CHAPTER 151. GENERAL PROVISIONS

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OCCUPATIONS CODE

TITLE 3. HEALTH PROFESSIONS

SUBTITLE B. PHYSICIANS

CHAPTER 151. GENERAL PROVISIONS

SUBCHAPTER A. GENERAL PROVISIONS

Sec. 151.001. SHORT TITLE. This subtitle may be cited as the

Medical Practice Act.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 151.002. DEFINITIONS. (a) In this subtitle:

(1) "Board" means the Texas Medical Board.

(2) "Continuing threat to the public welfare" means a real

danger to the health of a physician's patients or to the public

from the acts or omissions of the physician caused through the

physician's lack of competence, impaired status, or failure to

care adequately for the physician's patients, as determined by:

(A) the board;

(B) a medical peer review committee in this state;

otherwise lawfully practicing medicine in this state;

(D) a physician engaged in graduate medical education or

training; or

(E) a medical student.

(3) "Disciplinary order" means an action taken under Section

164.001, 164.053, 164.058, or 164.101.

(4) "Doctor of osteopathic medicine" includes a doctor of

osteopathy, an osteopath, an osteopathic physician, and an

osteopathic surgeon.

(5) "Health care entity" means:

(A) a hospital licensed under Chapter 241 or 577, Health and

Safety Code;

(B) an entity, including a health maintenance organization,

group medical practice, nursing home, health science center,

university medical school, hospital district, hospital authority,

or other health care facility, that:

(i) provides or pays for medical care or health care services;

and

(ii) follows a formal peer review process to further quality

medical care or health care;

committee of such a society or association, that follows a formal

peer review process to further quality medical care or health

care; or

(D) an organization established by a professional society or

association of physicians, hospitals, or both, that:

(i) collects and verifies the authenticity of documents and

other information concerning the qualifications, competence, or

performance of licensed health care professionals; and

(ii) acts as a health care facility's agent under the Health

Care Quality Improvement Act of 1986 (42 U.S.C. Section 11101 et

seq.).

(6) "Legally authorized representative" of a patient means:

(A) a parent or legal guardian if the patient is a minor;

(B) a legal guardian if the patient has been adjudicated

incompetent to manage the patient's personal affairs;

attorney for health care;

(D) an attorney ad litem appointed for the patient;

(E) a guardian ad litem appointed for the patient;

(F) a personal representative or statutory beneficiary if the

patient is deceased; or

(G) an attorney retained by the patient or by another person

listed by this subdivision.

(7) "Medical peer review" or "professional review action" means

the evaluation of medical and health care services, including

evaluation of the qualifications and professional conduct of

professional health care practitioners and of patient care

provided by those practitioners. The term includes evaluation of

the:

(A) merits of a complaint relating to a health care practitioner

and a determination or recommendation regarding the complaint;

(B) accuracy of a diagnosis;

(D) report made to a medical peer review committee concerning

activities under the committee's review authority;

(E) report made by a medical peer review committee to another

committee or to the board as permitted or required by law; and

(F) implementation of the duties of a medical peer review

committee by a member, agent, or employee of the committee.

(8) "Medical peer review committee" or "professional review

body" means a committee of a health care entity, the governing

board of a health care entity, or the medical staff of a health

care entity, that operates under written bylaws approved by the

policy-making body or the governing board of the health care

entity and is authorized to evaluate the quality of medical and

health care services or the competence of physicians, including

evaluation of the performance of those functions specified by

Section 85.204, Health and Safety Code. The term includes:

(A) an employee or agent of the committee, including an

assistant, investigator, intervenor, attorney, and any other

person or organization that serves the committee; and

(B) the governing body of a public hospital owned or operated by

a governmental entity, the governing body of a hospital authority

created under Chapter 262 or 264, Health and Safety Code, and the

governing body of a hospital district created under Article IX,

Texas Constitution, but only:

(i) in relation to the governing body's evaluation of the

competence of a physician or the quality of medical and health

care services provided by the public hospital, hospital

authority, or hospital district; and

(ii) to the extent that the evaluation under Subparagraph (i)

involves discussions or records that specifically or necessarily

identify an individual patient or physician.

