Act is covered by the law in effect when the offense was committed,
and the former law is continued in effect for that purpose. For
purposes of this section, an offense was committed before the
effective date of this Act if any element of the offense occurred
before that date.
SECTION 44. The change in law made by this Act relating to
the investigation and disposition of a complaint and any proceeding
begun as a result of a complaint investigation applies only to a
complaint filed with the Texas State Board of Medical Examiners on
or after the effective date of this Act. A complaint filed before
the effective date of this Act is governed by the law in effect on
the date the complaint was made, and the former law is continued in
effect for that purpose.
______________________________ ______________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 104 passed the Senate on
March 10, 2003, by the following vote: Yeas 31, Nays 0;
April 25, 2003, Senate refused to concur in House amendments and
requested appointment of Conference Committee; April 30, 2003,
House granted request of the Senate; May 23, 2003, Senate adopted
Conference Committee Report by the following vote: Yeas 30,
Nays 0.
______________________________
Secretary of the Senate
I hereby certify that S.B. No. 104 passed the House, with
amendments, on March 19, 2003, by the following vote: Yeas 147,
Nays 0, one present not voting; April 30, 2003, House granted
request of the Senate for appointment of Conference Committee;
May 22, 2003, House adopted Conference Committee Report by the
following vote: Yeas 142, Nays 0, one present not voting.
______________________________
Chief Clerk of the House
Approved:
______________________________
Date
______________________________
Governor
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