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89(R) HB 2038 - Enrolled version - Bill Text
H.B. No. 2038
AN ACT
relating to the issuance by the Texas Medical Board of certain
licenses to practice medicine and the authority of an insured to
select certain license holders under the insured's health policy;
requiring an occupational license; authorizing fees.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
ARTICLE 1. SHORT TITLE
SECTION 1.001. This Act shall be known as the Decreasing
Occupational Certification Timelines, Obstacles, and Regulations
(DOCTOR) Act.
ARTICLE 2. FOREIGN LICENSE HOLDERS
SECTION 2.001. Subchapter C, Chapter 155, Occupations Code,
is amended by adding Section 155.1015 to read as follows:
Sec.
155.1015.
ISSUANCE OF PROVISIONAL LICENSE TO CERTAIN
FOREIGN MEDICAL LICENSE HOLDERS WITH OFFERS OF EMPLOYMENT.
(a)
Subject to Subsection (b), on application, the board shall issue an
initial provisional license to practice medicine to an applicant
who:
(1)
has been granted a degree of doctor of medicine or
a substantially similar degree by a program of medical education
that meets eligibility requirements for the applicant to apply for
certification by the Educational Commission for Foreign Medical
Graduates;
(2)
has been licensed in good standing to practice
medicine in another country and is not the subject of any pending
disciplinary action before the licensing body;
(3)
has completed a residency or a substantially
similar postgraduate medical training required by the applicant's
country of licensure;
(4)
passes the Texas medical jurisprudence
examination;
(5) has proficiency in the English language;
(6)
is authorized under federal law to work in the
United States;
(7)
has been offered employment in this state as a
physician by a person who provides health care services in the
normal course of business in a facility-based or group practice
setting, including a health system, hospital, hospital-based
facility, freestanding emergency facility, or urgent care clinic;
(8)
has passed the first and second steps of the
examination described by Section 155.0511(7) in accordance with
Section 155.056(a); and
(9)
meets any other requirement the board prescribes
by rule.
(b)
Unless the applicant is a citizen of the United States
or has been issued a visa to legally work in the United States, the
board may not issue a provisional license under Subsection (a) to an
applicant who is a citizen of a country:
(1)
identified by the United States Director of
National Intelligence as a country that poses a risk to the national
security of the United States in the most recent Annual Threat
Assessment of the U.S. Intelligence Community issued pursuant to
Section 108B, National Security Act of 1947 (50 U.S.C. Section
3043b); or
(2)
identified as a country subject to prohibitions in
the International Traffic in Arms Regulations (22 C.F.R. Part
126.1).
(c)
A provisional license issued under Subsection (a)
expires on the second anniversary of the date the provisional
license was issued.
(d)
The holder of a provisional license issued under
Subsection (a) may practice only in:
(1) a facility-based or group practice setting with:
(A)
an Accreditation Council for Graduate
Medical Education residency program; or
(B)
an American Osteopathic Association
residency program;
(2)
an Accreditation Council for Graduate Medical
Education-affiliated setting; or
(3)
an American Osteopathic Association-affiliated
setting.
(e)
On application, the board shall renew a provisional
license to practice medicine issued under Subsection (a) if the
applicant:
(1)
has passed the first and second steps of the
examination described by Section 155.0511(7) in accordance with
Section 155.056(a); and
(2)
holds a valid certificate issued by the
Educational Commission for Foreign Medical Graduates.
(f)
The holder of a provisional license renewed under
Subsection (e):
(1)
may practice only in a rural community or
medically underserved area or health professional shortage area, as
designated by the United States Department of Health and Human
Services, that has a current shortage of physicians; and
(2)
is not subject to the restrictions of Subsection
(d).
(g)
Subject to Subsection (h), the board on application
shall issue a license under this subtitle to the holder of a
provisional license under this section if the provisional license
holder satisfies the examination requirements of Section 155.051.
(h)
The board may not issue as provided by Subsection (g) a
license under this subtitle to an applicant who:
(1)
is subject to board investigation or discipline
for conduct that occurred while holding the provisional license; or
(2)
has been convicted of, is on deferred adjudication
community supervision or deferred disposition for, or is under
active investigation for the commission of:
(A) a felony; or
(B) a misdemeanor involving moral turpitude.
(i)
The board shall adopt rules for the issuance of a
provisional license under Subsection (a), the renewal of a
provisional license under Subsection (e), and the issuance of a
license under this subtitle as provided by Subsection (g),
including rules establishing eligibility for and fees applicable to
the licenses.
