TITLE 22.EXAMINING BOARDS

Part 9. TEXAS STATE BOARD OF MEDICAL EXAMINERS

Chapter 163. LICENSURE

22 TAC §163.14

The Texas State Board of Medical Examiners adopts new §163.14, concerning Licensure to Practice Medicine Across State Lines, without changes to the proposed text as published in the April 23, 2004, issue of the Texas Register (29 TexReg 3894) and will not be republished.

The new rule is created in order to implement requirements for practicing medicine across state lines.

No comments were received regarding adoption of the rule.

The new section is adopted under the authority of the Occupations Code Annotated, §153.001, which provides the Texas State Board of Medical Examiners to adopt rules and bylaws as necessary to: govern its own proceedings; perform its duties; regulate the practice of medicine in this state; and enforce this subtitle.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on June 14, 2004.

TRD-200403861

Donald W. Patrick, MD, JD

Executive Director

Texas State Board of Medical Examiners

Effective date: July 4, 2004

Proposal publication date: April 23, 2004

For further information, please call: (512) 305-7016


Chapter 174. TELEMEDICINE

The Texas State Board of Medical Examiners adopts the repeal of §§174.1 - 174.17 and new §§174.1 - 174.5, concerning Telemedicine, without changes to the proposed text as published in the April 23, 2004, issue of the Texas Register (29 TexReg 3895) and will not be republished.

The new rules relate to standards for provision of telemedicine medical services and use of the Internet in transmission of information.

No comments were received regarding adoption of the rules.

22 TAC §§174.1 - 174.17

The repeals are adopted under the authority of the Occupations Code Annotated, §153.001, which provides the Texas State Board of Medical Examiners to adopt rules and bylaws as necessary to: govern its own proceedings; perform its duties; regulate the practice of medicine in this state; and enforce this subtitle.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on June 14, 2004.

TRD-200403862

Donald W. Patrick, MD, JD

Executive Director

Texas State Board of Medical Examiners

Effective date: July 4, 2004

Proposal publication date: April 23, 2004

For further information, please call: (512) 305-7016


22 TAC §§174.1 - 174.5

The new sections are adopted under the authority of the Occupations Code Annotated, §153.001, which provides the Texas State Board of Medical Examiners to adopt rules and bylaws as necessary to: govern its own proceedings; perform its duties; regulate the practice of medicine in this state; and enforce this subtitle.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on June 14, 2004.

TRD-200403863

Donald W. Patrick, MD, JD

Executive Director

Texas State Board of Medical Examiners

Effective date: July 4, 2004

Proposal publication date: April 23, 2004

For further information, please call: (512) 305-7016


Chapter 177. CERTIFICATION OF NON-PROFIT HEALTH ORGANIZATIONS

The Texas State Board of Medical Examiners adopts amendments to §§177.1 - 177.3, 177.5-177.8, the repeal of §§177.9 - 177.16 and new §§177.9 - 177.13, concerning Certification of Non-Profit Health Organizations, without changes to the proposed text as published in the April 23, 2004, issue of the Texas Register (29 TexReg 3898) and will not be republished. The Texas State Board of Medical Examiners also adopts an amendment to §177.4 with changes to the proposed text as published in the April 23, 2004, issue of the Texas Register (29 TexReg 3898). The text of the rule will be republished. There is a minor change in paragraph (2)(F). The words at the end of the sentence "unless the physician is terminated" have been removed.

The amendments, repeals and new rules are necessary for general cleanup of the chapter.

Elsewhere in this issue of the Texas Register , the Texas State Board of Medical Examiners adopts the rule review of Chapter 177.

No comments were received regarding adoption of the rules.

22 TAC §§177.1 - 177.8

The amendments are adopted under the authority of the Occupations Code Annotated, §153.001, which provides the Texas State Board of Medical Examiners to adopt rules and bylaws as necessary to: govern its own proceedings; perform its duties; regulate the practice of medicine in this state; and enforce this subtitle.

§177.4.Applications for Certification as a 162.001(b) Health Organization.

A health organization seeking certification under §162.001(b) of the Act shall submit an application to the board, to the attention of the Non-Profits department, on a form approved by the board. The application shall include:

(1) Initial Identification Statement. A statement signed and verified by the chief executive officer:

(A) indicating the name and mailing address of the health organization;

(B) indicating the names and mailing addresses of all members or that there are no members;

(C) indicating the names and mailing addresses of all officers; and

(D) indicating the names and mailing addresses of all directors.

(2) Initial Document Statement. A statement signed and verified by the chief executive officer attaching a copy of the current certificate of incorporation of the health organization and attaching a copy of the current by-laws of the health organization including provisions that:

(A) the health organization is organized for any or all of the following purposes:

(i) the carrying out of scientific research and research projects in the public interest in the fields of medical sciences, medical economics, public health, sociology, or related areas;

(ii) the supporting of medical education in medical schools through grants and scholarships;

(iii) the improving and developing of the abilities of individuals and institutions studying, teaching, and practicing medicine;

(iv) the delivery of health care to the public;

(v) the engaging in the instruction of the general public in the area of medical science, public health, and hygiene and related instruction useful to the individual and beneficial to the community.

