Texas 2017 - 85th Regular

Texas House Bill HB3040 Compare Versions

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1	1	85R21497 BEE-D
2	2	By: Burkett, Thompson of Harris, Flynn, H.B. No. 3040
3	3	Raymond
4	4	Substitute the following for H.B. No. 3040:
5	5	By: Price C.S.H.B. No. 3040
6	6
7	7
8	8	A BILL TO BE ENTITLED
9	9	AN ACT
10	10	relating to the continuation and functions of the Texas Medical
11	11	Board; authorizing a fee.
12	12	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
13	13	SECTION 1. Section 151.004, Occupations Code, is amended to
14	14	read as follows:
15	15	Sec. 151.004. APPLICATION OF SUNSET ACT. The Texas Medical
16	16	Board is subject to Chapter 325, Government Code (Texas Sunset
17	17	Act). Unless continued in existence as provided by that chapter,
18	18	the board is abolished and this subtitle and Chapters 204, 205, 206,
19	19	601, 602, 603, and 604 expire September 1, 2029 [2017].
20	20	SECTION 2. Section 152.010, Occupations Code, is amended by
21	21	amending Subsection (b) and adding Subsection (d) to read as
22	22	follows:
23	23	(b) The training program must provide the person with
24	24	information regarding:
25	25	(1) the law governing board operations [this
26	26	subtitle];
27	27	(2) the programs, functions, rules, and budget of
28	28	[operated by] the board;
29	29	(3) the scope of and limitations on the rulemaking
30	30	authority [role and functions] of the board;
31	31	(4) [the rules of the board, with an emphasis on the
32	32	rules that relate to disciplinary and investigatory authority;
33	33	[(5) the current budget for the board;
34	34	[(6)] the results of the most recent formal audit of
35	35	the board;
36	36	(5) [(7)] the requirements of:
37	37	(A) laws relating to open meetings, public
38	38	information, administrative procedure, and disclosing conflicts of
39	39	interest; and
40	40	(B) other laws applicable to members of the board
41	41	in performing their duties; and
42	42	(6) [(8)] any applicable ethics policies adopted by
43	43	the board or the Texas Ethics Commission.
44	44	(d) The executive director of the board shall create a
45	45	training manual that includes the information required by
46	46	Subsection (b). The executive director shall distribute a copy of
47	47	the training manual annually to each board member. On receipt of
48	48	the training manual, each board member shall sign and submit to the
49	49	executive director a statement acknowledging receipt of the
50	50	training manual.
51	51	SECTION 3. The heading to Section 153.007, Occupations
52	52	Code, is amended to read as follows:
53	53	Sec. 153.007. AUTHORITY TO ISSUE SUBPOENA OR ADMINISTER
54	54	OATH; SUBPOENA ENFORCEMENT.
55	55	SECTION 4. Section 153.007, Occupations Code, is amended by
56	56	adding Subsections (e) and (f) to read as follows:
57	57	(e) If a person fails to comply with a subpoena issued under
58	58	this section, the board, acting through the attorney general, may
59	59	file suit to enforce the subpoena in a district court in Travis
60	60	County or in a county in which a hearing conducted by the board may
61	61	be held.
62	62	(f) On finding that good cause exists for issuing the
63	63	subpoena, the court shall order the person to comply with the
64	64	subpoena.
65	65	SECTION 5. Section 153.058(a), Occupations Code, is amended
66	66	to read as follows:
67	67	(a) The board shall develop and implement a policy to
68	68	encourage the use of:
69	69	(1) negotiated rulemaking procedures under Chapter
70	70	2008, Government Code, for the adoption of any rules by the board
71	71	[rules]; and
72	72	(2) appropriate alternative dispute resolution
73	73	procedures under Chapter 2009, Government Code, to assist in the
74	74	resolution of internal and external disputes under the board's
75	75	jurisdiction.
76	76	SECTION 6. Section 155.056, Occupations Code, is amended by
77	77	amending Subsection (a) and adding Subsection (a-1) to read as
78	78	follows:
79	79	(a) Except as provided by Subsection (a-1), an [An]
80	80	applicant must pass each part of an examination within three
81	81	attempts.
82	82	(a-1) The limit on the number of examination attempts under
83	83	Subsection (a) does not apply to the Texas medical jurisprudence
84	84	examination.
85	85	SECTION 7. Subchapter A, Chapter 156, Occupations Code, is
86	86	amended by adding Section 156.010 to read as follows:
87	87	Sec. 156.010. REFUSAL FOR VIOLATION OF BOARD ORDER. The
88	88	board may refuse to renew a registration permit issued under this
89	89	chapter if the license holder is in violation of a board order.
90	90	SECTION 8. Section 162.106, Occupations Code, is amended to
91	91	read as follows:
92	92	Sec. 162.106. INSPECTIONS. (a) The board may conduct
93	93	inspections [to enforce this subchapter, including inspections of
94	94	an office site and of documents] of a physician's equipment and
95	95	office procedures [practice] that relate to the provision of
96	96	anesthesia in an outpatient setting as necessary to enforce this
97	97	subchapter.
98	98	(b) The board may establish a risk-based inspection process
99	99	in which the board conducts inspections based on the length of time
100	100	since:
101	101	(1) the equipment and outpatient setting were last
102	102	inspected; and
103	103	(2) the physician submitted to inspection.
104	104	(c) The board may contract with another state agency or
105	105	qualified person to conduct the inspections.
106	106	(d) [(b)] Unless it would jeopardize an ongoing
107	107	investigation, the board shall provide at least five business days'
108	108	notice before conducting an on-site inspection under this section.
109	109	(e) The board shall maintain a record of the outpatient
110	110	settings in which physicians provide anesthesia.
111	111	(f) A physician who provides anesthesia in an outpatient
112	112	setting shall inform the board of any other physician with whom the
113	113	physician shares equipment used to administer anesthesia.
114	114	(g) [(c)] This section does not require the board to make an
115	115	on-site inspection of a physician's office.
116	116	SECTION 9. Chapter 162, Occupations Code, is amended by
117	117	adding Subchapter G to read as follows:
118	118	SUBCHAPTER G. GENERAL PRACTICE PROVISIONS
119	119	Sec. 162.301. DUTIES RELATED TO CERTAIN PRESCRIPTIONS. (a)
120	120	A physician may not prescribe a drug listed in Subsection (b) to a
121	121	patient unless the physician has reviewed the patient's
122	122	prescription history by accessing the prescription information
123	123	submitted to the Texas State Board of Pharmacy as authorized by
124	124	Section 481.076(a)(5), Health and Safety Code.
125	125	(b) Subsection (a) applies only to the prescribing of:
126	126	(1) opioids;
127	127	(2) benzodiazepines;
128	128	(3) barbiturates; or
129	129	(4) carisoprodol.
130	130	(c) A physician is not subject to the requirements of
131	131	Subsection (a) if:
132	132	(1) the patient has been diagnosed with cancer or the
133	133	patient is receiving hospice care; and
134	134	(2) the physician clearly notes in the prescription
135	135	record that the patient was diagnosed with cancer or is receiving
136	136	hospice care, as applicable.
137	137	(d) Failure by a physician to comply with the requirements
138	138	of this section is grounds for disciplinary action under Section
139	139	164.051.
140	140	SECTION 10. Section 164.0015(d), Occupations Code, is
141	141	amended to read as follows:
142	142	(d) The board may not issue a remedial plan to resolve a
143	143	complaint against a license holder if the license holder has
144	144	[previously] entered into a remedial plan with the board in the
145	145	preceding five years [for the resolution of a different complaint
146	146	relating to this subtitle].
147	147	SECTION 11. Section 164.003, Occupations Code, is amended
148	148	by amending Subsections (b) and (f) and adding Subsection (f-1) to
149	149	read as follows:
150	150	(b) Rules adopted under this section must require that:
151	151	(1) an informal meeting in compliance with Section
152	152	2001.054, Government Code, be scheduled not later than the 180th
153	153	day after the date the board's official investigation of the
154	154	complaint is commenced as provided by Section 154.057(b), unless
155	155	good cause is shown by the board for scheduling the informal meeting
156	156	after that date;
157	157	(2) the board give notice to the license holder of the
158	158	time and place of the meeting not later than the 45th day before the
159	159	date the meeting is held;
160	160	(3) the complainant and the license holder be provided
161	161	an opportunity to be heard;
162	162	(4) at least one of the board members or district
163	163	review committee members participating in the informal meeting as a
164	164	panelist be a member who represents the public;
165	165	(5) the board's legal counsel or a representative of
166	166	the attorney general be present to advise the board or the board's
167	167	staff; [and]
168	168	(6) a member of the board's staff be at the meeting to
169	169	present to the board's representative the facts the staff
170	170	reasonably believes it could prove by competent evidence or
171	171	qualified witnesses at a hearing; and
172	172	(7) if the complaint includes an allegation that the
173	173	license holder has violated the standard of care, the panel
174	174	conducting the informal proceeding consider whether the physician
175	175	was practicing complementary and alternative medicine.
176	176	(f) The notice required by Subsection (b)(2) must be
177	177	accompanied by a written statement of the nature of the allegations
178	178	and the information the board intends to use at the meeting. If the
179	179	board does not provide the statement or information at that time,
180	180	the license holder may use that failure as grounds for rescheduling
181	181	the informal meeting. If the complaint includes an allegation that
182	182	the license holder has violated the standard of care, the notice
183	183	must include a copy of each [the] report prepared by an [the] expert
184	184	physician reviewer under Section 154.0561. The license holder must
185	185	provide to the board the license holder's rebuttal at least 15
186	186	business days before the date of the meeting in order for the
187	187	information to be considered at the meeting.
188	188	(f-1) Before providing a report to a license holder under
189	189	Subsection (f), the board must redact any identifying information
190	190	of an expert physician reviewer other than the specialty of the
191	191	expert physician reviewer.
192	192	SECTION 12. Sections 164.005(a) and (c), Occupations Code,
193	193	are amended to read as follows:
194	194	(a) In this section, "formal complaint" means a written
195	195	statement made by a credible person [under oath] that is filed and
196	196	presented by a board representative charging a person with having
197	197	committed an act that, if proven, could affect the legal rights or
198	198	privileges of a license holder or other person under the board's
199	199	jurisdiction.
200	200	(c) A charge must [be in the form of a written affidavit
201	201	that]:
202	202	(1) be [is] filed with the board's records custodian or
203	203	assistant records custodian; and
204	204	(2) detail [details] the nature of the charge as
205	205	required by this subtitle or other applicable law.
206	206	SECTION 13. Subchapter A, Chapter 164, Occupations Code, is
207	207	amended by adding Section 164.0105 to read as follows:
208	208	Sec. 164.0105. MONITORING HARMFUL PRESCRIBING PATTERNS.
