Texas 2019 - 86th Regular

Texas House Bill HB1504 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	H.B. No. 1504
	1	+	By: Paddie (Senate Sponsor - Nichols) H.B. No. 1504
	2	+	(In the Senate - Received from the House April 23, 2019;
	3	+	April 24, 2019, read first time and referred to Committee on Health &
	4	+	Human Services; May 8, 2019, reported adversely, with favorable
	5	+	Committee Substitute by the following vote: Yeas 9, Nays 0;
	6	+	May 8, 2019, sent to printer.)
	7	+	Click here to see the committee vote
	8	+	COMMITTEE SUBSTITUTE FOR H.B. No. 1504 By: Perry
2	9
3	10
	11	+	A BILL TO BE ENTITLED
4	12		AN ACT
5	13		relating to the continuation and functions of the Texas Medical
6	14		Board; authorizing a fee.
7	15		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
8	16		SECTION 1. Section 151.004, Occupations Code, is amended to
9	17		read as follows:
10	18		Sec. 151.004. APPLICATION OF SUNSET ACT. The Texas Medical
11	19		Board is subject to Chapter 325, Government Code (Texas Sunset
12	20		Act). Unless continued in existence as provided by that chapter,
13	21		the board is abolished and this subtitle and Chapters 204, 205, 206,
14	22		601, 602, 603, and 604 expire September 1, 2031 [2019].
15	23		SECTION 2. Section 152.010, Occupations Code, is amended by
16	24		amending Subsection (b) and adding Subsection (d) to read as
17	25		follows:
18	26		(b) The training program must provide the person with
19	27		information regarding:
20	28		(1) the law governing board operations [this
21	29		subtitle];
22	30		(2) the programs, functions, rules, and budget of
23	31		[operated by] the board;
24	32		(3) the scope of and limitations on the rulemaking
25	33		authority [role and functions] of the board;
26	34		(4) the types of board rules, interpretations, and
27	35		enforcement actions that may implicate federal antitrust law by
28	36		limiting competition or impacting prices charged by persons engaged
29	37		in a profession or business the board regulates, including any
30	38		rule, interpretation, or enforcement action that:
31	39		(A) regulates the scope of practice of persons in
32	40		a profession or business the board regulates;
33	41		(B) restricts advertising by persons in a
34	42		profession or business the board regulates;
35	43		(C) affects the price of goods or services
36	44		provided by persons in a profession or business the board
37	45		regulates; or
38	46		(D) restricts participation in a profession or
39	47		business the board regulates [the rules of the board, with an
40	48		emphasis on the rules that relate to disciplinary and investigatory
41	49		authority];
42	50		(5) [the current budget for the board;
43	51		[(6)] the results of the most recent formal audit of
44	52		the board;
45	53		(6) [(7)] the requirements of:
46	54		(A) laws relating to open meetings, public
47	55		information, administrative procedure, and disclosure of conflicts
48	56		of interest; and
49	57		(B) other laws applicable to members of the board
50	58		in performing their duties; and
51	59		(7) [(8)] any applicable ethics policies adopted by
52	60		the board or the Texas Ethics Commission.
53	61		(d) The executive director of the board shall create a
54	62		training manual that includes the information required by
55	63		Subsection (b). The executive director shall distribute a copy of
56	64		the training manual annually to each board member. Each board
57	65		member shall sign and submit to the executive director a statement
58	66		acknowledging that the member received and has reviewed the
59	67		training manual.
60	68		SECTION 3. Section 153.058(a), Occupations Code, is amended
61	69		to read as follows:
62	70		(a) The board shall develop and implement a policy to
63	71		encourage the use of:
64	72		(1) negotiated rulemaking procedures under Chapter
65	73		2008, Government Code, for the adoption of any rules by the board
66	74		[rules]; and
67	75		(2) appropriate alternative dispute resolution
68	76		procedures under Chapter 2009, Government Code, to assist in the
69	77		resolution of internal and external disputes under the board's
70	78		jurisdiction.
71	79		SECTION 4. Section 154.006, Occupations Code, is amended by
72		-	amending Subsections (b)~~, (g), (i), (j),~~ and (k) and adding
73		-	~~Subsections (b-1), (i-1), and (l) to~~ read as follows:
	80	+	amending Subsections (b) and (k) and adding Subsection (b-1) to
	81	+	read as follows:
74	82		(b) Except as otherwise provided by this section, a [A]
75	83		profile must contain the following information on each physician:
76	84		(1) the name of each medical school attended and the
77	85		dates of:
78	86		(A) graduation; or
79	87		(B) Fifth Pathway designation and completion of
80	88		the Fifth Pathway Program;
81	89		(2) a description of all graduate medical education in
82	90		the United States or Canada;
83	91		(3) any specialty certification held by the physician
84	92		and issued by a medical licensing board that is a member of the
85	93		American Board of Medical Specialties or the Bureau of Osteopathic
86	94		Specialists;
87	95		(4) the number of years the physician has actively
88	96		practiced medicine in:
89	97		(A) the United States or Canada; and
90	98		(B) this state;
91	99		(5) the name of each hospital in this state in which
92	100		the physician has privileges;
93	101		(6) the physician's primary practice location;
94	102		(7) the type of language translating services,
95	103		including translating services for a person with impairment of
96	104		hearing, that the physician provides at the physician's primary
97	105		practice location;
98	106		(8) whether the physician participates in the Medicaid
99	107		program;
100	108		(9) a description of any conviction for a felony, a
101	109		Class A or Class B misdemeanor, or a Class C misdemeanor involving
102	110		moral turpitude;
103	111		(10) a description of any charges reported to the
104	112		board to which the physician has pleaded no contest, for which the
105	113		physician is the subject of deferred adjudication or pretrial
106	114		diversion, or in which sufficient facts of guilt were found and the
107	115		matter was continued by a court;
108	116		(11) a description of any disciplinary action against
109	117		the physician by the board;
110	118		(12) a description of any disciplinary action against
111	119		the physician by a medical licensing board of another state;
112	120		(13) a description of the final resolution taken by
113	121		the board on medical malpractice claims or complaints required to
114	122		be opened by the board under Section 164.201;
115	123		(14) whether the physician's patient service areas are
116	124		accessible to disabled persons, as defined by federal law;
117	125		(15) a description of any formal complaint against the
118	126		physician initiated and filed under Section 164.005 and the status
119	127		of the complaint; and
120	128		(16) a description of any medical malpractice claim
121	129		against the physician, not including a description of any offers by
122	130		the physician to settle the claim, for which the physician was found
123	131		liable, a jury awarded monetary damages to the claimant, and the
124	132		award has been determined to be final and not subject to further
125	133		appeal.
