85R21497 BEE-D
By: Burkett, Thompson of Harris, Flynn, H.B. No. 3040
Raymond
Substitute the following for H.B. No. 3040:
By: Price C.S.H.B. No. 3040
A BILL TO BE ENTITLED
AN ACT
relating to the continuation and functions of the Texas Medical
Board; authorizing a fee.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 151.004, Occupations Code, is amended to
read as follows:
Sec. 151.004. APPLICATION OF SUNSET ACT. The Texas Medical
Board is subject to Chapter 325, Government Code (Texas Sunset
Act). Unless continued in existence as provided by that chapter,
the board is abolished and this subtitle and Chapters 204, 205, 206,
601, 602, 603, and 604 expire September 1, 2029 [2017].
SECTION 2. Section 152.010, Occupations Code, is amended by
amending Subsection (b) and adding Subsection (d) to read as
follows:
(b) The training program must provide the person with
information regarding:
(1) the law governing board operations [this
subtitle];
(2) the programs, functions, rules, and budget of
[operated by] the board;
(3) the scope of and limitations on the rulemaking
authority [role and functions] of the board;
(4) [the rules of the board, with an emphasis on the
rules that relate to disciplinary and investigatory authority;
[(5) the current budget for the board;
[(6)] the results of the most recent formal audit of
the board;
(5) [(7)] the requirements of:
(A) laws relating to open meetings, public
information, administrative procedure, and disclosing conflicts of
interest; and
(B) other laws applicable to members of the board
in performing their duties; and
(6) [(8)] any applicable ethics policies adopted by
the board or the Texas Ethics Commission.
(d) The executive director of the board shall create a
training manual that includes the information required by
Subsection (b). The executive director shall distribute a copy of
the training manual annually to each board member. On receipt of
the training manual, each board member shall sign and submit to the
executive director a statement acknowledging receipt of the
training manual.
SECTION 3. The heading to Section 153.007, Occupations
Code, is amended to read as follows:
Sec. 153.007. AUTHORITY TO ISSUE SUBPOENA OR ADMINISTER
OATH; SUBPOENA ENFORCEMENT.
SECTION 4. Section 153.007, Occupations Code, is amended by
adding Subsections (e) and (f) to read as follows:
(e) If a person fails to comply with a subpoena issued under
this section, the board, acting through the attorney general, may
file suit to enforce the subpoena in a district court in Travis
County or in a county in which a hearing conducted by the board may
be held.
(f) On finding that good cause exists for issuing the
subpoena, the court shall order the person to comply with the
subpoena.
SECTION 5. Section 153.058(a), Occupations Code, is amended
to read as follows:
(a) The board shall develop and implement a policy to
encourage the use of:
(1) negotiated rulemaking procedures under Chapter
2008, Government Code, for the adoption of any rules by the board
[rules]; and
(2) appropriate alternative dispute resolution
procedures under Chapter 2009, Government Code, to assist in the
resolution of internal and external disputes under the board's
jurisdiction.
SECTION 6. Section 155.056, Occupations Code, is amended by
amending Subsection (a) and adding Subsection (a-1) to read as
follows:
(a) Except as provided by Subsection (a-1), an [An]
applicant must pass each part of an examination within three
attempts.
(a-1) The limit on the number of examination attempts under
Subsection (a) does not apply to the Texas medical jurisprudence
examination.
SECTION 7. Subchapter A, Chapter 156, Occupations Code, is
amended by adding Section 156.010 to read as follows:
Sec. 156.010. REFUSAL FOR VIOLATION OF BOARD ORDER. The
board may refuse to renew a registration permit issued under this
chapter if the license holder is in violation of a board order.
SECTION 8. Section 162.106, Occupations Code, is amended to
read as follows:
Sec. 162.106. INSPECTIONS. (a) The board may conduct
inspections [to enforce this subchapter, including inspections of
an office site and of documents] of a physician's equipment and
office procedures [practice] that relate to the provision of
anesthesia in an outpatient setting as necessary to enforce this
subchapter.
(b) The board may establish a risk-based inspection process
in which the board conducts inspections based on the length of time
since:
(1) the equipment and outpatient setting were last
inspected; and
(2) the physician submitted to inspection.
(c) The board may contract with another state agency or
qualified person to conduct the inspections.
(d) [(b)] Unless it would jeopardize an ongoing
investigation, the board shall provide at least five business days'
notice before conducting an on-site inspection under this section.
(e) The board shall maintain a record of the outpatient
settings in which physicians provide anesthesia.
(f) A physician who provides anesthesia in an outpatient
setting shall inform the board of any other physician with whom the
physician shares equipment used to administer anesthesia.
(g) [(c)] This section does not require the board to make an
on-site inspection of a physician's office.
SECTION 9. Chapter 162, Occupations Code, is amended by
adding Subchapter G to read as follows:
SUBCHAPTER G. GENERAL PRACTICE PROVISIONS
Sec. 162.301. DUTIES RELATED TO CERTAIN PRESCRIPTIONS. (a)
A physician may not prescribe a drug listed in Subsection (b) to a
patient unless the physician has reviewed the patient's
prescription history by accessing the prescription information
submitted to the Texas State Board of Pharmacy as authorized by
Section 481.076(a)(5), Health and Safety Code.
(b) Subsection (a) applies only to the prescribing of:
(1) opioids;
(2) benzodiazepines;
(3) barbiturates; or
(4) carisoprodol.
(c) A physician is not subject to the requirements of
Subsection (a) if:
(1) the patient has been diagnosed with cancer or the
patient is receiving hospice care; and
(2) the physician clearly notes in the prescription
record that the patient was diagnosed with cancer or is receiving
hospice care, as applicable.
(d) Failure by a physician to comply with the requirements
of this section is grounds for disciplinary action under Section
164.051.
SECTION 10. Section 164.0015(d), Occupations Code, is
amended to read as follows:
(d) The board may not issue a remedial plan to resolve a
complaint against a license holder if the license holder has
[previously] entered into a remedial plan with the board in the
preceding five years [for the resolution of a different complaint
relating to this subtitle].
SECTION 11. Section 164.003, Occupations Code, is amended
by amending Subsections (b) and (f) and adding Subsection (f-1) 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 board's official investigation of the
complaint is commenced as provided by Section 154.057(b), 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 45th day before the
date the meeting is held;
(3) the complainant and the license holder be provided
an opportunity to be heard;
(4) at least one of the board members or district
review committee members participating in the informal meeting as a
panelist be a member who represents the public;
(5) the board's legal counsel or a representative of
the attorney general be present to advise the board or the board's
staff; [and]
(6) a member of the board's staff be at the meeting to
present to the board's representative the facts the staff
reasonably believes it could prove by competent evidence or
qualified witnesses at a hearing; and
(7) if the complaint includes an allegation that the
license holder has violated the standard of care, the panel
conducting the informal proceeding consider whether the physician
was practicing complementary and alternative medicine.
(f) The notice required by Subsection (b)(2) must be
accompanied by a written statement of the nature of the allegations
and the information the board intends to use at the meeting. If the
board does not provide the statement or information at that time,
the license holder may use that failure as grounds for rescheduling
the informal meeting. If the complaint includes an allegation that
the license holder has violated the standard of care, the notice
must include a copy of each [the] report prepared by an [the] expert
physician reviewer under Section 154.0561. The license holder must
provide to the board the license holder's rebuttal at least 15
business days before the date of the meeting in order for the
information to be considered at the meeting.
(f-1) Before providing a report to a license holder under
Subsection (f), the board must redact any identifying information
of an expert physician reviewer other than the specialty of the
expert physician reviewer.
SECTION 12. Sections 164.005(a) and (c), Occupations Code,
are amended to read as follows:
(a) In this section, "formal complaint" means a written
statement made by a credible person [under oath] that is filed and
presented by a board representative charging a person with having
committed an act that, if proven, could affect the legal rights or
privileges of a license holder or other person under the board's
jurisdiction.
(c) A charge must [be in the form of a written affidavit
that]:
(1) be [is] filed with the board's records custodian or
assistant records custodian; and
(2) detail [details] the nature of the charge as
required by this subtitle or other applicable law.
SECTION 13. Subchapter A, Chapter 164, Occupations Code, is
amended by adding Section 164.0105 to read as follows:
Sec. 164.0105. MONITORING HARMFUL PRESCRIBING PATTERNS.
(a) The board shall periodically check the prescribing information
submitted to the Texas State Board of Pharmacy as authorized by
Section 481.076(a)(1), Health and Safety Code, to determine whether
a physician is engaging in potentially harmful prescribing patterns
or practices.
