BILL ANALYSIS Senate Research Center S.B. 2695 89R16079 BEE-F By: Kolkhorst Health & Human Services 4/16/2025 As Filed AUTHOR'S / SPONSOR'S STATEMENT OF INTENT The Texas Cure Act offers solutions to increase and improve healthcare access for rural areas, creating a first-in-the-nation program and new incentives for both doctors and advanced-practice nurses (APRNs). The act encourages medical providers to work together in our underserved areas, so that more doctors and APRNs will be willing to train, practice, and serve in rural settings. This is achieved by vastly reducing the regulations currently placed on APRNs, such as fees and required reviews, as well as by setting up a new loan repayment program, and creating an accelerated pathway for APRNs to become doctors. Building on the success of the Joint Admission Medical Program (JAMP) enacted by the 77th Texas Legislature, the Rural Admission Medical Program (RAMP) is an educational program designed to recruit and train students from rural areas for medical school, increasing the likelihood that these individuals will choose to practice in rural Texas. While RAMP targets those entering undergrad, the nurse-to-physician pathway offers a new and innovative route for APRNs to become physicians. This pathway supports APRNs, who have a qualified tenure of rural clinical experience by providing them with a swift path to become a licensed physician, while also offering loan repayment for their required two years of medical school if they return to a rural area following licensure. APRNs in rural areas often have a unique understanding of local health needs, and by allowing them to cultivate their interest in medicine by transitioning into physicians, Texas creates a new and permanent pipeline to increase the number of providers with the training, collaboration, and experience to deliver healthcare to our underserved areas. S.B. 2695 encourages more healthcare providers to focus their talents on underserved areas of Texas by granting the Board of Nursing the authority to establish and limit the fees an APRN may be charged by a delegating physician. The bill also increases the number of APRNs allowed to be under a physician's delegation, and reduces the required physician reviews to a quarterly basis. The Texas Cure Act bill offers fresh ideas that will incentivize both APRNs and physicians to collaborate in new waysand ultimately deliver more care in our most underserved regions. As proposed, S.B. 2695 amends current law relating to education programs to enable certain students and advanced practice registered nurses to practice medicine in certain rural counties and physician delegation of certain medical acts to advanced practice registered nurses and physician assistants. RULEMAKING AUTHORITY Rulemaking authority is expressly granted to the Texas Higher Education Coordinating Board in SECTION 5.001 of this bill. Rulemaking authority is expressly granted to the Texas Medical Board in SECTION 4.001 (Section 157.008, Occupations Code) of this bill. SECTION BY SECTION ANALYSIS ARTICLE 1. SHORT TITLE SECTION 1.001. Authorizes this Act to be cited as the Texas Critically Underserved Relief and Enhancement Act (Texas Cure Act). ARTICLE 2. RURAL ADMISSION MEDICAL PROGRAM (RAMP) SECTION 2.001. Amends Chapter 51, Education Code, by adding Subchapter X, as follows: SUBCHAPTER X. RURAL ADMISSION MEDICAL PROGRAM Sec. 51.851. DEFINITIONS. Defines "council," "general academic teaching institution," "private or independent institution of higher education," "participating medical school," "participating student," and "program." Sec. 51.852. RURAL ADMISSION MEDICAL PROGRAM. Provides that the Rural Admission Medical Program (program) is a program administered by the Rural Admission Medical Program Council (council) to provide services to support and encourage highly qualified students from counties in this state with populations of less than 25,000 who are pursuing a medical education, award undergraduate and graduate scholarships and summer stipends to those students, and guarantee the admission of those students to at least one participating medical school, subject to the conditions under Section 51.827 and under other provisions of this subchapter. Sec. 51.853. COMPOSITION OF COUNCIL. (a) Requires the participating medical schools to jointly established the council consisting of one faculty member employed by and representing each of the participating medical schools. (b) Requires the council to select one of its members to serve as council chair for a term of two years. Sec. 51.854. COUNCIL DUTIES. (a) Requires the council to take certain actions. (b) Requires the council to match each participating student with