CHAPTER 162. REGULATION OF PRACTICE OF MEDICINE
OCCUPATIONS CODE
TITLE 3. HEALTH PROFESSIONS
SUBTITLE B. PHYSICIANS
CHAPTER 162. REGULATION OF PRACTICE OF MEDICINE
SUBCHAPTER A. REGULATION BY BOARD OF CERTAIN NONPROFIT HEALTH
CORPORATIONS
Sec. 162.001. CERTIFICATION BY BOARD. (a) The board by rule
shall certify a health organization that:
(1) applies for certification on a form approved by the board;
and
(2) presents proof satisfactory to the board that the
organization meets the requirements of Subsection (b) or (c).
(b) The board shall approve and certify a health organization
that:
(1) is a nonprofit corporation under the Texas Non-Profit
Corporation Act (Article 1396-1.01 et seq., Vernon's Texas Civil
Statutes) organized to:
(A) conduct scientific research and research projects in the
public interest in the field of medical science, medical
economics, public health, sociology, or a related area;
(B) support medical education in medical schools through grants
and scholarships;
(C) improve and develop the capabilities of individuals and
institutions studying, teaching, and practicing medicine;
(D) deliver health care to the public; or
(E) instruct the general public in medical science, public
health, and hygiene and provide related instruction useful to
individuals and beneficial to the community;
(2) is organized and incorporated solely by persons licensed by
the board; and
(3) has as its directors and trustees persons who are:
(A) licensed by the board; and
(B) actively engaged in the practice of medicine.
(c) The board shall certify a health organization to contract
with or employ physicians licensed by the board if the
organization:
(1) is a nonprofit corporation under the Texas Non-Profit
Corporation Act (Article 1396-1.01 et seq., Vernon's Texas Civil
Statutes) and Section 501(c)(3), Internal Revenue Code of 1986
(26 U.S.C. Sec. 501(c)(3)); and
(2) is organized and operated as:
(A) a migrant, community, or homeless health center under the
authority of and in compliance with 42 U.S.C. Section 254b or
254c; or
(B) a federally qualified health center under 42 U.S.C. Section
1396d(l)(2)(B).
(c-4) The board shall certify a health organization to contract
with or employ physicians licensed by the board if the
organization:
(1) is a hospital district:
(A) recognized by a federal agency as a public entity eligible
to receive a grant related to a community or federally qualified
health center described by Subdivision (2); and
(B) created in a county with a population of more than 800,000
that was not included in the boundaries of a hospital district
before September 1, 2003; and
(2) is organized and operated as:
(A) a migrant, community, or homeless health center under the
authority of and in compliance with 42 U.S.C. Section 254b or
254c; or
(B) a federally qualified health center under 42 U.S.C. Section
1396d(l)(2)(B).
(c-5) This section applies to a hospital district described by
Subsection (c-4) only in relation to the hospital district's
operations as a community or federally qualified health center
described by Subsection (c-4)(2).
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Amended by:
Acts 2005, 79th Leg., Ch.
601, Sec. 1, eff. September 1, 2005.
Acts 2007, 80th Leg., R.S., Ch.
164, Sec. 8, eff. September 1, 2007.
Sec. 162.002. LIMITATION ON PHYSICIAN FEES. A physician who
provides professional medical services for a health organization
certified under Section 162.001(c) shall provide those services
free of charge, or at a reduced fee commensurate with the
patient's ability to pay, in compliance with 42 U.S.C. Section
254b or 254c.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Sec. 162.003. REFUSAL TO CERTIFY; REVOCATION. On a
determination that a health organization is established,
organized, or operated in violation of or with the intent to
violate this subtitle, the board:
(1) may refuse to certify the health organization on application
for certification by the organization under Section 162.001; and
(2) shall revoke a certification made under Section 162.001 to
that organization.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
SUBCHAPTER B. AUTHORITY TO FORM CERTAIN ENTITIES
Sec. 162.051. AUTHORITY TO FORM CERTAIN JOINTLY OWNED ENTITIES.