The board may adopt rules for the reporting of board
specialty certification requirement information as requested by a
board specialty organization.
ARTICLE 3. PHYSICIAN GRADUATES
SECTION 3.001. Chapter 155, Occupations Code, is amended by
adding Subchapter E to read as follows:
SUBCHAPTER E.
PHYSICIAN GRADUATES
Sec. 155.201. DEFINITIONS. In this subchapter:
(1)
"Physician graduate" means an individual issued a
limited license under this subchapter to practice medicine under a
supervising practice agreement with a sponsoring physician.
(2)
"Sponsoring physician" means a physician who
enters into a supervising practice agreement with a physician
graduate.
(3)
"Supervising practice agreement" means an
agreement between a sponsoring physician and a physician graduate
regarding the sponsoring physician's supervision of the physician
graduate's practice of medicine.
Sec.
155.202.
RULES. The board shall adopt rules in
accordance with this subchapter relating to the licensing and
regulation of physician graduates, including rules relating to:
(1)
procedures and fees for the issuance, term, and
renewal of a license under this subchapter, including continuing
medical education requirements for renewal of the license;
(2)
practices and requirements for the supervision of
physician graduates; and
(3)
any other matter necessary to ensure protection of
the public, including disciplinary procedures.
Sec.
155.203.
LICENSE ISSUANCE. On application, the board
shall issue a limited license to practice medicine under this
subchapter to an applicant who:
(1) is a resident of this state and is:
(A) a United States citizen;
(B)
a legal permanent resident of the United
States; or
(C)
otherwise authorized under federal law to
work in the United States;
(2) has proficiency in the English language;
(3) has graduated:
(A)
in the two years preceding the date that the
applicant initially applies for a physician graduate license, from:
(i)
a board-recognized accredited medical
school or osteopathic medical school in the United States or
Canada; or
(ii)
a medical school located outside of
the United States and Canada that the board recognizes as
acceptable; or
(B)
if the applicant is licensed in good standing
to practice medicine in another country, from a medical school
located outside of the United States and Canada that the board
recognizes as acceptable;
(4)
has passed the first and second components of the
United States Medical Licensing Examination or equivalent
components of another board-approved licensing examination
described by Section 155.0511;
(5)
is not enrolled in a board-approved postgraduate
residency program; and
(6)
meets any other requirement prescribed by board
rule.
Sec.
155.204.
FEES. The amount of a fee for the issuance or
renewal of a license under this subchapter may not exceed the amount
of a fee for the issuance or renewal of a physician assistant
license under Chapter 204.
Sec.
155.205.
SPONSORING PHYSICIAN. (a)
A physician is
eligible to enter into a supervising practice agreement as a
sponsoring physician if the physician:
(1)
holds a full and unrestricted license to practice
medicine issued under this subtitle;
(2)
is not currently the subject of disciplinary
action by the board or the medical licensing authority of any other
jurisdiction;
(3)
is certified by a medical specialty member board
of:
(A) the American Board of Medical Specialties;
(B)
the American Osteopathic Association Bureau
of Osteopathic Specialists;
(C)
the American Board of Oral and Maxillofacial
Surgery; or
(D)
any other medical specialty member
organization the board recognizes; and
(4)
practices medicine in the specialty for which the
physician is certified under Subdivision (3).
(b)
A sponsoring physician who enters into a supervising
practice agreement with a physician graduate shall comply with all
board rules related to the supervision of physician graduates.
(c)
The board by rule shall establish the maximum number of
physician graduates that a sponsoring physician may supervise under
supervising practice agreements.
Sec.
155.206.
SUPERVISING PRACTICE AGREEMENT REQUIRED. (a)
A physician graduate shall enter into a supervising practice
agreement with a sponsoring physician.
(b)
A physician graduate who has not entered into a
supervising practice agreement may not practice or attempt to
practice medicine.
(c)
A physician graduate who enters into a supervising
practice agreement may practice under the delegation and
supervision of another physician if:
(1)
the sponsoring physician authorizes the practice
of the physician graduate under the delegation and supervision of
the other physician in a written document that identifies the other
physician by name; and
(2) the other physician is:
(A)
part of the sponsoring physician's physician
group or facility; and
(B)
certified in the same specialty as the
sponsoring physician by a medical specialty member board of:
(i)
the American Board of Medical
Specialties;
(ii)
the American Osteopathic Association
Bureau of Osteopathic Specialists;
(iii)
the American Board of Oral and
Maxillofacial Surgery; or
(iv)
any other medical specialty member
organization recognized by the board.
