OCCUPATIONS CODE
SUBTITLE B. PHYSICIANS
CHAPTER 151. GENERAL PROVISIONS
SUBCHAPTER A. GENERAL PROVISIONS
§ 151.001. SHORT TITLE. This subtitle may be cited as
the Medical Practice Act.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 151.002. DEFINITIONS. (a) In this subtitle:
(1) "Board" means the Texas State Board of Medical
Examiners.
(2) "Continuing threat to the public welfare" means a
real danger to the health of a physician's patients or to the public
from the acts or omissions of the physician caused through the
physician's lack of competence, impaired status, or failure to care
adequately for the physician's patients, as determined by:
(A) the board;
(B) a medical peer review committee in this
state;
(C) a physician licensed to practice medicine in
this state or otherwise lawfully practicing medicine in this state;
(D) a physician engaged in graduate medical
education or training; or
(E) a medical student.
(3) "Disciplinary order" means an action taken under
Section 164.001, 164.053, 164.058, or 164.101.
(4) "Doctor of osteopathic medicine" includes a doctor
of osteopathy, an osteopath, an osteopathic physician, and an
osteopathic surgeon.
(5) "Health care entity" means:
(A) a hospital licensed under Chapter 241 or 577,
Health and Safety Code;
(B) an entity, including a health maintenance
organization, group medical practice, nursing home, health science
center, university medical school, hospital district, hospital
authority, or other health care facility, that:
(i) provides or pays for medical care or
health care services; and
(ii) follows a formal peer review process
to further quality medical care or health care;
(C) a professional society or association of
physicians, or a committee of such a society or association, that
follows a formal peer review process to further quality medical
care or health care; or
(D) an organization established by a
professional society or association of physicians, hospitals, or
both, that:
(i) collects and verifies the authenticity
of documents and other information concerning the qualifications,
competence, or performance of licensed health care professionals;
and
(ii) acts as a health care facility's agent
under the Health Care Quality Improvement Act of 1986 (42 U.S.C.
Section 11101 et seq.).
(6) "Legally authorized representative" of a patient
means:
(A) a parent or legal guardian if the patient is a
minor;
(B) a legal guardian if the patient has been
adjudicated incompetent to manage the patient's personal affairs;
(C) an agent of the patient authorized under a
durable power of attorney for health care;
(D) an attorney ad litem appointed for the
patient;
(E) a guardian ad litem appointed for the
patient;
(F) a personal representative or statutory
beneficiary if the patient is deceased; or
(G) an attorney retained by the patient or by
another person listed by this subdivision.
(7) "Medical peer review" or "professional review
action" means the evaluation of medical and health care services,
including evaluation of the qualifications of professional health
care practitioners and of patient care provided by those
practitioners. The term includes evaluation of the:
(A) merits of a complaint relating to a health
care practitioner and a determination or recommendation regarding
the complaint;
(B) accuracy of a diagnosis;
(C) quality of the care provided by a health care
practitioner;
(D) report made to a medical peer review
committee concerning activities under the committee's review
authority;
(E) report made by a medical peer review
committee to another committee or to the board as permitted or
required by law; and
(F) implementation of the duties of a medical
peer review committee by a member, agent, or employee of the
committee.
(8) "Medical peer review committee" or "professional
review body" means a committee of a health care entity, the
governing board of a health care entity, or the medical staff of a
health care entity, that operates under written bylaws approved by
the policy-making body or the governing board of the health care
entity and is authorized to evaluate the quality of medical and
health care services or the competence of physicians, including
evaluation of the performance of those functions specified by
Section 85.204, Health and Safety Code. The term includes:
(A) an employee or agent of the committee,
including an assistant, investigator, intervenor, attorney, and
any other person or organization that serves the committee; and
(B) the governing body of a public hospital owned
or operated by a governmental entity, the governing body of a
hospital authority created under Chapter 262 or 264, Health and
Safety Code, and the governing body of a hospital district created
under Article IX, Texas Constitution, but only:
(i) in relation to the governing body's
evaluation of the competence of a physician or the quality of
medical and health care services provided by the public hospital,
hospital authority, or hospital district; and
(ii) to the extent that the evaluation
under Subparagraph (i) involves discussions or records that
specifically or necessarily identify an individual patient or
physician.