209	209	(a) The board shall periodically check the prescribing information
210	210	submitted to the Texas State Board of Pharmacy as authorized by
211	211	Section 481.076(a)(1), Health and Safety Code, to determine whether
212	212	a physician is engaging in potentially harmful prescribing patterns
213	213	or practices.
214	214	(b) The board, in coordination with the Texas State Board of
215	215	Pharmacy, shall determine the conduct that constitutes a
216	216	potentially harmful prescribing pattern or practice for purposes of
217	217	Subsection (a). In determining the conduct that constitutes a
218	218	potentially harmful prescribing pattern or practice, the board
219	219	shall consider:
220	220	(1) the number of times a physician prescribes a drug
221	221	listed in Section 162.301(b); and
222	222	(2) for prescriptions described by Subdivision (1),
223	223	patterns of prescribing combinations of those drugs and other
224	224	dangerous combinations of drugs identified by the board.
225	225	(c) If the board suspects that a physician may be engaging
226	226	in potentially harmful prescribing patterns or practices, the board
227	227	may notify the physician of the potentially harmful prescribing
228	228	pattern or practice.
229	229	(d) The board may initiate a complaint against a physician
230	230	based on information obtained under this section.
231	231	SECTION 14. Chapter 167, Occupations Code, is amended by
232	232	adding Sections 167.012 and 167.013 to read as follows:
233	233	Sec. 167.012. MEMORANDUM OF UNDERSTANDING WITH BOARD. The
234	234	governing board and the board shall enter into a memorandum of
235	235	understanding to better coordinate services and operations of the
236	236	program. The memorandum of understanding must be adopted by rule
237	237	and:
238	238	(1) establish performance measures for the program,
239	239	including the number of participants who successfully complete the
240	240	program;
241	241	(2) include a list of services the board will provide
242	242	for the program; and
243	243	(3) require that an internal audit of the program be
244	244	conducted at least once every three years to ensure the program is
245	245	properly documenting and referring all noncompliance to the board.
246	246	Sec. 167.013. GIFTS, GRANTS, AND DONATIONS. In addition to
247	247	any fees paid to the board or money appropriated to the board for
248	248	the program, the governing board may receive and accept a gift,
249	249	grant, donation, or other thing of value from any source, including
250	250	the United States or a private source, for the program.
251	251	SECTION 15. Subchapter A, Chapter 168, Occupations Code, is
252	252	amended by adding Section 168.003 to read as follows:
253	253	Sec. 168.003. LEGISLATIVE FINDING. The legislature finds
254	254	that deaths resulting from the use of opioids and other controlled
255	255	substances constitute a public health crisis and that there is a
256	256	compelling state interest in the board closely regulating the
257	257	prescribing of opioids and other controlled substances by
258	258	physicians and their delegates. Accordingly, the legislature finds
259	259	that inspections and investigations conducted by the board,
260	260	including the board's use of subpoenas for immediate production,
261	261	inspection, and copying of medical and billing records, are
262	262	necessary to adequately regulate the prescribing of opioids and
263	263	other controlled substances in order to protect the public health
264	264	and welfare.
265	265	SECTION 16. Section 168.052, Occupations Code, is amended
266	266	to read as follows:
267	267	Sec. 168.052. INSPECTIONS. (a) The board may inspect a
268	268	pain management clinic certified under this chapter, including the
269	269	documents of a physician practicing at the clinic, as necessary to
270	270	ensure compliance with this chapter.
271	271	(b) The board may inspect a clinic or facility that is not
272	272	certified under this chapter to determine whether the clinic or
273	273	facility is required to be certified under Section 168.101. The
274	274	board by rule shall establish the grounds for conducting an
275	275	inspection under this subsection, including grounds based on:
276	276	(1) the population of patients served by the clinic or
277	277	facility;
278	278	(2) the volume or combination of drugs prescribed to
279	279	patients served by the clinic or facility; and
280	280	(3) any other criteria the board considers sufficient
281	281	to require an inspection of the clinic or facility.
282	282	SECTION 17. Section 168.201, Occupations Code, is amended
283	283	by adding Subsection (a-1) to read as follows:
284	284	(a-1) For the purposes of this section, inappropriate
285	285	prescribing includes nontherapeutic prescribing or other conduct
286	286	as specified by board rule.
287	287	SECTION 18. Subtitle B, Title 3, Occupations Code, is
288	288	amended by adding Chapter 170 to read as follows:
289	289	CHAPTER 170. INTERSTATE MEDICAL LICENSURE COMPACT
290	290	Sec. 170.001. INTERSTATE MEDICAL LICENSURE COMPACT. The
291	291	Interstate Medical Licensure Compact is enacted and entered into
292	292	with all other jurisdictions that legally join in the compact,
293	293	which reads as follows:
294	294	INTERSTATE MEDICAL LICENSURE COMPACT
295	295	SECTION 1. PURPOSE
296	296	In order to strengthen access to health care, and in
297	297	recognition of the advances in the delivery of health care, the
298	298	member states of the Interstate Medical Licensure Compact have
299	299	allied in common purpose to develop a comprehensive process that
300	300	complements the existing licensing and regulatory authority of
301	301	state medical boards, and provides a streamlined process that
302	302	allows physicians to become licensed in multiple states, thereby
303	303	enhancing the portability of a medical license and ensuring the
304	304	safety of patients. The Compact creates another pathway for
305	305	licensure and does not otherwise change a state's existing Medical
306	306	Practice Act. The Compact also adopts the prevailing standard for
307	307	licensure and affirms that the practice of medicine occurs where
308	308	the patient is located at the time of the physician-patient
309	309	encounter, and therefore, requires the physician to be under the
310	310	jurisdiction of the state medical board where the patient is
311	311	located. State medical boards that participate in the Compact
312	312	retain the jurisdiction to impose an adverse action against a
313	313	license to practice medicine in that state issued to a physician
314	314	through the procedures in the Compact.
315	315	SECTION 2. DEFINITIONS
316	316	In this compact:
317	317	(a) "Bylaws" means those bylaws established by the
318	318	Interstate Commission pursuant to Section 11 for its governance, or
319	319	for directing and controlling its actions and conduct.
320	320	(b) "Commissioner" means the voting representative
321	321	appointed by each member board pursuant to Section 11.
322	322	(c) "Conviction" means a finding by a court that an
323	323	individual is guilty of a criminal offense through adjudication, or
324	324	entry of a plea of guilt or no contest to the charge by the offender.
325	325	Evidence of an entry of a conviction of a criminal offense by the
326	326	court shall be considered final for purposes of disciplinary action
327	327	by a member board.
328	328	(d) "Expedited License" means a full and unrestricted
329	329	medical license granted by a member state to an eligible physician
330	330	through the process set forth in the Compact.
331	331	(e) "Interstate Commission" means the interstate commission
332	332	created pursuant to Section 11.
333	333	(f) "License" means authorization by a state for a physician
334	334	to engage in the practice of medicine, which would be unlawful
335	335	without the authorization.
336	336	(g) "Medical Practice Act" means laws and regulations
337	337	governing the practice of allopathic and osteopathic medicine
338	338	within a member state.
339	339	(h) "Member Board" means a state agency in a member state
340	340	that acts in the sovereign interests of the state by protecting the
341	341	public through licensure, regulation, and education of physicians
342	342	as directed by the state government.
343	343	(i) "Member State" means a state that has enacted the
344	344	Compact.
345	345	(j) "Practice of Medicine" means the clinical prevention,
346	346	diagnosis, or treatment of human disease, injury, or condition
347	347	requiring a physician to obtain and maintain a license in
348	348	compliance with the Medical Practice Act of a member state.
349	349	(k) "Physician" means any person who:
350	350	(1) Is a graduate of a medical school accredited by the
351	351	Liaison Committee on Medical Education, the Commission on
352	352	Osteopathic College Accreditation, or a medical school listed in
353	353	the International Medical Education Directory or its equivalent;
354	354	(2) Passed each component of the United States Medical
355	355	Licensing Examination (USMLE) or the Comprehensive Osteopathic
356	356	Medical Licensing Examination (COMLEX-USA) within three attempts,
357	357	or any of its predecessor examinations accepted by a state medical
358	358	board as an equivalent examination for licensure purposes;
359	359	(3) Successfully completed graduate medical education
360	360	approved by the Accreditation Council for Graduate Medical
361	361	Education or the American Osteopathic Association;
362	362	(4) Holds specialty certification or a time-unlimited
363	363	specialty certificate recognized by the American Board of Medical
364	364	Specialties or the American Osteopathic Association's Bureau of
365	365	Osteopathic Specialists;
366	366	(5) Possesses a full and unrestricted license to
367	367	engage in the practice of medicine issued by a member board;
368	368	(6) Has never been convicted, received adjudication,
369	369	deferred adjudication, community supervision, or deferred
370	370	disposition for any offense by a court of appropriate jurisdiction;
371	371	(7) Has never held a license authorizing the practice
372	372	of medicine subjected to discipline by a licensing agency in any
373	373	state, federal, or foreign jurisdiction, excluding any action
374	374	related to non-payment of fees related to a license;
375	375	(8) Has never had a controlled substance license or
376	376	permit suspended or revoked by a state or the United States Drug
377	377	Enforcement Administration; and
378	378	(9) Is not under active investigation by a licensing
379	379	agency or law enforcement authority in any state, federal, or
380	380	foreign jurisdiction.
381	381	(l) "Offense" means a felony, gross misdemeanor, or crime of
382	382	moral turpitude.
383	383	(m) "Rule" means a written statement by the Interstate
384	384	Commission promulgated pursuant to Section 12 of the Compact that
385	385	is of general applicability, implements, interprets, or prescribes
386	386	a policy or provision of the Compact, or an organizational,
387	387	procedural, or practice requirement of the Interstate Commission,
388	388	and has the force and effect of statutory law in a member state, and
389	389	includes the amendment, repeal, or suspension of an existing rule.
390	390	(n) "State" means any state, commonwealth, district, or
391	391	territory of the United States.
392	392	(o) "State of Principal License" means a member state where
393	393	a physician holds a license to practice medicine and which has been
394	394	designated as such by the physician for purposes of registration
395	395	and participation in the Compact.
396	396	SECTION 3. ELIGIBILITY
397	397	(a) A physician must meet the eligibility requirements as
398	398	defined in Section 2(k) to receive an expedited license under the
399	399	terms and provisions of the Compact.
400	400	(b) A physician who does not meet the requirements of
401	401	Section 2(k) may obtain a license to practice medicine in a member
402	402	state if the individual complies with all laws and requirements,
403	403	other than the Compact, relating to the issuance of a license to
404	404	practice medicine in that state.
