OCCUPATIONS CODE
SUBTITLE C. OTHER PROFESSIONS PERFORMING MEDICAL PROCEDURES
CHAPTER 201. CHIROPRACTORS
SUBCHAPTER A. GENERAL PROVISIONS
§ 201.001. DEFINITIONS. In this chapter:
(1) "Board" means the Texas Board of Chiropractic
Examiners.
(2) "Chiropractor" means a person licensed to practice
chiropractic by the board.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.002. PRACTICE OF CHIROPRACTIC. (a) In this
section, "incisive or surgical procedure" includes making an
incision into any tissue, cavity, or organ by any person or
implement. The term does not include the use of a needle for the
purpose of drawing blood for diagnostic testing.
(b) A person practices chiropractic under this chapter if
the person:
(1) uses objective or subjective means to analyze,
examine, or evaluate the biomechanical condition of the spine and
musculoskeletal system of the human body;
(2) performs nonsurgical, nonincisive procedures,
including adjustment and manipulation, to improve the subluxation
complex or the biomechanics of the musculoskeletal system;
(3) represents to the public that the person is a
chiropractor; or
(4) uses the term "chiropractor," "chiropractic,"
"doctor of chiropractic," "D.C.," or any derivative of those terms
or initials in connection with the person's name.
(c) The practice of chiropractic does not include:
(1) incisive or surgical procedures;
(2) the prescription of controlled substances,
dangerous drugs, or any other drug that requires a prescription; or
(3) the use of x-ray therapy or therapy that exposes
the body to radioactive materials.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.003. APPLICATIONS AND EXEMPTIONS.
(a) This chapter does not apply to a registered nurse
licensed under Chapter 301, a vocational nurse licensed under
Chapter 301, a person who provides spinal screening services as
authorized by Chapter 37, Health and Safety Code, a physical
therapist licensed under Chapter 453, or a massage therapist or a
massage therapy instructor qualified and registered under Chapter
455 if:
(1) the person does not represent to the public that
the person is a chiropractor or use the term 'chiropractor,' '
chiropractic,' 'doctor of chiropractic,' 'D.C.,' or any derivative
of those terms or initials in connection with the person's name or
practice; and
(2) the person practices strictly within the scope of
the license or registration held in compliance with all laws
relating to the license and registration.
(b) This chapter does not limit or affect the rights and
powers of a physician licensed in this state to practice medicine.
(c) This section does not affect or prevent a student
enrolled in a college of chiropractic in this state from engaging in
all phases of clinical practice if the practice is:
(1) part of the curriculum; and
(2) conducted under the supervision of a licensed
chiropractor or a licensed physician.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2003, 78th Leg., ch. 553, § 2.014, eff. Feb. 1, 2004.
§ 201.004. APPLICATION OF SUNSET ACT. The Texas Board
of Chiropractic 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 chapter expires
September 1, 2005.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
SUBCHAPTER B. TEXAS BOARD OF CHIROPRACTIC EXAMINERS
§ 201.051. BOARD; MEMBERSHIP. (a) The Texas Board of
Chiropractic Examiners consists of nine members appointed by the
governor with the advice and consent of the senate as follows:
(1) six chiropractors who are reputable practicing
chiropractors and who have resided in this state for at least five
years preceding appointment; and
(2) three members who represent the public.
(b) Appointments to the board shall be made without regard
to the race, color, disability, sex, religion, age, or national
origin of the appointee.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.052. MEMBERSHIP ELIGIBILITY. (a) A person is
not eligible to serve as a member of the board if the person:
(1) is a member of the faculty or board of trustees of
a chiropractic school;
(2) is a stockholder in a chiropractic school or
college; or
(3) has a financial interest in a chiropractic school
or college.
(b) A person is not eligible for appointment as a public
member of the board if the person or the person's spouse:
(1) is registered, certified, or licensed by an
occupational regulatory agency in the field of health care;
(2) is employed by or participates in the management
of a business entity or other organization regulated by or
receiving funds from the board;
(3) owns or controls, directly or indirectly, more
than a 10 percent interest in a business entity or other
organization regulated by or receiving funds from the board; or
(4) uses or receives a substantial amount of tangible
goods, services, or funds from the board, other than compensation
or reimbursement authorized by law for board membership,
attendance, or expenses.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.053. MEMBERSHIP AND EMPLOYEE
RESTRICTIONS. (a) In this section, "Texas trade association"
means a nonprofit, cooperative, and voluntarily joined association
of business or professional competitors in this state designed to
assist its members and its industry or profession in dealing with
mutual business or professional problems and in promoting their
common interest.
(b) An officer, employee, or paid consultant of a Texas
trade association in the field of health care may not be a member or
employee of the board who is exempt from the state's position
classification plan or is compensated at or above the amount
prescribed by the General Appropriations Act for step 1, salary
group A17, of the position classification salary schedule.
(c) A person who is the spouse of, or who is related within
the first degree by affinity or within the first degree by
consanguinity to, an officer, manager, or paid consultant of a
Texas trade association in the field of health care may not be a
member or employee of the board who is exempt from the state's
position classification plan or is compensated at or above the
amount prescribed by the General Appropriations Act for step 1,
salary group A17, of the position classification salary schedule.
(d) A person may not serve as a member of the board or act as
the general counsel to the board if the person is required to
register as a lobbyist under Chapter 305, Government Code, because
of the person's activities for compensation on behalf of a
profession related to the operation of the board.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.054. TERMS; VACANCY. (a) Members of the board
are appointed for staggered six-year terms. The terms of one-third
of the members expire on February 1 of each odd-numbered year.
(b) A person may not be appointed to serve more than two
terms.
(c) If a vacancy occurs because of the death or resignation
of a board member, the governor shall appoint a replacement to fill
the unexpired term.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.055. OFFICERS. (a) The governor shall designate
a chiropractic member of the board as the board's president. The
president serves in that capacity at the will of the governor.
(b) The board shall elect one of its members as vice
president and one of its members as secretary-treasurer at the
first board meeting after the biennial appointment of board
members.
(c) Repealed by Acts 2003, 78th Leg., ch. 285, § 31(31).
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2003, 78th Leg., ch. 285, § 31(31), eff. Sept. 1, 2003.
§ 201.056. GROUNDS FOR REMOVAL. (a) It is a ground for
removal from the board that a member:
(1) does not have at the time of appointment the
qualifications required by Sections 201.051 and 201.052(b);
(2) does not maintain during service on the board the
qualifications required by Sections 201.051 and 201.052(b);
(3) violates a prohibition established by Section
201.053;
(4) cannot, because of illness or disability,
discharge the member's duties for a substantial part of the member's
term; or
(5) is absent from more than half of the regularly
scheduled board meetings that the member is eligible to attend
during a calendar year unless the absence is excused by majority
vote of the board.
(b) The validity of an action of the board is not affected by
the fact that it is taken when a ground for removal of a board member
exists.
(c) If the executive director has knowledge that a potential
ground for removal exists, the executive director shall notify the
governor and the attorney general that a potential ground for
removal exists.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.057. PER DIEM; REIMBURSEMENT. (a) A board
member is entitled to a per diem as set by the General
Appropriations Act for each day the member engages in the business
of the board.
(b) A member may not receive reimbursement for travel
expenses, including expenses for meals and lodging, other than
transportation expenses as provided by the General Appropriations
Act.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.058. MEETINGS. (a) The board shall hold regular
meetings to examine applicants and transact business at least twice
each year at the times and places determined by the board.
(b) A special meeting may be held at the call of three board
members.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.059. ADVISORY COMMISSION. (a) An advisory
commission to advise the board consists of:
(1) three chiropractors appointed by the board;
(2) two chiropractors licensed in this state and
appointed by the board from a list submitted by the president or
governing body of each chiropractic college;
(3) two physicians licensed and appointed by the Texas
State Board of Medical Examiners;
(4) one registered nurse licensed and appointed by the
Board of Nurse Examiners; and
(5) one pharmacist licensed and appointed by the Texas
State Board of Pharmacy.
