85R13698 TSR-F
By: Hughes S.B. No. 1941
A BILL TO BE ENTITLED
AN ACT
relating to the licensing and regulation of neurodiagnostic
practitioners and neurodiagnostic technologists; requiring an
occupational license; creating an offense; providing penalties and
authorizing fees.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle K, Title 3, Occupations Code, is
amended by adding Chapter 606 to read as follows:
CHAPTER 606. NEURODIAGNOSTIC PRACTITIONERS AND NEURODIAGNOSTIC
TECHNOLOGISTS
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 606.001. DEFINITIONS. In this chapter:
(1) "Autonomic reflex testing" means a test used to
measure how autonomic nerves work in controlling involuntary body
functions, including blood pressure, heart rate, and sweating, in
response to different maneuvers, such as deep breathing, blowing
into a mouthpiece, sweating, and lying for several minutes on a
table that is tilted to a near standing position.
(2) "Board" means the Texas Medical Board.
(3) "Credentialing organization" means an accrediting
organization that is recognized by the board and that administers
and awards credentials in the modalities of neurodiagnostic
technology.
(4) "Direct supervision" means supervision by a
responsible physician or neurodiagnostic practitioner or
neurodiagnostic technologist who is physically present and
immediately available to provide assistance and direction while a
neurodiagnostic procedure is being performed.
(5) "Electroencephalography" means the recording and
analysis of the ongoing electrical activity of the brain using a
digital or analog instrument with a minimum of 16 channels and 21
electrodes to assist in the diagnosis of epilepsy and other
neurological symptoms.
(6) "Electromyography" means the recording and
analysis of electrical activity generated by a needle insertion
into a muscle.
(7) "Evoked potentials" means the recording of
electrical activity from the brain, spinal nerves, or sensory
receptors that occurs in direct response to auditory, visual, or
electrical stimulation using surface electrodes and computer
equipment to average the electrical potentials generated.
(8) "Intraoperative monitoring" means the use of a
neurophysiological monitoring technique during surgery that
ensures the safety of a patient by:
(A) providing information to the surgeon that
relates to the integrity of the central and peripheral nervous
systems; and
(B) using real-time electrographic information
or stimulus evoked recordings of auditory, visual, somatosensory,
or motor pathways via surface or subdermal needle electrodes.
(9) "License holder" means a person who holds a
license as a neurodiagnostic practitioner or neurodiagnostic
technologist under this chapter.
(10) "Long-term monitoring" means the prolonged
recording, by video recording or digital analysis, of the ongoing
electrical activity of the brain to evaluate and diagnose epilepsy
and other intermittent or infrequent neurological disturbances.
(11) "Magnetoencephalography" means the use of a
neuroimaging technique for mapping brain activity by recording
magnetic fields, outside the head, that are produced by electrical
currents that occur naturally in the brain.
(12) "Nerve conduction study" means a recording
obtained from electrical stimulation of peripheral nerves using
surface electrodes and standard equipment with oscilloscopes for
waveform analysis to evaluate and diagnose a disorder of the
peripheral nervous system.
(13) "Neurodiagnostic practitioner" means a person
who holds a doctoral degree approved by the board and a license
issued under this chapter to:
(A) perform the duties of a neurodiagnostic
technologist;
(B) perform intraoperative monitoring under the
general supervision of a physician; and
(C) supervise the performance of intraoperative
monitoring and interpret intraoperative monitoring data under the
delegated authority and general supervision of a physician.
(14) "Neurodiagnostic student" means a person who is
enrolled in a neurodiagnostics program.
(15) "Neurodiagnostic technologist" means a person
who holds a license issued under this chapter to:
(A) use specialized equipment to record and
analyze physiological data and electrical activity from the central
and peripheral nervous systems; and
(B) perform one or more of the following
neurodiagnostic procedures under the appropriate level of
supervision by a physician or a neurodiagnostic practitioner:
(i) electroencephalography;
(ii) evoked potentials;
(iii) continuous electroencephalography
monitoring;
(iv) intraoperative neuromonitoring;
(v) long-term monitoring;
(vi) magnetoencephalography;
(vii) nerve conduction studies;
(viii) polysomnography; or
(ix) autonomic reflex testing.
(16) "Neurodiagnostic trainee" means a license holder
who performs a neurodiagnostic procedure that the person does not
have a credential to perform while under the direct supervision of a
physician or neurodiagnostic practitioner or neurodiagnostic
technologist who does have a credential to perform the procedure.