405	405	SECTION 4. DESIGNATION OF STATE OF PRINCIPAL LICENSE
406	406	(a) A physician shall designate a member state as the state
407	407	of principal license for purposes of registration for expedited
408	408	licensure through the Compact if the physician possesses a full and
409	409	unrestricted license to practice medicine in that state, and the
410	410	state is:
411	411	(1) the state of primary residence for the physician,
412	412	or
413	413	(2) the state where at least 25 percent of the practice
414	414	of medicine occurs, or
415	415	(3) the location of the physician's employer, or
416	416	(4) if no state qualifies under subsection (1),
417	417	subsection (2), or subsection (3), the state designated as state of
418	418	residence for purpose of federal income tax.
419	419	(b) A physician may redesignate a member state as state of
420	420	principal license at any time, as long as the state meets the
421	421	requirements in subsection (a).
422	422	(c) The Interstate Commission is authorized to develop
423	423	rules to facilitate redesignation of another member state as the
424	424	state of principal license.
425	425	SECTION 5. APPLICATION AND ISSUANCE OF EXPEDITED LICENSURE
426	426	(a) A physician seeking licensure through the Compact shall
427	427	file an application for an expedited license with the member board
428	428	of the state selected by the physician as the state of principal
429	429	license.
430	430	(b) Upon receipt of an application for an expedited license,
431	431	the member board within the state selected as the state of principal
432	432	license shall evaluate whether the physician is eligible for
433	433	expedited licensure and issue a letter of qualification, verifying
434	434	or denying the physician's eligibility, to the Interstate
435	435	Commission.
436	436	(i) Static qualifications, which include verification
437	437	of medical education, graduate medical education, results of any
438	438	medical or licensing examination, and other qualifications as
439	439	determined by the Interstate Commission through rule, shall not be
440	440	subject to additional primary source verification where already
441	441	primary source verified by the state of principal license.
442	442	(ii) The member board within the state selected as the
443	443	state of principal license shall, in the course of verifying
444	444	eligibility, perform a criminal background check of an applicant,
445	445	including the use of the results of fingerprint or other biometric
446	446	data checks compliant with the requirements of the Federal Bureau
447	447	of Investigation, with the exception of federal employees who have
448	448	suitability determination in accordance with U.S. C.F.R. Section
449	449	731.202.
450	450	(iii) Appeal on the determination of eligibility shall
451	451	be made to the member state where the application was filed and
452	452	shall be subject to the law of that state.
453	453	(c) Upon verification in subsection (b), physicians
454	454	eligible for an expedited license shall complete the registration
455	455	process established by the Interstate Commission to receive a
456	456	license in a member state selected pursuant to subsection (a),
457	457	including the payment of any applicable fees.
458	458	(d) After receiving verification of eligibility under
459	459	subsection (b) and any fees under subsection (c), a member board
460	460	shall issue an expedited license to the physician. This license
461	461	shall authorize the physician to practice medicine in the issuing
462	462	state consistent with the Medical Practice Act and all applicable
463	463	laws and regulations of the issuing member board and member state.
464	464	(e) An expedited license shall be valid for a period
465	465	consistent with the licensure period in the member state and in the
466	466	same manner as required for other physicians holding a full and
467	467	unrestricted license within the member state.
468	468	(f) An expedited license obtained though the Compact shall
469	469	be terminated if a physician fails to maintain a license in the
470	470	state of principal licensure for a non-disciplinary reason, without
471	471	redesignation of a new state of principal licensure.
472	472	(g) The Interstate Commission is authorized to develop
473	473	rules regarding the application process, including payment of any
474	474	applicable fees, and the issuance of an expedited license.
475	475	SECTION 6. FEES FOR EXPEDITED LICENSURE
476	476	(a) A member state issuing an expedited license authorizing
477	477	the practice of medicine in that state may impose a fee for a
478	478	license issued or renewed through the Compact.
479	479	(b) The Interstate Commission is authorized to develop
480	480	rules regarding fees for expedited licenses.
481	481	SECTION 7. RENEWAL AND CONTINUED PARTICIPATION
482	482	(a) A physician seeking to renew an expedited license
483	483	granted in a member state shall complete a renewal process with the
484	484	Interstate Commission if the physician:
485	485	(1) Maintains a full and unrestricted license in a
486	486	state of principal license;
487	487	(2) Has not been convicted, received adjudication,
488	488	deferred adjudication, community supervision, or deferred
489	489	disposition for any offense by a court of appropriate jurisdiction;
490	490	(3) Has not had a license authorizing the practice of
491	491	medicine subject to discipline by a licensing agency in any state,
492	492	federal, or foreign jurisdiction, excluding any action related to
493	493	non-payment of fees related to a license; and
494	494	(4) Has not had a controlled substance license or
495	495	permit suspended or revoked by a state or the United States Drug
496	496	Enforcement Administration.
497	497	(b) Physicians shall comply with all continuing
498	498	professional development or continuing medical education
499	499	requirements for renewal of a license issued by a member state.
500	500	(c) The Interstate Commission shall collect any renewal
501	501	fees charged for the renewal of a license and distribute the fees to
502	502	the applicable member board.
503	503	(d) Upon receipt of any renewal fees collected in subsection
504	504	(c), a member board shall renew the physician's license.
505	505	(e) Physician information collected by the Interstate
506	506	Commission during the renewal process will be distributed to all
507	507	member boards.
508	508	(f) The Interstate Commission is authorized to develop
509	509	rules to address renewal of licenses obtained through the Compact.
510	510	SECTION 8. COORDINATED INFORMATION SYSTEM
511	511	(a) The Interstate Commission shall establish a database of
512	512	all physicians licensed, or who have applied for licensure, under
513	513	Section 5.
514	514	(b) Notwithstanding any other provision of law, member
515	515	boards shall report to the Interstate Commission any public action
516	516	or complaints against a licensed physician who has applied or
517	517	received an expedited license through the Compact.
518	518	(c) Member boards shall report disciplinary or
519	519	investigatory information determined as necessary and proper by
520	520	rule of the Interstate Commission.
521	521	(d) Member boards may report any non-public complaint,
522	522	disciplinary, or investigatory information not required by
523	523	subsection (c) to the Interstate Commission.
524	524	(e) Member boards shall share complaint or disciplinary
525	525	information about a physician upon request of another member board.
526	526	(f) All information provided to the Interstate Commission
527	527	or distributed by member boards shall be confidential, filed under
528	528	seal, and used only for investigatory or disciplinary matters.
529	529	(g) The Interstate Commission is authorized to develop
530	530	rules for mandated or discretionary sharing of information by
531	531	member boards.
532	532	SECTION 9. JOINT INVESTIGATIONS
533	533	(a) Licensure and disciplinary records of physicians are
534	534	deemed investigative.
535	535	(b) In addition to the authority granted to a member board
536	536	by its respective Medical Practice Act or other applicable state
537	537	law, a member board may participate with other member boards in
538	538	joint investigations of physicians licensed by the member boards.
539	539	(c) A subpoena issued by a member state shall be enforceable
540	540	in other member states.
541	541	(d) Member boards may share any investigative, litigation,
542	542	or compliance materials in furtherance of any joint or individual
543	543	investigation initiated under the Compact.
544	544	(e) Any member state may investigate actual or alleged
545	545	violations of the statutes authorizing the practice of medicine in
546	546	any other member state in which a physician holds a license to
547	547	practice medicine.
548	548	SECTION 10. DISCIPLINARY ACTIONS
549	549	(a) Any disciplinary action taken by any member board
550	550	against a physician licensed through the Compact shall be deemed
551	551	unprofessional conduct which may be subject to discipline by other
552	552	member boards, in addition to any violation of the Medical Practice
553	553	Act or regulations in that state.
554	554	(b) If a license granted to a physician by the member board
555	555	in the state of principal license is revoked, surrendered or
556	556	relinquished in lieu of discipline, or suspended, then all licenses
557	557	issued to the physician by member boards shall automatically be
558	558	placed, without further action necessary by any member board, on
559	559	the same status. If the member board in the state of principal
560	560	license subsequently reinstates the physician's license, a license
561	561	issued to the physician by any other member board shall remain
562	562	encumbered until that respective member board takes action to
563	563	reinstate the license in a manner consistent with the Medical
564	564	Practice Act of that state.
565	565	(c) If disciplinary action is taken against a physician by a
566	566	member board not in the state of principal license, any other member
567	567	board may deem the action conclusive as to matter of law and fact
568	568	decided, and:
569	569	(i) impose the same or lesser sanction(s) against the
570	570	physician so long as such sanctions are consistent with the Medical
571	571	Practice Act of that state;
572	572	(ii) or pursue separate disciplinary action against
573	573	the physician under its respective Medical Practice Act, regardless
574	574	of the action taken in other member states.
575	575	(d) If a license granted to a physician by a member board is
576	576	revoked, surrendered or relinquished in lieu of discipline, or
577	577	suspended, then any license(s) issued to the physician by any other
578	578	member board(s) shall be suspended, automatically and immediately
579	579	without further action necessary by the other member board(s), for
580	580	ninety (90) days upon entry of the order by the disciplining board,
581	581	to permit the member board(s) to investigate the basis for the
582	582	action under the Medical Practice Act of that state. A member board
583	583	may terminate the automatic suspension of the license it issued
584	584	prior to the completion of the ninety (90) day suspension period in
585	585	a manner consistent with the Medical Practice Act of that state.
586	586	SECTION 11. INTERSTATE MEDICAL LICENSURE COMPACT
587	587	COMMISSION
588	588	(a) The member states hereby create the "Interstate Medical
589	589	Licensure Compact Commission".
590	590	(b) The purpose of the Interstate Commission is the
591	591	administration of the Interstate Medical Licensure Compact, which
592	592	is a discretionary state function.
593	593	(c) The Interstate Commission shall be a body corporate and
594	594	joint agency of the member states and shall have all the
595	595	responsibilities, powers, and duties set forth in the Compact, and
596	596	such additional powers as may be conferred upon it by a subsequent
597	597	concurrent action of the respective legislatures of the member
598	598	states in accordance with the terms of the Compact.
599	599	(d) The Interstate Commission shall consist of two voting
600	600	representatives appointed by each member state who shall serve as
601	601	Commissioners. In states where allopathic and osteopathic
602	602	physicians are regulated by separate member boards, or if the
603	603	licensing and disciplinary authority is split between multiple
604	604	member boards within a member state, the member state shall appoint
605	605	one representative from each member board. A Commissioner shall be
606	606	a(n):
607	607	(1) Allopathic or osteopathic physician appointed to a
608	608	member board;
609	609	(2) Executive director, executive secretary, or
610	610	similar executive of a member board; or
611	611	(3) Member of the public appointed to a member board.
612	612	(e) The Interstate Commission shall meet at least once each
613	613	calendar year. A portion of this meeting shall be a business
614	614	meeting to address such matters as may properly come before the
615	615	Commission, including the election of officers. The chairperson
616	616	may call additional meetings and shall call for a meeting upon the
617	617	request of a majority of the member states.
