Texas 2025 - 89th Regular

Texas Senate Bill SB881 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	2025S0021-1 01/10/25
2	2	By: Sparks S.B. No. 881
3	3
4	4
5	5
6	6
7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to the issuance by the Texas Medical Board of certain
10	10	licenses to practice medicine and the authority of an insured to
11	11	select certain license holders under the insured's health policy;
12	12	requiring an occupational license; authorizing fees.
13	13	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
14	14	ARTICLE 1. SHORT TITLE
15	15	SECTION 1.001. This Act shall be known as the Decreasing
16	16	Occupational Certification Timelines, Obstacles, and Regulations
17	17	(DOCTOR) Act.
18	18	ARTICLE 2. FOREIGN LICENSE HOLDERS
19	19	SECTION 2.001. Subchapter C, Chapter 155, Occupations Code,
20	20	is amended by adding Section 155.1015 to read as follows:
21	21	Sec. 155.1015. ISSUANCE OF PROVISIONAL LICENSE TO
22	22	CERTAIN FOREIGN MEDICAL LICENSE HOLDERS WITH OFFERS OF
23	23	EMPLOYMENT. (a) Upon receiving an application, the board shall
24	24	issue a provisional license to practice medicine to an applicant
25	25	who:
26	26	(1) has been granted a degree of doctor of medicine or
27	27	a substantially similar degree by a program of medical education
28	28	that meets eligibility requirements for the applicant to apply for
29	29	certification by the Educational Commission for Foreign Medical
30	30	Graduates;
31	31	(2) has been licensed in good standing to practice
32	32	medicine in another country in the five years preceding application
33	33	under this section and is not the subject of any pending
34	34	disciplinary action before the licensing body;
35	35	(3) either:
36	36	(A) has completed a residency or substantially
37	37	similar postgraduate medical training required by the applicant's
38	38	country of licensure and has practiced medicine as a licensed
39	39	physician in that country for at least five years after the
40	40	completion of the required postgraduate medical training; or
41	41	(B) if the applicant's country of licensure does
42	42	not require postgraduate medical training, has practiced as a
43	43	medical professional performing the duties of a physician in that
44	44	country for at least five years and has practiced medicine as a
45	45	licensed physician in that country for at least 10 years after
46	46	completing medical school;
47	47	(4) satisfies the examination requirements of Section
48	48	155.051;
49	49	(5) has proficiency in the English language;
50	50	(6) is authorized under federal law to work in the
51	51	United States; and
52	52	(7) has been offered employment in this state as a
53	53	physician by a person who provides health care services in the
54	54	normal course of business, including a health system, hospital,
55	55	hospital-based facility, freestanding emergency facility, or
56	56	urgent care clinic.
57	57	(b) A provisional license issued under this section expires
58	58	on the earlier of:
59	59	(1) the date the board issues the provisional license
60	60	holder a license under this subtitle or denies the provisional
61	61	license holder's application for a license under Subsection (c); or
62	62	(2) the third anniversary of the date the provisional
63	63	license was issued.
64	64	(c) Upon receiving an application, the board shall issue a
65	65	license under this subtitle to the holder of a provisional license
66	66	under this section if the provisional license holder:
67	67	(1) will have practiced under the provisional license
68	68	for at least three years at the time the license will be issued; and
69	69	(2) has not been and is not currently subject to board
70	70	investigation or discipline for conduct that occurred while holding
71	71	the provisional license.
72	72	ARTICLE 3. MILITARY VETERANS
73	73	SECTION 3.001. Subchapter C, Chapter 155, Occupations Code,
74	74	is amended by adding Section 155.108 to read as follows:
75	75	Sec. 155.108. LICENSE FOR MILITARY VETERAN TO PRACTICE IN
76	76	CERTAIN AREAS. (a) In this section, "active duty" and "armed
77	77	forces of the United States" have the meanings assigned by Section
78	78	55.001.
