CHAPTER 204. PHYSICIAN ASSISTANTS

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OCCUPATIONS CODE

TITLE 3. HEALTH PROFESSIONS

SUBTITLE C. OTHER PROFESSIONS PERFORMING MEDICAL PROCEDURES

CHAPTER 204. PHYSICIAN ASSISTANTS

SUBCHAPTER A. GENERAL PROVISIONS

Sec. 204.001. SHORT TITLE. This chapter may be cited as the

Physician Assistant Licensing Act.

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

Sec. 204.002. DEFINITIONS. In this chapter:

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

(2) "Physician assistant board" means the Texas Physician

Assistant Board.

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

Amended by:

Acts 2005, 79th Leg., Ch.

269, Sec. 2.01, eff. September 1, 2005.

Sec. 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;

(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, Sec. 1, eff. Sept. 1, 1999.

SUBCHAPTER B. TEXAS PHYSICIAN ASSISTANT BOARD

Sec. 204.051. TEXAS PHYSICIAN ASSISTANT BOARD. (a) The Texas

Physician Assistant Board is an advisory board to the Texas State

Board of Medical Examiners.

(b) A reference in any other law to the former Texas State Board

of Physician Assistant Examiners means the Texas Physician

Assistant Board.

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

Amended by:

Acts 2005, 79th Leg., Ch.

269, Sec. 2.03, eff. September 1, 2005.

Sec. 204.052. APPOINTMENT OF BOARD. (a) The physician

assistant board consists of nine members appointed by the

governor with the advice and consent of the senate 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.

(b) Appointments to the physician assistant board shall be made

without regard to the race, color, disability, sex, religion,

age, or national origin of the appointee.

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

Amended by:

Acts 2005, 79th Leg., Ch.

269, Sec. 2.04, eff. September 1, 2005.

Sec. 204.053. MEMBERSHIP ELIGIBILITY AND RESTRICTIONS. (a) In

this section, "Texas trade association" means a cooperative and

voluntarily joined statewide association of business or

professional competitors in this state designed to assist its

members and its industry or profession in dealing with mutual

business or profession problems and in promoting their common

interest.

(b) A person may not be a public member of the physician

assistant board if the person or the person's spouse:

(1) is registered, certified, or licensed by a regulatory agency

in the field of health care;

(2) is employed by or participates in the management of a

business entity or other organization regulated by or receiving

money from the medical board or physician assistant board;

(3) owns or controls, directly or indirectly, more than a 10

percent interest in a business entity or other organization

regulated by or receiving money from the medical board or

physician assistant board; or

(4) uses or receives a substantial amount of tangible goods,

services, or money from the medical board or physician assistant

board other than compensation or reimbursement authorized by law

for physician assistant board membership, attendance, or

expenses.

board and may not be a medical board employee in a "bona fide

executive, administrative, or professional capacity," as that

phrase is used for purposes of establishing an exemption to the

overtime provisions of the federal Fair Labor Standards Act of

1938 (29 U.S.C. Section 201 et seq.), if:

(1) the person is an officer, employee, or paid consultant of a

Texas trade association in the field of health care; or

(2) the person's spouse is an officer, manager, or paid

consultant of a Texas trade association in the field of health

care.

(d) A person may not be a member of the physician assistant

board or act as the general counsel to the physician assistant

board if the person is required to register as a lobbyist under

Chapter 305, Government Code, because of the person's activities

for compensation on behalf of a profession related to the

operation of the medical board or physician assistant board.

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

Amended by:

Acts 2005, 79th Leg., Ch.

269, Sec. 2.05, eff. September 1, 2005.

Sec. 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.

shall appoint a new member to fill the unexpired term.

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

Sec. 204.055. OFFICERS. The governor shall designate a member

of the physician assistant board as the presiding officer of the

board to serve in that capacity at the will of the governor. The

physician assistant board shall select from its membership a

secretary to serve a one-year term.

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

Amended by:

Acts 2005, 79th Leg., Ch.

269, Sec. 2.06, eff. September 1, 2005.