appropriate internship programs offered by participating medical schools during the summers immediately following the student's sophomore and junior years. (c) Requires the council to match each participating student with any appropriate undergraduate mentoring program required of the student by the council. (d) Requires the council, during a participating student's senior year, to match the student with an appropriate participating medical school as necessary to fill the percentage of enrollment capacity set aside by each medical school under the program. Sec. 51.855. ELIGIBILITY FOR ADMISSION TO PROGRAM. (a) Requires an undergraduate student, to be eligible for admission to the program, to meet certain requirements. (b) Provides that, for purposes of Subsection (a)(2) (relating to requiring an undergraduate student to be a resident of this state for purposes of tuition), a student is not a Texas resident as described by that subdivision solely because the student is eligible to pay tuition at the resident tuition rate. Sec. 51.856. ELIGIBILITY TO CONTINUE PARTICIPATION IN PROGRAM. (a) Requires an undergraduate student who is admitted to the program, to be eligible to continue participation in the rural program, to meet certain requirements. (b) Authorizes the council, if an undergraduate student who is admitted to the program fails to meet the requirements of Subsection (a) without good cause as determined by the council, to terminate that student's participation in the program at the end of the semester during which the student failed to meet the requirements of that subsection. Provides that a student's participation in the program is automatically terminated if the student fails to meet the requirements of Subsection (a) for two consecutive semesters without good cause. Sec. 51.857. COUNCIL AGREEMENT WITH STUDENT ADMITTED TO PROGRAM. (a) Requires a student admitted to the program to enter into an agreement with the council under which the student agrees to take certain actions. (b) Requires the council, at the time the student enters into an agreement under this section, to provide the student with information regarding available program benefits, including undergraduate and graduate scholarships and summer stipends and repayment of scholarship and stipend benefits received under the program. Sec. 51.858. COUNCIL AGREEMENT WITH PARTICIPATING MEDICAL SCHOOL. (a) Requires each participating medical school to enter into an agreement with the council under which the medical school agrees to take certain actions. (b) Requires the Baylor College of Medicine to agree under Subsection (a) to set aside under Subsection (a)(3) (relating to requiring each participating medical school to agree to set aside for certain students at least 10 percent of the enrollment capacity) not less than 10 percent of its enrollment capacity set aside for students who are entitled to pay tuition at the rate provided by Chapter 54 (Tuition and Fees) for resident students. Sec. 51.859. COUNCIL AGREEMENT WITH GENERAL ACADEMIC TEACHING INSTITUTION. Requires each general academic teaching institution to enter into an agreement with the council under which the institution agrees to take certain actions. Sec. 51.860. COUNCIL AGREEMENT WITH PRIVATE OR INDEPENDENT INSTITUTION OF HIGHER EDUCATION. Requires each private or independent institution of higher education to enter into an agreement with the council under which the institution agrees to take certain actions. Sec. 51.861. NONTRADITIONAL STUDENTS. (a) Requires a participating medical school, if for any reason the medical school does not fill the percentage of enrollment capacity set aside for participating students under the program, to fill the remaining openings with economically disadvantaged students who meet certain requirements. (b) Provides that a nontraditional student admitted to the program under this section is subject only to program benefits and requirements applicable to a participating student after enrollment in a participating medical school. Requires the nontraditional student to sign an agreement to that effect. Sec. 51.862. FUNDING. (a) Authorizes the council to accept a gift, grant, devise, or bequest of money, securities, service, or property to carry out any purpose of this subchapter, including funds raised or services provided by a volunteer or volunteer group to promote the work of the council. (b) Authorizes the legislature to appropriate money for the purposes of this subchapter. Sec. 51.863. REPORT. (a) Requires the council to deliver a report on the program to the governor, the lieutenant governor, and the speaker of the house of representatives not later than December 31 of each even-numbered