85R8303 BEE-D
 
  By: Hinojosa, et al. S.B. No. 315
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the continuation and functions of the Texas Medical
  Board; authorizing a fee.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 151.004, Occupations Code, is amended to
  read as follows:
         Sec. 151.004.  APPLICATION OF SUNSET ACT.  The Texas Medical
  Board is subject to Chapter 325, Government Code (Texas Sunset
  Act).  Unless continued in existence as provided by that chapter,
  the board is abolished and this subtitle and Chapters 204, 205, 206,
  601, 602, 603, and 604 expire September 1, 2029 [2017].
         SECTION 2.  Section 152.010, Occupations Code, is amended by
  amending Subsection (b) and adding Subsection (d) to read as
  follows:
         (b)  The training program must provide the person with
  information regarding:
               (1)  the law governing board operations [this
  subtitle];
               (2)  the programs, functions, rules, and budget of
  [operated by] the board;
               (3)  the scope of and limitations on the rulemaking
  authority [role and functions] of the board;
               (4)  [the rules of the board, with an emphasis on the
  rules that relate to disciplinary and investigatory authority;
               [(5)  the current budget for the board;
               [(6)]  the results of the most recent formal audit of
  the board;
               (5) [(7)]  the requirements of:
                     (A)  laws relating to open meetings, public
  information, administrative procedure, and disclosing conflicts of
  interest; and
                     (B)  other laws applicable to members of the board
  in performing their duties; and
               (6) [(8)]  any applicable ethics policies adopted by
  the board or the Texas Ethics Commission.
         (d)  The executive director of the board shall create a
  training manual that includes the information required by
  Subsection (b). The executive director shall distribute a copy of
  the training manual annually to each board member. On receipt of
  the training manual, each board member shall sign and submit to the
  executive director a statement acknowledging receipt of the
  training manual.
         SECTION 3.  The heading to Section 153.007, Occupations
  Code, is amended to read as follows:
         Sec. 153.007.  AUTHORITY TO ISSUE SUBPOENA OR ADMINISTER
  OATH; SUBPOENA ENFORCEMENT.
         SECTION 4.  Section 153.007, Occupations Code, is amended by
  adding Subsection (e) to read as follows:
         (e)  If a person fails to comply with a subpoena issued under
  this section, the board, acting through the attorney general, may
  file suit to enforce the subpoena in a district court in Travis
  County or in a county in which a hearing conducted by the board may
  be held.
         SECTION 5.  Section 153.058(a), Occupations Code, is amended
  to read as follows:
         (a)  The board shall develop and implement a policy to
  encourage the use of:
               (1)  negotiated rulemaking procedures under Chapter
  2008, Government Code, for the adoption of any rules by the board
  [rules]; and
               (2)  appropriate alternative dispute resolution
  procedures under Chapter 2009, Government Code, to assist in the
  resolution of internal and external disputes under the board's
  jurisdiction.
         SECTION 6.  Section 155.056, Occupations Code, is amended by
  amending Subsection (a) and adding Subsection (a-1) to read as
  follows:
         (a)  Except as provided by Subsection (a-1), an [An]
  applicant must pass each part of an examination within three
  attempts.
         (a-1)  The limit on the number of examination attempts under
  Subsection (a) does not apply to the Texas medical jurisprudence
  examination.
         SECTION 7.  Subchapter A, Chapter 156, Occupations Code, is
  amended by adding Section 156.010 to read as follows:
         Sec. 156.010.  REFUSAL FOR VIOLATION OF BOARD ORDER. The
  board may refuse to renew a registration permit issued under this
  chapter if the license holder is in violation of a board order.
         SECTION 8.  Section 162.106, Occupations Code, is amended to
  read as follows:
         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 equipment and
  office procedures [practice] that relate to the provision of
  anesthesia in an outpatient setting as necessary to enforce this
  subchapter.
         (b)  The board may establish a risk-based inspection process
  in which the board conducts inspections based on the length of time
  since:
               (1)  the equipment and outpatient setting were last
  inspected; and
               (2)  the physician submitted to inspection.
         (c)  The board may contract with another state agency or
  qualified person to conduct the inspections.
         (d) [(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.
         (e)  The board shall maintain a record of the outpatient
  settings in which physicians provide anesthesia.
         (f)  A physician who provides anesthesia in an outpatient
  setting shall inform the board of any other physician with whom the
  physician shares equipment used to administer anesthesia.
         (g) [(c)]  This section does not require the board to make an
  on-site inspection of a physician's office.
         SECTION 9.  Chapter 162, Occupations Code, is amended by
  adding Subchapter G to read as follows:
  SUBCHAPTER G. GENERAL PRACTICE PROVISIONS 
         Sec. 162.301.  DUTIES RELATED TO CERTAIN PRESCRIPTIONS. (a)
  A physician may not prescribe a drug listed in Subsection (b) to a
  patient unless the physician has reviewed the patient's
  prescription history by accessing the prescription information
  submitted to the Texas State Board of Pharmacy as authorized by
  Section 481.076(a)(5), Health and Safety Code.
         (b)  Subsection (a) applies only to the prescribing of:
               (1)  opioids;
               (2)  benzodiazepines;
               (3)  barbiturates; or
               (4)  carisoprodol.
         (c)  A physician is not subject to the requirements of
  Subsection (a) if:
               (1)  the patient has been diagnosed with cancer or the
  patient is receiving hospice care; and
               (2)  the physician clearly notes in the prescription
  record that the patient was diagnosed with cancer or is receiving
  hospice care, as applicable.
         (d)  Failure by a physician to comply with the requirements
  of this section is grounds for disciplinary action under Section
  164.051.
         SECTION 10.  Section 164.0015(d), Occupations Code, is
  amended to read as follows:
         (d)  The board may not issue a remedial plan to resolve a
  complaint against a license holder if the license holder has
  [previously] entered into a remedial plan with the board in the
  preceding five years [for the resolution of a different complaint
  relating to this subtitle].
         SECTION 11.  Section 164.003, Occupations Code, is amended
  by amending Subsections (b) and (f) and adding Subsection (f-1) to
  read as follows:
         (b)  Rules adopted under this section must require that:
               (1)  an informal meeting in compliance with Section
  2001.054, Government Code, be scheduled not later than the 180th
  day after the date the board's official investigation of the
  complaint is commenced as provided by Section 154.057(b), unless
  good cause is shown by the board for scheduling the informal meeting
  after that date;
               (2)  the board give notice to the license holder of the
  time and place of the meeting not later than the 45th day before the
  date the meeting is held;
               (3)  the complainant and the license holder be provided
  an opportunity to be heard;
               (4)  at least one of the board members or district
  review committee members participating in the informal meeting as a
  panelist be a member who represents the public;
               (5)  the board's legal counsel or a representative of
  the attorney general be present to advise the board or the board's
  staff; [and]
               (6)  a member of the board's staff be at the meeting to
  present to the board's representative the facts the staff
  reasonably believes it could prove by competent evidence or
  qualified witnesses at a hearing; and
               (7)  if the complaint includes an allegation that the
  license holder has violated the standard of care, the panel
  conducting the informal proceeding consider whether the physician
  was practicing complementary and alternative medicine.
         (f)  The notice required by Subsection (b)(2) must be
  accompanied by a written statement of the nature of the allegations
  and the information the board intends to use at the meeting.  If the
  board does not provide the statement or information at that time,
  the license holder may use that failure as grounds for rescheduling
  the informal meeting.  If the complaint includes an allegation that
  the license holder has violated the standard of care, the notice
  must include a copy of each [the] report prepared by an [the] expert
  physician reviewer under Section 154.0561.  The license holder must
  provide to the board the license holder's rebuttal at least 15
  business days before the date of the meeting in order for the
  information to be considered at the meeting.
         (f-1)  Before providing a report to a license holder under
  Subsection (f), the board must redact any identifying information
  of an expert physician reviewer other than the specialty of the
  expert physician reviewer.
         SECTION 12.  Sections 164.005(a) and (c), Occupations Code,
  are amended to read as follows:
         (a)  In this section, "formal complaint" means a written
  statement made by a credible person [under oath] that is filed and
  presented by a board representative charging a person with having
  committed an act that, if proven, could affect the legal rights or
  privileges of a license holder or other person under the board's
  jurisdiction.
         (c)  A charge must [be in the form of a written affidavit
  that]:
               (1)  be [is] filed with the board's records custodian or
  assistant records custodian; and
               (2)  detail [details] the nature of the charge as
  required by this subtitle or other applicable law.
         SECTION 13.  Subchapter A, Chapter 164, Occupations Code, is
  amended by adding Section 164.0105 to read as follows:
         Sec. 164.0105.  MONITORING HARMFUL PRESCRIBING PATTERNS.
  (a) The board shall periodically check the prescribing information
  submitted to the Texas State Board of Pharmacy as authorized by
  Section 481.076(a)(1), Health and Safety Code, to determine whether
  a physician is engaging in potentially harmful prescribing patterns
  or practices.
