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

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At its December 3-4, 2015 meeting, the Texas Medical Board disciplined 54 licensed physicians and issued two cease and desist orders. The disciplinary actions included: ten orders related to quality of care violations, three orders related to unprofessional conduct, five revocations, eight voluntary surrenders, five suspensions, three orders related to other states’ actions, four orders related to peer review actions, three orders related to impairment, nine orders related to violation of prior Board order, one order related to advertising violations, and three orders related to inadequate medical records.

The Board issued 137 physician licenses at the December meeting, bringing the total number of physician licenses issued in FY16 to 800.

RULE CHANGES ADOPTED

CHAPTER 163. LICENSURE

§163.1, Definitions
The amendments to 163.1, relating to Definitions, added definitions for “Active Duty” and “Armed Forces of the United States” and amends definit ions for “Military service member” “Military spouse ” and “military veteran.” These amendments are in accordance with the passage of SB1307 (84th Reg. Session) which amended Chapter 55 of the Tex. Occ. Code.

§163.2, Full Texas Medical License
The amendments to 163.2, relating to Full Texas Medical License, adds language to 163.2(d), expanding subsection (d), Alternative Licensing Procedure, to include military service members and military veterans. The amendment also includes language allowing the executive director to waive any prerequisite to obtaining a license for an applicant described by subsection (d)(1) after reviewing the applicant’s credentials. These amendments are in accordance with the passage of SB1307 (84th Reg. Session) which amended Chapter 55 of the Tex. Occ. Code.

CHAPTER 165. MEDICAL RECORDS

§165.6, Medical Records Regarding an Abortion on an Unemancipated Minor
The amendments to 165.6, relating to Medical Records Regarding an Abortion on an Unemancipated Minor, are adopted in accordance with House Bill 3994, enacted by the 84th Legislature. The amendment to §165.6 changes language in subsection (b)(4) so that a physician who performs an abortion on an unemancipated minor during a medical emergency is required to execute an affidavit explaining the specific nature of the medical emergency that necessitated the immediate abortion and include a copy of the affidavit in the minor patient’s file. Other language under subsection (b)(4) is deleted, as it was made redundant by HB 3994’s changes. Further, language is added to subsection (c) requiring a physician’s duty to maintain in the minor’s medical record a return receipt of the required written notice from the physician who performed an abortion on the minor under emergency circumstances without the opportunity to obtain consent, to the parents or guardians of the minor. The amendments to subsection (c) also require that if the notice was delivered “undeliverable”, the physician is required to maintain a copy of the notice itself. Finally, physician to show due diligence in determining any woman on whom the physician performs an abortion has reached the age of majority or has had the disabilities of a minority removed, and establishes the requirements of showing “due diligence”, tracking the language of HB 3994.

CHAPTER 166. PHYSICIAN REGISTRATION

§166.1, Physician Registration
The amendment to 166.1, relating to Physician Registration, adds new subsection (h) providing that military service members who hold a license to practice in Texas are entitled to two years of additional time to complete any other requirement related to the renewal of the military service member’s license. This amendment is in accordance with the passage of SB1307 (84th Reg. Session) which amended Chapter 55 of the Tex. Occ. Code.

§166.2, Continuing Medical Education
The amendment to 166.2, relating to Continuing Medical Education, adds new subsection (p) providing that a physician, who is a military service member, may request an extension of time, not to exceed two years, to complete any continuing medical education requirements. This amendment is in accordance with the passage of SB1307 (84th Reg. Session) which amended Chapter 55 of the Tex. Occ. Code.

CHAPTER 171. POSTGRADUATE TRAINING PERMITS

§171.5, Duties of PIT Holders to Report
The amendment to 171.5, relating to Duties of PIT Holders to Report, amends section (b)(3) by eliminating the word “could.” This amendment is necessary to align the rule with the PIT application questions relating to impairment.