year. (b) Requires that the report contain detailed information regarding certain subjects. ARTICLE 3. MEDICALLY EXTENDED GEOGRAPHIC ACCESS (MEGA) ADVANCED PRACTICE REGISTERED NURSES TO PHYSICIAN PATHWAY PROGRAM SECTION 3.001. Amends Chapter 301, Occupations Code, by adding Subchapter O, as follows: SUBCHAPTER O. MEGA ADVANCED PRACTICE REGISTERED NURSE TO PHYSICIAN PATHWAY PROGRAM Sec. 301.701. DEFINITIONS. Defines "coordinating board" and "program." Sec. 301.702. PROGRAM ESTABLISHMENT AND GENERAL ELIGIBILITY. Provides that the Medically Extended Geographic Access (MEGA) Advanced Practice Registered Nurse to Physician Pathway program (MEGA program) is established under this subchapter. Requires the Texas Higher Education Coordinating Board (THECB) to accept into the MEGA program certain individuals licensed in this state as advanced practice registered nurses. Sec. 301.703. INELIGIBILITY OF CERTAIN PROCEDURES AND TYPES OF PRACTICE. Prohibits an individual from participating in the MEGA program if the individual meets certain criteria. Sec. 301.704. ELIGIBILITY FOR MEDICAL SCHOOL ADMISSION AND ADVANCED COURSEWORK. (a) Provides that an individual who participates in the program is eligible to apply for admission to a medical school in this state as a third-year medical student if the individual satisfies the requirements described by Section 301.702 and successfully completes step one of the United States Medical Licensing Examination. (b) Provides that this subchapter does not require a medical school in this state to accept an applicant who participates in the program. Requires a medical school applicant who participates in the program to complete the medical school's application and selection process in addition to satisfying the criteria described by Subsection (a). Sec. 301.705. ELIGIBILITY FOR MEDICAL LICENSING EXAMINATION. Provides that an individual who participates in the program is eligible to take step one of the United States Medical Licensing Examination if the individual has practiced as an advanced practice registered nurse for at least seven years in primary care under physician delegation and supervision in a county with a population of less than 25,000 and meets all other requirements established by THECB rule for continued participation in the program. Sec. 301.706. ELIGIBILITY FOR MEDICAL SCHOOL LOAN REPAYMENT. (a) Provides that an individual who participates in the program is eligible for loan repayment to cover the full cost of the final two years of medical school if the individual meets certain requirements. (b) Authorizes THECB, in administering loan repayment under Subsection (a), to disburse payments monthly or according to any other schedule to allow physicians to participate in existing federal student loan repayment plans. ARTICLE 4. PROVISIONS APPLICABLE TO CERTAIN DELEGATION AGREEMENTS SECTION 4.001. Amends Subchapter A, Chapter 157, Occupations Code, by adding Section 157.008, as follows: Sec. 157.008. FEE FOR DELEGATION AGREEMENT. (a) Prohibits a physician from charging more than a reasonable fee to an advanced practice registered nurse or physician assistant to enter into a delegation agreement, including a prescriptive authority agreement. (b) Requires the Texas Medical Board (TMB) by rule to adopt criteria for consideration in determining whether a fee is reasonable for purposes of Subsection (a), including the types of medical acts delegated and supervised under the agreement, the time required of the physician to provide adequate supervision of medical acts under the agreement, and the liability risks associated with the delegation and supervision of medical acts under the agreement. SECTION 4.002. Amends Section 157.0512, Occupations Code, by amending Subsections (c), (d), and (f) and adding Subsections (c-1) and (f-1), as follows: (c) Provides that, except as provided by Subsection (c-1) and subject to Subsection (d), the combined number of advanced practice registered nurses and physician assistants with whom a physician is authorized to enter into a prescriptive authority agreement is prohibited from exceeding seven advanced practice registered nurses and physician assistants or the full-time equivalent of seven advanced practice registered nurses and physician assistants. (c-1) Provides that, notwithstanding Subsection (c) and subject to Subsection (d), if a physician delegates and supervises the exercise of prescriptive authority exclusively in a county with a population of less than 25,000, the combined number of advanced practice registered nurses and physician assistants with whom the physician is authorized to enter into a prescriptive authority agreement is prohibited from exceeding a total of