(b) The board, in coordination with the Texas State Board of
Pharmacy, shall determine the conduct that constitutes a
potentially harmful prescribing pattern or practice for purposes of
Subsection (a). In determining the conduct that constitutes a
potentially harmful prescribing pattern or practice, the board
shall consider:
(1) the number of times a physician prescribes a drug
listed in Section 162.301(b); and
(2) for prescriptions described by Subdivision (1),
patterns of prescribing combinations of those drugs and other
dangerous combinations of drugs identified by the board.
(c) If the board suspects that a physician may be engaging
in potentially harmful prescribing patterns or practices, the board
may notify the physician of the potentially harmful prescribing
pattern or practice.
(d) The board may initiate a complaint against a physician
based on information obtained under this section.
SECTION 14. Chapter 167, Occupations Code, is amended by
adding Sections 167.012 and 167.013 to read as follows:
Sec. 167.012. MEMORANDUM OF UNDERSTANDING WITH BOARD. The
governing board and the board shall enter into a memorandum of
understanding to better coordinate services and operations of the
program. The memorandum of understanding must be adopted by rule
and:
(1) establish performance measures for the program,
including the number of participants who successfully complete the
program;
(2) include a list of services the board will provide
for the program; and
(3) require that an internal audit of the program be
conducted at least once every three years to ensure the program is
properly documenting and referring all noncompliance to the board.
Sec. 167.013. GIFTS, GRANTS, AND DONATIONS. In addition to
any fees paid to the board or money appropriated to the board for
the program, the governing board may receive and accept a gift,
grant, donation, or other thing of value from any source, including
the United States or a private source, for the program.
SECTION 15. Subchapter A, Chapter 168, Occupations Code, is
amended by adding Section 168.003 to read as follows:
Sec. 168.003. LEGISLATIVE FINDING. The legislature finds
that deaths resulting from the use of opioids and other controlled
substances constitute a public health crisis and that there is a
compelling state interest in the board closely regulating the
prescribing of opioids and other controlled substances by
physicians and their delegates. Accordingly, the legislature finds
that inspections and investigations conducted by the board,
including the board's use of subpoenas for immediate production,
inspection, and copying of medical and billing records, are
necessary to adequately regulate the prescribing of opioids and
other controlled substances in order to protect the public health
and welfare.
SECTION 16. Section 168.052, Occupations Code, is amended
to read as follows:
Sec. 168.052. INSPECTIONS. (a) The board may inspect a
pain management clinic certified under this chapter, including the
documents of a physician practicing at the clinic, as necessary to
ensure compliance with this chapter.
(b) The board may inspect a clinic or facility that is not
certified under this chapter to determine whether the clinic or
facility is required to be certified under Section 168.101. The
board by rule shall establish the grounds for conducting an
inspection under this subsection, including grounds based on:
(1) the population of patients served by the clinic or
facility;
(2) the volume or combination of drugs prescribed to
patients served by the clinic or facility; and
(3) any other criteria the board considers sufficient
to require an inspection of the clinic or facility.
SECTION 17. Section 168.201, Occupations Code, is amended
by adding Subsection (a-1) to read as follows:
(a-1) For the purposes of this section, inappropriate
prescribing includes nontherapeutic prescribing or other conduct
as specified by board rule.
SECTION 18. Subtitle B, Title 3, Occupations Code, is
amended by adding Chapter 170 to read as follows:
CHAPTER 170. INTERSTATE MEDICAL LICENSURE COMPACT
Sec. 170.001. INTERSTATE MEDICAL LICENSURE COMPACT. The
Interstate Medical Licensure Compact is enacted and entered into
with all other jurisdictions that legally join in the compact,
which reads as follows:
INTERSTATE MEDICAL LICENSURE COMPACT
SECTION 1. PURPOSE
In order to strengthen access to health care, and in
recognition of the advances in the delivery of health care, the
member states of the Interstate Medical Licensure Compact have
allied in common purpose to develop a comprehensive process that
complements the existing licensing and regulatory authority of
state medical boards, and provides a streamlined process that
allows physicians to become licensed in multiple states, thereby
enhancing the portability of a medical license and ensuring the
safety of patients. The Compact creates another pathway for
licensure and does not otherwise change a state's existing Medical
Practice Act. The Compact also adopts the prevailing standard for
licensure and affirms that the practice of medicine occurs where
the patient is located at the time of the physician-patient
encounter, and therefore, requires the physician to be under the
jurisdiction of the state medical board where the patient is
located. State medical boards that participate in the Compact
retain the jurisdiction to impose an adverse action against a
license to practice medicine in that state issued to a physician
through the procedures in the Compact.
SECTION 2. DEFINITIONS
In this compact:
(a) "Bylaws" means those bylaws established by the
Interstate Commission pursuant to Section 11 for its governance, or
for directing and controlling its actions and conduct.
(b) "Commissioner" means the voting representative
appointed by each member board pursuant to Section 11.
(c) "Conviction" means a finding by a court that an
individual is guilty of a criminal offense through adjudication, or
entry of a plea of guilt or no contest to the charge by the offender.
Evidence of an entry of a conviction of a criminal offense by the
court shall be considered final for purposes of disciplinary action
by a member board.
(d) "Expedited License" means a full and unrestricted
medical license granted by a member state to an eligible physician
through the process set forth in the Compact.
(e) "Interstate Commission" means the interstate commission
created pursuant to Section 11.
(f) "License" means authorization by a state for a physician
to engage in the practice of medicine, which would be unlawful
without the authorization.
(g) "Medical Practice Act" means laws and regulations
governing the practice of allopathic and osteopathic medicine
within a member state.
(h) "Member Board" means a state agency in a member state
that acts in the sovereign interests of the state by protecting the
public through licensure, regulation, and education of physicians
as directed by the state government.
(i) "Member State" means a state that has enacted the
Compact.
(j) "Practice of Medicine" means the clinical prevention,
diagnosis, or treatment of human disease, injury, or condition
requiring a physician to obtain and maintain a license in
compliance with the Medical Practice Act of a member state.
(k) "Physician" means any person who:
(1) Is a graduate of a medical school accredited by the
Liaison Committee on Medical Education, the Commission on
Osteopathic College Accreditation, or a medical school listed in
the International Medical Education Directory or its equivalent;
(2) Passed each component of the United States Medical
Licensing Examination (USMLE) or the Comprehensive Osteopathic
Medical Licensing Examination (COMLEX-USA) within three attempts,
or any of its predecessor examinations accepted by a state medical
board as an equivalent examination for licensure purposes;
(3) Successfully completed graduate medical education
approved by the Accreditation Council for Graduate Medical
Education or the American Osteopathic Association;
(4) Holds specialty certification or a time-unlimited
specialty certificate recognized by the American Board of Medical
Specialties or the American Osteopathic Association's Bureau of
Osteopathic Specialists;
(5) Possesses a full and unrestricted license to
engage in the practice of medicine issued by a member board;
(6) Has never been convicted, received adjudication,
deferred adjudication, community supervision, or deferred
disposition for any offense by a court of appropriate jurisdiction;
(7) Has never held a license authorizing the practice
of medicine subjected to discipline by a licensing agency in any
state, federal, or foreign jurisdiction, excluding any action
related to non-payment of fees related to a license;
(8) Has never had a controlled substance license or
permit suspended or revoked by a state or the United States Drug
Enforcement Administration; and
(9) Is not under active investigation by a licensing
agency or law enforcement authority in any state, federal, or
foreign jurisdiction.
(l) "Offense" means a felony, gross misdemeanor, or crime of
moral turpitude.
(m) "Rule" means a written statement by the Interstate
Commission promulgated pursuant to Section 12 of the Compact that
is of general applicability, implements, interprets, or prescribes
a policy or provision of the Compact, or an organizational,
procedural, or practice requirement of the Interstate Commission,
and has the force and effect of statutory law in a member state, and
includes the amendment, repeal, or suspension of an existing rule.
(n) "State" means any state, commonwealth, district, or
territory of the United States.
(o) "State of Principal License" means a member state where
a physician holds a license to practice medicine and which has been
designated as such by the physician for purposes of registration
and participation in the Compact.
SECTION 3. ELIGIBILITY
(a) A physician must meet the eligibility requirements as
defined in Section 2(k) to receive an expedited license under the
terms and provisions of the Compact.