618	618	(f) The bylaws may provide for meetings of the Interstate
619	619	Commission to be conducted by telecommunication or electronic
620	620	communication.
621	621	(g) Each Commissioner participating at a meeting of the
622	622	Interstate Commission is entitled to one vote. A majority of
623	623	Commissioners shall constitute a quorum for the transaction of
624	624	business, unless a larger quorum is required by the bylaws of the
625	625	Interstate Commission. A Commissioner shall not delegate a vote to
626	626	another Commissioner. In the absence of its Commissioner, a member
627	627	state may delegate voting authority for a specified meeting to
628	628	another person from that state who shall meet the requirements of
629	629	subsection (d).
630	630	(h) The Interstate Commission shall provide public notice
631	631	of all meetings and all meetings shall be open to the public. The
632	632	Interstate Commission may close a meeting, in full or in portion,
633	633	where it determines by a two-thirds vote of the Commissioners
634	634	present that an open meeting would be likely to:
635	635	(1) Relate solely to the internal personnel practices
636	636	and procedures of the Interstate Commission;
637	637	(2) Discuss matters specifically exempted from
638	638	disclosure by federal statute;
639	639	(3) Discuss trade secrets, commercial, or financial
640	640	information that is privileged or confidential;
641	641	(4) Involve accusing a person of a crime, or formally
642	642	censuring a person;
643	643	(5) Discuss information of a personal nature where
644	644	disclosure would constitute a clearly unwarranted invasion of
645	645	personal privacy;
646	646	(6) Discuss investigative records compiled for law
647	647	enforcement purposes; or
648	648	(7) Specifically relate to the participation in a
649	649	civil action or other legal proceeding.
650	650	(i) The Interstate Commission shall keep minutes which
651	651	shall fully describe all matters discussed in a meeting and shall
652	652	provide a full and accurate summary of actions taken, including
653	653	record of any roll call votes.
654	654	(j) The Interstate Commission shall make its information
655	655	and official records, to the extent not otherwise designated in the
656	656	Compact or by its rules, available to the public for inspection.
657	657	(k) The Interstate Commission shall establish an executive
658	658	committee, which shall include officers, members, and others as
659	659	determined by the bylaws. The executive committee shall have the
660	660	power to act on behalf of the Interstate Commission, with the
661	661	exception of rulemaking, during periods when the Interstate
662	662	Commission is not in session. When acting on behalf of the
663	663	Interstate Commission, the executive committee shall oversee the
664	664	administration of the Compact including enforcement and compliance
665	665	with the provisions of the Compact, its bylaws and rules, and other
666	666	such duties as necessary.
667	667	(l) The Interstate Commission may establish other
668	668	committees for governance and administration of the Compact.
669	669	SECTION 12. POWERS AND DUTIES OF THE INTERSTATE COMMISSION
670	670	The Interstate Commission shall have the duty and power to:
671	671	(a) Oversee and maintain the administration of the Compact;
672	672	(b) Promulgate rules which shall be binding to the extent
673	673	and in the manner provided for in the Compact;
674	674	(c) Issue, upon the request of a member state or member
675	675	board, advisory opinions concerning the meaning or interpretation
676	676	of the Compact, its bylaws, rules, and actions;
677	677	(d) Enforce compliance with Compact provisions, the rules
678	678	promulgated by the Interstate Commission, and the bylaws, using all
679	679	necessary and proper means, including but not limited to the use of
680	680	judicial process;
681	681	(e) Establish and appoint committees including, but not
682	682	limited to, an executive committee as required by Section 11, which
683	683	shall have the power to act on behalf of the Interstate Commission
684	684	in carrying out its powers and duties;
685	685	(f) Pay, or provide for the payment of the expenses related
686	686	to the establishment, organization, and ongoing activities of the
687	687	Interstate Commission;
688	688	(g) Establish and maintain one or more offices;
689	689	(h) Borrow, accept, hire, or contract for services of
690	690	personnel;
691	691	(i) Purchase and maintain insurance and bonds;
692	692	(j) Employ an executive director who shall have such powers
693	693	to employ, select or appoint employees, agents, or consultants, and
694	694	to determine their qualifications, define their duties, and fix
695	695	their compensation;
696	696	(k) Establish personnel policies and programs relating to
697	697	conflicts of interest, rates of compensation, and qualifications of
698	698	personnel;
699	699	(l) Accept donations and grants of money, equipment,
700	700	supplies, materials and services, and to receive, utilize, and
701	701	dispose of it in a manner consistent with the conflict of interest
702	702	policies established by the Interstate Commission;
703	703	(m) Lease, purchase, accept contributions or donations of,
704	704	or otherwise to own, hold, improve or use, any property, real,
705	705	personal, or mixed;
706	706	(n) Sell, convey, mortgage, pledge, lease, exchange,
707	707	abandon, or otherwise dispose of any property, real, personal, or
708	708	mixed;
709	709	(o) Establish a budget and make expenditures;
710	710	(p) Adopt a seal and bylaws governing the management and
711	711	operation of the Interstate Commission;
712	712	(q) Report annually to the legislatures and governors of the
713	713	member states concerning the activities of the Interstate
714	714	Commission during the preceding year. Such reports shall also
715	715	include reports of financial audits and any recommendations that
716	716	may have been adopted by the Interstate Commission;
717	717	(r) Coordinate education, training, and public awareness
718	718	regarding the Compact, its implementation, and its operation;
719	719	(s) Maintain records in accordance with the bylaws;
720	720	(t) Seek and obtain trademarks, copyrights, and patents;
721	721	and
722	722	(u) Perform such functions as may be necessary or
723	723	appropriate to achieve the purposes of the Compact.
724	724	SECTION 13. FINANCE POWERS
725	725	(a) The Interstate Commission may levy on and collect an
726	726	annual assessment from each member state to cover the cost of the
727	727	operations and activities of the Interstate Commission and its
728	728	staff. The total assessment must be sufficient to cover the annual
729	729	budget approved each year for which revenue is not provided by other
730	730	sources. The aggregate annual assessment amount shall be allocated
731	731	upon a formula to be determined by the Interstate Commission, which
732	732	shall promulgate a rule binding upon all member states.
733	733	(b) The Interstate Commission shall not incur obligations
734	734	of any kind prior to securing the funds adequate to meet the same.
735	735	(c) The Interstate Commission shall not pledge the credit of
736	736	any of the member states, except by, and with the authority of, the
737	737	member state.
738	738	(d) The Interstate Commission shall be subject to a yearly
739	739	financial audit conducted by a certified or licensed public
740	740	accountant and the report of the audit shall be included in the
741	741	annual report of the Interstate Commission.
742	742	SECTION 14. ORGANIZATION AND OPERATION OF THE INTERSTATE
743	743	COMMISSION
744	744	(a) The Interstate Commission shall, by a majority of
745	745	Commissioners present and voting, adopt bylaws to govern its
746	746	conduct as may be necessary or appropriate to carry out the purposes
747	747	of the Compact within twelve (12) months of the first Interstate
748	748	Commission meeting.
749	749	(b) The Interstate Commission shall elect or appoint
750	750	annually from among its Commissioners a chairperson, a
751	751	vice-chairperson, and a treasurer, each of whom shall have such
752	752	authority and duties as may be specified in the bylaws. The
753	753	chairperson, or in the chairperson's absence or disability, the
754	754	vice-chairperson, shall preside at all meetings of the Interstate
755	755	Commission.
756	756	(c) Officers selected in subsection (b) shall serve without
757	757	remuneration from the Interstate Commission.
758	758	(d) The officers and employees of the Interstate Commission
759	759	shall be immune from suit and liability, either personally or in
760	760	their official capacity, for a claim for damage to or loss of
761	761	property or personal injury or other civil liability caused or
762	762	arising out of, or relating to, an actual or alleged act, error, or
763	763	omission that occurred, or that such person had a reasonable basis
764	764	for believing occurred, within the scope of Interstate Commission
765	765	employment, duties, or responsibilities; provided that such person
766	766	shall not be protected from suit or liability for damage, loss,
767	767	injury, or liability caused by the intentional or willful and
768	768	wanton misconduct of such person.
769	769	(1) The liability of the executive director and
770	770	employees of the Interstate Commission or representatives of the
771	771	Interstate Commission, acting within the scope of such person's
772	772	employment or duties for acts, errors, or omissions occurring
773	773	within such person's state, may not exceed the limits of liability
774	774	set forth under the constitution and laws of that state for state
775	775	officials, employees, and agents. The Interstate Commission is
776	776	considered to be an instrumentality of the states for the purposes
777	777	of any such action. Nothing in this subsection shall be construed
778	778	to protect such person from suit or liability for damage, loss,
779	779	injury, or liability caused by the intentional or willful and
780	780	wanton misconduct of such person.
781	781	(2) The Interstate Commission shall defend the
782	782	executive director, its employees, and subject to the approval of
783	783	the attorney general or other appropriate legal counsel of the
784	784	member state represented by an Interstate Commission
785	785	representative, shall defend such Interstate Commission
786	786	representative in any civil action seeking to impose liability
787	787	arising out of an actual or alleged act, error or omission that
788	788	occurred within the scope of Interstate Commission employment,
789	789	duties or responsibilities, or that the defendant had a reasonable
790	790	basis for believing occurred within the scope of Interstate
791	791	Commission employment, duties, or responsibilities, provided that
792	792	the actual or alleged act, error, or omission did not result from
793	793	intentional or willful and wanton misconduct on the part of such
794	794	person.
795	795	(3) To the extent not covered by the state involved,
796	796	member state, or the Interstate Commission, the representatives or
797	797	employees of the Interstate Commission shall be held harmless in
798	798	the amount of a settlement or judgment, including attorney's fees
799	799	and costs, obtained against such persons arising out of an actual or
800	800	alleged act, error, or omission that occurred within the scope of
801	801	Interstate Commission employment, duties, or responsibilities, or
802	802	that such persons had a reasonable basis for believing occurred
803	803	within the scope of Interstate Commission employment, duties, or
804	804	responsibilities, provided that the actual or alleged act, error,
805	805	or omission did not result from intentional or willful and wanton
806	806	misconduct on the part of such persons.
807	807	SECTION 15. RULEMAKING FUNCTIONS OF THE INTERSTATE
808	808	COMMISSION
809	809	(a) The Interstate Commission shall promulgate reasonable
810	810	rules in order to effectively and efficiently achieve the purposes
811	811	of the Compact. Notwithstanding the foregoing, in the event the
812	812	Interstate Commission exercises its rulemaking authority in a
813	813	manner that is beyond the scope of the purposes of the Compact, or
814	814	the powers granted hereunder, then such an action by the Interstate
815	815	Commission shall be invalid and have no force or effect.
