Category Archives: TMB Proposed Rules

Surgical Assistant Proposed Rule Changes

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See summary below.  For full text, view the Texas Register September 27, 2013 issue, page  6489.

CHAPTER 184. SURGICAL ASSISTANTS
22 TAC §§184.2, 184.4, 184.8
The Texas Medical Board (Board) proposes amendments to §§184.2, 184.4 and 184.8, concerning Surgical Assistants.

The amendment to §184.2, concerning Definitions, adds definitions for”military service member,””military spouse” and “military veteran” based on the passage of Senate Bill(SB) 162 (83rd Regular Session) that amended Chapter 55 of the Texas Occupations Code.

The amendment to §184.4, concerning Qualifications for Licensure, adds language to subsection (c)(3), allowing for an expedited licensure process for military spouses, based on the passage of SB 162 (83rd Regular Session). New subsection (d) adds a provision for recognizing certain training for Applicants with military experience, based on the passage of SB 162 (83rd Regular Session).

The amendment to §184.8, concerning Expired Annual Registration Permits, corrects citations to other rules in subsection (g).

Rule Changes for Temporary and Limited Licenses (Physicians)

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See summary below.  For full text, view the Texas Register September 27, 2013 issue, page 6484.

CHAPTER 172. TEMPORARY AND LIMITED LICENSES
The Texas Medical Board (Board) proposes amendments to §§172.1, 172.4, 172.9, and 172.13 and new §172.18, concerning Temporary and Limited Licenses.

The amendment to §172.1, concerning Purpose, adds a reference to newly created §155.103 of the Texas Occupations Code, based on the passage of Senate Bill(SB) 61 (83rd Regular Session) which created §155.103 of the Texas Occupations Code.  This amendment also adds a reference to §155.101 of the Texas Occupations Code in order to correct the previously adopted version that omitted such reference.

The amendment to §172.4, concerning State Health Agency Temporary License, corrects citations to other rules.

The amendment to §172.9, concerning Postgraduate Research Temporary License, provides that a postgraduate research temporary license may be issued to a medical school graduate who holds a research appointment at an institution, under certain terms and conditions.

The amendment to §172.13, Conceded Eminence, concerns subsection (c) and remedies incorrect citations to other rules.

New §172.18, concerning Military Limited Volunteer Licenses, sets forth the criteria under which an applicant may qualify for a military limited volunteer license, based on the passage of SB 61 (83rd Regular Session) and the creation of §155.103 of the Texas Occupations Code, which provides a licensing mechanism for active and retired military physicians who do not hold a Texas medical license to provide charitable care in Texas.

Proposed Rule Changes for Reinstatement and Reissuance of Physician Licenses

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See summary below.  For full text, view the Texas Register September 27, 2013 issue, page 6485

CHAPTER 167. REINSTATEMENT AND REISSUANCE

22 TAC §167.4, §167.6
The Texas Medical Board (Board) proposes amendments to §167.4, concerning Best Interests of the Public, and §167.6, concerning Final Action.

The amendment to §167.4 mandates that the underlying action leading to the revocation of a physician’s license be considered in determining whether the reinstatement of the physician license would be in the best interests of the public.

The amendment to §167.6 mandates that the order revoking or suspending a physician’s license be admissible in the contested case proceeding regarding a physician license reinstatement or reissuance request and mandates that the basis for the Board’s revocation must be considered and addressed by the ALJ as a factor in the best interest of the public determination in the Proposal for Decision.

TMB’s Proposed Physician Licensure Rule Changes

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Summary below – for full text go to the Texas Register 9/27/13 issue, page 6468.

CHAPTER 163. LICENSURE
22 TAC §§163.1, 163.2, 163.5, 163.6, 163.13
The Texas Medical Board (Board) proposes amendments to §§163.1, 163.2, 163.5, 163.6 and 163.13, concerning Licensure.

The amendment to §163.1, concerning Definitions, adds definitions for “license holder,” “military service member,” “military spouse” and “military veteran” based on the passage of Senate Bill (SB) 162 and Senate Bill 949 (83rd Regular Session) that amended Chapters 55 and 155 of the Texas Occupations Code.

The amendment to §163.2, concerning Full Texas Medical License, deletes subsection (d) of this rule related to the requirements for applicants who are not U.S. citizens or permanent residents, in accordance with SB 949 (83rd Regular Session), which repealed §155.0045 of the Texas Occupations Code, related to additional eligibility requirements for certain aliens. Also, the amendment changes subsection (e) to subsection (d), in light of the previous deletion of subsection (d). The amendment also adds language to subsection (d), allowing for an expedited licensure process for military spouses, based on the passage of SB 162 (83rd Regular Session). New subsection (e) adds a provision for recognizing certain training for Applicants with military experience, based on the passage of SB 162 (83rd Regular Session).

The amendment to §163.5(b)(12), concerning Licensure Documentation–Citizenship or Permanent Residence, is deleted as a result of §163.2(d) being deleted by virtue of §155.0045 of the Texas Occupations Code being repealed by SB 949 (83rd Regular Session).

The amendment to §163.6, concerning Examinations Accepted for Licensure, amends the language in subsection (b)(3), relating to the exemption from limits on exam attempts, in order to be consistent with the remainder of the rule. New subsection (f) adds language which provides for an exemption from time frame in which an applicant must pass the examinations required for licensure, based on the passage of SB 949 (83rd Regular Session).

The amendment to §163.13, concerning Expedited Licensure Process, amends the language to include applicants who meet the criteria under §163.2(d), based on the passage of SB 162 (83rd Regular Session).

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

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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

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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.