83R2223 SLB-D
By: Zerwas H.B. No. 1546
A BILL TO BE ENTITLED
AN ACT
relating to the regulation of medical radiologic technology;
providing penalties; imposing fees.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 601.002, Occupations Code, is amended by
amending Subdivision (3) and adding Subdivisions (5-a), (10-a), and
(11-a) to read as follows:
(3) "Department" means the [Texas] Department of State
Health Services.
(5-a) "Executive commissioner" means the executive
commissioner of the Health and Human Services Commission.
(10-a) "Radiologist" means a physician specializing
in radiology certified by or board-eligible for the American Board
of Radiology, the American Osteopathic Board of Radiology, the
British Royal College of Radiologists, or the Canadian College of
Physicians and Surgeons.
(11-a) "Registered radiologist assistant" means an
advanced-level medical radiologic technologist, other than a
practitioner, who is registered under Chapter 207 as a radiologist
assistant.
SECTION 2. Sections 601.056(a) and (b), Occupations Code,
are amended to read as follows:
(a) The executive commissioner [board] with the assistance
of other appropriate state agencies shall identify by rule
radiologic procedures, other than radiologic procedures described
by Subsection (c), that are dangerous or hazardous and that may be
performed only by a practitioner, [or] a medical radiologic
technologist certified under this chapter, or a registered
radiologist assistant.
(b) In adopting rules under Subsection (a), the executive
commissioner [board] may consider whether the radiologic procedure
will be performed by a registered nurse, [or] a licensed physician
assistant, or a registered radiologist assistant.
SECTION 3. Subtitle C, Title 3, Occupations Code, is
amended by adding Chapter 207 to read as follows:
CHAPTER 207. REGISTERED RADIOLOGIST ASSISTANTS
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 207.001. DEFINITIONS. In this chapter:
(1) "Board" means the Texas Medical Board.
(2) "Direct supervision" means supervision by a
radiologist who is present in the facility in which the registered
radiologist assistant is performing radiology services and is
immediately available to provide assistance and direction while
radiology services are being performed.
(3) "Immediately available" means in the same physical
location or facility in which the services are provided.
(4) "Radiologist" means a physician specializing in
radiology certified by the American Board of Radiology, the
American Osteopathic Board of Radiology, the British Royal College
of Radiologists, or the Canadian College of Physicians and
Surgeons.
(5) "Registered radiologist assistant" means a person
who is registered under this chapter as a registered radiologist
assistant.
SUBCHAPTER B. POWERS AND DUTIES OF BOARD
Sec. 207.051. GENERAL POWERS AND DUTIES. The board shall:
(1) establish qualifications for a registered
radiologist assistant to practice in this state;
(2) establish requirements for an examination for
registration to practice as a registered radiologist assistant;
(3) establish minimum education and training
requirements necessary for registration to practice as a registered
radiologist assistant;
(4) prescribe the application form for registration to
practice as a registered radiologist assistant; and
(5) develop an approved program of mandatory
continuing education and the manner in which attendance at all
approved courses, clinics, forums, lectures, programs, or seminars
is monitored and recorded.
Sec. 207.052. GIFTS, GRANTS, AND DONATIONS. In addition to
any fees paid to the board or money appropriated to the board, the
board may receive and accept under this chapter a gift, grant,
donation, or other item of value from any source, including the
United States or a private source.
SUBCHAPTER C. PUBLIC INTEREST INFORMATION; COMPLAINT AND
INVESTIGATIVE INFORMATION
Sec. 207.101. PUBLIC PARTICIPATION. (a) The board shall
develop and implement policies that provide the public with a
reasonable opportunity to appear before the board and speak on any
issue relating to registered radiologist assistants.
(b) The executive director of the board shall prepare and
maintain a written plan that describes how a person who does not
speak English may be provided reasonable access to the board's
programs and services under this chapter.