(B) the physician(s) organizing and incorporating the health organization shall select the initial board of directors consistent with the mission, goals, and purposes of the health organization;

(C) the by-laws of the health organization shall be interpreted in a manner that reserves to the health organization through its retained physicians the sole authority to engage in the practice of medicine and reserves to the health organization through its board of directors the sole authority to direct the medical, professional, and ethical aspects of the practice of medicine;

(D) each director is required to immediately report to the board any action or event which such director reasonably and in good faith believes constitutes a violation or attempted violation of the Act or the Rules;

(E) each director is required to individually disclose to the member(s), if any, and to the board of directors (at the times of nomination and appointment) and to the board (at the times of initial application and biennial reports) the identity of each financial relationship known to such director, if any, which such director has with any member, any other director, any supplier of the health organization or any affiliate of any member, other director , or supplier of the health organization, and to provide a concise explanation of the nature of each such financial relationship; and

(F) the termination of the retention of any physician to provide medical services on behalf of the health organization during such physician's term of retention may be accomplished only by the board of directors or its physician designee(s) and such termination shall be subject to due process procedures adopted by the board of directors or its physician designee(s) or provided by the retention agreement between the health organization and the subject physician.

(3) Initial Director Statements. Statements signed and verified by each current director indicating that:

(A) such director is licensed by the board;

(B) such director is actively engaged in the practice of medicine and has no restrictions on his or her Texas medical license ;

(C) such director will, as a director, exercise independent judgment in all matters and, specifically, matters relating to credentialing, quality assurance, utilization review, peer review, and the practice of medicine;

(D) such director will, as a director, exercise best efforts to cause the health organization to comply with all relevant provisions of the Act and the Rules;

(E) such director will, as a director, immediately report to the board any action or event which such director reasonably and in good faith believes constitutes a violation or attempted violation of the Act or the Rules; and

(F) such director has disclosed within such director's statement the identity of all of such director's financial relationships, if any, of the type described in paragraph (2)(E) of this subsection and provided a concise explanation of the nature of each such financial relationship within such director's statement.

(4) Initial Compliance Statement. A statement signed and verified by the chief executive officer indicating that the health organization is in compliance with the requirements for certification and continued certification as required by the provisions of the Act and the Rules.

(5) Initial Fee Payment. A fee in the amount and form specified by the Rules.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on June 14, 2004.

TRD-200403864

Donald W. Patrick, MD, JD

Executive Director

Texas State Board of Medical Examiners

Effective date: July 4, 2004

Proposal publication date: April 23, 2004

For further information, please call: (512) 305-7016


Chapter 177. CERTIFICATION OF NON-PROFIT ORGANIZATIONS

22 TAC §§177.9 - 177.16

The repeals are adopted under the authority of the Occupations Code Annotated, §153.001, which provides the Texas State Board of Medical Examiners to adopt rules and bylaws as necessary to: govern its own proceedings; perform its duties; regulate the practice of medicine in this state; and enforce this subtitle.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on June 14, 2004.

TRD-200403865

Donald W. Patrick, MD, JD

Executive Director

Texas State Board of Medical Examiners

Effective date: July 4, 2004

Proposal publication date: April 23, 2004

For further information, please call: (512) 305-7016


Chapter 177. CERTIFICATION OF NON-PROFIT HEALTH ORGANIZATIONS

22 TAC §§177.9 - 177.13

The new rules are adopted under the authority of the Occupations Code Annotated, §153.001, which provides the Texas State Board of Medical Examiners to adopt rules and bylaws as necessary to: govern its own proceedings; perform its duties; regulate the practice of medicine in this state; and enforce this subtitle.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on June 14, 2004.

TRD-200403866

Donald W. Patrick, MD, JD

Executive Director

Texas State Board of Medical Examiners

Effective date: July 4, 2004

Proposal publication date: April 23, 2004

For further information, please call: (512) 305-7016


Chapter 184. SURGICAL ASSISTANTS

22 TAC §184.14

The Texas State Board of Medical Examiners adopts an amendment to §184.14, concerning qualifications of supervising physicians without changes to the proposed text as published in the April 23, 2004, issue of the Texas Register (29 TexReg 3902) and will not be republished.

The amendment clarifies that a supervising physician's license must be unrestricted and active.

No comments were received regarding adoption of the rule.

The amendment is adopted under the authority of the Occupations Code Annotated, §153.001, which provides the Texas State Board of Medical Examiners to adopt rules and bylaws as necessary to: govern its own proceedings; perform its duties; regulate the practice of medicine in this state; and enforce this subtitle.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on June 14, 2004.