(b) The advisory commission shall advise the board on
scientific and technical matters regarding new and experimental
diagnostic and treatment practices, procedures, or instruments
that are within the meaning of practicing chiropractic under
Section 201.002.
(c) Each member of the advisory commission serves at the
will of the authority that appointed the member to the advisory
commission.
(d) The presiding officer of the advisory commission shall
be selected from among the three members of the commission
appointed by the board.
(e) A member of the advisory commission serves without
compensation. Each member is entitled to reimbursement for actual
expenses incurred in carrying out the member's official duties,
subject to the approval of the presiding officer of the advisory
commission.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.060. BOARD SEAL. The seal of the board consists
of a five-point star with the words, "The State of Texas," and the
words, "Texas Board of Chiropractic Examiners," around the margin.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
SUBCHAPTER C. BOARD PERSONNEL
§ 201.101. DIVISION OF RESPONSIBILITIES. The board
shall develop and implement policies that clearly define the
respective responsibilities of the board and the staff of the
board.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.102. QUALIFICATIONS AND STANDARDS OF CONDUCT
INFORMATION. The board shall provide as often as necessary to its
members and employees information regarding their:
(1) qualifications for office or employment under this
chapter; and
(2) responsibilities under applicable laws relating
to standards of conduct for state officers or employees.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.103. CAREER LADDER PROGRAM; PERFORMANCE
EVALUATIONS. (a) The executive director or the executive
director's designee shall develop an intra-agency career ladder
program. The program must require intra-agency postings of all
nonentry level positions concurrently with any public posting.
(b) The executive director or the executive director's
designee shall develop a system of annual performance evaluations.
All merit pay for board employees must be based on the system
established under this subsection.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.104. EQUAL EMPLOYMENT OPPORTUNITY;
REPORT. (a) The executive director or the executive director's
designee shall prepare and maintain a written policy statement to
ensure implementation of an equal employment opportunity program
under which all personnel transactions are made without regard to
race, color, disability, sex, religion, age, or national origin.
The policy statement must include:
(1) personnel policies, including policies relating
to recruitment, evaluation, selection, application, training, and
promotion of personnel, that are in compliance with Chapter 21,
Labor Code;
(2) a comprehensive analysis of the board workforce
that meets federal and state guidelines;
(3) procedures by which a determination can be made of
the significant underuse in the board workforce of all persons for
whom federal or state guidelines encourage a more equitable
balance; and
(4) reasonable methods to appropriately address those
areas of significant underuse.
(b) A policy statement prepared under Subsection (a) must
be:
(1) prepared to cover an annual period;
(2) updated annually;
(3) reviewed by the Commission on Human Rights for
compliance with Subsection (a)(1); and
(4) filed with the governor.
(c) The governor shall deliver a biennial report to the
legislature based on the information received under Subsection (b).
The report may be made separately or as part of other biennial
reports made to the legislature.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
SUBCHAPTER D. BOARD POWERS AND DUTIES
§ 201.151. GENERAL POWERS AND DUTIES. The board shall
administer the purposes of and enforce this chapter.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.152. RULES. (a) The board may adopt rules and
bylaws:
(1) necessary to:
(A) perform the board's duties; and
(B) regulate the practice of chiropractic; and
(2) relating to the board's proceedings and the
board's examination of an applicant for a license to practice
chiropractic.
(b) The board shall adopt rules for the enforcement of this
chapter. The board shall issue all opinions based on a vote of a
majority of the board at a regular or special meeting. The issuance
of a disciplinary action or disciplinary order of the board is not
limited by this subsection.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.153. FEES. (a) The board by rule shall set fees
in amounts reasonable and necessary to cover the costs of
administering this chapter. The board may not set a fee in an
amount that is less than the amount of that fee on September 1,
1993.
(b) Each of the following fees imposed under Subsection (a)
is increased by $200:
(1) the fee for an annual renewal of a license;
(2) the fee for issuance of a license to an
out-of-state applicant;
(3) the fee for an examination; and
(4) the fee for a reexamination.
(c) For each $200 fee increase collected under Subsection
(b), $50 shall be deposited in the foundation school fund and $150
shall be deposited in the general revenue fund.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2003, 78th Leg., ch. 899, § 2.
§ 201.154. CERTIFICATION FOR MANIPULATION UNDER
ANESTHESIA PROHIBITED. Notwithstanding any other provision of
this chapter, the board may not adopt a process to certify
chiropractors to perform manipulation under anesthesia.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.155. RULES RESTRICTING ADVERTISING OR COMPETITIVE
BIDDING. (a) The board may not adopt rules restricting
advertising or competitive bidding by a person regulated by the
board except to prohibit false, misleading, or deceptive practices
by that person.
(b) The board may not include in rules to prohibit false,
misleading, or deceptive practices by a person regulated by the
board a rule that:
(1) restricts the use of any advertising medium;
(2) restricts the person's personal appearance or use
of the person's voice in an advertisement;
(3) relates to the size or duration of an
advertisement by the person; or
(4) restricts the use of a trade name in advertising by
the person.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.156. BOARD DUTIES REGARDING COMPLAINTS. (a) The
board by rule shall:
(1) adopt a form to standardize information concerning
complaints made to the board; and
(2) prescribe information to be provided to a person
when the person files a complaint with the board.
(b) The board shall provide reasonable assistance to a
person who wishes to file a complaint with the board.
(c) The board by rule shall adopt procedures concerning:
(1) the retention of information files on license
holders; and
(2) the expunction of files on license holders,
including complaints, adverse reports, and other investigative
information on license holders.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.157. IMMUNITY. In the absence of fraud,
conspiracy, or malice, a member or employee of the board, a witness
called to testify by the board, or a consultant or hearing officer
is not liable in a civil action for any alleged injury, wrong, loss,
or damage for any investigation, report, recommendation,
statement, evaluation, finding, order, or award made in the course
of performing the person's official duties.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.158. BOARD COMMITTEES. (a) The board may
appoint committees from its own members.
(b) A committee appointed from the members of the board
shall:
(1) consider matters referred to the committee
relating to the enforcement of this chapter and the rules adopted by
the board; and
(2) make recommendations to the board.
(c) The board may delegate to a committee of the board an
authority granted to the board under Section 201.505(c).
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.159. RECORDS. (a) The board shall preserve a
record of its proceedings in a register that contains:
(1) the name, age, place, and duration of residence of
each applicant for a license;
(2) the amount of time spent by the applicant in the
study of chiropractic in respective chiropractic schools; and
(3) other information the board desires to record.
(b) The register shall show whether an applicant was
rejected or licensed.
(c) The information recorded in the register is prima facie
evidence of the matters contained in the register. A certified copy
of the register with the seal of the board is admissible as evidence
in any court of this state.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2001, 77th Leg., ch. 1420, § 14.051(a), eff. Sept. 1,
2001.
§ 201.160. PAYMENT OF OTHER EXPENSES. The board shall
pay the necessary expenses of an employee of the board incurred in
the performance of the employee's duties.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2003, 78th Leg., ch. 285, § 24, eff. Sept. 1, 2003.
§ 201.161. APPROPRIATION FROM STATE TREASURY
PROHIBITED. The legislature may not appropriate money, other than
fees, from the state treasury for an expenditure made necessary by
this chapter.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.162. ANNUAL REPORT. (a) The board shall file
annually with the governor and the presiding officer of each house
of the legislature a complete and detailed written report
accounting for all funds received and disbursed by the board during
the preceding fiscal year.
