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