         (b)  The board, in coordination with the Texas State Board of
  Pharmacy, shall determine the conduct that constitutes a
  potentially harmful prescribing pattern or practice for purposes of
  Subsection (a). In determining the conduct that constitutes a
  potentially harmful prescribing pattern or practice, the board
  shall consider:
               (1)  the number of times a physician prescribes a drug
  listed in Section 162.301(b); and
               (2)  for prescriptions described by Subdivision (1),
  patterns of prescribing combinations of those drugs and other
  dangerous combinations of drugs identified by the board.
         (c)  If the board suspects that a physician may be engaging
  in potentially harmful prescribing patterns or practices, the board
  may notify the physician of the potentially harmful prescribing
  pattern or practice.
         (d)  The board may initiate a complaint against a physician
  based on information obtained under this section.
         SECTION 14.  Chapter 167, Occupations Code, is amended by
  adding Sections 167.012 and 167.013 to read as follows:
         Sec. 167.012.  MEMORANDUM OF UNDERSTANDING WITH BOARD. The
  governing board and the board shall enter into a memorandum of
  understanding to better coordinate services and operations of the
  program.  The memorandum of understanding must be adopted by rule
  and:
               (1)  establish performance measures for the program,
  including the number of participants who successfully complete the
  program;
               (2)  include a list of services the board will provide
  for the program; and
               (3)  require that an internal audit of the program be
  conducted at least once every three years to ensure the program is
  properly documenting and referring all noncompliance to the board.
         Sec. 167.013.  GIFTS, GRANTS, AND DONATIONS. In addition to
  any fees paid to the board or money appropriated to the board for
  the program, 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, for the program.
         SECTION 15.  Section 168.052, Occupations Code, is amended
  to read as follows:
         Sec. 168.052.  INSPECTIONS. (a) The board may inspect a
  pain management clinic certified under this chapter, including the
  documents of a physician practicing at the clinic, as necessary to
  ensure compliance with this chapter.
         (b)  The board may inspect a clinic or facility that is not
  certified under this chapter to determine whether the clinic or
  facility is required to be certified under Section 168.101.  The
  board by rule shall establish the grounds for conducting an
  inspection under this subsection, including grounds based on:
               (1)  the population of patients served by the clinic or
  facility;
               (2)  the volume or combination of drugs prescribed to
  patients served by the clinic or facility; and
               (3)  any other criteria the board considers sufficient
  to require an inspection of the clinic or facility.
         SECTION 16.  Section 168.201, Occupations Code, is amended
  by adding Subsection (a-1) to read as follows:
         (a-1)  For the purposes of this section, inappropriate
  prescribing includes nontherapeutic prescribing or other conduct
  as specified by board rule.
         SECTION 17.  Subtitle B, Title 3, Occupations Code, is
  amended by adding Chapter 170 to read as follows:
  CHAPTER 170. INTERSTATE MEDICAL LICENSURE COMPACT
         Sec. 170.001.  INTERSTATE MEDICAL LICENSURE COMPACT. The
  Interstate Medical Licensure Compact is enacted and entered into
  with all other jurisdictions that legally join in the compact,
  which reads as follows:
  INTERSTATE MEDICAL LICENSURE COMPACT
         SECTION 1.  PURPOSE
         In order to strengthen access to health care, and in
  recognition of the advances in the delivery of health care, the
  member states of the Interstate Medical Licensure Compact have
  allied in common purpose to develop a comprehensive process that
  complements the existing licensing and regulatory authority of
  state medical boards, and provides a streamlined process that
  allows physicians to become licensed in multiple states, thereby
  enhancing the portability of a medical license and ensuring the
  safety of patients. The Compact creates another pathway for
  licensure and does not otherwise change a state's existing Medical
  Practice Act. The Compact also adopts the prevailing standard for
  licensure and affirms that the practice of medicine occurs where
  the patient is located at the time of the physician-patient
  encounter, and therefore, requires the physician to be under the
  jurisdiction of the state medical board where the patient is
  located. State medical boards that participate in the Compact
  retain the jurisdiction to impose an adverse action against a
  license to practice medicine in that state issued to a physician
  through the procedures in the Compact.
         SECTION 2.  DEFINITIONS
         In this compact:
         (a)  "Bylaws" means those bylaws established by the
  Interstate Commission pursuant to Section 11 for its governance, or
  for directing and controlling its actions and conduct.
         (b)  "Commissioner" means the voting representative
  appointed by each member board pursuant to Section 11.
         (c)  "Conviction" means a finding by a court that an
  individual is guilty of a criminal offense through adjudication, or
  entry of a plea of guilt or no contest to the charge by the offender.
  Evidence of an entry of a conviction of a criminal offense by the
  court shall be considered final for purposes of disciplinary action
  by a member board.
         (d)  "Expedited License" means a full and unrestricted
  medical license granted by a member state to an eligible physician
  through the process set forth in the Compact.
         (e)  "Interstate Commission" means the interstate commission
  created pursuant to Section 11.
         (f)  "License" means authorization by a state for a physician
  to engage in the practice of medicine, which would be unlawful
  without the authorization.
         (g)  "Medical Practice Act" means laws and regulations
  governing the practice of allopathic and osteopathic medicine
  within a member state.
         (h)  "Member Board" means a state agency in a member state
  that acts in the sovereign interests of the state by protecting the
  public through licensure, regulation, and education of physicians
  as directed by the state government.
         (i)  "Member State" means a state that has enacted the
  Compact.
         (j)  "Practice of Medicine" means the clinical prevention,
  diagnosis, or treatment of human disease, injury, or condition
  requiring a physician to obtain and maintain a license in
  compliance with the Medical Practice Act of a member state.
         (k)  "Physician" means any person who:
               (1)  Is a graduate of a medical school accredited by the
  Liaison Committee on Medical Education, the Commission on
  Osteopathic College Accreditation, or a medical school listed in
  the International Medical Education Directory or its equivalent;
               (2)  Passed each component of the United States Medical
  Licensing Examination (USMLE) or the Comprehensive Osteopathic
  Medical Licensing Examination (COMLEX-USA) within three attempts,
  or any of its predecessor examinations accepted by a state medical
  board as an equivalent examination for licensure purposes;
               (3)  Successfully completed graduate medical education
  approved by the Accreditation Council for Graduate Medical
  Education or the American Osteopathic Association;
               (4)  Holds specialty certification or a time-unlimited
  specialty certificate recognized by the American Board of Medical
  Specialties or the American Osteopathic Association's Bureau of
  Osteopathic Specialists;
               (5)  Possesses a full and unrestricted license to
  engage in the practice of medicine issued by a member board;
               (6)  Has never been convicted, received adjudication,
  deferred adjudication, community supervision, or deferred
  disposition for any offense by a court of appropriate jurisdiction;
               (7)  Has never held a license authorizing the practice
  of medicine subjected to discipline by a licensing agency in any
  state, federal, or foreign jurisdiction, excluding any action
  related to non-payment of fees related to a license;
               (8)  Has never had a controlled substance license or
  permit suspended or revoked by a state or the United States Drug
  Enforcement Administration; and
               (9)  Is not under active investigation by a licensing
  agency or law enforcement authority in any state, federal, or
  foreign jurisdiction.
         (l)  "Offense" means a felony, gross misdemeanor, or crime of
  moral turpitude.
         (m)  "Rule" means a written statement by the Interstate
  Commission promulgated pursuant to Section 12 of the Compact that
  is of general applicability, implements, interprets, or prescribes
  a policy or provision of the Compact, or an organizational,
  procedural, or practice requirement of the Interstate Commission,
  and has the force and effect of statutory law in a member state, and
  includes the amendment, repeal, or suspension of an existing rule.
         (n)  "State" means any state, commonwealth, district, or
  territory of the United States.
         (o)  "State of Principal License" means a member state where
  a physician holds a license to practice medicine and which has been
  designated as such by the physician for purposes of registration
  and participation in the Compact.
         SECTION 3.  ELIGIBILITY
         (a)  A physician must meet the eligibility requirements as
  defined in Section 2(k) to receive an expedited license under the
  terms and provisions of the Compact.
         (b)  A physician who does not meet the requirements of
  Section 2(k) may obtain a license to practice medicine in a member
  state if the individual complies with all laws and requirements,
  other than the Compact, relating to the issuance of a license to
  practice medicine in that state.
         SECTION 4.  DESIGNATION OF STATE OF PRINCIPAL LICENSE
         (a)  A physician shall designate a member state as the state
  of principal license for purposes of registration for expedited
  licensure through the Compact if the physician possesses a full and
  unrestricted license to practice medicine in that state, and the
  state is:
               (1)  the state of primary residence for the physician,
  or
               (2)  the state where at least 25 percent of the practice
  of medicine occurs, or
               (3)  the location of the physician's employer, or
               (4)  if no state qualifies under subsection (1),
  subsection (2), or subsection (3), the state designated as state of
  residence for purpose of federal income tax.
