CHAPTER 206. SURGICAL ASSISTANTS

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OCCUPATIONS CODE

TITLE 3. HEALTH PROFESSIONS

SUBTITLE C. OTHER PROFESSIONS PERFORMING MEDICAL PROCEDURES

CHAPTER 206. SURGICAL ASSISTANTS

SUBCHAPTER A. GENERAL PROVISIONS

Sec. 206.001. DEFINITIONS. In this chapter:

(1) "Advisory committee" means the advisory committee created

under this chapter.

(2) "Delegating physician" means a physician who is licensed by

the medical board either as a doctor of medicine or doctor of

osteopathic medicine and who delegates, to a licensed surgical

assistant, surgical assisting and oversees and accepts

responsibility for that surgical assisting.

(3) "Direct supervision" means supervision by a delegating

physician who is physically present and who personally directs

delegated acts and remains immediately available to personally

respond to any emergency until the patient is released from the

operating room or care and has been transferred, as determined by

medical board rule, to another physician.

(4) "Executive director" means the executive director of the

medical board.

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

(6) "Surgical assisting" means providing aid under direct

supervision in exposure, hemostasis, and other intraoperative

technical functions that assist a physician in performing a safe

operation with optimal results for the patient, including the

delegated authority to provide local infiltration or the topical

application of a local anesthetic at the operation site. This

term is synonymous with "first assisting."

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Amended by:

Acts 2005, 79th Leg., Ch.

269, Sec. 4.01, eff. September 1, 2005.

Sec. 206.002. APPLICABILITY. (a) A person is not required to

hold a license under this chapter if the person is:

(1) a student enrolled in a surgical assistant education program

approved by the medical board who is assisting in a surgical

operation that is an integral part of the program of study;

(2) a surgical assistant employed in the service of the federal

government while performing duties related to that employment;

(3) a person acting under the delegated authority of a licensed

physician;

(4) a licensed health care worker acting within the scope of the

person's license;

(5) a registered nurse; or

(6) a licensed physician assistant.

(b) This chapter does not affect the authority of a licensed

physician to delegate acts under Subtitle B.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

SUBCHAPTER B. ADVISORY COMMITTEE

Sec. 206.051. ADVISORY COMMITTEE. (a) The advisory committee

is an informal advisory committee to the medical board and is not

subject to Chapter 2110, Government Code.

(b) The advisory committee has no independent rulemaking

authority.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.052. APPOINTMENT OF ADVISORY COMMITTEE. (a) The

advisory committee consists of six members appointed by the

president of the medical board. One member must be a registered

perioperative nurse with at least five years of clinical

experience as a registered perioperative nurse. Each of the

remaining members must be:

(1) a practicing surgical assistant who has at least five years

of clinical experience as a surgical assistant; or

(2) a physician licensed in this state who supervises a surgical

assistant.

(b) Appointments to the advisory committee shall be made without

regard to the race, color, disability, sex, religion, age, or

national origin of the appointees.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.053. MEMBERSHIP AND EMPLOYEE RESTRICTIONS. (a) In

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

voluntarily joined 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

professional problems and in promoting their common interest.

(b) A person may not be a member of the advisory committee if:

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

Texas trade association in the field of surgical assisting; or

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

consultant of a Texas trade association in the field of surgical

assisting.

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 field of

surgical assisting.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.054. TERMS; VACANCY. (a) Members of the advisory

committee are appointed for two-year terms. The terms of the

members expire on February 1 of each odd-numbered year.

(b) If a vacancy occurs during a member's term, the president of

the medical board shall appoint a new member to fill the

unexpired term.

consecutive full terms.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.055. GROUNDS FOR REMOVAL. (a) It is a ground for

removal from the advisory committee that a member:

(1) does not have at the time of appointment the qualifications

required by Section 206.052;

(2) does not maintain during service on the advisory committee

the qualifications required by Section 206.052;

(3) is ineligible for membership under Section 206.053; or

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

member's duties for a substantial part of the member's term.