126	134		(b-1) On or after the fifth anniversary of the date a
127	135		remedial plan is issued under Section 164.0015, the board may
128	136		remove from the profile of the physician subject to the plan any
129	137		information regarding the plan and the complaint resolved by the
130	138		plan unless:
131	139		(1) the complaint was related to the delivery of
132	140		health care; or
133	141		(2) more than one remedial plan has been issued to
134	142		resolve complaints alleging the same violation by the physician,
135	143		including a complaint not related to the delivery of health care.
136		-	(g) Except as otherwise provided by this section, the [The]
137		-	board shall update the information contained in a physician's
138		-	profile annually[, except that information provided under
139		-	Subsection (i) shall be updated not later than the 10th working day
140		-	after the date the formal complaint is filed or the board's order is
141		-	issued]. The board shall adopt a form that allows a physician to
142		-	update information contained in a physician's profile. The form
143		-	shall be made available on the Internet and in other formats as
144		-	prescribed by board rule. The board may adopt rules concerning the
145		-	type and content of additional information that may be included in a
146		-	physician's profile.
147		-	(i) In addition to the information required by Subsection
148		-	(b) and except as otherwise provided by this section, a profile must
149		-	be updated to contain the text of a formal complaint filed under
150		-	Section 164.005 against the physician or of a board order related to
151		-	the formal complaint not later than the 10th working day after the
152		-	date the complaint is filed.
153		-	(i-1) Not later than the 10th working day after the date the
154		-	board issues a final order related to a formal complaint filed under
155		-	Section 164.005 against a physician, the board shall:
156		-	(1) remove from the physician's profile any record of
157		-	the formal complaint or any prior disciplinary action related to
158		-	the formal complaint; and
159		-	(2) update the physician's profile to contain the
160		-	board's final order.
161		-	(j) Information included in a physician's profile under
162		-	Subsections (b), [and] (i), and (i-1) may not include any patient
163		-	identifying information.
164		-	(k) Not later than the 10th working day after the date the
165		-	board dismisses [In the annual update of a physician's profile
166		-	under Subsection (g), the board shall remove any record of] a formal
167		-	complaint against a physician required to be included in the
168		-	physician's profile under Subsection (b)(15) or (i) [if the
169		-	complaint was dismissed more than five years before the date of the
170		-	update and the complaint was dismissed] as baseless, unfounded, or
171		-	not supported by sufficient evidence that a violation occurred, or
172		-	resolves the complaint and takes no action [was taken] against the
173		-	physician's license as a result of the complaint, the board shall:
174		-	(1) remove from the physician's profile any record of
175		-	the formal complaint or any prior disciplinary action related to
176		-	the formal complaint; and
177		-	(2) update the physician's profile to contain the
178		-	board's final order dismissing or resolving the complaint.
179		-	(l) If no action is taken against a physician's license as a
180		-	result of an [The board shall also remove any record of the]
	144	+	(k) In the annual update of a physician's profile under
	145	+	Subsection (g), the board shall remove any record of a formal
	146	+	complaint required under Subsection (b)(15) or (i) if the complaint
	147	+	[was dismissed more than five years before the date of the update
	148	+	and the complaint] was dismissed as baseless, unfounded, or not
	149	+	supported by sufficient evidence that a violation occurred, or no
	150	+	action was taken against the physician's license as a result of the
	151	+	complaint. The board shall also remove any record of the
181	152		investigation of medical malpractice claims or complaints required
182		-	to be investigated by the board under Section 164.201, the board
183		-	shall, not later than the 10th working day after the date the board
184		-	resolves the investigation, remove any record of the investigation
185		-	from the physician's profile [if the investigation was resolved
186		-	more than five years before the date of the update and no action was
187		-	taken against the physician's license as a result of the
188		-	investigation].
189		-	SECTION 5. Section 154.057, Occupations Code, is amended by
190		-	amending Subsection (b) and adding Subsection (b-1) to read as
191		-	follows:
192		-	(b) Except as provided by Subsection (b-1), the [The] board
193		-	shall complete a preliminary investigation of the complaint not
194		-	later than the 45th day after the date of receiving the complaint.
195		-	The board shall first determine whether the physician constitutes a
196		-	continuing threat to the public welfare. On completion of the
197		-	preliminary investigation, the board shall determine whether to
198		-	officially proceed on the complaint. If the board fails to complete
199		-	the preliminary investigation in the time required by this
200		-	subsection, the board's official investigation of the complaint is
201		-	considered to commence on that date.
202		-	(b-1) The board, for good cause, may extend a preliminary
203		-	investigation under Subsection (b) for not more than 15 days after
204		-	the date required for completion under that subsection.
205		-	SECTION 6. Subchapter A, Chapter 155, Occupations Code, is
	153	+	to be investigated by the board under Section 164.201 if the
	154	+	investigation was resolved [more than five years before the date of
	155	+	the update] and no action was taken against the physician's license
	156	+	as a result of the investigation.