Sec. 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 taking office the

qualifications required by Sections 204.052 and 204.053;

(2) does not maintain during service on the physician assistant

board the qualifications required by Sections 204.052 and

204.053;

(3) is ineligible for membership under Section 204.053;

(4) cannot, because of illness or disability, discharge the

member's duties for a substantial part of the member's term; or

(5) is absent from more than half of the regularly scheduled

physician assistant board meetings that the member is eligible to

attend during a calendar year without an excuse approved by a

majority vote of the board.

(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.

that a potential ground for removal exists, the executive

director shall notify the presiding officer of the physician

assistant board of the potential ground. The presiding officer

shall then notify the governor and the attorney general that a

potential ground for removal exists. If the potential ground for

removal involves the presiding officer, the executive director

shall notify the next highest ranking officer of the physician

assistant board, who shall then notify the governor and the

attorney general that a potential ground for removal exists.

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

Amended by:

Acts 2005, 79th Leg., Ch.

269, Sec. 2.07, eff. September 1, 2005.

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

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

Sec. 204.059. TRAINING. (a) A person who is appointed to and

qualifies for office as a member of the physician assistant board

may not vote, deliberate, or be counted as a member in attendance

at a meeting of the board until the person completes a training

program that complies with this section.

(b) The training program must provide the person with

information regarding:

(1) this chapter and the physician assistant board's programs,

functions, rules, and budget;

(2) the results of the most recent formal audit of the physician

assistant board;

(3) the requirements of laws relating to open meetings, public

information, administrative procedure, and conflicts of interest;

and

(4) any applicable ethics policies adopted by the physician

assistant board or the Texas Ethics Commission.

entitled to reimbursement, as provided by the General

Appropriations Act, for the travel expenses incurred in attending

the training program regardless of whether the attendance at the

program occurs before or after the person qualifies for office.

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

269, Sec. 2.08, eff. September 1, 2005.

SUBCHAPTER C. POWERS AND DUTIES OF PHYSICIAN ASSISTANT BOARD AND

MEDICAL BOARD

Sec. 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

(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, Sec. 1, eff. Sept. 1, 1999.

Sec. 204.1015. GUIDELINES FOR EARLY INVOLVEMENT IN RULEMAKING

PROCESS. (a) The physician assistant board shall adopt

guidelines to establish procedures for receiving input during the

rulemaking process from individuals and groups that have an

interest in matters under the board's jurisdiction. The

guidelines must provide an opportunity for those individuals and

groups to provide input before the physician assistant board

submits the rule to the medical board for approval.

(b) A rule adopted by the medical board may not be challenged on

the grounds that the physician assistant board did not comply

with this section. If the physician assistant board was unable

to solicit a significant amount of input from the public or

affected persons early in the rulemaking process, the physician

assistant board shall state in writing the reasons why the

physician assistant board was unable to do so.

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

269, Sec. 2.09, eff. September 1, 2005.

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

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

Sec. 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 Texas Department of Rural Affairs shall establish

policies for and adopt rules to administer the loan program.

medical board shall transfer annually the funds designated under

Subsection (a) to the Texas Department of Rural Affairs to

administer the loan program.

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

Amended by Acts 2001, 77th Leg., ch. 1424, Sec. 10, eff. Sept. 1,

2001.

Amended by:

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

112, Sec. 100, eff. September 1, 2009.

Sec. 204.105. RULES ON CONSEQUENCES OF CRIMINAL CONVICTION. The

physician assistant board shall adopt rules and guidelines as

necessary to comply with Chapter 53, except to the extent the

requirements of this chapter are stricter than the requirements

of Chapter 53.

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

269, Sec. 2.10, eff. September 1, 2005.

Sec. 204.106. DIVISION OF RESPONSIBILITIES. Subject to the

advice and approval of the medical board, the physician assistant

board shall develop and implement policies that clearly separate

the policy-making responsibilities of the physician assistant

board and the management responsibilities of the executive

director and the staff of the medical board.

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

269, Sec. 2.11, eff. September 1, 2005.