(9) "Medical records" means all records relating to
the history, diagnosis, treatment, or prognosis of a patient.
(10) "Operation" means the application of surgery or
the performance of surgical services.
(11) "Person" means an individual, unless the term is
expressly made applicable to a partnership, association, or
corporation.
(12) "Physician" means a person licensed to practice
medicine in this state.
(13) "Practicing medicine" means the diagnosis,
treatment, or offer to treat a mental or physical disease or
disorder or a physical deformity or injury by any system or method,
or the attempt to effect cures of those conditions, by a person who:
(A) publicly professes to be a physician or
surgeon; or
(B) directly or indirectly charges money or other
compensation for those services.
(14) "Surgery" includes:
(A) surgical services, procedures, and
operations; and
(B) the procedures described in the surgery
section of the common procedure coding system as adopted by the
Health Care Financing Administration of the United States
Department of Health and Human Services.
(b) The terms "physician" and "surgeon" are synonyms. As
used in this subtitle, the terms "practitioner" and "practitioner
of medicine" include physicians and surgeons.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2001, 77th Leg., ch. 1420, § 14.021(a), eff. Sept. 1,
2001; Acts 2003, 78th Leg., ch. 202, § 1, eff. June 10, 2003.
§ 151.003. LEGISLATIVE FINDINGS. The legislature finds
that:
(1) the practice of medicine is a privilege and not a
natural right of individuals and as a matter of public policy it is
necessary to protect the public interest through enactment of this
subtitle to regulate the granting of that privilege and its
subsequent use and control; and
(2) the board should remain the primary means of
licensing, regulating, and disciplining physicians.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 151.004. APPLICATION OF SUNSET ACT. The Texas State
Board of Medical Examiners 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 expires
September 1, 2005.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 151.005. GOVERNMENTAL DISCRIMINATION
PROHIBITED. (a) A program supported in whole or in part by the
state or by a political subdivision of the state may not
discriminate against a health care practitioner because the
practitioner is a physician specializing in ophthalmology.
(b) A law or policy of the state or of a political
subdivision of the state that requires or encourages a person to
obtain vision care or medical eye care that is within the scope of
practice of an optometrist or therapeutic optometrist may not
discriminate against a health care practitioner because the
practitioner is a physician specializing in ophthalmology.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
SUBCHAPTER B. APPLICATION AND CONSTRUCTION OF SUBTITLE
§ 151.051. DISCRIMINATION BASED ON TYPE OF ACADEMIC
MEDICAL DEGREE OR CERTAIN RELIGIOUS TENETS PROHIBITED. (a) A
hospital, institution, or program that is licensed by the state, is
operated by the state or a political subdivision of the state, or
directly or indirectly receives state financial assistance may not
differentiate in regard to a person licensed under this subtitle
solely on the basis of the academic medical degree held by the
person. The hospital, institution, program, state agency, or
political subdivision may adopt rules and requirements relating to
qualifications for medical staff appointments, including
reappointments and the termination of appointments, the
delineation of clinical privileges, or the curtailment of clinical
privileges of persons who are appointed to that medical staff or
permitted to participate in educational programs if those rules and
requirements do not differentiate solely on the basis of the
academic medical degree held by the affected physician and are:
(1) determined on a reasonable basis, such as the
professional and ethical qualifications of the physician;
(2) based on reasonable standards;
(3) applied without irrelevant considerations;
(4) supported by sufficient evidence; and
(5) not arbitrary or capricious.
(b) The limitations imposed under this section relating to
discrimination based on the academic medical degree of a physician
do not apply to practice limitations adopted by:
(1) a medical school or college, including a program
of a medical school or college; or
(2) any office or offices of physicians, singularly or
in groups, in the conduct of their profession.
