HBA-MPA C.S.H.B. 110 76(R) BILL ANALYSIS
Office of House Bill AnalysisC.S.H.B. 110
By: Maxey
Public Health
3/6/1999
Committee Report (Substituted)
BACKGROUND AND PURPOSE
Choosing a doctor to perform surgery, deliver a child, or perform any other
procedure can be one of life's most important decisions. The information
consumers need in order to make informed decisions about their doctor or
prospective doctor is not readily available. Information such as
education, hospital privileges, and nationally recognized specialty
certification, along with information on past criminal conduct and paid
malpractice claims, could be helpful to consumers in making informed
choices when selecting a physician.
RULEMAKING AUTHORITY
It is the opinion of the Office of House Bill Analysis that this bill
expressly delegates additional rulemaking authority to the Texas State
Board of Medical Examiners in SECTION 2 (Section 5.12, Medical Practice
Act, Article 4495b,V.T.C.S.) of this bill.
SECTION BY SECTION ANALYSIS
SECTION 1. Amends Section 5.07(a), Medical Practice Act (Article
4495b,V.T.C.S.), to change the reporting requirement under this section to
any offense constituting a felony or a Class A or Class B misdemeanor.
Deletes "involving moral turpitude." Makes a conforming change.
SECTION 2. Amends Subchapter E, Article 4495b,V.T.C.S. (Medical Practice
Act), by adding Section 5.12, as follows:
Sec. 5.12. PHYSICIAN PROFILES. (a) Requires the Texas State Board of
Medical Examiners (board) to create a profile of each physician licensed
under the Medical Practice Act, and to compile them in a format which the
board can make available to the public.
(b) Provides that the profile must contain:
(1) the name and graduation date of each medical school attended by the
physician, or Fifth Pathway designation and the date of program completion;
(2) a description of all graduate medical education in the U.S. or Canada;
(3) any specialty certification issued by a member licensing board of the
American Board of Medical Specialties or the Bureau of Osteopathic
Specialists;
(4) number of years of active practice in the U.S. or Canada, and in this
state;
(5) the name of each hospital in this state in which the physician has
privileges;
(6) the location of the physician's primary practice;
(7) any language translation services, including any for a person with
impaired hearing, provided at the primary practice location;
(8) whether the physician participates in the Medicaid program;
(9) any convictions of a felony or Class A or Class B misdemeanor during
the previous 10-year period;
(10) any charges reported to the board to which the physician pleaded no
contest or which a court has continued within the previous 10-year period;
(11) any disciplinary action taken by the board against the physician
within the previous 10-year period;
(12) any disciplinary action taken against the physician by the medical
licensing board of another state within the previous 10-year period;
(13) the description of types of medical malpractice claims or complaints
reported as resolved under Section 5.05 (Reports and Data from Insurers),
V.T.C.S., in a five-year period;
(14) whether the physician's patient service area is accessible to disabled
persons; and
(15) a description of any formal complaint against the physician initiated
and filed under Section 4.03 (Initiation of Charges), Article 4495b,
V.T.C.S., and the status of the complaint.
(c) Requires information necessary to complete this profile which is not
kept in the ordinary course of board operation be made available by the
physician when the physician renews the physician's license. Requires the
board to inform the physician: that it is mandatory to provide this
information; the date the information will be made available to the public;
and that upon request the physician will receive a copy of the profile, to
ensure its accuracy.
(d) Does not prevent the board from providing explanations of the
significance of categories in which malpractice settlements are reported,
or require the board to disclose confidential settlement information.
(e) Prohibits a pending malpractice claim or complaint from being disclosed
to the public by the board, unless the claim was already included in the
physician's profile in accordance with Subsection (b) of this section.
Provides that this subsection does not prevent the board from investigating
and disciplining a physician on the basis of such a claim.
(f) Requires the board to provide upon request at the time of renewal of
the physician's license a copy of the profile, and to give the physician
one month from the date the copy is provided to correct any factual errors.
(g) Requires the board to update physician profiles annually; to adopt a
form that allows a physician to update the profile or provide additional
information to be included in the profile; and that the form be available
on the Internet and in other formats prescribed by board rule. Authorizes
the board to adopt rules concerning the type and content of additional
information included in the physician profile.
(h) Requires the board to adopt rules as necessary to implement this
section.