TRD-200403867

Donald W. Patrick, MD, JD

Executive Director

Texas State Board of Medical Examiners

Effective date: July 4, 2004

Proposal publication date: April 23, 2004

For further information, please call: (512) 305-7016


Chapter 185. PHYSICIAN ASSISTANTS

22 TAC §§185.8, 185.16, 185.20

The Texas State Board of Medical Examiners adopts amendments to §§185.8, 185.16 and 185.20, concerning Physician Assistants, without changes to the proposed text as published in the April 23, 2004, issue of the Texas Register (29 TexReg 3903) and will not be republished.

The amendments regard inactive status, supervising physicians, employment guidelines, and complaints.

Elsewhere in this issue of the Texas Register , the Texas State Board of Medical Examiners adopts the rule review of Chapter 185.

No comments were received regarding adoption of the rules.

The amendments are adopted under the authority of the Occupations Code Annotated, §153.001, which provides the Texas State Board of Medical Examiners to adopt rules and bylaws as necessary to: govern its own proceedings; perform its duties; regulate the practice of medicine in this state; and enforce this subtitle.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on June 14, 2004.

TRD-200403868

Donald W. Patrick, MD, JD

Executive Director

Texas State Board of Medical Examiners

Effective date: July 4, 2004

Proposal publication date: April 23, 2004

For further information, please call: (512) 305-7016


Chapter 187. PROCEDURAL RULES

The Texas State Board of Medical Examiners adopts an amendment to §187.2 and §187.31, the repeal of §§187.26-187.28 and new §187.26 and §187.27, concerning Procedural Rules, without changes to the proposed text as published in the April 23, 2004, issue of the Texas Register (29 TexReg 3904) and will not be republished.

The amendments, repeals and new rules regard default judgments by the Board in SOAH administrative proceedings.

No comments were received regarding adoption of the rules.

Subchapter A. GENERAL PROVISIONS AND DEFINITIONS

22 TAC §187.2

The amendment is adopted under the authority of the Occupations Code Annotated, §153.001, which provides the Texas State Board of Medical Examiners to adopt rules and bylaws as necessary to: govern its own proceedings; perform its duties; regulate the practice of medicine in this state; and enforce this subtitle.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on June 14, 2004.

TRD-200403869

Donald W. Patrick, MD, JD

Executive Director

Texas State Board of Medical Examiners

Effective date: July 4, 2004

Proposal publication date: April 23, 2004

For further information, please call: (512) 305-7016


Subchapter C. FORMAL BOARD PROCEEDINGS AT SOAH

22 TAC §§187.26 - 187.28

The repeals are adopted under the authority of the Occupations Code Annotated, §153.001, which provides the Texas State Board of Medical Examiners to adopt rules and bylaws as necessary to: govern its own proceedings; perform its duties; regulate the practice of medicine in this state; and enforce this subtitle.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on June 14, 2004.

TRD-200403870

Donald W. Patrick, MD, JD

Executive Director

Texas State Board of Medical Examiners

Effective date: July 4, 2004

Proposal publication date: April 23, 2004

For further information, please call: (512) 305-7016


22 TAC §187.26, §187.27

The new rules are adopted under the authority of the Occupations Code Annotated, §153.001, which provides the Texas State Board of Medical Examiners to adopt rules and bylaws as necessary to: govern its own proceedings; perform its duties; regulate the practice of medicine in this state; and enforce this subtitle.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on June 14, 2004.

TRD-200403871

Donald W. Patrick, MD, JD

Executive Director

Texas State Board of Medical Examiners

Effective date: July 4, 2004

Proposal publication date: April 23, 2004

For further information, please call: (512) 305-7016


22 TAC §187.31

The amendment is adopted under the authority of the Occupations Code Annotated, §153.001, which provides the Texas State Board of Medical Examiners to adopt rules and bylaws as necessary to: govern its own proceedings; perform its duties; regulate the practice of medicine in this state; and enforce this subtitle.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on June 14, 2004.

TRD-200403872

Donald W. Patrick, MD, JD

Executive Director

Texas State Board of Medical Examiners

Effective date: July 4, 2004

Proposal publication date: April 23, 2004

For further information, please call: (512) 305-7016


Chapter 190. DISCIPLINARY GUIDELINES

Subchapter B. VIOLATION GUIDELINES

22 TAC §190.8

The Texas State Board of Medical Examiners adopts an amendment to §190.8, concerning Disciplinary Guidelines, without changes to the proposed text as published in the April 23, 2004, issue of the Texas Register (29 TexReg 3908) and will not be republished.

The amendment clarifies the definition of a proper physician/patient relationship for hospice patients.

No comments were received regarding adoption of the amendment.

The amendment is adopted under the authority of the Occupations Code Annotated, §153.001, which provides the Texas State Board of Medical Examiners to adopt rules and bylaws as necessary to: govern its own proceedings; perform its duties; regulate the practice of medicine in this state; and enforce this subtitle.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on June 14, 2004.

TRD-200403873

Donald W. Patrick, MD, JD

Executive Director

Texas State Board of Medical Examiners

Effective date: July 4, 2004

Proposal publication date: April 23, 2004

For further information, please call: (512) 305-7016