(b) A physician who does not meet the requirements of
Section 2(k) may obtain a license to practice medicine in a member
state if the individual complies with all laws and requirements,
other than the Compact, relating to the issuance of a license to
practice medicine in that state.
SECTION 4. DESIGNATION OF STATE OF PRINCIPAL LICENSE
(a) A physician shall designate a member state as the state
of principal license for purposes of registration for expedited
licensure through the Compact if the physician possesses a full and
unrestricted license to practice medicine in that state, and the
state is:
(1) the state of primary residence for the physician,
or
(2) the state where at least 25 percent of the practice
of medicine occurs, or
(3) the location of the physician's employer, or
(4) if no state qualifies under subsection (1),
subsection (2), or subsection (3), the state designated as state of
residence for purpose of federal income tax.
(b) A physician may redesignate a member state as state of
principal license at any time, as long as the state meets the
requirements in subsection (a).
(c) The Interstate Commission is authorized to develop
rules to facilitate redesignation of another member state as the
state of principal license.
SECTION 5. APPLICATION AND ISSUANCE OF EXPEDITED LICENSURE
(a) A physician seeking licensure through the Compact shall
file an application for an expedited license with the member board
of the state selected by the physician as the state of principal
license.
(b) Upon receipt of an application for an expedited license,
the member board within the state selected as the state of principal
license shall evaluate whether the physician is eligible for
expedited licensure and issue a letter of qualification, verifying
or denying the physician's eligibility, to the Interstate
Commission.
(i) Static qualifications, which include verification
of medical education, graduate medical education, results of any
medical or licensing examination, and other qualifications as
determined by the Interstate Commission through rule, shall not be
subject to additional primary source verification where already
primary source verified by the state of principal license.
(ii) The member board within the state selected as the
state of principal license shall, in the course of verifying
eligibility, perform a criminal background check of an applicant,
including the use of the results of fingerprint or other biometric
data checks compliant with the requirements of the Federal Bureau
of Investigation, with the exception of federal employees who have
suitability determination in accordance with U.S. C.F.R. Section
731.202.
(iii) Appeal on the determination of eligibility shall
be made to the member state where the application was filed and
shall be subject to the law of that state.
(c) Upon verification in subsection (b), physicians
eligible for an expedited license shall complete the registration
process established by the Interstate Commission to receive a
license in a member state selected pursuant to subsection (a),
including the payment of any applicable fees.
(d) After receiving verification of eligibility under
subsection (b) and any fees under subsection (c), a member board
shall issue an expedited license to the physician. This license
shall authorize the physician to practice medicine in the issuing
state consistent with the Medical Practice Act and all applicable
laws and regulations of the issuing member board and member state.
(e) An expedited license shall be valid for a period
consistent with the licensure period in the member state and in the
same manner as required for other physicians holding a full and
unrestricted license within the member state.
(f) An expedited license obtained though the Compact shall
be terminated if a physician fails to maintain a license in the
state of principal licensure for a non-disciplinary reason, without
redesignation of a new state of principal licensure.
(g) The Interstate Commission is authorized to develop
rules regarding the application process, including payment of any
applicable fees, and the issuance of an expedited license.
SECTION 6. FEES FOR EXPEDITED LICENSURE
(a) A member state issuing an expedited license authorizing
the practice of medicine in that state may impose a fee for a
license issued or renewed through the Compact.
(b) The Interstate Commission is authorized to develop
rules regarding fees for expedited licenses.
SECTION 7. RENEWAL AND CONTINUED PARTICIPATION
(a) A physician seeking to renew an expedited license
granted in a member state shall complete a renewal process with the
Interstate Commission if the physician:
(1) Maintains a full and unrestricted license in a
state of principal license;
(2) Has not been convicted, received adjudication,
deferred adjudication, community supervision, or deferred
disposition for any offense by a court of appropriate jurisdiction;
(3) Has not had a license authorizing the practice of
medicine subject to discipline by a licensing agency in any state,
federal, or foreign jurisdiction, excluding any action related to
non-payment of fees related to a license; and
(4) Has not had a controlled substance license or
permit suspended or revoked by a state or the United States Drug
Enforcement Administration.
(b) Physicians shall comply with all continuing
professional development or continuing medical education
requirements for renewal of a license issued by a member state.
(c) The Interstate Commission shall collect any renewal
fees charged for the renewal of a license and distribute the fees to
the applicable member board.
(d) Upon receipt of any renewal fees collected in subsection
(c), a member board shall renew the physician's license.
(e) Physician information collected by the Interstate
Commission during the renewal process will be distributed to all
member boards.
(f) The Interstate Commission is authorized to develop
rules to address renewal of licenses obtained through the Compact.
SECTION 8. COORDINATED INFORMATION SYSTEM
(a) The Interstate Commission shall establish a database of
all physicians licensed, or who have applied for licensure, under
Section 5.
(b) Notwithstanding any other provision of law, member
boards shall report to the Interstate Commission any public action
or complaints against a licensed physician who has applied or
received an expedited license through the Compact.
(c) Member boards shall report disciplinary or
investigatory information determined as necessary and proper by
rule of the Interstate Commission.
(d) Member boards may report any non-public complaint,
disciplinary, or investigatory information not required by
subsection (c) to the Interstate Commission.
(e) Member boards shall share complaint or disciplinary
information about a physician upon request of another member board.
(f) All information provided to the Interstate Commission
or distributed by member boards shall be confidential, filed under
seal, and used only for investigatory or disciplinary matters.
(g) The Interstate Commission is authorized to develop
rules for mandated or discretionary sharing of information by
member boards.
SECTION 9. JOINT INVESTIGATIONS
(a) Licensure and disciplinary records of physicians are
deemed investigative.
(b) In addition to the authority granted to a member board
by its respective Medical Practice Act or other applicable state
law, a member board may participate with other member boards in
joint investigations of physicians licensed by the member boards.
(c) A subpoena issued by a member state shall be enforceable
in other member states.
(d) Member boards may share any investigative, litigation,
or compliance materials in furtherance of any joint or individual
investigation initiated under the Compact.
(e) Any member state may investigate actual or alleged
violations of the statutes authorizing the practice of medicine in
any other member state in which a physician holds a license to
practice medicine.
SECTION 10. DISCIPLINARY ACTIONS
(a) Any disciplinary action taken by any member board
against a physician licensed through the Compact shall be deemed
unprofessional conduct which may be subject to discipline by other
member boards, in addition to any violation of the Medical Practice
Act or regulations in that state.
(b) If a license granted to a physician by the member board
in the state of principal license is revoked, surrendered or
relinquished in lieu of discipline, or suspended, then all licenses
issued to the physician by member boards shall automatically be
placed, without further action necessary by any member board, on
the same status. If the member board in the state of principal
license subsequently reinstates the physician's license, a license
issued to the physician by any other member board shall remain
encumbered until that respective member board takes action to
reinstate the license in a manner consistent with the Medical
Practice Act of that state.
(c) If disciplinary action is taken against a physician by a
member board not in the state of principal license, any other member
board may deem the action conclusive as to matter of law and fact
decided, and:
(i) impose the same or lesser sanction(s) against the
physician so long as such sanctions are consistent with the Medical
Practice Act of that state;
(ii) or pursue separate disciplinary action against
the physician under its respective Medical Practice Act, regardless
of the action taken in other member states.
(d) If a license granted to a physician by a member board is
revoked, surrendered or relinquished in lieu of discipline, or
suspended, then any license(s) issued to the physician by any other
member board(s) shall be suspended, automatically and immediately
without further action necessary by the other member board(s), for
ninety (90) days upon entry of the order by the disciplining board,
to permit the member board(s) to investigate the basis for the
action under the Medical Practice Act of that state. A member board
may terminate the automatic suspension of the license it issued
prior to the completion of the ninety (90) day suspension period in
a manner consistent with the Medical Practice Act of that state.
SECTION 11. INTERSTATE MEDICAL LICENSURE COMPACT
COMMISSION
(a) The member states hereby create the "Interstate Medical
Licensure Compact Commission".
(b) The purpose of the Interstate Commission is the
administration of the Interstate Medical Licensure Compact, which
is a discretionary state function.
(c) The Interstate Commission shall be a body corporate and
joint agency of the member states and shall have all the
responsibilities, powers, and duties set forth in the Compact, and
such additional powers as may be conferred upon it by a subsequent
concurrent action of the respective legislatures of the member
states in accordance with the terms of the Compact.
