Click here to see the original Texas Medical Board Press Release.

***

At its June 12, 2015 meeting, the Texas Medical Board disciplined 40 licensed physicians and issued two cease and desist orders. The disciplinary actions included four orders related to quality of care violations, four orders related to unprofessional conduct, four revocations, two voluntary surrenders, one order related to criminal activity, two orders related to peer review actions, two orders related to other states’ actions, one order related to nontherapeutic prescribing, four orders related to improper prescribing, two orders related to violation of Board rules, two orders related to Texas Physician Health Program violations, ten orders related to violation of prior Board order, and two orders related to inadequate medical records. The Board also took disciplinary action against a surgical assistant.

The Board issued 168 physician licenses at the June meeting, bringing the total number of physician licenses issued in FY15 to 3,177.

RULE CHANGES ADOPTED
CHAPTER 163. LICENSURE

§163.6, Examinations Accepted for Licensure
The Amendment to §163.6, relating to Examinations Accepted for Licensure, revises the language in section 163.6(b)(3)(A) through (D) to clarify exemptions relating to Examination Attempt Limit as is relates to licenses held in other states. The purpose of the amendment is to have clear and more precise rules for applicants.

CHAPTER 166. PHYSICIAN REGISTRATION

§166.2, Continuing Medical Education
The Amendments to §166.2, relating to Continuing Medical Education, amends 166.2(e) by adding the word “physician” to subsections (1)-(4) in order to clarify that the exemption reasons must be those of the “physician” and not anyone else, such as a family member. The rule is further amended in that all references to “licensee” are changed to “physician” in order to be consistent throughout the rule. The purpose of the amendment is to have clear rules that are consistent and unambiguous.

CHAPTER 170. PAIN MANAGEMENT

§170.1, Purpose
The Amendments to §170.1, concerning Purpose, clarify the requirements related to a physician’s treatment of pain. Throughout the section, amendments modify language so that the provisions are more clearly delineated as minimum requirements that a physician must do in every case when treating pain. Terms such as “policy” and “guideline(s)” have been changed to read as “rule(s)” and “minimum requirements”, and the term “should” has been changed in certain cases to “must.”

§170.2, Definitions
The Amendments to §170.2, concerning Definitions, delete definitions for “improper pain treatment” and “non-therapeutic” found in paragraphs (8) and (9) respectively, as such terms are encompassed in the concept of the standard of care that will be determined and applied by the board in reviewing a physician’s treatment of pain. Other amendments reflect renumbering to account for the deleted provisions.

§170.3, Guidelines
The Amendments to §170.3, concerning Guidelines, change the title of the section to “Minimum Requirements for the Treatment of Pain.” The amendments further clarify the requirements related to a physician’s treatment of pain. Throughout the section, amendments modify language so that the provisions are more clearly delineated as minimum requirements that a physician must do in every case when treating pain. Terms such as “policy” and “guideline(s)” have been changed to read as “rule(s)” and “minimum requirements”, and the term “should” has been changed to “must.”

CHAPTER 180. TEXAS PHYSICIAN HEALTH PROGRAM AND REHABILITATION ORDERS

§180.4, Operation of Program
The Amendments to §180.4, concerning Operation of Program, eliminate the prohibitions on eligibility for referrals made regarding individuals that have violated the standard of care as a result of the use or abuse of drugs or alcohol, committed a boundary violation with a patient or patient’s family member(s), or been convicted of, or placed on deferred adjudication community supervision or deferred disposition for a felony. Further amendments add language providing that the Medical Board may refer such individuals publicly through the entry of an order that addresses the standard of care, boundary, and/or criminal law related violations. In the event of such a referral, the Medical Board retains the authority to discipline the individuals for the standard of care, boundary, and criminal law related violations.

CHAPTER 183. ACUPUNCTURE

§183.4, Licensure
The Amendment to §183.4, concerning Licensure, pertains to the addition of subsection (a)(10), Alternative License Procedure for Military Spouse. The amendment is made to allow alternative demonstration of competency for certain licensing requirements for military spouses as required by Texas Occupations Code, §55.004.

§183.6, Denial of License; Discipline of Licensee
The Amendment to §183.6, concerning Denial of License; Discipline of Licensee, adds subsection (e), relating to Informal Board Proceedings Relating to Licensure Eligibility. The amendment is made to clarify the Acupuncture Board’s authority to impose non-disciplinary remedial plans as a condition of licensure.