nine advanced practice registered nurses and physician assistants or the full-time equivalent of a total of nine advanced practice registered nurses and physician assistants. (d) Provides that Subsections (c) and (c-1) do not apply to a prescriptive authority agreement if the prescriptive authority is being exercised in certain practices. Makes nonsubstantive changes. (f) Creates an exception under Subsection (f-1). (f-1) Requires that the periodic meetings described by Subsection (e)(9)(B) (relating to requiring a prescriptive agreement to describe a prescriptive authority quality assurance and improvement plan that includes periodic meetings), notwithstanding Subsection (f)(3) (relating to requiring that the periodic meetings take place at least once a month), if a physician delegates and supervises the exercise of prescriptive authority exclusively in a county with a population of less than 25,000, take place at least quarterly in a manner determined by the physician. SECTION 4.003. Amends Subchapter B, Chapter 157, Occupations Code, by adding Section 157.061, as follows: Sec. 157.061. ADDITIONAL LOAN REPAYMENT ASSISTANCE FOR CERTAIN PHYSICIANS WHO DELEGATE AND SUPERVISE. (a) Authorizes a physician to apply to THECB for an additional $45,000 in medical school loan repayment assistance under Subchapter J (Repayment of Certain Physician Education Loans), Chapter 61 (Texas Higher Education Coordinating Board), Education Code, if the physician delegates and supervises the exercise of prescriptive authority exclusively in a county with a population of less than 25,000 under a prescriptive authority agreement that satisfies the requirements of this subchapter. (b) Authorizes THECB, in administering the loan repayment assistance under this section, to disburse payments monthly or according to any other schedule to allow physicians to participate in existing federal student loan repayment plans. ARTICLE 5. TRANSITION AND EFFECTIVE DATE SECTION 5.001 Requires THECB and TMB, not later than February 1, 2026, to adopt rules necessary to implement the changes in law made by this Act. SECTION 5.002. Effective date: September 1, 2025.
BILL ANALYSIS
Senate Research Center S.B. 2695
89R16079 BEE-F By: Kolkhorst
Health & Human Services
4/16/2025
As Filed
Senate Research Center
S.B. 2695
89R16079 BEE-F
By: Kolkhorst
Health & Human Services
4/16/2025
As Filed
AUTHOR'S / SPONSOR'S STATEMENT OF INTENT
The Texas Cure Act offers solutions to increase and improve healthcare access for rural areas, creating a first-in-the-nation program and new incentives for both doctors and advanced-practice nurses (APRNs). The act encourages medical providers to work together in our underserved areas, so that more doctors and APRNs will be willing to train, practice, and serve in rural settings. This is achieved by vastly reducing the regulations currently placed on APRNs, such as fees and required reviews, as well as by setting up a new loan repayment program, and creating an accelerated pathway for APRNs to become doctors.
Building on the success of the Joint Admission Medical Program (JAMP) enacted by the 77th Texas Legislature, the Rural Admission Medical Program (RAMP) is an educational program designed to recruit and train students from rural areas for medical school, increasing the likelihood that these individuals will choose to practice in rural Texas. While RAMP targets those entering undergrad, the nurse-to-physician pathway offers a new and innovative route for APRNs to become physicians. This pathway supports APRNs, who have a qualified tenure of rural clinical experience by providing them with a swift path to become a licensed physician, while also offering loan repayment for their required two years of medical school if they return to a rural area following licensure. APRNs in rural areas often have a unique understanding of local health needs, and by allowing them to cultivate their interest in medicine by transitioning into physicians, Texas creates a new and permanent pipeline to increase the number of providers with the training, collaboration, and experience to deliver healthcare to our underserved areas.
S.B. 2695 encourages more healthcare providers to focus their talents on underserved areas of Texas by granting the Board of Nursing the authority to establish and limit the fees an APRN may be charged by a delegating physician. The bill also increases the number of APRNs allowed to be under a physician's delegation, and reduces the required physician reviews to a quarterly basis. The Texas Cure Act bill offers fresh ideas that will incentivize both APRNs and physicians to collaborate in new waysand ultimately deliver more care in our most underserved regions.