	157	+	SECTION 5. Subchapter A, Chapter 155, Occupations Code, is
206	158		amended by adding Section 155.011 to read as follows:
207	159		Sec. 155.011. EXPEDITED LICENSING PROCESS FOR CERTAIN
208	160		OUT-OF-STATE APPLICANTS. The board by rule shall develop and
209	161		implement an expedited licensing process for an applicant who is
210	162		considered to have satisfied the examination requirements of this
211	163		chapter under Section 155.0561(d).
212		-	SECTION 7. Section 155.056(a), Occupations Code, is amended
	164	+	SECTION 6. Section 155.056(a), Occupations Code, is amended
213	165		to read as follows:
214	166		(a) Except as otherwise provided by Subsection (a-1) and
215	167		Section 155.0561, an applicant must pass each part of an
216	168		examination within three attempts.
217		-	SECTION 8. Subchapter B, Chapter 155, Occupations Code, is
	169	+	SECTION 7. Subchapter B, Chapter 155, Occupations Code, is
218	170		amended by adding Section 155.0561 to read as follows:
219	171		Sec. 155.0561. EXCEPTIONS TO EXAMINATION ATTEMPT LIMITS FOR
220	172		CERTAIN OUT-OF-STATE APPLICANTS. (a) In this section:
221	173		(1) "Active practice" means the practice of medicine
222	174		by a person after successful completion of a residency, fellowship,
223	175		or other supervised training program.
224	176		(2) "Full license" means a license to practice
225	177		medicine that is not a training license, a permit, or any other form
226	178		of authority to practice medicine issued to a person while the
227	179		person is completing or enrolled in a residency, fellowship, or
228	180		other supervised training program.
229	181		(b) This section applies only to an applicant who:
230	182		(1) has successfully completed a graduate medical
231	183		education program approved by the board;
232	184		(2) holds a full license and is in good standing as a
233	185		physician in another state or Canada;
234	186		(3) does not hold and has never held a medical license
235	187		subject to any restriction, disciplinary order, or probation;
236	188		(4) is not and has never been the subject of a peer
237	189		review that has resulted or may result in limitation, restriction,
238	190		suspension, or other adverse impact on the applicant's hospital or
239	191		other medical facility privileges; and
240	192		(5) is not under investigation by any licensing or law
241	193		enforcement agency.
242	194		(c) An applicant described by Subsection (b) who has held a
243	195		full license and been in active practice for at least one year but
244	196		less than five years and has passed within three attempts all but
245	197		one part of the examination approved by the board is considered to
246	198		have satisfied the examination requirements of this chapter if the
247	199		applicant passed the remaining part of the examination within:
248	200		(1) one additional attempt; or
249	201		(2) three additional attempts, if the applicant is
250	202		specialty board certified by a specialty board that is:
251	203		(A) a member of the American Board of Medical
252	204		Specialties; or
253	205		(B) approved by the American Osteopathic
254	206		Association.
255	207		(d) An applicant described by Subsection (b) who has held a
256	208		full license and been in active practice for at least five years is
257	209		considered to have satisfied the examination requirements of this
258	210		chapter regardless of the type of examination the applicant passed
259	211		or the number of attempts within which the applicant passed the
260	212		examination or any part of the examination.
261		-	SECTION 9. Section 162.106, Occupations Code, is amended to
	213	+	SECTION 8. Section 162.106, Occupations Code, is amended to
262	214		read as follows:
263	215		Sec. 162.106. INSPECTIONS. (a) The board may conduct
264	216		inspections [to enforce this subchapter, including inspections of
265	217		an office site and of documents] of a physician's equipment and
266	218		office procedures [practice] that relate to the provision of
267	219		anesthesia in an outpatient setting as necessary to enforce this
268	220		subchapter.
269	221		(b) The board may establish a risk-based inspection process
270	222		in which the board conducts inspections based on the length of time
271	223		since:
272	224		(1) the equipment and outpatient setting were last
273	225		inspected; and
274	226		(2) the physician submitted to inspection.
275	227		(c) The board may contract with another state agency or
276	228		qualified person to conduct the inspections.
277	229		(d) [(b)] Unless it would jeopardize an ongoing
278	230		investigation, the board shall provide at least five business days'
279	231		notice before conducting an on-site inspection under this section.
280	232		(e) The board shall maintain a record of the outpatient
281	233		settings in which physicians provide anesthesia.
282	234		(f) A physician who provides anesthesia in an outpatient
283	235		setting shall inform the board of any other physician with whom the
284	236		physician shares equipment used to administer anesthesia.
285	237		(g) [(c)] This section does not require the board to make an
286	238		on-site inspection of a physician's office.
287		-	SECTION 10. Section 164.0015(d), Occupations Code, is
	239	+	SECTION 9. Section 164.0015(d), Occupations Code, is
288	240		amended to read as follows:
289	241		(d) The board may not issue a remedial plan to resolve a
290	242		complaint against a license holder if the license holder has
291	243		[previously] entered into a remedial plan with the board in the
292	244		preceding five years [for the resolution of a different complaint
293	245		relating to this subtitle].
294		-	SECTION 11. Section 164.003, Occupations Code, is amended
	246	+	SECTION 10. Section 164.003, Occupations Code, is amended
295	247		by amending Subsections (b) and (f) and adding Subsection (f-1) to
296	248		read as follows:
297	249		(b) Rules adopted under this section must require that:
298	250		(1) an informal meeting in compliance with Section
299	251		2001.054, Government Code, be scheduled not later than the 180th
300	252		day after the date the board's official investigation of the
301	253		complaint is commenced as provided by Section 154.057(b), unless
302	254		good cause is shown by the board for scheduling the informal meeting
303	255		after that date;
304	256		(2) the board give notice to the license holder of the
305	257		time and place of the meeting not later than the 45th day before the
306	258		date the meeting is held;
307	259		(3) the complainant and the license holder be provided
308	260		an opportunity to be heard;
309	261		(4) at least one of the board members or district
310	262		review committee members participating in the informal meeting as a
311	263		panelist be a member who represents the public;
312	264		(5) the board's legal counsel or a representative of
313	265		the attorney general be present to advise the board or the board's
314	266		staff; [and]
315	267		(6) a member of the board's staff be at the meeting to
316	268		present to the board's representative the facts the staff
317	269		reasonably believes it could prove by competent evidence or
318	270		qualified witnesses at a hearing; and
319	271		(7) if the complaint includes an allegation that the
320	272		license holder has violated the standard of care, the panel
321	273		conducting the informal proceeding consider whether the physician
322	274		was practicing complementary and alternative medicine.
