OCCUPATIONS CODE
CHAPTER 204. PHYSICIAN ASSISTANTS
SUBCHAPTER A. GENERAL PROVISIONS
§ 204.001. SHORT TITLE. This chapter may be cited as
the Physician Assistant Licensing Act.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.002. DEFINITIONS. In this chapter:
(1) "Medical board" means the Texas State Board of
Medical Examiners.
(2) "Physician assistant board" means the Texas State
Board of Physician Assistant Examiners.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.003. APPLICABILITY. (a) A person is not
required to hold a license issued under this chapter to practice as:
(1) a technician, assistant, or employee of a
physician who performs delegated tasks but does not act as a
physician assistant or represent that the person is a physician
assistant; or
(2) any other licensed health care worker acting
within the scope of that person's license if the person:
(A) does not use the title "physician assistant"
or the initials "P.A."; or
(B) is not represented or designated as a
physician assistant.
(b) This chapter does not limit the employment arrangement
of a physician assistant licensed under this chapter.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.004. APPLICATION OF SUNSET ACT. The Texas State
Board of Physician Assistant 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 STATE BOARD OF PHYSICIAN ASSISTANT EXAMINERS
§ 204.051. TEXAS STATE BOARD OF PHYSICIAN ASSISTANT
EXAMINERS. The Texas State Board of Physician Assistant Examiners
is an advisory board to the Texas State Board of Medical Examiners.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.052. APPOINTMENT OF BOARD. The physician
assistant board consists of nine members appointed by the governor
as follows:
(1) three practicing physician assistant members who
each have at least five years of clinical experience as a physician
assistant;
(2) three physician members who are licensed in this
state and who supervise physician assistants; and
(3) three public members who are not licensed as a
physician or physician assistant.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.053. MEMBERSHIP ELIGIBILITY AND
RESTRICTIONS. (a) A person is not eligible for appointment as a
public member of the physician assistant board if the person or the
person's spouse:
(1) is licensed by an occupational regulatory agency
in the field of health care; or
(2) is employed by or participates in the management
of a business entity or other organization that provides health
care services or that sells, manufactures, or distributes health
care supplies or equipment.
(b) A person may not serve as a member of the physician
assistant board if the person is required to register as a lobbyist
under Chapter 305, Government Code.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.054. TERMS; VACANCIES. (a) Members of the
physician assistant board are appointed for staggered six-year
terms. The terms of three members expire on February 1 of each
odd-numbered year.
(b) A member may not serve more than:
(1) two consecutive full terms; or
(2) a total of three full terms.
(c) If a vacancy occurs during a member's term, the governor
shall appoint a new member to fill the unexpired term.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.055. OFFICERS. The physician assistant board
shall select from its membership a presiding officer and a
secretary to serve one-year terms.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.056. GROUNDS FOR REMOVAL. (a) It is a ground for
removal from the physician assistant board that a member:
(1) does not have at the time of appointment the
qualifications required by this subchapter for appointment to the
board;
(2) does not maintain during the service on the board
the qualifications required by this subchapter for appointment to
the board; or
(3) fails to attend at least one-half of the regularly
scheduled board meetings that the member is eligible to attend
during a calendar year.