79	79	(b) The board shall issue a medical license to practice
80	80	medicine to an applicant who:
81	81	(1) is licensed in good standing as a physician in
82	82	another state;
83	83	(2) is a veteran of the armed forces of the United
84	84	States who retired from or otherwise left military service not more
85	85	than three years before the application date for a license under
86	86	this section;
87	87	(3) was, at the time of retiring from or leaving
88	88	military service:
89	89	(A) serving on active duty in this state; and
90	90	(B) authorized as a physician to treat persons
91	91	enlisted in the armed forces of the United States or veterans; and
92	92	(4) has passed the Texas medical jurisprudence
93	93	examination.
94	94	(c) The board may not issue a license under this section to
95	95	an applicant who:
96	96	(1) was discharged or separated from the armed forces
97	97	of the United States:
98	98	(A) on the basis of substandard conduct; or
99	99	(B) for any act of misconduct or moral or
100	100	professional dereliction;
101	101	(2) holds a medical license or a license to prescribe,
102	102	dispense, administer, supply, or sell a controlled substance that:
103	103	(A) is currently under active investigation; or
104	104	(B) is or was subject to a disciplinary order or
105	105	action or to denial by another jurisdiction; or
106	106	(3) has been convicted of, is on deferred adjudication
107	107	community supervision or deferred disposition for, or is under
108	108	active investigation for the commission of:
109	109	(A) a felony; or
110	110	(B) a misdemeanor involving moral turpitude.
111	111	ARTICLE 4. PHYSICIAN GRADUATES
112	112	SECTION 4.001. Chapter 155, Occupations Code, is amended by
113	113	adding Subchapter E to read as follows:
114	114	SUBCHAPTER E. PHYSICIAN GRADUATE
115	115	Sec. 155.201. DEFINITIONS. In this subchapter:
116	116	(1) "Physician graduate" means an individual issued a
117	117	limited license under this subchapter to practice medicine under a
118	118	supervising practice agreement with a sponsoring physician.
119	119	(2) "Sponsoring physician" means a physician who
120	120	enters into a supervising practice agreement with a physician
121	121	graduate.
122	122	(3) "Supervising practice agreement" means an
123	123	agreement between a sponsoring physician and a physician graduate
124	124	regarding the supervision by the sponsoring physician of the
125	125	physician graduate's practice of medicine.
126	126	Sec. 155.202. RULES. The board shall adopt rules in
127	127	accordance with this subchapter relating to the licensing and
128	128	regulation of physician graduates, including rules relating to:
129	129	(1) procedures and fees for the issuance, term, and
130	130	renewal of a license under this subchapter, including continuing
131	131	medical education requirements for renewal of the license;
132	132	(2) practices and requirements for the supervision of
133	133	physician graduates; and
134	134	(3) any other matter necessary to ensure protection of
135	135	the public, including disciplinary procedures.
136	136	Sec. 155.203. LICENSE ISSUANCE. Upon receiving an
137	137	application, the board shall issue a limited license to practice
138	138	medicine under this subchapter to an applicant who:
139	139	(1) is a resident of this state and is:
140	140	(A) a United States citizen or a legal permanent
141	141	resident; or
142	142	(B) otherwise authorized under federal law to
143	143	work in the United States;
144	144	(2) has proficiency in the English language;
145	145	(3) has graduated:
146	146	(A) in the two years preceding the date that the
147	147	applicant initially applies for a physician graduate license, from:
148	148	(i) a board-recognized accredited medical
149	149	school or osteopathic medical school in the United States or
150	150	Canada; or
151	151	(ii) a medical school located outside of
152	152	the United States and Canada that is recognized by the board as
153	153	acceptable; or
154	154	(B) if the applicant is licensed in good standing
155	155	to practice medicine in another country, from a medical school
156	156	located outside of the United States and Canada that is recognized
157	157	by the board as acceptable;
158	158	(4) has passed the first and second components of the
159	159	United States Medical Licensing Examination or equivalent
160	160	components of another board-approved licensing examination
161	161	described by Section 155.0511;
162	162	(5) is not enrolled in a board-approved postgraduate
163	163	residency program;
164	164	(6) has not been and is not currently the subject of
165	165	disciplinary action by the board or the medical licensing authority
166	166	of any other jurisdiction; and
167	167	(7) meets any other requirement prescribed by board
168	168	rule.