(d)
The physician profile under Section 154.006 of a
sponsoring physician or physician graduate must indicate in the
manner prescribed by board rule that the sponsoring physician or
physician graduate has entered into a supervising practice
agreement.
Sec.
155.207.
LIMITED PRACTICE BY LICENSE HOLDER. (a) A
physician graduate may:
(1)
practice only in a county with a population of less
than 100,000; and
(2)
provide only medical services in the specialty in
which the physician graduate's sponsoring physician is certified as
described by Section 155.205(a)(3) under supervision in accordance
with a supervising practice agreement.
(b)
Before a license holder under this subchapter provides a
treatment, consultation, or other medical service, the license
holder must disclose to the patient that the license holder:
(1) is a physician graduate; and
(2)
has not completed any formal specialized
postgraduate or resident training.
Sec.
155.208.
LIABILITY OF SPONSORING PHYSICIAN. A
sponsoring physician who enters into a supervising practice
agreement with a physician graduate retains legal responsibility
for a physician graduate's patient care activities, including the
provision of care and treatment to a patient in a health care
facility.
Sec.
155.209.
IDENTIFICATION REQUIREMENTS; USE OF TITLE.
(a) The holder of a license issued under this subchapter shall at
all times while practicing as a physician graduate display a
personal identification document identifying the license holder as
a physician graduate.
(b)
A physician graduate may use the following titles or
abbreviations:
(1) "doctor"; or
(2) "Dr." or "doc."
Sec.
155.210.
STATUS OF PHYSICIAN GRADUATE. A physician
graduate license holder is considered a general practitioner for
purposes of regulations of the federal Centers for Medicare and
Medicaid Services.
Sec.
155.211.
LICENSE RENEWAL. The board may not renew a
license issued under this subchapter unless:
(1)
the board verifies that the license holder has
practiced in accordance with this subchapter under a supervising
practice agreement with a sponsoring physician in the license term
preceding the application for renewal; and
(2)
the license
holder satisfies the continuing
medical education requirements established by board rule.
Sec.
155.212.
DENIAL, SUSPENSION, OR REVOCATION OF LICENSE.
The board may deny an application for licensure or suspend or revoke
a license issued under this subchapter:
(1)
for any ground provided by Chapter 164 or board
rule; and
(2)
in the manner provided by Chapter 164 and board
rule.
SECTION 3.002. Section 1451.001, Insurance Code, is amended
by adding Subdivision (16-a) to read as follows:
(16-a) "Physician graduate" has the meaning assigned
by Section 155.201, Occupations Code.
SECTION 3.003. Subchapter C, Chapter 1451, Insurance Code,
is amended by adding Section 1451.129 to read as follows:
Sec.
1451.129.
SELECTION OF PHYSICIAN GRADUATE. An insured
may select a physician graduate to provide the services scheduled
in the health insurance policy that are within the scope of the
physician graduate's license under Subchapter E, Chapter 155,
Occupations Code.
SECTION 3.004. Section 1451.129, Insurance Code, as added
by this Act, applies only to a health insurance policy that is
delivered, issued for delivery, or renewed on or after January 1,
2026.
ARTICLE 4. RULEMAKING
SECTION 4.001. Not later than January 1, 2026, the Texas
Medical Board shall adopt rules as necessary to implement the
following provisions of the Occupations Code, as added by this Act:
(1) Section 155.1015; and
(2) Subchapter E, Chapter 155.
ARTICLE 5. EFFECTIVE DATE
SECTION 5.001. This Act takes effect September 1, 2025.
______________________________
______________________________
President of the Senate
Speaker of the House
I certify that H.B. No. 2038 was passed by the House on May 6,
2025, by the following vote: Yeas 144, Nays 0, 2 present, not
voting; and that the House concurred in Senate amendments to H.B.
No. 2038 on May 29, 2025, by the following vote: Yeas 108, Nays 31,
1 present, not voting.
______________________________
Chief Clerk of the House
I certify that H.B. No. 2038 was passed by the Senate, with
amendments, on May 26, 2025, by the following vote: Yeas 30, Nays
1.
______________________________
Secretary of the Senate
APPROVED: __________________
Date
__________________
Governor