(b) The validity of an action of the physician assistant
board is not affected by the fact that it is taken when a ground for
removal of a board member exists.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.057. PER DIEM. A member of the physician
assistant board is entitled to receive a per diem as set by
legislative appropriation for each day that the member engages in
the business of the board. If the General Appropriations Act does
not prescribe the amount of the per diem, the per diem is equal to a
member's actual expenses for meals, lodging, and transportation
plus $100.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.058. OPEN MEETINGS; ADMINISTRATIVE PROCEDURE
LAW. Except as otherwise provided by this chapter, the physician
assistant board is subject to Chapters 551 and 2001, Government
Code.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
SUBCHAPTER C. POWERS AND DUTIES OF PHYSICIAN ASSISTANT BOARD AND
MEDICAL BOARD
§ 204.101. GENERAL POWERS AND DUTIES OF BOARD. The
physician assistant board shall:
(1) adopt rules that are reasonable and necessary for
the performance of the physician assistant board's duties under
this chapter, as provided by Chapter 2001, Government Code,
including rules to establish:
(A) licensing and other fees;
(B) license renewal dates; and
(C) procedures for disciplinary actions;
(2) review and approve or reject each application for
the issuance or renewal of a license;
(3) issue each license;
(4) deny, suspend, or revoke a license or otherwise
discipline a license holder; and
(5) take any action necessary to carry out the
functions and duties of the physician assistant board under this
chapter.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.102. POWERS AND DUTIES OF MEDICAL BOARD RELATING
TO PHYSICIAN ASSISTANTS. (a) The medical board shall adopt rules
consistent with this chapter to regulate physician assistants and
physicians who supervise physician assistants.
(b) The medical board, by a majority vote, shall approve or
reject each rule adopted by the physician assistant board. If
approved, the rule may take effect. If the rule is rejected, the
medical board shall return the rule to the physician assistant
board for revision.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.103. FEES. The physician assistant board shall
establish and collect fees in amounts that are reasonable and
necessary to cover the cost of administering this chapter.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.104. RURAL PHYSICIAN ASSISTANT LOAN REIMBURSEMENT
PROGRAM. (a) A program shall be established to provide student
loan reimbursement for graduates of physician assistant training
programs from any state who practice in rural health professional
shortage areas and medically underserved areas identified by the
Texas Department of Health. The physician assistant board shall
fund the program by designating annually a portion of the revenue
generated under this chapter from physician assistant licensing
fees.
(b) The Office of Rural Community Affairs shall establish
policies for and adopt rules to administer the loan program.
(c) The physician assistant board shall authorize and the
medical board shall transfer annually the funds designated under
Subsection (a) to the Office of Rural Community Affairs to
administer the loan program.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2001, 77th Leg., ch. 1424, § 10, eff. Sept. 1, 2001.
SUBCHAPTER D. LICENSE REQUIREMENTS, EXEMPTIONS, AND RENEWAL
§ 204.151. LICENSE REQUIRED. A person may not practice
as a physician assistant in this state unless the person holds a
physician assistant license issued under this chapter.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.152. ISSUANCE OF LICENSE. The physician
assistant board shall issue a license to an applicant who:
(1) meets the eligibility requirements of Section
204.153;
(2) submits an application on a form prescribed by the
board;
(3) pays the required application fee;
(4) certifies that the applicant is mentally and
physically able to function safely as a physician assistant; and
(5) submits to the board any other information the
board considers necessary to evaluate the applicant's
qualifications.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.153. ELIGIBILITY REQUIREMENTS. (a) To be
eligible for a license under this chapter, an applicant must:
(1) successfully complete an educational program for
physician assistants or surgeon assistants accredited by the
Committee on Allied Health Education and Accreditation or by that
committee's predecessor or successor entities;
(2) pass the Physician Assistant National Certifying
Examination administered by the National Commission on
Certification of Physician Assistants;
(3) hold a certificate issued by the National
Commission on Certification of Physician Assistants;
(4) be of good moral character; and
(5) meet any other requirement established by board
rule.