(a) Except as provided by Section 165.155, a physician and an
optometrist or therapeutic optometrist may, for a purpose
described by Subsection (b), organize, jointly own, and manage
any legal entity, including:
(1) a partnership under the Texas Revised Partnership Act
(Article 6132b-1.01 et seq., Vernon's Texas Civil Statutes);
(2) a limited partnership under the Texas Revised Limited
Partnership Act (Article 6132a-1, Vernon's Texas Civil Statutes);
and
(3) a limited liability company under the Texas Limited
Liability Company Act (Article 1528n, Vernon's Texas Civil
Statutes).
(b) An entity authorized under Subsection (a) may:
(1) own real property, other physical facilities, or equipment
for the delivery of health care services or management;
(2) lease, rent, or otherwise acquire the use of real property,
other physical facilities, or equipment for the delivery of
health care services or management; or
(3) employ or otherwise use a person who is not a physician,
optometrist, or therapeutic optometrist for the delivery of
health care services or management.
(c) Only a physician, optometrist, or therapeutic optometrist
may own an interest in an entity authorized under Subsection (a).
This subsection does not prohibit an entity from making one or
more payments to an owner's estate following the owner's death
under an agreement with the owner or as otherwise authorized or
required by law.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Sec. 162.052. NOTICE OF CERTAIN OWNERSHIP INTERESTS. (a) In
this section, "niche hospital" has the meaning assigned by
Section 105.002.
(b) A physician shall notify the Department of State Health
Services of any ownership interest held by the physician in a
niche hospital.
(c) Subsection (b) does not apply to an ownership interest in
publicly available shares of a registered investment company,
such as a mutual fund, that owns publicly traded equity
securities or debt obligations issued by a niche hospital or an
entity that owns the niche hospital.
(d) The board, in consultation with the Department of State
Health Services, shall adopt rules governing the form and content
of the notice required by Subsection (b).
Added by Acts 2005, 79th Leg., Ch.
836, Sec. 2, eff. September 1, 2005.
SUBCHAPTER C. ANESTHESIA IN OUTPATIENT SETTING
Sec. 162.101. DEFINITION. In this subchapter, "outpatient
setting" means a facility, clinic, center, office, or other
setting that is not part of a licensed hospital or a licensed
ambulatory surgical center.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Sec. 162.102. RULES. (a) The board by rule shall establish the
minimum standards for anesthesia services provided in an
outpatient setting by a person licensed by the board.
(b) The rules adopted under this section must be designed to
protect the health, safety, and welfare of the public and include
requirements relating to:
(1) general anesthesia, regional anesthesia, and monitored
anesthesia care;
(2) patient evaluation, diagnosis, counseling, and preparation;
(3) patient monitoring to be performed and equipment to be used
during a procedure and during post-procedure monitoring;
(4) emergency procedures, drugs, and equipment, including
education, training, and certification of personnel, as
appropriate, and including protocols for transfers to a hospital;
(5) the documentation necessary to demonstrate compliance with
this subchapter; and
(6) the period in which protocols or procedures covered by rules
of the board shall be reviewed, updated, or amended.
(c) The board shall cooperate with the Texas Board of Nursing in
the adoption of rules under this subchapter to eliminate, to the
extent possible, conflicts between the rules adopted by each
board.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Amended by:
Acts 2007, 80th Leg., R.S., Ch.
889, Sec. 34, eff. September 1, 2007.
Sec. 162.103. APPLICABILITY. Rules adopted by the board under
this subchapter do not apply to:
(1) an outpatient setting in which only local anesthesia,
peripheral nerve blocks, or both are used;
(2) a licensed hospital, including an outpatient facility of
the hospital that is located separate from the hospital;
(3) a licensed ambulatory surgical center;
(4) a clinic located on land recognized as tribal land by the
federal government and maintained or operated by a federally
recognized Indian tribe or tribal organization as listed by the
United States secretary of the interior under 25 U.S.C. Section
479a-1 or as listed under a successor federal statute or
regulation;
(5) a facility maintained or operated by a state or local
governmental entity;
(6) a clinic directly maintained or operated by the United
States; or
(7) an outpatient setting accredited by:
(A) the Joint Commission on Accreditation of Healthcare
Organizations relating to ambulatory surgical centers;
(B) the American Association for the Accreditation of Ambulatory
Surgery Facilities; or
(C) the Accreditation Association for Ambulatory Health Care.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Amended by:
Acts 2005, 79th Leg., Ch.