Sec. 204.107. PUBLIC PARTICIPATION. Subject to the advice and

approval of the medical board, the physician assistant board

shall develop and implement policies that provide the public with

a reasonable opportunity to appear before the physician assistant

board and to speak on any issue under the jurisdiction of the

physician assistant board.

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

269, Sec. 2.12, eff. September 1, 2005.

Sec. 204.108. RECORDS OF COMPLAINTS. (a) The physician

assistant board shall maintain a system to promptly and

efficiently act on complaints filed with the physician assistant

board. The board shall maintain:

(1) information about the parties to the complaint and the

subject matter of the complaint;

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

the complaint; and

(3) information about the disposition of the complaint.

(b) The physician assistant board shall make information

available describing its procedures for complaint investigation

and resolution.

parties of the status of the complaint until final disposition of

the complaint, unless the notice would jeopardize an

investigation.

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

269, Sec. 2.13, eff. September 1, 2005.

Sec. 204.109. USE OF TECHNOLOGY. Subject to the advice and

approval of the medical board, the physician assistant board

shall implement a policy requiring the physician assistant board

to use appropriate technological solutions to improve the

physician assistant board's ability to perform its functions.

The policy must ensure that the public is able to interact with

the board on the Internet.

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

269, Sec. 2.14, eff. September 1, 2005.

Sec. 204.110. NEGOTIATED RULEMAKING AND ALTERNATIVE DISPUTE

RESOLUTION POLICY. (a) Subject to the advice and approval of

the medical board, the physician assistant board shall develop

and implement a policy to encourage the use of:

(1) negotiated rulemaking procedures under Chapter 2008,

Government Code, for the adoption of physician assistant board

rules; and

(2) appropriate alternative dispute resolution procedures under

Chapter 2009, Government Code, to assist in the resolution of

internal and external disputes under the physician assistant

board's jurisdiction.

(b) The physician assistant board's procedures relating to

alternative dispute resolution must conform, to the extent

possible, to any model guidelines issued by the State Office of

Administrative Hearings for the use of alternative dispute

resolution by state agencies.

person to:

(1) coordinate the implementation of the policy adopted under

Subsection (a);

(2) serve as a resource for any training needed to implement the

procedures for negotiated rulemaking or alternative dispute

resolution; and

(3) collect data concerning the effectiveness of those

procedures, as implemented by the physician assistant board.

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

269, Sec. 2.15, eff. September 1, 2005.

SUBCHAPTER D. LICENSE REQUIREMENTS, EXEMPTIONS, AND RENEWAL

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

Sec. 204.152. ISSUANCE OF LICENSE. (a) 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.

(b) The physician assistant board may delegate authority to

medical board employees to issue licenses under this chapter to

applicants who clearly meet all licensing requirements. If the

medical board employees determine that the applicant does not

clearly meet all licensing requirements, the application shall be

returned to the physician assistant board. A license issued

under this subsection does not require formal physician assistant

board approval.

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

Amended by:

Acts 2005, 79th Leg., Ch.

269, Sec. 2.16, eff. September 1, 2005.

Sec. 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;

(5) meet any other requirement established by board rule; and

(6) pass a jurisprudence examination approved by the physician

assistant board as provided by Subsection (a-1).

(a-1) The jurisprudence examination shall be conducted on the

licensing requirements and other laws, rules, or regulations

applicable to the physician assistant profession in this state.

The physician assistant board shall establish rules for the

jurisprudence examination under Subsection (a)(6) regarding:

(1) the development of the examination;

(2) applicable fees;

(3) administration of the examination;

(4) reexamination procedures;

(5) grading procedures; and

(6) notice of results.

(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, Sec. 1, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch.

269, Sec. 2.17, eff. September 1, 2005.

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

Sec. 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

(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, Sec. 1, eff. Sept. 1, 1999.

Amended by Acts 2001, 77th Leg., ch. 578, Sec. 1, eff. Sept. 1,

2001.

Sec. 204.156. LICENSE RENEWAL. (a) 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.