(c) This subtitle may not be construed in a manner that:
(1) discriminates against a school or system of
medical practice; or
(2) affects the use of the principles or teachings of
any church in ministering to the sick or suffering by prayer or
pastoral counseling without the use of a drug or other material
substance represented as medically effective.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 151.052. EXEMPTIONS. (a) This subtitle does not
apply to:
(1) a dentist, licensed under the laws of this state,
engaged strictly in the practice of dentistry;
(2) a licensed optometrist or therapeutic optometrist
engaged strictly in the practice of optometry or therapeutic
optometry as defined by law;
(3) a licensed chiropractor engaged strictly in the
practice of chiropractic as defined by law;
(4) a registered nurse or licensed vocational nurse
engaged strictly in the practice of nursing in accordance with the
applicable licensing acts and other laws of this state;
(5) a licensed podiatrist engaged strictly in the
practice of podiatry as defined by law;
(6) a licensed or certified psychologist engaged
strictly in the practice of psychology as defined by law;
(7) a licensed physical therapist engaged strictly in
the practice of physical therapy in accordance with the law
relating to physical therapy practice;
(8) a commissioned or contract surgeon in the United
States uniformed services or Public Health Service in the
performance of that person's duties if the person is not engaged in
private practice;
(9) a person who furnishes medical assistance in an
emergency or disaster situation if no charge is made for the medical
assistance;
(10) a student in training in a board-approved medical
school while performing, under the supervision of a licensed
practitioner, the duties assigned in the course of training;
(11) a legally qualified physician of another state
who is in this state for consultation with a physician licensed in
this state but who does not:
(A) maintain an office in this state; or
(B) appoint a place in this state for seeing,
examining, or treating a patient; or
(12) any other activity that the board designates as
exempt from the application of this subtitle.
(b) Notwithstanding Subsection (a)(10), a medical resident,
intern, or fellow is required to register and is subject to the
other applicable provisions of this subtitle.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 151.053. APPLICATION TO CERTAIN PERSONS PROVIDING
NUTRITIONAL ADVICE. (a) This subtitle does not prohibit a person
from giving advice regarding the use and role of food and food
ingredients, including dietary supplements.
(b) Subsection (a) does not authorize a person to:
(1) practice medicine; or
(2) state, in violation of law, that a product might
cure a disease, disorder, or condition.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 151.054. APPLICATION TO SELF-CARE. (a) This
subtitle does not prohibit:
(1) a person from providing or seeking advice or
information relating to that person's self-care; or
(2) the dissemination of information relating to
self-care.
(b) This section does not confer authority to practice
medicine.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 151.055. APPLICATION TO CERTAIN INDEPENDENT
CONTRACTOR AGREEMENTS. This subtitle does not prohibit a hospital
from entering into an independent contractor agreement with a
physician to provide services at the hospital or at another health
care facility owned or operated by the hospital and:
(1) paying the physician a minimum guaranteed amount
to ensure the physician's availability;
(2) billing and collecting from patients the
physician's professional fees; or
(3) retaining the collected professional fees up to
the amount of the minimum guaranteed amount plus a reasonable
collection fee.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 151.056. APPLICATION TO TELEMEDICINE. (a) A person
who is physically located in another jurisdiction but who, through
the use of any medium, including an electronic medium, performs an
act that is part of a patient care service initiated in this state,
including the taking of an x-ray examination or the preparation of
pathological material for examination, and that would affect the
diagnosis or treatment of the patient, is considered to be engaged
in the practice of medicine in this state and is subject to
appropriate regulation by the board.
(b) This section does not apply to the act of:
(1) a medical specialist located in another
jurisdiction who provides only episodic consultation services on
request to a physician licensed in this state who practices in the
same medical specialty;
(2) a physician located in another jurisdiction who is
providing consultation services to a medical school as defined by
Section 61.501, Education Code;
(3) a physician located in another jurisdiction who is
providing consultation services to an institution subject to:
(A) Subchapter C, Chapter 73, Education Code; or
(B) Subchapter K, Chapter 74, Education Code; or
(4) a physician located in another jurisdiction of a
state having borders contiguous with the borders of this state who
is the treating physician of a patient and orders home health or
hospice services for a resident of this state to be delivered by a
home and community support services agency licensed in this state.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2001, 77th Leg., ch. 1420, § 14.022(a), eff. Sept. 1,
2001.