(d) The Interstate Commission shall consist of two voting
representatives appointed by each member state who shall serve as
Commissioners. In states where allopathic and osteopathic
physicians are regulated by separate member boards, or if the
licensing and disciplinary authority is split between multiple
member boards within a member state, the member state shall appoint
one representative from each member board. A Commissioner shall be
a(n):
(1) Allopathic or osteopathic physician appointed to a
member board;
(2) Executive director, executive secretary, or
similar executive of a member board; or
(3) Member of the public appointed to a member board.
(e) The Interstate Commission shall meet at least once each
calendar year. A portion of this meeting shall be a business
meeting to address such matters as may properly come before the
Commission, including the election of officers. The chairperson
may call additional meetings and shall call for a meeting upon the
request of a majority of the member states.
(f) The bylaws may provide for meetings of the Interstate
Commission to be conducted by telecommunication or electronic
communication.
(g) Each Commissioner participating at a meeting of the
Interstate Commission is entitled to one vote. A majority of
Commissioners shall constitute a quorum for the transaction of
business, unless a larger quorum is required by the bylaws of the
Interstate Commission. A Commissioner shall not delegate a vote to
another Commissioner. In the absence of its Commissioner, a member
state may delegate voting authority for a specified meeting to
another person from that state who shall meet the requirements of
subsection (d).
(h) The Interstate Commission shall provide public notice
of all meetings and all meetings shall be open to the public. The
Interstate Commission may close a meeting, in full or in portion,
where it determines by a two-thirds vote of the Commissioners
present that an open meeting would be likely to:
(1) Relate solely to the internal personnel practices
and procedures of the Interstate Commission;
(2) Discuss matters specifically exempted from
disclosure by federal statute;
(3) Discuss trade secrets, commercial, or financial
information that is privileged or confidential;
(4) Involve accusing a person of a crime, or formally
censuring a person;
(5) Discuss information of a personal nature where
disclosure would constitute a clearly unwarranted invasion of
personal privacy;
(6) Discuss investigative records compiled for law
enforcement purposes; or
(7) Specifically relate to the participation in a
civil action or other legal proceeding.
(i) The Interstate Commission shall keep minutes which
shall fully describe all matters discussed in a meeting and shall
provide a full and accurate summary of actions taken, including
record of any roll call votes.
(j) The Interstate Commission shall make its information
and official records, to the extent not otherwise designated in the
Compact or by its rules, available to the public for inspection.
(k) The Interstate Commission shall establish an executive
committee, which shall include officers, members, and others as
determined by the bylaws. The executive committee shall have the
power to act on behalf of the Interstate Commission, with the
exception of rulemaking, during periods when the Interstate
Commission is not in session. When acting on behalf of the
Interstate Commission, the executive committee shall oversee the
administration of the Compact including enforcement and compliance
with the provisions of the Compact, its bylaws and rules, and other
such duties as necessary.
(l) The Interstate Commission may establish other
committees for governance and administration of the Compact.
SECTION 12. POWERS AND DUTIES OF THE INTERSTATE COMMISSION
The Interstate Commission shall have the duty and power to:
(a) Oversee and maintain the administration of the Compact;
(b) Promulgate rules which shall be binding to the extent
and in the manner provided for in the Compact;
(c) Issue, upon the request of a member state or member
board, advisory opinions concerning the meaning or interpretation
of the Compact, its bylaws, rules, and actions;
(d) Enforce compliance with Compact provisions, the rules
promulgated by the Interstate Commission, and the bylaws, using all
necessary and proper means, including but not limited to the use of
judicial process;
(e) Establish and appoint committees including, but not
limited to, an executive committee as required by Section 11, which
shall have the power to act on behalf of the Interstate Commission
in carrying out its powers and duties;
(f) Pay, or provide for the payment of the expenses related
to the establishment, organization, and ongoing activities of the
Interstate Commission;
(g) Establish and maintain one or more offices;
(h) Borrow, accept, hire, or contract for services of
personnel;
(i) Purchase and maintain insurance and bonds;
(j) Employ an executive director who shall have such powers
to employ, select or appoint employees, agents, or consultants, and
to determine their qualifications, define their duties, and fix
their compensation;
(k) Establish personnel policies and programs relating to
conflicts of interest, rates of compensation, and qualifications of
personnel;
(l) Accept donations and grants of money, equipment,
supplies, materials and services, and to receive, utilize, and
dispose of it in a manner consistent with the conflict of interest
policies established by the Interstate Commission;
(m) Lease, purchase, accept contributions or donations of,
or otherwise to own, hold, improve or use, any property, real,
personal, or mixed;
(n) Sell, convey, mortgage, pledge, lease, exchange,
abandon, or otherwise dispose of any property, real, personal, or
mixed;
(o) Establish a budget and make expenditures;
(p) Adopt a seal and bylaws governing the management and
operation of the Interstate Commission;
(q) Report annually to the legislatures and governors of the
member states concerning the activities of the Interstate
Commission during the preceding year. Such reports shall also
include reports of financial audits and any recommendations that
may have been adopted by the Interstate Commission;
(r) Coordinate education, training, and public awareness
regarding the Compact, its implementation, and its operation;
(s) Maintain records in accordance with the bylaws;
(t) Seek and obtain trademarks, copyrights, and patents;
and
(u) Perform such functions as may be necessary or
appropriate to achieve the purposes of the Compact.
SECTION 13. FINANCE POWERS
(a) The Interstate Commission may levy on and collect an
annual assessment from each member state to cover the cost of the
operations and activities of the Interstate Commission and its
staff. The total assessment must be sufficient to cover the annual
budget approved each year for which revenue is not provided by other
sources. The aggregate annual assessment amount shall be allocated
upon a formula to be determined by the Interstate Commission, which
shall promulgate a rule binding upon all member states.
(b) The Interstate Commission shall not incur obligations
of any kind prior to securing the funds adequate to meet the same.
(c) The Interstate Commission shall not pledge the credit of
any of the member states, except by, and with the authority of, the
member state.
(d) The Interstate Commission shall be subject to a yearly
financial audit conducted by a certified or licensed public
accountant and the report of the audit shall be included in the
annual report of the Interstate Commission.
SECTION 14. ORGANIZATION AND OPERATION OF THE INTERSTATE
COMMISSION
(a) The Interstate Commission shall, by a majority of
Commissioners present and voting, adopt bylaws to govern its
conduct as may be necessary or appropriate to carry out the purposes
of the Compact within twelve (12) months of the first Interstate
Commission meeting.
(b) The Interstate Commission shall elect or appoint
annually from among its Commissioners a chairperson, a
vice-chairperson, and a treasurer, each of whom shall have such
authority and duties as may be specified in the bylaws. The
chairperson, or in the chairperson's absence or disability, the
vice-chairperson, shall preside at all meetings of the Interstate
Commission.
(c) Officers selected in subsection (b) shall serve without
remuneration from the Interstate Commission.
(d) The officers and employees of the Interstate Commission
shall be immune from suit and liability, either personally or in
their official capacity, for a claim for damage to or loss of
property or personal injury or other civil liability caused or
arising out of, or relating to, an actual or alleged act, error, or
omission that occurred, or that such person had a reasonable basis
for believing occurred, within the scope of Interstate Commission
employment, duties, or responsibilities; provided that such person
shall not be protected from suit or liability for damage, loss,
injury, or liability caused by the intentional or willful and
wanton misconduct of such person.
(1) The liability of the executive director and
employees of the Interstate Commission or representatives of the
Interstate Commission, acting within the scope of such person's
employment or duties for acts, errors, or omissions occurring
within such person's state, may not exceed the limits of liability
set forth under the constitution and laws of that state for state
officials, employees, and agents. The Interstate Commission is
considered to be an instrumentality of the states for the purposes
of any such action. Nothing in this subsection shall be construed
to protect such person from suit or liability for damage, loss,
injury, or liability caused by the intentional or willful and
wanton misconduct of such person.
(2) The Interstate Commission shall defend the
executive director, its employees, and subject to the approval of
the attorney general or other appropriate legal counsel of the
member state represented by an Interstate Commission
representative, shall defend such Interstate Commission
representative in any civil action seeking to impose liability
arising out of an actual or alleged act, error or omission that
occurred within the scope of Interstate Commission employment,
duties or responsibilities, or that the defendant had a reasonable
basis for believing occurred within the scope of Interstate
Commission employment, duties, or responsibilities, provided that
the actual or alleged act, error, or omission did not result from
intentional or willful and wanton misconduct on the part of such
person.