169	169	Sec. 155.204. FEES. The amount of a fee for the issuance or
170	170	renewal of a license under this subchapter may not exceed the amount
171	171	of a fee for the issuance or renewal of a physician assistant
172	172	license under Chapter 204.
173	173	Sec. 155.205. SPONSORING PHYSICIAN. (a) A physician is
174	174	eligible to enter into a supervising practice agreement as a
175	175	sponsoring physician if the physician:
176	176	(1) holds a full and unrestricted license to practice
177	177	medicine issued under this subtitle;
178	178	(2) has not been and is not currently the subject of
179	179	disciplinary action by the board or the medical licensing authority
180	180	of any other jurisdiction;
181	181	(3) is certified by:
182	182	(A) a medical specialty member board of the
183	183	American Board of Medical Specialties;
184	184	(B) a medical specialty member board of the
185	185	American Osteopathic Association Bureau of Osteopathic
186	186	Specialists;
187	187	(C) the American Board of Oral and Maxillofacial
188	188	Surgery; or
189	189	(D) any other medical specialty member board
190	190	recognized by the Texas Medical Board; and
191	191	(4) practices medicine in the specialty for which the
192	192	physician is certified under Subdivision (3).
193	193	(b) A sponsoring physician who enters into a supervising
194	194	practice agreement with a physician graduate shall comply with all
195	195	board rules related to the supervision of physician graduates.
196	196	(c) The board by rule shall establish the maximum number of
197	197	physician graduates that a sponsoring physician may supervise under
198	198	supervising practice agreements.
199	199	Sec. 155.206. SUPERVISING PRACTICE AGREEMENT REQUIRED.
200	200	(a) A physician graduate shall enter into a supervising practice
201	201	agreement with a sponsoring physician.
202	202	(b) A physician graduate who has not entered into a
203	203	supervising practice agreement may not practice or attempt to
204	204	practice medicine.
205	205	(c) A physician graduate who enters into a supervising
206	206	practice agreement may practice under the delegation and
207	207	supervision of another physician if:
208	208	(1) the sponsoring physician authorizes the practice
209	209	of the physician graduate under the delegation and supervision of
210	210	the other physician in a written document that identifies the other
211	211	physician by name; and
212	212	(2) the other physician is:
213	213	(A) part of the sponsoring physician's physician
214	214	group or facility; and
215	215	(B) certified in the same specialty as the
216	216	sponsoring physician by:
217	217	(i) a medical specialty member board of the
218	218	American Board of Medical Specialties;
219	219	(ii) a medical specialty member board of
220	220	the American Osteopathic Association Bureau of Osteopathic
221	221	Specialists;
222	222	(iii) the American Board of Oral and
223	223	Maxillofacial Surgery; or
224	224	(iv) any other medical specialty member
225	225	board recognized by the Texas Medical Board.
226	226	(d) The physician profile under Section 154.006 of a
227	227	sponsoring physician or physician graduate must indicate in the
228	228	manner prescribed by board rule that the sponsoring physician or
229	229	physician graduate has entered into a supervising practice
230	230	agreement.
231	231	Sec. 155.207. LIMITED PRACTICE BY LICENSE HOLDER. (a) A
232	232	physician graduate may provide only medical services in the
233	233	specialty in which the physician graduate's sponsoring physician is
234	234	certified as described by Section 155.205(a)(3) under supervision
235	235	in accordance with a supervising practice agreement.
236	236	(b) Before a license holder under this subchapter provides a
237	237	treatment, consultation, or other medical service, the license
238	238	holder must disclose to the patient:
239	239	(1) that the license holder is a physician graduate;
240	240	and
241	241	(2) that the license holder has not completed any
242	242	formal specialized postgraduate or resident training.