CHAPTER 172. TEMPORARY AND LIMITED LICENSES

§172.5, Visiting Physician Temporary Permit
The amendments to 172.5, relating to Visiting Physician Temporary Permit, adds language to subsection (a)(2) by requiring an applicant for such permit to have an active medical license in another state, territory, Canadian province, or country and mandates that such license may not be under investigation. Subsections (a)(2) and (b)(1) are further amended to provide that a supervising physician for any Visiting Physician Permit holder may not have an investigation or proceeding pending for the restriction, cancellation, suspension, revocation, or other discipline of the supervising physician’s medical license, permit, or authority to practice medicine. These amendments will ensure that a Visiting Physician Temporary Permit holder has demonstrated the qualifications for licensure in another state, territory, Canadian province, or country and is not the subject of an investigation or subject to any disciplinary order. These amendments also ensure that a Visiting Physician Temporary Permit holder will have adequate and competent oversight of a supervising physician that is not the subject of any pending investigation.

CHAPTER 175. FEES AND PENALTIES

§175.3, Penalties
The amendment to 175.3, relating to Penalties, adds new subsection (7) providing that a Military Service Member is exempt from any penalty for failing to renew the license in a timely manner if the individual establishes that such failure to timely renew was because the individual was serving as a military service member. This amendment is in accordance with the passage of SB1307 (84th Reg. Session) which amended Chapter 55 of the Tex. Occ. Code.

§175.4, Fee Exemption for Military Service Member, Military Veteran, or Military Spouse
New section 175.4 is added to Chapter 175, relating to Fee Exemption for Military Service Member, Military Veteran, or Military Spouse, thereby exempting Military Service Members, Military Veterans and Military Spouses from license application fees. This amendment is in accordance with the passage of SB807 (84th Reg. Session) which amended Chapter 55 of the Tex. Occ. Code.

CHAPTER 178. COMPLAINTS

§178.3, Complaint Procedure Notification
The amendment to 178.3, relating to Complaint Procedure Notification, corrects an incorrect reference to the Health and Safety Code in subsection (a)(2). This amendment is necessary in order to have clear and accurate citations in the rule.

CHAPTER 183. ACUPUNCTURE

§183.25, Inactive Status License
New section 183.25, is added to Chapter 183, relating to Inactive Status License, governs the creation of an inactive status license for acupuncture license holders with a current registration permit and license in good standing.

§183.26, Retired License
New section 183.26, is added to Chapter 183, relating to Retired License, governs the creation of a retired license status for acupuncture license holders who meet certain requirements.

§183.14, Acudetox Specialist
The amendments to 183.14, relating to Acudetox Specialist, adds language in Section (b)(4) to clarify that an Acudetox Specialist shall work under the supervision of a current and active licensed Texas physician or licensed Texas acupuncturist and such supervision shall be registered with the board and updated within 30days of any change in such supervision. The amendment further clarifies that the Acudetox Specialist shall work pursuant to protocols developed by the Acudetox Specialist and supervising physician or acupuncturist and such protocols shall be agreed upon and signed by the supervising licensee and the acudetox specialist, reviewed and signed at least annually and maintained on site. Section (j)(3) is also amended to eliminate an incorrect amount related to fees. These amendments clarify the existing rule requirements and provide guidance for compliance.

CHAPTER 184. SURGICAL ASSISTANTS

§184.2, Definitions
The amendments to 184.2, relating to Definitions, added definitions for “Active Duty” and “Armed Forces of the United States” and amends definitions for “Military service member” “Military spouse ” and “military veteran.” These amendments are in accordance with the passage of SB1307 (84th Reg. Session) which amended Chapter 55 of the Tex. Occ. Code.

§184.4, Qualifications for Licensure
The amendments to 184.4, relating to Qualifications for Licensure, adds language to 184.4(c), expanding subsection (d), Alternative Licensing Procedure, to include military service members and military veterans. The amendment also includes language allowing the executive director to waive any prerequisite to obtaining a license for an applicant described by subsection (c)(1) after reviewing the applicant’s credentials. These amendments are in accordance with the passage of SB1307 (84th Reg. Session) which amended Chapter 55 of the Tex. Occ. Code.

§184.6, Licensure Documentation
The amendment to 184.6, relating to Licensure Documentation, amends language in subsection (b)(3) to clarify the requirements for submitting examination verification to the board. This amendment clarifies the existing rule and provides guidance for applicants.

§184.8, License Renewal
The amendment to 184.8, relating to License Renewal, adds new subsection (h) providing that military service members who hold a license to practice in Texas are entitled to two years of additional time to complete any other requirement related to the renewal of the military service member’s license. This amendment is in accordance with the passage of SB1307 (84th Reg. Session) which amended Chapter 55 of the Tex. Occ. Code.