323	275		(f) The notice required by Subsection (b)(2) must be
324	276		accompanied by a written statement of the nature of the allegations
325	277		and the information the board intends to use at the meeting. If the
326	278		board does not provide the statement or information at that time,
327	279		the license holder may use that failure as grounds for rescheduling
328	280		the informal meeting. If the complaint includes an allegation that
329	281		the license holder has violated the standard of care, the notice
330	282		must include a copy of each [the] report prepared by an [the] expert
331	283		physician reviewer under Section 154.0561. The license holder must
332	284		provide to the board the license holder's rebuttal at least 15
333	285		business days before the date of the meeting in order for the
334	286		information to be considered at the meeting.
335	287		(f-1) Before providing a report to a license holder under
336	288		Subsection (f), the board must redact any identifying information
337	289		of an expert physician reviewer other than the specialty of the
338	290		expert physician reviewer.
339		-	SECTION 12. Sections 164.005(a) and (c), Occupations Code,
	291	+	SECTION 11. Sections 164.005(a) and (c), Occupations Code,
340	292		are amended to read as follows:
341	293		(a) In this section, "formal complaint" means a written
342	294		statement made by a credible person [under oath] that is filed and
343	295		presented by a board representative charging a person with having
344	296		committed an act that, if proven, could affect the legal rights or
345	297		privileges of a license holder or other person under the board's
346	298		jurisdiction.
347	299		(c) A charge must [be in the form of a written affidavit
348	300		that]:
349	301		(1) be [is] filed with the board's records custodian or
350	302		assistant records custodian; and
351	303		(2) detail [details] the nature of the charge as
352	304		required by this subtitle or other applicable law.
353		-	SECTION 13. Sections 164.006(a) and (b), Occupations Code,
	305	+	SECTION 12. Sections 164.006(a) and (b), Occupations Code,
354	306		are amended to read as follows:
355	307		(a) Notice [Service of process] to [notify] the respondent
356	308		of a hearing about the charges against the person must be served:
357	309		(1) in accordance with Chapter 2001, Government Code;
358	310		and
359	311		(2) by certified mail.
360	312		(b) If notice [service] described by Subsection (a) is
361	313		impossible or cannot be effected, the board shall publish once a
362	314		week for two successive weeks a notice of the hearing in a newspaper
363	315		published in the county of the last known place of practice in this
364	316		state of the person, if known.
365		-	SECTION 14. Sections 164.007(a) and (a-1), Occupations
366		-	Code, are amended to read as follows:
367		-	(a) The board by rule shall adopt procedures governing
368		-	formal disposition of a contested case under Chapter 2001,
369		-	Government Code. A formal hearing shall be conducted by an
370		-	administrative law judge employed by the State Office of
371		-	Administrative Hearings. After receiving the administrative law
372		-	judge's findings of fact and conclusions of law, the board shall:
373		-	(1) dispose of the contested case by issuing a final
374		-	order based on the administrative law judge's findings of fact and
375		-	conclusions of law; or
376		-	(2) appeal the administrative law judge's findings of
377		-	fact and conclusions of law in the manner provided by Section
378		-	164.0072.
379		-	(a-1) Notwithstanding Section 2001.058(e), Government
380		-	Code, the board may not change a finding of fact or conclusion of
381		-	law or vacate or modify an order of the administrative law judge.
382		-	[The board may obtain judicial review of any finding of fact or
383		-	conclusion of law issued by the administrative law judge as
384		-	provided by Section 2001.058(f)(5), Government Code.] For each
385		-	case, the board has the sole authority and discretion to determine
386		-	the appropriate action or sanction. The [, and the] administrative
387		-	law judge may not make any recommendation regarding the appropriate
388		-	action or sanction.
389		-	SECTION 15. Subchapter A, Chapter 164, Occupations Code, is
390		-	amended by adding Section 164.0072 to read as follows:
391		-	Sec. 164.0072. BOARD APPEAL OF FINDINGS OF FACT AND
392		-	CONCLUSIONS OF LAW. (a) The board may, before disposing of a
393		-	contested case by issuing a final order, obtain judicial review of
394		-	any finding of fact or conclusion of law issued by the
395		-	administrative law judge by filing suit in a Travis County district
396		-	court not later than the 30th day after the date the findings of
397		-	fact and conclusions of law are issued.
398		-	(b) The board shall join in a suit filed under this section
399		-	the respondent in the contested case for which the board seeks to
400		-	obtain judicial review.
401		-	(c) The scope of judicial review under this section is the
402		-	same as the scope of judicial review provided for an appeal under
403		-	Section 164.009.
404		-	(d) After the court issues a final order in a suit filed
405		-	under this section, the board shall dispose of the contested case by
406		-	issuing a final order based on the court's final order. The
407		-	respondent may not appeal a sanction ordered by the board unless the
408		-	sanction exceeds the board's published sanctions guidelines.