CHAPTER 184. SURGICAL ASSISTANTS

§184.4, Qualifications for Licensure
The Amendments to §184.4, relating to Qualifications for Licensure, amends the section 184.4(a)(13)(A) and (B)(iii) by adding language that clarifies the surgical assistant program or substantially equivalent program must be accredited for the entire duration of applicant’s attendance. The purpose of the amendment is to have clear requirements relating to acceptable education programs for those applying for surgical assistant licensure.

CHAPTER 187. PROCEDURAL RULES

§187.13, Informal Board Proceedings Relating to Licensure Eligibility
The Amendment to §187.13, relating to Informal Board Proceedings Relating to Licensure Eligibility, amends subsection (c)(1), (4)(A) and (B) by making a case change in the word “Board”. The rule is further amended in subsection (c)(3)(B)(ii) by adding a 20 day deadline for accepting offers of the committee and changing the word “determined” to “deemed”. The rule is also amended in subsection (c)(4)(A) by adding the words “deemed ineligibility” to further clarify what qualifies as “ineligible” and further describe the possible situations to which the subsection applies. Subsection (c)(4)(B) is further amended to change the word “will” to “shall” in order to be consistent with the remainder of the rules. Subsection (c)(4)(E) is amended by eliminating the words “submitted to the board for ratification” and adding language that the committee’s determination of ineligibility shall be deemed accepted by the applicant without the need for resubmitting such deemed acceptance to the full board for ratification. The purpose of the amendment is to have consistent wording throughout the rules in order to improve the clarity of the rules and ensure that the rules relating to licensure comport with the procedures.

§187.24, Pleadings
The Amendments to §187.24, relating to Pleadings, amends subsection (b)(1) by making a case change in the word “Board”. The rule is further amended in subsection (b)(5) by eliminating the words “submitted to the board for ratification” and adding language that provides that the committee’s determination of ineligibility shall be deemed accepted by the applicant without the need for resubmitting such deemed acceptance to the full board for ratification. The purpose of the amendment is to have consistent wording throughout the rules in order to improve the clarity of the rules and ensure that the rules relating to licensure comport with the procedures.

§187.43, Proceedings for the Modification/Termination of Agreed Orders and Disciplinary Orders
The Amendments to §187.43, concerning Proceedings for the Modification/Termination of Agreed Orders and Disciplinary Orders, clarify the requirements related to a probationer’s eligibility for submitting a petition to the board requesting modification or termination of an order.

§187.61, Ancillary Proceeding
The Amendments to §187.61, concerning Ancillary Proceeding, reorganizes language under subsection (b) so that certain language under subsection (b)(2) is moved to new subsection (c) and further modified to clarify that in cases of suspension based upon arrest for certain offenses listed under §164.1595 of the Texas Occupations Code and §187.57(d) of this title (relating to Charge of the Disciplinary Panel), final dispositions of criminal cases may include a deferred adjudication, acquittal, dismissal of the criminal case, or plea agreement, in addition to a court order of guilt and sentence.

§187.70, Purposes and Construction
The Amendments to §187.70, concerning Purposes and Construction, add language clarifying that an adjudication of guilt of the offense charged includes but is not limited to a finding of guilt by a judge or jury. For purposes of §187.70, the Board interprets the term initial conviction, under Chapter 167 of the Occupations Code, to mean an adjudication of guilt, and the suspension of the medical license is mandated upon an initial conviction of certain criminal offenses listed in §164.057.

§187.72, Decision of the Panel
The amendments to §187.72, concerning Decision of the Panel, delete language in subsection (a) providing that an order of suspension by operation of law represents an imminent peril to the public health, safety, or welfare and requires immediate effect and is considered administratively final for purposes of appealing the decision to district court. Further amendments to subsection (a) insert citations to the applicable sections of §164.057, which mandate suspension upon an initial conviction.

§187.73, Termination of Suspension
Repeal of §187.73, concerning Termination of Suspension, is repealed, as the section is redundant, in that termination of the suspension would be governed by the terms of the agreed order probating the suspension under 187.72. The Board also believes that the rule cited is an incorrect standard for determining if a suspension should be terminated, specifically, physical and mental competence to practice medicine. This standard is not relevant to the underlying basis of the suspension, which is criminal conduct that the legislature determined poses a risk to a physician’s patients, requiring suspension of the physician’s medical license. Physical and mental competence do not mitigate such a risk.

CHAPTER 189. COMPLIANCE PROGRAM

§189.7, Modification/Termination Hearings
The Amendments to §189.7, concerning Modification/Termination Hearings, clarify the requirements related to a probationer’s eligibility for submitting a petition to the board requesting modification or termination of an order.

***

Click here to see the original Texas Medical Board Press Release.