As proposed, S.B. 2695 amends current law relating to education programs to enable certain students and advanced practice registered nurses to practice medicine in certain rural counties and physician delegation of certain medical acts to advanced practice registered nurses and physician assistants.
RULEMAKING AUTHORITY
Rulemaking authority is expressly granted to the Texas Higher Education Coordinating Board in SECTION 5.001 of this bill.
Rulemaking authority is expressly granted to the Texas Medical Board in SECTION 4.001 (Section 157.008, Occupations Code) of this bill.
SECTION BY SECTION ANALYSIS
ARTICLE 1. SHORT TITLE
SECTION 1.001. Authorizes this Act to be cited as the Texas Critically Underserved Relief and Enhancement Act (Texas Cure Act).
ARTICLE 2. RURAL ADMISSION MEDICAL PROGRAM (RAMP)
SECTION 2.001. Amends Chapter 51, Education Code, by adding Subchapter X, as follows:
SUBCHAPTER X. RURAL ADMISSION MEDICAL PROGRAM
Sec. 51.851. DEFINITIONS. Defines "council," "general academic teaching institution," "private or independent institution of higher education," "participating medical school," "participating student," and "program."
Sec. 51.852. RURAL ADMISSION MEDICAL PROGRAM. Provides that the Rural Admission Medical Program (program) is a program administered by the Rural Admission Medical Program Council (council) to provide services to support and encourage highly qualified students from counties in this state with populations of less than 25,000 who are pursuing a medical education, award undergraduate and graduate scholarships and summer stipends to those students, and guarantee the admission of those students to at least one participating medical school, subject to the conditions under Section 51.827 and under other provisions of this subchapter.
Sec. 51.853. COMPOSITION OF COUNCIL. (a) Requires the participating medical schools to jointly established the council consisting of one faculty member employed by and representing each of the participating medical schools.
(b) Requires the council to select one of its members to serve as council chair for a term of two years.
Sec. 51.854. COUNCIL DUTIES. (a) Requires the council to take certain actions.
(b) Requires the council to match each participating student with appropriate internship programs offered by participating medical schools during the summers immediately following the student's sophomore and junior years.
(c) Requires the council to match each participating student with any appropriate undergraduate mentoring program required of the student by the council.
(d) Requires the council, during a participating student's senior year, to match the student with an appropriate participating medical school as necessary to fill the percentage of enrollment capacity set aside by each medical school under the program.
Sec. 51.855. ELIGIBILITY FOR ADMISSION TO PROGRAM. (a) Requires an undergraduate student, to be eligible for admission to the program, to meet certain requirements.
(b) Provides that, for purposes of Subsection (a)(2) (relating to requiring an undergraduate student to be a resident of this state for purposes of tuition), a student is not a Texas resident as described by that subdivision solely because the student is eligible to pay tuition at the resident tuition rate.
Sec. 51.856. ELIGIBILITY TO CONTINUE PARTICIPATION IN PROGRAM. (a) Requires an undergraduate student who is admitted to the program, to be eligible to continue participation in the rural program, to meet certain requirements.
(b) Authorizes the council, if an undergraduate student who is admitted to the program fails to meet the requirements of Subsection (a) without good cause as determined by the council, to terminate that student's participation in the program at the end of the semester during which the student failed to meet the requirements of that subsection. Provides that a student's participation in the program is automatically terminated if the student fails to meet the requirements of Subsection (a) for two consecutive semesters without good cause.
Sec. 51.857. COUNCIL AGREEMENT WITH STUDENT ADMITTED TO PROGRAM. (a) Requires a student admitted to the program to enter into an agreement with the council under which the student agrees to take certain actions.
(b) Requires the council, at the time the student enters into an agreement under this section, to provide the student with information regarding available program benefits, including undergraduate and graduate scholarships and summer stipends and repayment of scholarship and stipend benefits received under the program.
Sec. 51.858. COUNCIL AGREEMENT WITH PARTICIPATING MEDICAL SCHOOL. (a) Requires each participating medical school to enter into an agreement with the council under which the medical school agrees to take certain actions.