409		-	SECTION 16. Section 164.052(a), Occupations Code, is
410		-	amended to read as follows:
411		-	(a) A physician or an applicant for a license to practice
412		-	medicine commits a prohibited practice if that person:
413		-	(1) submits to the board a false or misleading
414		-	statement, document, or certificate in an application for a
415		-	license;
416		-	(2) presents to the board a license, certificate, or
417		-	diploma that was illegally or fraudulently obtained;
418		-	(3) commits fraud or deception in taking or passing an
419		-	examination;
420		-	(4) uses alcohol or drugs in an intemperate manner
421		-	that, in the board's opinion, could endanger a patient's life;
422		-	(5) commits unprofessional or dishonorable conduct
423		-	that is likely to deceive or defraud the public, as provided by
424		-	Section 164.053, or injure the public;
425		-	(6) uses an advertising statement that is false,
426		-	misleading, or deceptive;
427		-	(7) advertises professional superiority or the
428		-	performance of professional service in a superior manner if that
429		-	advertising is not readily subject to verification;
430		-	(8) purchases, sells, barters, or uses, or offers to
431		-	purchase, sell, barter, or use, a medical degree, license,
432		-	certificate, or diploma, or a transcript of a license, certificate,
433		-	or diploma in or incident to an application to the board for a
434		-	license to practice medicine;
435		-	(9) alters, with fraudulent intent, a medical license,
436		-	certificate, or diploma, or a transcript of a medical license,
437		-	certificate, or diploma;
438		-	(10) uses a medical license, certificate, or diploma,
439		-	or a transcript of a medical license, certificate, or diploma that
440		-	has been:
441		-	(A) fraudulently purchased or issued;
442		-	(B) counterfeited; or
443		-	(C) materially altered;
444		-	(11) impersonates or acts as proxy for another person
445		-	in an examination required by this subtitle for a medical license;
446		-	(12) engages in conduct that subverts or attempts to
447		-	subvert an examination process required by this subtitle for a
448		-	medical license;
449		-	(13) impersonates a physician or permits another to
450		-	use the person's license or certificate to practice medicine in
451		-	this state;
452		-	(14) directly or indirectly employs a person whose
453		-	license to practice medicine has been suspended, canceled, or
454		-	revoked;
455		-	(15) associates in the practice of medicine with a
456		-	person:
457		-	(A) whose license to practice medicine has been
458		-	suspended, canceled, or revoked; or
459		-	(B) who has been convicted of the unlawful
460		-	practice of medicine in this state or elsewhere;
461		-	(16) performs or procures a criminal abortion, aids or
462		-	abets in the procuring of a criminal abortion, attempts to perform
463		-	or procure a criminal abortion, or attempts to aid or abet the
464		-	performance or procurement of a criminal abortion;
465		-	(17) directly or indirectly aids or abets the practice
466		-	of medicine by a person, partnership, association, or corporation
467		-	that is not licensed to practice medicine by the board;
468		-	(18) performs an abortion on a woman who is pregnant
469		-	with a viable unborn child during the third trimester of the
470		-	pregnancy unless:
471		-	(A) the abortion is necessary to prevent the
472		-	death of the woman;
473		-	(B) the viable unborn child has a severe,
474		-	irreversible brain impairment; or
475		-	(C) the woman is diagnosed with a significant
476		-	likelihood of suffering imminent severe, irreversible brain damage
477		-	or imminent severe, irreversible paralysis;
478		-	(19) performs an abortion on an unemancipated minor
479		-	without the written consent of the child's parent, managing
480		-	conservator, or legal guardian or without a court order, as
481		-	provided by Section 33.003 or 33.004, Family Code, unless the
482		-	abortion is necessary due to a medical emergency, as defined by
483		-	Section 171.002, Health and Safety Code;
484		-	(20) otherwise performs an abortion on an
485		-	unemancipated minor in violation of Chapter 33, Family Code; [or]
486		-	(21) performs or induces or attempts to perform or
487		-	induce an abortion in violation of Subchapter C, F, or G, Chapter
488		-	171, Health and Safety Code; or
489		-	(22) in complying with the procedures outlined in
490		-	Sections 166.045 and 166.046, Health and Safety Code, wilfully
491		-	fails to make a reasonable effort to transfer a patient to a
492		-	physician who is willing to comply with a directive.
493		-	SECTION 17. Chapter 167, Occupations Code, is amended by
	317	+	SECTION 13. Chapter 167, Occupations Code, is amended by
494	318		adding Sections 167.012 and 167.013 to read as follows:
495	319		Sec. 167.012. MEMORANDUM OF UNDERSTANDING WITH BOARD. The
496	320		governing board and the board shall enter into a memorandum of
497	321		understanding to better coordinate services and operations of the
498	322		program. The memorandum of understanding must be adopted by rule
499	323		and:
500	324		(1) establish performance measures for the program,
501	325		including the number of participants who successfully complete the
502	326		program;
503	327		(2) include a list of services the board will provide
504	328		for the program; and
505	329		(3) require that an internal audit of the program be
506	330		conducted at least once every three years to ensure the program is
507	331		properly documenting and referring all noncompliance to the board.
508	332		Sec. 167.013. GIFTS, GRANTS, AND DONATIONS. In addition to
509	333		any fees paid to the board or money appropriated to the board for
510	334		the program, the governing board may receive and accept a gift,
511	335		grant, donation, or other thing of value from any source, including
512	336		the United States or a private source, for the program.
513		-	SECTION 18. Section 205.057, Occupations Code, is amended
	337	+	SECTION 14. Section 205.057, Occupations Code, is amended
514	338		by amending Subsection (b) and adding Subsection (d) to read as
515	339		follows:
516	340		(b) The training program must provide the person with
517	341		information regarding:
518	342		(1) the law governing acupuncture board operations
519	343		[this chapter];
520	344		(2) the programs, [operated by the acupuncture board;
521	345		[(3) the role and] functions, rules, and budget of the
522	346		acupuncture board;
523	347		(3) [(4)] the scope of and limitations on the
524	348		rulemaking authority [rules] of the acupuncture board;
525	349		(4) the types of acupuncture board rules,
526	350		interpretations, and enforcement actions that may implicate
527	351		federal antitrust law by limiting competition or impacting prices
528	352		charged by persons engaged in a profession or business the
529	353		acupuncture board regulates, including any rule, interpretation,
530	354		or enforcement action that:
531	355		(A) regulates the scope of practice of persons in
532	356		a profession or business the acupuncture board regulates;
533	357		(B) restricts advertising by persons in a
534	358		profession or business the acupuncture board regulates;
535	359		(C) affects the price of goods or services
536	360		provided by persons in a profession or business the acupuncture
537	361		board regulates; or
538	362		(D) restricts participation in a profession or
539	363		business the acupuncture board regulates;
540	364		(5) [the current budget for the acupuncture board;
541	365		[(6)] the results of the most recent formal audit of
542	366		the acupuncture board;
543	367		(6) [(7)] the requirements of:
544	368		(A) laws relating to open meetings, public
545	369		information, administrative procedure, and disclosure of conflicts
546	370		of interest; and
547	371		(B) other laws applicable to members of the
548	372		acupuncture board in performing their duties; and
549	373		(7) [(8)] any applicable ethics policies adopted by
550	374		the acupuncture board or the Texas Ethics Commission.