(b) The validity of an action of the committee is not affected

by the fact that it is taken when a ground for removal of a

committee member exists.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.056. OFFICERS. The president of the medical board

shall designate biennially a committee member as the presiding

officer of the advisory committee to serve in that capacity at

the will of the president.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.057. PER DIEM. An advisory committee member is not

entitled to reimbursement for travel expenses or compensation.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.058. MEETINGS. (a) The advisory committee shall meet

as requested by the medical board.

(b) A meeting may be held by telephone conference call.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

SUBCHAPTER C. POWERS AND DUTIES OF MEDICAL BOARD

Sec. 206.101. GENERAL POWERS AND DUTIES. The medical board

shall:

(1) establish qualifications for a surgical assistant to

practice in this state;

(2) establish requirements for an examination for a license to

practice as a surgical assistant;

(3) establish minimum education and training requirements

necessary for a license to practice as a surgical assistant;

(4) prescribe the application form for a license to practice as

a surgical assistant; and

(5) develop an approved program of mandatory continuing

education and the manner in which attendance at all approved

courses, clinics, forums, lectures, programs, or seminars is

monitored and recorded.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.102. ANNUAL REPORT. (a) The medical board shall

prepare annually a complete and detailed written report

accounting for all funds received and disbursed by the medical

board under this chapter during the preceding fiscal year.

(b) The annual report must meet the reporting requirements

applicable to financial reporting provided in the General

Appropriations Act.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.103. GIFTS, GRANTS, AND DONATIONS. In addition to any

fees paid to the medical board or money appropriated to the

medical board, the medical board may receive and accept under

this chapter a gift, grant, donation, or other item of value from

any source, including the United States or a private source.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

SUBCHAPTER D. PUBLIC INTEREST INFORMATION; COMPLAINT AND

INVESTIGATIVE INFORMATION

Sec. 206.151. PUBLIC PARTICIPATION. (a) The medical board

shall develop and implement policies that provide the public with

a reasonable opportunity to appear before the medical board and

speak on any issue relating to surgical assistants.

(b) The executive director of the medical 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

medical board's programs and services under this chapter.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.152. PUBLIC INTEREST INFORMATION. (a) The medical

board shall prepare information of public interest describing the

functions of the medical board and the procedures by which

complaints are filed and resolved under this chapter.

(b) The medical board shall make the information available to

the public and appropriate state agencies.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.153. COMPLAINTS. (a) The medical board by rule shall

establish methods by which consumers and service recipients are

notified of the name, mailing address, and telephone number of

the medical board for the purpose of directing complaints about

licensed surgical assistants to the medical board.

(b) The medical 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

licensed surgical assistant.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.154. RECORDS OF COMPLAINTS. (a) The medical board

shall maintain a file on each written complaint filed with the

medical board under this chapter. The file must include:

(1) the name of the person who filed the complaint;

(2) the date the complaint is received by the medical board;

(3) the subject matter of the complaint;

(4) the name of each person contacted in relation to the

complaint;

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

the complaint; and

(6) an explanation of the reason the file was closed, if the

medical board closed the file without taking action other than to

investigate the complaint.

(b) The medical board shall provide to the person filing the

complaint and to each person who is a subject of the complaint a

copy of the medical board's policies and procedures relating to

complaint investigation and resolution. A person who reports a

complaint by phone shall be given information on how to file a

written complaint.

disposition of the complaint, shall notify the person filing the

complaint and each person who is a subject of the complaint of

the status of the investigation unless the notice would

jeopardize an undercover investigation.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.155. LICENSE HOLDER ACCESS TO COMPLAINT INFORMATION.