(b) The physician assistant board by rule may adopt a system

under which licenses expire on various dates during the year.

renew an unexpired license by paying the required renewal fee to

the physician assistant board before the expiration date of the

license. A person whose license has expired may not engage in

activities that require a license until the license has been

renewed.

(d) A person whose license has been expired for 90 days or less

may renew the license by paying to the physician assistant board

a fee that is equal to 1-1/2 times the renewal fee for the

license.

(e) A person whose license has been expired for more than 90

days but less than one year may renew the license by paying to

the physician assistant board a fee equal to two times the

renewal fee for the license.

(f) A person who was licensed in this state, moved to another

state, and is currently licensed and has been in practice in the

other state for the two years preceding the date of the

application may obtain a new license without reexamination. The

person must pay to the physician assistant board a fee that is

equal to two times the normally required renewal fee for the

license.

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

Amended by:

Acts 2005, 79th Leg., Ch.

269, Sec. 2.18, eff. September 1, 2005.

Sec. 204.1562. CONTINUING MEDICAL EDUCATION REQUIREMENTS. (a)

The physician assistant board by rule shall adopt, monitor, and

enforce a reporting program for the continuing medical education

of license holders. The physician assistant board shall adopt

and administer rules that:

(1) establish the number of hours of continuing medical

education the physician assistant board determines appropriate as

a prerequisite to the renewal of a license under this chapter;

(2) require at least one-half of the hours of continuing medical

education established under Subdivision (1) to be approved by the

physician assistant board; and

(3) adopt a process to assess a license holder's participation

in continuing medical education courses.

(b) The physician assistant board may require that a specified

number of continuing medical education hours be completed

informally, including through self-study and self-directed

education.

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

269, Sec. 2.19, eff. September 1, 2005.

Sec. 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, Sec. 14.053(a), eff.

Sept. 1, 2001.

Sec. 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.

section may return the person's license to active status by:

(1) applying to the physician assistant board;

(2) satisfying the requirements of Section 204.156; and

(3) paying the fee established by the physician assistant board

for returning a license to active status.

(d) The physician assistant board by rule shall establish a

limit on the length of time a physician assistant's license may

remain on inactive status.

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

Amended by:

Acts 2005, 79th Leg., Ch.

269, Sec. 2.20, eff. September 1, 2005.

SUBCHAPTER E. PRACTICE BY LICENSE HOLDER

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

Sec. 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.

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

Amended by Acts 2001, 77th Leg., ch. 112, Sec. 3, eff. May 11,

2001; Acts 2001, 77th Leg., ch. 178, Sec. 1, eff. Sept. 1, 2001;

Acts 2001, 77th Leg., ch. 1420, Sec. 14.054(a), eff. Sept. 1,

2001.

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

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

Sec. 204.2045. SERVICES PERFORMED DURING DISASTER. (a) The

supervision and delegation requirements of this chapter and

Subtitle B do not apply to medical tasks performed by a physician

assistant during a disaster under the state emergency management

plan adopted under Section 418.042, Government Code, or a

disaster declared by the governor or United States government.

This section does not apply to medical tasks performed by a

physician assistant for compensation or other remuneration.

(b) A physician assistant performing medical tasks under this

section is entitled to the immunity from liability provided by

Section 74.151, Civil Practice and Remedies Code.

section:

(1) under the supervision of any physician who is also

performing volunteer work in the disaster; or

(2) without the supervision of a physician, if a physician is

not available to provide supervision.

(d) A physician assistant employed by the United States

government or licensed in another state may perform medical tasks

in this state in circumstances described by Subsection (a)

without holding a license in this state.

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

580, Sec. 1, eff. June 17, 2005.

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

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

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

Sec. 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.

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

Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 14.055, eff.

Sept. 1, 2001.

SUBCHAPTER F. COMPLAINTS AND INVESTIGATIVE INFORMATION

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

Sec. 204.2511. CONDUCT OF INVESTIGATION. The physician

assistant board shall complete a preliminary investigation of a

complaint filed with the physician assistant board not later than

the 30th day after the date of receiving the complaint. The

physician assistant board shall first determine whether the

physician assistant constitutes a continuing threat to the public

welfare. On completion of the preliminary investigation, the

physician assistant board shall determine whether to officially

proceed on the complaint. If the physician assistant board fails

to complete the preliminary investigation in the time required by

this section, the physician assistant board's official

investigation of the complaint is considered to commence on that

date.