(b) In addition to the requirements of Subsection (a), an
applicant is not eligible for a license, unless the physician
assistant board takes the fact into consideration in determining
whether to issue the license, if the applicant:
(1) has been issued a license, certificate, or
registration as a physician assistant in this state or from a
licensing authority in another state that is revoked or suspended;
or
(2) is subject to probation or other disciplinary
action for cause resulting from the applicant's acts as a physician
assistant.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.154. EXEMPTIONS FROM LICENSING REQUIREMENT FOR
CERTAIN PHYSICIAN ASSISTANTS. A person is not required to hold a
license issued under this chapter to practice as:
(1) a physician assistant student enrolled in a
physician assistant or surgeon assistant educational program
accredited by the Committee on Allied Health Education and
Accreditation of the American Medical Association or by successor
entities as approved and designated by physician assistant board
rule; or
(2) a physician assistant employed in the service of
the federal government while performing duties related to that
employment.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.155. TEMPORARY LICENSE. (a) The physician
assistant board may issue a temporary license to an applicant who:
(1) meets all the qualifications for a license under
this chapter but is waiting for the license to be issued at the next
scheduled meeting of the board;
(2) seeks to temporarily substitute for a licensed
physician assistant during the license holder's absence, if the
applicant:
(A) is licensed or registered in good standing in
another state;
(B) submits an application on a form prescribed
by the board; and
(C) pays the appropriate fee prescribed by the
board; or
(3) has graduated from an educational program for
physician assistants or surgeon assistants described by Section
204.153(a)(1) not later than six months before applying for a
temporary license and is waiting for examination results from the
National Commission on Certification of Physician Assistants.
(b) A temporary license may be valid for not more than one
year after the date issued as determined by board rule.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2001, 77th Leg., ch. 578, § 1, eff. Sept. 1, 2001.
§ 204.156. LICENSE RENEWAL. On notification from the
physician assistant board, a person who holds a license under this
chapter may renew the license by:
(1) paying the required renewal fee;
(2) submitting the appropriate form; and
(3) meeting any other requirement established by board
rule.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.1565. INFORMAL CONTINUING MEDICAL
EDUCATION. (a) In this section, "site serving a medically
underserved population" has the meaning assigned by Section
157.052.
(b) The physician assistant board by rule shall permit a
license holder to complete half of any informal continuing medical
education hours required to renew a license under this chapter by
providing volunteer medical services at a site serving a medically
underserved population, other than a site that is a primary
practice site of the license holder.
Added by Acts 2001, 77th Leg., ch. 1420, § 14.053(a), eff. Sept.
1, 2001.
§ 204.157. INACTIVE STATUS. (a) A person licensed
under this chapter may place the person's license on inactive
status by applying to the physician assistant board. A person whose
license is on inactive status is excused from paying renewal fees
for the license.
(b) The holder of a license on inactive status may not
practice as a physician assistant. A violation of this subsection
is considered to be practicing without a license.
(c) A person whose license is on inactive status under this
section may return the person's license to active status by:
(1) applying to the physician assistant board; and
(2) satisfying the requirements of Section 204.156.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
SUBCHAPTER E. PRACTICE BY LICENSE HOLDER
§ 204.201. NOTICE OF INTENT TO PRACTICE. (a) Before
beginning practice, each physician assistant licensed under this
chapter shall submit on a form prescribed by the physician
assistant board notice of the license holder's intent to practice.
The notice must include:
(1) the name, business address, license number, and
telephone number of the physician assistant; and
(2) the name, business address, Texas license number,
and telephone number of the physician assistant's supervising
physician.
(b) A physician assistant shall notify the physician
assistant board of any change in, or addition to, the person acting
as a supervising physician for the physician assistant not later
than the 30th day after the date the change or addition occurs.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.202. SCOPE OF PRACTICE. (a) The practice of a
physician assistant includes providing medical services delegated
by a supervising physician that are within the education, training,
and experience of the physician assistant.
(b) Medical services provided by a physician assistant may
include:
(1) obtaining patient histories and performing
physical examinations;
(2) ordering or performing diagnostic and therapeutic
procedures;
(3) formulating a working diagnosis;
(4) developing and implementing a treatment plan;
(5) monitoring the effectiveness of therapeutic
interventions;
(6) assisting at surgery;
(7) offering counseling and education to meet patient
needs;
(8) requesting, receiving, and signing for the receipt
of pharmaceutical sample prescription medications and distributing
the samples to patients in a specific practice setting in which the
physician assistant is authorized to prescribe pharmaceutical
medications and sign prescription drug orders as provided by
Section 157.052, 157.053, 157.054, 157.0541, or 157.0542 or as
otherwise authorized by physician assistant board rule;
(9) signing or completing a prescription as provided
by Subchapter B, Chapter 157; and
(10) making appropriate referrals.