         (b)  A physician may redesignate a member state as state of
  principal license at any time, as long as the state meets the
  requirements in subsection (a).
         (c)  The Interstate Commission is authorized to develop
  rules to facilitate redesignation of another member state as the
  state of principal license.
         SECTION 5.  APPLICATION AND ISSUANCE OF EXPEDITED LICENSURE
         (a)  A physician seeking licensure through the Compact shall
  file an application for an expedited license with the member board
  of the state selected by the physician as the state of principal
  license.
         (b)  Upon receipt of an application for an expedited license,
  the member board within the state selected as the state of principal
  license shall evaluate whether the physician is eligible for
  expedited licensure and issue a letter of qualification, verifying
  or denying the physician's eligibility, to the Interstate
  Commission.
               (i)  Static qualifications, which include verification
  of medical education, graduate medical education, results of any
  medical or licensing examination, and other qualifications as
  determined by the Interstate Commission through rule, shall not be
  subject to additional primary source verification where already
  primary source verified by the state of principal license.
               (ii)  The member board within the state selected as the
  state of principal license shall, in the course of verifying
  eligibility, perform a criminal  background check of an applicant,
  including the use of the results of fingerprint or other biometric
  data checks compliant with the requirements of the Federal Bureau
  of Investigation, with the exception of federal employees who have
  suitability determination in accordance with U.S. C.F.R. Section
  731.202.
               (iii)  Appeal on the determination of eligibility shall
  be made to the member state where the application was filed and
  shall be subject to the law of that state.
         (c)  Upon verification in subsection (b), physicians
  eligible for an expedited license shall complete the registration
  process established by the Interstate Commission to receive a
  license in a member state selected pursuant to subsection (a),
  including the payment of any applicable fees.
         (d)  After receiving verification of eligibility under
  subsection (b) and any fees under subsection (c), a member board
  shall issue an expedited license to the physician. This license
  shall authorize the physician to practice medicine in the issuing
  state consistent with the Medical Practice Act and all applicable
  laws and regulations of the issuing member board and member state.
         (e)  An expedited license shall be valid for a period
  consistent with the licensure period in the member state and in the
  same manner as required for other physicians holding a full and
  unrestricted license within the member state.
         (f)  An expedited license obtained though the Compact shall
  be terminated if a physician fails to maintain a license in the
  state of principal licensure for a non-disciplinary reason, without
  redesignation of a new state of principal licensure.
         (g)  The Interstate Commission is authorized to develop
  rules regarding the application process, including payment of any
  applicable fees, and the issuance of an expedited license.
         SECTION 6.  FEES FOR EXPEDITED LICENSURE
         (a)  A member state issuing an expedited license authorizing
  the practice of medicine in that state may impose a fee for a
  license issued or renewed through the Compact.
         (b)  The Interstate Commission is authorized to develop
  rules regarding fees for expedited licenses.
         SECTION 7.  RENEWAL AND CONTINUED PARTICIPATION
         (a)  A physician seeking to renew an expedited license
  granted in a member state shall complete a renewal process with the
  Interstate Commission if the physician:
               (1)  Maintains a full and unrestricted license in a
  state of principal license;
               (2)  Has not been convicted, received adjudication,
  deferred adjudication, community supervision, or deferred
  disposition for any offense by a court of appropriate jurisdiction;
               (3)  Has not had a license authorizing the practice of
  medicine subject to discipline by a licensing agency in any state,
  federal, or foreign jurisdiction, excluding any action related to
  non-payment of fees related to a license; and
               (4)  Has not had a controlled substance license or
  permit suspended or revoked by a state or the United States Drug
  Enforcement Administration.
         (b)  Physicians shall comply with all continuing
  professional development or continuing medical education
  requirements for renewal of a license issued by a member state.
         (c)  The Interstate Commission shall collect any renewal
  fees charged for the renewal of a license and distribute the fees to
  the applicable member board.
         (d)  Upon receipt of any renewal fees collected in subsection
  (c), a member board shall renew the physician's license.
         (e)  Physician information collected by the Interstate
  Commission during the renewal process will be distributed to all
  member boards.
         (f)  The Interstate Commission is authorized to develop
  rules to address renewal of licenses obtained through the Compact.
         SECTION 8.  COORDINATED INFORMATION SYSTEM
         (a)  The Interstate Commission shall establish a database of
  all physicians licensed, or who have applied for licensure, under
  Section 5.
         (b)  Notwithstanding any other provision of law, member
  boards shall report to the Interstate Commission any public action
  or complaints against a licensed physician who has applied or
  received an expedited license through the Compact.
         (c)  Member boards shall report disciplinary or
  investigatory information determined as necessary and proper by
  rule of the Interstate Commission.
         (d)  Member boards may report any non-public complaint,
  disciplinary, or investigatory information not required by
  subsection (c) to the Interstate Commission.
         (e)  Member boards shall share complaint or disciplinary
  information about a physician upon request of another member board.
         (f)  All information provided to the Interstate Commission
  or distributed by member boards shall be confidential, filed under
  seal, and used only for investigatory or disciplinary matters.
         (g)  The Interstate Commission is authorized to develop
  rules for mandated or discretionary sharing of information by
  member boards.
         SECTION 9.  JOINT INVESTIGATIONS
         (a)  Licensure and disciplinary records of physicians are
  deemed investigative.
         (b)  In addition to the authority granted to a member board
  by its respective Medical Practice Act or other applicable state
  law, a member board may participate with other member boards in
  joint investigations of physicians licensed by the member boards.
         (c)  A subpoena issued by a member state shall be enforceable
  in other member states.
         (d)  Member boards may share any investigative, litigation,
  or compliance materials in furtherance of any joint or individual
  investigation initiated under the Compact.
         (e)  Any member state may investigate actual or alleged
  violations of the statutes authorizing the practice of medicine in
  any other member state in which a physician holds a license to
  practice medicine.
         SECTION 10.  DISCIPLINARY ACTIONS
         (a)  Any disciplinary action taken by any member board
  against a physician licensed through the Compact shall be deemed
  unprofessional conduct which may be subject to discipline by other
  member boards, in addition to any violation of the Medical Practice
  Act or regulations in that state.
         (b)  If a license granted to a physician by the member board
  in the state of principal license is revoked, surrendered or
  relinquished in lieu of discipline, or suspended, then all licenses
  issued to the physician by member boards shall automatically be
  placed, without further action necessary by any member board, on
  the same status. If the member board in the state of principal
  license subsequently reinstates the physician's license, a license
  issued to the physician by any other member board shall remain
  encumbered until that respective member board takes action to
  reinstate the license in a manner consistent with the Medical
  Practice Act of that state.
         (c)  If disciplinary action is taken against a physician by a
  member board not in the state of principal license, any other member
  board may deem the action conclusive as to matter of law and fact
  decided, and:
               (i)  impose the same or lesser sanction(s) against the
  physician so long as such sanctions are consistent with the Medical
  Practice Act of that state;
               (ii)  or pursue separate disciplinary action against
  the physician under its respective Medical Practice Act, regardless
  of the action taken in other member states.
         (d)  If a license granted to a physician by a member board is
  revoked, surrendered or relinquished in lieu of discipline, or
  suspended, then any license(s) issued to the physician by any other
  member board(s) shall be suspended, automatically and immediately
  without further action necessary by the other member board(s), for
  ninety (90) days upon entry of the order by the disciplining board,
  to permit the member board(s) to investigate the basis for the
  action under the Medical Practice Act of that state. A member board
  may terminate the automatic suspension of the license it issued
  prior to the completion of the ninety (90) day suspension period in
  a manner consistent with the Medical Practice Act of that state.
         SECTION 11.  INTERSTATE MEDICAL LICENSURE COMPACT
  COMMISSION
         (a)  The member states hereby create the "Interstate Medical
  Licensure Compact Commission".
         (b)  The purpose of the Interstate Commission is the
  administration of the Interstate Medical Licensure Compact, which
  is a discretionary state function.
         (c)  The Interstate Commission shall be a body corporate and
  joint agency of the member states and shall have all the
  responsibilities, powers, and duties set forth in the Compact, and
  such additional powers as may be conferred upon it by a subsequent
  concurrent action of the respective legislatures of the member
  states in accordance with the terms of the Compact.
         (d)  The Interstate Commission shall consist of two voting
  representatives appointed by each member state who shall serve as
  Commissioners.  In states where allopathic and osteopathic
  physicians are regulated by separate member boards, or if the
  licensing and disciplinary authority is split between multiple
  member boards within a member state, the member state shall appoint
  one representative from each member board. A Commissioner shall be
  a(n):
               (1)  Allopathic or osteopathic physician appointed to a
  member board;
               (2)  Executive director, executive secretary, or
  similar executive of a member board; or
               (3)  Member of the public appointed to a member board.