(a) The medical 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 medical

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 medical 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 medical board is not

required to provide:

(1) medical 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.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.156. HEALTH CARE ENTITY REQUEST FOR INFORMATION. On

the written request of a health care entity, the medical 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 medical board; or

(B) an agreed settlement; and

(2) the basis of and current status of any complaint under

active investigation that has been referred by the executive

director or the director's designee for legal action.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.157. CONFIDENTIALITY OF INVESTIGATIVE INFORMATION. A

complaint, adverse report, investigation file, or other report,

the identity of and reports made by a physician or surgical

assistant performing or supervising compliance monitoring for the

medical board, or other investigative information in the

possession of or received or gathered by the medical board,

medical 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 medical board or medical board employee or

agent involved in license holder discipline.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.1575. CONDUCT OF INVESTIGATION. The medical board

shall complete a preliminary investigation of a complaint not

later than the 30th day after the date of receiving the

complaint. The medical board shall first determine whether the

surgical assistant constitutes a continuing threat to the public

welfare. On completion of the preliminary investigation, the

medical board shall determine whether to officially proceed on

the complaint. If the medical board fails to complete the

preliminary investigation in the time required by this section,

the medical board's official investigation is considered to

commence on that date.

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

269, Sec. 4.02, eff. September 1, 2005.

Sec. 206.158. PERMITTED DISCLOSURE OF INVESTIGATIVE INFORMATION.

(a) Investigative information in the possession of the medical

board, medical 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 a territory 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 the investigative information in the possession of the

medical board or a medical board employee or agent indicates a

crime may have been committed, the medical board shall report the

information to the proper law enforcement agency. The medical

board shall cooperate with and assist all law enforcement

agencies conducting criminal investigations of a license holder

by providing information relevant to the investigation.

Confidential information disclosed by the medical board to a law

enforcement agency remains confidential and may not be disclosed

by the law enforcement agency except as necessary to further the

investigation.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.159. IMMUNITY AND REPORTING REQUIREMENTS. (a) A

medical peer review committee in this state, a quality assurance

committee in this state, a surgical assistant, a surgical

assistant student, a physician practicing medicine in this state,

or any person usually present in an operating room, including a

nurse or surgical technologist, shall report relevant information

to the advisory committee related to the acts of a surgical

assistant in this state if, in that person's opinion, a surgical

assistant poses a continuing threat to the public welfare through

the person's practice as a surgical assistant. The duty to report

under this section may not be nullified through contract.

(b) A person who, without malice, furnishes records,

information, or assistance to the advisory committee under this

section is immune from any civil liability arising from that

action in a suit against the person brought by or on behalf of a

surgical assistant who is reported under this section.

160.013, and 160.014 apply to medical peer review regarding a

licensed surgical assistant.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

SUBCHAPTER E. LICENSE REQUIREMENTS

Sec. 206.201. LICENSE REQUIRED. (a) Except as provided by

Section 206.002, a person may not practice as a surgical

assistant unless the person is licensed under this chapter.

(b) Unless the person holds a license under this chapter, a

person may not use, in connection with the person's name:

(1) the title "Licensed Surgical Assistant"; or

(2) any other designation that would imply that the person is a

licensed surgical assistant.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.202. LICENSE APPLICATION. An applicant for a license

must:

(1) file a written application with the medical board on a form

prescribed by the medical board; and

(2) pay the application fee set by the medical board.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.203. LICENSE ELIGIBILITY. (a) Except as provided by

Section 206.206, to be eligible for a license, a person must:

(1) be of good moral character;

(2) have not been convicted of a felony or a crime involving

moral turpitude;

(3) not use drugs or alcohol to an extent that affects the

applicant's professional competency;

(4) not have had a license or certification revoked by a

licensing agency or by a certifying professional organization;

and

(5) not have engaged in fraud or deceit in applying for a

license under this chapter.

(b) In addition to meeting the requirements of Subsection (a), a

person must:

(1) pass the examination required by Section 206.204;

(2) hold at least an associate's degree based on completion of

an educational program that is substantially equivalent to the

education required for a registered nurse or physician assistant

who specializes in surgical assisting;

(3) demonstrate to the satisfaction of the medical board the

completion of full-time work experience performed in this country

under the direct supervision of a physician licensed in this

country and consisting of at least 2,000 hours of performance as

an assistant in surgical procedures for the three years preceding

the date of application; and

(4) possess a current certification by a national certifying

body approved by the medical board.

a clinical component and must include courses in anatomy,

physiology, basic pharmacology, aseptic techniques, operative

procedures, chemistry, microbiology, and pathophysiology.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.204. EXAMINATION. An applicant for a surgical

assistant license must pass a surgical assistant examination

approved by the medical board. Any written portion of the

examination must be validated by an independent testing

professional.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.205. SPECIAL ELIGIBILITY FOR LICENSE. (a) A person

who is otherwise eligible for a license under Section 206.203 is

not required to take the examination required by Section

206.203(b)(1) if the person:

(1) passed a surgical assistant examination required for

certification under Section 206.203(b)(4) that the medical board

determines is substantially equivalent to the examination

required by the medical board under this chapter; and

(2) applies for a license under this section before September 1,

2002.