(3) To the extent not covered by the state involved,
member state, or the Interstate Commission, the representatives or
employees of the Interstate Commission shall be held harmless in
the amount of a settlement or judgment, including attorney's fees
and costs, obtained against such persons arising out of an actual or
alleged act, error, or omission that occurred within the scope of
Interstate Commission employment, duties, or responsibilities, or
that such persons had a reasonable basis for believing occurred
within the scope of Interstate Commission employment, duties, or
responsibilities, provided that the actual or alleged act, error,
or omission did not result from intentional or willful and wanton
misconduct on the part of such persons.
SECTION 15. RULEMAKING FUNCTIONS OF THE INTERSTATE
COMMISSION
(a) The Interstate Commission shall promulgate reasonable
rules in order to effectively and efficiently achieve the purposes
of the Compact. Notwithstanding the foregoing, in the event the
Interstate Commission exercises its rulemaking authority in a
manner that is beyond the scope of the purposes of the Compact, or
the powers granted hereunder, then such an action by the Interstate
Commission shall be invalid and have no force or effect.
(b) Rules deemed appropriate for the operations of the
Interstate Commission shall be made pursuant to a rulemaking
process that substantially conforms to the "Model State
Administrative Procedure Act" of 2010, and subsequent amendments
thereto.
(c) Not later than thirty (30) days after a rule is
promulgated, any person may file a petition for judicial review of
the rule in the United States District Court for the District of
Columbia or the federal district where the Interstate Commission
has its principal offices, provided that the filing of such a
petition shall not stay or otherwise prevent the rule from becoming
effective unless the court finds that the petitioner has a
substantial likelihood of success. The court shall give deference
to the actions of the Interstate Commission consistent with
applicable law and shall not find the rule to be unlawful if the
rule represents a reasonable exercise of the authority granted to
the Interstate Commission.
SECTION 16. OVERSIGHT OF INTERSTATE COMPACT
(a) The executive, legislative, and judicial branches of
state government in each member state shall enforce the Compact and
shall take all actions necessary and appropriate to effectuate the
Compact's purposes and intent. The provisions of the Compact and
the rules promulgated hereunder shall have standing as statutory
law but shall not override existing state authority to regulate the
practice of medicine.
(b) All courts shall take judicial notice of the Compact and
the rules in any judicial or administrative proceeding in a member
state pertaining to the subject matter of the Compact which may
affect the powers, responsibilities or actions of the Interstate
Commission.
(c) The Interstate Commission shall be entitled to receive
all service of process in any such proceeding, and shall have
standing to intervene in the proceeding for all purposes. Failure
to provide service of process to the Interstate Commission shall
render a judgment or order void as to the Interstate Commission, the
Compact, or promulgated rules.
SECTION 17. ENFORCEMENT OF INTERSTATE COMPACT
(a) The Interstate Commission, in the reasonable exercise
of its discretion, shall enforce the provisions and rules of the
Compact.
(b) The Interstate Commission may, by majority vote of the
Commissioners, initiate legal action in the United States District
Court for the District of Columbia, or, at the discretion of the
Interstate Commission, in the federal district where the Interstate
Commission has its principal offices, to enforce compliance with
the provisions of the Compact, and its promulgated rules and
bylaws, against a member state in default. The relief sought may
include both injunctive relief and damages. In the event judicial
enforcement is necessary, the prevailing party shall be awarded all
costs of such litigation including reasonable attorney's fees.
(c) The remedies herein shall not be the exclusive remedies
of the Interstate Commission. The Interstate Commission may avail
itself of any other remedies available under state law or the
regulation of a profession.
SECTION 18. DEFAULT PROCEDURES
(a) The grounds for default include, but are not limited to,
failure of a member state to perform such obligations or
responsibilities imposed upon it by the Compact, or the rules and
bylaws of the Interstate Commission promulgated under the Compact.
(b) If the Interstate Commission determines that a member
state has defaulted in the performance of its obligations or
responsibilities under the Compact, or the bylaws or promulgated
rules, the Interstate Commission shall:
(1) Provide written notice to the defaulting state and
other member states, of the nature of the default, the means of
curing the default, and any action taken by the Interstate
Commission. The Interstate Commission shall specify the conditions
by which the defaulting state must cure its default; and
(2) Provide remedial training and specific technical
assistance regarding the default.
(c) If the defaulting state fails to cure the default, the
defaulting state shall be terminated from the Compact upon an
affirmative vote of a majority of the Commissioners and all rights,
privileges, and benefits conferred by the Compact shall terminate
on the effective date of termination. A cure of the default does not
relieve the offending state of obligations or liabilities incurred
during the period of the default.
(d) Termination of membership in the Compact shall be
imposed only after all other means of securing compliance have been
exhausted. Notice of intent to terminate shall be given by the
Interstate Commission to the governor, the majority and minority
leaders of the defaulting state's legislature, and each of the
member states.
(e) The Interstate Commission shall establish rules and
procedures to address licenses and physicians that are materially
impacted by the termination of a member state, or the withdrawal of
a member state.
(f) The member state which has been terminated is
responsible for all dues, obligations, and liabilities incurred
through the effective date of termination including obligations,
the performance of which extends beyond the effective date of
termination.
(g) The Interstate Commission shall not bear any costs
relating to any state that has been found to be in default or which
has been terminated from the Compact, unless otherwise mutually
agreed upon in writing between the Interstate Commission and the
defaulting state.
(h) The defaulting state may appeal the action of the
Interstate Commission by petitioning the United States District
Court for the District of Columbia or the federal district where the
Interstate Commission has its principal offices. The prevailing
party shall be awarded all costs of such litigation including
reasonable attorney's fees.
SECTION 19. DISPUTE RESOLUTION
(a) The Interstate Commission shall attempt, upon the
request of a member state, to resolve disputes which are subject to
the Compact and which may arise among member states or member
boards.
(b) The Interstate Commission shall promulgate rules
providing for both mediation and binding dispute resolution as
appropriate.
SECTION 20. MEMBER STATES, EFFECTIVE DATE AND AMENDMENT
(a) Any state is eligible to become a member state of the
Compact.
(b) The Compact shall become effective and binding upon
legislative enactment of the Compact into law by no less than seven
(7) states. Thereafter, it shall become effective and binding on a
state upon enactment of the Compact into law by that state.
(c) The governors of non-member states, or their designees,
shall be invited to participate in the activities of the Interstate
Commission on a non-voting basis prior to adoption of the Compact by
all states.
(d) The Interstate Commission may propose amendments to the
Compact for enactment by the member states. No amendment shall
become effective and binding upon the Interstate Commission and the
member states unless and until it is enacted into law by unanimous
consent of the member states.
SECTION 21. WITHDRAWAL
(a) Once effective, the Compact shall continue in force and
remain binding upon each and every member state; provided that a
member state may withdraw from the Compact by specifically
repealing the statute which enacted the Compact into law.
(b) Withdrawal from the Compact shall be by the enactment of
a statute repealing the same, but shall not take effect until one
(1) year after the effective date of such statute and until written
notice of the withdrawal has been given by the withdrawing state to
the governor of each other member state.
(c) The withdrawing state shall immediately notify the
chairperson of the Interstate Commission in writing upon the
introduction of legislation repealing the Compact in the
withdrawing state.
(d) The Interstate Commission shall notify the other member
states of the withdrawing state's intent to withdraw within sixty
(60) days of its receipt of notice provided under subsection (c).
(e) The withdrawing state is responsible for all dues,
obligations and liabilities incurred through the effective date of
withdrawal, including obligations, the performance of which extend
beyond the effective date of withdrawal.
(f) Reinstatement following withdrawal of a member state
shall occur upon the withdrawing state reenacting the Compact or
upon such later date as determined by the Interstate Commission.
(g) The Interstate Commission is authorized to develop
rules to address the impact of the withdrawal of a member state on
licenses granted in other member states to physicians who
designated the withdrawing member state as the state of principal
license.
SECTION 22. DISSOLUTION
(a) The Compact shall dissolve effective upon the date of
the withdrawal or default of the member state which reduces the
membership in the Compact to one (1) member state.
(b) Upon the dissolution of the Compact, the Compact becomes
null and void and shall be of no further force or effect, and the
business and affairs of the Interstate Commission shall be
concluded and surplus funds shall be distributed in accordance with
the bylaws.
SECTION 23. SEVERABILITY AND CONSTRUCTION
(a) The provisions of the Compact shall be severable, and if
any phrase, clause, sentence, or provision is deemed unenforceable,
the remaining provisions of the Compact shall be enforceable.
(b) The provisions of the Compact shall be liberally
construed to effectuate its purposes.