         (e)  The Interstate Commission shall meet at least once each
  calendar year.  A portion of this meeting shall be a business
  meeting to address such matters as may properly come before the
  Commission, including the election of officers.  The chairperson
  may call additional meetings and shall call for a meeting upon the
  request of a majority of the member states.
         (f)  The bylaws may provide for meetings of the Interstate
  Commission to be conducted by telecommunication or electronic
  communication.
         (g)  Each Commissioner participating at a meeting of the
  Interstate Commission is entitled to one vote.  A majority of
  Commissioners shall constitute a quorum for the transaction of
  business, unless a larger quorum is required by the bylaws of the
  Interstate Commission.  A Commissioner shall not delegate a vote to
  another Commissioner.  In the absence of its Commissioner, a member
  state may delegate voting authority for a specified meeting to
  another person from that state who shall meet the requirements of
  subsection (d).
         (h)  The Interstate Commission shall provide public notice
  of all meetings and all meetings shall be open to the public.  The
  Interstate Commission may close a meeting, in full or in portion,
  where it determines by a two-thirds vote of the Commissioners
  present that an open meeting would be likely to:
               (1)  Relate solely to the internal personnel practices
  and procedures of the Interstate Commission;
               (2)  Discuss matters specifically exempted from
  disclosure by federal statute;
               (3)  Discuss trade secrets, commercial, or financial
  information that is privileged or confidential;
               (4)  Involve accusing a person of a crime, or formally
  censuring a person;
               (5)  Discuss information of a personal nature where
  disclosure would constitute a clearly unwarranted invasion of
  personal privacy;
               (6)  Discuss investigative records compiled for law
  enforcement purposes; or
               (7)  Specifically relate to the participation in a
  civil action or other legal proceeding.
         (i)  The Interstate Commission shall keep minutes which
  shall fully describe all matters discussed in a meeting and shall
  provide a full and accurate summary of actions taken, including
  record of any roll call votes.
         (j)  The Interstate Commission shall make its information
  and official records, to the extent not otherwise designated in the
  Compact or by its rules, available to the public for inspection.
         (k)  The Interstate Commission shall establish an executive
  committee, which shall include officers, members, and others as
  determined by the bylaws.  The executive committee shall have the
  power to act on behalf of the Interstate Commission, with the
  exception of rulemaking, during periods when the Interstate
  Commission is not in session.  When acting on behalf of the
  Interstate Commission, the executive committee shall oversee the
  administration of the Compact including enforcement and compliance
  with the provisions of the Compact, its bylaws and rules, and other
  such duties as necessary.
         (l)  The Interstate Commission may establish other
  committees for governance and administration of the Compact.
         SECTION 12.  POWERS AND DUTIES OF THE INTERSTATE COMMISSION
         The Interstate Commission shall have the duty and power to:
         (a)  Oversee and maintain the administration of the Compact;
         (b)  Promulgate rules which shall be binding to the extent
  and in the manner provided for in the Compact;
         (c)  Issue, upon the request of a member state or member
  board, advisory opinions concerning the meaning or interpretation
  of the Compact, its bylaws, rules, and actions;
         (d)  Enforce compliance with Compact provisions, the rules
  promulgated by the Interstate Commission, and the bylaws, using all
  necessary and proper means, including but not limited to the use of
  judicial process;
         (e)  Establish and appoint committees including, but not
  limited to, an executive committee as required by Section 11, which
  shall have the power to act on behalf of the Interstate Commission
  in carrying out its powers and duties;
         (f)  Pay, or provide for the payment of the expenses related
  to the establishment, organization, and ongoing activities of the
  Interstate Commission;
         (g)  Establish and maintain one or more offices;
         (h)  Borrow, accept, hire, or contract for services of
  personnel;
         (i)  Purchase and maintain insurance and bonds;
         (j)  Employ an executive director who shall have such powers
  to employ, select or appoint employees, agents, or consultants, and
  to determine their qualifications, define their duties, and fix
  their compensation;
         (k)  Establish personnel policies and programs relating to
  conflicts of interest, rates of compensation, and qualifications of
  personnel;
         (l)  Accept donations and grants of money, equipment,
  supplies, materials and services, and to receive, utilize, and
  dispose of it in a manner consistent with the conflict of interest
  policies established by the Interstate Commission;
         (m)  Lease, purchase, accept contributions or donations of,
  or otherwise to own, hold, improve or use, any property, real,
  personal, or mixed;
         (n)  Sell, convey, mortgage, pledge, lease, exchange,
  abandon, or otherwise dispose of any property, real, personal, or
  mixed;
         (o)  Establish a budget and make expenditures;
         (p)  Adopt a seal and bylaws governing the management and
  operation of the Interstate Commission;
         (q)  Report annually to the legislatures and governors of the
  member states concerning the activities of the Interstate
  Commission during the preceding year. Such reports shall also
  include reports of financial audits and any recommendations that
  may have been adopted by the Interstate Commission;
         (r)  Coordinate education, training, and public awareness
  regarding the Compact, its implementation, and its operation;
         (s)  Maintain records in accordance with the bylaws;
         (t)  Seek and obtain trademarks, copyrights, and patents;
  and
         (u)  Perform such functions as may be necessary or
  appropriate to achieve the purposes of the Compact.
         SECTION 13.  FINANCE POWERS
         (a)  The Interstate Commission may levy on and collect an
  annual assessment from each member state to cover the cost of the
  operations and activities of the Interstate Commission and its
  staff.  The total assessment must be sufficient to cover the annual
  budget approved each year for which revenue is not provided by other
  sources.  The aggregate annual assessment amount shall be allocated
  upon a formula to be determined by the Interstate Commission, which
  shall promulgate a rule binding upon all member states.
         (b)  The Interstate Commission shall not incur obligations
  of any kind prior to securing the funds adequate to meet the same.
         (c)  The Interstate Commission shall not pledge the credit of
  any of the member states, except by, and with the authority of, the
  member state.
         (d)  The Interstate Commission shall be subject to a yearly
  financial audit conducted by a certified or licensed public
  accountant and the report of the audit shall be included in the
  annual report of the Interstate Commission.
         SECTION 14.  ORGANIZATION AND OPERATION OF THE INTERSTATE
  COMMISSION
         (a)  The Interstate Commission shall, by a majority of
  Commissioners present and voting, adopt bylaws to govern its
  conduct as may be necessary or appropriate to carry out the purposes
  of the Compact within twelve (12) months of the first Interstate
  Commission meeting.
         (b)  The Interstate Commission shall elect or appoint
  annually from among its Commissioners a chairperson, a
  vice-chairperson, and a treasurer, each of whom shall have such
  authority and duties as may be specified in the bylaws.  The
  chairperson, or in the chairperson's absence or disability, the
  vice-chairperson, shall preside at all meetings of the Interstate
  Commission.
         (c)  Officers selected in subsection (b) shall serve without
  remuneration from the Interstate Commission.
         (d)  The officers and employees of the Interstate Commission
  shall be immune from suit and liability, either personally or in
  their official capacity, for a claim for damage to or loss of
  property or personal injury or other civil liability caused or
  arising out of, or relating to, an actual or alleged act, error, or
  omission that occurred, or that such person had a reasonable basis
  for believing occurred, within the scope of Interstate Commission
  employment, duties, or responsibilities; provided that such person
  shall not be protected from suit or liability for damage, loss,
  injury, or liability caused by the intentional or willful and
  wanton misconduct of such person.
               (1)  The liability of the executive director and
  employees of the Interstate Commission or representatives of the
  Interstate Commission, acting within the scope of such person's
  employment or duties for acts, errors, or omissions occurring
  within such person's state, may not exceed the limits of liability
  set forth under the constitution and laws of that state for state
  officials, employees, and agents.  The Interstate Commission is
  considered to be an instrumentality of the states for the purposes
  of any such action.  Nothing in this subsection shall be construed
  to protect such person from suit or liability for damage, loss,
  injury, or liability caused by the intentional or willful and
  wanton misconduct of such person.
               (2)  The Interstate Commission shall defend the
  executive director, its employees, and subject to the approval of
  the attorney general or other appropriate legal counsel of the
  member state represented by an Interstate Commission
  representative, shall defend such Interstate Commission
  representative in any civil action seeking to impose liability
  arising out of an actual or alleged act, error or omission that
  occurred within the scope of Interstate Commission employment,
  duties or responsibilities, or that the defendant had a reasonable
  basis for believing occurred within the scope of Interstate
  Commission employment, duties, or responsibilities, provided that
  the actual or alleged act, error, or omission did not result from
  intentional or willful and wanton misconduct on the part of such
  person.