(b) A person who is otherwise eligible for a license under

Section 206.203 is not required to meet the educational

requirements under Section 206.203(b)(2) if the person applies

for a license under this section before September 1, 2002, and:

(1) will complete before the third anniversary of the date the

license is issued under this subsection the following academic

courses approved by the medical board:

(A) anatomy;

(B) physiology;

(D) aseptic techniques;

(E) operative procedures;

(F) chemistry; and

(G) microbiology; or

(2) has been continuously certified since September 30, 1995, as

a surgical assistant by a national certifying body approved by

the medical board and has practiced full-time as a surgical

assistant under the direct supervision of a physician licensed in

this country.

after the third anniversary of the date of issuance unless the

license holder completes the academic courses described by

Subsection (b)(1).

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.206. TEMPORARY LICENSE. (a) The medical board may,

through the executive director, issue a temporary license to an

applicant who:

(1) submits an application on a form prescribed by the medical

board;

(2) has passed an examination required by the medical board

relating to the practice of surgical assisting;

(3) pays the appropriate fee set by the medical board;

(4) if licensed in another state, is licensed in good standing;

and

(5) meets all the qualifications for a license under this

chapter and is waiting for the next scheduled meeting of the

medical board for the license to be issued.

(b) A temporary license is valid until the 100th day after the

date issued and may be extended until the 130th day after the

date issued.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.207. ASSISTANCE BY MEDICAL BOARD. The medical board

shall provide administrative and clerical employees as necessary

to administer this subchapter.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.208. FEES. (a) The medical board shall set and

collect fees in amounts that are reasonable and necessary to

cover the costs of administering and enforcing this chapter

without the use of any other funds generated by the medical

board.

(b) Fees collected by the medical board under this chapter shall

be deposited by the medical board in the state treasury to the

credit of an account in the general revenue fund and may be spent

to cover the costs of administering and enforcing this chapter.

At the end of each fiscal biennium, the comptroller shall

transfer any surplus money remaining in the account to the

general revenue fund.

subject to Subchapter F, Chapter 404, Government Code.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.209. ISSUANCE AND RENEWAL OF LICENSE. (a) The medical

board shall issue a surgical assistant license in this state to a

person who meets the requirements of this chapter and the rules

adopted under this chapter.

(b) The medical board may delegate authority to 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 medical

board. A license issued under this subsection does not require

formal medical board approval.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Amended by:

Acts 2005, 79th Leg., Ch.

269, Sec. 4.03, eff. September 1, 2005.

Sec. 206.210. LICENSE RENEWAL. (a) A surgical assistant

license expires on the second anniversary of the date of

issuance. The medical board by rule shall provide for the renewal

of a surgical assistant license.

(b) The medical board by rule may adopt a system under which

licenses expire on various dates during the year. For the year in

which the license expiration date is changed, license fees shall

be prorated on a monthly basis so that each license holder pays

only that portion of the license fee that is allocable to the

number of months during which the license is valid. On renewal of

the license on the new expiration date, the total license renewal

fee is payable.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001. Amended by Acts 2003, 78th Leg., ch. 886, Sec. 1, eff.

Sept. 1, 2003.

Sec. 206.211. NOTICE OF LICENSE RENEWAL. At least 30 days

before the expiration of a person's license, the medical board

shall send written notice of the impending license expiration to

the person at the license holder's last known address according

to the records of the medical board.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.212. PROCEDURE FOR RENEWAL. (a) A person who is

otherwise eligible to renew a license may renew an unexpired

license by paying the required renewal fee to the medical 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 under this section.