551	375		(d) The executive director shall create a training manual
552	376		that includes the information required by Subsection (b). The
553	377		executive director shall distribute a copy of the training manual
554	378		annually to each acupuncture board member. Each board member shall
555	379		sign and submit to the executive director a statement acknowledging
556	380		that the member received and has reviewed the training manual.
557		-	SECTION 19. Subchapter E, Chapter 205, Occupations Code, is
	381	+	SECTION 15. Subchapter E, Chapter 205, Occupations Code, is
558	382		amended by adding Section 205.2025 to read as follows:
559	383		Sec. 205.2025. CRIMINAL HISTORY RECORD INFORMATION
560	384		REQUIREMENT FOR LICENSE ISSUANCE. (a) The acupuncture board shall
561	385		require that an applicant for a license submit a complete and
562	386		legible set of fingerprints, on a form prescribed by the board, to
563	387		the board or to the Department of Public Safety for the purpose of
564	388		obtaining criminal history record information from the Department
565	389		of Public Safety and the Federal Bureau of Investigation.
566	390		(b) The acupuncture board may not issue a license to a
567	391		person who does not comply with the requirement of Subsection (a).
568	392		(c) The acupuncture board shall conduct a criminal history
569	393		record information check of each applicant for a license using
570	394		information:
571	395		(1) provided by the individual under this section; and
572	396		(2) made available to the board by the Department of
573	397		Public Safety, the Federal Bureau of Investigation, and any other
574	398		criminal justice agency under Chapter 411, Government Code.
575	399		(d) The acupuncture board may:
576	400		(1) enter into an agreement with the Department of
577	401		Public Safety to administer a criminal history record information
578	402		check required under this section; and
579	403		(2) authorize the Department of Public Safety to
580	404		collect from each applicant the costs incurred by the Department of
581	405		Public Safety in conducting the criminal history record information
582	406		check.
583		-	SECTION 20. Subchapter F, Chapter 205, Occupations Code, is
	407	+	SECTION 16. Subchapter F, Chapter 205, Occupations Code, is
584	408		amended by adding Section 205.2515 to read as follows:
585	409		Sec. 205.2515. CRIMINAL HISTORY RECORD INFORMATION
586	410		REQUIREMENT FOR RENEWAL. (a) An applicant for renewal of a license
587	411		issued under this chapter shall submit a complete and legible set of
588	412		fingerprints for purposes of performing a criminal history record
589	413		information check of the applicant as provided by Section 205.2025.
590	414		(b) The acupuncture board may administratively suspend or
591	415		refuse to renew the license of a person who does not comply with the
592	416		requirement of Subsection (a).
593	417		(c) A license holder is not required to submit fingerprints
594	418		under this section for the renewal of the license if the holder has
595	419		previously submitted fingerprints under:
596	420		(1) Section 205.2025 for the initial issuance of the
597	421		license; or
598	422		(2) this section as part of a prior renewal of a
599	423		license.
600		-	SECTION 21. Subchapter E, Chapter 206, Occupations Code, is
	424	+	SECTION 17. Subchapter E, Chapter 206, Occupations Code, is
601	425		amended by adding Section 206.2025 to read as follows:
602	426		Sec. 206.2025. CRIMINAL HISTORY RECORD INFORMATION
603	427		REQUIREMENT FOR LICENSE ISSUANCE. (a) The medical board shall
604	428		require that an applicant for a license submit a complete and
605	429		legible set of fingerprints, on a form prescribed by the board, to
606	430		the board or to the Department of Public Safety for the purpose of
607	431		obtaining criminal history record information from the Department
608	432		of Public Safety and the Federal Bureau of Investigation.
609	433		(b) The medical board may not issue a license to a person who
610	434		does not comply with the requirement of Subsection (a).
611	435		(c) The medical board shall conduct a criminal history
612	436		record information check of each applicant for a license using
613	437		information:
614	438		(1) provided by the individual under this section; and
615	439		(2) made available to the board by the Department of
616	440		Public Safety, the Federal Bureau of Investigation, and any other
617	441		criminal justice agency under Chapter 411, Government Code.
618	442		(d) The medical board may:
619	443		(1) enter into an agreement with the Department of
620	444		Public Safety to administer a criminal history record information
621	445		check required under this section; and
622	446		(2) authorize the Department of Public Safety to
623	447		collect from each applicant the costs incurred by the Department of
624	448		Public Safety in conducting the criminal history record information
625	449		check.
626		-	SECTION 22. Section 206.203(a), Occupations Code, is
	450	+	SECTION 18. Section 206.203(a), Occupations Code, is
627	451		amended to read as follows:
628	452		(a) Except as provided by Section 206.206, to be eligible
629	453		for a license, a person must:
630	454		(1) [be of good moral character;
631	455		[(2)] have not been convicted of a felony or a crime
632	456		involving moral turpitude;
633	457		(2) [(3)] not use drugs or alcohol to an extent that
634	458		affects the applicant's professional competency;
635	459		(3) [(4)] not have had a license or certification
636	460		revoked by a licensing agency or by a certifying professional
637	461		organization; and
638	462		(4) [(5)] not have engaged in fraud or deceit in
639	463		applying for a license under this chapter.
