88R2262 JCG-F
By: Allison H.B. No. 2324
A BILL TO BE ENTITLED
AN ACT
relating to the regulation of certain health professionals and
health facilities; providing civil and administrative penalties;
creating a criminal offense.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 241.009, Health and Safety Code, is
amended by amending Subsections (b) and (c) and adding Subsection
(d) to read as follows:
(b) A hospital licensed under this chapter shall adopt a
policy requiring a health care provider providing direct patient
care at the hospital to wear a photo identification badge during all
patient encounters, unless precluded by adopted isolation or
sterilization protocols. The badge must be of sufficient size and
worn in a manner to be visible and must clearly state:
(1) at minimum the provider's first or last name;
(2) the department of the hospital with which the
provider is associated;
(3) only the type of license held by the provider as
prescribed by Subsection (c), if the provider holds a license under
Title 3, Occupations Code; and
(4) if applicable, the provider's status as a student,
intern, trainee, or resident.
(c) For purposes of Subsection (b)(3), the identification
badge of a health care provider licensed under Title 3, Occupations
Code, must clearly state only the following designations for which
the health care provider holds a license:
(1) "physician," if the provider holds a license under
Subtitle B of that title;
(2) "chiropractor," "podiatrist," "midwife,"
"physician assistant," "acupuncturist," or "surgical assistant,"
as applicable, if the provider holds a license under Subtitle C of
that title;
(3) "dentist" or "dental hygienist," as applicable, if
the provider holds a license under Subtitle D of that title;
(4) "licensed vocational nurse," "registered nurse,"
"advanced practice registered nurse [practitioner]," "nurse
midwife," "certified registered nurse anesthetist," or "clinical
nurse specialist," as applicable, if the provider holds a license
under Subtitle E of that title;
(5) "optometrist," or "therapeutic optometrist," as
applicable, if the provider holds a license under Subtitle F of that
title;
(6) "speech-language pathologist," [pathologist" or]
"audiologist," "hearing instrument fitter and dispenser,"
"licensed dyslexia practitioner," or "licensed dyslexia
therapist," as applicable, if the provider holds a license under
Subtitle G of that title;
(7) "athletic trainer," "physical therapist,"
"occupational therapist," or "massage therapist," as applicable,
if the provider holds a license under Subtitle H of that title;
(8) "medical radiologic technologist," "medical
physicist," "perfusionist," "respiratory care practitioner,"
"orthotist," or "prosthetist," as applicable, if the provider holds
a license or certificate, as appropriate, under Subtitle K of that
title; and
(9) "dietitian," if the provider holds a license under
Subtitle M of that title.
(d) For purposes of Subsection (b)(4), a person may not use
the title "resident" unless the person is a graduate of a medical
school and receiving graduate medical training.
SECTION 2. Section 241.0585, Health and Safety Code, is
amended to read as follows:
Sec. 241.0585. RECOVERY OF COSTS. If the attorney general
brings an action to collect a civil penalty authorized under or to
enforce an administrative penalty assessed under this subchapter
[Section 241.058] and the court orders the payment of the penalty,
the attorney general may recover reasonable expenses incurred in
the investigation, initiation, or prosecution of the enforcement
suit, including investigative costs, court costs, reasonable
attorney fees, witness fees, and deposition expenses.
SECTION 3. Section 241.059(b), Health and Safety Code, is
amended to read as follows:
(b) In determining the amount of the penalty, the department
shall consider:
(1) the hospital's previous violations;
(2) the seriousness of the violation;
(3) any threat to the health, safety, or rights of the
hospital's patients;
(4) the demonstrated good faith of the hospital;
(5) the amount necessary to deter a future violation;
(6) the efforts to correct the violation; and
(7) [(5)] such other matters as justice may require.
SECTION 4. Subchapter D, Chapter 254, Health and Safety
Code, is amended by adding Section 254.161 to read as follows:
Sec. 254.161. PHOTO IDENTIFICATION BADGE REQUIRED. A
facility shall adopt a policy requiring a health care provider, as
defined by Section 241.009(a), providing direct patient care at the
facility to wear a photo identification badge in the manner and
containing the information required by Section 241.009.
SECTION 5. Section 254.206(d), Health and Safety Code, is
amended to read as follows:
(d) If the person does not pay the penalty and the
enforcement of the penalty is not stayed, the penalty may be
collected. The attorney general may sue to collect the penalty.