Sec. 207.102. PUBLIC INTEREST INFORMATION. (a) The board
shall prepare information of public interest describing the
functions of the board and the procedures by which complaints are
filed and resolved under this chapter.
(b) The board shall make the information available to the
public and appropriate state agencies.
Sec. 207.103. COMPLAINTS. (a) The board by rule shall
establish methods by which consumers and service recipients are
notified of the name, mailing address, and telephone number of the
board for the purpose of directing complaints about registered
radiologist assistants to the board.
(b) The board shall list with its regular telephone number
any toll-free telephone number established under other state law
that may be called to present a complaint about a registered
radiologist assistant.
Sec. 207.104. RECORDS OF COMPLAINTS. (a) The board shall
maintain a file on each written complaint filed with the board under
this chapter. The file must include:
(1) the name of the person who filed the complaint;
(2) the date the complaint is received by the board;
(3) the subject matter of the complaint;
(4) the name of each person contacted in relation to
the complaint;
(5) a summary of the results of the review or
investigation of the complaint; and
(6) an explanation of the reason the file was closed,
if the board closed the file without taking action other than to
investigate the complaint.
(b) The board shall provide to the person filing the
complaint and to each person who is a subject of the complaint a
copy of the board's policies and procedures relating to complaint
investigation and resolution. A person who reports a complaint by
phone shall be given information on how to file a written complaint.
(c) The board, at least quarterly and until final
disposition of the complaint, shall notify the person filing the
complaint and each person who is a subject of the complaint of the
status of the investigation unless the notice would jeopardize an
undercover investigation.
Sec. 207.105. REGISTRATION HOLDER ACCESS TO COMPLAINT
INFORMATION. (a) The board shall provide a registration holder who
is the subject of a formal complaint filed under this chapter with
access to all information in its possession that the board intends
to offer into evidence in presenting its case in chief at the
contested hearing on the complaint, subject to any other privilege
or restriction established by rule, statute, or legal precedent.
The board shall provide the information not later than the 30th day
after receipt of a written request from the registration holder or
the registration holder's counsel, unless good cause is shown for
delay.
(b) Notwithstanding Subsection (a), the board is not
required to provide:
(1) board investigative reports;
(2) investigative memoranda;
(3) the identity of a nontestifying complainant;
(4) attorney-client communications;
(5) attorney work product; or
(6) other material covered by a privilege recognized
by the Texas Rules of Civil Procedure or the Texas Rules of
Evidence.
(c) The provision of information does not constitute a
waiver of privilege or confidentiality under this chapter or other
law.
Sec. 207.106. HEALTH CARE ENTITY REQUEST FOR INFORMATION.
On the written request of a health care entity, the board shall
provide to the entity:
(1) information about a complaint filed against a
registration 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 referred by the executive
director or the director's designee for legal action.
Sec. 207.107. CONFIDENTIALITY OF INVESTIGATIVE
INFORMATION. A complaint, adverse report, investigation file, or
other report, the identity of and reports made by a physician or
registered radiologist assistant performing or supervising
compliance monitoring for the board, or other investigative
information in the possession of or received or gathered by the
board, a board employee, or an agent relating to a registration
holder, a registration application, or a criminal investigation or
proceeding is privileged and confidential and is not subject to
discovery, subpoena, or other means of legal compulsion for release
to any person other than the board or a board employee or agent
involved in registration holder discipline.
Sec. 207.108. PERMITTED DISCLOSURE OF INVESTIGATIVE
INFORMATION. (a) Investigative information in the possession of
the board, a board employee, or an agent that relates to the
discipline of a registration holder may be disclosed to:
(1) a licensing authority in another state or a
territory or country in which the registration holder is licensed
or registered or has applied for a license or registration; or
(2) a peer review committee reviewing:
(A) an application for privileges; or
(B) the qualifications of the registration
holder with respect to retaining privileges.