               (3)  To the extent not covered by the state involved,
  member state, or the Interstate Commission, the representatives or
  employees of the Interstate Commission shall be held harmless in
  the amount of a settlement or judgment, including attorney's fees
  and costs, obtained against such persons arising out of an actual or
  alleged act, error, or omission that occurred within the scope of
  Interstate Commission employment, duties, or responsibilities, or
  that such persons had a reasonable basis for believing occurred
  within the scope of Interstate Commission employment, duties, or
  responsibilities, provided that the actual or alleged act, error,
  or omission did not result from intentional or willful and wanton
  misconduct on the part of such persons.
         SECTION 15.  RULEMAKING FUNCTIONS OF THE INTERSTATE
  COMMISSION
         (a)  The Interstate Commission shall promulgate reasonable
  rules in order to effectively and efficiently achieve the purposes
  of the Compact. Notwithstanding the foregoing, in the event the
  Interstate Commission exercises its rulemaking authority in a
  manner that is beyond the scope of the purposes of the Compact, or
  the powers granted hereunder, then such an action by the Interstate
  Commission shall be invalid and have no force or effect.
         (b)  Rules deemed appropriate for the operations of the
  Interstate Commission shall be made pursuant to a rulemaking
  process that substantially conforms to the "Model State
  Administrative Procedure Act" of 2010, and subsequent amendments
  thereto.
         (c)  Not later than thirty (30) days after a rule is
  promulgated, any person may file a petition for judicial review of
  the rule in the United States District Court for the District of
  Columbia or the federal district where the Interstate Commission
  has its principal offices, provided that the filing of such a
  petition shall not stay or otherwise prevent the rule from becoming
  effective unless the court finds that the petitioner has a
  substantial likelihood of success. The court shall give deference
  to the actions of the Interstate Commission consistent with
  applicable law and shall not find the rule to be unlawful if the
  rule represents a reasonable exercise of the authority granted to
  the Interstate Commission.
         SECTION 16.  OVERSIGHT OF INTERSTATE COMPACT
         (a)  The executive, legislative, and judicial branches of
  state government in each member state shall enforce the Compact and
  shall take all actions necessary and appropriate to effectuate the
  Compact's purposes and intent. The provisions of the Compact and
  the rules promulgated hereunder shall have standing as statutory
  law but shall not override existing state authority to regulate the
  practice of medicine.
         (b)  All courts shall take judicial notice of the Compact and
  the rules in any judicial or administrative proceeding in a member
  state pertaining to the subject matter of the Compact which may
  affect the powers, responsibilities or actions of the Interstate
  Commission.
         (c)  The Interstate Commission shall be entitled to receive
  all service of process in any such proceeding, and shall have
  standing to intervene in the proceeding for all purposes.  Failure
  to provide service of process to the Interstate Commission shall
  render a judgment or order void as to the Interstate Commission, the
  Compact, or promulgated rules.
         SECTION 17.  ENFORCEMENT OF INTERSTATE COMPACT
         (a)  The Interstate Commission, in the reasonable exercise
  of its discretion, shall enforce the provisions and rules of the
  Compact.
         (b)  The Interstate Commission may, by majority vote of the
  Commissioners, initiate legal action in the United States District
  Court for the District of Columbia, or, at the discretion of the
  Interstate Commission, in the federal district where the Interstate
  Commission has its principal offices, to enforce compliance with
  the provisions of the Compact, and its promulgated rules and
  bylaws, against a member state in default.  The relief sought may
  include both injunctive relief and damages.  In the event judicial
  enforcement is necessary, the prevailing party shall be awarded all
  costs of such litigation including reasonable attorney's fees.
         (c)  The remedies herein shall not be the exclusive remedies
  of the Interstate Commission. The Interstate Commission may avail
  itself of any other remedies available under state law or the
  regulation of a profession.
         SECTION 18.  DEFAULT PROCEDURES
         (a)  The grounds for default include, but are not limited to,
  failure of a member state to perform such obligations or
  responsibilities imposed upon it by the Compact, or the rules and
  bylaws of the Interstate Commission promulgated under the Compact.
         (b)  If the Interstate Commission determines that a member
  state has defaulted in the performance of its obligations or
  responsibilities under the Compact, or the bylaws or promulgated
  rules, the Interstate Commission shall:
               (1)  Provide written notice to the defaulting state and
  other member states, of the nature of the default, the means of
  curing the default, and any action taken by the Interstate
  Commission.  The Interstate Commission shall specify the conditions
  by which the defaulting state must cure its default; and
               (2)  Provide remedial training and specific technical
  assistance regarding the default.
         (c)  If the defaulting state fails to cure the default, the
  defaulting state shall be terminated from the Compact upon an
  affirmative vote of a majority of the Commissioners and all rights,
  privileges, and benefits conferred by the Compact shall terminate
  on the effective date of termination. A cure of the default does not
  relieve the offending state of obligations or liabilities incurred
  during the period of the default.
         (d)  Termination of membership in the Compact shall be
  imposed only after all other means of securing compliance have been
  exhausted. Notice of intent to terminate shall be given by the
  Interstate Commission to the governor, the majority and minority
  leaders of the defaulting state's legislature, and each of the
  member states.
         (e)  The Interstate Commission shall establish rules and
  procedures to address licenses and physicians that are materially
  impacted by the termination of a member state, or the withdrawal of
  a member state.
         (f)  The member state which has been terminated is
  responsible for all dues, obligations, and liabilities incurred
  through the effective date of termination including obligations,
  the performance of which extends beyond the effective date of
  termination.
         (g)  The Interstate Commission shall not bear any costs
  relating to any state that has been found to be in default or which
  has been terminated from the Compact, unless otherwise mutually
  agreed upon in writing between the Interstate Commission and the
  defaulting state.
         (h)  The defaulting state may appeal the action of the
  Interstate Commission by petitioning the United States District
  Court for the District of Columbia or the federal district where the
  Interstate Commission has its principal offices. The prevailing
  party shall be awarded all costs of such litigation including
  reasonable attorney's fees.
         SECTION 19.  DISPUTE RESOLUTION
         (a)  The Interstate Commission shall attempt, upon the
  request of a member state, to resolve disputes which are subject to
  the Compact and which may arise among member states or member
  boards.
         (b)  The Interstate Commission shall promulgate rules
  providing for both mediation and binding dispute resolution as
  appropriate.
         SECTION 20.  MEMBER STATES, EFFECTIVE DATE AND AMENDMENT
         (a)  Any state is eligible to become a member state of the
  Compact.
         (b)  The Compact shall become effective and binding upon
  legislative enactment of the Compact into law by no less than seven
  (7) states. Thereafter, it shall become effective and binding on a
  state upon enactment of the Compact into law by that state.
         (c)  The governors of non-member states, or their designees,
  shall be invited to participate in the activities of the Interstate
  Commission on a non-voting basis prior to adoption of the Compact by
  all states.
         (d)  The Interstate Commission may propose amendments to the
  Compact for enactment by the member states. No amendment shall
  become effective and binding upon the Interstate Commission and the
  member states unless and until it is enacted into law by unanimous
  consent of the member states.
         SECTION 21.  WITHDRAWAL
         (a)  Once effective, the Compact shall continue in force and
  remain binding upon each and every member state; provided that a
  member state may withdraw from the Compact by specifically
  repealing the statute which enacted the Compact into law.
         (b)  Withdrawal from the Compact shall be by the enactment of
  a statute repealing the same, but shall not take effect until one
  (1) year after the effective date of such statute and until written
  notice of the withdrawal has been given by the withdrawing state to
  the governor of each other member state.
         (c)  The withdrawing state shall immediately notify the
  chairperson of the Interstate Commission in writing upon the
  introduction of legislation repealing the Compact in the
  withdrawing state.
         (d)  The Interstate Commission shall notify the other member
  states of the withdrawing state's intent to withdraw within sixty
  (60) days of its receipt of notice provided under subsection (c).
         (e)  The withdrawing state is responsible for all dues,
  obligations and liabilities incurred through the effective date of
  withdrawal, including obligations, the performance of which extend
  beyond the effective date of withdrawal.
         (f)  Reinstatement following withdrawal of a member state
  shall occur upon the withdrawing state reenacting the Compact or
  upon such later date as determined by the Interstate Commission.
         (g)  The Interstate Commission is authorized to develop
  rules to address the impact of the withdrawal of a member state on
  licenses granted in other member states to physicians who
  designated the withdrawing member state as the state of principal
  license.
         SECTION 22.  DISSOLUTION
         (a)  The Compact shall dissolve effective upon the date of
  the withdrawal or default of the member state which reduces the
  membership in the Compact to one (1) member state.
         (b)  Upon the dissolution of the Compact, the Compact becomes
  null and void and shall be of no further force or effect, and the
  business and affairs of the Interstate Commission shall be
  concluded and surplus funds shall be distributed in accordance with
  the bylaws.