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

269, Sec. 2.21, eff. September 1, 2005.

Sec. 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.

privilege or confidentiality under this chapter or other law.

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

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

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

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

SUBCHAPTER G. DISCIPLINARY PROCEEDINGS

Sec. 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 application for a license or license

renewal 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.

license or remove any disciplinary or corrective measure that the

board has imposed.

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

Amended by:

Acts 2005, 79th Leg., Ch.

269, Sec. 2.22, eff. September 1, 2005.

Sec. 204.3011. DELEGATION OF CERTAIN COMPLAINT DISPOSITIONS.

(a) The physician assistant board may delegate to a committee of

medical board employees the authority to dismiss or enter into an

agreed settlement of a complaint that does not relate directly to

patient care or that involves only administrative violations.

The disposition determined by the committee must be approved by

the physician assistant board at a public meeting.

(b) A complaint delegated under this section shall be referred

for informal proceedings under Section 204.312 if:

(1) the committee of employees determines that the complaint

should not be dismissed or settled;

(2) the committee is unable to reach an agreed settlement; or

(3) the affected physician assistant requests that the complaint

be referred for informal proceedings.

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

269, Sec. 2.23, eff. September 1, 2005.

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

Sec. 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.

(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, Sec. 1, eff. Sept. 1, 1999.

Sec. 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.

state action on the part of the association, society, or hospital

medical staff.

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

Sec. 204.3045. PHYSICAL OR MENTAL EXAMINATION. (a) The

physician assistant board shall adopt guidelines, in conjunction

with persons interested in or affected by this section, to enable

the physician assistant board to evaluate circumstances in which

a physician assistant or applicant may be required to submit to

an examination for mental or physical health conditions, alcohol

and substance abuse, or professional behavior problems.

(b) The physician assistant board shall refer a physician

assistant or applicant with a physical or mental health condition

to the most appropriate medical specialist for evaluation. The

physician assistant board may not require a physician assistant

or applicant to submit to an examination by a physician having a

specialty specified by the physician assistant board unless

medically indicated. The physician assistant board may not

require a physician assistant or applicant to submit to an

examination to be conducted an unreasonable distance from the

person's home or place of business unless the physician assistant

or applicant resides and works in an area in which there are a

limited number of physicians able to perform an appropriate

examination.

remove the physician assistant board's power to make an

independent licensing decision.

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

269, Sec. 2.24, eff. September 1, 2005.

Sec. 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

(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, Sec. 1, eff. Sept. 1, 1999.

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

Sec. 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, Sec. 2, eff. Sept. 1,

2001.

Sec. 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.

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, Sec. 2, eff. Sept. 1,

2001.

Sec. 204.312. INFORMAL PROCEEDINGS. (a) The physician

assistant board by rule shall adopt procedures governing:

(1) informal disposition of a contested case under Section

2001.056, Government Code; and

(2) informal proceedings held in compliance with Section

2001.054, Government Code.

(b) Rules adopted under this section must require that:

(1) an informal meeting in compliance with Section 2001.054,

Government Code, be scheduled not later than the 180th day after

the date the complaint is filed with the physician assistant

board, unless good cause is shown by the physician assistant

board for scheduling the informal meeting after that date;

(2) the physician assistant board give notice to the license

holder of the time and place of the meeting not later than the

30th day before the date the meeting is held;

(3) the complainant and the license holder be provided an

opportunity to be heard;

(4) at least one of the physician assistant board members

participating in the informal meeting as a panelist be a member

who represents the public;

(5) the physician assistant board's legal counsel or a

representative of the attorney general be present to advise the

physician assistant board or the medical board's staff; and

(6) a member of the medical board's staff be at the meeting to

present to the physician assistant board's representative the

facts the staff reasonably believes it could prove by competent

evidence or qualified witnesses at a hearing.