640		-	SECTION 23. Subchapter E, Chapter 206, Occupations Code, is
	464	+	SECTION 19. Subchapter E, Chapter 206, Occupations Code, is
641	465		amended by adding Section 206.2105 to read as follows:
642	466		Sec. 206.2105. CRIMINAL HISTORY RECORD INFORMATION
643	467		REQUIREMENT FOR RENEWAL. (a) An applicant for renewal of a license
644	468		issued under this chapter shall submit a complete and legible set of
645	469		fingerprints for purposes of performing a criminal history record
646	470		information check of the applicant as provided by Section 206.2025.
647	471		(b) The medical board may administratively suspend or
648	472		refuse to renew the license of a person who does not comply with the
649	473		requirement of Subsection (a).
650	474		(c) A license holder is not required to submit fingerprints
651	475		under this section for the renewal of the license if the holder has
652	476		previously submitted fingerprints under:
653	477		(1) Section 206.2025 for the initial issuance of the
654	478		license; or
655	479		(2) this section as part of a prior renewal of a
656	480		license.
657		-	SECTION 24. Section 601.002, Occupations Code, is amended
	481	+	SECTION 20. Section 601.002, Occupations Code, is amended
658	482		by adding Subdivisions (10-a) and (10-b) to read as follows:
659	483		(10-a) "Radiologist" means a physician specializing
660	484		in radiology certified by or board-eligible for the American Board
661	485		of Radiology, the American Osteopathic Board of Radiology, the
662	486		Royal College of Radiologists, or the Royal College of Physicians
663	487		and Surgeons of Canada.
664	488		(10-b) "Radiologist assistant" means an
665	489		advanced-level medical radiologic technologist who is certified
666	490		as:
667	491		(A) a registered radiologist assistant by the
668	492		American Registry of Radiologic Technologists; or
669	493		(B) a radiology practitioner assistant by the
670	494		Certification Board for Radiology Practitioner Assistants.
671		-	SECTION 25. Section 601.030, Occupations Code, is amended
	495	+	SECTION 21. Section 601.030, Occupations Code, is amended
672	496		by amending Subsection (b) and adding Subsection (d) to read as
673	497		follows:
674	498		(b) The training program must provide the person with
675	499		information regarding:
676	500		(1) the law governing advisory board operations;
677	501		(2) [this chapter and] the [advisory board's]
678	502		programs, functions, rules, and budget of the advisory board;
679	503		(3) the scope of and limitations on the rulemaking
680	504		authority of the advisory board;
681	505		(4) the types of advisory board rules,
682	506		interpretations, and enforcement actions that may implicate
683	507		federal antitrust law by limiting competition or impacting prices
684	508		charged by persons engaged in a profession or business the advisory
685	509		board regulates, including any rule, interpretation, or
686	510		enforcement action that:
687	511		(A) regulates the scope of practice of persons in
688	512		a profession or business the advisory board regulates;
689	513		(B) restricts advertising by persons in a
690	514		profession or business the advisory board regulates;
691	515		(C) affects the price of goods or services
692	516		provided by persons in a profession or business the advisory board
693	517		regulates; or
694	518		(D) restricts participation in a profession or
695	519		business the advisory board regulates;
696	520		(5) [(2)] the results of the most recent formal audit
697	521		of the advisory board;
698	522		(6) [(3)] the requirements of:
699	523		(A) laws relating to open meetings, public
700	524		information, administrative procedure, and disclosure of conflicts
701	525		of interest; and
702	526		(B) other laws applicable to members of the
703	527		advisory board in performing their duties; and
704	528		(7) [(4)] any applicable ethics policies adopted by
705	529		the advisory board or the Texas Ethics Commission.
706	530		(d) The executive director of the medical board shall create
707	531		a training manual that includes the information required by
708	532		Subsection (b). The executive director shall distribute a copy of
709	533		the training manual annually to each advisory board member. Each
710	534		board member shall sign and submit to the executive director a
711	535		statement acknowledging that the member received and has reviewed
712	536		the training manual.
713		-	SECTION 26. Sections 601.102(b) and (c), Occupations Code,
	537	+	SECTION 22. Sections 601.102(b) and (c), Occupations Code,
714	538		are amended to read as follows:
715	539		(b) The advisory board may issue to a person:
716	540		(1) a general certificate to perform radiologic
717	541		procedures; [or]
718	542		(2) a limited certificate that authorizes the person
719	543		to perform radiologic procedures only on specific parts of the
720	544		human body; or
721	545		(3) a radiologist assistant certificate to a person
722	546		who meets the requirements established under Section 601.1021.
723	547		(c) The advisory board may issue to a person a temporary
724	548		general certificate, [or] a temporary limited certificate, or a
725	549		temporary radiologist assistant certificate that authorizes the
726	550		person to perform radiologic procedures for a period not to exceed
727	551		one year.
728		-	SECTION 27. Subchapter C, Chapter 601, Occupations Code, is
	552	+	SECTION 23. Subchapter C, Chapter 601, Occupations Code, is
729	553		amended by adding Section 601.1021 to read as follows:
730	554		Sec. 601.1021. RADIOLOGIST ASSISTANT CERTIFICATE. (a) The
731	555		advisory board by rule shall establish the education and training
732	556		required for a person to obtain a radiologist assistant
733	557		certificate.
734	558		(b) A radiologist assistant certificate holder:
735	559		(1) may perform radiologic procedures only under the
736	560		supervision of a radiologist; and
737	561		(2) may not interpret images, make diagnoses, or
738	562		prescribe any medication or therapy.