(c) Nothing in the Compact shall be construed to prohibit
the applicability of other interstate compacts to which the states
are members.
SECTION 24. BINDING EFFECT OF COMPACT AND OTHER LAWS
(a) Nothing herein prevents the enforcement of any other law
of a member state that is not inconsistent with the Compact.
(b) All laws in a member state in conflict with the Compact
are superseded to the extent of the conflict.
(c) All lawful actions of the Interstate Commission,
including all rules and bylaws promulgated by the Commission, are
binding upon the member states.
(d) All agreements between the Interstate Commission and
the member states are binding in accordance with their terms.
(e) In the event any provision of the Compact exceeds the
constitutional limits imposed on the legislature of any member
state, such provision shall be ineffective to the extent of the
conflict with the constitutional provision in question in that
member state.
Sec. 170.002. RULES. The board may adopt rules necessary to
implement this chapter.
Sec. 170.003. COLLECTION OF FINGERPRINTS FOR EXPEDITED
LICENSE; DISSEMINATION OF INFORMATION. (a) The board may require
an applicant for an expedited license under the Interstate Medical
Licensure Compact to submit a set of fingerprints to the board for
the purpose of performing a criminal history record information
check to qualify the applicant for the expedited license.
(b) The board may not disseminate information obtained from
a criminal history record information check described by Subsection
(a) except as authorized by law.
SECTION 19. Subchapter B, Chapter 204, Occupations Code, is
amended by adding Section 204.0585 to read as follows:
Sec. 204.0585. EXECUTIVE SESSION. After hearing all
evidence and arguments in an open meeting, the physician assistant
board may conduct deliberations relating to a license application
or disciplinary action in an executive session. The board shall
vote and announce its decision in open session.
SECTION 20. Section 204.059, Occupations Code, is amended
by amending Subsection (b) and adding Subsection (d) to read as
follows:
(b) The training program must provide the person with
information regarding:
(1) the law governing physician assistant board
operations;
(2) the [this chapter and the physician assistant
board's] programs, functions, rules, and budget of the physician
assistant board;
(3) the scope of and limitations on the rulemaking
authority of the physician assistant board;
(4) [(2)] the results of the most recent formal audit
of the physician assistant board;
(5) [(3)] the requirements of:
(A) laws relating to open meetings, public
information, administrative procedure, and disclosing conflicts of
interest; and
(B) other laws applicable to members of the
physician assistant board in performing their duties; and
(6) [(4)] any applicable ethics policies adopted by
the physician assistant board or the Texas Ethics Commission.
(d) The executive director of the medical board shall create
a training manual that includes the information required by
Subsection (b). The executive director shall distribute a copy of
the training manual annually to each physician assistant board
member. On receipt of the training manual, each board member shall
sign and submit to the executive director a statement acknowledging
receipt of the training manual.
SECTION 21. Subchapter D, Chapter 204, Occupations Code, is
amended by adding Section 204.1525 to read as follows:
Sec. 204.1525. CRIMINAL HISTORY RECORD INFORMATION
REQUIREMENT FOR LICENSE ISSUANCE. (a) The physician assistant
board shall require that an applicant for a license submit a
complete and legible set of fingerprints, on a form prescribed by
the board, to the board or to the Department of Public Safety for
the purpose of obtaining criminal history record information from
the Department of Public Safety and the Federal Bureau of
Investigation.
(b) The physician assistant board may not issue a license to
a person who does not comply with the requirement of Subsection (a).
(c) The physician assistant board shall conduct a criminal
history record information check of each applicant for a license
using information:
(1) provided by the individual under this section; and
(2) made available to the board by the Department of
Public Safety, the Federal Bureau of Investigation, and any other
criminal justice agency under Chapter 411, Government Code.
(d) The physician assistant board may:
(1) enter into an agreement with the Department of
Public Safety to administer a criminal history record information
check required under this section; and
(2) authorize the Department of Public Safety to
collect from each applicant the costs incurred by the Department of
Public Safety in conducting the criminal history record information
check.
SECTION 22. Section 204.153(a), Occupations Code, is
amended to read as follows:
(a) To be eligible for a license under this chapter, an
applicant must:
(1) successfully complete an educational program for
physician assistants or surgeon assistants accredited by the
Committee on Allied Health Education and Accreditation or by that
committee's predecessor or successor entities;
(2) pass the Physician Assistant National Certifying
Examination administered by the National Commission on
Certification of Physician Assistants;
(3) hold a certificate issued by the National
Commission on Certification of Physician Assistants;
(4) [be of good moral character;
[(5)] meet any other requirement established by
physician assistant board rule; and
(5) [(6)] pass a jurisprudence examination approved
by the physician assistant board as provided by Subsection (a-1).
SECTION 23. Section 204.156, Occupations Code, is amended
by amending Subsection (a) and adding Subsection (a-1) to read as
follows:
(a) A license issued under this chapter is valid for a term
of one or two years, as determined by physician assistant board
rule.
(a-1) On notification from the physician assistant board, a
person who holds a license under this chapter may renew the license
by:
(1) paying the required renewal fee;
(2) submitting the appropriate form; and
(3) meeting any other requirement established by board
rule.
SECTION 24. Subchapter D, Chapter 204, Occupations Code, is
amended by adding Section 204.1561 to read as follows:
Sec. 204.1561. CRIMINAL HISTORY RECORD INFORMATION
REQUIREMENT FOR RENEWAL. (a) An applicant for renewal of a license
issued under this chapter shall submit a complete and legible set of
fingerprints for purposes of performing a criminal history record
information check of the applicant as provided by Section 204.1525.
(b) The physician assistant board may administratively
suspend or refuse to renew the license of a person who does not
comply with the requirement of Subsection (a).
(c) A license holder is not required to submit fingerprints
under this section for the renewal of the license if the holder has
previously submitted fingerprints under:
(1) Section 204.1525 for the initial issuance of the
license; or
(2) this section as part of a prior renewal of a
license.
SECTION 25. Subchapter D, Chapter 204, Occupations Code, is
amended by adding Section 204.158 to read as follows:
Sec. 204.158. REFUSAL FOR VIOLATION OF BOARD ORDER. The
physician assistant board may refuse to renew a license issued
under this chapter if the license holder is in violation of a
physician assistant board order.
SECTION 26. Subchapter E, Chapter 204, Occupations Code, is
amended by adding Section 204.210 to read as follows:
Sec. 204.210. DUTIES RELATED TO CERTAIN PRESCRIPTIONS. (a)
A physician assistant authorized to prescribe a drug may not
prescribe a drug listed in Subsection (b) to a patient unless the
physician assistant has reviewed the patient's prescription
history by accessing the prescription information submitted to the
Texas State Board of Pharmacy as authorized by Section
481.076(a)(5), Health and Safety Code.
(b) Subsection (a) applies only to the prescribing of:
(1) opioids;
(2) benzodiazepines;
(3) barbiturates; or
(4) carisoprodol.
(c) A physician assistant is not subject to the requirements
of Subsection (a) if:
(1) the patient has been diagnosed with cancer or the
patient is receiving hospice care; and
(2) the physician assistant clearly notes in the
prescription record that the patient was diagnosed with cancer or
is receiving hospice care, as applicable.
(d) Failure by a physician assistant to comply with the
requirements of this section is grounds for disciplinary action
under Section 204.301.
SECTION 27. Subchapter G, Chapter 204, Occupations Code, is
amended by adding Section 204.305 to read as follows:
Sec. 204.305. MONITORING HARMFUL PRESCRIBING PATTERNS. (a)
The physician assistant board shall periodically check the
prescribing information submitted to the Texas State Board of
Pharmacy as authorized by Section 481.076(a)(1), Health and Safety
Code, to determine whether a physician assistant licensed under
this chapter is engaging in potentially harmful prescribing
patterns or practices.
(b) The physician assistant board, in coordination with the
Texas State Board of Pharmacy, shall determine the conduct that
constitutes a potentially harmful prescribing pattern or practice
for purposes of Subsection (a). In determining the conduct that
constitutes a potentially harmful prescribing pattern or practice,
the physician assistant board shall consider:
(1) the number of times a physician assistant
prescribes a drug listed in Section 204.210(b); and
(2) for prescriptions described by Subdivision (1),
patterns of prescribing combinations of those drugs and other
dangerous combinations of drugs identified by the physician
assistant board.
(c) If the physician assistant board suspects that a
physician assistant may be engaging in potentially harmful
prescribing patterns or practices, the physician assistant board
may notify the physician assistant of the potentially harmful
prescribing pattern or practice.