816	816	(b) Rules deemed appropriate for the operations of the
817	817	Interstate Commission shall be made pursuant to a rulemaking
818	818	process that substantially conforms to the "Model State
819	819	Administrative Procedure Act" of 2010, and subsequent amendments
820	820	thereto.
821	821	(c) Not later than thirty (30) days after a rule is
822	822	promulgated, any person may file a petition for judicial review of
823	823	the rule in the United States District Court for the District of
824	824	Columbia or the federal district where the Interstate Commission
825	825	has its principal offices, provided that the filing of such a
826	826	petition shall not stay or otherwise prevent the rule from becoming
827	827	effective unless the court finds that the petitioner has a
828	828	substantial likelihood of success. The court shall give deference
829	829	to the actions of the Interstate Commission consistent with
830	830	applicable law and shall not find the rule to be unlawful if the
831	831	rule represents a reasonable exercise of the authority granted to
832	832	the Interstate Commission.
833	833	SECTION 16. OVERSIGHT OF INTERSTATE COMPACT
834	834	(a) The executive, legislative, and judicial branches of
835	835	state government in each member state shall enforce the Compact and
836	836	shall take all actions necessary and appropriate to effectuate the
837	837	Compact's purposes and intent. The provisions of the Compact and
838	838	the rules promulgated hereunder shall have standing as statutory
839	839	law but shall not override existing state authority to regulate the
840	840	practice of medicine.
841	841	(b) All courts shall take judicial notice of the Compact and
842	842	the rules in any judicial or administrative proceeding in a member
843	843	state pertaining to the subject matter of the Compact which may
844	844	affect the powers, responsibilities or actions of the Interstate
845	845	Commission.
846	846	(c) The Interstate Commission shall be entitled to receive
847	847	all service of process in any such proceeding, and shall have
848	848	standing to intervene in the proceeding for all purposes. Failure
849	849	to provide service of process to the Interstate Commission shall
850	850	render a judgment or order void as to the Interstate Commission, the
851	851	Compact, or promulgated rules.
852	852	SECTION 17. ENFORCEMENT OF INTERSTATE COMPACT
853	853	(a) The Interstate Commission, in the reasonable exercise
854	854	of its discretion, shall enforce the provisions and rules of the
855	855	Compact.
856	856	(b) The Interstate Commission may, by majority vote of the
857	857	Commissioners, initiate legal action in the United States District
858	858	Court for the District of Columbia, or, at the discretion of the
859	859	Interstate Commission, in the federal district where the Interstate
860	860	Commission has its principal offices, to enforce compliance with
861	861	the provisions of the Compact, and its promulgated rules and
862	862	bylaws, against a member state in default. The relief sought may
863	863	include both injunctive relief and damages. In the event judicial
864	864	enforcement is necessary, the prevailing party shall be awarded all
865	865	costs of such litigation including reasonable attorney's fees.
866	866	(c) The remedies herein shall not be the exclusive remedies
867	867	of the Interstate Commission. The Interstate Commission may avail
868	868	itself of any other remedies available under state law or the
869	869	regulation of a profession.
870	870	SECTION 18. DEFAULT PROCEDURES
871	871	(a) The grounds for default include, but are not limited to,
872	872	failure of a member state to perform such obligations or
873	873	responsibilities imposed upon it by the Compact, or the rules and
874	874	bylaws of the Interstate Commission promulgated under the Compact.
875	875	(b) If the Interstate Commission determines that a member
876	876	state has defaulted in the performance of its obligations or
877	877	responsibilities under the Compact, or the bylaws or promulgated
878	878	rules, the Interstate Commission shall:
879	879	(1) Provide written notice to the defaulting state and
880	880	other member states, of the nature of the default, the means of
881	881	curing the default, and any action taken by the Interstate
882	882	Commission. The Interstate Commission shall specify the conditions
883	883	by which the defaulting state must cure its default; and
884	884	(2) Provide remedial training and specific technical
885	885	assistance regarding the default.
886	886	(c) If the defaulting state fails to cure the default, the
887	887	defaulting state shall be terminated from the Compact upon an
888	888	affirmative vote of a majority of the Commissioners and all rights,
889	889	privileges, and benefits conferred by the Compact shall terminate
890	890	on the effective date of termination. A cure of the default does not
891	891	relieve the offending state of obligations or liabilities incurred
892	892	during the period of the default.
893	893	(d) Termination of membership in the Compact shall be
894	894	imposed only after all other means of securing compliance have been
895	895	exhausted. Notice of intent to terminate shall be given by the
896	896	Interstate Commission to the governor, the majority and minority
897	897	leaders of the defaulting state's legislature, and each of the
898	898	member states.
899	899	(e) The Interstate Commission shall establish rules and
900	900	procedures to address licenses and physicians that are materially
901	901	impacted by the termination of a member state, or the withdrawal of
902	902	a member state.
903	903	(f) The member state which has been terminated is
904	904	responsible for all dues, obligations, and liabilities incurred
905	905	through the effective date of termination including obligations,
906	906	the performance of which extends beyond the effective date of
907	907	termination.
908	908	(g) The Interstate Commission shall not bear any costs
909	909	relating to any state that has been found to be in default or which
910	910	has been terminated from the Compact, unless otherwise mutually
911	911	agreed upon in writing between the Interstate Commission and the
912	912	defaulting state.
913	913	(h) The defaulting state may appeal the action of the
914	914	Interstate Commission by petitioning the United States District
915	915	Court for the District of Columbia or the federal district where the
916	916	Interstate Commission has its principal offices. The prevailing
917	917	party shall be awarded all costs of such litigation including
918	918	reasonable attorney's fees.
919	919	SECTION 19. DISPUTE RESOLUTION
920	920	(a) The Interstate Commission shall attempt, upon the
921	921	request of a member state, to resolve disputes which are subject to
922	922	the Compact and which may arise among member states or member
923	923	boards.
924	924	(b) The Interstate Commission shall promulgate rules
925	925	providing for both mediation and binding dispute resolution as
926	926	appropriate.
927	927	SECTION 20. MEMBER STATES, EFFECTIVE DATE AND AMENDMENT
928	928	(a) Any state is eligible to become a member state of the
929	929	Compact.
930	930	(b) The Compact shall become effective and binding upon
931	931	legislative enactment of the Compact into law by no less than seven
932	932	(7) states. Thereafter, it shall become effective and binding on a
933	933	state upon enactment of the Compact into law by that state.
934	934	(c) The governors of non-member states, or their designees,
935	935	shall be invited to participate in the activities of the Interstate
936	936	Commission on a non-voting basis prior to adoption of the Compact by
937	937	all states.
938	938	(d) The Interstate Commission may propose amendments to the
939	939	Compact for enactment by the member states. No amendment shall
940	940	become effective and binding upon the Interstate Commission and the
941	941	member states unless and until it is enacted into law by unanimous
942	942	consent of the member states.
943	943	SECTION 21. WITHDRAWAL
944	944	(a) Once effective, the Compact shall continue in force and
945	945	remain binding upon each and every member state; provided that a
946	946	member state may withdraw from the Compact by specifically
947	947	repealing the statute which enacted the Compact into law.
948	948	(b) Withdrawal from the Compact shall be by the enactment of
949	949	a statute repealing the same, but shall not take effect until one
950	950	(1) year after the effective date of such statute and until written
951	951	notice of the withdrawal has been given by the withdrawing state to
952	952	the governor of each other member state.
953	953	(c) The withdrawing state shall immediately notify the
954	954	chairperson of the Interstate Commission in writing upon the
955	955	introduction of legislation repealing the Compact in the
956	956	withdrawing state.
957	957	(d) The Interstate Commission shall notify the other member
958	958	states of the withdrawing state's intent to withdraw within sixty
959	959	(60) days of its receipt of notice provided under subsection (c).
960	960	(e) The withdrawing state is responsible for all dues,
961	961	obligations and liabilities incurred through the effective date of
962	962	withdrawal, including obligations, the performance of which extend
963	963	beyond the effective date of withdrawal.
964	964	(f) Reinstatement following withdrawal of a member state
965	965	shall occur upon the withdrawing state reenacting the Compact or
966	966	upon such later date as determined by the Interstate Commission.
967	967	(g) The Interstate Commission is authorized to develop
968	968	rules to address the impact of the withdrawal of a member state on
969	969	licenses granted in other member states to physicians who
970	970	designated the withdrawing member state as the state of principal
971	971	license.
972	972	SECTION 22. DISSOLUTION
973	973	(a) The Compact shall dissolve effective upon the date of
974	974	the withdrawal or default of the member state which reduces the
975	975	membership in the Compact to one (1) member state.
976	976	(b) Upon the dissolution of the Compact, the Compact becomes
977	977	null and void and shall be of no further force or effect, and the
978	978	business and affairs of the Interstate Commission shall be
979	979	concluded and surplus funds shall be distributed in accordance with
980	980	the bylaws.
981	981	SECTION 23. SEVERABILITY AND CONSTRUCTION
982	982	(a) The provisions of the Compact shall be severable, and if
983	983	any phrase, clause, sentence, or provision is deemed unenforceable,
984	984	the remaining provisions of the Compact shall be enforceable.
985	985	(b) The provisions of the Compact shall be liberally
986	986	construed to effectuate its purposes.
987	987	(c) Nothing in the Compact shall be construed to prohibit
988	988	the applicability of other interstate compacts to which the states
989	989	are members.
990	990	SECTION 24. BINDING EFFECT OF COMPACT AND OTHER LAWS
991	991	(a) Nothing herein prevents the enforcement of any other law
992	992	of a member state that is not inconsistent with the Compact.
993	993	(b) All laws in a member state in conflict with the Compact
994	994	are superseded to the extent of the conflict.
995	995	(c) All lawful actions of the Interstate Commission,
996	996	including all rules and bylaws promulgated by the Commission, are
997	997	binding upon the member states.
998	998	(d) All agreements between the Interstate Commission and
999	999	the member states are binding in accordance with their terms.
1000	1000	(e) In the event any provision of the Compact exceeds the
1001	1001	constitutional limits imposed on the legislature of any member
1002	1002	state, such provision shall be ineffective to the extent of the
1003	1003	conflict with the constitutional provision in question in that
1004	1004	member state.
1005	1005	Sec. 170.002. RULES. The board may adopt rules necessary to
1006	1006	implement this chapter.
1007	1007	Sec. 170.003. COLLECTION OF FINGERPRINTS FOR EXPEDITED
1008	1008	LICENSE; DISSEMINATION OF INFORMATION. (a) The board may require
1009	1009	an applicant for an expedited license under the Interstate Medical
1010	1010	Licensure Compact to submit a set of fingerprints to the board for
1011	1011	the purpose of performing a criminal history record information
1012	1012	check to qualify the applicant for the expedited license.
1013	1013	(b) The board may not disseminate information obtained from
1014	1014	a criminal history record information check described by Subsection
1015	1015	(a) except as authorized by law.
