1-1 AN ACT
1-2 relating to the regulation of surgical assistants; granting
1-3 rulemaking authority; providing an administrative penalty.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Subtitle C, Title 3, Occupations Code, is amended
1-6 by adding Chapter 206 to read as follows:
1-7 CHAPTER 206. SURGICAL ASSISTANTS
1-8 SUBCHAPTER A. GENERAL PROVISIONS
1-9 Sec. 206.001. DEFINITIONS. In this chapter:
1-10 (1) "Advisory committee" means the advisory committee
1-11 created under this chapter.
1-12 (2) "Delegating physician" means a physician who is
1-13 licensed by the medical board either as a doctor of medicine or
1-14 doctor of osteopathic medicine and who delegates, to a licensed
1-15 surgical assistant, surgical assisting and oversees and accepts
1-16 responsibility for that surgical assisting.
1-17 (3) "Direct supervision" means supervision by a
1-18 delegating physician who is physically present and who personally
1-19 directs delegated acts and remains immediately available to
1-20 personally respond to any emergency until the patient is released
1-21 from the operating room or care and has been transferred, as
1-22 determined by medical board rule, to another physician.
1-23 (4) "Executive director" means the executive director
1-24 of the medical board.
2-1 (5) "Medical board" means the Texas State Board of
2-2 Medical Examiners.
2-3 (6) "Surgical assisting" means providing aid under
2-4 direct supervision in exposure, hemostasis, and other
2-5 intraoperative technical functions that assist a physician in
2-6 performing a safe operation with optimal results for the patient,
2-7 including the delegated authority to provide local infiltration or
2-8 the topical application of a local anesthetic at the operation
2-9 site. This term is synonymous with "first assisting."
2-10 Sec. 206.002. APPLICABILITY. (a) A person is not required
2-11 to hold a license under this chapter if the person is:
2-12 (1) a student enrolled in a surgical assistant
2-13 education program approved by the medical board who is assisting in
2-14 a surgical operation that is an integral part of the program of
2-15 study;
2-16 (2) a surgical assistant employed in the service of
2-17 the federal government while performing duties related to that
2-18 employment;
2-19 (3) a person acting under the delegated authority of a
2-20 licensed physician;
2-21 (4) a licensed health care worker acting within the
2-22 scope of the person's license;
2-23 (5) a registered nurse; or
2-24 (6) a licensed physician assistant.
2-25 (b) This chapter does not affect the authority of a licensed
2-26 physician to delegate acts under Subtitle B.
2-27 (Sections 206.003-206.050 reserved for expansion
3-1 SUBCHAPTER B. ADVISORY COMMITTEE
3-2 Sec. 206.051. ADVISORY COMMITTEE. (a) The advisory
3-3 committee is an informal advisory committee to the medical board
3-4 and is not subject to Chapter 2110, Government Code.
3-5 (b) The advisory committee has no independent rulemaking
3-6 authority.
3-7 Sec. 206.052. APPOINTMENT OF ADVISORY COMMITTEE. (a) The
3-8 advisory committee consists of six members appointed by the
3-9 president of the medical board. One member must be a registered
3-10 perioperative nurse with at least five years of clinical experience
3-11 as a registered perioperative nurse. Each of the remaining members
3-12 must be:
3-13 (1) a practicing surgical assistant who has at least
3-14 five years of clinical experience as a surgical assistant; or
3-15 (2) a physician licensed in this state who supervises
3-16 a surgical assistant.
3-17 (b) Appointments to the advisory committee shall be made
3-18 without regard to the race, color, disability, sex, religion, age,
3-19 or national origin of the appointees.
3-20 Sec. 206.053. MEMBERSHIP AND EMPLOYEE RESTRICTIONS. (a) In
3-21 this section, "Texas trade association" means a cooperative and
3-22 voluntarily joined association of business or professional
3-23 competitors in this state designed to assist its members and its
3-24 industry or profession in dealing with mutual business or
3-25 professional problems and in promoting their common interest.
3-26 (b) A person may not be a member of the advisory committee
3-27 if:
4-1 (1) the person is an officer, employee, or paid
4-2 consultant of a Texas trade association in the field of surgical
4-3 assisting; or
4-4 (2) the person's spouse is an officer, manager, or
4-5 paid consultant of a Texas trade association in the field of
4-6 surgical assisting.
4-7 (c) A person may not be a member of the advisory committee
4-8 if the person is required to register as a lobbyist under Chapter
4-9 305, Government Code, because of the person's activities for
4-10 compensation on behalf of a profession related to the field of
4-11 surgical assisting.
4-12 Sec. 206.054. TERMS; VACANCY. (a) Members of the advisory
4-13 committee are appointed for two-year terms. The terms of the
4-14 members expire on February 1 of each odd-numbered year.
4-15 (b) If a vacancy occurs during a member's term, the
4-16 president of the medical board shall appoint a new member to fill
4-17 the unexpired term.
4-18 (c) An advisory committee member may not serve more than two
4-19 consecutive full terms.
4-20 Sec. 206.055. GROUNDS FOR REMOVAL. (a) It is a ground for
4-21 removal from the advisory committee that a member:
4-22 (1) does not have at the time of appointment the
4-23 qualifications required by Section 206.052;
4-24 (2) does not maintain during service on the advisory
4-25 committee the qualifications required by Section 206.052;
4-26 (3) is ineligible for membership under Section
4-27 206.053; or
5-1 (4) cannot, because of illness or disability,
5-2 discharge the member's duties for a substantial part of the
5-3 member's term.
5-4 (b) The validity of an action of the committee is not
5-5 affected by the fact that it is taken when a ground for removal of
5-6 a committee member exists.
5-7 Sec. 206.056. OFFICERS. The president of the medical board
5-8 shall designate biennially a committee member as the presiding
5-9 officer of the advisory committee to serve in that capacity at the
5-10 will of the president.
5-11 Sec. 206.057. PER DIEM. An advisory committee member is not
5-12 entitled to reimbursement for travel expenses or compensation.
5-13 Sec. 206.058. MEETINGS. (a) The advisory committee shall
5-14 meet as requested by the medical board.
5-15 (b) A meeting may be held by telephone conference call.
5-16 (Sections 206.059-206.100 reserved for expansion
5-17 SUBCHAPTER C. POWERS AND DUTIES OF MEDICAL BOARD
5-18 Sec. 206.101. GENERAL POWERS AND DUTIES. The medical board
5-19 shall:
5-20 (1) establish qualifications for a surgical assistant
5-21 to practice in this state;
5-22 (2) establish requirements for an examination for a
5-23 license to practice as a surgical assistant;
5-24 (3) establish minimum education and training
5-25 requirements necessary for a license to practice as a surgical
5-26 assistant;
5-27 (4) prescribe the application form for a license to
6-1 practice as a surgical assistant; and
6-2 (5) develop an approved program of mandatory
6-3 continuing education and the manner in which attendance at all
6-4 approved courses, clinics, forums, lectures, programs, or seminars
6-5 is monitored and recorded.