(17) "Polysomnography" means the recording of the
biophysiological changes that occur during sleep by monitoring the
ongoing electrical activity of the brain, eye movements, muscle
activity, heart rhythm, and respiratory effort to diagnose and
treat sleep disorders.
Sec. 606.002. EXEMPTIONS. This chapter does not apply to:
(1) a physician licensed in this state;
(2) a person performing a neurodiagnostic procedure:
(A) for research if the results of the procedure
are not used to diagnose or treat a patient;
(B) as a neurodiagnostic student or
neurodiagnostic trainee under the direct supervision of a physician
or a neurodiagnostic practitioner or neurodiagnostic technologist;
(C) as an employee under the direct supervision
of a physician as part of the employee's job training; or
(D) as an audiologist or physical therapist
licensed in this state while performing only a procedure that the
audiologist or physical therapist is authorized to perform as
determined by board rule; or
(3) a faculty member of an accredited school or
university with a neurodiagnostics, allied health, or health
education program.
SUBCHAPTER B. POWERS AND DUTIES OF BOARD
Sec. 606.051. GENERAL POWERS AND DUTIES; RULES. (a) The
board shall administer and enforce this chapter.
(b) The board shall adopt rules necessary to implement this
chapter.
Sec. 606.052. FEES. (a) The board by rule shall establish
reasonable and necessary fees in amounts sufficient to cover the
costs of administering and enforcing this chapter.
(b) The board may modify the fee for the issuance or renewal
of a license as necessary to cover the costs of enforcing this
chapter.
SUBCHAPTER C. LICENSE REQUIREMENTS
Sec. 606.101. LICENSE REQUIRED. (a) A person may not act
as or offer to act as a neurodiagnostic practitioner or
neurodiagnostic technologist unless the person holds the
applicable license issued under this chapter.
(b) A person who is not licensed under this chapter, or
whose license has been suspended or revoked, may not:
(1) use the word "neurodiagnostic" on a sign, name
tag, or any form of advertising unless the person is expressly
exempt from the licensing requirements of this chapter;
(2) use in connection with the person's practice any
abbreviations or credentials indicating or implying that the person
is a neurodiagnostic practitioner or neurodiagnostic technologist;
or
(3) directly or by implication represent in any way
that the person is a neurodiagnostic practitioner or
neurodiagnostic technologist.
(c) A license:
(1) is valid only with respect to the person named on
the license; and
(2) authorizes the license holder to engage in the
neurodiagnostic procedure for which the license holder has a
credential issued by a credentialing organization.
(d) A license issued under this chapter is not transferable
or assignable.
Sec. 606.102. LICENSING APPLICATION. (a) An applicant for
a license must:
(1) apply to the board on a form prescribed by the
board and under rules adopted by the board;
(2) submit with the application a nonrefundable
application fee in an amount set by the board; and
(3) pass a credentialing organization examination
administered or accepted by the board.
(b) The board by rule shall specify the information that
must be included on an application submitted to the board. The
rules must require:
(1) each application to include the name and address
of the applicant; and
(2) each applicant for a license by examination to
present satisfactory evidence to the board that the applicant is:
(A) at least 18 years of age; and
(B) of good moral character.
Sec. 606.103. CRIMINAL BACKGROUND CHECKS. (a) On receipt
of an application for a license under this chapter, the board shall
conduct a criminal background check on the applicant.
(b) An applicant is not eligible for a license under this
chapter if the applicant, in the 10 years preceding the date of the
application, has been finally convicted of a misdemeanor involving
moral turpitude or a felony.
Sec. 606.104. EXAMINATIONS ADMINISTERED OR ACCEPTED BY
BOARD. The board may administer or accept for licensing a
credentialing organization examination as determined by rule.
Sec. 606.1041. REDUCED LICENSE REQUIREMENTS. (a) A person
who applies for a license under this chapter not later than July 1,
2017, is exempt from the examination required under this chapter if
the person presents satisfactory evidence to the board that the
person has been actively performing neurodiagnostic procedures
since before January 1, 2017.
(b) Satisfactory evidence under Subsection (a) must be in
the form of a signed letter submitted by the employer or supervising
physician of the applicant.