(b) The report must be in the form and reported in the time
provided by the General Appropriations Act.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
SUBCHAPTER E. PUBLIC INTEREST INFORMATION AND COMPLAINT PROCEDURES
§ 201.201. PUBLIC INTEREST INFORMATION. (a) The board
shall prepare information of public interest describing the
functions of the board and the procedures by which complaints are
filed with and resolved by the board.
(b) The board shall make the information available to the
public and appropriate state agencies.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.202. PUBLIC PARTICIPATION. (a) The board shall
develop and implement policies that provide the public with a
reasonable opportunity to appear before the board and to speak on
any issue under the board's jurisdiction.
(b) The board shall prepare and maintain a written plan that
describes how a person who does not speak English may be provided
reasonable access to the board's programs.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.203. COMPLAINTS. (a) The board by rule shall
establish methods by which consumers and service recipients are
notified of the name, mailing address, and telephone number of the
board for the purpose of directing complaints to the board. The
board may provide for that notice:
(1) on each registration form, application, or written
contract for services of a person regulated by the board; or
(2) on a sign prominently displayed in the place of
business of each person regulated by the board.
(b) The board shall list with its regular telephone number
any toll-free telephone number established under other state law
that may be called to present a complaint about a health
professional.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.204. RECORDS OF COMPLAINTS. (a) The board shall
keep an information file about each complaint filed with the board.
The board's information file must be kept current and contain a
record for each complaint of:
(1) each person contacted in relation to the
complaint;
(2) a summary of findings made at each step of the
complaint process;
(3) an explanation of the legal basis and reason for a
complaint that is dismissed;
(4) the schedule required under Section 201.205 and a
notification of any change in the schedule; and
(5) other relevant information.
(b) Except as provided by Subsection (c), if a written
complaint is filed with the board that the board has authority to
resolve, the board, at least quarterly and until final disposition
of the complaint, shall notify the parties to the complaint of the
status of the complaint unless the notice would jeopardize an
undercover investigation.
(c) If a written complaint that the board has authority to
resolve is referred to the enforcement committee, the board at
least semiannually and until final disposition of the complaint,
shall notify the parties to the complaint of the status of the
complaint unless the notice would jeopardize an undercover
investigation.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.205. GENERAL RULES REGARDING COMPLAINT
INVESTIGATION AND DISPOSITION. (a) The board shall adopt rules
concerning the investigation of a complaint filed with the board.
The rules adopted under this section must:
(1) distinguish between categories of complaints;
(2) ensure that a complaint is not dismissed without
appropriate consideration;
(3) require that the board be advised of a complaint
that is dismissed and that a letter be sent to the person who filed
the complaint explaining the action taken on the complaint;
(4) ensure that the person who filed the complaint has
the opportunity to explain the allegations made in the complaint;
and
(5) prescribe guidelines concerning the categories of
complaints that require the use of a private investigator and the
procedures for the board to obtain the services of a private
investigator.
(b) The board shall:
(1) dispose of a complaint in a timely manner; and
(2) establish a schedule for conducting each phase of
the complaint process that is under the control of the board not
later than the 30th day after the date the board receives the
complaint.
(c) The board shall notify the parties to the complaint of
the projected time requirements for pursuing the complaint.
(d) The board shall notify the parties to the complaint of
any change in the schedule not later than the seventh day after the
date the change is made.
(e) The executive director shall notify the board of a
complaint that is unresolved after the time prescribed by the board
for resolving the complaint so that the board may take necessary
action on the complaint.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.206. CONFIDENTIALITY OF INVESTIGATION
FILES. (a) The board's investigation files are confidential,
privileged, and not subject to discovery, subpoena, or any other
means of legal compulsion for release other than to the board or an
employee or agent of the board.
(b) The board shall share information in investigation
files, on request, with another state or federal regulatory agency
or with a local, state, or federal law enforcement agency
regardless of whether the investigation has been completed. The
board is not required to disclose under this subsection information
that is an attorney-client communication, an attorney work product,
or other information protected by a privilege recognized by the
Texas Rules of Civil Procedure or the Texas Rules of Evidence.
(c) On the completion of the investigation and before a
hearing under Section 201.505, the board shall provide to the
license holder, subject to any other privilege or restriction set
forth by rule, statute, or legal precedent, access to all
information in the board's possession that the board intends to
offer into evidence in presenting its case in chief at the contested
case hearing on the complaint. The board is not required to
provide:
(1) a board investigative report or memorandum;
(2) the identity of a nontestifying complainant; or
(3) attorney-client communications, attorney work
product, or other materials covered by a privilege recognized by
the Texas Rules of Civil Procedure or the Texas Rules of Evidence.
(d) Notwithstanding Subsection (a), the board may:
(1) disclose a complaint to the affected license
holder; and
(2) provide to a complainant the license holder's
response to the complaint, if providing the response is considered
by the board to be necessary to investigate the complaint.
(e) This section does not prohibit the board or another
party in a disciplinary action from offering into evidence in a
contested case under Chapter 2001, Government Code, a record,
document, or other information obtained or created during an
investigation.
Added by Acts 2003, 78th Leg., ch. 329, § 1.
SUBCHAPTER F. PEER REVIEW COMMITTEES
§ 201.251. APPOINTMENT OF PEER REVIEW COMMITTEES. The
board shall appoint local chiropractic peer review committees. The
board shall appoint the members of the peer review committee from a
list of nominees submitted by the local chiropractic association to
conduct peer review procedures.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.252. COMMITTEE MEMBER ELIGIBILITY. (a) Only a
chiropractor who has completed a program of peer review training
approved by the board is eligible to serve on a chiropractic peer
review committee.
(b) A member of a local peer review committee may not be a
consultant to or an employee of any company or carrier of health
care insurance.
(c) The board shall establish requirements for peer review
training programs that do not discriminate against any
chiropractor.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.253. EXECUTIVE PEER REVIEW COMMITTEE. (a) The
board shall appoint an executive chiropractic peer review committee
to direct the activities of the local committees. The executive
peer review committee consists of six volunteer members. The
executive peer review committee shall elect a presiding officer
from its members.
(b) The executive peer review committee shall conduct
hearings relating to disputes referred by a local peer review
committee and shall make its recommendations based solely on
evidence presented in the hearings.
(c) A member of an executive peer review committee may not
be a consultant to or an employee of any company or carrier of
health care insurance.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.254. DUTIES OF PEER REVIEW COMMITTEE. (a) Each
local chiropractic peer review committee shall:
(1) review and evaluate chiropractic treatment and
services in disputes involving a chiropractor and a patient or a
person obligated to pay a fee for chiropractic services or
treatment; and
(2) mediate in a dispute involving a chiropractor and
a patient or person obligated to pay a fee for chiropractic services
or treatment.
(b) Each local peer review committee shall report its
findings and recommendations to the executive chiropractic peer
review committee. A local peer review committee shall refer a
dispute that is not resolved at the local level to the executive
peer review committee.
(c) In the absence of fraud, conspiracy, or malice, a member
of a peer review committee is not liable in a civil action for a
finding, evaluation, recommendation, or other action made or taken
by the member as a member of the committee or by the committee. The
immunity granted by this subsection does not limit the operation of
federal or state antitrust laws as applied to the conduct of a local
or executive peer review committee that involves price fixing or
any other unreasonable restraint of trade.
(d) A member of a peer review committee may not participate
in committee deliberations or other activities involving
chiropractic services or treatment rendered or performed by the
member.
