Non-Citizen/Non-Permanent Resident Physician Requirement Repealed!

SB 949 (by Jane Nelson) repeals Section 155.0045, Occupations Code.  The change in law became effective 6/14/2013.   The section repealed is the section that was added last legislative session requiring that non-citizen/non-permanent residents perform 3 years of full-time service in a medically underserved area before being able to practice solely in non-MUAs.  Although the TMB’s rulemaking process has not yet caught up, the Licensing Division is complying with the statutory change effective immediately.

New Requirement for Non-Citizen/Non-Permanent Resident Physicians

Effective September 1, 2012 applicants for licensure who are not US citizens or who have not been admitted for permanent residence.  These rules are a direct result of SB 189 authored by Senator Jane Nelson.  Below you will find G&M’s attempt to explain the new law/rules in an easy format.  Please note that board staff has stated that there are anticipated changes that will be proposed later in the year but as of now the proposed rules will be in effect soon.

Will you have to work 3 years in Texas in an MUA or HPSA before becoming eligible for a full license?

The Texas Medical Board will adopt rules at their meeting August 30-31, 2012 to implement the law that was passed in the 2011 Texas legislative session.  Based on the proposed rules, find out if you will need to perform the 3-year MUA/HPSA service requirement.

1.  Are you a US citizen or permanent resident applying for a full physician license in Texas? If you are you will need to present documentation to the board verifying this status.  You will not be required to work 3 years in an MUA or HPSA.

2.  Did you file your application on or before 8/31/12 no matter your citizenship status? You will not be required to work 3 years in an MUA or HPSA.
3.  Did you practice medicine in Texas prior to 9/1/12 for at least one year under a PIT, a temporary license or a limited license no matter your citizenship status?

You will not be required to work 3 years in an MUA or HPSA.

4. Are you applying to practice medicine at an institution that maintains a GME program in Texas no matter your citizenship status?

You will not be required to work 3 years in an MUA or HPSA.

5. Have you already practiced medicine full time in Texas in MUAs or HPSAs for at least 3 years? You must document your 3 years of service to satisfy the requirements for full licensure. (Full time practice is defined as at least 20 hours a week for 40 weeks in a year.)

FAQ

Does this new rule apply to all types of physician licenses?

No.  It does not apply to physicians practicing under postgraduate training permits, faculty temporary licenses and other temporary or limited licenses as defined in board rule.

 

Can I work outside of the MUA/HPSA as long as I work the minimum for full-time at the MUA/HPSA?

Yes.

If I decide to sign an agreement to practice in an MUA/HPSA, do I have to tell anyone about the agreement?

Yes.  You must notify any individual or entity with whom you contract to practice medicine that you are fulfilling a service requirement to practice full-time in Texas, in medically underserved areas and health professional shortage areas as designated by the U.S. Department of Health and Human Services, for at least three years.

How do I document my 3 years of service in an MUA/HPSA and get a full license to practice anywhere in Texas?

As you are coming close to completing the 3 years of service, begin collecting documents required by board rule:

  • Individual Federal income tax returns, including copies of the International Medical Graduate’s (IMG) W-2 forms and/or pay stubs covering the three-year period (showing employment in a qualifying underserved location);
  • Letter(s) from your employer(s) attesting to the full-time medical service rendered during the required aggregate period; and
  • If you established your own practice, documents confirming establishment of the practice, e.g., documentation showing incorporation of the medical practice (if incorporated), the business license, and the business tax returns and tax withholding documents submitted for the entire three-year period.

What if I am exempt but later decide I want a full license to practice anywhere in Texas?

If you are determined exempt because you are applying to practice medicine at an institution that maintains a graduate medical education program in this state and subsequently apply for full licensure without completing the 3 years under the exemption, you are subject to the requirements of the 3 year service agreement.

Does any of my work while I was exempt count towards the 3 years of service?

No – If you were exempt because you were training under a PIT permit.

Yes – If you were exempt because you applied to practice medicine at an institution that maintains a graduate medical education program in this state.

I’m a US citizen or have permanent residence.  How do I document that?

Acceptable citizenship documentation:

  • Copy of a U.S. passport;
  • Copy of Certification of Naturalization;
  • Copy of Certificate of U.S. Citizenship; or
  • Both a copy of a citizenship document and a copy of an identification document.

 

Citizenship documents:

  • Birth certificate;
  • Report or Certification of Birth Abroad of a U.S. Citizen;
  • U.S. Citizen I.D. Card;
  • Adoption papers; or
  • Military record if it shows birth place.

 

Identification documents:

  • Current driver’s license or state identity card;
  • School identification card;
  • Federal, state or local government identification card; or
  • U.S. military identification card.

 

Acceptable evidence of Lawful Permanent Resident (LPR) status:

  • Copy of a current Permanent Resident Card;
  • Form I-797 “Welcome Notice” indicating approval of Form I-485 (permanent residence application);
  • “I-551 stamp” in the applicant’s passport, indicating temporary evidence of LPR status while waiting on issuance of the Permanent Residence card; or
  • Form I-797 Receipt Notice for Form I-751, when that notice is specifically endorsed as providing temporary evidence of LPR status.

A big shout out to Jaime Garanflo.

Jaime was awarded the Meritorious Service Award by the Federation of State Medical Boards at its centennial meeting in Dallas, TX in April.  Jaime was recognized primarily for her work in reducing the processing time of physician applications by 50% as well as founding an outreach program for the Texas Medical Board.  Now we know Jaime did way more than that during her time at the medical board but I think they ran out of space.  Check out all the award winners at http://www.fsmb.org/pdf/pub-nl-spring-2012.pdf All for now – Denise Meyer.