269, Sec. 1.31, eff. September 1, 2005.
Sec. 162.104. REGISTRATION REQUIRED. (a) The board shall
require each physician who administers anesthesia or performs a
surgical procedure for which anesthesia services are provided in
an outpatient setting to register with the board on a form
prescribed by the board and to pay a fee to the board in an
amount established by the board.
(b) The board shall coordinate the registration required under
this section with the registration required under Chapter 156 so
that the times of registration, payment, notice, and imposition
of penalties for late payment are similar and provide a minimum
of administrative burden to the board and to physicians.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001. Amended by Acts 2003, 78th Leg., ch. 202, Sec. 25,
eff. June 10, 2003.
Sec. 162.105. COMPLIANCE WITH ANESTHESIA RULES. (a) A
physician who practices medicine in this state and who
administers anesthesia or performs a surgical procedure for which
anesthesia services are provided in an outpatient setting shall
comply with the rules adopted under this subchapter.
(b) The board may require a physician to submit and comply with
a corrective action plan to remedy or address any current or
potential deficiencies with the physician's provision of
anesthesia in an outpatient setting in accordance with this
subtitle or rules of the board.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Sec. 162.106. INSPECTIONS. (a) The board may conduct
inspections to enforce this subchapter, including inspections of
an office site and of documents of a physician's practice that
relate to the provision of anesthesia in an outpatient setting.
The board may contract with another state agency or qualified
person to conduct the inspections.
(b) Unless it would jeopardize an ongoing investigation, the
board shall provide at least five business days' notice before
conducting an on-site inspection under this section.
(c) This section does not require the board to make an on-site
inspection of a physician's office.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Sec. 162.107. REQUESTS FOR INSPECTION AND ADVISORY OPINION. (a)
The board may consider a request by a physician for an on-site
inspection. The board, on payment of a fee established by the
board, may conduct the inspection and issue an advisory opinion.
(b) An advisory opinion issued by the board under this section
is not binding on the board. Except as provided by Subsection
(c), the board may take any action under this subtitle relating
to the situation addressed by the advisory opinion that the board
considers appropriate.
(c) A physician who requests and relies on an advisory opinion
of the board may use the opinion as mitigating evidence in an
action or proceeding to impose an administrative penalty or
assess a civil penalty under this subtitle. On receipt of proof
of reliance on an advisory opinion, the board or court, as
appropriate, shall consider the reliance and mitigate imposition
of an administrative penalty or assessment of a civil penalty
accordingly.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
SUBCHAPTER D. PHYSICIAN CREDENTIALING
Sec. 162.151. DEFINITIONS. In this subchapter:
(1) "Core credentials data" means:
(A) name and other demographic data;
(B) professional education;
(C) professional training;
(D) licenses; and
(E) Educational Commission for Foreign Medical Graduates
certification.
(2) "Credentials verification organization" means an
organization that is certified or accredited and organized to
collect, verify, maintain, store, and provide to health care
entities a health care practitioner's verified credentials data,
including all corrections, updates, and modifications to that
data. For purposes of this subdivision, "certified" or
"accredited" includes certification or accreditation by a
nationally recognized accreditation organization.
(3) "Health care entity" means:
(A) a health care facility or other health care organization
licensed or certified to provide approved medical and allied
health services in this state;
(B) an entity licensed by the Texas Department of Insurance as a
prepaid health care plan or health maintenance organization or as
an insurer to provide coverage for health care services through a
network of providers; or
(C) a health care provider entity accepting delegated
credentialing functions from a health maintenance organization.