(e) Except for the express immunity provided by Subsection
(c), this section does not deprive any person of a right or remedy,
legal or equitable.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.255. REQUEST FOR INFORMATION. The board may
request from a chiropractic peer review committee information
pertaining to actions taken by the peer review committee.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
SUBCHAPTER G. LICENSE REQUIREMENTS
§ 201.301. LICENSE REQUIRED. A person may not practice
chiropractic unless the person holds a license issued by the board.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.302. LICENSING EXAMINATION APPLICATION. (a) An
applicant for a license by examination must present satisfactory
evidence to the board that the applicant:
(1) is at least 18 years of age;
(2) is of good moral character;
(3) has completed 60 semester hours of college courses
at a school other than a chiropractic school; and
(4) is either a graduate or a final semester student of
a bona fide reputable chiropractic school.
(b) An application for examination must be:
(1) made in writing;
(2) verified by affidavit;
(3) filed with the secretary-treasurer of the board on
a form prescribed by the board; and
(4) accompanied by a fee.
(c) Each applicant shall be given reasonable notice of the
time and place of the examination.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.303. EDUCATIONAL REQUIREMENTS. (a) To comply
with the requirements of Section 201.302(a)(3), the applicant must
submit to the board a transcript of credits that certifies that the
applicant has satisfactorily completed 60 or more semester hours of
college credits at a college or university that issues credits
accepted by The University of Texas at Austin for a bachelor of arts
or bachelor of science degree.
(b) Repealed by Acts 2003, 78th Leg., ch. 329, § 5.
(c) The board may charge a fee of not more than $50 for
verifying that the applicant has satisfied the requirements of this
section.
(d) A bona fide reputable chiropractic school that
satisfies Section 201.302(a)(4) is one that:
(1) has entrance requirements and a course of
instruction as high as those of a better class of chiropractic
schools in the United States;
(2) maintains a resident course of instruction
equivalent to:
(A) not less than four terms of eight months
each; or
(B) not less than the number of semester hours
required by The University of Texas for a bachelor of arts or
bachelor of science degree;
(3) provides a course of instruction in the
fundamental subjects listed in Section 201.305(b); and
(4) has the necessary teaching staff and facilities
for proper instruction in all of the fundamental subjects listed in
Section 201.305(b).
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2003, 78th Leg., ch. 329, § 5.
§ 201.304. EXAMINATION REQUIREMENTS. (a) To receive a
license, an applicant for a license by examination must pass:
(1) the required and optional parts of the examination
given by the National Board of Chiropractic Examiners, as required
by and under conditions established by board rule; and
(2) an examination prepared by the board that tests
the applicant's knowledge and understanding of the laws relating to
the practice of chiropractic in this state.
(b) The board shall periodically determine whether
applicants who hold National Board of Chiropractic Examiners
certificates have been adequately examined. If the board
determines that those applicants have not been adequately examined,
the board shall require those applicants to submit to an additional
examination prepared by the board.
(c) The board may give an examination during the applicant's
last semester of college if the board receives evidence indicating
the applicant has satisfactory grades. Immediately after the
applicant graduates from chiropractic college, the applicant must
forward to the board evidence of satisfactory completion of the
applicant's course of study.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2001, 77th Leg., ch. 721, § 1, eff. Sept. 1, 2001.
§ 201.305. EXAMINATION PROCEDURE. (a) Each
examination for a license to practice chiropractic shall be
conducted in the English language and in a fair and impartial
manner.
(b) An examination given under Section 201.304(a)(1) shall
be conducted on practical and theoretical chiropractic and in the
subjects of anatomy-histology, chemistry, bacteriology,
physiology, symptomatology, pathology and analysis of the human
spine, and hygiene and public health.
(c) Applicants may be known to the examiners only by
numbers, without a name or another method of identification on
examination papers by which members of the board could identify an
applicant, until after the general averages of the applicants'
numbers in the class are determined and the licenses are granted or
refused.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2001, 77th Leg., ch. 721, § 2, eff. Sept. 1, 2001.
§ 201.306. EXAMINATION RESULTS. (a) The board shall
notify each applicant of the results of an examination given by the
board not later than the 30th day after the date the licensing
examination is administered.
(b) If requested by a person who fails an examination given
by the board, the board shall review with the person the
circumstances surrounding the adverse score.
(c) To pass the examination under Section 201.304(a)(2), an
applicant must score a grade of at least 75 percent.
(d) All questions and answers from an examination given by
the board, with the grades attached, authenticated by the signature
of the examiner, shall be preserved in the executive office of the
board for at least one year.
(e) Each license shall be attested by the seal of the board
and signed by all members of the board or a quorum of the board.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2001, 77th Leg., ch. 721, § 3, eff. Sept. 1, 2001.
§ 201.307. REEXAMINATION. (a) An applicant who fails
to pass a required examination may take another examination.
(b) The board by rule shall establish the number of times
and the conditions under which an applicant may retake an
examination. The board may require an applicant to fulfill
additional educational requirements.
(c) If the applicant makes a satisfactory grade on
reexamination, the board shall grant to the applicant a license to
practice chiropractic.
(d) The board's decision under this section is final.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2001, 77th Leg., ch. 721, § 4, eff. Sept. 1, 2001.
§ 201.308. TEMPORARY LICENSE. (a) The board by rule
may provide for the issuance of a temporary license.
(b) The board by rule shall provide a time limit for the
period a temporary license is valid.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.309. LICENSE ISSUANCE TO CERTAIN OUT-OF-STATE
APPLICANTS. The board shall issue a license to practice
chiropractic to an out-of-state applicant who:
(1) submits a written application to the board on a
form prescribed by the board, accompanied by the application fee
set by the board and any other information requested by the board;
(2) is licensed in good standing to practice
chiropractic in another state or foreign country that has licensing
requirements substantially equivalent to the requirements of this
chapter;
(3) has not been the subject of a disciplinary action
and is not the subject of a pending investigation in any
jurisdiction in which the applicant is or has been licensed;
(4) has graduated from a chiropractic school
accredited by the Council on Chiropractic Education and approved by
rule by the board;
(5) has passed a national or other examination
recognized by the board relating to the practice of chiropractic;
(6) has passed the board's jurisprudence examination;
(7) has practiced chiropractic:
(A) for at least the three years immediately
preceding the date of the application under this section; or
(B) as a chiropractic educator at a chiropractic
school accredited by the Council on Chiropractic Education for at
least the three years immediately preceding the date of the
application under this section; and
(8) meets any other requirements adopted by rule by
the board under this chapter.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2003, 78th Leg., ch. 899, § 1.
§ 201.311. INACTIVE STATUS. (a) The board by rule
shall adopt a system by which a license holder may place the license
on inactive status. A license holder must apply for inactive
status, on a form prescribed by the board, before the expiration
date of the license.
(b) A license holder whose license is on inactive status:
(1) is not required to pay license renewal fees; and
(2) may not perform an activity regulated under this
chapter.
(c) A license holder whose license is on inactive status may
return to active practice by notifying the board in writing. The
board shall remove the license holder's license from inactive
status after the holder pays an administrative fee and complies
with any educational or other requirements established by board
rules.
(d) The board by rule shall establish a rule setting a limit
on the time a license holder's license may remain on inactive
status.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.312. REGISTRATION OF FACILITIES. (a) The board
by rule shall adopt requirements for registering chiropractic
facilities as necessary to protect the public health, safety, and
welfare.
(b) The rules adopted under this section must:
(1) specify the registration requirements for a
chiropractic facility;
(2) prescribe the standards for the chiropractic
facility registration program;
(3) provide for the issuance of a separate certificate
of registration to an owner of a chiropractic facility for each
chiropractic facility owned by the owner; and
(4) provide for the board to send notice to an owner of
a chiropractic facility and to each chiropractor practicing in the
facility of the impending expiration of the facility's certificate
of registration before the expiration of the certificate.
(c) The standards adopted under Subsection (b)(2) must be
consistent with industry standards for the practice of
chiropractic.
(d) To register a chiropractic facility, the owner of the
facility must:
(1) file with the board a written application for
registration; and
(2) pay, with the application, a registration fee in
an amount set by the board not to exceed $75.