(c) The activities listed by Subsection (b) may be performed
in any place authorized by a supervising physician, including a
clinic, hospital, ambulatory surgical center, patient home,
nursing home, or other institutional setting.
(d) A physician assistant's signature attesting to the
provision of a service the physician assistant is legally
authorized to provide satisfies any documentation requirement for
that service established by a state agency.
(e) A physician assistant is the agent of the physician
assistant's supervising physician for any medical services that are
delegated by that physician and that:
(1) are within the physician assistant's scope of
practice; and
(2) are delineated by protocols, practice guidelines,
or practice directives established by the supervising physician.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2001, 77th Leg., ch. 112, § 3, eff. May 11, 2001; Acts
2001, 77th Leg., ch. 178, § 1, eff. Sept. 1, 2001; Acts 2001,
77th Leg., ch. 1420, § 14.054(a), eff. Sept. 1, 2001.
§ 204.203. IDENTIFICATION REQUIREMENTS. A physician
assistant shall:
(1) keep the physician assistant's license available
for inspection at the physician assistant's primary place of
business; and
(2) when engaged in the physician assistant's
professional activities, wear a name tag identifying the license
holder as a physician assistant.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.204. SUPERVISION REQUIREMENTS. (a) A physician
assistant shall be supervised by a supervising physician. A
physician assistant may have more than one supervising physician.
The supervising physician oversees the activities of, and accepts
responsibility for, medical services provided by the physician
assistant.
(b) Supervision of a physician assistant by a supervising
physician must be continuous. The supervision does not require the
constant physical presence of the supervising physician where
physician assistant services are being performed, but, if a
supervising physician is not present, the supervising physician and
the physician assistant must be, or must be able to easily be, in
contact with one another by radio, telephone, or another
telecommunication device.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.205. REQUIREMENTS FOR SUPERVISING PHYSICIAN. A
supervising physician must:
(1) hold an unrestricted and active license as a
physician in this state;
(2) notify the medical board of the physician's intent
to supervise a physician assistant;
(3) submit to the medical board a statement that the
physician will:
(A) supervise the physician assistant according
to medical board rule; and
(B) retain professional and legal responsibility
for the care provided by the physician assistant; and
(4) receive approval from the medical board to
supervise the physician assistant.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.206. ESTABLISHMENT OF CERTAIN FUNCTIONS AND
STANDARDS. Each physician assistant and the physician assistant's
supervising physician shall ensure that:
(1) the physician assistant's scope of function is
identified;
(2) delegation of medical tasks is appropriate to the
physician assistant's level of competence;
(3) the relationship between the physician assistant
and the supervising physician and the access of the physician
assistant to the supervising physician are defined; and
(4) a process is established for evaluating the
physician assistant's performance.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.207. ASSUMPTION OF PROFESSIONAL
LIABILITY. (a) Each supervising physician retains legal
responsibility for a physician assistant's patient care
activities, including the provision of care and treatment to a
patient in a health care facility.
(b) If a physician assistant is employed by an entity,
including a health care facility, the entity shares the legal
responsibility for the physician assistant's acts or omissions with
the physician assistant's supervising physician.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.208. DUTY TO REPORT; MEDICAL PEER REVIEW. (a) A
medical peer review committee in this state, physician assistant,
physician assistant student, or physician lawfully practicing
medicine in this state shall report relevant information to the
physician assistant board related to the acts of a physician
assistant in this state if, in the person's opinion, a physician
assistant poses a continuing threat to the public welfare through
practice as a physician assistant. The duty to report under this
section may not be nullified through contract.