(b) If the investigative information in the possession of
the board or a board employee or agent indicates a crime may have
been committed, the board shall report the information to the
proper law enforcement agency. The board shall cooperate with and
assist all law enforcement agencies conducting criminal
investigations of a registration holder by providing information
relevant to the investigation. Confidential information disclosed
by the board to a law enforcement agency remains confidential and
may not be disclosed by the law enforcement agency except as
necessary to further the investigation.
Sec. 207.109. IMMUNITY AND REPORTING REQUIREMENTS. (a) A
medical peer review committee in this state, a quality assurance
committee in this state, a registered radiologist assistant, a
registered radiologist assistant student, or a physician
practicing medicine in this state shall report relevant information
to the board related to the acts of a registered radiologist
assistant in this state if, in that person's opinion, a registered
radiologist assistant poses a continuing threat to the public
welfare through the person's practice as a registered radiologist
assistant. The duty to report under this section may not be
nullified through contract.
(b) A person who, without malice, furnishes records,
information, or assistance to the board under this section is
immune from any civil liability arising from that action in a suit
against the person brought by or on behalf of a registered
radiologist assistant who is reported under this section.
(c) Sections 160.002, 160.003, 160.006, 160.007, 160.009,
160.013, and 160.014 apply to medical peer review regarding a
registered radiologist assistant.
SUBCHAPTER D. REGISTRATION REQUIREMENTS
Sec. 207.151. LICENSE REQUIRED. (a) A person may not
practice as a registered radiologist assistant unless the person is
registered under this chapter.
(b) Unless the person holds a registration under this
chapter, a person may not use, in connection with the person's name:
(1) the title "Registered Radiologist Assistant"; or
(2) any other designation that would imply that the
person is a registered radiologist assistant.
Sec. 207.152. REGISTRATION APPLICATION. An applicant for
registration must:
(1) file a written application with the board on a form
prescribed by the board; and
(2) pay the application fee set by the board.
Sec. 207.153. REGISTRATION ELIGIBILITY. To be eligible for
a registration, a person must:
(1) be a medical radiologic technologist certified
under Chapter 601;
(2) have a baccalaureate degree, postbaccalaureate
certificate, or graduate degree from an advanced academic program
encompassing a nationally recognized radiologist assistant
curriculum that incorporates a radiologist-directed clinical
preceptorship;
(3) be certified as a registered radiologist assistant
by the American Registry of Radiologic Technologists or be
certified as a radiology practitioner assistant by the
Certification Board for Radiology Practitioner Assistants; and
(4) be credentialed to provide radiology services
under the supervision of a radiologist.
Sec. 207.154. FEES. (a) The board shall set and collect
fees in amounts that are reasonable and necessary to cover the costs
of administering and enforcing this chapter without the use of any
other funds generated by the board.
(b) Fees collected by the board under this chapter shall be
deposited by the board in the state treasury to the credit of an
account in the general revenue fund and may be spent to cover the
costs of administering and enforcing this chapter. At the end of
each fiscal biennium, the comptroller shall transfer any surplus
money remaining in the account to the general revenue fund.
(c) All money paid to the board under this chapter is
subject to Subchapter F, Chapter 404, Government Code.
Sec. 207.155. ISSUANCE AND RENEWAL OF REGISTRATION. The
board shall issue a registered radiologist assistant registration
in this state to a person who meets the requirements of this chapter
and the rules adopted under this chapter.
Sec. 207.156. REGISTRATION RENEWAL. (a) The board by rule
shall provide for the annual renewal of a registered radiologist
assistant registration.
(b) The board by rule may adopt a system under which
registrations expire on various dates during the year. For the year
in which the registration expiration date is changed, registration
fees shall be prorated on a monthly basis so that each registration
holder pays only that portion of the registration fee that is
allocable to the number of months during which the registration is
valid. On renewal of the registration on the new expiration date,
the total registration renewal fee is payable.