The attorney general may recover reasonable expenses incurred in
the investigation, initiation, or prosecution of the enforcement
suit, including investigative costs, court costs, reasonable
attorney's fees, witness fees, and deposition expenses.
SECTION 6. Subchapter E, Chapter 254, Health and Safety
Code, is amended by adding Section 254.208 to read as follows:
Sec. 254.208. CIVIL PENALTY: PHOTO IDENTIFICATION
REQUIREMENT. (a) A facility that violates Section 254.161 is
liable to the state for a civil penalty not to exceed $1,000 for
each day the violation continues.
(b) The attorney general, a district or county attorney, or
a municipal attorney may sue to collect the penalty and may recover
reasonable expenses incurred in obtaining relief under this
section, including court costs, reasonable attorney's fees,
investigation costs, witness fees, and deposition expenses.
SECTION 7. The heading to Subchapter E, Chapter 101,
Occupations Code, is amended to read as follows:
SUBCHAPTER E. CERTAIN PRACTICES RELATED TO ADVERTISING AND BILLING
PROHIBITED [GROUNDS FOR LICENSE REVOCATION OR DENIAL]
SECTION 8. Section 101.201, Occupations Code, is amended by
amending Subsection (b) and adding Subsections (c) and (d) to read
as follows:
(b) False, misleading, or deceptive advertising or
advertising not readily subject to verification includes
advertising that:
(1) makes a material misrepresentation of fact or
omits a fact necessary to make the statement as a whole not
materially misleading;
(2) makes a representation likely to create an
unjustified expectation about the results of a health care service
or procedure;
(3) compares a health care professional's services
with another health care professional's services unless the
comparison can be factually substantiated;
(4) contains a testimonial;
(5) causes confusion or misunderstanding as to the
credentials, education, or licensing of a health care professional,
including using a title, term, or other words that misstate,
falsely describe, falsely hold out, or falsely detail the health
care professional's:
(A) professional skills;
(B) training;
(C) expertise;
(D) educational degree;
(E) specialty certification; or
(F) licensure;
(6) represents that health care insurance deductibles
or copayments may be waived or are not applicable to health care
services to be provided if the deductibles or copayments are
required;
(7) represents that the benefits of a health benefit
plan will be accepted as full payment when deductibles or
copayments are required;
(8) makes a representation that is designed to take
advantage of the fears or emotions of a particularly susceptible
type of patient; or
(9) represents in the use of a professional name a
title or professional identification that is associated with
another profession and the health care professional is not licensed
or otherwise authorized to practice that profession [expressly or
commonly reserved to or used by another profession or
professional].
(c) For purposes of this section, advertising that does not
include the name of the health care professional and the
professional identification required by Section 104.003 is
considered false, misleading, deceptive, or not readily subject to
verification.
(d) In this section, "advertising" includes:
(1) any printed, electronic, or oral statement, with
respect to the provision of health care services by a health care
professional:
(A) that is communicated or disseminated to the
public;
(B) that:
(i) is intended to encourage a person to use
the professional's services; or
(ii) for a commercial purpose, names the
professional in connection with the practice, profession, or
institution in which the professional provides health care
services; and
(C) the preparation, communication, or
dissemination of which is controlled by the professional or a group
to which the professional is affiliated; and
(2) any communication or statement not described by
Subdivision (1) but that is used in the regular course of the
professional's business for the purpose of promoting the
professional's services to the public, including:
(A) business cards;
(B) letterhead;
(C) signs;
(D) pamphlets;
(E) brochures;
(F) e-mails and any other communication or
statement transmitted through the internet; or
(G) audio or video communications, including
television or radio advertisements.
SECTION 9. Section 104.003, Occupations Code, is amended by
amending Subsections (b) and (c) and adding Subsection (h) to read
as follows:
(b) A person who is licensed by the Texas Medical [State]
Board [of Medical Examiners] and holds a doctor of medicine degree
shall use:
(1) physician or surgeon, M.D.;
(2) doctor, M.D.; [or]
(3) doctor of medicine, M.D.; or
(4) a designation indicating that the person is
certified or eligible for certification, as applicable, by a
certifying board of the American Board of Medical Specialties or a
successor organization.
(c) A person who is licensed by the Texas Medical [State]
Board [of Medical Examiners] and holds a doctor of osteopathy
degree shall use:
(1) physician or surgeon, D.O.;
(2) osteopathic physician or surgeon;
(3) doctor, D.O.;
(4) doctor of osteopathy;
(5) doctor of osteopathic medicine;
(6) osteopath; [or]
(7) D.O.; or
(8) a designation indicating that the person is
certified or eligible for certification, as applicable, by a
certifying board of the American Osteopathic Association or a
successor organization.