(b) Sections 160.002, 160.003, 160.006, 160.007(d),
160.009, 160.013, 160.014, and 160.015 apply to medical peer review
relating to the practice of a physician assistant.
(c) A person, including a health care entity or medical peer
review committee, that without malice furnishes records,
information, or assistance to the physician assistant board is
immune from any civil liability arising from that act.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended
by Acts 2001, 77th Leg., ch. 1420, § 14.055, eff. Sept. 1, 2001.
SUBCHAPTER F. COMPLAINTS AND INVESTIGATIVE INFORMATION
§ 204.251. COMPLAINT INFORMATION AND STATUS. (a) The
physician assistant board shall keep information on file about each
complaint filed with the board.
(b) If a written complaint is filed with the physician
assistant board relating to a person licensed by the board, the
board, as often as quarterly and until final determination of the
action to be taken on the complaint, shall notify the parties to the
complaint of the status of the complaint unless the notice would
jeopardize an active investigation.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.252. LICENSE HOLDER ACCESS TO COMPLAINT
INFORMATION. (a) The physician assistant board shall provide a
license holder who is the subject of a formal complaint filed under
this chapter with access to all information in its possession that
the board intends to offer into evidence in presenting its case in
chief at the contested hearing on the complaint, subject to any
other privilege or restriction established by rule, statute, or
legal precedent. The board shall provide the information not later
than the 30th day after receipt of a written request from the
license holder or the license holder's counsel, unless good cause
is shown for delay.
(b) Notwithstanding Subsection (a), the board is not
required to provide:
(1) board investigative reports;
(2) investigative memoranda;
(3) the identity of a nontestifying complainant;
(4) attorney-client communications;
(5) attorney work product; or
(6) other material covered by a privilege recognized
by the Texas Rules of Civil Procedure or the Texas Rules of
Evidence.
(c) The provision of information does not constitute a
waiver of privilege or confidentiality under this chapter or other
law.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.253. HEALTH CARE ENTITY REQUEST FOR
INFORMATION. On the written request of a health care entity, the
physician assistant board shall provide to the entity:
(1) information about a complaint filed against a
license holder that was resolved after investigation by:
(A) a disciplinary order of the board; or
(B) an agreed settlement; and
(2) the basis of and current status of any complaint
under active investigation.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.254. CONFIDENTIALITY OF INVESTIGATIVE
INFORMATION. A complaint, adverse report, investigation file,
other report, or other investigative information in the possession
of or received or gathered by the physician assistant board or a
board employee or agent relating to a license holder, a license
application, or a criminal investigation or proceeding is
privileged and confidential and is not subject to discovery,
subpoena, or other means of legal compulsion for release to any
person other than the board or a board employee or agent involved in
license holder discipline.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.255. PERMITTED DISCLOSURE OF INVESTIGATIVE
INFORMATION. (a) Investigative information in the possession of
a physician assistant board employee or agent that relates to the
discipline of a license holder may be disclosed to:
(1) a licensing authority in another state or country
in which the license holder is licensed or has applied for a
license; or
(2) a peer review committee reviewing:
(A) an application for privileges; or
(B) the qualifications of the license holder with
respect to retaining privileges.
(b) If investigative information in the possession of the
physician assistant board or a board employee or agent indicates
that a crime may have been committed, the board shall report the
information to the proper law enforcement agency. The board shall
cooperate with and assist each law enforcement agency conducting a
criminal investigation of a license holder by providing information
relevant to the investigation. Confidential information disclosed
by the board to a law enforcement agency under this subsection
remains confidential and may not be disclosed by the law
enforcement agency except as necessary to further the
investigation.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
SUBCHAPTER G. DISCIPLINARY PROCEEDINGS
§ 204.301. DISCIPLINARY AUTHORITY OF
BOARD. (a) Except as provided by Section 204.305, on a
determination that an applicant or license holder committed an act
described in Section 204.302, 204.303, or 204.304, the physician
assistant board by order shall take any of the following actions:
(1) deny the person's license application or revoke
the person's license or other authorization;
(2) require the person to submit to the care,
counseling, or treatment of a health care practitioner designated
by the physician assistant board;
(3) stay enforcement of an order and place the person
on probation;
(4) require the person to complete additional
training;
(5) suspend, limit, or restrict the person's license,
including:
(A) limiting the practice of the person to, or
excluding from the practice, one or more specified activities of
the practice as a physician assistant; or
(B) stipulating periodic physician assistant
board review;
(6) assess an administrative penalty against the
person under Section 204.351;
(7) order the person to perform public service; or
(8) administer a public reprimand.