6-6 Sec. 206.102. ANNUAL REPORT. (a) The medical board shall
6-7 prepare annually a complete and detailed written report accounting
6-8 for all funds received and disbursed by the medical board under
6-9 this chapter during the preceding fiscal year.
6-10 (b) The annual report must meet the reporting requirements
6-11 applicable to financial reporting provided in the General
6-12 Appropriations Act.
6-13 Sec. 206.103. GIFTS, GRANTS, AND DONATIONS. In addition to
6-14 any fees paid to the medical board or money appropriated to the
6-15 medical board, the medical board may receive and accept under this
6-16 chapter a gift, grant, donation, or other item of value from any
6-17 source, including the United States or a private source.
6-18 (Sections 206.104-206.150 reserved for expansion
6-19 SUBCHAPTER D. PUBLIC INTEREST INFORMATION; COMPLAINT AND
6-20 INVESTIGATIVE INFORMATION
6-21 Sec. 206.151. PUBLIC PARTICIPATION. (a) The medical board
6-22 shall develop and implement policies that provide the public with a
6-23 reasonable opportunity to appear before the medical board and speak
6-24 on any issue relating to surgical assistants.
6-25 (b) The executive director of the medical board shall
6-26 prepare and maintain a written plan that describes how a person who
6-27 does not speak English may be provided reasonable access to the
7-1 medical board's programs and services under this chapter.
7-2 Sec. 206.152. PUBLIC INTEREST INFORMATION. (a) The medical
7-3 board shall prepare information of public interest describing the
7-4 functions of the medical board and the procedures by which
7-5 complaints are filed and resolved under this chapter.
7-6 (b) The medical board shall make the information available
7-7 to the public and appropriate state agencies.
7-8 Sec. 206.153. COMPLAINTS. (a) The medical board by rule
7-9 shall establish methods by which consumers and service recipients
7-10 are notified of the name, mailing address, and telephone number of
7-11 the medical board for the purpose of directing complaints about
7-12 licensed surgical assistants to the medical board.
7-13 (b) The medical board shall list with its regular telephone
7-14 number any toll-free telephone number established under other state
7-15 law that may be called to present a complaint about a licensed
7-16 surgical assistant.
7-17 Sec. 206.154. RECORDS OF COMPLAINTS. (a) The medical board
7-18 shall maintain a file on each written complaint filed with the
7-19 medical board under this chapter. The file must include:
7-20 (1) the name of the person who filed the complaint;
7-21 (2) the date the complaint is received by the medical
7-22 board;
7-23 (3) the subject matter of the complaint;
7-24 (4) the name of each person contacted in relation to
7-25 the complaint;
7-26 (5) a summary of the results of the review or
7-27 investigation of the complaint; and
8-1 (6) an explanation of the reason the file was closed,
8-2 if the medical board closed the file without taking action other
8-3 than to investigate the complaint.
8-4 (b) The medical board shall provide to the person filing the
8-5 complaint and to each person who is a subject of the complaint a
8-6 copy of the medical board's policies and procedures relating to
8-7 complaint investigation and resolution. A person who reports a
8-8 complaint by phone shall be given information on how to file a
8-9 written complaint.
8-10 (c) The medical board, at least quarterly and until final
8-11 disposition of the complaint, shall notify the person filing the
8-12 complaint and each person who is a subject of the complaint of the
8-13 status of the investigation unless the notice would jeopardize an
8-14 undercover investigation.
8-15 Sec. 206.155. LICENSE HOLDER ACCESS TO COMPLAINT
8-16 INFORMATION. (a) The medical board shall provide a license holder
8-17 who is the subject of a formal complaint filed under this chapter
8-18 with access to all information in its possession that the medical
8-19 board intends to offer into evidence in presenting its case in
8-20 chief at the contested hearing on the complaint, subject to any
8-21 other privilege or restriction established by rule, statute, or
8-22 legal precedent. The medical board shall provide the information
8-23 not later than the 30th day after receipt of a written request from
8-24 the license holder or the license holder's counsel, unless good
8-25 cause is shown for delay.
8-26 (b) Notwithstanding Subsection (a), the medical board is not
8-27 required to provide:
9-1 (1) medical board investigative reports;
9-2 (2) investigative memoranda;
9-3 (3) the identity of a nontestifying complainant;
9-4 (4) attorney-client communications;
9-5 (5) attorney work product; or
9-6 (6) other material covered by a privilege recognized
9-7 by the Texas Rules of Civil Procedure or the Texas Rules of
9-8 Evidence.
9-9 (c) The provision of information does not constitute a
9-10 waiver of privilege or confidentiality under this chapter or other
9-11 law.
9-12 Sec. 206.156. HEALTH CARE ENTITY REQUEST FOR INFORMATION. On
9-13 the written request of a health care entity, the medical board
9-14 shall provide to the entity:
9-15 (1) information about a complaint filed against a
9-16 license holder that was resolved after investigation by:
9-17 (A) a disciplinary order of the medical board;
9-18 or
9-19 (B) an agreed settlement; and
9-20 (2) the basis of and current status of any complaint
9-21 under active investigation that has been referred by the executive
9-22 director or the director's designee for legal action.
9-23 Sec. 206.157. CONFIDENTIALITY OF INVESTIGATIVE INFORMATION.
9-24 A complaint, adverse report, investigation file, or other report,
9-25 the identity of and reports made by a physician or surgical
9-26 assistant performing or supervising compliance monitoring for the
9-27 medical board, or other investigative information in the possession
10-1 of or received or gathered by the medical board, medical board
10-2 employee or agent relating to a license holder, a license
10-3 application, or a criminal investigation or proceeding is
10-4 privileged and confidential and is not subject to discovery,
10-5 subpoena, or other means of legal compulsion for release to any
10-6 person other than the medical board or medical board employee or
10-7 agent involved in license holder discipline.
10-8 Sec. 206.158. PERMITTED DISCLOSURE OF INVESTIGATIVE
10-9 INFORMATION. (a) Investigative information in the possession of
10-10 the medical board, medical board employee, or agent that relates to
10-11 the discipline of a license holder may be disclosed to:
10-12 (1) a licensing authority in another state or a
10-13 territory or country in which the license holder is licensed or
10-14 has applied for a license; or
10-15 (2) a peer review committee reviewing:
10-16 (A) an application for privileges; or
10-17 (B) the qualifications of the license holder
10-18 with respect to retaining privileges.
