CHAPTER 154. PUBLIC INTEREST INFORMATION AND COMPLAINT PROCEDURES

State Codes and Statutes

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OCCUPATIONS CODE

TITLE 3. HEALTH PROFESSIONS

SUBTITLE B. PHYSICIANS

CHAPTER 154. PUBLIC INTEREST INFORMATION AND COMPLAINT PROCEDURES

SUBCHAPTER A. PUBLIC INTEREST INFORMATION

Sec. 154.001. 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, Sec. 1, eff. Sept. 1, 1999.

Sec. 154.002. INFORMATION FOR PUBLIC DISSEMINATION. (a) The

board shall prepare:

(1) an alphabetical list of the names of the license holders;

(2) an alphabetical list of the names of the license holders by

the county in which the license holder's principal place of

practice is located;

(3) a summary of the board's functions;

(4) a copy of this subtitle and a list of other laws relating to

the practice of medicine;

(5) a copy of the board's rules;

(6) a statistical report each fiscal year to the legislature and

the public that provides aggregate information about all

complaints received by the board categorized by type of

complaint, including administrative, quality of care, medical

error, substance abuse, other criminal behavior, and the

disposition of those complaints by category; and

(7) other information considered appropriate by the board.

(b) The board shall provide:

(1) a copy of the information prepared under Subsection (a) to

each person who requests a copy; and

(2) copies of the information prepared under Subsection (a) to

each public library in this state that requests the copies.

website a consumer guide to health care. The board shall include

information in the guide concerning the billing and reimbursement

of health care services provided by physicians, including

information that advises consumers that:

(1) the charge for a health care service or supply will vary

based on:

(A) the person's medical condition;

(B) any unknown medical conditions of the person;

and

(D) other factors associated with performance of the health care

service;

(2) the charge for a health care service or supply may differ

from the amount to be paid by the consumer or the consumer's

third-party payor;

(3) the consumer may be personally liable for payment for the

health care service or supply depending on the consumer's health

benefit plan coverage; and

(4) the consumer should contact the consumer's health benefit

plan for accurate information regarding the plan structure,

benefit coverage, deductibles, copayments, coinsurance, and other

plan provisions that may impact the consumer's liability for

payment for the health care services or supplies.

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

Amended by Acts 2003, 78th Leg., ch. 202, Sec. 6, eff. June 10,

2003.

Amended by:

Acts 2007, 80th Leg., R.S., Ch.

997, Sec. 7, eff. September 1, 2007.

Sec. 154.003. INFORMATION FOR PHYSICIANS. (a) The board shall

disseminate at least twice a year and at other times determined

necessary by the board information of significant interest to the

physicians of this state. The information must include summaries

of:

(1) disciplinary orders made against physicians licensed in this

state;

(2) board activities and functions;

(3) pertinent changes in this subtitle or board rules; and

(4) attorney general opinions.

(b) The requirements of this section are in addition to the

reporting requirements imposed under Section 164.060.

(1) each physician practicing in this state;

(2) each health care entity and other board-designated health

care institution operating in this state;

(3) each member of a health-related legislative committee;

(4) a member of the public who submits a written request; and

(5) public libraries throughout this state.

(d) Except as provided by this subsection, the board shall

publish information regarding errors in and reversals of

disciplinary actions taken by the board. The information to be

published under this subsection includes instances in which a

disciplinary action initiated by the board is overturned by a

court. The board shall disseminate the information under this

subsection in the same format, size, style, and manner as the

information regarding the original action by the board was

disseminated. The board may not publish information under this

subsection if the physician who was the subject of the

disciplinary action requests that the information not be

published.

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

Amended by:

Acts 2005, 79th Leg., Ch.

269, Sec. 1.14, eff. September 1, 2005.

Sec. 154.004. DISCLOSURE OF DISCIPLINARY ORDERS. (a) On

written request the board shall make available to the general

public on payment of a reasonable fee to cover expenses and to

appropriate state agencies information that includes:

(1) a summary of any previous disciplinary order by the board

against a specific physician licensed in this state;

(2) the date of the order; and

(3) the current status of the order.

(b) If the board is not required under other state law to

establish a toll-free telephone number, the board shall establish

an eight-hour toll-free telephone number to make the information

required by this section immediately available to any caller.

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

Sec. 154.005. 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, Sec. 1, eff. Sept. 1, 1999.