         SECTION 23.  SEVERABILITY AND CONSTRUCTION
         (a)  The provisions of the Compact shall be severable, and if
  any phrase, clause, sentence, or provision is deemed unenforceable,
  the remaining provisions of the Compact shall be enforceable.
         (b)  The provisions of the Compact shall be liberally
  construed to effectuate its purposes.
         (c)  Nothing in the Compact shall be construed to prohibit
  the applicability of other interstate compacts to which the states
  are members.
         SECTION 24.  BINDING EFFECT OF COMPACT AND OTHER LAWS
         (a)  Nothing herein prevents the enforcement of any other law
  of a member state that is not inconsistent with the Compact.
         (b)  All laws in a member state in conflict with the Compact
  are superseded to the extent of the conflict.
         (c)  All lawful actions of the Interstate Commission,
  including all rules and bylaws promulgated by the Commission, are
  binding upon the member states.
         (d)  All agreements between the Interstate Commission and
  the member states are binding in accordance with their terms.
         (e)  In the event any provision of the Compact exceeds the
  constitutional limits imposed on the legislature of any member
  state, such provision shall be ineffective to the extent of the
  conflict with the constitutional provision in question in that
  member state.
         Sec. 170.002.  RULES. The board may adopt rules necessary to
  implement this chapter.
         SECTION 18.  Subchapter B, Chapter 204, Occupations Code, is
  amended by adding Section 204.0585 to read as follows:
         Sec. 204.0585.  EXECUTIVE SESSION. After hearing all
  evidence and arguments in an open meeting, the physician assistant
  board may conduct deliberations relating to a license application
  or disciplinary action in an executive session. The board shall
  vote and announce its decision in open session.
         SECTION 19.  Section 204.059, Occupations Code, is amended
  by amending Subsection (b) and adding Subsection (d) to read as
  follows:
         (b)  The training program must provide the person with
  information regarding:
               (1)  the law governing physician assistant board
  operations;
               (2)  the [this chapter and the physician assistant
  board's] programs, functions, rules, and budget of the physician
  assistant board;
               (3)  the scope of and limitations on the rulemaking
  authority of the physician assistant board;
               (4) [(2)]  the results of the most recent formal audit
  of the physician assistant board;
               (5) [(3)]  the requirements of:
                     (A)  laws relating to open meetings, public
  information, administrative procedure, and disclosing conflicts of
  interest; and
                     (B)  other laws applicable to members of the
  physician assistant board in performing their duties; and
               (6) [(4)]  any applicable ethics policies adopted by
  the physician assistant board or the Texas Ethics Commission.
         (d)  The executive director of the medical board shall create
  a training manual that includes the information required by
  Subsection (b). The executive director shall distribute a copy of
  the training manual annually to each physician assistant board
  member. On receipt of the training manual, each board member shall
  sign and submit to the executive director a statement acknowledging
  receipt of the training manual.
         SECTION 20.  Subchapter D, Chapter 204, Occupations Code, is
  amended by adding Section 204.1525 to read as follows:
         Sec. 204.1525.  CRIMINAL HISTORY RECORD INFORMATION
  REQUIREMENT FOR LICENSE ISSUANCE. (a) The physician assistant
  board shall require that an applicant for a license submit a
  complete and legible set of fingerprints, on a form prescribed by
  the board, to the board or to the Department of Public Safety for
  the purpose of obtaining criminal history record information from
  the Department of Public Safety and the Federal Bureau of
  Investigation.
         (b)  The physician assistant board may not issue a license to
  a person who does not comply with the requirement of Subsection (a).
         (c)  The physician assistant board shall conduct a criminal
  history record information check of each applicant for a license
  using information:
               (1)  provided by the individual under this section; and
               (2)  made available to the board by the Department of
  Public Safety, the Federal Bureau of Investigation, and any other
  criminal justice agency under Chapter 411, Government Code.
         (d)  The physician assistant board may:
               (1)  enter into an agreement with the Department of
  Public Safety to administer a criminal history record information
  check required under this section; and
               (2)  authorize the Department of Public Safety to
  collect from each applicant the costs incurred by the Department of
  Public Safety in conducting the criminal history record information
  check.
         SECTION 21.  Section 204.153(a), Occupations Code, is
  amended to read as follows:
         (a)  To be eligible for a license under this chapter, an
  applicant must:
               (1)  successfully complete an educational program for
  physician assistants or surgeon assistants accredited by the
  Committee on Allied Health Education and Accreditation or by that
  committee's predecessor or successor entities;
               (2)  pass the Physician Assistant National Certifying
  Examination administered by the National Commission on
  Certification of Physician Assistants;
               (3)  hold a certificate issued by the National
  Commission on Certification of Physician Assistants;
               (4)  [be of good moral character;
               [(5)]  meet any other requirement established by
  physician assistant board rule; and
               (5) [(6)]  pass a jurisprudence examination approved
  by the physician assistant board as provided by Subsection (a-1).
         SECTION 22.  Section 204.156, Occupations Code, is amended
  by amending Subsection (a) and adding Subsection (a-1) to read as
  follows:
         (a)  A license issued under this chapter is valid for a term
  of one or two years, as determined by physician assistant board
  rule.
         (a-1)  On notification from the physician assistant board, a
  person who holds a license under this chapter may renew the license
  by:
               (1)  paying the required renewal fee;
               (2)  submitting the appropriate form; and
               (3)  meeting any other requirement established by board
  rule.
         SECTION 23.  Subchapter D, Chapter 204, Occupations Code, is
  amended by adding Section 204.1561 to read as follows:
         Sec. 204.1561.  CRIMINAL HISTORY RECORD INFORMATION
  REQUIREMENT FOR RENEWAL. (a) An applicant for renewal of a license
  issued under this chapter shall submit a complete and legible set of
  fingerprints for purposes of performing a criminal history record
  information check of the applicant as provided by Section 204.1525.
         (b)  The physician assistant board may administratively
  suspend or refuse to renew the license of a person who does not
  comply with the requirement of Subsection (a).
         (c)  A license holder is not required to submit fingerprints
  under this section for the renewal of the license if the holder has
  previously submitted fingerprints under:
               (1)  Section 204.1525 for the initial issuance of the
  license; or
               (2)  this section as part of a prior renewal of a
  license.
         SECTION 24.  Subchapter D, Chapter 204, Occupations Code, is
  amended by adding Section 204.158 to read as follows:
         Sec. 204.158.  REFUSAL FOR VIOLATION OF BOARD ORDER. The
  physician assistant board may refuse to renew a license issued
  under this chapter if the license holder is in violation of a
  physician assistant board order.
         SECTION 25.  Subchapter E, Chapter 204, Occupations Code, is
  amended by adding Section 204.210 to read as follows:
         Sec. 204.210.  DUTIES RELATED TO CERTAIN PRESCRIPTIONS. (a)
  A physician assistant authorized to prescribe a drug may not
  prescribe a drug listed in Subsection (b) to a patient unless the
  physician assistant has reviewed the patient's prescription
  history by accessing the prescription information submitted to the
  Texas State Board of Pharmacy as authorized by Section
  481.076(a)(5), Health and Safety Code.
         (b)  Subsection (a) applies only to the prescribing of:
               (1)  opioids;
               (2)  benzodiazepines;
               (3)  barbiturates; or
               (4)  carisoprodol.
         (c)  A physician assistant is not subject to the requirements
  of Subsection (a) if:
               (1)  the patient has been diagnosed with cancer or the
  patient is receiving hospice care; and
               (2)  the physician assistant clearly notes in the
  prescription record that the patient was diagnosed with cancer or
  is receiving hospice care, as applicable.
         (d)  Failure by a physician assistant to comply with the
  requirements of this section is grounds for disciplinary action
  under Section 204.301.
         SECTION 26.  Subchapter G, Chapter 204, Occupations Code, is
  amended by adding Section 204.305 to read as follows:
         Sec. 204.305.  MONITORING HARMFUL PRESCRIBING PATTERNS. (a)
  The physician assistant board shall periodically check the
  prescribing information submitted to the Texas State Board of
  Pharmacy as authorized by Section 481.076(a)(1), Health and Safety
  Code, to determine whether a physician assistant licensed under
  this chapter is engaging in potentially harmful prescribing
  patterns or practices.
         (b)  The physician assistant board, in coordination with the
  Texas State Board of Pharmacy, shall determine the conduct that
  constitutes a potentially harmful prescribing pattern or practice
  for purposes of Subsection (a). In determining the conduct that
  constitutes a potentially harmful prescribing pattern or practice,
  the physician assistant board shall consider:
               (1)  the number of times a physician assistant
  prescribes a drug listed in Section 204.210(b); and
               (2)  for prescriptions described by Subdivision (1),
  patterns of prescribing combinations of those drugs and other
  dangerous combinations of drugs identified by the physician
  assistant board.