(d) The physician assistant board may initiate a complaint
against a physician assistant based on information obtained under
this section.
SECTION 28. Section 204.313(a), Occupations Code, is
amended to read as follows:
(a) In an informal meeting under Section 204.312, at least
two panelists shall be appointed to determine whether an informal
disposition is appropriate. At least one of the panelists must be a
licensed physician assistant.
SECTION 29. Section 205.057, Occupations Code, is amended
by amending Subsection (b) and adding Subsection (d) to read as
follows:
(b) The training program must provide the person with
information regarding:
(1) the law governing acupuncture board operations
[this chapter];
(2) the programs, [operated by the acupuncture board;
[(3) the role and] functions, rules, and budget of the
acupuncture board;
(3) [(4)] the scope of and limitations on the
rulemaking authority [rules] of the acupuncture board;
(4) [(5) the current budget for the acupuncture board;
[(6)] the results of the most recent formal audit of
the acupuncture board;
(5) [(7)] the requirements of:
(A) laws relating to open meetings, public
information, administrative procedure, and disclosing conflicts of
interest; and
(B) other laws applicable to members of the
acupuncture board in performing their duties; and
(6) [(8)] any applicable ethics policies adopted by
the acupuncture board or the Texas Ethics Commission.
(d) The executive director shall create a training manual
that includes the information required by Subsection (b). The
executive director shall distribute a copy of the training manual
annually to each acupuncture board member. On receipt of the
training manual, each board member shall sign and submit to the
executive director a statement acknowledging receipt of the
training manual.
SECTION 30. Subchapter E, Chapter 205, Occupations Code, is
amended by adding Section 205.2025 to read as follows:
Sec. 205.2025. CRIMINAL HISTORY RECORD INFORMATION
REQUIREMENT FOR LICENSE ISSUANCE. (a) The acupuncture board shall
require that an applicant for a license submit a complete and
legible set of fingerprints, on a form prescribed by the board, to
the board or to the Department of Public Safety for the purpose of
obtaining criminal history record information from the Department
of Public Safety and the Federal Bureau of Investigation.
(b) The acupuncture board may not issue a license to a
person who does not comply with the requirement of Subsection (a).
(c) The acupuncture board shall conduct a criminal history
record information check of each applicant for a license using
information:
(1) provided by the individual under this section; and
(2) made available to the board by the Department of
Public Safety, the Federal Bureau of Investigation, and any other
criminal justice agency under Chapter 411, Government Code.
(d) The acupuncture board may:
(1) enter into an agreement with the Department of
Public Safety to administer a criminal history record information
check required under this section; and
(2) authorize the Department of Public Safety to
collect from each applicant the costs incurred by the Department of
Public Safety in conducting the criminal history record information
check.
SECTION 31. The heading to Section 205.251, Occupations
Code, is amended to read as follows:
Sec. 205.251. [ANNUAL] RENEWAL REQUIRED.
SECTION 32. Section 205.251(a), Occupations Code, is
amended to read as follows:
(a) The medical board by rule shall provide for the annual
or biennial renewal of a license to practice acupuncture.
SECTION 33. Subchapter F, Chapter 205, Occupations Code, is
amended by adding Section 205.2515 to read as follows:
Sec. 205.2515. CRIMINAL HISTORY RECORD INFORMATION
REQUIREMENT FOR RENEWAL. (a) An applicant for renewal of a license
issued under this chapter shall submit a complete and legible set of
fingerprints for purposes of performing a criminal history record
information check of the applicant as provided by Section 205.2025.
(b) The acupuncture board may administratively suspend or
refuse to renew the license of a person who does not comply with the
requirement of Subsection (a).
(c) A license holder is not required to submit fingerprints
under this section for the renewal of the license if the holder has
previously submitted fingerprints under:
(1) Section 205.2025 for the initial issuance of the
license; or
(2) this section as part of a prior renewal of a
license.
SECTION 34. Subchapter F, Chapter 205, Occupations Code, is
amended by adding Section 205.256 to read as follows:
Sec. 205.256. REFUSAL FOR VIOLATION OF BOARD ORDER. The
acupuncture board may refuse to renew a license issued under this
chapter if the license holder is in violation of an acupuncture
board order.
SECTION 35. Subchapter E, Chapter 206, Occupations Code, is
amended by adding Section 206.2025 to read as follows:
Sec. 206.2025. CRIMINAL HISTORY RECORD INFORMATION
REQUIREMENT FOR LICENSE ISSUANCE. (a) The medical board shall
require that an applicant for a license submit a complete and
legible set of fingerprints, on a form prescribed by the board, to
the board or to the Department of Public Safety for the purpose of
obtaining criminal history record information from the Department
of Public Safety and the Federal Bureau of Investigation.
(b) The medical board may not issue a license to a person who
does not comply with the requirement of Subsection (a).
(c) The medical board shall conduct a criminal history
record information check of each applicant for a license using
information:
(1) provided by the individual under this section; and
(2) made available to the board by the Department of
Public Safety, the Federal Bureau of Investigation, and any other
criminal justice agency under Chapter 411, Government Code.
(d) The medical board may:
(1) enter into an agreement with the Department of
Public Safety to administer a criminal history record information
check required under this section; and
(2) authorize the Department of Public Safety to
collect from each applicant the costs incurred by the Department of
Public Safety in conducting the criminal history record information
check.
SECTION 36. Section 206.203(a), Occupations Code, is
amended to read as follows:
(a) Except as provided by Section 206.206, to be eligible
for a license, a person must:
(1) [be of good moral character;
[(2)] have not been convicted of a felony or a crime
involving moral turpitude;
(2) [(3)] not use drugs or alcohol to an extent that
affects the applicant's professional competency;
(3) [(4)] not have had a license or certification
revoked by a licensing agency or by a certifying professional
organization; and
(4) [(5)] not have engaged in fraud or deceit in
applying for a license under this chapter.
SECTION 37. Subchapter E, Chapter 206, Occupations Code, is
amended by adding Section 206.2105 to read as follows:
Sec. 206.2105. CRIMINAL HISTORY RECORD INFORMATION
REQUIREMENT FOR RENEWAL. (a) An applicant for renewal of a license
issued under this chapter shall submit a complete and legible set of
fingerprints for purposes of performing a criminal history record
information check of the applicant as provided by Section 206.2025.
(b) The medical board may administratively suspend or
refuse to renew the license of a person who does not comply with the
requirement of Subsection (a).
(c) A license holder is not required to submit fingerprints
under this section for the renewal of the license if the holder has
previously submitted fingerprints under:
(1) Section 206.2025 for the initial issuance of the
license; or
(2) this section as part of a prior renewal of a
license.
SECTION 38. Subchapter E, Chapter 206, Occupations Code, is
amended by adding Section 206.215 to read as follows:
Sec. 206.215. REFUSAL FOR VIOLATION OF BOARD ORDER. The
medical board may refuse to renew a license issued under this
chapter if the license holder is in violation of a medical board
order.
SECTION 39. Section 601.002, Occupations Code, is amended
by adding Subdivisions (10-a) and (10-b) to read as follows:
(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
Royal College of Radiologists, or the Royal College of Physicians
and Surgeons of Canada.
(10-b) "Radiologist assistant" means an
advanced-level medical radiologic technologist who is certified
as:
(A) a registered radiologist assistant by the
American Registry of Radiologic Technologists; or
(B) a radiology practitioner assistant by the
Certification Board for Radiology Practitioner Assistants.
SECTION 40. Section 601.030, Occupations Code, is amended
by amending Subsection (b) and adding Subsection (d) to read as
follows:
(b) The training program must provide the person with
information regarding:
(1) the law governing advisory board operations;
(2) [this chapter and] the [advisory board's]
programs, functions, rules, and budget of the advisory board;
(3) the scope of and limitations on the rulemaking
authority of the advisory board;
(4) [(2)] the results of the most recent formal audit
of the advisory board;
(5) [(3)] the requirements of:
(A) laws relating to open meetings, public
information, administrative procedure, and disclosing conflicts of
interest; and
(B) other laws applicable to members of the
advisory board in performing their duties; and
(6) [(4)] any applicable ethics policies adopted by
the advisory board or the Texas Ethics Commission.
(d) The executive director of the medical board shall create
a training manual that includes the information required by
Subsection (b). The executive director shall distribute a copy of
the training manual annually to each advisory board member. On
receipt of the training manual, each board member shall sign and
submit to the executive director a statement acknowledging receipt
of the training manual.