(b) Requires the Baylor College of Medicine to agree under Subsection (a) to set aside under Subsection (a)(3) (relating to requiring each participating medical school to agree to set aside for certain students at least 10 percent of the enrollment capacity) not less than 10 percent of its enrollment capacity set aside for students who are entitled to pay tuition at the rate provided by Chapter 54 (Tuition and Fees) for resident students.
Sec. 51.859. COUNCIL AGREEMENT WITH GENERAL ACADEMIC TEACHING INSTITUTION. Requires each general academic teaching institution to enter into an agreement with the council under which the institution agrees to take certain actions.
Sec. 51.860. COUNCIL AGREEMENT WITH PRIVATE OR INDEPENDENT INSTITUTION OF HIGHER EDUCATION. Requires each private or independent institution of higher education to enter into an agreement with the council under which the institution agrees to take certain actions.
Sec. 51.861. NONTRADITIONAL STUDENTS. (a) Requires a participating medical school, if for any reason the medical school does not fill the percentage of enrollment capacity set aside for participating students under the program, to fill the remaining openings with economically disadvantaged students who meet certain requirements.
(b) Provides that a nontraditional student admitted to the program under this section is subject only to program benefits and requirements applicable to a participating student after enrollment in a participating medical school. Requires the nontraditional student to sign an agreement to that effect.
Sec. 51.862. FUNDING. (a) Authorizes the council to accept a gift, grant, devise, or bequest of money, securities, service, or property to carry out any purpose of this subchapter, including funds raised or services provided by a volunteer or volunteer group to promote the work of the council.
(b) Authorizes the legislature to appropriate money for the purposes of this subchapter.
Sec. 51.863. REPORT. (a) Requires the council to deliver a report on the program to the governor, the lieutenant governor, and the speaker of the house of representatives not later than December 31 of each even-numbered year.
(b) Requires that the report contain detailed information regarding certain subjects.
ARTICLE 3. MEDICALLY EXTENDED GEOGRAPHIC ACCESS (MEGA) ADVANCED PRACTICE REGISTERED NURSES TO PHYSICIAN PATHWAY PROGRAM
SECTION 3.001. Amends Chapter 301, Occupations Code, by adding Subchapter O, as follows:
SUBCHAPTER O. MEGA ADVANCED PRACTICE REGISTERED NURSE TO PHYSICIAN PATHWAY PROGRAM
Sec. 301.701. DEFINITIONS. Defines "coordinating board" and "program."
Sec. 301.702. PROGRAM ESTABLISHMENT AND GENERAL ELIGIBILITY. Provides that the Medically Extended Geographic Access (MEGA) Advanced Practice Registered Nurse to Physician Pathway program (MEGA program) is established under this subchapter. Requires the Texas Higher Education Coordinating Board (THECB) to accept into the MEGA program certain individuals licensed in this state as advanced practice registered nurses.
Sec. 301.703. INELIGIBILITY OF CERTAIN PROCEDURES AND TYPES OF PRACTICE. Prohibits an individual from participating in the MEGA program if the individual meets certain criteria.
Sec. 301.704. ELIGIBILITY FOR MEDICAL SCHOOL ADMISSION AND ADVANCED COURSEWORK. (a) Provides that an individual who participates in the program is eligible to apply for admission to a medical school in this state as a third-year medical student if the individual satisfies the requirements described by Section 301.702 and successfully completes step one of the United States Medical Licensing Examination.
(b) Provides that this subchapter does not require a medical school in this state to accept an applicant who participates in the program. Requires a medical school applicant who participates in the program to complete the medical school's application and selection process in addition to satisfying the criteria described by Subsection (a).
Sec. 301.705. ELIGIBILITY FOR MEDICAL LICENSING EXAMINATION. Provides that an individual who participates in the program is eligible to take step one of the United States Medical Licensing Examination if the individual has practiced as an advanced practice registered nurse for at least seven years in primary care under physician delegation and supervision in a county with a population of less than 25,000 and meets all other requirements established by THECB rule for continued participation in the program.