(b) If the physician assistant board stays enforcement of an
order and places a person on probation, the board retains the right
to vacate the probationary stay and enforce the original order for
noncompliance with the terms of probation or impose any other
remedial measure or sanction authorized by this section.
(c) The physician assistant board may restore or reissue a
license or remove any disciplinary or corrective measure that the
board has imposed.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.302. CONDUCT RELATED TO FRAUD OR
MISREPRESENTATION. The physician assistant board may take action
under Section 204.301 against an applicant or license holder who:
(1) fraudulently or deceptively obtains or attempts to
obtain a license;
(2) fraudulently or deceptively uses a license;
(3) falsely represents that the person is a physician;
(4) acts in an unprofessional or dishonorable manner
that is likely to deceive, defraud, or injure the public;
(5) fraudulently alters a physician assistant
license, certificate, or diploma;
(6) uses a physician assistant license, certificate,
or diploma that has been fraudulently purchased, issued, or
counterfeited or that has been materially altered;
(7) directly or indirectly aids or abets a person not
licensed to practice as a physician assistant in practicing as a
physician assistant; or
(8) unlawfully advertises in a false, misleading, or
deceptive manner, as described by Section 101.201.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.303. CONDUCT RELATED TO VIOLATION OF
LAW. (a) The physician assistant board may take action under
Section 204.301 against an applicant or license holder who:
(1) violates this chapter or a rule adopted under this
chapter;
(2) is convicted of a felony, placed on deferred
adjudication, or placed in a pretrial diversion program;
(3) violates state law if the violation is connected
with practice as a physician assistant;
(4) fails to keep complete and accurate records of the
purchase and disposal of drugs as required by Chapter 483, Health
and Safety Code, or any subsequent rules; or
(5) writes a false or fictitious prescription for a
dangerous drug as defined by Chapter 483, Health and Safety Code.
(b) A complaint, indictment, or conviction of a law
violation is not necessary for the physician assistant board to act
under Subsection (a)(3). Proof of the commission of the act while
in practice as a physician assistant or under the guise of practice
as a physician assistant is sufficient for action by the physician
assistant board.
(c) A failure to keep the records described under Subsection
(a)(4) for a reasonable time is grounds for disciplinary action
against a physician assistant. The physician assistant board or
its representative may enter and inspect a physician assistant's
place or places of practice during reasonable business hours to:
(1) verify the correctness of the records; and
(2) inventory the drugs on hand.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.304. CONDUCT INDICATING LACK OF
FITNESS. (a) The physician assistant board may take action under
Section 204.301 against an applicant or license holder who:
(1) habitually uses drugs or intoxicating liquors to
the extent that, in the board's opinion, the person cannot safely
perform as a physician assistant;
(2) has been adjudicated as mentally incompetent;
(3) has a mental or physical condition that renders
the person unable to safely perform as a physician assistant;
(4) has committed an act of moral turpitude;
(5) has failed to practice as a physician assistant in
an acceptable manner consistent with public health and welfare;
(6) has had the person's license to practice as a
physician assistant suspended, revoked, or restricted;
(7) has had other disciplinary action taken by another
state or by the uniformed services of the United States regarding
practice as a physician assistant;
(8) prescribes, dispenses, or administers a drug or
treatment that is nontherapeutic in nature or nontherapeutic in the
manner the drug or treatment is prescribed, dispensed, or
administered;
(9) is removed or suspended from, or has had
disciplinary action taken by the person's peers in, any
professional association or society, or is being disciplined by a
licensed hospital or medical staff of a hospital, including
removal, suspension, limitation of privileges, or other
disciplinary action, if the reason for the discipline, in the
board's opinion, is unprofessional conduct or professional
incompetence likely to harm the public;
(10) has repeated or recurring meritorious health care
liability claims that, in the board's opinion, are evidence of
professional incompetence likely to harm the public; or
(11) sexually abuses or exploits another person
through the license holder's practice as a physician assistant.