(4) "Physician" means a holder of or applicant for a license
under this subtitle as a medical doctor or doctor of osteopathy.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Sec. 162.152. ASSOCIATIONS. Each provision of this subchapter
that applies to a health care entity also applies to an
association that represents federally qualified health centers.
For purposes of this section, "federally qualified health center"
has the meaning assigned by 42 U.S.C. Section 1396d(l)(2)(B), as
amended.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Sec. 162.153. STANDARDIZED CREDENTIALS VERIFICATION PROGRAM.
(a) The board shall develop standardized forms and guidelines
for and administer:
(1) the collection, verification, correction, updating,
modification, maintenance, and storage of information relating to
physician credentials; and
(2) the release of that information to health care entities or
designated credentials verification organizations authorized by
the physician to receive that information.
(b) Except as provided by Subsection (c), a physician whose core
credentials data is submitted to the board is not required to
resubmit the data when applying for practice privileges with a
health care entity.
(c) A physician shall:
(1) provide to the board any correction, update, or modification
of the physician's core credentials data not later than the 30th
day after the date the data on file is no longer accurate; and
(2) resubmit the physician's core credentials data annually if
the physician did not submit a correction, update, or
modification during the preceding year.
(d) A health care entity that employs, contracts with, or
credentials physicians must use the board to obtain core
credentials data for items for which the board is designated or
accepted as a primary source by a national accreditation
organization. A health care entity may act through its designated
credentials verification organization.
(e) This section does not restrict the authority of a health
care entity to approve or deny an original or renewal application
for hospital staff membership, clinical privileges, or managed
care network participation.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Sec. 162.154. FURNISHING OF DATA TO HEALTH CARE ENTITY. Not
later than the 15th business day after the date the board
receives a request for the data, the board shall make available
to a health care entity or its designated credentials
verification organization all core credentials data it collects
on a physician, including any correction, update, or modification
of that data, if authorized by the physician.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Sec. 162.155. REVIEW OF DATA BY PHYSICIAN. (a) Before
releasing a physician's core credentials data from its data bank
for the first time, the board shall provide to the affected
physician 15 business days to review the data and request
reconsideration or resolution of errors in or omissions from the
data. The board shall include with the data any change or
clarification made by the physician.
(b) The board shall notify a physician of any change to the
physician's core credentials data when a change is made or
initiated by a person other than the physician.
(c) A physician may request to review the physician's core
credentials data collected at any time after the initial release
of information. The board is not required to hold, release, or
modify any information because of the request.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Sec. 162.156. DATA DUPLICATION PROHIBITED. (a) A health care
entity may not collect or attempt to collect duplicate core
credentials data from a physician if the information is already
on file with the board. This section does not restrict the right
of a health care entity to request additional information not
included in the core credentials data on file with the board that
is necessary for the entity to credential the physician. A health
care entity or its designated credentials verification
organization may collect any additional information required by
the health care entity's credentialing process from a primary
source of that information.
(b) A state agency may not collect or attempt to collect
duplicate core credentials data from a physician if the
information is already on file with the board. This section does
not restrict the right of a state agency to request additional
information not included in the core credentials data on file
with the board that the agency considers necessary for its
specific credentialing purposes.
(c) The board by rule may except from Subsections (a) and (b) a
request for core credentials data that is necessary for a health
care entity to provide temporary privileges during the
credentialing process.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Sec. 162.157. IMMUNITY. A health care entity or its designated
credentials verification organization is immune from liability
arising from its reliance on data furnished by the board under
this subchapter.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Sec. 162.158. RULES. The board shall adopt rules as necessary
to develop and implement the standardized credentials
verification program established by this subchapter.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Sec. 162.159. CONFIDENTIALITY. The information collected,
maintained, or stored by the board under this subchapter is
privileged and confidential and not subject to discovery,
subpoena, or other means of legal compulsion for its release or
to disclosure under Chapter 552, Government Code, except as
otherwise provided by this subchapter.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Sec. 162.160. USE OF INDEPENDENT CONTRACTOR. The board may
contract with an independent contractor to collect, verify,
maintain, store, or release information. The contract must
provide for board oversight and for the confidentiality of the
information. If the board contracts with an independent entity
that is not a governmental unit to carry out this subchapter, the
independent entity is not immune from liability.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Sec. 162.161. FEES. (a) The board shall prescribe and assess
fees in amounts necessary to cover its cost of operating under
and administering this subchapter.