(e) The board may issue a certificate of registration only
to a chiropractic facility that complies with the requirements of
this section.
(f) A certificate of registration under this section must be
renewed annually. To renew the certificate, the certificate holder
shall apply to the board and pay an annual fee equal to the amount of
the registration fee under Subsection (d)(2).
(g) A person licensed to practice chiropractic in this state
is subject to disciplinary action under this chapter if the person
practices chiropractic in a chiropractic facility that the person
knows is not registered under this section.
(h) An owner of a chiropractic facility who violates this
section or a rule adopted under this section is subject to
disciplinary action by the board in the same manner as a license
holder who violates this chapter or a rule adopted under this
chapter.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2001, 77th Leg., ch. 227, § 1, eff. Sept. 1, 2001; Acts
2003, 78th Leg., ch. 329, § 2.
SUBCHAPTER H. ANNUAL REGISTRATION AND LICENSE RENEWAL
§ 201.351. ANNUAL REGISTRATION. A chiropractor may not
practice chiropractic in this state unless the chiropractor
annually registers with the board not later than January 1 of each
year.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.352. APPLICATION FOR ANNUAL REGISTRATION. (a) A
person required to register shall:
(1) file annually with the board a written application
for registration; and
(2) pay, with the application, an annual registration
fee to the board.
(b) The application must include:
(1) the person's full name, age, post office address,
and place of residence;
(2) each place where the person is engaged in the
practice of chiropractic;
(3) the college of chiropractic from which the person
graduated; and
(4) the number and date of the person's license.
(c) On receipt of the application and registration fee, the
board shall determine whether the applicant is licensed to practice
chiropractic in this state based on the records of the board or
other sources the board considers reliable.
(d) If the board determines that the applicant is licensed
to practice chiropractic in this state, the board shall issue an
annual registration receipt certifying that the applicant has filed
an application and paid the registration fee.
(e) The registration receipt is not evidence in a
prosecution for the unlawful practice of chiropractic under Section
201.605 that the person is lawfully entitled to practice
chiropractic.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.353. LICENSE EXPIRATION DATE. (a) The board by
rule may adopt a system under which licenses expire on various dates
during the year.
(b) For a year in which the license expiration date is
changed, license fees payable on January 1 shall be prorated on a
monthly basis so that each license holder pays only the portion of
the fee that is allocable to the number of months during which the
license is valid. On renewal of the license on the new expiration
date, the total license renewal fee is payable.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.354. LICENSE RENEWAL. (a) A person may renew an
unexpired license by paying the required renewal fee to the board
before the expiration date of the license.
(b) At least 30 days before the expiration of a person's
license, the board shall send written notice of the impending
license expiration to the person at the person's last known address
according to the board's records.
(c) The annual renewal fee applies to each person licensed
by the board, even if the person is not practicing chiropractic in
this state.
(d) A person whose license has been expired for 90 days or
less may renew the license by paying to the board the required
renewal fee and an additional fee equal to one-half of the
examination fee for the license. If a person's license has been
expired for more than 90 days but less than one year, the person may
renew the license by paying to the board all unpaid renewal fees and
an additional fee equal to the examination fee for the license.
(e) Except as provided by Subsection (g) and Section
201.355, a person may not renew a license that has been expired for
one year or more. The person may obtain a new license by submitting
to reexamination and complying with the requirements and procedures
for obtaining an original license.
(f) A person who practices chiropractic without an annual
renewal receipt for the current year practices chiropractic without
a license.
(g) A person may renew a license that has been expired for at
least one year but not more than three years if:
(1) the board determines according to criteria adopted
by board rule that the person has shown good cause for the failure
to renew the license; and
(2) the person pays to the board the required renewal
fee for each year in which the license was expired and an additional
fee in an amount equal to the sum of:
(A) the examination fee for the license,
multiplied by the number of years the license was expired, prorated
for fractional years; and
(B) two times the examination fee for the
license.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2001, 77th Leg., ch. 230, § 1, eff. Sept. 1, 2001.
§ 201.355. RENEWAL OF EXPIRED LICENSE BY OUT-OF-STATE
PRACTITIONER. (a) The board may renew without reexamination an
expired license of a person who was licensed in this state, moved to
another state or foreign country, and is currently licensed in good
standing and has been in practice in the other state or foreign
country for the two years preceding application.
(b) The person must pay to the board a fee that is equal to
the amount of the examination fee for the license.
(c) For purposes of this section, a person is currently
licensed if the person is licensed by another chiropractic
licensing board recognized by the board. The board shall adopt
requirements for recognizing another chiropractic licensing board
that:
(1) has licensing requirements substantially
equivalent to the requirements of this chapter; and
(2) maintains professional standards considered by
the board to be equivalent to the standards under this chapter.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2003, 78th Leg., ch. 329, § 3.
§ 201.356. CONTINUING EDUCATION. (a) The board by
rule shall:
(1) assess the continuing education needs of license
holders;
(2) adopt requirements for mandatory continuing
education for license holders in subjects relating to the practice
of chiropractic;
(3) establish a minimum number of hours of continuing
education required to renew a license; and
(4) develop a process to evaluate and approve
continuing education courses.
(b) The board may require license holders to attend
continuing education courses specified by the board. The board
shall adopt a procedure to assess a license holder's participation
and performance in continuing education programs.
(c) The board shall identify the key factors for the
competent performance by a license holder of the license holder's
professional duties.
(d) The board shall notify license holders of approved
continuing education courses at least annually.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
SUBCHAPTER I. PATIENT CONFIDENTIALITY
§ 201.401. DEFINITION OF PATIENT. In this subchapter,
"patient" means any person who consults or is seen by a chiropractor
to receive chiropractic care.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.402. PATIENT
CONFIDENTIALITY. (a) Communications between a chiropractor and a
patient relating to or in connection with any professional services
provided by a chiropractor to the patient are confidential and
privileged and may not be disclosed except as provided by this
subchapter.
(b) Records of the identity, diagnosis, evaluation, or
treatment of a patient by a chiropractor that are created or
maintained by a chiropractor are confidential and privileged and
may not be disclosed except as provided by this subchapter.
(c) A person who receives information from the confidential
communications or records, excluding a person listed in Section
201.404(a) who is acting on the patient's behalf, may not disclose
the information except to the extent that disclosure is consistent
with the authorized purposes for which the information was first
obtained.
(d) The prohibitions of this section apply to confidential
communications or records concerning any patient regardless of when
the patient received the services of a chiropractor.
(e) The privilege of confidentiality may be claimed by the
patient or chiropractor acting on the patient's behalf. The
authority of a chiropractor to claim the privilege of
confidentiality on behalf of a patient is presumed in the absence of
evidence to the contrary.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.403. EXCEPTIONS TO CONFIDENTIALITY FOR
ADMINISTRATIVE PROCEDURE. (a) Section 201.402 does not apply in
a court or administrative proceeding:
(1) brought by a patient against a chiropractor,
including:
(A) a malpractice proceeding; and
(B) any criminal or license revocation
proceeding in which the patient is a complaining witness and
disclosure is relevant to the claims or defense of the
chiropractor;
(2) in which the patient or a person authorized to act
on the patient's behalf submits a written consent to the release of
confidential information, as provided by Section 201.405;
(3) brought to substantiate and collect on a claim for
chiropractic services rendered to the patient;
(4) brought by the patient or a person on the patient's
behalf who is attempting to recover monetary damages for any
physical or mental condition, including death of the patient;
(5) brought in connection with a disciplinary
investigation of a chiropractor under this chapter, except as
provided by Subsection (b);
(6) brought in connection with a criminal
investigation of a chiropractor if the board is participating or
assisting in the investigation or proceeding by providing certain
records obtained from the chiropractor, except as provided by
Subsection (c); and
(7) brought in connection with a criminal prosecution
in which the patient is a victim, witness, or defendant except as
provided by Subsection (d).