(h) Unless another provision of this title specifies
another designation, the person shall use only the following
designations for each healing art the person is licensed to
practice:
(1) "midwife," "physician assistant,"
"acupuncturist," or "surgical assistant," as applicable, if the
person holds a license under Subtitle C;
(2) "dental hygienist," if the person holds a license
to practice dental hygiene issued under Chapter 256;
(3) "licensed vocational nurse," "registered nurse,"
"advanced practice registered nurse," "nurse midwife," "certified
registered nurse anesthetist," or "clinical nurse specialist," as
applicable, if the person holds a license under Subtitle E;
(4) "speech-language pathologist," "audiologist,"
"hearing instrument fitter and dispenser," "licensed dyslexia
practitioner," or "licensed dyslexia therapist," as applicable, if
the person holds a license under Subtitle G;
(5) "athletic trainer," "physical therapist,"
"occupational therapist," or "massage therapist," as applicable,
if the person holds a license under Subtitle H;
(6) "psychologist," "psychological associate,"
"marriage and family therapist," "marriage and family therapist
associate," "professional counselor," "counselor," "chemical
dependency counselor," "social worker," "behavioral analyst," or
"assistant behavioral analyst," as applicable, if the person holds
a license under Subtitle I;
(7) "medical radiologic technologist," "medical
physicist," "perfusionist," "respiratory care practitioner,"
"orthotist," or "prosthetist," as applicable, if the person holds a
license or certificate, as appropriate, under Subtitle K; and
(8) "dietitian," if the person holds a license under
Chapter 701.
SECTION 10. Chapter 104, Occupations Code, is amended by
adding Section 104.0035 to read as follows:
Sec. 104.0035. FALSE AND DECEPTIVE ADVERTISING. A healing
art practitioner may not use advertising that is false, misleading,
or deceptive, or not readily subject to verification as provided by
Section 101.201.
SECTION 11. Section 104.005(a), Occupations Code, is
amended to read as follows:
(a) On the request of a healing art licensing board that
issues a license, certificate, or other authorization described by
[listed in] Section 104.003, the district or county attorney shall
file and prosecute appropriate judicial proceedings in the name of
the state against a person who violates Section 104.003.
SECTION 12. The heading to Section 104.007, Occupations
Code, is amended to read as follows:
Sec. 104.007. CRIMINAL PENALTIES.
SECTION 13. Chapter 104, Occupations Code, is amended by
adding Section 104.008 to read as follows:
Sec. 104.008. ADMINISTRATIVE PENALTY. (a) A healing art
licensing board that issues a license, certificate, or other
authorization described by Section 104.003, may impose an
administrative penalty on a person who:
(1) holds a license, certificate, or other
authorization issued by the healing art licensing board; and
(2) violates this chapter.
(b) The amount of an administrative penalty may not exceed
$1,000 for each violation. Each day a violation continues or occurs
is a separate violation for purposes of imposing a penalty.
(c) A proceeding to impose an administrative penalty under
this section is subject to Chapter 2001, Government Code.
SECTION 14. Section 165.156, Occupations Code, is amended
to read as follows:
Sec. 165.156. MISREPRESENTATION REGARDING ENTITLEMENT TO
PRACTICE MEDICINE. A person, partnership, trust, association, or
corporation commits an offense if the person, partnership, trust,
association, or corporation, through the use of any title,
abbreviation, description of services, designation, letters,
words, or terms, alone or in combination with any other title,
affixed on stationery or on advertisements, or in any other manner,
including oral or written communications, indicates or induces
another to believe that the person, partnership, trust,
association, or corporation is entitled to practice medicine if the
person, partnership, trust, association, or corporation is not
licensed to do so.