(b) If the person's license has been expired for 90 days or

less, the person may renew the license by paying to the medical

board one and one-half times the required renewal fee.

days but less than one year, the person may renew the license by

paying to the medical board two times the required renewal fee.

(d) If the person's license has been expired for one year or

longer, the person may not renew the license. The person may

obtain a new license by complying with the requirements and

procedures for obtaining an original license.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.213. RENEWAL OF EXPIRED LICENSE BY OUT-OF-STATE

PRACTITIONER. (a) If the person was licensed as a surgical

assistant in this state, moved to another state, and is currently

licensed as a surgical assistant and has been in practice as a

surgical assistant in the other state for the two years preceding

application, the person may renew an expired surgical assistant

license without reexamination.

(b) The person must pay to the medical board a fee that is equal

to two times the required renewal fee for the license.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.214. LICENSE HOLDER INFORMATION. (a) Each license

holder shall file with the medical board:

(1) the license holder's mailing address;

(2) the address of the license holder's residence;

(3) the mailing address of each of the license holder's offices;

and

(4) the address for the location of each of the license holder's

offices if that address is different from the office's mailing

address.

(b) A license holder shall:

(1) notify the medical board of a change of the license holder's

residence or business address; and

(2) provide the medical board with the license holder's new

address not later than the 30th day after the date the address

change occurs.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

SUBCHAPTER F. SCOPE OF PRACTICE

Sec. 206.251. SCOPE OF PRACTICE. (a) The practice of a

surgical assistant is limited to surgical assisting performed

under the direct supervision of a physician who delegated the

acts.

(b) The practice of a surgical assistant may be performed in any

place authorized by a delegating licensed physician, including a

clinic, hospital, ambulatory surgical center, or other

institutional setting.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.252. SERVICE CONTRACTS. This chapter does not:

(1) limit the employment arrangement of a surgical assistant

licensed under this chapter;

(2) require a surgeon or hospital to contract with a surgical

assistant;

(3) authorize a health maintenance organization, preferred

provider organization, or health benefit plan to require a

surgeon to contract with a surgical assistant; or

(4) require a hospital to use a licensed surgical assistant for

surgical assisting.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.2525. REIMBURSEMENT FOR SERVICES. (a) This chapter

does not limit the way in which a surgical assistant licensed

under this chapter may be reimbursed for services.

(b) A surgical assistant licensed under this chapter may

directly bill a patient or third-party payor for services

provided by the surgical assistant.

Added by Acts 2003, 78th Leg., ch. 886, Sec. 2, eff. Sept. 1,

2003.

Sec. 206.253. CERTAIN PROHIBITED PRACTICES. (a) This chapter

does not authorize a person who holds a license issued under this

chapter to engage in the practice of:

(1) medicine, as defined by Subtitle B; or

(2) nursing, as defined by Chapter 301.

(b) A health maintenance organization, preferred provider

organization, or health benefit plan may not require a registered

nurse or physician assistant to be licensed as a surgical

assistant as a condition for reimbursement.

facility may not require a registered nurse or physician

assistant to be licensed as a surgical assistant as a condition

for assisting at surgery at the facility.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001. Amended by Acts 2003, 78th Leg., ch. 553, Sec. 2.016, eff.

Feb. 1, 2004.

Sec. 206.254. ESTABLISHMENT OF CERTAIN FUNCTIONS AND STANDARDS.

A surgical assistant and the surgical assistant's delegating

physician shall ensure that:

(1) the surgical assistant's scope of function is identified;

(2) the delegation of medical tasks is appropriate to the

surgical assistant's level of competence;

(3) the relationship between the surgical assistant and the

delegating physician and the access of the surgical assistant to

the delegating physician are defined; and

(4) a process is established for evaluating the surgical

assistant's performance.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

SUBCHAPTER G. DISCIPLINARY PROCEEDINGS

Sec. 206.301. DISCIPLINARY ACTIONS BY THE MEDICAL BOARD. (a)

Except as provided by Section 206.305, on a determination that an

applicant or license holder committed an act described by Section

206.302, 206.303, or 206.304, the medical board by order shall

take any of the following actions:

(1) deny the person's license application or revoke the person's

license;

(2) require the person to submit to the care, counseling, or

treatment of a health care practitioner designated by the medical

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 person's practice, one or more specified activities of

surgical assisting; or

(B) stipulating periodic medical board review;

(6) assess an administrative penalty against the person as

provided by Section 206.351;

(7) order the person to perform public service; or

(8) administer a public reprimand.

