TX
Texas House Bill HB4023

Texas 2017 - 85th Regular

Texas House Bill HB4023 Compare Versions

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11 85R13698 TSR-F
22 By: Zedler H.B. No. 4023
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55 A BILL TO BE ENTITLED
66 AN ACT
77 relating to the licensing and regulation of neurodiagnostic
88 practitioners and neurodiagnostic technologists; requiring an
99 occupational license; creating an offense; providing penalties and
1010 authorizing fees.
1111 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1212 SECTION 1. Subtitle K, Title 3, Occupations Code, is
1313 amended by adding Chapter 606 to read as follows:
1414 CHAPTER 606. NEURODIAGNOSTIC PRACTITIONERS AND NEURODIAGNOSTIC
1515 TECHNOLOGISTS
1616 SUBCHAPTER A. GENERAL PROVISIONS
1717 Sec. 606.001. DEFINITIONS. In this chapter:
1818 (1) "Autonomic reflex testing" means a test used to
1919 measure how autonomic nerves work in controlling involuntary body
2020 functions, including blood pressure, heart rate, and sweating, in
2121 response to different maneuvers, such as deep breathing, blowing
2222 into a mouthpiece, sweating, and lying for several minutes on a
2323 table that is tilted to a near standing position.
2424 (2) "Board" means the Texas Medical Board.
2525 (3) "Credentialing organization" means an accrediting
2626 organization that is recognized by the board and that administers
2727 and awards credentials in the modalities of neurodiagnostic
2828 technology.
2929 (4) "Direct supervision" means supervision by a
3030 responsible physician or neurodiagnostic practitioner or
3131 neurodiagnostic technologist who is physically present and
3232 immediately available to provide assistance and direction while a
3333 neurodiagnostic procedure is being performed.
3434 (5) "Electroencephalography" means the recording and
3535 analysis of the ongoing electrical activity of the brain using a
3636 digital or analog instrument with a minimum of 16 channels and 21
3737 electrodes to assist in the diagnosis of epilepsy and other
3838 neurological symptoms.
3939 (6) "Electromyography" means the recording and
4040 analysis of electrical activity generated by a needle insertion
4141 into a muscle.
4242 (7) "Evoked potentials" means the recording of
4343 electrical activity from the brain, spinal nerves, or sensory
4444 receptors that occurs in direct response to auditory, visual, or
4545 electrical stimulation using surface electrodes and computer
4646 equipment to average the electrical potentials generated.
4747 (8) "Intraoperative monitoring" means the use of a
4848 neurophysiological monitoring technique during surgery that
4949 ensures the safety of a patient by:
5050 (A) providing information to the surgeon that
5151 relates to the integrity of the central and peripheral nervous
5252 systems; and
5353 (B) using real-time electrographic information
5454 or stimulus evoked recordings of auditory, visual, somatosensory,
5555 or motor pathways via surface or subdermal needle electrodes.
5656 (9) "License holder" means a person who holds a
5757 license as a neurodiagnostic practitioner or neurodiagnostic
5858 technologist under this chapter.
5959 (10) "Long-term monitoring" means the prolonged
6060 recording, by video recording or digital analysis, of the ongoing
6161 electrical activity of the brain to evaluate and diagnose epilepsy
6262 and other intermittent or infrequent neurological disturbances.
6363 (11) "Magnetoencephalography" means the use of a
6464 neuroimaging technique for mapping brain activity by recording
6565 magnetic fields, outside the head, that are produced by electrical
6666 currents that occur naturally in the brain.
6767 (12) "Nerve conduction study" means a recording
6868 obtained from electrical stimulation of peripheral nerves using
6969 surface electrodes and standard equipment with oscilloscopes for
7070 waveform analysis to evaluate and diagnose a disorder of the
7171 peripheral nervous system.
7272 (13) "Neurodiagnostic practitioner" means a person
7373 who holds a doctoral degree approved by the board and a license
7474 issued under this chapter to:
7575 (A) perform the duties of a neurodiagnostic
7676 technologist;
7777 (B) perform intraoperative monitoring under the
7878 general supervision of a physician; and
7979 (C) supervise the performance of intraoperative
8080 monitoring and interpret intraoperative monitoring data under the
8181 delegated authority and general supervision of a physician.
8282 (14) "Neurodiagnostic student" means a person who is
8383 enrolled in a neurodiagnostics program.
8484 (15) "Neurodiagnostic technologist" means a person
8585 who holds a license issued under this chapter to:
8686 (A) use specialized equipment to record and
8787 analyze physiological data and electrical activity from the central
8888 and peripheral nervous systems; and
8989 (B) perform one or more of the following
9090 neurodiagnostic procedures under the appropriate level of
9191 supervision by a physician or a neurodiagnostic practitioner:
9292 (i) electroencephalography;
9393 (ii) evoked potentials;
9494 (iii) continuous electroencephalography
9595 monitoring;
9696 (iv) intraoperative neuromonitoring;
9797 (v) long-term monitoring;
9898 (vi) magnetoencephalography;
9999 (vii) nerve conduction studies;
100100 (viii) polysomnography; or
101101 (ix) autonomic reflex testing.