10-19 (b) If the investigative information in the possession of
10-20 the medical board or a medical board employee or agent indicates a
10-21 crime may have been committed, the medical board shall report the
10-22 information to the proper law enforcement agency. The medical
10-23 board shall cooperate with and assist all law enforcement agencies
10-24 conducting criminal investigations of a license holder by providing
10-25 information relevant to the investigation. Confidential
10-26 information disclosed by the medical board to a law enforcement
10-27 agency remains confidential and may not be disclosed by the law
11-1 enforcement agency except as necessary to further the
11-2 investigation.
11-3 Sec. 206.159. IMMUNITY AND REPORTING REQUIREMENTS. (a) A
11-4 medical peer review committee in this state, a quality assurance
11-5 committee in this state, a surgical assistant, a surgical assistant
11-6 student, a physician practicing medicine in this state, or any
11-7 person usually present in an operating room, including a nurse or
11-8 surgical technologist, shall report relevant information to the
11-9 advisory committee related to the acts of a surgical assistant in
11-10 this state if, in that person's opinion, a surgical assistant poses
11-11 a continuing threat to the public welfare through the person's
11-12 practice as a surgical assistant. The duty to report under this
11-13 section may not be nullified through contract.
11-14 (b) A person who, without malice, furnishes records,
11-15 information, or assistance to the advisory committee under this
11-16 section is immune from any civil liability arising from that action
11-17 in a suit against the person brought by or on behalf of a surgical
11-18 assistant who is reported under this section.
11-19 (c) Sections 160.002, 160.003, 160.006, 160.007, 160.009,
11-20 160.013, and 160.014 apply to medical peer review regarding a
11-21 licensed surgical assistant.
11-22 (Sections 206.160-206.200 reserved for expansion
11-23 SUBCHAPTER E. LICENSE REQUIREMENTS
11-24 Sec. 206.201. LICENSE REQUIRED. (a) Except as provided by
11-25 Section 206.002, a person may not practice as a surgical assistant
11-26 unless the person is licensed under this chapter.
11-27 (b) Unless the person holds a license under this chapter, a
12-1 person may not use, in connection with the person's name:
12-2 (1) the title "Licensed Surgical Assistant"; or
12-3 (2) any other designation that would imply that the
12-4 person is a licensed surgical assistant.
12-5 Sec. 206.202. LICENSE APPLICATION. An applicant for a
12-6 license must:
12-7 (1) file a written application with the medical board
12-8 on a form prescribed by the medical board; and
12-9 (2) pay the application fee set by the medical board.
12-10 Sec. 206.203. LICENSE ELIGIBILITY. (a) Except as provided
12-11 by Section 206.206, to be eligible for a license, a person must:
12-12 (1) be of good moral character;
12-13 (2) have not been convicted of a felony or a crime
12-14 involving moral turpitude;
12-15 (3) not use drugs or alcohol to an extent that affects
12-16 the applicant's professional competency;
12-17 (4) not have had a license or certification revoked by
12-18 a licensing agency or by a certifying professional organization;
12-19 and
12-20 (5) not have engaged in fraud or deceit in applying
12-21 for a license under this chapter.
12-22 (b) In addition to meeting the requirements of Subsection
12-23 (a), a person must:
12-24 (1) pass the examination required by Section 206.204;
12-25 (2) hold at least an associate's degree based on
12-26 completion of an educational program that is substantially
12-27 equivalent to the education required for a registered nurse or
13-1 physician assistant who specializes in surgical assisting;
13-2 (3) demonstrate to the satisfaction of the medical
13-3 board the completion of full-time work experience performed in this
13-4 country under the direct supervision of a physician licensed in
13-5 this country and consisting of at least 2,000 hours of performance
13-6 as an assistant in surgical procedures for the three years
13-7 preceding the date of application; and
13-8 (4) possess a current certification by a national
13-9 certifying body approved by the medical board.
13-10 (c) A degree program described by Subsection (b)(2) must
13-11 contain a clinical component and must include courses in anatomy,
13-12 physiology, basic pharmacology, aseptic techniques, operative
13-13 procedures, chemistry, microbiology, and pathophysiology.
13-14 Sec. 206.204. EXAMINATION. An applicant for a surgical
13-15 assistant license must pass a surgical assistant examination
13-16 approved by the medical board. Any written portion of the
13-17 examination must be validated by an independent testing
13-18 professional.
13-19 Sec. 206.205. SPECIAL ELIGIBILITY FOR LICENSE. (a) A person
13-20 who is otherwise eligible for a license under Section 206.203 is
13-21 not required to take the examination required by Section
13-22 206.203(b)(1) if the person:
13-23 (1) passed a surgical assistant examination required
13-24 for certification under Section 206.203(b)(4) that the medical
13-25 board determines is substantially equivalent to the examination
13-26 required by the medical board under this chapter; and
13-27 (2) applies for a license under this section before
14-1 September 1, 2002.
14-2 (b) A person who is otherwise eligible for a license under
14-3 Section 206.203 is not required to meet the educational
14-4 requirements under Section 206.203(b)(2) if the person applies for
14-5 a license under this section before September 1, 2002, and:
14-6 (1) will complete before the third anniversary of the
14-7 date the license is issued under this subsection the following
14-8 academic courses approved by the medical board:
14-9 (A) anatomy;
14-10 (B) physiology;
14-11 (C) basic pharmacology;
14-12 (D) aseptic techniques;
14-13 (E) operative procedures;
14-14 (F) chemistry; and
14-15 (G) microbiology; or
14-16 (2) has been continuously certified since September
14-17 30, 1995, as a surgical assistant by a national certifying body
14-18 approved by the medical board and has practiced full-time as a
14-19 surgical assistant under the direct supervision of a physician
14-20 licensed in this country.
14-21 (c) A license issued under Subsection (b)(1) may not be
14-22 renewed after the third anniversary of the date of issuance unless
14-23 the license holder completes the academic courses described by
14-24 Subsection (b)(1).
14-25 Sec. 206.206. TEMPORARY LICENSE. (a) The medical board
14-26 may, through the executive director, issue a temporary license to
14-27 an applicant who:
15-1 (1) submits an application on a form prescribed by the
15-2 medical board;
15-3 (2) has passed an examination required by the medical
15-4 board relating to the practice of surgical assisting;
15-5 (3) pays the appropriate fee set by the medical board;
15-6 (4) if licensed in another state, is licensed in good
15-7 standing; and
15-8 (5) meets all the qualifications for a license under
15-9 this chapter and is waiting for the next scheduled meeting of the
15-10 medical board for the license to be issued.
15-11 (b) A temporary license is valid until the 100th day after
15-12 the date issued and may be extended until the 130th day after the
15-13 date issued.