SECTION 3. Requires that the following agencies provide cost estimates and
methodology for assembling similar profiles for persons regulated or
licensed by each agency to the presiding officer of each house of the 77th
Legislature no later than January 1, 2000: Texas Board of Chiropractic
Examiners; State Board of Dental Examiners; Texas Board of Occupational
Therapy Examiners; Texas Optometry Board; Texas State Board of Pharmacy;
Texas Board of Physical Therapy Examiners; Texas State Board of Podiatric
Medical Examiners; and Texas State Board of Examiners of Psychologists.
SECTION 4. (a) Effective date: September 1, 1999.
(b) Makes application of Section 1 of this Act prospective.
(c) Requires the board to adopt rules providing for physician profiles no
later than April 1, 2000, and to make the profiles available to the public
no later than September 1, 2001.
(d) Requires the board to raise fees for each physician licensed by the
board by not more than $20 for each fiscal year in the 2000-2001 biennium
and by not more than $10 for each fiscal year in the 2002-2003 biennium to
cover the costs of establishing the physician profile system. Requires
these fees to be reduced not later than the second anniversary of the date
the profiles are made available to the public to the extent the increase in
fees was necessary to cover the initial costs incurred by the board in
establishing a physician profile system.
SECTION 5. Emergency clause.
COMPARISON OF ORIGINAL TO SUBSTITUTE
SECTION 1. C.S.H.B. 110 differs from the original bill in requiring the
reporting of any offense by a practicing physician constituting a felony or
a Class A or Class B misdemeanor, rather than any offense not punishable by
fine only. The substitute bill also deletes a requirement that certain
information be sent to the Texas state board of Medical Examiners. Makes a
conforming change.
SECTION 2. C.S.H.B. 110 differs from the original bill in providing that a
physician profile must contain the following information in accordance with
Section 5.12(b), Article 4495b, as added by the Act:
(1) adds Fifth Pathway designation and date of program completion to the
information required regarding the medical school attended;
(2) confines the description of medical education to that taking place in
the U.S. and Canada, and makes nonsubstantive change;
(3) adds reference to a medical licensing board that is a member of the
American Board of Medical Specialties or the Bureau of Osteopathic
Specialists with respect to the issuance of specialty certification;
(4)confines information related to the number of years a physician has
practiced medicine to those years spent in active practice in the U.S. and
Canada, and in this state;
(5) requires only information regarding the hospitals in this state at
which a physician has privileges rather than each hospital;
(7) refers to the type of translation service, rather than whether the
physician provides such service;
(9) makes conforming change in reference to type of offense, and deletes
reference to offenses which reflect adversely on the physician's competence
and ability to practice, and on patient safety;
(10) deletes reference to Section 5.07(a), and adds reporting condition of
charges for which the physician is the subject of deferred adjudication or
pretrial diversion;
(11) deletes the word "final" before " disciplinary action";
(12) deletes the word "final" before "disciplinary action,"
the substitue deletes Subdivision (13) from the original bill which makes
reference to revocation or involuntary restriction of hospital privileges
for over 30 days during the previous 10 years, and adds reference to the
types of medical malpractice claims or complaints resolved under Section
5.05(f), Article 4495b, V.T.C.S., in a five-year period;
the substitute deletes Subdivision (14) from the original bill which makes
reference to resignations or nonrenewal of hospital privileges for over 30
days during the previous 10 years imposed as settlement of pending
disciplinary proceedings;
(13) adds reference to the type of medical malpractice claims or complaints
made under Section 5.05(b), Article 4495b,V.T.C.S., and deletes reference
to type of allegation and review action taken by the board if the physician
has had three or more malpractice claims; and
(15) adds a description of any formal complaint against the physician
initiated and filed under Section 4.03 (Initiation of Charges), Article
4495b, V.T.C.S., and the status of the complaint.
(d) C.S.H.B. 110 differs from the original bill in adding to Section 5.12
(d), a provision that the board is not required to disclose confidential
settlement information. Makes a conforming change.
(e) C.S.H.B. 110 differs from the original bill in adding to Section 5.12
(e), a reference to a malpractice complaint.
(g) C.S.H.B. 110 differs from the original bill in deleting to Section 5.12
(g), a provision allowing a physician to update the profile, and for the
board to assess a fee for doing so. Adds provision that the board may
prescribe rules regarding the availability of the form.
SECTION 4. C.S.H.B. 110 differs from the original bill in changing the
date by which the board is required to adopt rules under the Medical
Practice Act from January 1, 2000 to April 1, 2000, and the date the
physician profiles are made available to the public from June 1, 2001 to
September 1, 2001. Changes the amount of the fee that the board is
required to raise from $15 to $20.