739		-	SECTION 28. Section 604.030, Occupations Code, is amended
	563	+	SECTION 24. Section 604.030, Occupations Code, is amended
740	564		by amending Subsection (b) and adding Subsection (d) to read as
741	565		follows:
742	566		(b) The training program must provide the person with
743	567		information regarding:
744	568		(1) the law governing advisory board operations;
745	569		(2) the [this chapter and the advisory board's]
746	570		programs, functions, rules, and budget of the advisory board;
747	571		(3) the scope of and limitations on the rulemaking
748	572		authority of the advisory board;
749	573		(4) the types of advisory board rules,
750	574		interpretations, and enforcement actions that may implicate
751	575		federal antitrust law by limiting competition or impacting prices
752	576		charged by persons engaged in a profession or business the advisory
753	577		board regulates, including any rule, interpretation, or
754	578		enforcement action that:
755	579		(A) regulates the scope of practice of persons in
756	580		a profession or business the advisory board regulates;
757	581		(B) restricts advertising by persons in a
758	582		profession or business the advisory board regulates;
759	583		(C) affects the price of goods or services
760	584		provided by persons in a profession or business the advisory board
761	585		regulates; or
762	586		(D) restricts participation in a profession or
763	587		business the advisory board regulates;
764	588		(5) [(2)] the results of the most recent formal audit
765	589		of the advisory board;
766	590		(6) [(3)] the requirements of:
767	591		(A) laws relating to open meetings, public
768	592		information, administrative procedure, and disclosure of conflicts
769	593		of interest; and
770	594		(B) other laws applicable to members of the
771	595		advisory board in performing their duties; and
772	596		(7) [(4)] any applicable ethics policies adopted by
773	597		the advisory board or the Texas Ethics Commission.
774	598		(d) The executive director of the medical board shall create
775	599		a training manual that includes the information required by
776	600		Subsection (b). The executive director shall distribute a copy of
777	601		the training manual annually to each advisory board member. Each
778	602		board member shall sign and submit to the executive director a
779	603		statement acknowledging that the member received and has reviewed
780	604		the training manual.
781		-	SECTION 29. Sections 155.056(c) and (d), Occupations Code,
	605	+	SECTION 25. Sections 155.056(c) and (d), Occupations Code,
782	606		are repealed.
783		-	SECTION 30. (a) Except as provided by Subsection (b) of
	607	+	SECTION 26. (a) Except as provided by Subsection (b) of
784	608		this section, Sections 152.010, 205.057, 601.030, and 604.030,
785	609		Occupations Code, as amended by this Act, apply to a member of the
786	610		applicable board appointed before, on, or after the effective date
787	611		of this Act.
788	612		(b) A member of a board who, before the effective date of
789	613		this Act, completed the training program required by Section
790	614		152.010, 205.057, 601.030, or 604.030, Occupations Code, as the
791	615		applicable law existed before the effective date of this Act, is
792	616		only required to complete additional training on subjects added by
793	617		this Act to the training program required by, as applicable,
794	618		Section 152.010, 205.057, 601.030, or 604.030, Occupations Code, as
795	619		amended by this Act. A board member described by this subsection
796	620		may not vote, deliberate, or be counted as a member in attendance at
797	621		a meeting of the applicable board held on or after December 1, 2019,
798	622		until the member completes the additional training.
799		-	SECTION 31. Not later than March 1, 2020, the Texas Medical
	623	+	SECTION 27. Not later than March 1, 2020, the Texas Medical
800	624		Board shall adopt rules necessary to implement Section 164.003(b),
801	625		Occupations Code, as amended by this Act.
802		-	SECTION 32. Not later than January 1, 2020, the Texas
	626	+	SECTION 28. Not later than January 1, 2020, the Texas
803	627		Medical Board and the governing board of the Texas Physician Health
804	628		Program by rule shall adopt the memorandum of understanding
805	629		required by Section 167.012, Occupations Code, as added by this
806	630		Act.
807		-	SECTION 33. Not later than September 1, 2021, the Texas
	631	+	SECTION 29. Not later than September 1, 2021, the Texas
808	632		State Board of Acupuncture Examiners and the Texas Medical Board
809	633		shall obtain criminal history record information on each person
810	634		who, on the effective date of this Act, holds a license issued under
811	635		Chapter 205 or 206, Occupations Code, as applicable, and did not
812	636		undergo a criminal history record information check based on the
813	637		license holder's fingerprints on the initial application for the
814	638		license. A board may suspend the license of a license holder who
815	639		does not provide the criminal history record information as
816	640		required by the board and this section.
817		-	SECTION 34. Not later than January 1, 2020, the Texas
	641	+	SECTION 30. Not later than January 1, 2020, the Texas
818	642		Medical Board shall approve the rules required by Section 601.1021,
819	643		Occupations Code, as added by this Act.
820		-	SECTION 35. This Act takes effect September 1, 2019.
821		-	______________________________ ______________________________
822		-	President of the Senate Speaker of the House
823		-	I certify that H.B. No. 1504 was passed by the House on April
824		-	17, 2019, by the following vote: Yeas 127, Nays 7, 2 present, not
825		-	voting; that the House refused to concur in Senate amendments to
826		-	H.B. No. 1504 on May 20, 2019, and requested the appointment of a
827		-	conference committee to consider the differences between the two
828		-	houses; and that the House adopted the conference committee report
829		-	on H.B. No. 1504 on May 25, 2019, by the following vote: Yeas 137,
830		-	Nays 0, 1 present, not voting.
831		-	______________________________
832		-	Chief Clerk of the House
833		-	I certify that H.B. No. 1504 was passed by the Senate, with
834		-	amendments, on May 14, 2019, by the following vote: Yeas 31, Nays
835		-	0; at the request of the House, the Senate appointed a conference
836		-	committee to consider the differences between the two houses; and
837		-	that the Senate adopted the conference committee report on H.B. No.
838		-	1504 on May 25, 2019, by the following vote: Yeas 30, Nays 0.
839		-	______________________________
840		-	Secretary of the Senate
841		-	APPROVED: __________________
842		-	Date
843		-	__________________
844		-	Governor
	644	+	SECTION 31. This Act takes effect September 1, 2019.
	645	+	* * * * *