15-14 Sec. 206.207. ASSISTANCE BY MEDICAL BOARD. The medical
15-15 board shall provide administrative and clerical employees as
15-16 necessary to administer this subchapter.
15-17 Sec. 206.208. FEES. (a) The medical board shall set and
15-18 collect fees in amounts that are reasonable and necessary to cover
15-19 the costs of administering and enforcing this chapter without the
15-20 use of any other funds generated by the medical board.
15-21 (b) Fees collected by the medical board under this chapter
15-22 shall be deposited by the medical board in the state treasury to
15-23 the credit of an account in the general revenue fund and may be
15-24 spent to cover the costs of administering and enforcing this
15-25 chapter. At the end of each fiscal biennium, the comptroller shall
15-26 transfer any surplus money remaining in the account to the general
15-27 revenue fund.
16-1 (c) All money paid to the medical board under this chapter
16-2 is subject to Subchapter F, Chapter 404, Government Code.
16-3 Sec. 206.209. ISSUANCE AND RENEWAL OF LICENSE. The medical
16-4 board shall issue a surgical assistant license in this state to a
16-5 person who meets the requirements of this chapter and the rules
16-6 adopted under this chapter.
16-7 Sec. 206.210. LICENSE RENEWAL. (a) The medical board by
16-8 rule shall provide for the annual renewal of a surgical assistant
16-9 license.
16-10 (b) The medical board by rule may adopt a system under which
16-11 licenses expire on various dates during the year. For the year in
16-12 which the license expiration date is changed, license fees shall be
16-13 prorated on a monthly basis so that each license holder pays only
16-14 that portion of the license fee that is allocable to the number of
16-15 months during which the license is valid. On renewal of the license
16-16 on the new expiration date, the total license renewal fee is
16-17 payable.
16-18 Sec. 206.211. NOTICE OF LICENSE RENEWAL. At least 30 days
16-19 before the expiration of a person's license, the medical board
16-20 shall send written notice of the impending license expiration to
16-21 the person at the license holder's last known address according to
16-22 the records of the medical board.
16-23 Sec. 206.212. PROCEDURE FOR RENEWAL. (a) A person who is
16-24 otherwise eligible to renew a license may renew an unexpired
16-25 license by paying the required renewal fee to the medical board
16-26 before the expiration date of the license. A person whose license
16-27 has expired may not engage in activities that require a license
17-1 until the license has been renewed under this section.
17-2 (b) If the person's license has been expired for 90 days or
17-3 less, the person may renew the license by paying to the medical
17-4 board one and one-half times the required renewal fee.
17-5 (c) If the person's license has been expired for longer than
17-6 90 days but less than one year, the person may renew the license by
17-7 paying to the medical board two times the required renewal fee.
17-8 (d) If the person's license has been expired for one year or
17-9 longer, the person may not renew the license. The person may
17-10 obtain a new license by complying with the requirements and
17-11 procedures for obtaining an original license.
17-12 Sec. 206.213. RENEWAL OF EXPIRED LICENSE BY OUT-OF-STATE
17-13 PRACTITIONER. (a) If the person was licensed as a surgical
17-14 assistant in this state, moved to another state, and is currently
17-15 licensed as a surgical assistant and has been in practice as a
17-16 surgical assistant in the other state for the two years preceding
17-17 application, the person may renew an expired surgical assistant
17-18 license without reexamination.
17-19 (b) The person must pay to the medical board a fee that is
17-20 equal to two times the required renewal fee for the license.
17-21 Sec. 206.214. LICENSE HOLDER INFORMATION. (a) Each license
17-22 holder shall file with the medical board:
17-23 (1) the license holder's mailing address;
17-24 (2) the address of the license holder's residence;
17-25 (3) the mailing address of each of the license
17-26 holder's offices; and
17-27 (4) the address for the location of each of the
18-1 license holder's offices if that address is different from the
18-2 office's mailing address.
18-3 (b) A license holder shall:
18-4 (1) notify the medical board of a change of the
18-5 license holder's residence or business address; and
18-6 (2) provide the medical board with the license
18-7 holder's new address not later than the 30th day after the date the
18-8 address change occurs.
18-9 (Sections 206.215-206.250 reserved for expansion
18-10 SUBCHAPTER F. SCOPE OF PRACTICE
18-11 Sec. 206.251. SCOPE OF PRACTICE. (a) The practice of a
18-12 surgical assistant is limited to surgical assisting performed under
18-13 the direct supervision of a physician who delegated the acts.
18-14 (b) The practice of a surgical assistant may be performed in
18-15 any place authorized by a delegating licensed physician, including
18-16 a clinic, hospital, ambulatory surgical center, or other
18-17 institutional setting.
18-18 Sec. 206.252. SERVICE CONTRACTS. This chapter does not:
18-19 (1) limit the employment arrangement of a surgical
18-20 assistant licensed under this chapter;
18-21 (2) require a surgeon or hospital to contract with a
18-22 surgical assistant;
18-23 (3) authorize a health maintenance organization,
18-24 preferred provider organization, or health benefit plan to require
18-25 a surgeon to contract with a surgical assistant; or
18-26 (4) require a hospital to use a licensed surgical
18-27 assistant for surgical assisting.
19-1 Sec. 206.253. CERTAIN PROHIBITED PRACTICES. (a) This
19-2 chapter does not authorize a person who holds a license issued
19-3 under this chapter to engage in the practice of:
19-4 (1) medicine, as defined by Subtitle B, Title 3,
19-5 Occupations Code;
19-6 (2) professional nursing, as defined by Chapter 301,
19-7 Occupations Code; or
19-8 (3) nursing, as defined by Chapter 302, Occupations
19-9 Code.
19-10 (b) A health maintenance organization, preferred provider
19-11 organization, or health benefit plan may not require a registered
19-12 nurse or physician assistant to be licensed as a surgical assistant
19-13 as a condition for reimbursement.
19-14 (c) A clinic, hospital, ambulatory surgical center, or other
19-15 facility may not require a registered nurse or physician assistant
19-16 to be licensed as a surgical assistant as a condition for assisting
19-17 at surgery at the facility.
19-18 Sec. 206.254. ESTABLISHMENT OF CERTAIN FUNCTIONS AND
19-19 STANDARDS. A surgical assistant and the surgical assistant's
19-20 delegating physician shall ensure that:
19-21 (1) the surgical assistant's scope of function is
19-22 identified;
19-23 (2) the delegation of medical tasks is appropriate to
19-24 the surgical assistant's level of competence;
19-25 (3) the relationship between the surgical assistant
19-26 and the delegating physician and the access of the surgical
19-27 assistant to the delegating physician are defined; and
20-1 (4) a process is established for evaluating the
20-2 surgical assistant's performance.