Sec. 301.706. ELIGIBILITY FOR MEDICAL SCHOOL LOAN REPAYMENT. (a) Provides that an individual who participates in the program is eligible for loan repayment to cover the full cost of the final two years of medical school if the individual meets certain requirements.
(b) Authorizes THECB, in administering loan repayment under Subsection (a), to disburse payments monthly or according to any other schedule to allow physicians to participate in existing federal student loan repayment plans.
ARTICLE 4. PROVISIONS APPLICABLE TO CERTAIN DELEGATION AGREEMENTS
SECTION 4.001. Amends Subchapter A, Chapter 157, Occupations Code, by adding Section 157.008, as follows:
Sec. 157.008. FEE FOR DELEGATION AGREEMENT. (a) Prohibits a physician from charging more than a reasonable fee to an advanced practice registered nurse or physician assistant to enter into a delegation agreement, including a prescriptive authority agreement.
(b) Requires the Texas Medical Board (TMB) by rule to adopt criteria for consideration in determining whether a fee is reasonable for purposes of Subsection (a), including the types of medical acts delegated and supervised under the agreement, the time required of the physician to provide adequate supervision of medical acts under the agreement, and the liability risks associated with the delegation and supervision of medical acts under the agreement.
SECTION 4.002. Amends Section 157.0512, Occupations Code, by amending Subsections (c), (d), and (f) and adding Subsections (c-1) and (f-1), as follows:
(c) Provides that, except as provided by Subsection (c-1) and subject to Subsection (d), the combined number of advanced practice registered nurses and physician assistants with whom a physician is authorized to enter into a prescriptive authority agreement is prohibited from exceeding seven advanced practice registered nurses and physician assistants or the full-time equivalent of seven advanced practice registered nurses and physician assistants.
(c-1) Provides that, notwithstanding Subsection (c) and subject to Subsection (d), if a physician delegates and supervises the exercise of prescriptive authority exclusively in a county with a population of less than 25,000, the combined number of advanced practice registered nurses and physician assistants with whom the physician is authorized to enter into a prescriptive authority agreement is prohibited from exceeding a total of nine advanced practice registered nurses and physician assistants or the full-time equivalent of a total of nine advanced practice registered nurses and physician assistants.
(d) Provides that Subsections (c) and (c-1) do not apply to a prescriptive authority agreement if the prescriptive authority is being exercised in certain practices. Makes nonsubstantive changes.
(f) Creates an exception under Subsection (f-1).
(f-1) Requires that the periodic meetings described by Subsection (e)(9)(B) (relating to requiring a prescriptive agreement to describe a prescriptive authority quality assurance and improvement plan that includes periodic meetings), notwithstanding Subsection (f)(3) (relating to requiring that the periodic meetings take place at least once a month), if a physician delegates and supervises the exercise of prescriptive authority exclusively in a county with a population of less than 25,000, take place at least quarterly in a manner determined by the physician.
SECTION 4.003. Amends Subchapter B, Chapter 157, Occupations Code, by adding Section 157.061, as follows:
Sec. 157.061. ADDITIONAL LOAN REPAYMENT ASSISTANCE FOR CERTAIN PHYSICIANS WHO DELEGATE AND SUPERVISE. (a) Authorizes a physician to apply to THECB for an additional $45,000 in medical school loan repayment assistance under Subchapter J (Repayment of Certain Physician Education Loans), Chapter 61 (Texas Higher Education Coordinating Board), Education Code, if the physician delegates and supervises the exercise of prescriptive authority exclusively in a county with a population of less than 25,000 under a prescriptive authority agreement that satisfies the requirements of this subchapter.
(b) Authorizes THECB, in administering the loan repayment assistance under this section, to disburse payments monthly or according to any other schedule to allow physicians to participate in existing federal student loan repayment plans.
ARTICLE 5. TRANSITION AND EFFECTIVE DATE
SECTION 5.001 Requires THECB and TMB, not later than February 1, 2026, to adopt rules necessary to implement the changes in law made by this Act.
SECTION 5.002. Effective date: September 1, 2025.