(b) The board shall protect the identity of any patient
whose chiropractic records are examined in connection with an
investigation or proceeding described by Subsection (a)(5),
excluding patients described by Subsection (a)(1) and patients who
have submitted written consent to the release of their chiropractic
records as provided by Section 201.405.
(c) The board shall protect the identity of any patient
whose records are provided in connection with an investigation or
proceeding described by Subsection (a)(6), excluding patients
described by Subsection (a)(1) and patients who have submitted
written consent to the release of their chiropractic records as
provided by Section 201.405. The board does not authorize the
release of any confidential information for the purpose of
instigating or substantiating criminal charges against a patient.
(d) In a proceeding described by Subsection (a)(7), records
or communications are not discoverable until the court in which the
prosecution is pending makes an in camera determination of
relevancy. A determination of relevancy by a court under this
subsection is not a determination of the admissibility of any
record or communication.
(e) Information is discoverable in a court or
administrative proceeding in this state if the court or
administrative body has jurisdiction over the subject matter of the
proceeding.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.404. EXCEPTIONS TO CONFIDENTIALITY FOR OTHER
CIRCUMSTANCES. (a) In circumstances other than court or
administrative proceedings, exceptions to Section 201.402 exist
only for:
(1) a governmental agency, if the disclosure is
required or permitted by law except as provided by Subsection (b);
(2) medical or law enforcement personnel, if the
chiropractor determines that a probability of imminent physical
injury to the patient, the chiropractor, or others exists or a
probability of immediate mental or emotional injury to the patient
exists;
(3) qualified personnel for the purpose of management
audits, financial audits, program evaluations, or research, under
the conditions provided by Subsection (c);
(4) those parts of the records reflecting charges and
specific services performed, if necessary to collect fees for
services provided by a chiropractor, a professional association, or
another entity qualified to render or arrange for services;
(5) any person who possesses a written consent
described by Section 201.405;
(6) an individual, corporation, or governmental
agency involved in paying or collecting fees for services performed
by a chiropractor;
(7) another chiropractor or personnel under the
direction of the chiropractor who participate in the diagnosis,
evaluation, or treatment of the patient; or
(8) an official legislative inquiry of state hospitals
or state schools under the conditions provided under Subsection
(d).
(b) A governmental agency shall protect the identity of any
patient whose chiropractic records are examined under Subsection
(a)(1).
(c) Personnel described by Subsection (a)(3) may not
directly or indirectly identify a patient in any report of
research, audit, or evaluation or otherwise disclose a patient's
identity in any manner.
(d) Information released under Subsection (a)(8) may not
include:
(1) information or records that identify a patient or
client for any purpose without proper consent given by the patient;
and
(2) records that were not created by the state
hospital or school or its employees.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.405. CONSENT FOR RELEASE. (a) In this section,
"chiropractic records" means any record relating to the history,
diagnosis, treatment, or prognosis of a patient.
(b) Consent for the release of confidential information
must be in writing and signed by:
(1) the patient;
(2) a parent or legal guardian if the patient is a
minor;
(3) a legal guardian if the patient has been
adjudicated incompetent to manage the patient's personal affairs;
(4) an attorney ad litem appointed for the patient, as
authorized by:
(A) Subtitle B, Title 6, Health and Safety Code;
(B) Subtitle C, D, or E, Title 7, Health and
Safety Code;
(C) Chapter XIII, Texas Probate Code;
(D) Chapter 107, Family Code; or
(E) another applicable provision; or
(5) a personal representative if the patient is
deceased.
(c) The written consent must specify:
(1) the information records covered by the release;
(2) the reason or purpose for the release; and
(3) the person to whom the information is to be
released.
(d) The patient or the person authorized to consent to
disclosure under this section may withdraw consent to the release
of any information. Withdrawal of consent does not affect any
information disclosed before written notice of the withdrawal.
(e) A person who receives information made confidential by
this chapter may disclose the information to another only to the
extent that disclosure is consistent with the authorized purposes
for which consent to release the information was obtained.
(f) A chiropractor shall furnish copies of chiropractic
records or a summary or narrative of the records requested under a
written consent for release of the information. The chiropractor
shall furnish the information within a reasonable time. The
patient or a person acting on the patient's behalf shall pay a
reasonable fee for the information provided by the chiropractor.
The chiropractor may delete confidential information about another
person who has not consented to the release.
(g) A chiropractor who determines that access to
information requested under Subsection (f) would be harmful to the
physical, mental, or emotional health of the patient may refuse to
release the information requested under this section.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
SUBCHAPTER J. REQUIREMENTS REGARDING USE OF CHIROPRACTIC
ASSISTANTS AND TECHNOLOGY
§ 201.451. DELEGATION TO ASSISTANTS. (a) The board by
rule shall establish guidelines relating to the tasks and
procedures that a chiropractor may delegate to an assistant.
(b) A chiropractor who delegates a task or procedure under
this section retains full responsibility for the task or procedure.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.452. USE OF X-RAY. (a) The board may require
evidence of proper training and safety in the use of analytical and
diagnostic x-ray in conformity with:
(1) Chapter 401, Health and Safety Code; and
(2) rules of the Texas Radiation Control Agency and
the Texas Department of Health.
(b) This section does not modify or amend:
(1) Section 201.002 by enlarging the scope of the
practice of chiropractic or the acts that a chiropractor is
authorized to perform; or
(2) Chapter 151.
(c) The board shall implement any federal and state
requirements relating to radiologic training of the employees of a
chiropractor.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
SUBCHAPTER K. DISCIPLINARY PROCEDURES
§ 201.501. DISCIPLINARY POWERS OF BOARD. (a) On a
determination that a person has violated this chapter or a rule
adopted by the board under this chapter, the board:
(1) shall revoke or suspend the person's license,
place on probation a person whose license has been suspended, or
reprimand a license holder; or
(2) may impose an administrative penalty.
(b) If a license suspension is probated, the board may
require the license holder to:
(1) report regularly to the board on matters that are
the basis of the probation;
(2) limit practice to the areas prescribed by the
board; or
(3) continue or review continuing professional
education until the license holder attains a degree of skill
satisfactory to the board in those areas that are the basis of the
probation.
(c) In addition to other disciplinary actions authorized by
this chapter, the board may require a license holder who violates
this chapter to participate in a continuing education program. The
board shall specify the continuing education programs that the
license holder may attend and the number of hours that the license
holder must complete.