(b) If the medical board stays enforcement of an order and

places a person on probation, the medical 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.

any disciplinary or corrective measure that the medical board has

imposed.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.302. CONDUCT RELATED TO FRAUD OR MISREPRESENTATION.

The medical board may take action under Section 206.301 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 any surgical assistant license,

certificate, or diploma;

(6) uses any surgical 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 the practice as a

surgical assistant by any person not licensed by the medical

board to practice as a surgical assistant; or

(8) unlawfully advertises in a false, misleading, or deceptive

manner as defined by Section 101.201.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.303. CONDUCT RELATED TO VIOLATION OF LAW. (a) The

medical board may take action under Section 206.301 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; or

(3) violates state law if the violation is connected with

practice as a surgical assistant.

(b) A complaint, indictment, or conviction of a law violation is

not necessary for the medical board to act under Subsection

(a)(3). Proof of the commission of the act while in practice as a

surgical assistant or under the guise of practice as a surgical

assistant is sufficient for action by the medical board.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.304. CONDUCT INDICATING LACK OF FITNESS. (a) The

medical board may take action under Section 206.301 against an

applicant or license holder who:

(1) habitually uses drugs or intoxicating liquors to the extent

that, in the medical board's opinion, the person cannot safely

perform as a surgical 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 surgical assistant;

(4) has committed an act of moral turpitude;

(5) has failed to practice as a surgical assistant in an

acceptable manner consistent with public health and welfare;

(6) has had the person's license or other authorization to

practice as a surgical 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 surgical assistant;

(8) is removed or suspended or has 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 that action, in the

opinion of the medical board, was based on unprofessional conduct

or professional incompetence that was likely to harm the public;

(9) has repeated or recurring meritorious health care liability

claims that, in the medical board's opinion, are evidence of

professional incompetence likely to harm the public; or

(10) sexually abuses or exploits another person during the

license holder's practice as a surgical assistant.

(b) For the purpose of Subsection (a)(7), a certified copy of

the record of the state or uniformed services of the United

States taking the action constitutes conclusive evidence of that

action.

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

medical staff.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.305. REHABILITATION ORDER. (a) The medical board,

through an agreed order or after a contested case proceeding, may

impose a rehabilitation order on an applicant, as a prerequisite

for issuing a license, or on a license holder based on:

(1) the person's intemperate use of drugs or alcohol directly

resulting from habituation or addiction caused by medical care or

treatment provided by a physician;

(2) the person's intemperate use of drugs or alcohol during the

five years preceding the date of the report that could adversely

affect the person's ability to safely practice as a surgical

assistant, if the person:

(A) reported the use;

(B) has not previously been the subject of a substance abuse

related order of the medical board; and

result of the intemperate use of drugs or alcohol;

(3) a judgment by a court that the person is of unsound mind; or

(4) the results of a mental or physical examination, or an

admission by the person, indicating that the person suffers from

a potentially dangerous limitation or an inability to practice as

a surgical assistant with reasonable skill and safety because of

illness or any other physical or mental condition.

(b) The medical board may not issue an order under this section

if, before the individual signs the proposed order, the board

receives a valid complaint with regard to the individual based on

the individual's intemperate use of drugs or alcohol in a manner

affecting the standard of care.

committed a standard of care violation described by Subsection

(a)(2) before imposing an order under this section.

(d) The medical board may disclose a rehabilitation order to a

local or statewide private medical or surgical assistant

association only as provided by Section 206.3075.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Amended by:

Acts 2005, 79th Leg., Ch.

269, Sec. 4.04, eff. September 1, 2005.