1016	1016	SECTION 19. Subchapter B, Chapter 204, Occupations Code, is
1017	1017	amended by adding Section 204.0585 to read as follows:
1018	1018	Sec. 204.0585. EXECUTIVE SESSION. After hearing all
1019	1019	evidence and arguments in an open meeting, the physician assistant
1020	1020	board may conduct deliberations relating to a license application
1021	1021	or disciplinary action in an executive session. The board shall
1022	1022	vote and announce its decision in open session.
1023	1023	SECTION 20. Section 204.059, Occupations Code, is amended
1024	1024	by amending Subsection (b) and adding Subsection (d) to read as
1025	1025	follows:
1026	1026	(b) The training program must provide the person with
1027	1027	information regarding:
1028	1028	(1) the law governing physician assistant board
1029	1029	operations;
1030	1030	(2) the [this chapter and the physician assistant
1031	1031	board's] programs, functions, rules, and budget of the physician
1032	1032	assistant board;
1033	1033	(3) the scope of and limitations on the rulemaking
1034	1034	authority of the physician assistant board;
1035	1035	(4) [(2)] the results of the most recent formal audit
1036	1036	of the physician assistant board;
1037	1037	(5) [(3)] the requirements of:
1038	1038	(A) laws relating to open meetings, public
1039	1039	information, administrative procedure, and disclosing conflicts of
1040	1040	interest; and
1041	1041	(B) other laws applicable to members of the
1042	1042	physician assistant board in performing their duties; and
1043	1043	(6) [(4)] any applicable ethics policies adopted by
1044	1044	the physician assistant board or the Texas Ethics Commission.
1045	1045	(d) The executive director of the medical board shall create
1046	1046	a training manual that includes the information required by
1047	1047	Subsection (b). The executive director shall distribute a copy of
1048	1048	the training manual annually to each physician assistant board
1049	1049	member. On receipt of the training manual, each board member shall
1050	1050	sign and submit to the executive director a statement acknowledging
1051	1051	receipt of the training manual.
1052	1052	SECTION 21. Subchapter D, Chapter 204, Occupations Code, is
1053	1053	amended by adding Section 204.1525 to read as follows:
1054	1054	Sec. 204.1525. CRIMINAL HISTORY RECORD INFORMATION
1055	1055	REQUIREMENT FOR LICENSE ISSUANCE. (a) The physician assistant
1056	1056	board shall require that an applicant for a license submit a
1057	1057	complete and legible set of fingerprints, on a form prescribed by
1058	1058	the board, to the board or to the Department of Public Safety for
1059	1059	the purpose of obtaining criminal history record information from
1060	1060	the Department of Public Safety and the Federal Bureau of
1061	1061	Investigation.
1062	1062	(b) The physician assistant board may not issue a license to
1063	1063	a person who does not comply with the requirement of Subsection (a).
1064	1064	(c) The physician assistant board shall conduct a criminal
1065	1065	history record information check of each applicant for a license
1066	1066	using information:
1067	1067	(1) provided by the individual under this section; and
1068	1068	(2) made available to the board by the Department of
1069	1069	Public Safety, the Federal Bureau of Investigation, and any other
1070	1070	criminal justice agency under Chapter 411, Government Code.
1071	1071	(d) The physician assistant board may:
1072	1072	(1) enter into an agreement with the Department of
1073	1073	Public Safety to administer a criminal history record information
1074	1074	check required under this section; and
1075	1075	(2) authorize the Department of Public Safety to
1076	1076	collect from each applicant the costs incurred by the Department of
1077	1077	Public Safety in conducting the criminal history record information
1078	1078	check.
1079	1079	SECTION 22. Section 204.153(a), Occupations Code, is
1080	1080	amended to read as follows:
1081	1081	(a) To be eligible for a license under this chapter, an
1082	1082	applicant must:
1083	1083	(1) successfully complete an educational program for
1084	1084	physician assistants or surgeon assistants accredited by the
1085	1085	Committee on Allied Health Education and Accreditation or by that
1086	1086	committee's predecessor or successor entities;
1087	1087	(2) pass the Physician Assistant National Certifying
1088	1088	Examination administered by the National Commission on
1089	1089	Certification of Physician Assistants;
1090	1090	(3) hold a certificate issued by the National
1091	1091	Commission on Certification of Physician Assistants;
1092	1092	(4) [be of good moral character;
1093	1093	[(5)] meet any other requirement established by
1094	1094	physician assistant board rule; and
1095	1095	(5) [(6)] pass a jurisprudence examination approved
1096	1096	by the physician assistant board as provided by Subsection (a-1).
1097	1097	SECTION 23. Section 204.156, Occupations Code, is amended
1098	1098	by amending Subsection (a) and adding Subsection (a-1) to read as
1099	1099	follows:
1100	1100	(a) A license issued under this chapter is valid for a term
1101	1101	of one or two years, as determined by physician assistant board
1102	1102	rule.
1103	1103	(a-1) On notification from the physician assistant board, a
1104	1104	person who holds a license under this chapter may renew the license
1105	1105	by:
1106	1106	(1) paying the required renewal fee;
1107	1107	(2) submitting the appropriate form; and
1108	1108	(3) meeting any other requirement established by board
1109	1109	rule.
1110	1110	SECTION 24. Subchapter D, Chapter 204, Occupations Code, is
1111	1111	amended by adding Section 204.1561 to read as follows:
1112	1112	Sec. 204.1561. CRIMINAL HISTORY RECORD INFORMATION
1113	1113	REQUIREMENT FOR RENEWAL. (a) An applicant for renewal of a license
1114	1114	issued under this chapter shall submit a complete and legible set of
1115	1115	fingerprints for purposes of performing a criminal history record
1116	1116	information check of the applicant as provided by Section 204.1525.
1117	1117	(b) The physician assistant board may administratively
1118	1118	suspend or refuse to renew the license of a person who does not
1119	1119	comply with the requirement of Subsection (a).
1120	1120	(c) A license holder is not required to submit fingerprints
1121	1121	under this section for the renewal of the license if the holder has
1122	1122	previously submitted fingerprints under:
1123	1123	(1) Section 204.1525 for the initial issuance of the
1124	1124	license; or
1125	1125	(2) this section as part of a prior renewal of a
1126	1126	license.
1127	1127	SECTION 25. Subchapter D, Chapter 204, Occupations Code, is
1128	1128	amended by adding Section 204.158 to read as follows:
1129	1129	Sec. 204.158. REFUSAL FOR VIOLATION OF BOARD ORDER. The
1130	1130	physician assistant board may refuse to renew a license issued
1131	1131	under this chapter if the license holder is in violation of a
1132	1132	physician assistant board order.
1133	1133	SECTION 26. Subchapter E, Chapter 204, Occupations Code, is
1134	1134	amended by adding Section 204.210 to read as follows:
1135	1135	Sec. 204.210. DUTIES RELATED TO CERTAIN PRESCRIPTIONS. (a)
1136	1136	A physician assistant authorized to prescribe a drug may not
1137	1137	prescribe a drug listed in Subsection (b) to a patient unless the
1138	1138	physician assistant has reviewed the patient's prescription
1139	1139	history by accessing the prescription information submitted to the
1140	1140	Texas State Board of Pharmacy as authorized by Section
1141	1141	481.076(a)(5), Health and Safety Code.
1142	1142	(b) Subsection (a) applies only to the prescribing of:
1143	1143	(1) opioids;
1144	1144	(2) benzodiazepines;
1145	1145	(3) barbiturates; or
1146	1146	(4) carisoprodol.
1147	1147	(c) A physician assistant is not subject to the requirements
1148	1148	of Subsection (a) if:
1149	1149	(1) the patient has been diagnosed with cancer or the
1150	1150	patient is receiving hospice care; and
1151	1151	(2) the physician assistant clearly notes in the
1152	1152	prescription record that the patient was diagnosed with cancer or
1153	1153	is receiving hospice care, as applicable.
1154	1154	(d) Failure by a physician assistant to comply with the
1155	1155	requirements of this section is grounds for disciplinary action
1156	1156	under Section 204.301.
1157	1157	SECTION 27. Subchapter G, Chapter 204, Occupations Code, is
1158	1158	amended by adding Section 204.305 to read as follows:
1159	1159	Sec. 204.305. MONITORING HARMFUL PRESCRIBING PATTERNS. (a)
1160	1160	The physician assistant board shall periodically check the
1161	1161	prescribing information submitted to the Texas State Board of
1162	1162	Pharmacy as authorized by Section 481.076(a)(1), Health and Safety
1163	1163	Code, to determine whether a physician assistant licensed under
1164	1164	this chapter is engaging in potentially harmful prescribing
1165	1165	patterns or practices.
1166	1166	(b) The physician assistant board, in coordination with the
1167	1167	Texas State Board of Pharmacy, shall determine the conduct that
1168	1168	constitutes a potentially harmful prescribing pattern or practice
1169	1169	for purposes of Subsection (a). In determining the conduct that
1170	1170	constitutes a potentially harmful prescribing pattern or practice,
1171	1171	the physician assistant board shall consider:
1172	1172	(1) the number of times a physician assistant
1173	1173	prescribes a drug listed in Section 204.210(b); and
1174	1174	(2) for prescriptions described by Subdivision (1),
1175	1175	patterns of prescribing combinations of those drugs and other
1176	1176	dangerous combinations of drugs identified by the physician
1177	1177	assistant board.
1178	1178	(c) If the physician assistant board suspects that a
1179	1179	physician assistant may be engaging in potentially harmful
1180	1180	prescribing patterns or practices, the physician assistant board
1181	1181	may notify the physician assistant of the potentially harmful
1182	1182	prescribing pattern or practice.
1183	1183	(d) The physician assistant board may initiate a complaint
1184	1184	against a physician assistant based on information obtained under
1185	1185	this section.
1186	1186	SECTION 28. Section 204.313(a), Occupations Code, is
1187	1187	amended to read as follows:
1188	1188	(a) In an informal meeting under Section 204.312, at least
1189	1189	two panelists shall be appointed to determine whether an informal
1190	1190	disposition is appropriate. At least one of the panelists must be a
1191	1191	licensed physician assistant.
1192	1192	SECTION 29. Section 205.057, Occupations Code, is amended
1193	1193	by amending Subsection (b) and adding Subsection (d) to read as
1194	1194	follows:
1195	1195	(b) The training program must provide the person with
1196	1196	information regarding:
1197	1197	(1) the law governing acupuncture board operations
1198	1198	[this chapter];
1199	1199	(2) the programs, [operated by the acupuncture board;
1200	1200	[(3) the role and] functions, rules, and budget of the
1201	1201	acupuncture board;
1202	1202	(3) [(4)] the scope of and limitations on the
1203	1203	rulemaking authority [rules] of the acupuncture board;
1204	1204	(4) [(5) the current budget for the acupuncture board;
1205	1205	[(6)] the results of the most recent formal audit of
1206	1206	the acupuncture board;
1207	1207	(5) [(7)] the requirements of:
1208	1208	(A) laws relating to open meetings, public
1209	1209	information, administrative procedure, and disclosing conflicts of
1210	1210	interest; and
1211	1211	(B) other laws applicable to members of the
1212	1212	acupuncture board in performing their duties; and
1213	1213	(6) [(8)] any applicable ethics policies adopted by
1214	1214	the acupuncture board or the Texas Ethics Commission.