SECTION 15. Subchapter D, Chapter 165, Occupations Code, is
amended by adding Section 165.1565 to read as follows:
Sec. 165.1565. USE OF TITLE. (a) In this section, "medical
or medical specialty title" means:
(1) "doctor of medicine" or "M.D.";
(2) "doctor of osteopathy" or "D.O.";
(3) "physician";
(4) "surgeon";
(5) "osteopathic physician";
(6) "osteopathic surgeon";
(7) "doctor";
(8) "anesthesiologist";
(9) "cardiologist";
(10) "dermatologist";
(11) "endocrinologist";
(12) "gastroenterologist";
(13) "general practitioner";
(14) "gynecologist";
(15) "hematologist";
(16) "intensivist";
(17) "internist";
(18) "laryngologist";
(19) "nephrologist";
(20) "neurologist";
(21) "obstetrician";
(22) "oncologist";
(23) "ophthalmologist";
(24) "orthopedic surgeon";
(25) "orthopedist";
(26) "osteopath";
(27) "otologist";
(28) "otolaryngologist";
(29) "otorhinolaryngologist";
(30) "pathologist";
(31) "pediatrician";
(32) "primary care physician";
(33) "proctologist";
(34) "psychiatrist";
(35) "radiologist";
(36) "resident";
(37) "rheumatologist";
(38) "rhinologist"; or
(39) "urologist".
(b) Except as provided by Section 104.004, a person who is
not licensed to practice medicine by the board may not:
(1) use or publicly display a medical or medical
specialty title in connection with the person's name either alone
or in combination with another word or title; or
(2) indicate or induce another to believe that the
person is an attending doctor or attending physician.
SECTION 16. Section 204.203, Occupations Code, is amended
to read as follows:
Sec. 204.203. IDENTIFICATION REQUIREMENTS. A physician
assistant shall:
(1) keep the physician assistant's license available
for inspection at the physician assistant's primary place of
business; and
(2) when engaged in the physician assistant's
professional activities, wear a name tag identifying the license
holder as a physician assistant by title or the initials "P.A.".
SECTION 17. Subchapter E, Chapter 204, Occupations Code, is
amended by adding Section 204.2035 to read as follows:
Sec. 204.2035. FALSE AND DECEPTIVE ADVERTISING. A
physician assistant may not use advertising that is false,
misleading, deceptive, or not readily subject to verification as
provided by Section 101.201.
SECTION 18. Sections 301.351(a), (b), and (c), Occupations
Code, are amended to read as follows:
(a) A person who holds a license [as a registered nurse]
under this chapter[:
[(1)] is referred to as:
(1) a registered nurse or [; and
[(2) may use the abbreviation] "R.N.";
(2) a licensed vocational nurse or "L.V.N.";
(3) an advanced practice registered nurse or
"A.P.R.N.";
(4) a nurse practitioner or "N.P.";
(5) a nurse midwife;
(6) a certified registered nurse anesthetist or
"C.R.N.A."; or
(7) a clinical nurse specialist or "C.N.S.".
(b) A person who holds a license [as a vocational nurse]
under this chapter may not use the title "doctor" unless the person
also holds a license issued by the Texas Medical Board under
Subtitle B, as provided by Section 165.1565. [:
[(1) is referred to as a licensed vocational nurse or
vocational nurse; and
[(2) may use the abbreviation "L.V.N." or "V.N."]
(c) While interacting with the public in a nursing role,
each nurse shall wear a clearly legible insignia identifying the
nurse in accordance with Subsection (a) [as a registered or
vocational nurse]. The insignia may not contain information other
than:
(1) the appropriate [registered or vocational nurse]
designation;
(2) the nurse's name, certifications, academic
degrees, or practice position;
(3) the name of the employing facility or agency, or
other employer;
(4) a picture of the nurse; or
(5) any other information authorized by the board.
SECTION 19. Subchapter H, Chapter 301, Occupations Code, is
amended by adding Section 301.3515 to read as follows:
Sec. 301.3515. FALSE AND DECEPTIVE ADVERTISING. A nurse
may not use advertising that is false, misleading, deceptive, or
not readily subject to verification as provided by Section 101.201.
SECTION 20. Subchapter L, Chapter 301, Occupations Code, is
amended by adding Section 301.5545 to read as follows:
Sec. 301.5545. CRIMINAL PENALTY: CERTAIN TITLES FOR NURSING
EDUCATION PROGRAMS PROHIBITED. (a) A person who provides a nursing
education program approved under Section 301.157 or Section 301.303
commits an offense if the person uses the term "residency" or
"fellowship" in the name of that program.
(b) An offense under this section is a Class A misdemeanor.
SECTION 21. The changes in law made by this Act apply only
to conduct that occurs on or after the effective date of this Act.
Conduct that occurs before that date is governed by the law in
effect on the date the conduct occurred, and the former law is
continued in effect for that purpose.
SECTION 22. This Act takes effect September 1, 2023.