         (c)  If the physician assistant board suspects that a
  physician assistant may be engaging in potentially harmful
  prescribing patterns or practices, the physician assistant board
  may notify the physician assistant of the potentially harmful
  prescribing pattern or practice.
         (d)  The physician assistant board may initiate a complaint
  against a physician assistant based on information obtained under
  this section.
         SECTION 27.  Section 204.313(a), Occupations Code, is
  amended to read as follows:
         (a)  In an informal meeting under Section 204.312, at least
  two panelists shall be appointed to determine whether an informal
  disposition is appropriate. At least one of the panelists must be a
  licensed physician assistant.
         SECTION 28.  Section 205.057, Occupations Code, is amended
  by amending Subsection (b) and adding Subsection (d) to read as
  follows:
         (b)  The training program must provide the person with
  information regarding:
               (1)  the law governing acupuncture board operations
  [this chapter];
               (2)  the programs, [operated by the acupuncture board;
               [(3)  the role and] functions, rules, and budget of the
  acupuncture board;
               (3) [(4)]  the scope of and limitations on the
  rulemaking authority [rules] of the acupuncture board;
               (4) [(5)  the current budget for the acupuncture board;
               [(6)]  the results of the most recent formal audit of
  the acupuncture board;
               (5) [(7)]  the requirements of:
                     (A)  laws relating to open meetings, public
  information, administrative procedure, and disclosing conflicts of
  interest; and
                     (B)  other laws applicable to members of the
  acupuncture board in performing their duties; and
               (6) [(8)]  any applicable ethics policies adopted by
  the acupuncture board or the Texas Ethics Commission.
         (d)  The executive director shall create a training manual
  that includes the information required by Subsection (b). The
  executive director shall distribute a copy of the training manual
  annually to each acupuncture board member. On receipt of the
  training manual, each board member shall sign and submit to the
  executive director a statement acknowledging receipt of the
  training manual.
         SECTION 29.  Subchapter E, Chapter 205, Occupations Code, is
  amended by adding Section 205.2025 to read as follows:
         Sec. 205.2025.  CRIMINAL HISTORY RECORD INFORMATION
  REQUIREMENT FOR LICENSE ISSUANCE. (a) The acupuncture board shall
  require that an applicant for a license submit a complete and
  legible set of fingerprints, on a form prescribed by the board, to
  the board or to the Department of Public Safety for the purpose of
  obtaining criminal history record information from the Department
  of Public Safety and the Federal Bureau of Investigation.
         (b)  The acupuncture board may not issue a license to a
  person who does not comply with the requirement of Subsection (a).
         (c)  The acupuncture board shall conduct a criminal history
  record information check of each applicant for a license using
  information:
               (1)  provided by the individual under this section; and
               (2)  made available to the board by the Department of
  Public Safety, the Federal Bureau of Investigation, and any other
  criminal justice agency under Chapter 411, Government Code.
         (d)  The acupuncture board may:
               (1)  enter into an agreement with the Department of
  Public Safety to administer a criminal history record information
  check required under this section; and
               (2)  authorize the Department of Public Safety to
  collect from each applicant the costs incurred by the Department of
  Public Safety in conducting the criminal history record information
  check.
         SECTION 30.  The heading to Section 205.251, Occupations
  Code, is amended to read as follows:
         Sec. 205.251.  [ANNUAL] RENEWAL REQUIRED.
         SECTION 31.  Section 205.251(a), Occupations Code, is
  amended to read as follows:
         (a)  The medical board by rule shall provide for the annual
  or biennial renewal of a license to practice acupuncture.
         SECTION 32.  Subchapter F, Chapter 205, Occupations Code, is
  amended by adding Section 205.2515 to read as follows:
         Sec. 205.2515.  CRIMINAL HISTORY RECORD INFORMATION
  REQUIREMENT FOR RENEWAL. (a)  An applicant for renewal of a license
  issued under this chapter shall submit a complete and legible set of
  fingerprints for purposes of performing a criminal history record
  information check of the applicant as provided by Section 205.2025.
         (b)  The acupuncture board may administratively suspend or
  refuse to renew the license of a person who does not comply with the
  requirement of Subsection (a).
         (c)  A license holder is not required to submit fingerprints
  under this section for the renewal of the license if the holder has
  previously submitted fingerprints under:
               (1)  Section 205.2025 for the initial issuance of the
  license; or
               (2)  this section as part of a prior renewal of a
  license.  
         SECTION 33.  Subchapter F, Chapter 205, Occupations Code, is
  amended by adding Section 205.256 to read as follows:
         Sec. 205.256.  REFUSAL FOR VIOLATION OF BOARD ORDER. The
  acupuncture board may refuse to renew a license issued under this
  chapter if the license holder is in violation of an acupuncture
  board order.  
         SECTION 34.  Subchapter E, Chapter 206, Occupations Code, is
  amended by adding Section 206.2025 to read as follows:
         Sec. 206.2025.  CRIMINAL HISTORY RECORD INFORMATION
  REQUIREMENT FOR LICENSE ISSUANCE. (a)  The medical board shall
  require that an applicant for a license submit a complete and
  legible set of fingerprints, on a form prescribed by the board, to
  the board or to the Department of Public Safety for the purpose of
  obtaining criminal history record information from the Department
  of Public Safety and the Federal Bureau of Investigation.
         (b)  The medical board may not issue a license to a person who
  does not comply with the requirement of Subsection (a).
         (c)  The medical board shall conduct a criminal history
  record information check of each applicant for a license using
  information:
               (1)  provided by the individual under this section; and
               (2)  made available to the board by the Department of
  Public Safety, the Federal Bureau of Investigation, and any other
  criminal justice agency under Chapter 411, Government Code.
         (d)  The medical board may:
               (1)  enter into an agreement with the Department of
  Public Safety to administer a criminal history record information
  check required under this section; and
               (2)  authorize the Department of Public Safety to
  collect from each applicant the costs incurred by the Department of
  Public Safety in conducting the criminal history record information
  check.  
         SECTION 35.  Section 206.203(a), Occupations Code, is
  amended to read as follows:
         (a)  Except as provided by Section 206.206, to be eligible
  for a license, a person must:
               (1)  [be of good moral character;
               [(2)]  have not been convicted of a felony or a crime
  involving moral turpitude;
               (2) [(3)]  not use drugs or alcohol to an extent that
  affects the applicant's professional competency;
               (3) [(4)]  not have had a license or certification
  revoked by a licensing agency or by a certifying professional
  organization; and
               (4) [(5)]  not have engaged in fraud or deceit in
  applying for a license under this chapter.
         SECTION 36.  Subchapter E, Chapter 206, Occupations Code, is
  amended by adding Section 206.2105 to read as follows:
         Sec. 206.2105.  CRIMINAL HISTORY RECORD INFORMATION
  REQUIREMENT FOR RENEWAL. (a)  An applicant for renewal of a license
  issued under this chapter shall submit a complete and legible set of
  fingerprints for purposes of performing a criminal history record
  information check of the applicant as provided by Section 206.2025.
         (b)  The medical board may administratively suspend or
  refuse to renew the license of a person who does not comply with the
  requirement of Subsection (a).
         (c)  A license holder is not required to submit fingerprints
  under this section for the renewal of the license if the holder has
  previously submitted fingerprints under:
               (1)  Section 206.2025 for the initial issuance of the
  license; or
               (2)  this section as part of a prior renewal of a
  license.  
         SECTION 37.  Subchapter E, Chapter 206, Occupations Code, is
  amended by adding Section 206.215 to read as follows:
         Sec. 206.215.  REFUSAL FOR VIOLATION OF BOARD ORDER. The
  medical board may refuse to renew a license issued under this
  chapter if the license holder is in violation of a medical board
  order.  
         SECTION 38.  Section 601.002, Occupations Code, is amended
  by adding Subdivisions (10-a) and (10-b) to read as follows:
               (10-a)  "Radiologist" means a physician specializing
  in radiology certified by or board-eligible for the American Board
  of Radiology, the American Osteopathic Board of Radiology, the
  Royal College of Radiologists, or the Royal College of Physicians
  and Surgeons of Canada.
               (10-b)  "Radiologist assistant" means an
  advanced-level medical radiologic technologist who is certified
  as:
                     (A)  a registered radiologist assistant by the
  American Registry of Radiologic Technologists; or
                     (B)  a radiology practitioner assistant by the
  Certification Board for Radiology Practitioner Assistants.  
         SECTION 39.  Section 601.030, Occupations Code, is amended
  by amending Subsection (b) and adding Subsection (d) to read as
  follows:
         (b)  The training program must provide the person with
  information regarding:
               (1)  the law governing advisory board operations;
               (2)  [this chapter and] the [advisory board's]
  programs, functions, rules, and budget of the advisory board;
               (3)  the scope of and limitations on the rulemaking
  authority of the advisory board;
               (4) [(2)]  the results of the most recent formal audit
  of the advisory board;
               (5) [(3)]  the requirements of:
                     (A)  laws relating to open meetings, public
  information, administrative procedure, and disclosing conflicts of
  interest; and
                     (B)  other laws applicable to members of the
  advisory board in performing their duties; and
               (6) [(4)]  any applicable ethics policies adopted by
  the advisory board or the Texas Ethics Commission.