(d) Disciplinary proceedings of the board are governed by
Chapter 2001, Government Code.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.502. GROUNDS FOR REFUSAL, REVOCATION, OR
SUSPENSION OF LICENSE. (a) The board may refuse to admit a person
to examinations and may revoke or suspend a license or place a
license holder on probation for a period determined by the board
for:
(1) violating this chapter or a rule adopted under
this chapter;
(2) engaging in deception or fraud in the practice of
chiropractic;
(3) presenting to the board or using a license,
certificate, or diploma that was illegally or fraudulently
obtained;
(4) presenting to the board an untrue statement or a
document or testimony that was illegally used to pass the
examination;
(5) being convicted of a crime involving moral
turpitude or a felony;
(6) procuring or assisting in the procuring of an
abortion;
(7) engaging in grossly unprofessional conduct or
dishonorable conduct of a character likely to deceive or defraud
the public;
(8) having a habit of intemperance or drug addiction
or another habit that, in the opinion of the board, endangers the
life of a patient;
(9) using an advertising statement that tends to
mislead or deceive the public;
(10) directly or indirectly employing or associating
with a person who, in the course of the person's employment, commits
an act constituting the practice of chiropractic when the person is
not licensed to practice chiropractic;
(11) advertising professional superiority, or
advertising the performance of professional services in a superior
manner;
(12) purchasing, selling, bartering, using, or
offering to purchase, sell, barter, or use a chiropractic degree,
license, certificate, or diploma or transcript of a license,
certificate, or diploma in or relating to an application to the
board for a license to practice chiropractic;
(13) altering with fraudulent intent a chiropractic
license, certificate, or diploma or transcript of a chiropractic
license, certificate, or diploma;
(14) impersonating or acting as proxy for another in
an examination required by this chapter for a chiropractic license;
(15) impersonating a licensed chiropractor;
(16) allowing one's chiropractic license to be used by
another person to practice chiropractic;
(17) being proved insane by a person having authority
to make that determination;
(18) failing to use proper diligence in the practice
of chiropractic or using gross inefficiency in the practice of
chiropractic;
(19) failing to clearly differentiate a chiropractic
office or clinic from another business or enterprise;
(20) personally soliciting a patient or causing a
patient to be solicited by the use of a case history of another
patient of another chiropractor;
(21) using for the purpose of soliciting patients an
accident report prepared by a peace officer in a manner prohibited
by Section 38.12, Penal Code; or
(22) advertising using the term "physician" or
"chiropractic physician" or any combination or derivation of the
term "physician."
(b) Notwithstanding Subsection (a)(22), the term
"chiropractic physician" may be used for the express purpose of
filing a claim for necessary services within the definition of
chiropractic under this chapter if the billing for the services has
universally applied, predetermined coding or description
requirements that are a prerequisite to appropriate reimbursement.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.503. SCHEDULE OF SANCTIONS. (a) The board by
rule shall adopt a schedule of the maximum amount of sanctions that
may be assessed against a license holder for each category of
violation of this chapter. In establishing the schedule of
sanctions or in imposing the amount of an administrative penalty
under this chapter, the board shall consider:
(1) the seriousness of the violation, including the
nature, circumstances, extent, or gravity of any prohibited acts
and the hazard or potential hazard created to the health, safety, or
economic welfare of the public;
(2) the economic harm to property or the environment
caused by the violation;
(3) the history of previous violations;
(4) the amount necessary to deter a future violation;
(5) efforts to correct the violation; and
(6) any other matter that justice may require.
(b) The State Office of Administrative Hearings shall use
the schedule of sanctions for any sanction imposed as the result of
a hearing conducted by that office.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.504. INFORMAL PROCEEDINGS. (a) The board by
rule shall adopt procedures governing:
(1) informal disposition of a contested case under
Section 2001.056, Government Code; and
(2) an informal proceeding held in compliance with
Section 2001.054, Government Code.
(b) Rules adopted under Subsection (a) must:
(1) provide the complainant and the license holder an
opportunity to be heard; and
(2) require the presence of a representative of the
attorney general or the board's legal counsel to advise the board or
the board's employees.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.505. HEARINGS. (a) A person is entitled to a
hearing before the board if the board proposes to:
(1) refuse the person's application for a license;
(2) suspend or revoke the person's license; or
(3) place on probation or reprimand the person.
(b) The board is not bound by strict rules of evidence or
procedure in conducting its proceedings and hearings, but the board
must base its determination on sufficient legal evidence.
(c) The board may:
(1) issue subpoenas and subpoenas duces tecum to
compel the attendance of witnesses and the production of books,
records, and other documents;
(2) administer oaths; and
(3) take testimony concerning all matters within its
jurisdiction.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.506. ENFORCEMENT COMMITTEE. (a) The board shall
appoint an enforcement committee to:
(1) oversee and conduct the investigation of
complaints filed with the board under this chapter; and
(2) perform other enforcement duties as directed by
the board.
(b) The enforcement committee consists of three board
members. Two members must be chiropractors, and one member must be
a representative of the public.
(c) The attorney general shall provide legal counsel to the
enforcement committee concerning enforcement matters, including
the investigation and disposition of complaints.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.507. TEMPORARY LICENSE SUSPENSION. (a) The
enforcement committee may temporarily suspend the license of a
license holder on an emergency basis if the enforcement committee
determines from the evidence or information presented to the
committee that the continued practice of chiropractic by the
license holder constitutes a continuing or imminent threat to the
public welfare.
(b) The board by rule shall adopt procedures for the
temporary suspension of a license under this section.
(c) A license temporarily suspended under this section may
be suspended without notice or hearing if, at the time the
suspension is ordered, a hearing on whether disciplinary
proceedings under this chapter should be initiated against the
license holder is scheduled to be held not later than the 14th day
after the date of the suspension.
(d) A second hearing on the suspended license shall be held
not later than the 60th day after the date the suspension is
ordered. If the second hearing is not held in the time required by
this subsection, the suspended license is automatically
reinstated.
(e) A temporary suspension may also be ordered on a vote of
two-thirds of the board.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.508. POWERS OF DISTRICT COURTS; DUTIES OF
DISTRICT AND COUNTY ATTORNEYS. (a) A district court may revoke or
suspend a chiropractor's license on proof of a violation of the law
relating to the practice of chiropractic.
(b) On the request of the board, a district or county
attorney shall represent the state by filing and prosecuting a
judicial proceeding for the revocation, cancellation, or
suspension of the chiropractor's license.
(c) The district or county attorney may institute the
judicial proceeding by filing a petition that:
(1) is in writing;
(2) states the grounds for prosecution; and
(3) is signed officially by the prosecuting officer.
(d) Citation must be issued in the name of the state in the
manner and form as in other cases and shall be served on the
defendant, who is required to answer within the time and manner
provided by law in civil cases.
(e) If a chiropractor, after proper citation, is found
guilty or fails to appear and deny the charge, the court shall:
(1) enter an order to suspend or revoke the
chiropractor's license; and
(2) give proper judgment for costs.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.509. REPRESENTATION BY ATTORNEY
GENERAL. (a) The board may apply to the attorney general for
representation by stating that the board previously requested the
representation of a district or county attorney under Section
201.508 and the district or county attorney failed to prosecute or
proceed against the person accused of violating this chapter.
(b) The attorney general shall institute a civil or criminal
proceeding against the person in the county of the person's
residence.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.510. RIGHT TO APPEAL. (a) A person whose license
to practice chiropractic has been revoked or suspended or against
whom the board has imposed an administrative penalty may appeal to a
Travis County district court.
(b) The decision of the board may not be enjoined or stayed
unless the person appeals the board's decision as provided by
Subsection (a) and provides notices to the board.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2001, 77th Leg., ch. 228, § 1, eff. Sept. 1, 2001.
§ 201.511. REISSUANCE OF LICENSE. (a) On application,
the board may reissue a license to practice chiropractic to a person
whose license has been canceled or suspended.
(b) An applicant whose license has been canceled or revoked:
(1) may not apply for reissuance before the first
anniversary of the date the license was canceled or revoked; and
(2) must apply for reissuance in the manner and form
required by the board.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
SUBCHAPTER L. ADMINISTRATIVE PENALTY
§ 201.551. IMPOSITION OF ADMINISTRATIVE PENALTY. The
board may impose an administrative penalty on a person licensed or
regulated under this chapter if the person violates this chapter or
a rule or order adopted under this chapter.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.552. AMOUNT OF PENALTY. (a) The amount of an
administrative penalty may not exceed $1,000.
(b) Each day a violation continues or occurs is a separate
violation for purposes of imposing a penalty.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.553. ENFORCEMENT COMMITTEE
RECOMMENDATIONS. (a) On a determination by the enforcement
committee that a violation of this chapter or a rule or order
adopted under this chapter occurred, the committee may issue a
report to the board stating:
(1) the facts on which the determination is based; and
(2) the enforcement committee's recommendation on the
imposition of the administrative penalty, including a
recommendation on the amount of the penalty.