20-3 (Sections 206.255-206.300 reserved for expansion
20-4 SUBCHAPTER G. DISCIPLINARY PROCEEDINGS
20-5 Sec. 206.301. DISCIPLINARY ACTIONS BY THE MEDICAL BOARD. (a)
20-6 Except as provided by Section 206.305, on a determination that an
20-7 applicant or license holder committed an act described by Section
20-8 206.302, 206.303, or 206.304, the medical board by order shall take
20-9 any of the following actions:
20-10 (1) deny the person's license application or revoke
20-11 the person's license;
20-12 (2) require the person to submit to the care,
20-13 counseling, or treatment of a health care practitioner designated
20-14 by the medical board;
20-15 (3) stay enforcement of an order and place the person
20-16 on probation;
20-17 (4) require the person to complete additional
20-18 training;
20-19 (5) suspend, limit, or restrict the person's license,
20-20 including:
20-21 (A) limiting the practice of the person to, or
20-22 excluding from the person's practice, one or more specified
20-23 activities of surgical assisting; or
20-24 (B) stipulating periodic medical board review;
20-25 (6) assess an administrative penalty against the
20-26 person as provided by Section 206.351;
20-27 (7) order the person to perform public service; or
21-1 (8) administer a public reprimand.
21-2 (b) If the medical board stays enforcement of an order and
21-3 places a person on probation, the medical board retains the right
21-4 to vacate the probationary stay and enforce the original order for
21-5 noncompliance with the terms of probation or impose any other
21-6 remedial measure or sanction authorized by this section.
21-7 (c) The medical board may restore or reissue a license or
21-8 remove any disciplinary or corrective measure that the medical
21-9 board has imposed.
21-10 Sec. 206.302. CONDUCT RELATED TO FRAUD OR MISREPRESENTATION.
21-11 The medical board may take action under Section 206.301 against an
21-12 applicant or license holder who:
21-13 (1) fraudulently or deceptively obtains or attempts to
21-14 obtain a license;
21-15 (2) fraudulently or deceptively uses a license;
21-16 (3) falsely represents that the person is a physician;
21-17 (4) acts in an unprofessional or dishonorable manner
21-18 that is likely to deceive, defraud, or injure the public;
21-19 (5) fraudulently alters any surgical assistant
21-20 license, certificate, or diploma;
21-21 (6) uses any surgical assistant license, certificate,
21-22 or diploma that has been fraudulently purchased, issued, or
21-23 counterfeited or that has been materially altered;
21-24 (7) directly or indirectly aids or abets the practice
21-25 as a surgical assistant by any person not licensed by the medical
21-26 board to practice as a surgical assistant; or
21-27 (8) unlawfully advertises in a false, misleading, or
22-1 deceptive manner as defined by Section 101.201.
22-2 Sec. 206.303. CONDUCT RELATED TO VIOLATION OF LAW. (a) The
22-3 medical board may take action under Section 206.301 against an
22-4 applicant or license holder who:
22-5 (1) violates this chapter or a rule adopted under this
22-6 chapter;
22-7 (2) is convicted of a felony, placed on deferred
22-8 adjudication, or placed in a pretrial diversion program; or
22-9 (3) violates state law if the violation is connected
22-10 with practice as a surgical assistant.
22-11 (b) A complaint, indictment, or conviction of a law
22-12 violation is not necessary for the medical board to act under
22-13 Subsection (a)(3). Proof of the commission of the act while in
22-14 practice as a surgical assistant or under the guise of practice as
22-15 a surgical assistant is sufficient for action by the medical board.
22-16 Sec. 206.304. CONDUCT INDICATING LACK OF FITNESS. (a) The
22-17 medical board may take action under Section 206.301 against an
22-18 applicant or license holder who:
22-19 (1) habitually uses drugs or intoxicating liquors to
22-20 the extent that, in the medical board's opinion, the person cannot
22-21 safely perform as a surgical assistant;
22-22 (2) has been adjudicated as mentally incompetent;
22-23 (3) has a mental or physical condition that renders
22-24 the person unable to safely perform as a surgical assistant;
22-25 (4) has committed an act of moral turpitude;
22-26 (5) has failed to practice as a surgical assistant in
22-27 an acceptable manner consistent with public health and welfare;
23-1 (6) has had the person's license or other
23-2 authorization to practice as a surgical assistant suspended,
23-3 revoked, or restricted;
23-4 (7) has had other disciplinary action taken by another
23-5 state or by the uniformed services of the United States regarding
23-6 practice as a surgical assistant;
23-7 (8) is removed or suspended or has disciplinary action
23-8 taken by the person's peers in any professional association or
23-9 society or is being disciplined by a licensed hospital or medical
23-10 staff of a hospital, including removal, suspension, limitation of
23-11 privileges, or other disciplinary action, if that action, in the
23-12 opinion of the medical board, was based on unprofessional conduct
23-13 or professional incompetence that was likely to harm the public;
23-14 (9) has repeated or recurring meritorious health care
23-15 liability claims that, in the medical board's opinion, are evidence
23-16 of professional incompetence likely to harm the public; or
23-17 (10) sexually abuses or exploits another person during
23-18 the license holder's practice as a surgical assistant.
23-19 (b) For the purpose of Subsection (a)(7), a certified copy
23-20 of the record of the state or uniformed services of the United
23-21 States taking the action constitutes conclusive evidence of that
23-22 action.
23-23 (c) An action described by Subsection (a)(8) does not
23-24 constitute state action on the part of the association, society, or
23-25 hospital medical staff.
23-26 Sec. 206.305. REHABILITATION ORDER. The medical board,
23-27 through an agreed order or after a contested case proceeding, may
24-1 impose a rehabilitation order on an applicant, as a prerequisite
24-2 for issuing a license, or on a license holder based on:
24-3 (1) the person's intemperate use of drugs or alcohol
24-4 directly resulting from habituation or addiction caused by medical
24-5 care or treatment provided by a physician;
24-6 (2) the person's intemperate use of drugs or alcohol
24-7 during the five years preceding the date of the report that could
24-8 adversely affect the person's ability to safely practice as a
24-9 surgical assistant, if the person:
24-10 (A) reported the use; and
24-11 (B) has not previously been the subject of a
24-12 substance abuse related order of the medical board;
24-13 (3) a judgment by a court that the person is of
24-14 unsound mind; or
24-15 (4) the results of a mental or physical examination,
24-16 or an admission by the person, indicating that the person suffers
24-17 from a potentially dangerous limitation or an inability to practice
24-18 as a surgical assistant with reasonable skill and safety because of
24-19 illness or any other physical or mental condition.
24-20 Sec. 206.306. EFFECT OF REHABILITATION ORDER. (a) A
24-21 rehabilitation order imposed under Section 206.305 is a
24-22 nondisciplinary private order. If entered into by agreement, the
24-23 order is an agreed disposition or settlement agreement for purposes
24-24 of civil litigation and is exempt from Chapter 552, Government
24-25 Code.