243	243	Sec. 155.208. LIABILITY OF SUPERVISING PHYSICIAN. A
244	244	sponsoring physician who enters into a supervising practice
245	245	agreement with a physician graduate retains legal responsibility
246	246	for a physician graduate's patient care activities, including the
247	247	provision of care and treatment to a patient in a health care
248	248	facility.
249	249	Sec. 155.209. IDENTIFICATION REQUIREMENTS; USE OF TITLE.
250	250	(a) The holder of a license issued under this subchapter shall at
251	251	all times while practicing as a physician graduate display a
252	252	personal identification document identifying the license holder as
253	253	a physician graduate.
254	254	(b) A physician graduate may use the following titles or
255	255	abbreviations:
256	256	(1) "doctor"; or
257	257	(2) "Dr." or "doc."
258	258	Sec. 155.210. STATUS OF PHYSICIAN GRADUATE. A physician
259	259	graduate license holder is considered a general practitioner for
260	260	purposes of regulations of the federal Centers for Medicare and
261	261	Medicaid Services.
262	262	Sec. 155.211. LICENSE RENEWAL. The board may not renew a
263	263	license issued under this subchapter unless:
264	264	(1) the board verifies that the license holder has
265	265	practiced in accordance with this subchapter under a supervising
266	266	practice agreement with a sponsoring physician in the license term
267	267	preceding the application for renewal; and
268	268	(2) the license holder satisfies the continuing
269	269	medical education requirements established by board rule.
270	270	Sec. 155.212. DENIAL, SUSPENSION, OR REVOCATION OF LICENSE.
271	271	The board may deny an application for licensure or suspend or revoke
272	272	a license issued under this subchapter:
273	273	(1) for any ground provided by Chapter 164 or board
274	274	rule; and
275	275	(2) in the manner provided by Chapter 164 and board
276	276	rule.
277	277	SECTION 4.002. Section 1451.001, Insurance Code, is amended
278	278	by adding Subdivision (16-a) to read as follows:
279	279	(16-a) "Physician graduate" has the meaning assigned
280	280	by Section 155.201, Occupations Code.
281	281	SECTION 4.003. Subchapter C, Chapter 1451, Insurance Code,
282	282	is amended by adding Section 1451.129 to read as follows:
283	283	Sec. 1451.129. SELECTION OF PHYSICIAN GRADUATE. An insured
284	284	may select a physician graduate to provide the services scheduled
285	285	in the health insurance policy that are within the scope of the
286	286	physician graduate's license under Subchapter E, Chapter 155,
287	287	Occupations Code.
288	288	SECTION 4.004. Section 1451.129, Insurance Code, as added
289	289	by this Act, applies only to a health insurance policy that is
290	290	delivered, issued for delivery, or renewed on or after January 1,
291	291	2026.
292	292	ARTICLE 5. RULEMAKING
293	293	SECTION 5.001. (a) Not later than January 1, 2026, the
294	294	Texas Medical Board shall adopt rules as necessary to implement the
295	295	following provisions of the Occupations Code, as added by this Act:
296	296	(1) Sections 155.1015 and 155.108; and
297	297	(2) Subchapter E, Chapter 155.
298	298	(b) In adopting rules under Subsection (a) of
299	299	this section, the Texas Medical Board shall develop a process to
300	300	create a "whitelist" of countries whose licensure requirements
301	301	include residency or a substantially similar postgraduate medical
302	302	training under Section 155.1015(a)(3)(A), Occupations Code, as
303	303	added by this Act. The process must include a review by the Texas
304	304	Medical Board of at least 10 countries per year for inclusion on the
305	305	whitelist, and if after the review a country is not included, the
306	306	Texas Medical Board must identify, with specificity, the aspects of
307	307	the country's requirements that caused the country to not be
308	308	included.
309	309	ARTICLE 6. EFFECTIVE DATE
310	310	SECTION 6.001. This Act takes effect September 1, 2025.