(b) A certified copy of the record of the state or uniformed
services of the United States taking an action described by
Subsection (a)(7) is conclusive evidence of the action.
(c) An action described by Subsection (a)(9) does not
constitute state action on the part of the association, society, or
hospital medical staff.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.305. REHABILITATION ORDER. The physician
assistant board, through an agreed order or after a contested
proceeding, may impose a rehabilitation order on an applicant, as a
prerequisite for issuing a license, or on a license holder based on:
(1) the person's intemperate use of drugs or alcohol
directly resulting from habituation or addiction caused by medical
care or treatment provided by a physician;
(2) the person's intemperate use of drugs or alcohol
during the five years preceding the date of the report that could
adversely affect the person's ability to safely practice as a
physician assistant, if the person:
(A) reported the use; and
(B) has not previously been the subject of a
substance abuse related order of the board;
(3) a judgment by a court that the person is of unsound
mind; or
(4) the results of a mental or physical examination,
or an admission by the person, indicating that the person suffers
from a potentially dangerous limitation or an inability to practice
as a physician assistant with reasonable skill and safety because
of illness or any other physical or mental condition.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.306. EFFECT OF REHABILITATION ORDER. (a) A
rehabilitation order imposed under Section 204.305 is a
nondisciplinary private order. If entered by agreement, the order
is an agreed disposition or settlement agreement for purposes of
civil litigation and is exempt from Chapter 552, Government Code.
(b) The rehabilitation order must contain findings of fact
and conclusions of law. The order may impose a revocation,
suspension, period of probation or restriction, or any other term
authorized by this chapter or agreed to by the board and the person
subject to the order.
(c) A violation of a rehabilitation order may result in
disciplinary action under the provisions of this chapter relating
to contested matters or under the terms of the agreed order.
(d) A violation of a rehabilitation order is grounds for
disciplinary action based on:
(1) unprofessional or dishonorable conduct; or
(2) any provision of this chapter that applies to the
conduct that resulted in the violation.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.307. AUDIT OF REHABILITATION ORDER. (a) The
physician assistant board shall keep a rehabilitation order imposed
under Section 204.305 in a confidential file. The file is subject
to an independent audit by a state auditor or private auditor with
whom the physician assistant board contracts to perform the audit
to ensure that only qualified license holders are subject to
rehabilitation orders.
(b) An audit may be performed at any time at the direction of
the physician assistant board. The board shall ensure that an audit
is performed at least once in each three-year period.
(c) The audit results are a matter of public record and
shall be reported in a manner that maintains the confidentiality of
each license holder who is subject to a rehabilitation order.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.308. SUBPOENA. (a) The executive director or
the secretary-treasurer of the medical board may issue a subpoena
or subpoena duces tecum for the physician assistant board to:
(1) conduct an investigation or a contested proceeding
related to:
(A) alleged misconduct by a physician assistant;
(B) an alleged violation of this chapter or other
law related to practice as a physician assistant; or
(C) the provision of health care under this
chapter;
(2) issue, suspend, restrict, or revoke a license
under this chapter; or
(3) deny or grant an application for a license under
this chapter.