24-26 (b) The rehabilitation order must contain findings of fact
24-27 and conclusions of law. The order may impose a license revocation
25-1 or suspension, a period of probation or restriction, or any other
25-2 sanction authorized by this chapter or agreed to by the medical
25-3 board and the person subject to the order.
25-4 (c) A violation of a rehabilitation order may result in
25-5 disciplinary action under this chapter or under the terms of the
25-6 agreed order.
25-7 (d) A violation of a rehabilitation order is grounds for
25-8 disciplinary action based on:
25-9 (1) unprofessional or dishonorable conduct; or
25-10 (2) any provision of this chapter that applies to the
25-11 conduct that resulted in the violation.
25-12 Sec. 206.307. AUDIT OF REHABILITATION ORDER. (a) The
25-13 medical board shall maintain a rehabilitation order imposed under
25-14 Section 206.305 in a confidential file. The file is subject to an
25-15 independent audit by the state auditor or a private auditor with
25-16 whom the board contracts to perform the audit to ensure that only
25-17 qualified license holders are subject to rehabilitation orders.
25-18 (b) An audit may be performed at any time at the direction
25-19 of the medical board. The medical board shall ensure that an audit
25-20 is performed at least once in each three-year period.
25-21 (c) The audit results are a matter of public record and
25-22 shall be reported in a manner that maintains the confidentiality of
25-23 each license holder who is the subject of a rehabilitation order.
25-24 Sec. 206.308. SUBPOENA. (a) The executive director, the
25-25 director's designee, or the secretary-treasurer of the board may
25-26 issue a subpoena or subpoena duces tecum:
25-27 (1) to conduct an investigation or a contested case
26-1 proceeding related to:
26-2 (A) alleged misconduct by a surgical assistant;
26-3 (B) an alleged violation of this chapter or
26-4 another law related to the practice of a surgical assistant; or
26-5 (C) the provision of health care under this
26-6 chapter;
26-7 (2) for purposes of determining whether to issue,
26-8 suspend, restrict, or revoke a license under this chapter; or
26-9 (3) for purposes of determining whether to issue or
26-10 deny a license under this chapter.
26-11 (b) Failure to timely comply with a subpoena issued under
26-12 this section is a ground for:
26-13 (1) disciplinary action by the medical board or
26-14 another licensing or regulatory agency with jurisdiction over the
26-15 person subject to the subpoena; and
26-16 (2) denial of a license application.
26-17 Sec. 206.309. PROTECTION OF PATIENT IDENTITY. In a
26-18 disciplinary investigation or proceeding conducted under this
26-19 chapter, the medical board shall protect the identity of each
26-20 patient whose medical records are examined and used in a public
26-21 proceeding unless the patient:
26-22 (1) testifies in the public proceeding; or
26-23 (2) submits a written release in regard to the
26-24 patient's records or identity.
26-25 Sec. 206.310. RULES FOR DISCIPLINARY PROCEEDINGS. Rules of
26-26 practice adopted under this chapter by the medical board under
26-27 Section 2001.004, Government Code, applicable to the proceedings
27-1 for a disciplinary action may not conflict with rules adopted by
27-2 the State Office of Administrative Hearings.
27-3 Sec. 206.311. REQUIRED SUSPENSION OF INCARCERATED SURGICAL
27-4 ASSISTANT. Regardless of the offense, the medical board shall
27-5 suspend the license of a surgical assistant serving a prison term
27-6 in a state or federal penitentiary during the term of the
27-7 incarceration.
27-8 Sec. 206.312. TEMPORARY SUSPENSION. (a) The president of
27-9 the medical board, with medical board approval, shall appoint a
27-10 three-member disciplinary panel consisting of medical board members
27-11 to determine whether a surgical assistant's license should be
27-12 temporarily suspended.
27-13 (b) If the disciplinary panel determines from the evidence
27-14 or information presented to the panel that a person licensed to
27-15 practice as a surgical assistant would, by the person's
27-16 continuation in practice, constitute a continuing threat to the
27-17 public welfare, the disciplinary panel shall temporarily suspend
27-18 the license of that person.
27-19 (c) A license may be suspended under this section without
27-20 notice or hearing on the complaint if:
27-21 (1) institution of proceedings for a hearing before
27-22 the medical board is initiated simultaneously with the temporary
27-23 suspension; and
27-24 (2) a hearing is held under Chapter 2001, Government
27-25 Code, and this chapter as soon as possible.
27-26 (d) Notwithstanding Chapter 551, Government Code, the
27-27 disciplinary panel may hold a meeting by telephone conference call
28-1 if immediate action is required and convening the disciplinary
28-2 panel at one location is inconvenient for any member of the panel.
28-3 (Sections 206.313-206.350 reserved for expansion
28-4 SUBCHAPTER H. ADMINISTRATIVE PENALTY
28-5 Sec. 206.351. ADMINISTRATIVE PENALTY. (a) The medical board
28-6 by order may impose an administrative penalty against a person
28-7 licensed under this chapter who violates this chapter or a rule or
28-8 order adopted under this chapter.
28-9 (b) The penalty may be in an amount not to exceed $5,000.
28-10 Each day a violation continues or occurs is a separate violation
28-11 for purposes of imposing a penalty.
28-12 (c) The medical board shall base the amount of the penalty
28-13 on:
28-14 (1) the severity of patient harm;
28-15 (2) the severity of economic harm to any person;
28-16 (3) the severity of any environmental harm;
28-17 (4) the increased potential for harm to the public;
28-18 (5) any attempted concealment of misconduct;
28-19 (6) any premeditated or intentional misconduct;
28-20 (7) the motive for the violation;
28-21 (8) any prior misconduct of a similar or related
28-22 nature;
28-23 (9) the license holder's disciplinary history;
28-24 (10) any prior written warnings or written
28-25 admonishments from any government agency or official regarding
28-26 statutes or rules relating to the misconduct;
28-27 (11) whether the violation is of a board order;
29-1 (12) the person's failure to implement remedial
29-2 measures to correct or mitigate harm from the misconduct;
29-3 (13) the person's lack of rehabilitative potential or
29-4 likelihood of future misconduct of a similar nature;
29-5 (14) any relevant circumstances increasing the
29-6 seriousness of the misconduct; and
29-7 (15) any other matter that justice may require.
29-8 (d) The medical board by rule shall prescribe the procedures
29-9 by which it may impose an administrative penalty. A proceeding
29-10 under this section is subject to Chapter 2001, Government Code.