Sec. 207.157. NOTICE OF REGISTRATION RENEWAL. At least 30
days before the expiration of a person's registration, the board
shall send written notice of the impending registration expiration
to the person at the registration holder's last known address
according to the records of the board.
Sec. 207.158. PROCEDURE FOR RENEWAL. (a) A person who is
otherwise eligible to renew a registration may renew an unexpired
registration by paying the required renewal fee to the board before
the expiration date of the registration. A person whose
registration has expired may not engage in activities that require
a registration until the registration has been renewed under this
section.
(b) If the person's registration has been expired for 90
days or less, the person may renew the registration by paying to the
board one and one-half times the required renewal fee.
(c) If the person's registration has been expired for longer
than 90 days but less than one year, the person may renew the
registration by paying to the board two times the required renewal
fee.
(d) If the person's registration has been expired for one
year or longer, the person may not renew the registration. The
person may obtain a new registration by complying with the
requirements and procedures for obtaining an original
registration.
Sec. 207.159. REGISTRATION HOLDER INFORMATION. (a) Each
registration holder shall file with the board:
(1) the registration holder's mailing address;
(2) the address of the registration holder's
residence;
(3) the mailing address of each of the registration
holder's offices; and
(4) the address for the location of each of the
registration holder's offices if that address is different from the
office's mailing address.
(b) A registration holder shall:
(1) notify the board of a change of the registration
holder's residence or business address; and
(2) provide the board with the registration holder's
new address not later than the 30th day after the date the address
change occurs.
SUBCHAPTER E. SCOPE OF PRACTICE
Sec. 207.201. SCOPE OF PRACTICE. (a) The board shall adopt
rules to determine the scope of practice of a registered
radiologist assistant. The board shall consider guidelines adopted
by the American College of Radiology, the American Society of
Radiologic Technologists, and the American Registry of Radiologic
Technologists in adopting rules under this subsection
(b) A radiologist may use the services of a registered
radiologist assistant under the direct supervision of the
radiologist.
(c) The practice of a registered radiologist assistant may
be performed in any place authorized by a delegating radiologist,
including a clinic, hospital, health care center, or other
institutional setting.
(d) A registered radiologist assistant may not interpret
images, make diagnoses, or prescribe medications or therapies.
Sec. 207.202. ESTABLISHMENT OF CERTAIN FUNCTIONS AND
STANDARDS. A registered radiologist assistant and the registered
radiologist assistant's delegating radiologist shall ensure that:
(1) the registered radiologist assistant's scope of
function is identified;
(2) the delegation of medical tasks is appropriate to
the registered radiologist assistant's level of competence;
(3) the relationship between the registered
radiologist assistant and the delegating radiologist and the access
of the registered radiologist assistant to the delegating
radiologist are defined; and
(4) a process is established for evaluating the
registered radiologist assistant's performance.
SUBCHAPTER F. DISCIPLINARY PROCEEDINGS
Sec. 207.251. DISCIPLINARY ACTIONS BY THE BOARD. (a) On a
determination that an applicant or registration holder committed an
act described by Section 207.252, 207.253, or 207.254, the board by
order may take any of the following actions:
(1) deny the person's registration application or
revoke the person's registration;
(2) require the person to submit to the care,
counseling, or treatment of a health care practitioner designated
by the board;
(3) stay enforcement of an order and place the person
on probation;
(4) require the person to complete additional
training;
(5) suspend, limit, or restrict the person's
registration, including:
(A) limiting the practice of the person to, or
excluding from the person's practice, one or more specified
activities of radiologist assisting; or
(B) stipulating periodic board review;
(6) assess an administrative penalty against the
person as provided by Section 207.301;
(7) order the person to perform public service; or
(8) administer a public reprimand.
(b) If the board stays enforcement of an order and places a
person on probation, the board retains the right to vacate the
probationary stay and enforce the original order for noncompliance
with the terms of probation or impose any other remedial measure or
sanction authorized by this section.