Sec. 154.006. PHYSICIAN PROFILES. (a) The board shall create a

profile of each physician licensed under this subtitle. The

profile must:

(1) include the information required by Subsection (b); and

(2) be compiled in a format that makes the information contained

in the profile easily available to the public.

(b) A profile must contain the following information on each

physician:

(1) the name of each medical school attended and the dates of:

(A) graduation; or

(B) Fifth Pathway designation and completion of the Fifth

Pathway Program;

(2) a description of all graduate medical education in the

United States or Canada;

(3) any specialty certification held by the physician and issued

by a medical licensing board that is a member of the American

Board of Medical Specialties or the Bureau of Osteopathic

Specialists;

(4) the number of years the physician has actively practiced

medicine in:

(A) the United States or Canada; and

(B) this state;

(5) the name of each hospital in this state in which the

physician has privileges;

(6) the physician's primary practice location;

(7) the type of language translating services, including

translating services for a person with impairment of hearing,

that the physician provides at the physician's primary practice

location;

(8) whether the physician participates in the Medicaid program;

(9) a description of any conviction for a felony, a Class A or

Class B misdemeanor, or a Class C misdemeanor involving moral

turpitude;

(10) a description of any charges reported to the board to which

the physician has pleaded no contest, for which the physician is

the subject of deferred adjudication or pretrial diversion, or in

which sufficient facts of guilt were found and the matter was

continued by a court;

(11) a description of any disciplinary action against the

physician by the board;

(12) a description of any disciplinary action against the

physician by a medical licensing board of another state;

(13) a description of the final resolution taken by the board on

medical malpractice claims or complaints required to be opened by

the board under Section 164.201;

(14) whether the physician's patient service areas are

accessible to disabled persons, as defined by federal law;

(15) a description of any formal complaint against the physician

initiated and filed under Section 164.005 and the status of the

complaint; and

(16) a description of any medical malpractice claim against the

physician, not including a description of any offers by the

physician to settle the claim, for which the physician was found

liable, a jury awarded monetary damages to the claimant, and the

award has been determined to be final and not subject to further

appeal.

that is not maintained by the board in the ordinary course of the

board's duties shall be obtained from a physician at the time the

physician renews the physician's license. In requesting

information from the physician, the board shall:

(1) inform the physician that compliance with the request for

information is mandatory;

(2) inform the physician of the date the information will be

made available to the public; and

(3) instruct the physician about the requirements under

Subsection (f) for the physician to obtain a copy of the

physician's profile to make corrections.

(d) This section does not:

(1) prevent the board from providing explanatory information

regarding the significance of categories in which malpractice

settlements are reported; or

(2) require the board to disclose confidential settlement

information.

(e) A pending malpractice claim or complaint, other than a claim

disclosed under Subsection (b)(13), may not be disclosed to the

public by the board. This subsection does not prevent the board

from investigating and disciplining a physician on the basis of a

pending medical malpractice claim or complaint.

(f) The board shall provide a physician with a copy of the

physician's profile if the physician requests a copy at the time

the physician renews the physician's license. If a copy is

requested by a physician, the board shall provide the physician

one month from the date the copy is provided to the physician to

correct factual errors in the physician's profile.

(g) The board shall update the information contained in a

physician's profile annually, except that information provided

under Subsection (i) shall be updated not later than the 10th

working day after the date the formal complaint is filed or the

board's order is issued. The board shall adopt a form that allows

a physician to update information contained in a physician's

profile. The form shall be made available on the Internet and in

other formats as prescribed by board rule. The board may adopt

rules concerning the type and content of additional information

that may be included in a physician's profile.

(h) The board shall adopt rules as necessary to implement this

section.

(i) In addition to the information required by Subsection (b), a

profile must contain the text of a formal complaint filed under

Section 164.005 against the physician or of a board order related

to the formal complaint.

(j) Information included in a physician's profile under

Subsections (b) and (i) may not include any patient identifying

information.

(k) In the annual update of a physician's profile under

Subsection (g), the board shall remove any record of a formal

complaint required under Subsection (b)(15) or (i) if the

complaint was dismissed more than five years before the date of

the update and the complaint was dismissed as baseless,

unfounded, or not supported by sufficient evidence that a

violation occurred, or no action was taken against the

physician's license as a result of the complaint. The board

shall also remove any record of the investigation of medical

malpractice claims or complaints required to be investigated by

the board under Section 164.201 if the investigation was resolved

more than five years before the date of the update and no action

was taken against the physician's license as a result of the

investigation.

Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.026(a), eff.

Sept. 1, 2001. Amended by Acts 2003, 78th Leg., ch. 202, Sec. 7,

eff. June 10, 2003.

Amended by:

Acts 2009, 81st Leg., R.S., Ch.

607, Sec. 1, eff. September 1, 2009.

SUBCHAPTER B. COMPLAINT PROCEDURES

Sec. 154.051. COMPLAINT INITIATION. (a) The board by rule

shall establish methods by which members of the public and

license holders 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 or entity regulated under this subtitle;

(2) on a sign prominently displayed in the place of business of

each person or entity regulated under this subtitle; or

(3) in a bill for service provided by a person or entity

regulated under this subtitle.

(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.

or other entity, may file a complaint against a license holder

with the board. The board may file a complaint on its own

initiative.

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

Sec. 154.052. RECORDS OF COMPLAINTS. The board shall maintain a

system to promptly and efficiently act on complaints filed with

the board. The board shall maintain information about:

(1) the parties to the complaint;

(2) the subject matter of the complaint;

(3) a summary of the results of the review or investigation of

the complaint; and

(4) the disposition of the complaint.

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

Amended by:

Acts 2005, 79th Leg., Ch.

269, Sec. 1.15, eff. September 1, 2005.

Sec. 154.053. NOTIFICATION CONCERNING COMPLAINT. (a) The board

shall notify a physician who is the subject of a complaint filed

with the board that a complaint has been filed and shall notify

the physician of the nature of the complaint unless the notice

would jeopardize an investigation.

(b) Each party shall be notified of the projected time

requirements for pursuing the complaint. Each party to the

complaint must be notified of a change in the schedule not later

than the 14th day after the date the change is made unless the

notice would jeopardize an investigation.

complaint of the status of the complaint until final disposition

unless the notice would jeopardize an investigation.

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

Amended by:

Acts 2005, 79th Leg., Ch.

269, Sec. 1.16, eff. September 1, 2005.

Sec. 154.054. COMPLAINT INFORMATION TO HEALTH CARE ENTITY. On

written request, the board shall provide information to a health

care entity regarding:

(1) 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 that has been assigned by the executive

director to a person authorized by the board to pursue legal

action.

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

Amended by Acts 2003, 78th Leg., ch. 202, Sec. 8, eff. June 10,

2003.

Sec. 154.055. RELEASE OF COMPLAINT INFORMATION TO LEGISLATIVE

COMMITTEE. (a) On request from a legislative committee created

under Subchapter B, Chapter 301, Government Code, the board shall

release all information regarding a complaint against a physician

to aid in a legitimate legislative inquiry. The board may release

the information only to the members of the committee.

(b) In complying with a request under Subsection (a), the board

may not identify the complainant or the patient and may reveal

the identity of the affected physician only to the members of the

committee.

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

Sec. 154.056. GENERAL RULES REGARDING COMPLAINT INVESTIGATION;

DISPOSITION. (a) The board shall adopt rules concerning the

investigation and review of a complaint filed with the board. The

rules adopted under this section must:

(1) distinguish among categories of complaints and give priority

to complaints that involve sexual misconduct, quality of care,

and impaired physician issues;

(2) ensure that a complaint is not dismissed without appropriate

consideration;

(3) require that the board be advised of the dismissal of a

complaint and that a letter be sent to the person who filed the

complaint and to the physician who was the subject of the

complaint explaining the action taken on the complaint;

(4) ensure that a person who files a complaint has an

opportunity to explain the allegations made in the complaint;

(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;

(6) provide for an expert physician panel authorized under

Subsection (e) to assist with complaints and investigations

relating to medical competency; and

(7) require the review of reports filed with the National

Practitioner Data Bank for any report of the termination,

limitation, suspension, limitation in scope of practice, or

probation of clinical or hospital staff privileges of a physician

by:

(A) a hospital;

(B) a health maintenance organization;

(D) an approved nonprofit health corporation certified under

Section 162.001; or

(E) a physician network.

(b) The board shall:

(1) dispose of each complaint in a timely manner; and

(2) establish a schedule for conducting each phase of a

complaint that is under the control of the board not later than

the 30th day after the date the board receives the 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.