§184.21, Impaired Surgical Assistants
The amendment to 184.21, relating to Impaired Surgical Assistants, deletes subsection (b) referencing rehabilitation orders, and adds new language allowing the board to refer impaired surgical assistants to the Texas Physician Health Program. This amendment will ensure that the Board’s rules are consistent with Board processes.

§184.25, Continuing Education
The amendment to 184.25, relating to Continuing Education, adds new subsection (m) providing that a surgical assistant, who is a military service member, may request an extension of time, not to exceed two years, to complete any continuing education requirements. This amendment is in accordance with the passage of SB1307 (84th Reg. Session) which amended Chapter 55 of the Tex. Occ. Code.

CHAPTER 185. PHYSICIAN ASSISTANTS

§185.2, Definitions
The amendment to 185.2, relating to Definitions, changes the definition under paragraph (18) for “Presiding Officer” so as to comport with changes made to Texas Occupations Code §204.055 enacted by Senate Bill 622, 84th Legislature, Regular Session (2015).

§185.3, Meetings and Committees
The amendment to 185.3, relating to Meetings and Committees, adds language to subsection (e) clarifying that the governor must appoint a physician assistant member of the Physician Assistant Board, so as to comport with changes made to Texas Occupations Code §204.055 enacted by Senate Bill 622, 84th Legislature, Regular Session (2015).

§185.4, Procedural Rules for Licensure Applicants
The amendment to 185.4, relating to Procedural Rules for Licensure Applicants, deletes subsection (c) and re-letters subsection (d) to (c). The amendments further add new subsection (d), outlining the process related to a determination of licensure ineligibility by the board, and clarifying that the procedures outlined under Chapter 187 of this title (relating to Procedural Rules) concerning determinations of licensure ineligibility apply.

CHAPTER 187. PROCEDURAL RULES

§187.35, Presentation of Proposal for Decision
The amendments to 187.35, relating to Presentation of Proposal for Decision, revise subsection (a)’s provisions related to notice requirements, to comport with changes made to the Administrative Procedure Act by SB 1267, 84th Legislature, R.S. (2015).

§187.37, Final Decision and Orders
The amendments to §187.37, relating to Final Decisions and Orders, revise provisions related to notice and deadline requirements in order to comport with changes made to the Administrative Procedure Act by SB 1267, 84th Leg., R.S. (2015).

§187.38, Motions for Rehearing
The amendments to 187.38, relating to Motions for Rehearing, revise provisions related to notice and deadline requirements in order to comport with changes made to the Administrative Procedure Act by SB 1267, 84th Leg., R.S. (2015).

§187.61, Ancillary Proceeding
The amendments to 187.61, relating to Ancillary Proceeding, clarify the Medical Board meets the exception in §2001.054(c-1) of Texas Government Code related to filing requirements for certain proceedings.

§187.86, Scope
The amendments to 187.86, relating to Scope, revise language in order to correct a reference to the title of 28 TAC §21.5010.

§187.87, Definitions
The amendments to 187.87, relating to Definitions, revise definitions for a facility-based physician to include an assistant surgeon, in accordance with changes made by SB 481, 84th Legislature, R.S. (2015). Other changes are made to correct references to the title of 28 TAC §21.5010.

§187.88, Complaint Process and Resolution
The amendment to 187.88, relating to Complaint Process and Resolution, represents general cleanup to the rule.

§187.89, Notice of Availability of Mandatory Mediation
The amendments to 187.89, relating to Notice of Availability of Mandatory Mediation, revises language related to the notice required in a billing statement for certain facility-based physicians, in accordance with changes made by SB 481 84th Legislature, Regular Session (2015).

CHAPTER 189. COMPLIANCE PROGRAM

§189.16, Monitoring, Proctoring, or Supervising Physician/Professional’s Recommendation for Competency Assessment
New 189.16, concerning Monitoring, Proctoring, or Supervising Physician/Professional’s Recommendation for Competency Assessment. The new rule provides that a monitoring, proctoring, or supervising physician/professional (“monitor”) may recommend that a probationer complete a competency evaluation, requires that such a recommendation be reviewed and approved by the Disciplinary Process and Review Committee (DPRC) prior to enforcing the recommendation, and sets forth a process that will apply in the cases in which the DPRC Chair approves such a recommendation. The rule provides that the Board may take further appropriate action based upon the results of the competency evaluation or the probationer’s failure to comply with procedures related to the competency evaluation.