29-11 (e) If the medical board by order determines that a
29-12 violation has occurred and imposes an administrative penalty, the
29-13 medical board shall give notice to the person of the order. The
29-14 notice must include a statement of the person's right to judicial
29-15 review of the order.
29-16 SECTION 2. Subsection (B), Section 2, Chapter 397, Acts of
29-17 the 54th Legislature, Regular Session, 1955 (Article 3.70-2,
29-18 Vernon's Texas Insurance Code), is amended to read as follows:
29-19 (B) No policy of accident and sickness insurance shall make
29-20 benefits contingent upon treatment or examination by a particular
29-21 practitioner or by particular practitioners of the healing arts
29-22 hereinafter designated unless such policy contains a provision
29-23 designating the practitioner or practitioners who will be
29-24 recognized by the insurer and those who will not be recognized by
29-25 the insurer. Such provision may be located in the "Exceptions" or
29-26 "Exceptions and Reductions" provisions, or elsewhere in the policy,
29-27 or by endorsement attached to the policy, at the insurer's option.
30-1 In designating the practitioners who will and will not be
30-2 recognized, such provision shall use the following terms: Doctor
30-3 of Medicine, Doctor of Osteopathy, Doctor of Dentistry, Doctor of
30-4 Chiropractic, Doctor of Optometry, Doctor of Podiatry, Licensed
30-5 Audiologist, Licensed Speech-language Pathologist, Doctor in
30-6 Psychology, Licensed Master Social Worker--Advanced Clinical
30-7 Practitioner, Licensed Dietitian, Licensed Professional Counselor,
30-8 Licensed Marriage and Family Therapist, Licensed Chemical
30-9 Dependency Counselor, Licensed Hearing Instrument Fitter and
30-10 Dispenser, Advanced Practice Nurse, Physician Assistant, Licensed
30-11 Occupational Therapist, Licensed Physical Therapist, Licensed
30-12 Acupuncturist, [and] Licensed Psychological Associate, and Licensed
30-13 Surgical Assistant.
30-14 For purposes of this Act, such designations shall have the
30-15 following meanings:
30-16 Doctor of Medicine: One licensed by the Texas State Board of
30-17 Medical Examiners on the basis of the degree "Doctor of Medicine";
30-18 Doctor of Osteopathy: One licensed by the Texas State Board
30-19 of Medical Examiners on the basis of the degree of "Doctor of
30-20 Osteopathy";
30-21 Doctor of Dentistry: One licensed by the State Board of
30-22 Dental Examiners;
30-23 Doctor of Chiropractic: One licensed by the Texas Board of
30-24 Chiropractic Examiners;
30-25 Doctor of Optometry: One licensed by the Texas Optometry
30-26 Board;
30-27 Doctor of Podiatry: One licensed by the Texas State Board of
31-1 Podiatric Medical Examiners;
31-2 Licensed Audiologist: One with a master's or doctorate
31-3 degree in audiology from an accredited college or university and
31-4 who is licensed as an audiologist by the State Board of Examiners
31-5 for Speech-Language Pathology and Audiology;
31-6 Licensed Speech-language Pathologist: One with a master's or
31-7 doctorate degree in speech pathology or speech-language pathology
31-8 from an accredited college or university and who is licensed as a
31-9 speech-language pathologist by the State Board of Examiners for
31-10 Speech-Language Pathology and Audiology;
31-11 Doctor in Psychology: One licensed by the Texas State Board
31-12 of Examiners of Psychologists and certified as a Health Service
31-13 Provider;
31-14 Licensed Master Social Worker--Advanced Clinical
31-15 Practitioner: One licensed by the Texas State Board of Social
31-16 Worker Examiners as a Licensed Master Social Worker with the order
31-17 of recognition of Advanced Clinical Practitioner;
31-18 Licensed Dietitian: One licensed by the Texas State Board of
31-19 Examiners of Dietitians;
31-20 Licensed Professional Counselor: One licensed by the Texas
31-21 State Board of Examiners of Professional Counselors;
31-22 Licensed Marriage and Family Therapist: One licensed by the
31-23 Texas State Board of Examiners of Marriage and Family Therapists;
31-24 Licensed Chemical Dependency Counselor: One licensed by the
31-25 Texas Commission on Alcohol and Drug Abuse;
31-26 Licensed Hearing Instrument Fitter and Dispenser: One
31-27 licensed by the State Committee of Examiners in the Fitting and
32-1 Dispensing of Hearing Instruments;
32-2 Advanced Practice Nurse: One licensed by the Board of Nurse
32-3 Examiners as a registered nurse and recognized by that board as an
32-4 advanced practice nurse;
32-5 Physician Assistant: One licensed by the Texas State Board
32-6 of Physician Assistant Examiners;
32-7 Licensed Occupational Therapist: One licensed by the Texas
32-8 Board of Occupational Therapy Examiners;
32-9 Licensed Physical Therapist: One licensed by the Texas Board
32-10 of Physical Therapy Examiners;
32-11 Licensed Acupuncturist: One licensed by the Texas State
32-12 Board of Medical Examiners as an acupuncturist; [and]
32-13 Licensed Psychological Associate: One licensed by the Texas
32-14 State Board of Examiners of Psychologists and practicing under the
32-15 supervision of a licensed psychologist; and
32-16 Licensed Surgical Assistant: One licensed by the Texas State
32-17 Board of Medical Examiners as a surgical assistant.
32-18 SECTION 3. Section 1, Article 21.52, Insurance Code, is
32-19 amended by adding Subsection (u) to read as follows:
32-20 (u) "Surgical assistant" means a person licensed by the
32-21 Texas State Board of Medical Examiners as a surgical assistant.