(b) Failure to timely comply with a subpoena issued under
this section is a ground for:
(1) disciplinary action by the physician assistant
board or another licensing or regulatory agency with jurisdiction
over the person subject to the subpoena; and
(2) denial of a license application.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.309. PROTECTION OF PATIENT IDENTITY. In a
disciplinary investigation or proceeding conducted under this
chapter, the physician assistant board shall protect the identity
of each patient whose medical records are examined and used in a
public proceeding unless the patient:
(1) testifies in the public proceeding; or
(2) submits a written release in regard to the
patient's records or identity.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.310. REQUIRED SUSPENSION OF LICENSE OF
INCARCERATED PHYSICIAN ASSISTANT. Regardless of the offense, the
physician assistant board shall suspend the license of a physician
assistant serving a prison term in a state or federal penitentiary
during the term of the incarceration.
Added by Acts 2001, 77th Leg., ch. 578, § 2, eff. Sept. 1, 2001.
§ 204.311. TEMPORARY SUSPENSION. (a) The presiding
officer of the physician assistant board, with board approval,
shall appoint a three-member disciplinary panel consisting of board
members to determine whether a person's license to practice as a
physician assistant should be temporarily suspended.
(b) If the disciplinary panel determines from the evidence
or information presented to the panel that a person licensed to
practice as a physician assistant would, by the person's
continuation in practice, constitute a continuing threat to the
public welfare, the disciplinary panel shall temporarily suspend
the license of that person.
(c) A license may be suspended under this section without
notice or hearing on the complaint if:
(1) institution of proceedings for a hearing before
the physician assistant board is initiated simultaneously with the
temporary suspension; and
(2) a hearing is held under Chapter 2001, Government
Code, and this chapter as soon as possible.
(d) Notwithstanding Chapter 551, Government Code, the
disciplinary panel may hold a meeting by telephone conference call
if immediate action is required and convening of the panel at one
location is inconvenient for any member of the disciplinary panel.
Added by Acts 2001, 77th Leg., ch. 578, § 2, eff. Sept. 1, 2001.
SUBCHAPTER H. PENALTIES
§ 204.351. ADMINISTRATIVE PENALTY. (a) The physician
assistant board by order may impose an administrative penalty
against a person licensed under this chapter who violates this
chapter or a rule or order adopted under this chapter.
(b) The penalty may be in an amount not to exceed $5,000.
Each day a violation continues or occurs is a separate violation for
purposes of imposing a penalty.
(c) The physician assistant board shall base the amount of
the penalty on:
(1) the severity of patient harm;
(2) the severity of economic harm to any person;
(3) the severity of any environmental harm;
(4) increased potential for harm to the public;
(5) any attempted concealment of misconduct;
(6) any premeditated or intentional misconduct;
(7) the motive for the violation;
(8) prior misconduct of a similar or related nature;
(9) the license holder's disciplinary history;
(10) prior written warnings or written admonishments
from any government agency or official regarding statutes or
regulations relating to the misconduct;
(11) violation of a board order;
(12) failure to implement remedial measures to correct
or mitigate harm from the misconduct;
(13) lack of rehabilitative potential or likelihood of
future misconduct of a similar nature;
(14) relevant circumstances increasing the
seriousness of the misconduct; and
(15) any other matter that justice may require.
(d) The physician assistant board by rule shall prescribe
the procedure by which it may impose an administrative penalty. A
proceeding under this section is subject to Chapter 2001,
Government Code.
(e) If the physician assistant board by order determines
that a violation has occurred and imposes an administrative
penalty, the board shall give notice to the person of the board's
order. The notice must include a statement of the person's right to
judicial review of the order.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.352. CRIMINAL PENALTY. (a) A person commits an
offense if, without holding a license issued under this chapter,
the person:
(1) holds the person out as a physician assistant;
(2) uses any combination or abbreviation of the term
"physician assistant" to indicate or imply that the person is a
physician assistant; or
(3) acts as a physician assistant.
(b) An offense under this section is a felony of the third
degree.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