CHAPTER 195. PAIN MANAGEMENT CLINICS

§195.1, Definitions
The amendment to 195.1, relating to Definitions, is adopted in accordance with SB 1235, enacted by the 84th Texas Legislature. The amendment adds new paragraph (4), inserting the definition of “Operator” from SB 1235. This addition was to insure consistency between the rule and statute.

§195.2, Certification of Pain Management Clinics
The amendment to 195.2(a)(5), relating to Certification of Pain Management Clinics, is adopted in accordance with SB 1235, enacted by the 84th Texas Legislature. This amendment adds new subparagraph (C), stating violations of §§195 et al. and Chapter 168 of the Texas Occupations Code are subject to criminal prosecution, to be consistent with a similar provision in SB 1235. The amendment further adds language to §195.2(f) so that the practice of medicine includes but is not limited to all supervision and delegation activities related to the pain management clinic. The amendments to §195.2 are added to achieve consistency with SB 1235.

CHAPTER 197. EMERGENCY MEDICAL SERVICE

§197.1, Purpose; §197.2, Definitions; §197.7, Physician Supervision of Emergency Medical Technician-Paramedic or Licensed Paramedic Care Provided in a Health Care Facility Setting
The amendments to 197.1, concerning Purpose; and 197.2, concerning Definitions; and new 197.7, concerning Physician Supervision of Emergency Medical Technician-Paramedic or Licensed Paramedic Care Provided in a Health Care Facility Setting. The sections are adopted in accordance with House Bill 2020, enacted by the 84th Legislature, which amended Chapter 773 of the Health and Safety Code so that certified emergency medical technician paramedics (EMT-Ps) and licensed paramedics (LPs) are authorized to provide advanced life support in a health care facility’s emergency or urgent care clinical setting under the direct supervision of a licensed physician.

The amendments to 197.1 reorganize the section and make other general “clean-up” changes to the language.

The amendments to 197.2 reflect general “clean-up” changes to the language.

New 197.7 sets forth language reflecting the substantive changes to the law made by HB 2020. The new section sets forth definitions and the scope of allowed practice by EMT-Ps and LPs in a health care facility setting under a physician’s direct supervision and delegated authority, as permitted by HB 2020 and other law, and provides for the scope of a physician’s responsibility for such acts.

CHAPTER 198. STANDARDS FOR USE OF INVESTIGATIONAL AGENTS

§198.1, Purpose
The amendment to 198.1, relating to Purpose, is adopted in accordance with House Bills 177 and 21, enacted by the 84th Texas Legislature. The amendment to 198.1 adds language stating that specific requirements set forth under new 198.4 are applicable only to terminal patients being treated with investigational agents.

§198.3, Practice Guidelines for the Use of Investigational Agents
The amendment to 198.3, relating to Practice Guidelines for the Use of Investigational Agents, is adopted in accordance with House Bills 177 and 21, enacted by the 84th Texas Legislature. The amendment to 198.3 replaces the term “protocol” with the term “clinical trial.” This was to insure consistency between the language in HB 177 and the rule.

§198.4, Use of Investigational Agents for Patients with Terminal Illness
The amendment to 198.4, relating to Use of Investigational Agents for Patients with Terminal Illness, is adopted in accordance with House Bills 177 and 21, enacted by the 84th Texas Legislature. The language in new 198.4 reflects the requirements of HB 21 and makes clear that new 198.4 is limited to use of investigational agents by terminal patients

CHAPTER 200. STANDARDS FOR PHYSICIANS PRACTICING COMPLEMENTARY AND ALTERNATIVE MEDICINE

§200.3(7), Practice Guidelines for the Provision of Complementary and Alternative Medicine
The amendments to 200.3(7), relating to Practice Guidelines for the Provision of Complementary and Alternative Medicine, revise the language under subparagraphs (A) – (C) so that the outlined ethical standards relating to physicians using conventional medical practices or complementary and alternative medicine treatment while engaged in the clinical investigation of new drugs and procedures are mandatory rather than discretionary. The changes are adopted to make consistent with other language in the introductory paragraph of the section making such ethical standards mandatory.

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