(d) The board shall adopt other rules as appropriate to

administer this subchapter.

(e) The board by rule shall provide for an expert physician

panel appointed by the board to assist with complaints and

investigations relating to medical competency by acting as expert

physician reviewers. Each member of the expert physician panel

must be licensed to practice medicine in this state. The rules

adopted under this subsection must include provisions governing

the composition of the panel, qualifications for membership on

the panel, length of time a member may serve on the panel,

grounds for removal from the panel, the avoidance of conflicts of

interest, including situations in which the affected physician

and the panel member live or work in the same geographical area

or are competitors, and the duties to be performed by the panel.

The board's rules governing grounds for removal from the panel

must include providing for the removal of a panel member who is

repeatedly delinquent in reviewing complaints and in submitting

reports to the board. The board's rules governing appointment of

expert physician panel members to act as expert physician

reviewers must include a requirement that the board randomly

select, to the extent permitted by Section 154.058(b) and the

conflict of interest provisions adopted under this subsection,

panel members to review a complaint.

(f) In the board rules adopted under Subsection (a)(3), the

board shall require that the letter informing the person who

filed the complaint of the dismissal of the complaint include an

explanation of the reason the complaint was dismissed.

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

Amended by Acts 2003, 78th Leg., ch. 202, Sec. 9, eff. June 10,

2003.

Amended by:

Acts 2005, 79th Leg., Ch.

269, Sec. 1.17, eff. September 1, 2005.

Sec. 154.0561. PROCEDURES FOR EXPERT PHYSICIAN REVIEW. (a) A

physician on the expert physician panel authorized by Section

154.056(e) who is selected to review a complaint shall:

(1) determine whether the physician who is the subject of the

complaint has violated the standard of care applicable to the

circumstances; and

(2) issue a preliminary written report of that determination.

(b) A second expert physician reviewer shall review the first

physician's preliminary report and other information associated

with the complaint. If the second expert physician agrees with

the first expert physician, the first physician shall issue a

final written report on the matter.

conclusions of the first expert physician, a third expert

physician reviewer shall review the preliminary report and

information and decide between the conclusions reached by the

first two expert physicians. The final written report shall be

issued by the third physician or the physician with whom the

third physician concurs.

(d) In reviewing a complaint, the expert physician reviewers

assigned to examine the complaint may consult and communicate

with each other about the complaint in formulating their opinions

and reports.

Added by Acts 2005, 79th Leg., Ch.

269, Sec. 1.18, eff. September 1, 2005.

Sec. 154.057. CONDUCT OF INVESTIGATION; USE OF INVESTIGATORS AS

PEACE OFFICERS. (a) Except as otherwise provided by this

subchapter, each investigation of a complaint filed under this

subtitle shall be conducted by the board or by a person

authorized by the board to conduct the investigation.

(b) The board shall complete a preliminary investigation of the

complaint not later than the 30th day after the date of receiving

the complaint. The board shall first determine whether the

physician constitutes a continuing threat to the public welfare.

On completion of the preliminary investigation, the board shall

determine whether to officially proceed on the complaint. If the

board fails to complete the preliminary investigation in the time

required by this subsection, the board's official investigation

of the complaint is considered to commence on that date.

enforce this subtitle. An investigator commissioned as a peace

officer under this subsection may not carry a firearm or exercise

the powers of arrest.

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

Amended by:

Acts 2005, 79th Leg., Ch.

269, Sec. 1.19, eff. September 1, 2005.

Sec. 154.058. DETERMINATION OF MEDICAL COMPETENCY. (a) Each

complaint against a physician that requires a determination of

medical competency shall be reviewed initially by a board member,

consultant, or employee with a medical background considered

sufficient by the board.

(b) If the initial review under Subsection (a) indicates that an

act by a physician falls below an acceptable standard of care,

the complaint shall be reviewed by an expert physician panel

authorized under Section 154.056(e) consisting of physicians who

practice in the same specialty as the physician who is the

subject of the complaint or in another specialty that is similar

to the physician's specialty.

panel's determinations based on the review of the complaint under

Subsection (b). The report must specify the standard of care that

applies to the facts that are the basis of the complaint and the

clinical basis for the panel's determinations, including any

reliance on peer-reviewed journals, studies, or reports.

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

Amended by Acts 2003, 78th Leg., ch. 202, Sec. 10, eff. June 10,

2003.

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