SECTION 41. Sections 601.102(b) and (c), Occupations Code,
are amended to read as follows:
(b) The advisory board may issue to a person:
(1) a general certificate to perform radiologic
procedures; [or]
(2) a limited certificate that authorizes the person
to perform radiologic procedures only on specific parts of the
human body; or
(3) a radiologist assistant certificate to a person
who meets the requirements established under Section 601.1021.
(c) The advisory board may issue to a person a temporary
general certificate, [or] a temporary limited certificate, or a
temporary radiologist assistant certificate that authorizes the
person to perform radiologic procedures for a period not to exceed
one year.
SECTION 42. Subchapter C, Chapter 601, Occupations Code, is
amended by adding Section 601.1021 to read as follows:
Sec. 601.1021. RADIOLOGIST ASSISTANT CERTIFICATE. (a) The
advisory board by rule shall establish the education and training
required for a person to obtain a radiologist assistant
certificate.
(b) A radiologist assistant certificate holder:
(1) may perform radiologic procedures only under the
supervision of a radiologist; and
(2) may not interpret images, make diagnoses, or
prescribe any medication or therapy.
SECTION 43. Subchapter C, Chapter 601, Occupations Code, is
amended by adding Section 601.113 to read as follows:
Sec. 601.113. REFUSAL FOR VIOLATION OF BOARD ORDER. The
advisory board may refuse to renew a certificate issued under this
chapter if the certificate holder is in violation of an advisory
board order.
SECTION 44. Section 601.155, Occupations Code, is amended
to read as follows:
Sec. 601.155. STUDENTS. A person is not required to hold a
certificate issued under this chapter [or to comply with the
registration requirements adopted under Section 601.252] if the
person:
(1) is a student enrolled in a training program that
meets the minimum standards adopted under Section 601.201; and
(2) is performing a radiologic procedure in an
academic or clinical setting as part of the training program.
SECTION 45. Section 601.156, Occupations Code, is amended
to read as follows:
Sec. 601.156. PROCEDURE PERFORMED AS PART OF CONTINUING
EDUCATION PROGRAM. A person is not required to hold a certificate
issued under this chapter [or to comply with the registration
requirements adopted under Section 601.252] if the person is:
(1) licensed or otherwise registered as a medical
radiologic technologist by another state, the American Registry of
Radiologic Technologists, the American Registry of Clinical
Radiography Technologists, or a professional organization or
association recognized by the advisory board;
(2) enrolled in a continuing education program that
meets the requirements adopted under Section 601.108; and
(3) performing a radiologic procedure as part of the
continuing education program for not more than 10 days.
SECTION 46. Section 601.203(b), Occupations Code, is
amended to read as follows:
(b) The following conditions are considered to be a hardship
for the purposes of Subsection (a):
(1) that the applicant:
(A) reports an inability to attract and retain
medical radiologic technologists; and
(B) is located in a county with a population of
less than 50,000;
(2) that the applicant is located at a great distance
from a school of medical radiologic technology;
(3) that there is a list of qualified persons who have
applied to a school of medical radiologic technology whose
admissions are pending because of a lack of faculty or space;
(4) that the school of medical radiologic technology
produces an insufficient number of graduates in medical radiologic
technology to meet the needs of the applicant; or
(5) any other criteria determined by advisory board
rule.
SECTION 47. Sections 601.252(c) and (d), Occupations Code,
are amended to read as follows:
(c) Rules adopted under this section by the State Board of
Dental Examiners must:
(1) require an authorized person who performs
radiologic procedures under the delegation of a dentist, other than
a registered nurse, to register with the dental board [agency that
licenses the practitioner under whom the person performs radiologic
procedures];
(2) establish reasonable and necessary fees to cover
the administrative costs incurred by the dental board [agency] in
administering a registration program created under this
subsection;
(3) establish grounds for the suspension, revocation,
or nonrenewal of a registration issued under this subsection; and
(4) establish standards, in addition to those required
by this chapter, for training and supervising the operators of the
equipment.
(d) In adopting rules under Subsection (c), the State Board
of Dental Examiners [an agency] may take into account whether the
radiologic procedure will be performed by a registered nurse.
SECTION 48. Subchapter E, Chapter 602, Occupations Code, is
amended by adding Section 602.214 to read as follows:
Sec. 602.214. REFUSAL FOR VIOLATION OF BOARD ORDER. The
medical board may refuse to renew a license issued under this
chapter if the license holder is in violation of a medical board
order.
SECTION 49. Section 603.252(a), Occupations Code, is
amended to read as follows:
(a) An applicant for a perfusionist license must submit an
[a sworn] application accompanied by the application fee.
SECTION 50. Subchapter G, Chapter 603, Occupations Code, is
amended by adding Section 603.306 to read as follows:
Sec. 603.306. REFUSAL FOR VIOLATION OF BOARD ORDER. The
medical board may refuse to renew a license issued under this
chapter if the license holder is in violation of a medical board
order.
SECTION 51. Section 604.030, Occupations Code, is amended
by amending Subsection (b) and adding Subsection (d) to read as
follows:
(b) The training program must provide the person with
information regarding:
(1) the law governing advisory board operations;
(2) the [this chapter and the advisory board's]
programs, functions, rules, and budget of the advisory board;
(3) the scope of and limitations on the rulemaking
authority of the advisory board;
(4) [(2)] the results of the most recent formal audit
of the advisory board;
(5) [(3)] the requirements of:
(A) laws relating to open meetings, public
information, administrative procedure, and disclosing conflicts of
interest; and
(B) other laws applicable to members of the
advisory board in performing their duties; and
(6) [(4)] any applicable ethics policies adopted by
the advisory board or the Texas Ethics Commission.
(d) The executive director of the medical board shall create
a training manual that includes the information required by
Subsection (b). The executive director shall distribute a copy of
the training manual annually to each advisory board member. On
receipt of the training manual, each board member shall sign and
submit to the executive director a statement acknowledging receipt
of the training manual.
SECTION 52. Subchapter D, Chapter 604, Occupations Code, is
amended by adding Section 604.158 to read as follows:
Sec. 604.158. REFUSAL FOR VIOLATION OF BOARD ORDER. The
advisory board may refuse to renew a certificate or temporary
permit issued under this chapter if the certificate or permit
holder is in violation of an advisory board order.
SECTION 53. (a) Except as provided by Subsection (b) of this
section, Sections 152.010, 204.059, 205.057, 601.030, and 604.030,
Occupations Code, as amended by this Act, apply to a member of the
applicable board appointed before, on, or after the effective date
of this Act.
(b) A member of a board who, before the effective date of
this Act, completed the training program required by Section
152.010, 204.059, 205.057, 601.030, or 604.030, Occupations Code,
as the applicable law existed before the effective date of this Act,
is only required to complete additional training on the subjects
added by this Act to the training program required by Section
152.010, 204.059, 205.057, 601.030, or 604.030, Occupations Code,
as applicable. A board member described by this subsection may not
vote, deliberate, or be counted as a member in attendance at a
meeting of the applicable board held on or after December 1, 2017,
until the member completes the additional training.
SECTION 54. Sections 162.301 and 204.210, Occupations Code,
as added by this Act, apply only to a prescription issued on or
after September 1, 2018. A prescription issued before September 1,
2018, is governed by the law in effect immediately before the
effective date of this Act, and the former law is continued in
effect for that purpose.
SECTION 55. Not later than March 1, 2018, the Texas Medical
Board shall adopt rules necessary to implement Section 164.003(b),
Occupations Code, as amended by this Act.
SECTION 56. Not later than January 1, 2018, the Texas
Medical Board and the governing board of the Texas Physician Health
Program by rule shall adopt the memorandum of understanding
required by Section 167.012, Occupations Code, as added by this
Act.
SECTION 57. Not later than September 1, 2019, the Texas
Physician Assistant Board, the Texas State Board of Acupuncture
Examiners, and the Texas Medical Board shall obtain criminal
history record information on each person who, on the effective
date of this Act, holds a license issued under Chapter 204, 205, or
206, Occupations Code, as applicable, and did not undergo a
criminal history record information check based on the license
holder's fingerprints on the initial application for the license.
A board may suspend the license of a license holder who does not
provide the criminal history record information as required by the
board and this section.
SECTION 58. Not later than January 1, 2018, the Texas
Medical Board shall approve the rules required by Section 601.1021,
Occupations Code, as added by this Act.
SECTION 59. This Act takes effect September 1, 2017.