Sec. 206.306. EFFECT OF REHABILITATION ORDER. (a) A

rehabilitation order imposed under Section 206.305 is a

nondisciplinary private order. If entered into by agreement, the

order is an agreed disposition or settlement agreement for

purposes of civil litigation and is exempt from Chapter 552,

Government Code.

(b) The rehabilitation order must contain findings of fact and

conclusions of law. The order may impose a license revocation or

suspension, a period of probation or restriction, or any other

sanction authorized by this chapter or agreed to by the medical

board and the person subject to the order.

disciplinary action under this chapter or under the terms of the

agreed order.

(d) A violation of a rehabilitation order is grounds for

disciplinary action based on:

(1) unprofessional or dishonorable conduct; or

(2) any provision of this chapter that applies to the conduct

that resulted in the violation.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.307. AUDIT OF REHABILITATION ORDER. (a) The medical

board shall maintain a rehabilitation order imposed under Section

206.305 in a confidential file. The file is subject to an

independent audit by the state auditor or a private auditor with

whom the board contracts to perform the audit to ensure that only

qualified license holders are subject to rehabilitation orders.

(b) An audit may be performed at any time at the direction of

the medical board. The medical board shall ensure that an audit

is performed at least once in each three-year period.

reported in a manner that maintains the confidentiality of each

license holder who is the subject of a rehabilitation order.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.3075. RESPONSIBILITIES OF PRIVATE ASSOCIATIONS. (a)

If a rehabilitation order imposed under Section 206.305 requires

a license holder to participate in activities or programs

provided by a local or statewide private medical or surgical

assistant association, the medical board shall inform the

association of the license holder's duties under the order. The

information provided under this section must include specific

guidance to enable the association to comply with any

requirements necessary to assist in the surgical assistant's

rehabilitation.

(b) The medical board may provide to the association any

information that the board determines to be necessary, including

a copy of the rehabilitation order. Any information received by

the association remains confidential, is not subject to

discovery, subpoena, or other means of legal compulsion, and may

be disclosed only to the medical board.

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

269, Sec. 4.05, eff. September 1, 2005.

Sec. 206.308. SUBPOENA. (a) The executive director, the

director's designee, or the secretary-treasurer of the board may

issue a subpoena or subpoena duces tecum:

(1) to conduct an investigation or a contested case proceeding

related to:

(A) alleged misconduct by a surgical assistant;

(B) an alleged violation of this chapter or another law related

to the practice of a surgical assistant; or

(2) for purposes of determining whether to issue, suspend,

restrict, or revoke a license under this chapter; or

(3) for purposes of determining whether to issue or deny 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 medical board or another

licensing or regulatory agency with jurisdiction over the person

subject to the subpoena; and

(2) denial of a license application.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.309. PROTECTION OF PATIENT IDENTITY. In a disciplinary

investigation or proceeding conducted under this chapter, the

medical 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.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.310. RULES FOR DISCIPLINARY PROCEEDINGS. Rules of

practice adopted under this chapter by the medical board under

Section 2001.004, Government Code, applicable to the proceedings

for a disciplinary action may not conflict with rules adopted by

the State Office of Administrative Hearings.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.311. REQUIRED SUSPENSION OF INCARCERATED SURGICAL

ASSISTANT. Regardless of the offense, the medical board shall

suspend the license of a surgical assistant serving a prison term

in a state or federal penitentiary during the term of the

incarceration.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.312. TEMPORARY SUSPENSION. (a) The president of the

medical board, with medical board approval, shall appoint a

three-member disciplinary panel consisting of medical board

members to determine whether a surgical assistant's license

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 surgical 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 medical

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 the

disciplinary panel at one location is inconvenient for any member

of the panel.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

Sec. 206.313. INFORMAL PROCEEDINGS. (a) The medical board by

rule shall adopt procedures under this chapter 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 medical board's official investigation of the

complaint is commenced, unless good cause is shown by the board

for scheduling the informal meeting after that date;

(2) the medical 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 medical board members or district review

committee members participating in the informal meeting as a

panelist be a member who represents the public;

(5) the medical board's legal counsel or a representative of the

attorney general be present to advise the medical board or the

board's staff; and

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

present to the panel the facts the staff reasonably believes it

could prove by competent evidence or qualified witnesses at a

hearing.

writing, to:

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

(2) present the facts the surgical assistant reasonably believes

the surgical assistant could prove by competent evidence or

qualified witnesses at a hearing.