(c) The board may restore or reissue a registration or
remove any disciplinary or corrective measure that the board has
imposed.
Sec. 207.252. CONDUCT RELATED TO FRAUD OR
MISREPRESENTATION. The board may take action under Section 207.251
against an applicant or registration holder who:
(1) fraudulently or deceptively obtains or attempts to
obtain a registration;
(2) fraudulently or deceptively uses a registration;
(3) falsely represents that the person is a
radiologist;
(4) acts in an unprofessional or dishonorable manner
that is likely to deceive, defraud, or injure the public;
(5) fraudulently alters any registered radiologist
assistant registration, certificate, or diploma;
(6) uses any registered radiologist assistant
registration, certificate, or diploma that has been fraudulently
purchased, issued, or counterfeited or that has been materially
altered;
(7) directly or indirectly aids or abets the practice
as a registered radiologist assistant by any person not registered
by the board to practice as a registered radiologist assistant; or
(8) unlawfully advertises in a false, misleading, or
deceptive manner as defined by Section 101.201.
Sec. 207.253. CONDUCT RELATED TO VIOLATION OF LAW. The
board may take action under Section 207.251 against an applicant or
registration holder who:
(1) violates this chapter or a rule adopted under this
chapter;
(2) is convicted of a felony, placed on deferred
adjudication, or placed in a pretrial diversion program; or
(3) violates state law if the violation is connected
with practice as a registered radiologist assistant.
Sec. 207.254. CONDUCT INDICATING LACK OF FITNESS. (a) The
board may take action under Section 207.251 against an applicant or
registration holder who:
(1) habitually uses drugs or intoxicating liquors to
the extent that, in the board's opinion, the person cannot safely
perform as a registered radiologist assistant;
(2) has been adjudicated as mentally incompetent;
(3) has a mental or physical condition that renders
the person unable to safely perform as a registered radiologist
assistant;
(4) has committed an act of moral turpitude;
(5) has failed to practice as a registered radiologist
assistant in an acceptable manner consistent with public health and
welfare;
(6) has had the person's registration or other
authorization to practice as a registered radiologist assistant
suspended, revoked, or restricted;
(7) has had other disciplinary action taken by another
state or by the uniformed services of the United States regarding
practice as a registered radiologist assistant;
(8) is removed or suspended or has disciplinary action
taken by the person's peers in any professional association or
society or is being disciplined by a licensed hospital or medical
staff of a hospital, including removal, suspension, limitation of
privileges, or other disciplinary action, if that action, in the
opinion of the board, was based on unprofessional conduct or
professional incompetence that was likely to harm the public;
(9) has repeated or recurring meritorious health care
liability claims that, in the board's opinion, are evidence of
professional incompetence likely to harm the public; or
(10) sexually abuses or exploits another person during
the registration holder's practice as a registered radiologist
assistant.
(b) For the purpose of Subsection (a)(7), a certified copy
of the record of the state or uniformed services of the United
States taking the action constitutes conclusive evidence of that
action.
(c) An action described by Subsection (a)(8) does not
constitute state action on the part of the association, society, or
hospital medical staff.
Sec. 207.255. SUBPOENA. (a) The executive director, the
director's designee, or the secretary-treasurer of the board may
issue a subpoena or subpoena duces tecum:
(1) to conduct an investigation or a contested case
proceeding related to:
(A) alleged misconduct by a registered
radiologist assistant;
(B) an alleged violation of this chapter or
another law related to the practice of a registered radiologist
assistant; or
(C) the provision of health care under this
chapter;
(2) for purposes of determining whether to issue,
suspend, restrict, or revoke a registration under this chapter; or
(3) for purposes of determining whether to issue or
deny a registration under this chapter.
(b) Failure to timely comply with a subpoena issued under
this section is a ground for:
(1) disciplinary action by the board or another
licensing or regulatory agency with jurisdiction over the person
subject to the subpoena; and
(2) denial of a registration application.