(1) reply to the staff's presentation; and

(2) present the facts the physician assistant reasonably

believes the physician assistant could prove by competent

evidence or qualified witnesses at a hearing.

(d) After ample time is given for the presentations, the

physician assistant board representative shall recommend that the

investigation be closed or shall attempt to mediate the disputed

matters and make a recommendation regarding the disposition of

the case in the absence of a hearing under applicable law

concerning contested cases.

(e) If the license holder has previously been the subject of

disciplinary action by the physician assistant board, the

physician assistant board shall schedule the informal meeting as

soon as practicable but not later than the deadline prescribed by

Subsection (b)(1).

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

269, Sec. 2.27, eff. September 1, 2005.

Sec. 204.313. PHYSICIAN ASSISTANT BOARD REPRESENTATION IN

INFORMAL PROCEEDINGS. (a) In an informal meeting under Section

204.312, at least two panelists shall be appointed to determine

whether an informal disposition is appropriate.

(b) Notwithstanding Subsection (a) and Section 204.312(b)(4), an

informal proceeding may be conducted by one panelist if the

affected physician assistant waives the requirement that at least

two panelists conduct the informal proceeding. If the physician

assistant waives that requirement, the panelist may be any member

of the physician assistant board.

apply to an informal proceeding conducted by the physician

assistant board under Section 204.312, including a proceeding to:

(1) consider a disciplinary case to determine if a violation has

occurred; or

(2) request modification or termination of an order.

(d) The panel requirements described by Subsections (a) and (b)

do not apply to an informal proceeding conducted by the physician

assistant board under Section 204.312 to show compliance with an

order of the physician assistant board.

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

269, Sec. 2.28, eff. September 1, 2005.

Sec. 204.314. ROLES AND RESPONSIBILITIES OF PARTICIPANTS IN

INFORMAL PROCEEDINGS. (a) A physician assistant board member

that serves as a panelist at an informal meeting under Section

204.312 shall make recommendations for the disposition of a

complaint or allegation. The member may request the assistance

of a medical board employee at any time.

(b) Medical board employees shall present a summary of the

allegations against the affected physician assistant and of the

facts pertaining to the allegation that the employees reasonably

believe may be proven by competent evidence at a formal hearing.

act as counsel to the panel and, notwithstanding Subsection (e),

shall be present during the informal meeting and the panel's

deliberations to advise the panel on legal issues that arise

during the proceeding. The attorney may ask questions of

participants in the informal meeting to clarify any statement

made by the participant. The attorney shall provide to the panel

a historical perspective on comparable cases that have appeared

before the physician assistant board or medical board, keep the

proceedings focused on the case being discussed, and ensure that

the medical board's employees and the affected physician

assistant have an opportunity to present information related to

the case. During the panel's deliberations, the attorney may be

present only to advise the panel on legal issues and to provide

information on comparable cases that have appeared before the

physician assistant board or medical board.

(d) The panel and medical board employees shall provide an

opportunity for the affected physician assistant and the

physician assistant's authorized representative to reply to the

medical board employees' presentation and to present oral and

written statements and facts that the physician assistant and

representative reasonably believe could be proven by competent

evidence at a formal hearing.

(e) An employee of the medical board who participated in the

presentation of the allegation or information gathered in the

investigation of the complaint, the affected physician assistant,

the physician assistant's authorized representative, the

complainant, the witnesses, and members of the public may not be

present during the deliberations of the panel. Only the members

of the panel and the attorney serving as counsel to the panel may

be present during the deliberations.

(f) The panel shall recommend the dismissal of the complaint or

allegations or, if the panel determines that the affected

physician assistant has violated a statute or physician assistant

board rule, the panel may recommend physician assistant board

action and terms for an informal settlement of the case.

(g) The panel's recommendations under Subsection (f) must be

made in a written order and presented to the affected physician

assistant and the physician assistant's authorized

representative. The physician assistant may

State Codes and Statutes

State Codes and Statutes

State Codes and Statutes

State Codes and Statutes

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