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

board panel 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 medical board, the 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. 4.06, eff. September 1, 2005.

Sec. 206.314. ROLES AND RESPONSIBILITIES OF PARTICIPANTS IN

INFORMAL PROCEEDINGS. (a) A medical board or district review

committee member that serves as a panelist at an informal meeting

under Section 206.313 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 surgical assistant and of the

facts pertaining to the allegation that the employees reasonably

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

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 medical board,

keep the proceedings focused on the case being discussed, and

ensure that the medical board's employees and the affected

surgical 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 medical board.

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

opportunity for the affected surgical assistant and the surgical

assistant's authorized representative to reply to the board

employees' presentation and to present oral and written

statements and facts that the surgical 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 surgical assistant,

the surgical 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 medical board 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

surgical assistant has violated a statute or medical board rule,

the panel may recommend 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 surgical

assistant and the surgical assistant's authorized representative.

The surgical assistant may accept the proposed settlement within

the time established by the panel at the informal meeting. If

the surgical assistant rejects the proposed settlement or does

not act within the required time, the medical board may proceed

with the filing of a formal complaint with the State Office of

Administrative Hearings.

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

269, Sec. 4.06, eff. September 1, 2005.

Sec. 206.315. MEDICAL BOARD REPRESENTATION IN INFORMAL

PROCEEDINGS. (a) In an informal proceeding under Section

206.313, at least two panelists shall be appointed to determine

whether an informal disposition is appropriate.

(b) The medical board may request members of a committee under

Chapter 163 to participate in an informal meeting under Section

206.313.

informal proceeding may be conducted by one panelist if the

affected surgical assistant waives the requirement that at least

two panelists conduct the informal proceeding. If the surgical

assistant waives that requirement, the panelist may be either a

physician or a member who represents the public.

(d) The panel requirements described by Subsection (a) do not

apply to an informal proceeding conducted by the medical board

under Section 206.313 to show compliance with an order of the

board.

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

269, Sec. 4.06, eff. September 1, 2005.

SUBCHAPTER H. ADMINISTRATIVE PENALTY

Sec. 206.351. ADMINISTRATIVE PENALTY. (a) The medical board by

order may impose an administrative penalty against a person

licensed under this chapter who violates this chapter or a rule

or order adopted under this chapter.

(b) The penalty may be in an amount not to exceed $5,000. Each

day a violation continues or occurs is a separate violation for

purposes of imposing a penalty.

(1) the severity of patient harm;

(2) the severity of economic harm to any person;

(3) the severity of any environmental harm;

(4) the increased potential for harm to the public;

(5) any attempted concealment of misconduct;

(6) any premeditated or intentional misconduct;

(7) the motive for the violation;

(8) any prior misconduct of a similar or related nature;

(9) the license holder's disciplinary history;

(10) any prior written warnings or written admonishments from

any government agency or official regarding statutes or rules

relating to the misconduct;

(11) whether the violation is of a board order;

(12) the person's failure to implement remedial measures to

correct or mitigate harm from the misconduct;

(13) the person's lack of rehabilitative potential or likelihood

of future misconduct of a similar nature;

(14) any relevant circumstances increasing the seriousness of

the misconduct; and

(15) any other matter that justice may require.

(d) The medical board by rule shall prescribe the procedures by

which it may impose an administrative penalty. A proceeding under

this section is subject to Chapter 2001, Government Code.

(e) If the medical board by order determines that a violation

has occurred and imposes an administrative penalty, the medical

board shall give notice to the person of the order. The notice

must include a statement of the person's right to judicial review

of the order.

Added by Acts 2001, 77th Leg., ch. 1014, Sec. 1, eff. Sept. 1,

2001.

State Codes and Statutes

State Codes and Statutes

State Codes and Statutes

State Codes and Statutes

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