(b) The board may waive a fee for a state agency that is
required to obtain core credentials data from the board and that
Section 162.156 prohibits from collecting duplicate data.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Sec. 162.162. GIFTS, GRANTS, AND DONATIONS. In addition to any
fees paid to the board or money appropriated to the board, the
board may receive and accept a gift, grant, donation, or other
thing of value from any source, including the United States or a
private source.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
SUBCHAPTER E. EMPLOYMENT OF PHYSICIAN BY PRIVATE MEDICAL SCHOOL
Sec. 162.201. EMPLOYMENT OF PHYSICIAN PERMITTED. A private
nonprofit medical school that is certified under Section 162.203,
that is accredited by the Liaison Committee on Medical Education,
and that was appropriated funds by the legislature in the 75th
Legislature, Regular Session, 1997, may retain, in fulfilling its
educational mission, all or part of the professional income
generated by a physician for medical services if the physician is
employed as a faculty member of the school and provides medical
services as part of the physician's responsibilities.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Sec. 162.202. COMMITTEE ESTABLISHED BY SCHOOL. (a) A private
medical school subject to this subchapter shall establish a
committee consisting of at least five actively practicing
physicians who provide care in the clinical program of the
private medical school. The committee shall approve existing
policies, or adopt new policies if none exist, to ensure that a
physician whose professional income is retained under Section
162.201 is exercising the physician's independent medical
judgment in providing care to patients in the school's clinical
programs.
(b) The policies adopted under this section must include
policies relating to credentialing, quality assurance,
utilization review, peer review, medical decision-making,
governance of the committee, and due process.
(c) Each member of a committee under this section shall provide
to the board biennially a signed and verified statement
indicating that the member:
(1) is licensed by the board;
(2) will exercise independent medical judgment in all committee
matters, specifically in matters relating to credentialing,
quality assurance, utilization review, peer review, medical
decision-making, and due process;
(3) will exercise the member's best efforts to ensure compliance
with the private medical school's policies that are adopted or
established by the committee; and
(4) shall report immediately to the board any action or event
that the member reasonably and in good faith believes constitutes
a compromise of the independent judgment of a physician in caring
for a patient in the private medical school's clinical program or
in carrying out the member's duties as a committee member.
(d) The board shall adopt rules requiring the disclosure of
financial conflicts of interest by a committee member.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Sec. 162.203. CERTIFICATION OF SCHOOL BY BOARD. (a) A private
school that retains a physician's professional income under
Section 162.201 must be certified by the board as being in
compliance with this subchapter.
(b) The board shall prescribe an application form to be provided
to the school and may adopt rules as necessary to administer this
subchapter.
(c) The board may prescribe and assess a fee for the
certification of a school and for investigation and review of the
school in an amount not to exceed the fee assessed on an
organization described by Section 162.001.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Sec. 162.204. BIENNIAL REPORT. A private medical school
certified under Section 162.203 shall provide to the board a
biennial report certifying that the school is in compliance with
this subchapter.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Sec. 162.205. SUSPENSION OR REVOCATION OF CERTIFICATION. If the
board determines at any time that a private medical school
certified under Section 162.203 has failed to comply with this
subchapter, the board may suspend or revoke the school's
certification.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Sec. 162.206. LIMITATION ON SCHOOL'S AUTHORITY. A private
medical school's authority to retain a physician's professional
income does not apply to a physician providing care in a facility
owned or operated by the school that is established outside the
school's historical geographical service area as it existed June
19, 1999.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.
Sec. 162.207. APPLICATION OF SUBCHAPTER. This subchapter does
not:
(1) affect the reporting requirements under Section 160.003; or
(2) apply to a private medical school certified under this
subchapter if all or substantially all of the school's assets are
sold.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.033(a), eff.
Sept. 1, 2001.