(9) "Medical records" means all records relating to the history,

diagnosis, treatment, or prognosis of a patient.

(10) "Operation" means the application of surgery or the

performance of surgical services.

(11) "Person" means an individual, unless the term is expressly

made applicable to a partnership, association, or corporation.

(12) "Physician" means a person licensed to practice medicine in

this state.

(13) "Practicing medicine" means the diagnosis, treatment, or

offer to treat a mental or physical disease or disorder or a

physical deformity or injury by any system or method, or the

attempt to effect cures of those conditions, by a person who:

(A) publicly professes to be a physician or surgeon; or

(B) directly or indirectly charges money or other compensation

for those services.

(14) "Surgery" includes:

(A) surgical services, procedures, and operations; and

(B) the procedures described in the surgery section of the

common procedure coding system as adopted by the Health Care

Financing Administration of the United States Department of

Health and Human Services.

(b) The terms "physician" and "surgeon" are synonyms. As used in

this subtitle, the terms "practitioner" and "practitioner of

medicine" include physicians and surgeons.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 14.021(a), eff.

Sept. 1, 2001; Acts 2003, 78th Leg., ch. 202, Sec. 1, eff. June

10, 2003.

Amended by:

Acts 2005, 79th Leg., Ch.

269, Sec. 1.01, eff. September 1, 2005.

Sec. 151.003. LEGISLATIVE FINDINGS. The legislature finds that:

(1) the practice of medicine is a privilege and not a natural

right of individuals and as a matter of public policy it is

necessary to protect the public interest through enactment of

this subtitle to regulate the granting of that privilege and its

subsequent use and control; and

(2) the board should remain the primary means of licensing,

regulating, and disciplining physicians.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 151.004. APPLICATION OF SUNSET ACT. The Texas Medical

Board 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 subtitle and Chapters 204, 205,

and 206 expire September 1, 2017.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch.

269, Sec. 1.02, eff. September 1, 2005.

Sec. 151.005. GOVERNMENTAL DISCRIMINATION PROHIBITED. (a) A

program supported in whole or in part by the state or by a

political subdivision of the state may not discriminate against a

health care practitioner because the practitioner is a physician

specializing in ophthalmology.

(b) A law or policy of the state or of a political subdivision

of the state that requires or encourages a person to obtain

vision care or medical eye care that is within the scope of

practice of an optometrist or therapeutic optometrist may not

discriminate against a health care practitioner because the

practitioner is a physician specializing in ophthalmology.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

SUBCHAPTER B. APPLICATION AND CONSTRUCTION OF SUBTITLE

Sec. 151.051. DISCRIMINATION BASED ON TYPE OF ACADEMIC MEDICAL

DEGREE OR CERTAIN RELIGIOUS TENETS PROHIBITED. (a) A hospital,

institution, or program that is licensed by the state, is

operated by the state or a political subdivision of the state, or

directly or indirectly receives state financial assistance may

not differentiate in regard to a person licensed under this

subtitle solely on the basis of the academic medical degree held

by the person. The hospital, institution, program, state agency,

or political subdivision may adopt rules and requirements

relating to qualifications for medical staff appointments,

including reappointments and the termination of appointments, the

delineation of clinical privileges, or the curtailment of

clinical privileges of persons who are appointed to that medical

staff or permitted to participate in educational programs if

those rules and requirements do not differentiate solely on the

basis of the academic medical degree held by the affected

physician and are:

(1) determined on a reasonable basis, such as the professional

and ethical qualifications of the physician;

(2) based on reasonable standards;

(3) applied without irrelevant considerations;

(4) supported by sufficient evidence; and

(5) not arbitrary or capricious.

(b) The limitations imposed under this section relating to

discrimination based on the academic medical degree of a

physician do not apply to practice limitations adopted by:

(1) a medical school or college, including a program of a

medical school or college; or

(2) any office or offices of physicians, singularly or in

groups, in the conduct of their profession.