1215	1215	(d) The executive director shall create a training manual
1216	1216	that includes the information required by Subsection (b). The
1217	1217	executive director shall distribute a copy of the training manual
1218	1218	annually to each acupuncture board member. On receipt of the
1219	1219	training manual, each board member shall sign and submit to the
1220	1220	executive director a statement acknowledging receipt of the
1221	1221	training manual.
1222	1222	SECTION 30. Subchapter E, Chapter 205, Occupations Code, is
1223	1223	amended by adding Section 205.2025 to read as follows:
1224	1224	Sec. 205.2025. CRIMINAL HISTORY RECORD INFORMATION
1225	1225	REQUIREMENT FOR LICENSE ISSUANCE. (a) The acupuncture board shall
1226	1226	require that an applicant for a license submit a complete and
1227	1227	legible set of fingerprints, on a form prescribed by the board, to
1228	1228	the board or to the Department of Public Safety for the purpose of
1229	1229	obtaining criminal history record information from the Department
1230	1230	of Public Safety and the Federal Bureau of Investigation.
1231	1231	(b) The acupuncture board may not issue a license to a
1232	1232	person who does not comply with the requirement of Subsection (a).
1233	1233	(c) The acupuncture board shall conduct a criminal history
1234	1234	record information check of each applicant for a license using
1235	1235	information:
1236	1236	(1) provided by the individual under this section; and
1237	1237	(2) made available to the board by the Department of
1238	1238	Public Safety, the Federal Bureau of Investigation, and any other
1239	1239	criminal justice agency under Chapter 411, Government Code.
1240	1240	(d) The acupuncture board may:
1241	1241	(1) enter into an agreement with the Department of
1242	1242	Public Safety to administer a criminal history record information
1243	1243	check required under this section; and
1244	1244	(2) authorize the Department of Public Safety to
1245	1245	collect from each applicant the costs incurred by the Department of
1246	1246	Public Safety in conducting the criminal history record information
1247	1247	check.
1248	1248	SECTION 31. The heading to Section 205.251, Occupations
1249	1249	Code, is amended to read as follows:
1250	1250	Sec. 205.251. [ANNUAL] RENEWAL REQUIRED.
1251	1251	SECTION 32. Section 205.251(a), Occupations Code, is
1252	1252	amended to read as follows:
1253	1253	(a) The medical board by rule shall provide for the annual
1254	1254	or biennial renewal of a license to practice acupuncture.
1255	1255	SECTION 33. Subchapter F, Chapter 205, Occupations Code, is
1256	1256	amended by adding Section 205.2515 to read as follows:
1257	1257	Sec. 205.2515. CRIMINAL HISTORY RECORD INFORMATION
1258	1258	REQUIREMENT FOR RENEWAL. (a) An applicant for renewal of a license
1259	1259	issued under this chapter shall submit a complete and legible set of
1260	1260	fingerprints for purposes of performing a criminal history record
1261	1261	information check of the applicant as provided by Section 205.2025.
1262	1262	(b) The acupuncture board may administratively suspend or
1263	1263	refuse to renew the license of a person who does not comply with the
1264	1264	requirement of Subsection (a).
1265	1265	(c) A license holder is not required to submit fingerprints
1266	1266	under this section for the renewal of the license if the holder has
1267	1267	previously submitted fingerprints under:
1268	1268	(1) Section 205.2025 for the initial issuance of the
1269	1269	license; or
1270	1270	(2) this section as part of a prior renewal of a
1271	1271	license.
1272	1272	SECTION 34. Subchapter F, Chapter 205, Occupations Code, is
1273	1273	amended by adding Section 205.256 to read as follows:
1274	1274	Sec. 205.256. REFUSAL FOR VIOLATION OF BOARD ORDER. The
1275	1275	acupuncture board may refuse to renew a license issued under this
1276	1276	chapter if the license holder is in violation of an acupuncture
1277	1277	board order.
1278	1278	SECTION 35. Subchapter E, Chapter 206, Occupations Code, is
1279	1279	amended by adding Section 206.2025 to read as follows:
1280	1280	Sec. 206.2025. CRIMINAL HISTORY RECORD INFORMATION
1281	1281	REQUIREMENT FOR LICENSE ISSUANCE. (a) The medical board shall
1282	1282	require that an applicant for a license submit a complete and
1283	1283	legible set of fingerprints, on a form prescribed by the board, to
1284	1284	the board or to the Department of Public Safety for the purpose of
1285	1285	obtaining criminal history record information from the Department
1286	1286	of Public Safety and the Federal Bureau of Investigation.
1287	1287	(b) The medical board may not issue a license to a person who
1288	1288	does not comply with the requirement of Subsection (a).
1289	1289	(c) The medical board shall conduct a criminal history
1290	1290	record information check of each applicant for a license using
1291	1291	information:
1292	1292	(1) provided by the individual under this section; and
1293	1293	(2) made available to the board by the Department of
1294	1294	Public Safety, the Federal Bureau of Investigation, and any other
1295	1295	criminal justice agency under Chapter 411, Government Code.
1296	1296	(d) The medical board may:
1297	1297	(1) enter into an agreement with the Department of
1298	1298	Public Safety to administer a criminal history record information
1299	1299	check required under this section; and
1300	1300	(2) authorize the Department of Public Safety to
1301	1301	collect from each applicant the costs incurred by the Department of
1302	1302	Public Safety in conducting the criminal history record information
1303	1303	check.
1304	1304	SECTION 36. Section 206.203(a), Occupations Code, is
1305	1305	amended to read as follows:
1306	1306	(a) Except as provided by Section 206.206, to be eligible
1307	1307	for a license, a person must:
1308	1308	(1) [be of good moral character;
1309	1309	[(2)] have not been convicted of a felony or a crime
1310	1310	involving moral turpitude;
1311	1311	(2) [(3)] not use drugs or alcohol to an extent that
1312	1312	affects the applicant's professional competency;
1313	1313	(3) [(4)] not have had a license or certification
1314	1314	revoked by a licensing agency or by a certifying professional
1315	1315	organization; and
1316	1316	(4) [(5)] not have engaged in fraud or deceit in
1317	1317	applying for a license under this chapter.
1318	1318	SECTION 37. Subchapter E, Chapter 206, Occupations Code, is
1319	1319	amended by adding Section 206.2105 to read as follows:
1320	1320	Sec. 206.2105. CRIMINAL HISTORY RECORD INFORMATION
1321	1321	REQUIREMENT FOR RENEWAL. (a) An applicant for renewal of a license
1322	1322	issued under this chapter shall submit a complete and legible set of
1323	1323	fingerprints for purposes of performing a criminal history record
1324	1324	information check of the applicant as provided by Section 206.2025.
1325	1325	(b) The medical board may administratively suspend or
1326	1326	refuse to renew the license of a person who does not comply with the
1327	1327	requirement of Subsection (a).
1328	1328	(c) A license holder is not required to submit fingerprints
1329	1329	under this section for the renewal of the license if the holder has
1330	1330	previously submitted fingerprints under:
1331	1331	(1) Section 206.2025 for the initial issuance of the
1332	1332	license; or
1333	1333	(2) this section as part of a prior renewal of a
1334	1334	license.
1335	1335	SECTION 38. Subchapter E, Chapter 206, Occupations Code, is
1336	1336	amended by adding Section 206.215 to read as follows:
1337	1337	Sec. 206.215. REFUSAL FOR VIOLATION OF BOARD ORDER. The
1338	1338	medical board may refuse to renew a license issued under this
1339	1339	chapter if the license holder is in violation of a medical board
1340	1340	order.
1341	1341	SECTION 39. Section 601.002, Occupations Code, is amended
1342	1342	by adding Subdivisions (10-a) and (10-b) to read as follows:
1343	1343	(10-a) "Radiologist" means a physician specializing
1344	1344	in radiology certified by or board-eligible for the American Board
1345	1345	of Radiology, the American Osteopathic Board of Radiology, the
1346	1346	Royal College of Radiologists, or the Royal College of Physicians
1347	1347	and Surgeons of Canada.
1348	1348	(10-b) "Radiologist assistant" means an
1349	1349	advanced-level medical radiologic technologist who is certified
1350	1350	as:
1351	1351	(A) a registered radiologist assistant by the
1352	1352	American Registry of Radiologic Technologists; or
1353	1353	(B) a radiology practitioner assistant by the
1354	1354	Certification Board for Radiology Practitioner Assistants.
1355	1355	SECTION 40. Section 601.030, Occupations Code, is amended
1356	1356	by amending Subsection (b) and adding Subsection (d) to read as
1357	1357	follows:
1358	1358	(b) The training program must provide the person with
1359	1359	information regarding:
1360	1360	(1) the law governing advisory board operations;
1361	1361	(2) [this chapter and] the [advisory board's]
1362	1362	programs, functions, rules, and budget of the advisory board;
1363	1363	(3) the scope of and limitations on the rulemaking
1364	1364	authority of the advisory board;
1365	1365	(4) [(2)] the results of the most recent formal audit
1366	1366	of the advisory board;
1367	1367	(5) [(3)] the requirements of:
1368	1368	(A) laws relating to open meetings, public
1369	1369	information, administrative procedure, and disclosing conflicts of
1370	1370	interest; and
1371	1371	(B) other laws applicable to members of the
1372	1372	advisory board in performing their duties; and
1373	1373	(6) [(4)] any applicable ethics policies adopted by
1374	1374	the advisory board or the Texas Ethics Commission.
1375	1375	(d) The executive director of the medical board shall create
1376	1376	a training manual that includes the information required by
1377	1377	Subsection (b). The executive director shall distribute a copy of
1378	1378	the training manual annually to each advisory board member. On
1379	1379	receipt of the training manual, each board member shall sign and
1380	1380	submit to the executive director a statement acknowledging receipt
1381	1381	of the training manual.
1382	1382	SECTION 41. Sections 601.102(b) and (c), Occupations Code,
1383	1383	are amended to read as follows:
1384	1384	(b) The advisory board may issue to a person:
1385	1385	(1) a general certificate to perform radiologic
1386	1386	procedures; [or]
1387	1387	(2) a limited certificate that authorizes the person
1388	1388	to perform radiologic procedures only on specific parts of the
1389	1389	human body; or
1390	1390	(3) a radiologist assistant certificate to a person
1391	1391	who meets the requirements established under Section 601.1021.