102102 (16) "Neurodiagnostic trainee" means a license holder
103103 who performs a neurodiagnostic procedure that the person does not
104104 have a credential to perform while under the direct supervision of a
105105 physician or neurodiagnostic practitioner or neurodiagnostic
106106 technologist who does have a credential to perform the procedure.
107107 (17) "Polysomnography" means the recording of the
108108 biophysiological changes that occur during sleep by monitoring the
109109 ongoing electrical activity of the brain, eye movements, muscle
110110 activity, heart rhythm, and respiratory effort to diagnose and
111111 treat sleep disorders.
112112 Sec. 606.002. EXEMPTIONS. This chapter does not apply to:
113113 (1) a physician licensed in this state;
114114 (2) a person performing a neurodiagnostic procedure:
115115 (A) for research if the results of the procedure
116116 are not used to diagnose or treat a patient;
117117 (B) as a neurodiagnostic student or
118118 neurodiagnostic trainee under the direct supervision of a physician
119119 or a neurodiagnostic practitioner or neurodiagnostic technologist;
120120 (C) as an employee under the direct supervision
121121 of a physician as part of the employee's job training; or
122122 (D) as an audiologist or physical therapist
123123 licensed in this state while performing only a procedure that the
124124 audiologist or physical therapist is authorized to perform as
125125 determined by board rule; or
126126 (3) a faculty member of an accredited school or
127127 university with a neurodiagnostics, allied health, or health
128128 education program.
129129 SUBCHAPTER B. POWERS AND DUTIES OF BOARD
130130 Sec. 606.051. GENERAL POWERS AND DUTIES; RULES. (a) The
131131 board shall administer and enforce this chapter.
132132 (b) The board shall adopt rules necessary to implement this
133133 chapter.
134134 Sec. 606.052. FEES. (a) The board by rule shall establish
135135 reasonable and necessary fees in amounts sufficient to cover the
136136 costs of administering and enforcing this chapter.
137137 (b) The board may modify the fee for the issuance or renewal
138138 of a license as necessary to cover the costs of enforcing this
139139 chapter.
140140 SUBCHAPTER C. LICENSE REQUIREMENTS
141141 Sec. 606.101. LICENSE REQUIRED. (a) A person may not act
142142 as or offer to act as a neurodiagnostic practitioner or
143143 neurodiagnostic technologist unless the person holds the
144144 applicable license issued under this chapter.
145145 (b) A person who is not licensed under this chapter, or
146146 whose license has been suspended or revoked, may not:
147147 (1) use the word "neurodiagnostic" on a sign, name
148148 tag, or any form of advertising unless the person is expressly
149149 exempt from the licensing requirements of this chapter;
150150 (2) use in connection with the person's practice any
151151 abbreviations or credentials indicating or implying that the person
152152 is a neurodiagnostic practitioner or neurodiagnostic technologist;
153153 or
154154 (3) directly or by implication represent in any way
155155 that the person is a neurodiagnostic practitioner or
156156 neurodiagnostic technologist.
157157 (c) A license:
158158 (1) is valid only with respect to the person named on
159159 the license; and
160160 (2) authorizes the license holder to engage in the
161161 neurodiagnostic procedure for which the license holder has a
162162 credential issued by a credentialing organization.
163163 (d) A license issued under this chapter is not transferable
164164 or assignable.
165165 Sec. 606.102. LICENSING APPLICATION. (a) An applicant for
166166 a license must:
167167 (1) apply to the board on a form prescribed by the
168168 board and under rules adopted by the board;
169169 (2) submit with the application a nonrefundable
170170 application fee in an amount set by the board; and
171171 (3) pass a credentialing organization examination
172172 administered or accepted by the board.
173173 (b) The board by rule shall specify the information that
174174 must be included on an application submitted to the board. The
175175 rules must require:
176176 (1) each application to include the name and address
177177 of the applicant; and
178178 (2) each applicant for a license by examination to
179179 present satisfactory evidence to the board that the applicant is:
180180 (A) at least 18 years of age; and
181181 (B) of good moral character.
182182 Sec. 606.103. CRIMINAL BACKGROUND CHECKS. (a) On receipt
183183 of an application for a license under this chapter, the board shall
184184 conduct a criminal background check on the applicant.
185185 (b) An applicant is not eligible for a license under this
186186 chapter if the applicant, in the 10 years preceding the date of the
187187 application, has been finally convicted of a misdemeanor involving
188188 moral turpitude or a felony.
189189 Sec. 606.104. EXAMINATIONS ADMINISTERED OR ACCEPTED BY
190190 BOARD. The board may administer or accept for licensing a
191191 credentialing organization examination as determined by rule.
192192 Sec. 606.1041. REDUCED LICENSE REQUIREMENTS. (a) A person
193193 who applies for a license under this chapter not later than July 1,
194194 2017, is exempt from the examination required under this chapter if
195195 the person presents satisfactory evidence to the board that the
196196 person has been actively performing neurodiagnostic procedures
197197 since before January 1, 2017.
198198 (b) Satisfactory evidence under Subsection (a) must be in
199199 the form of a signed letter submitted by the employer or supervising
200200 physician of the applicant.