(1) discriminates against a school or system of medical

practice; or

(2) affects the use of the principles or teachings of any church

in ministering to the sick or suffering by prayer or pastoral

counseling without the use of a drug or other material substance

represented as medically effective.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 151.052. EXEMPTIONS. (a) This subtitle does not apply to:

(1) a dentist, licensed under the laws of this state, engaged

strictly in the practice of dentistry;

(2) a licensed optometrist or therapeutic optometrist engaged

strictly in the practice of optometry or therapeutic optometry as

defined by law;

(3) a licensed chiropractor engaged strictly in the practice of

chiropractic as defined by law;

(4) a registered nurse or licensed vocational nurse engaged

strictly in the practice of nursing in accordance with the

applicable licensing acts and other laws of this state;

(5) a licensed podiatrist engaged strictly in the practice of

podiatry as defined by law;

(6) a licensed or certified psychologist engaged strictly in the

practice of psychology as defined by law;

(7) a licensed physical therapist engaged strictly in the

practice of physical therapy in accordance with the law relating

to physical therapy practice;

(8) a commissioned or contract surgeon in the United States

uniformed services or Public Health Service in the performance of

that person's duties if the person is not engaged in private

practice;

(9) a person who furnishes medical assistance in an emergency or

disaster situation if no charge is made for the medical

assistance;

(10) a student in training in a board-approved medical school

while performing, under the supervision of a licensed

practitioner, the duties assigned in the course of training;

(11) a legally qualified physician of another state who is in

this state for consultation with a physician licensed in this

state but who does not:

(A) maintain an office in this state; or

(B) appoint a place in this state for seeing, examining, or

treating a patient; or

(12) any other activity that the board designates as exempt from

the application of this subtitle.

(b) Notwithstanding Subsection (a)(10), a medical resident,

intern, or fellow is required to register and is subject to the

other applicable provisions of this subtitle.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 151.053. APPLICATION TO CERTAIN PERSONS PROVIDING

NUTRITIONAL ADVICE. (a) This subtitle does not prohibit a

person from giving advice regarding the use and role of food and

food ingredients, including dietary supplements.

(b) Subsection (a) does not authorize a person to:

(1) practice medicine; or

(2) state, in violation of law, that a product might cure a

disease, disorder, or condition.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 151.054. APPLICATION TO SELF-CARE. (a) This subtitle does

not prohibit:

(1) a person from providing or seeking advice or information

relating to that person's self-care; or

(2) the dissemination of information relating to self-care.

(b) This section does not confer authority to practice medicine.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 151.055. APPLICATION TO CERTAIN INDEPENDENT CONTRACTOR

AGREEMENTS. This subtitle does not prohibit a hospital from

entering into an independent contractor agreement with a

physician to provide services at the hospital or at another

health care facility owned or operated by the hospital and:

(1) paying the physician a minimum guaranteed amount to ensure

the physician's availability;

(2) billing and collecting from patients the physician's

professional fees; or

(3) retaining the collected professional fees up to the amount

of the minimum guaranteed amount plus a reasonable collection

fee.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Sec. 151.056. APPLICATION TO TELEMEDICINE. (a) A person who is

physically located in another jurisdiction but who, through the

use of any medium, including an electronic medium, performs an

act that is part of a patient care service initiated in this

state, including the taking of an x-ray examination or the

preparation of pathological material for examination, and that

would affect the diagnosis or treatment of the patient, is

considered to be engaged in the practice of medicine in this

state and is subject to appropriate regulation by the board.

(b) This section does not apply to the act of:

(1) a medical specialist located in another jurisdiction who

provides only episodic consultation services on request to a

physician licensed in this state who practices in the same

medical specialty;

(2) a physician located in another jurisdiction who is providing

consultation services to a medical school as defined by Section

61.501, Education Code;

(3) a physician located in another jurisdiction who is providing

consultation services to an institution subject to:

(A) Subchapter C, Chapter 73, Education Code; or

(B) Subchapter K, Chapter 74, Education Code; or

(4) a physician located in another jurisdiction of a state

having borders contiguous with the borders of this state who is

the treating physician of a patient and orders home health or

hospice services for a resident of this state to be delivered by

a home and community support services agency licensed in this

state.

Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.

Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 14.022(a), eff.

Sept. 1, 2001.

State Codes and Statutes

State Codes and Statutes

State Codes and Statutes

State Codes and Statutes

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