(b) Not later than the 14th day after the date the report is
issued, the executive director shall give written notice of the
violation by certified mail to the person on whom the penalty may be
imposed.
(c) The notice issued under this section must:
(1) include a brief summary of the alleged violation;
(2) state the amount of the recommended penalty; and
(3) inform the person of the person's right to a
hearing on the occurrence of the violation, the amount of the
penalty, or both.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.554. PENALTY TO BE PAID OR HEARING
REQUESTED. (a) Not later than the 20th day after the date a
person receives the notice under Section 201.553, the person may:
(1) accept in writing the enforcement committee's
determination and recommended administrative penalty; or
(2) make a written request for a hearing on the
occurrence of the violation, the amount of the penalty, or both.
(b) If the person accepts the enforcement committee's
determination and recommended penalty, the board by order shall
approve the determination and impose the recommended penalty.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2001, 77th Leg., ch. 1420, § 14.0515, eff. Sept. 1, 2001.
§ 201.555. HEARING ON ENFORCEMENT COMMITTEE
RECOMMENDATIONS. (a) If the person requests a hearing or fails to
respond timely to the notice, the executive director shall set a
hearing and give notice of the hearing to the person.
(b) A hearing set by the executive director under Subsection
(a) shall be held by an administrative law judge of the State Office
of Administrative Hearings.
(c) The administrative law judge shall:
(1) make findings of fact and conclusions of law; and
(2) promptly issue to the board a proposal for a
decision as to the occurrence of the violation and the amount of a
proposed administrative penalty.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.556. DECISION BY BOARD. (a) Based on the
findings of fact, conclusions of law, and proposal for a decision,
the board by order may determine that:
(1) a violation has occurred and impose an
administrative penalty; or
(2) a violation did not occur.
(b) The notice of the board's order given to the person
under Chapter 2001, Government Code, must include a statement of
the right of the person to judicial review of the order.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.557. OPTIONS FOLLOWING DECISION: PAY OR
APPEAL. (a) Not later than the 30th day after the date the
board's order becomes final, the person shall:
(1) pay the administrative penalty;
(2) pay the penalty and file a petition for judicial
review contesting the fact of the violation, the amount of the
penalty, or both; or
(3) without paying the penalty, file a petition for
judicial review contesting the fact of the violation, the amount of
the penalty, or both.
(b) Within the 30-day period, a person who acts under
Subsection (a)(3) may:
(1) stay enforcement of the penalty by:
(A) paying the penalty to the court for placement
in an escrow account; or
(B) giving to the court a supersedeas bond that
is approved by the court and that:
(i) is for the amount of the penalty; and
(ii) is effective until judicial review of
the board's order is final; or
(2) request the court to stay enforcement of the
penalty by:
(A) filing with the court a sworn affidavit of
the person stating that the person is financially unable to pay the
penalty and is financially unable to give the supersedeas bond; and
(B) giving a copy of the affidavit to the
executive director by certified mail.
(c) If the executive director receives a copy of an
affidavit under Subsection (b)(2), the director may, at the
direction of the enforcement committee, file with the court a
contest to the affidavit not later than the fifth day after the date
the copy is received.
(d) The court shall hold a hearing on the facts alleged in
the affidavit as soon as practicable and stay the enforcement of the
penalty on finding that the alleged facts are true. The person who
files the affidavit has the burden of proving that the person is
financially unable to pay the penalty and to give a supersedeas
bond.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.558. COLLECTION OF PENALTY. If the person does
not pay the administrative penalty and the enforcement of the
penalty is not stayed, the executive director may, at the direction
of the enforcement committee, refer the matter to the attorney
general for collection of the penalty.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.559. DETERMINATION BY COURT. (a) If a court
sustains the finding that a violation occurred after the court
reviews the order of the board imposing an administrative penalty,
the court may uphold or reduce the amount of the penalty and order
the person to pay the full or reduced penalty.
(b) If the court does not sustain the finding that a
violation occurred, the court shall order that an administrative
penalty is not owed.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.560. REMITTANCE OF PENALTY AND INTEREST. (a) If
after judicial review, the administrative penalty is reduced or not
imposed by the court, the court shall, after the judgment becomes
final:
(1) order the appropriate amount, plus accrued
interest, be remitted to the person if the person paid the penalty;
or
(2) order the release of the bond in full if the
penalty is not imposed or order the release of the bond after the
person pays the penalty imposed if the person posted a supersedeas
bond.
(b) The interest paid under Subsection (a)(1) is the rate
charged on loans to depository institutions by the New York Federal
Reserve Bank. The interest shall be paid for the period beginning
on the date the penalty is paid and ending on the date the penalty is
remitted.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.561. ADMINISTRATIVE PROCEDURE. All proceedings
under this subchapter are subject to Chapter 2001, Government Code.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
SUBCHAPTER M. OTHER PENALTIES AND ENFORCEMENT PROVISIONS
§ 201.601. INJUNCTIVE RELIEF. (a) The board may
institute in the board's name an action to restrain a violation of
this chapter. An action under this subsection is in addition to any
other action authorized by law.
(b) The state may sue for an injunction to restrain the
practice of chiropractic in violation of this chapter.
(c) The state shall be represented in suits for injunction
by:
(1) the attorney general;
(2) the district attorney of the district in which the
defendant resides; or
(3) the county attorney of the county in which the
defendant resides.
(d) A suit for injunction under Subsection (b) may not be
filed before the final conviction for a violation of this chapter of
the party sought to be enjoined.
(e) The state is not required to show that a person is
personally injured by the defendant's unlawful practice of
chiropractic.
(f) A court may not grant a temporary or permanent
injunction until a hearing of the complaint on its merits. A court
may not issue an injunction or restraining order until the final
trial and final judgment on the merits of the suit.
(g) If the defendant is shown to have been unlawfully
practicing chiropractic or to have been about to unlawfully
practice chiropractic, the court shall perpetually enjoin the
defendant from practicing chiropractic in the manner that was the
subject of the suit.
(h) A defendant who disobeys the injunction is subject to
the penalties provided by law for the violation of an injunction.
The remedy by injunction is in addition to a criminal prosecution.
(i) A suit for injunction under this section shall be
advanced for trial on the docket of the trial court and advanced and
tried in the appellate courts in the same manner as other suits for
injunction.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.602. MONITORING LICENSE HOLDER. The board by rule
shall develop a system for monitoring compliance with the
requirements of this chapter of a license holder who is the subject
of disciplinary action. Rules adopted under this section must
include procedures to:
(1) monitor for compliance a license holder who is
ordered by the board to perform certain acts; and
(2) identify and monitor each license holder who is
the subject of disciplinary action and who presents a continuing
threat to the public welfare through the practice of chiropractic.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.603. CIVIL PENALTY. (a) A person who violates
this chapter or a rule adopted by the board under this chapter is
liable to the state for a civil penalty of $1,000 for each day of
violation.
(b) At the request of the board, the attorney general shall
bring an action to recover a civil penalty authorized by this
section.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.604. GENERAL CRIMINAL PENALTY. Except as
provided by Section 201.605, a person commits an offense if the
person violates this chapter. An offense under this section is a
misdemeanor punishable by a fine of not less than $50 or more than
$500 or by confinement in the county jail for not more than 30 days.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 201.605. CRIMINAL PENALTY: PRACTICE WITHOUT
LICENSE. (a) A person commits an offense if the person violates
Section 201.301.
(b) Except as provided by Subsection (c), an offense under
this section is a Class A misdemeanor.
(c) If it is shown on the trial of the offense that the
defendant has been previously convicted under Subsection (a), the
offense is a felony of the third degree.
(d) Each day of violation constitutes a separate offense.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