32-22 SECTION 4. Section 3(a), Article 21.52, Insurance Code, as
32-23 amended by Chapters 428 and 888, Acts of the 76th Legislature,
32-24 Regular Session, 1999, is amended to read as follows:
32-25 (a) Any person who is issued, who is a party to, or who is a
32-26 beneficiary under any health insurance policy delivered, renewed,
32-27 or issued for delivery in this state by any insurance company,
33-1 association, or organization to which this article applies may
33-2 select:
33-3 (1) a licensed doctor of podiatric medicine, a
33-4 licensed dentist, or a doctor of chiropractic to perform the
33-5 medical or surgical services or procedures scheduled in the policy
33-6 which fall within the scope of the license of that practitioner;
33-7 (2) a licensed doctor of optometry to perform the
33-8 services or procedures scheduled in the policy which fall within
33-9 the scope of the license of that doctor of optometry;
33-10 (3) an occupational therapist to provide the services
33-11 scheduled in the policy which fall within the scope of the license
33-12 of that occupational therapist;
33-13 (4) a physical therapist to provide the services
33-14 scheduled in the policy which fall within the scope of the license
33-15 of that physical therapist;
33-16 (5) a licensed audiologist to measure hearing for the
33-17 purpose of determining the presence or extent of a hearing loss and
33-18 to provide aural rehabilitation services to a person with a hearing
33-19 loss if those services or procedures are scheduled in the policy;
33-20 (6) a licensed speech-language pathologist to evaluate
33-21 speech and language and to provide habilitative and rehabilitative
33-22 services to restore speech or language loss or to correct a speech
33-23 or language impairment if those services or procedures are
33-24 scheduled in the policy;
33-25 (7) a licensed master social worker--advanced clinical
33-26 practitioner to provide the services that fall within the scope of
33-27 the license of such certified practitioner and which are specified
34-1 as services within the terms of the policy of insurance, including
34-2 the provision of direct, diagnostic, preventive, or clinical
34-3 services to individuals, families, and groups whose functioning is
34-4 threatened or affected by social or psychological stress or health
34-5 impairment, if those services or procedures are scheduled in the
34-6 policy;
34-7 (8) a licensed dietitian including a provisional
34-8 licensed dietitian under a licensed dietitian's supervision to
34-9 provide the services that fall within the scope of the license of
34-10 that dietitian if those services are scheduled in the policy;
34-11 (9) a licensed professional counselor to provide the
34-12 services that fall within the scope of the license of that
34-13 professional if those services are scheduled in the policy;
34-14 (10) a licensed marriage and family therapist to
34-15 provide the services that fall within the scope of the license of
34-16 that professional if those services are scheduled in the policy;
34-17 (11) a psychologist to perform the services or
34-18 procedures scheduled in the policy that fall within the scope of
34-19 the license of that psychologist;
34-20 (12) a licensed chemical dependency counselor to
34-21 perform the services or procedures scheduled in the policy that
34-22 fall within the scope of the license of that practitioner;
34-23 (13) [(12)] a licensed acupuncturist to perform the
34-24 services or procedures scheduled in the policy that fall within the
34-25 scope of the license of that practitioner;
34-26 (14) [(13)] an advanced practice nurse to provide the
34-27 services scheduled in the policy that fall within the scope of the
35-1 license of that practitioner;
35-2 (15) [(14)] a physician assistant to provide the
35-3 services scheduled in the policy that fall within the scope of the
35-4 license of that practitioner;
35-5 (16) [(15)] a licensed hearing instrument fitter and
35-6 dispenser to provide the services or procedures scheduled in the
35-7 policy that fall within the scope of the license of that
35-8 practitioner;
35-9 (17) a licensed surgical assistant to provide the
35-10 services or procedures scheduled in the policy that fall within the
35-11 scope of the license of that practitioner; or
35-12 (18) [(16)] a licensed psychological associate to
35-13 provide the services that fall within the scope of the license of
35-14 that professional if those services are scheduled in the policy.
35-15 SECTION 5. Section 3(d), Article 21.52, Insurance Code, is
35-16 amended to read as follows:
35-17 (d) There shall not be any classification, differentiation,
35-18 or other discrimination in the payment schedule or the payment
35-19 provisions in a health insurance policy, nor in the amount or
35-20 manner of payment or reimbursement thereunder, between scheduled
35-21 services or procedures when performed by a doctor of podiatric
35-22 medicine, a doctor of optometry, a doctor of chiropractic, a
35-23 licensed dentist, an occupational therapist, a physical therapist,
35-24 a licensed audiologist, a licensed speech-language pathologist, a
35-25 licensed master social worker--advanced clinical practitioner, a
35-26 licensed dietitian, a licensed professional counselor, a licensed
35-27 marriage and family therapist, a psychologist, a licensed
36-1 psychological associate, a licensed chemical dependency counselor,
36-2 an advanced practice nurse to provide the services scheduled in the
36-3 policy, a physician assistant to provide the services scheduled in
36-4 the policy, a licensed acupuncturist, or a licensed hearing
36-5 instrument fitter and dispenser which fall within the scope of that
36-6 practitioner's license or certification and the same services or
36-7 procedures when performed by any other practitioner of the healing
36-8 arts whose services or procedures are covered by the policy.
36-9 However, a health insurance policy may provide for a different
36-10 amount of payment or reimbursement for scheduled services or
36-11 procedures when performed by an advanced practice nurse, licensed
36-12 surgical assistant, or physician assistant provided the
36-13 reimbursement methodology used to calculate the payment for the
36-14 service or procedure is the same methodology used to calculate the
36-15 payment when the service or procedure is provided by a physician.
36-16 SECTION 6. Section 32.027, Human Resources Code, is amended
36-17 by adding Subsection (j) to read as follows:
36-18 (j) The department shall assure that a recipient of medical
36-19 assistance under this chapter may select a surgical assistant
36-20 licensed under Chapter 206, Occupations Code, to perform any health
36-21 care service or procedure covered under the medical assistance
36-22 program if:
36-23 (1) the selected surgical assistant is authorized by
36-24 law to perform the service or procedure; and
36-25 (2) the physician requests that the service or
36-26 procedure be performed by the surgical assistant.
36-27 SECTION 7. (a) Notwithstanding Section 206.201 and
37-1 Subchapter H, Chapter 206, Occupations Code, as added by this Act,
37-2 a person is not required to obtain a license under Chapter 206,
37-3 Occupations Code, as added by this Act, until September 1, 2002.
37-4 (b) The Texas State Board of Medical Examiners shall adopt
37-5 rules under Chapter 206, Occupations Code, as added by this Act,
37-6 not later than January 1, 2002.
37-7 SECTION 8. Section 2, Chapter 397, Acts of the 54th
37-8 Legislature, Regular Session, 1955 (Article 3.70-2, Vernon's Texas
37-9 Insurance Code), and Article 21.52, Insurance Code, as amended by
37-10 this Act, apply only to an insurance policy, contract, or evidence
37-11 of coverage delivered, issued for delivery, or renewed on or after
37-12 January 1, 2003. A policy, contract, or evidence of coverage
37-13 delivered, issued for delivery, or renewed before January 1, 2003,
37-14 is governed by the law as it existed immediately before the
37-15 effective date of this Act, and that law is continued in effect for
37-16 that purpose.
37-17 SECTION 9. This Act takes effect September 1, 2001.
_______________________________ _______________________________
President of the Senate Speaker of the House
I certify that H.B. No. 1183 was passed by the House on May
4, 2001, by a non-record vote; and that the House concurred in
Senate amendments to H.B. No. 1183 on May 24, 2001, by a non-record
vote.
_______________________________
Chief Clerk of the House
I certify that H.B. No. 1183 was passed by the Senate, with
amendments, on May 18, 2001, by a viva-voce vote.
_______________________________
Secretary of the Senate
APPROVED: __________________________
Date
__________________________
Governor