Sec. 207.256. PROTECTION OF PATIENT IDENTITY. In a
disciplinary investigation or proceeding conducted under this
chapter, the board shall protect the identity of each patient whose
medical records are examined and used in a public proceeding unless
the patient:
(1) testifies in the public proceeding; or
(2) submits a written release in regard to the
patient's records or identity.
Sec. 207.257. RULES FOR DISCIPLINARY PROCEEDINGS. Rules of
practice adopted under this chapter by the board under Section
2001.004, Government Code, applicable to the proceedings for a
disciplinary action may not conflict with rules adopted by the
State Office of Administrative Hearings.
Sec. 207.258. REQUIRED SUSPENSION OF INCARCERATED
REGISTERED RADIOLOGIST ASSISTANT. Regardless of the offense, the
board shall suspend the registration of a registered radiologist
assistant serving a prison term in a state or federal penitentiary
during the term of the incarceration.
Sec. 207.259. TEMPORARY SUSPENSION. (a) The president of
the board, with board approval, shall appoint a three-member
disciplinary panel consisting of board members to determine whether
a registered radiologist assistant's registration should be
temporarily suspended.
(b) If the disciplinary panel determines from the evidence
or information presented to the panel that a person registered to
practice as a registered radiologist assistant would, by the
person's continuation in practice, constitute a continuing threat
to the public welfare, the disciplinary panel shall temporarily
suspend the registration of that person.
(c) A registration may be suspended under this section
without notice or hearing on the complaint if:
(1) institution of proceedings for a hearing before
the board is initiated simultaneously with the temporary
suspension; and
(2) a hearing is held under Chapter 2001, Government
Code, and this chapter 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 the disciplinary
panel at one location is inconvenient for any member of the panel.
SUBCHAPTER G. ADMINISTRATIVE PENALTY
Sec. 207.301. ADMINISTRATIVE PENALTY. (a) The board by
order may impose an administrative penalty against a person
registered under this chapter who violates this chapter or a rule or
order adopted under this chapter.
(b) The penalty may be in an amount not to exceed $5,000.
Each day a violation continues or occurs is a separate violation for
purposes of imposing a penalty.
(c) The board shall base the amount of the penalty on:
(1) the severity of patient harm;
(2) the severity of economic harm to any person;
(3) the severity of any environmental harm;
(4) the increased potential for harm to the public;
(5) any attempted concealment of misconduct;
(6) any premeditated or intentional misconduct;
(7) the motive for the violation;
(8) any prior misconduct of a similar or related
nature;
(9) the registration holder's disciplinary history;
(10) any prior written warnings or written
admonishments from any government agency or official regarding
statutes or rules relating to the misconduct;
(11) whether the violation is of a board order;
(12) the person's failure to implement remedial
measures to correct or mitigate harm from the misconduct;
(13) the person's lack of rehabilitative potential or
likelihood of future misconduct of a similar nature;
(14) any relevant circumstances increasing the
seriousness of the misconduct; and
(15) any other matter that justice may require.
(d) The board by rule shall prescribe the procedures by
which it may impose an administrative penalty. A proceeding under
this section is subject to Chapter 2001, Government Code.
(e) If the board by order determines that a violation has
occurred and imposes an administrative penalty, the board shall
give notice to the person of the order. The notice must include a
statement of the person's right to judicial review of the order.
SECTION 4. Not later than January 1, 2014, the Texas Medical
Board shall adopt the rules and procedures necessary to administer
Chapter 207, Occupations Code, as added by this Act.
SECTION 5. Notwithstanding Chapter 207, Occupations Code,
as added by this Act, a registered radiologist assistant is not
required to hold a registration under that chapter to practice as a
registered radiologist assistant in this state before September 1,
2014.
SECTION 6. This Act takes effect September 1, 2013.