1392	1392	(c) The advisory board may issue to a person a temporary
1393	1393	general certificate, [or] a temporary limited certificate, or a
1394	1394	temporary radiologist assistant certificate that authorizes the
1395	1395	person to perform radiologic procedures for a period not to exceed
1396	1396	one year.
1397	1397	SECTION 42. Subchapter C, Chapter 601, Occupations Code, is
1398	1398	amended by adding Section 601.1021 to read as follows:
1399	1399	Sec. 601.1021. RADIOLOGIST ASSISTANT CERTIFICATE. (a) The
1400	1400	advisory board by rule shall establish the education and training
1401	1401	required for a person to obtain a radiologist assistant
1402	1402	certificate.
1403	1403	(b) A radiologist assistant certificate holder:
1404	1404	(1) may perform radiologic procedures only under the
1405	1405	supervision of a radiologist; and
1406	1406	(2) may not interpret images, make diagnoses, or
1407	1407	prescribe any medication or therapy.
1408	1408	SECTION 43. Subchapter C, Chapter 601, Occupations Code, is
1409	1409	amended by adding Section 601.113 to read as follows:
1410	1410	Sec. 601.113. REFUSAL FOR VIOLATION OF BOARD ORDER. The
1411	1411	advisory board may refuse to renew a certificate issued under this
1412	1412	chapter if the certificate holder is in violation of an advisory
1413	1413	board order.
1414	1414	SECTION 44. Section 601.155, Occupations Code, is amended
1415	1415	to read as follows:
1416	1416	Sec. 601.155. STUDENTS. A person is not required to hold a
1417	1417	certificate issued under this chapter [or to comply with the
1418	1418	registration requirements adopted under Section 601.252] if the
1419	1419	person:
1420	1420	(1) is a student enrolled in a training program that
1421	1421	meets the minimum standards adopted under Section 601.201; and
1422	1422	(2) is performing a radiologic procedure in an
1423	1423	academic or clinical setting as part of the training program.
1424	1424	SECTION 45. Section 601.156, Occupations Code, is amended
1425	1425	to read as follows:
1426	1426	Sec. 601.156. PROCEDURE PERFORMED AS PART OF CONTINUING
1427	1427	EDUCATION PROGRAM. A person is not required to hold a certificate
1428	1428	issued under this chapter [or to comply with the registration
1429	1429	requirements adopted under Section 601.252] if the person is:
1430	1430	(1) licensed or otherwise registered as a medical
1431	1431	radiologic technologist by another state, the American Registry of
1432	1432	Radiologic Technologists, the American Registry of Clinical
1433	1433	Radiography Technologists, or a professional organization or
1434	1434	association recognized by the advisory board;
1435	1435	(2) enrolled in a continuing education program that
1436	1436	meets the requirements adopted under Section 601.108; and
1437	1437	(3) performing a radiologic procedure as part of the
1438	1438	continuing education program for not more than 10 days.
1439	1439	SECTION 46. Section 601.203(b), Occupations Code, is
1440	1440	amended to read as follows:
1441	1441	(b) The following conditions are considered to be a hardship
1442	1442	for the purposes of Subsection (a):
1443	1443	(1) that the applicant:
1444	1444	(A) reports an inability to attract and retain
1445	1445	medical radiologic technologists; and
1446	1446	(B) is located in a county with a population of
1447	1447	less than 50,000;
1448	1448	(2) that the applicant is located at a great distance
1449	1449	from a school of medical radiologic technology;
1450	1450	(3) that there is a list of qualified persons who have
1451	1451	applied to a school of medical radiologic technology whose
1452	1452	admissions are pending because of a lack of faculty or space;
1453	1453	(4) that the school of medical radiologic technology
1454	1454	produces an insufficient number of graduates in medical radiologic
1455	1455	technology to meet the needs of the applicant; or
1456	1456	(5) any other criteria determined by advisory board
1457	1457	rule.
1458	1458	SECTION 47. Sections 601.252(c) and (d), Occupations Code,
1459	1459	are amended to read as follows:
1460	1460	(c) Rules adopted under this section by the State Board of
1461	1461	Dental Examiners must:
1462	1462	(1) require an authorized person who performs
1463	1463	radiologic procedures under the delegation of a dentist, other than
1464	1464	a registered nurse, to register with the dental board [agency that
1465	1465	licenses the practitioner under whom the person performs radiologic
1466	1466	procedures];
1467	1467	(2) establish reasonable and necessary fees to cover
1468	1468	the administrative costs incurred by the dental board [agency] in
1469	1469	administering a registration program created under this
1470	1470	subsection;
1471	1471	(3) establish grounds for the suspension, revocation,
1472	1472	or nonrenewal of a registration issued under this subsection; and
1473	1473	(4) establish standards, in addition to those required
1474	1474	by this chapter, for training and supervising the operators of the
1475	1475	equipment.
1476	1476	(d) In adopting rules under Subsection (c), the State Board
1477	1477	of Dental Examiners [an agency] may take into account whether the
1478	1478	radiologic procedure will be performed by a registered nurse.
1479	1479	SECTION 48. Subchapter E, Chapter 602, Occupations Code, is
1480	1480	amended by adding Section 602.214 to read as follows:
1481	1481	Sec. 602.214. REFUSAL FOR VIOLATION OF BOARD ORDER. The
1482	1482	medical board may refuse to renew a license issued under this
1483	1483	chapter if the license holder is in violation of a medical board
1484	1484	order.
1485	1485	SECTION 49. Section 603.252(a), Occupations Code, is
1486	1486	amended to read as follows:
1487	1487	(a) An applicant for a perfusionist license must submit an
1488	1488	[a sworn] application accompanied by the application fee.
1489	1489	SECTION 50. Subchapter G, Chapter 603, Occupations Code, is
1490	1490	amended by adding Section 603.306 to read as follows:
1491	1491	Sec. 603.306. REFUSAL FOR VIOLATION OF BOARD ORDER. The
1492	1492	medical board may refuse to renew a license issued under this
1493	1493	chapter if the license holder is in violation of a medical board
1494	1494	order.
1495	1495	SECTION 51. Section 604.030, Occupations Code, is amended
1496	1496	by amending Subsection (b) and adding Subsection (d) to read as
1497	1497	follows:
1498	1498	(b) The training program must provide the person with
1499	1499	information regarding:
1500	1500	(1) the law governing advisory board operations;
1501	1501	(2) the [this chapter and the advisory board's]
1502	1502	programs, functions, rules, and budget of the advisory board;
1503	1503	(3) the scope of and limitations on the rulemaking
1504	1504	authority of the advisory board;
1505	1505	(4) [(2)] the results of the most recent formal audit
1506	1506	of the advisory board;
1507	1507	(5) [(3)] the requirements of:
1508	1508	(A) laws relating to open meetings, public
1509	1509	information, administrative procedure, and disclosing conflicts of
1510	1510	interest; and
1511	1511	(B) other laws applicable to members of the
1512	1512	advisory board in performing their duties; and
1513	1513	(6) [(4)] any applicable ethics policies adopted by
1514	1514	the advisory board or the Texas Ethics Commission.
1515	1515	(d) The executive director of the medical board shall create
1516	1516	a training manual that includes the information required by
1517	1517	Subsection (b). The executive director shall distribute a copy of
1518	1518	the training manual annually to each advisory board member. On
1519	1519	receipt of the training manual, each board member shall sign and
1520	1520	submit to the executive director a statement acknowledging receipt
1521	1521	of the training manual.
1522	1522	SECTION 52. Subchapter D, Chapter 604, Occupations Code, is
1523	1523	amended by adding Section 604.158 to read as follows:
1524	1524	Sec. 604.158. REFUSAL FOR VIOLATION OF BOARD ORDER. The
1525	1525	advisory board may refuse to renew a certificate or temporary
1526	1526	permit issued under this chapter if the certificate or permit
1527	1527	holder is in violation of an advisory board order.
1528	1528	SECTION 53. (a) Except as provided by Subsection (b) of this
1529	1529	section, Sections 152.010, 204.059, 205.057, 601.030, and 604.030,
1530	1530	Occupations Code, as amended by this Act, apply to a member of the
1531	1531	applicable board appointed before, on, or after the effective date
1532	1532	of this Act.
1533	1533	(b) A member of a board who, before the effective date of
1534	1534	this Act, completed the training program required by Section
1535	1535	152.010, 204.059, 205.057, 601.030, or 604.030, Occupations Code,
1536	1536	as the applicable law existed before the effective date of this Act,
1537	1537	is only required to complete additional training on the subjects
1538	1538	added by this Act to the training program required by Section
1539	1539	152.010, 204.059, 205.057, 601.030, or 604.030, Occupations Code,
1540	1540	as applicable. A board member described by this subsection may not
1541	1541	vote, deliberate, or be counted as a member in attendance at a
1542	1542	meeting of the applicable board held on or after December 1, 2017,
1543	1543	until the member completes the additional training.
1544	1544	SECTION 54. Sections 162.301 and 204.210, Occupations Code,
1545	1545	as added by this Act, apply only to a prescription issued on or
1546	1546	after September 1, 2018. A prescription issued before September 1,
1547	1547	2018, is governed by the law in effect immediately before the
1548	1548	effective date of this Act, and the former law is continued in
1549	1549	effect for that purpose.
1550	1550	SECTION 55. Not later than March 1, 2018, the Texas Medical
1551	1551	Board shall adopt rules necessary to implement Section 164.003(b),
1552	1552	Occupations Code, as amended by this Act.
1553	1553	SECTION 56. Not later than January 1, 2018, the Texas
1554	1554	Medical Board and the governing board of the Texas Physician Health
1555	1555	Program by rule shall adopt the memorandum of understanding
1556	1556	required by Section 167.012, Occupations Code, as added by this
1557	1557	Act.
1558	1558	SECTION 57. Not later than September 1, 2019, the Texas
1559	1559	Physician Assistant Board, the Texas State Board of Acupuncture
1560	1560	Examiners, and the Texas Medical Board shall obtain criminal
1561	1561	history record information on each person who, on the effective
1562	1562	date of this Act, holds a license issued under Chapter 204, 205, or
1563	1563	206, Occupations Code, as applicable, and did not undergo a
1564	1564	criminal history record information check based on the license
1565	1565	holder's fingerprints on the initial application for the license.
1566	1566	A board may suspend the license of a license holder who does not
1567	1567	provide the criminal history record information as required by the
1568	1568	board and this section.
1569	1569	SECTION 58. Not later than January 1, 2018, the Texas
1570	1570	Medical Board shall approve the rules required by Section 601.1021,
1571	1571	Occupations Code, as added by this Act.
1572	1572	SECTION 59. This Act takes effect September 1, 2017.