LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION April 6, 2025 TO: Honorable Gary VanDeaver, Chair, House Committee on Public Health FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB2038 by Oliverson (Relating to the issuance by the Texas Medical Board of certain licenses to practice medicine and the authority of an insured to select certain license holders under the insured's health policy; requiring an occupational license; authorizing fees.), As Introduced Estimated Two-year Net Impact to General Revenue Related Funds for HB2038, As Introduced: a positive impact of $39,170 through the biennium ending August 31, 2027. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill. General Revenue-Related Funds, Five- Year Impact: Fiscal Year Probable Net Positive/(Negative) Impact toGeneral Revenue Related Funds2026$19,5852027$19,5852028$19,5852029$19,5852030$19,585All Funds, Five-Year Impact: Fiscal Year Probable Savings/(Cost) fromGeneral Revenue Fund1 Probable Revenue Gain/(Loss) fromGeneral Revenue Fund1 Change in Number of State Employees from FY 20252026($173,690)$193,2752.02027($173,690)$193,2752.02028($173,690)$193,2752.02029($173,690)$193,2752.02030($173,690)$193,2752.0 Fiscal AnalysisThe bill would amend the Texas Occupations Code to require the Texas Medical Board (TMB) to issue provisional licenses to practice medicine to certain foreign applicants who have been granted a medical degree, or a similar degree, and have been licensed in good standing in another country for five years preceding the application. TMB would be required to issue a standard license to a provisional license holder if they have practiced for at least three years and are not under investigation for misconduct. The provisional licenses would expire upon issuance of a standard license or three years after the issuance of the provisional license. The bill would require TMB to licenses certain military veterans who are licensed in good standing in another state, retired from the military no more than three years before applying for a license, and have passed the Texas medical jurisprudence examination.The bill would require TMB to issue limited licenses to practice medicine to medical school graduates who have no matched into a residency program and authorizes a fee. these graduates would be able to practice a limited scope of medicine under a supervising practice agreement with a sponsoring physician.The bill would take effect September 1, 2025.
LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION
April 6, 2025
TO: Honorable Gary VanDeaver, Chair, House Committee on Public Health FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB2038 by Oliverson (Relating to the issuance by the Texas Medical Board of certain licenses to practice medicine and the authority of an insured to select certain license holders under the insured's health policy; requiring an occupational license; authorizing fees.), As Introduced
TO: Honorable Gary VanDeaver, Chair, House Committee on Public Health
FROM: Jerry McGinty, Director, Legislative Budget Board
IN RE: HB2038 by Oliverson (Relating to the issuance by the Texas Medical Board of certain licenses to practice medicine and the authority of an insured to select certain license holders under the insured's health policy; requiring an occupational license; authorizing fees.), As Introduced
Honorable Gary VanDeaver, Chair, House Committee on Public Health
Honorable Gary VanDeaver, Chair, House Committee on Public Health
Jerry McGinty, Director, Legislative Budget Board
Jerry McGinty, Director, Legislative Budget Board
HB2038 by Oliverson (Relating to the issuance by the Texas Medical Board of certain licenses to practice medicine and the authority of an insured to select certain license holders under the insured's health policy; requiring an occupational license; authorizing fees.), As Introduced
HB2038 by Oliverson (Relating to the issuance by the Texas Medical Board of certain licenses to practice medicine and the authority of an insured to select certain license holders under the insured's health policy; requiring an occupational license; authorizing fees.), As Introduced
Estimated Two-year Net Impact to General Revenue Related Funds for HB2038, As Introduced: a positive impact of $39,170 through the biennium ending August 31, 2027. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.
Estimated Two-year Net Impact to General Revenue Related Funds for HB2038, As Introduced: a positive impact of $39,170 through the biennium ending August 31, 2027. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.
The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.
General Revenue-Related Funds, Five- Year Impact:
2026 $19,585
2027 $19,585
2028 $19,585
2029 $19,585
2030 $19,585
All Funds, Five-Year Impact:
2026 ($173,690) $193,275 2.0
2027 ($173,690) $193,275 2.0
2028 ($173,690) $193,275 2.0
2029 ($173,690) $193,275 2.0
2030 ($173,690) $193,275 2.0
Fiscal Analysis
The bill would amend the Texas Occupations Code to require the Texas Medical Board (TMB) to issue provisional licenses to practice medicine to certain foreign applicants who have been granted a medical degree, or a similar degree, and have been licensed in good standing in another country for five years preceding the application. TMB would be required to issue a standard license to a provisional license holder if they have practiced for at least three years and are not under investigation for misconduct. The provisional licenses would expire upon issuance of a standard license or three years after the issuance of the provisional license. The bill would require TMB to licenses certain military veterans who are licensed in good standing in another state, retired from the military no more than three years before applying for a license, and have passed the Texas medical jurisprudence examination.The bill would require TMB to issue limited licenses to practice medicine to medical school graduates who have no matched into a residency program and authorizes a fee. these graduates would be able to practice a limited scope of medicine under a supervising practice agreement with a sponsoring physician.The bill would take effect September 1, 2025.
The bill would require TMB to licenses certain military veterans who are licensed in good standing in another state, retired from the military no more than three years before applying for a license, and have passed the Texas medical jurisprudence examination.
The bill would require TMB to issue limited licenses to practice medicine to medical school graduates who have no matched into a residency program and authorizes a fee. these graduates would be able to practice a limited scope of medicine under a supervising practice agreement with a sponsoring physician.
The bill would take effect September 1, 2025.
Methodology
Based upon analysis provided by the Texas Medical Board (TMB), this estimate assumes that the agency will require 2.0 additional License and Permit Specialist positions ($57,851 each year with $17,309 in estimated benefits) to address the increased amount of licensure applications while maintaining current licensing processing times. This estimate assumes an additional annual cost of $23,370 for equipment and operating expenses related to the additional staffing position. Based upon analysis provided by TMB and the Comptroller of Public Accounts, this estimate assumes that 200 individuals would apply each year for the foreign applicant provisional license and will pay a one-time application fee of $552 per applicant, resulting in $110,400 in annual revenue to the credit of the General Revenue Fund. Additionally, this estimate assumes that 170 individuals would apply each year for the graduate limited license and would pay a $220 application fee and a $267.50 registration fee for a license term of two years, resulting in annual revenue of $82,875 to the credit of the General Revenue Fund. This estimate assumes there will be no renewal applications and that all graduate limited licensees will enter into a residency program before they would need to renew their limited license.
Based upon analysis provided by TMB and the Comptroller of Public Accounts, this estimate assumes that 200 individuals would apply each year for the foreign applicant provisional license and will pay a one-time application fee of $552 per applicant, resulting in $110,400 in annual revenue to the credit of the General Revenue Fund. Additionally, this estimate assumes that 170 individuals would apply each year for the graduate limited license and would pay a $220 application fee and a $267.50 registration fee for a license term of two years, resulting in annual revenue of $82,875 to the credit of the General Revenue Fund. This estimate assumes there will be no renewal applications and that all graduate limited licensees will enter into a residency program before they would need to renew their limited license.
Local Government Impact
No significant fiscal implication to units of local government is anticipated.
Source Agencies: b > td > 304 Comptroller of Public Accounts, 503 Texas Medical Board
304 Comptroller of Public Accounts, 503 Texas Medical Board
LBB Staff: b > td > JMc, NPe, GDZ, BFa
JMc, NPe, GDZ, BFa