201201 (c) A person who qualifies under this section for an
202202 exemption from the requirement to take the examination required
203203 under this chapter must comply with all other requirements under
204204 this chapter for the issuance and renewal of a license.
205205 (d) This section expires July 1, 2018.
206206 Sec. 606.105. TEMPORARY LICENSES. (a) The board may adopt
207207 rules and set fees relating to granting temporary licenses.
208208 (b) A temporary license under this chapter expires on the
209209 second anniversary of the date the temporary license is issued or
210210 the date the applicant presents satisfactory evidence to the board
211211 that the applicant has passed the examination required under this
212212 chapter, whichever date occurs first.
213213 (c) The board by rule may extend the expiration date of a
214214 temporary license by not more than an additional 12 months.
215215 SUBCHAPTER D. LICENSE RENEWAL
216216 Sec. 606.151. LICENSE RENEWAL. (a) A license is valid for
217217 two years from the date of issuance and may be renewed biennially.
218218 (b) The board by rule may adopt a system under which
219219 licenses expire on various dates during the year.
220220 (c) A person may renew an unexpired license by paying the
221221 required renewal fee to the board before the license expiration
222222 date.
223223 (d) To renew a license under this chapter, a person must
224224 submit proof satisfactory to the board that the person has:
225225 (1) maintained the appropriate credentials issued by a
226226 credentialing organization; and
227227 (2) complied with the continuing education
228228 requirements prescribed by the board.
229229 Sec. 606.152. CONTINUING EDUCATION. (a) The board shall
230230 establish for the renewal of a license or temporary license uniform
231231 continuing education requirements of not less than 30 continuing
232232 education hours for each renewal period.
233233 (b) The board shall adopt a procedure to assess a license
234234 holder's participation in continuing education programs.
235235 SUBCHAPTER E. PRACTICE BY LICENSE HOLDER
236236 Sec. 606.201. ADVERTISING. (a) A license holder shall
237237 include the license holder's license number in each advertisement.
238238 (b) A person who advertises that the person is a
239239 neurodiagnostic practitioner or neurodiagnostic technologist is
240240 presumed to be engaging in conduct regulated by this chapter.
241241 SUBCHAPTER F. PROHIBITED PRACTICES AND ENFORCEMENT PROVISIONS
242242 Sec. 606.251. PROHIBITED PRACTICES. (a) A license holder
243243 may not engage in a neurodiagnostic procedure for which the license
244244 holder does not hold the proper credential issued by a
245245 credentialing organization.
246246 (b) A license holder may not:
247247 (1) interpret neurodiagnostic data, including making
248248 a determination of normal or abnormal findings and identifying the
249249 presence, absence, type, severity, or likelihood of an illness,
250250 injury, or other condition;
251251 (2) provide clinical correlation of data, including
252252 making statements about the meaning of test results based on a
253253 person's symptoms, medical history, physical examination, or other
254254 clinical test results;
255255 (3) perform needle insertion electromyography in a
256256 clinical setting; or
257257 (4) meet with a patient except under the direct
258258 supervision of a physician.
259259 Sec. 606.252. INVESTIGATION OF COMPLAINTS. (a) The board
260260 shall investigate any complaint alleging that a violation of this
261261 chapter or a rule or order adopted under this chapter has occurred.
262262 (b) A complaint must be filed in a manner prescribed by the
263263 board.
264264 Sec. 606.253. SANCTIONS. The board may impose sanctions
265265 under this chapter in the same manner as provided by Chapter 164 for
266266 imposition of sanctions against a physician.
267267 SUBCHAPTER G. PENALTIES
268268 Sec. 606.301. ADMINISTRATIVE PENALTY. The board may impose
269269 an administrative penalty against a person under this chapter in
270270 the same manner as provided by Subchapter A, Chapter 165, against a
271271 physician, regardless of whether the person holds a license under
272272 this chapter, if the person violates this chapter or a rule or order
273273 adopted under this chapter.
274274 Sec. 606.302. CRIMINAL PENALTY. (a) A person commits an
275275 offense if the person violates this chapter.
276276 (b) An offense under this section is a Class A misdemeanor.
277277 SECTION 2. Not later than February 1, 2018, the Texas
278278 Medical Board shall adopt rules and forms necessary to implement
279279 Chapter 606, Occupations Code, as added by this Act.
280280 SECTION 3. The Texas Medical Board shall issue a
281281 neurodiagnostic practitioner or neurodiagnostic technologist
282282 license, as applicable, under Chapter 606, Occupations Code, as
283283 added by this Act, to an applicant who:
284284 (1) applies for the license under this section not
285285 later than July 1, 2018;
286286 (2) submits to the board the information required by
287287 rule;
288288 (3) meets the requirements of Section 606.1041,
289289 Occupations Code, as added by this Act; and
290290 (4) pays the application fee established by the board.
291291 SECTION 4. (a) Except as provided by Subsection (b) of this
292292 section, this Act takes effect September 1, 2017.
293293 (b) Section 606.101 and Subchapter G, Chapter 606,
294294 Occupations Code, as added by this Act, take effect September 1,
295295 2018.