(c) A person who qualifies under this section for an
exemption from the requirement to take the examination required
under this chapter must comply with all other requirements under
this chapter for the issuance and renewal of a license.
(d) This section expires July 1, 2018.
Sec. 606.105. TEMPORARY LICENSES. (a) The board may adopt
rules and set fees relating to granting temporary licenses.
(b) A temporary license under this chapter expires on the
second anniversary of the date the temporary license is issued or
the date the applicant presents satisfactory evidence to the board
that the applicant has passed the examination required under this
chapter, whichever date occurs first.
(c) The board by rule may extend the expiration date of a
temporary license by not more than an additional 12 months.
SUBCHAPTER D. LICENSE RENEWAL
Sec. 606.151. LICENSE RENEWAL. (a) A license is valid for
two years from the date of issuance and may be renewed biennially.
(b) The board by rule may adopt a system under which
licenses expire on various dates during the year.
(c) A person may renew an unexpired license by paying the
required renewal fee to the board before the license expiration
date.
(d) To renew a license under this chapter, a person must
submit proof satisfactory to the board that the person has:
(1) maintained the appropriate credentials issued by a
credentialing organization; and
(2) complied with the continuing education
requirements prescribed by the board.
Sec. 606.152. CONTINUING EDUCATION. (a) The board shall
establish for the renewal of a license or temporary license uniform
continuing education requirements of not less than 30 continuing
education hours for each renewal period.
(b) The board shall adopt a procedure to assess a license
holder's participation in continuing education programs.
SUBCHAPTER E. PRACTICE BY LICENSE HOLDER
Sec. 606.201. ADVERTISING. (a) A license holder shall
include the license holder's license number in each advertisement.
(b) A person who advertises that the person is a
neurodiagnostic practitioner or neurodiagnostic technologist is
presumed to be engaging in conduct regulated by this chapter.
SUBCHAPTER F. PROHIBITED PRACTICES AND ENFORCEMENT PROVISIONS
Sec. 606.251. PROHIBITED PRACTICES. (a) A license holder
may not engage in a neurodiagnostic procedure for which the license
holder does not hold the proper credential issued by a
credentialing organization.
(b) A license holder may not:
(1) interpret neurodiagnostic data, including making
a determination of normal or abnormal findings and identifying the
presence, absence, type, severity, or likelihood of an illness,
injury, or other condition;
(2) provide clinical correlation of data, including
making statements about the meaning of test results based on a
person's symptoms, medical history, physical examination, or other
clinical test results;
(3) perform needle insertion electromyography in a
clinical setting; or
(4) meet with a patient except under the direct
supervision of a physician.
Sec. 606.252. INVESTIGATION OF COMPLAINTS. (a) The board
shall investigate any complaint alleging that a violation of this
chapter or a rule or order adopted under this chapter has occurred.
(b) A complaint must be filed in a manner prescribed by the
board.
Sec. 606.253. SANCTIONS. The board may impose sanctions
under this chapter in the same manner as provided by Chapter 164 for
imposition of sanctions against a physician.
SUBCHAPTER G. PENALTIES
Sec. 606.301. ADMINISTRATIVE PENALTY. The board may impose
an administrative penalty against a person under this chapter in
the same manner as provided by Subchapter A, Chapter 165, against a
physician, regardless of whether the person holds a license under
this chapter, if the person violates this chapter or a rule or order
adopted under this chapter.
Sec. 606.302. CRIMINAL PENALTY. (a) A person commits an
offense if the person violates this chapter.
(b) An offense under this section is a Class A misdemeanor.
SECTION 2. Not later than February 1, 2018, the Texas
Medical Board shall adopt rules and forms necessary to implement
Chapter 606, Occupations Code, as added by this Act.
SECTION 3. The Texas Medical Board shall issue a
neurodiagnostic practitioner or neurodiagnostic technologist
license, as applicable, under Chapter 606, Occupations Code, as
added by this Act, to an applicant who:
(1) applies for the license under this section not
later than July 1, 2018;
(2) submits to the board the information required by
rule;
(3) meets the requirements of Section 606.1041,
Occupations Code, as added by this Act; and
(4) pays the application fee established by the board.
SECTION 4. (a) Except as provided by Subsection (b) of this
section, this Act takes effect September 1, 2017.
(b) Section 606.101 and Subchapter G, Chapter 606,
Occupations Code, as added by this Act, take effect September 1,
2018.