         (d)  The executive director of the medical board shall create
  a training manual that includes the information required by
  Subsection (b). The executive director shall distribute a copy of
  the training manual annually to each advisory board member. On
  receipt of the training manual, each board member shall sign and
  submit to the executive director a statement acknowledging receipt
  of the training manual.  
         SECTION 40.  Sections 601.102(b) and (c), Occupations Code,
  are amended to read as follows:
         (b)  The advisory board may issue to a person:
               (1)  a general certificate to perform radiologic
  procedures; [or]
               (2)  a limited certificate that authorizes the person
  to perform radiologic procedures only on specific parts of the
  human body; or
               (3)  a radiologist assistant certificate to a person
  who meets the requirements established under Section 601.1021.
         (c)  The advisory board may issue to a person a temporary
  general certificate, [or] a temporary limited certificate, or a
  temporary radiologist assistant certificate that authorizes the
  person to perform radiologic procedures for a period not to exceed
  one year.
         SECTION 41.  Subchapter C, Chapter 601, Occupations Code, is
  amended by adding Section 601.1021 to read as follows:
         Sec. 601.1021.  RADIOLOGIST ASSISTANT CERTIFICATE. (a) The
  advisory board by rule shall establish the education and training
  required for a person to obtain a radiologist assistant
  certificate.
         (b)  A radiologist assistant certificate holder:
               (1)  may perform radiologic procedures only under the
  supervision of a radiologist; and
               (2)  may not interpret images, make diagnoses, or
  prescribe any medication or therapy.  
         SECTION 42.  Subchapter C, Chapter 601, Occupations Code, is
  amended by adding Section 601.113 to read as follows:
         Sec. 601.113.  REFUSAL FOR VIOLATION OF BOARD ORDER. The
  advisory board may refuse to renew a certificate issued under this
  chapter if the certificate holder is in violation of an advisory
  board order.  
         SECTION 43.  Section 601.155, Occupations Code, is amended
  to read as follows:
         Sec. 601.155.  STUDENTS. A person is not required to hold a
  certificate issued under this chapter [or to comply with the
  registration requirements adopted under Section 601.252] if the
  person:
               (1)  is a student enrolled in a training program that
  meets the minimum standards adopted under Section 601.201; and
               (2)  is performing a radiologic procedure in an
  academic or clinical setting as part of the training program.
         SECTION 44.  Section 601.156, Occupations Code, is amended
  to read as follows:
         Sec. 601.156.  PROCEDURE PERFORMED AS PART OF CONTINUING
  EDUCATION PROGRAM.  A person is not required to hold a certificate
  issued under this chapter [or to comply with the registration
  requirements adopted under Section 601.252] if the person is:
               (1)  licensed or otherwise registered as a medical
  radiologic technologist by another state, the American Registry of
  Radiologic Technologists, the American Registry of Clinical
  Radiography Technologists, or a professional organization or
  association recognized by the advisory board;
               (2)  enrolled in a continuing education program that
  meets the requirements adopted under Section 601.108; and
               (3)  performing a radiologic procedure as part of the
  continuing education program for not more than 10 days.
         SECTION 45.  Section 601.203(b), Occupations Code, is
  amended to read as follows:
         (b)  The following conditions are considered to be a hardship
  for the purposes of Subsection (a):
               (1)  that the applicant:
                     (A)  reports an inability to attract and retain
  medical radiologic technologists; and
                     (B)  is located in a county with a population of
  less than 50,000;
               (2)  that the applicant is located at a great distance
  from a school of medical radiologic technology;
               (3)  that there is a list of qualified persons who have
  applied to a school of medical radiologic technology whose
  admissions are pending because of a lack of faculty or space;
               (4)  that the school of medical radiologic technology
  produces an insufficient number of graduates in medical radiologic
  technology to meet the needs of the applicant; or
               (5)  any other criteria determined by advisory board
  rule.
         SECTION 46.  Subchapter E, Chapter 602, Occupations Code, is
  amended by adding Section 602.214 to read as follows:
         Sec. 602.214.  REFUSAL FOR VIOLATION OF BOARD ORDER. The
  medical board may refuse to renew a license issued under this
  chapter if the license holder is in violation of a medical board
  order.  
         SECTION 47.  Section 603.252(a), Occupations Code, is
  amended to read as follows:
         (a)  An applicant for a perfusionist license must submit an
  [a sworn] application accompanied by the application fee.
         SECTION 48.  Subchapter G, Chapter 603, Occupations Code, is
  amended by adding Section 603.306 to read as follows:
         Sec. 603.306.  REFUSAL FOR VIOLATION OF BOARD ORDER. The
  medical board may refuse to renew a license issued under this
  chapter if the license holder is in violation of a medical board
  order.  
         SECTION 49.  Section 604.030, Occupations Code, is amended
  by amending Subsection (b) and adding Subsection (d) to read as
  follows:
         (b)  The training program must provide the person with
  information regarding:
               (1)  the law governing advisory board operations;
               (2)  the [this chapter and the advisory board's]
  programs, functions, rules, and budget of the advisory board;
               (3)  the scope of and limitations on the rulemaking
  authority of the advisory board;
               (4) [(2)]  the results of the most recent formal audit
  of the advisory board;
               (5) [(3)]  the requirements of:
                     (A)  laws relating to open meetings, public
  information, administrative procedure, and disclosing conflicts of
  interest; and
                     (B)  other laws applicable to members of the
  advisory board in performing their duties; and
               (6) [(4)]  any applicable ethics policies adopted by
  the advisory board or the Texas Ethics Commission.
         (d)  The executive director of the medical board shall create
  a training manual that includes the information required by
  Subsection (b). The executive director shall distribute a copy of
  the training manual annually to each advisory board member. On
  receipt of the training manual, each board member shall sign and
  submit to the executive director a statement acknowledging receipt
  of the training manual.  
         SECTION 50.  Subchapter D, Chapter 604, Occupations Code, is
  amended by adding Section 604.158 to read as follows:
         Sec. 604.158.  REFUSAL FOR VIOLATION OF BOARD ORDER. The
  advisory board may refuse to renew a certificate or temporary
  permit issued under this chapter if the certificate or permit
  holder is in violation of an advisory board order.
         SECTION 51.  Sections 601.252(c) and (d), Occupations Code,
  are repealed.
         SECTION 52.  (a) Except as provided by Subsection (b) of this
  section, Sections 152.010, 204.059, 205.057, 601.030, and 604.030,
  Occupations Code, as amended by this Act, apply to a member of the
  applicable board appointed before, on, or after the effective date
  of this Act.
         (b)  A member of a board who, before the effective date of
  this Act, completed the training program required by Section
  152.010, 204.059, 205.057, 601.030, or 604.030, Occupations Code,
  as the applicable law existed before the effective date of this Act,
  is only required to complete additional training on the subjects
  added by this Act to the training program required by Section
  152.010, 204.059, 205.057, 601.030, or 604.030, Occupations Code,
  as applicable. A board member described by this subsection may not
  vote, deliberate, or be counted as a member in attendance at a
  meeting of the applicable board held on or after December 1, 2017,
  until the member completes the additional training.
         SECTION 53.  Sections 162.301 and 204.210, Occupations Code,
  as added by this Act, apply only to a prescription issued on or
  after September 1, 2018. A prescription issued before September 1,
  2018, is governed by the law in effect immediately before the
  effective date of this Act, and the former law is continued in
  effect for that purpose.
         SECTION 54.  Not later than March 1, 2018, the Texas Medical
  Board shall adopt rules necessary to implement Section 164.003(b),
  Occupations Code, as amended by this Act.
         SECTION 55.  Not later than January 1, 2018, the Texas
  Medical Board and the governing board of the Texas Physician Health
  Program by rule shall adopt the memorandum of understanding
  required by Section 167.012, Occupations Code, as added by this
  Act.
         SECTION 56.  Not later than September 1, 2019, the Texas
  Physician Assistant Board, the Texas State Board of Acupuncture
  Examiners, and the Texas Medical Board shall obtain criminal
  history record information on each person who, on the effective
  date of this Act, holds a license issued under Chapter 204, 205, or
  206, Occupations Code, as applicable, and did not undergo a
  criminal history record information check based on the license
  holder's fingerprints on the initial application for the license.
  A board may suspend the license of a license holder who does not
  provide the criminal history record information as required by the
  board and this section.
         SECTION 57.  Not later than January 1, 2018, the Texas
  Medical Board shall approve the rules required by Section 601.1021,
  Occupations Code, as added by this Act.
         SECTION 58.  This Act takes effect September 1, 2017.