Office of House Bill AnalysisH.B. 3217
By: McCall
Public Health


Currently, the Medical Practice Act of Texas is used to license physicians
in this state.  The Act assures that physicians seeking licensure in Texas
by way of endorsement or by way of original license are reviewed, examined,
and evaluated according to certain standards.  The Texas State Board of
Medical Examiners (board) is the state agency that oversees the appropriate
regulation of physicians who practice medicine in Texas. 

H.B. 3217 rewrites the licensure section of the Medical Practice Act for
clarification purposes, consolidates relevant subsections and deletes
obsolete wording.  This bill also establishes provisions regarding the
board and the licensure of physicians, while providing penalties for
violations of the Act. 


It is the opinion of the Office of House Bill Analysis that rulemaking
authority is expressly delegated to the Texas State Board of Medical
Examiners in SECTION 2 (Section 3.015, Article 4495b, V.T.C.S.) and in
SECTION 4 (Section 3.035, Article 4495b, V.T.C.S.) of this bill. 


SECTION 1.  Amends Section 2.09, Article 4495b, V.T.C.S. (Medical Practice
Act), by amending Subsections (d), (h), (k), and (t) and adding Subsection
(bb), as follows: 

(d)  Deletes the requirement that the Texas State Board of Medical
Examiners (board) maintain records showing the name, age, place, and
duration of residence of each applicant, the time spent in medical study in
respective medical schools, and the years and schools from which degrees
were granted.  Requires a certified copy of permanent records to be
admitted in evidence in all courts with the hand and seal of the executive
director, rather than the secretary-treasurer.  Makes a nonsubstantive

(h)  Authorizes, rather than requires, the board to submit to the
Department of Public Safety a complete set of fingerprints of every
applicant for a license.  Deletes the requirement that any applicant for
licensure or any licensee whose license is subject to revocation,
cancellation, or suspension because of adverse information contained in the
criminal records or reports be afforded the opportunity for a hearing
before the board prior to any action on the application for license or
revocation, cancellation, or suspension of license.  Makes a nonsubstantive

(k)  Requires the board to place all money, rather than all fees, received
under the authority of this Act in the state treasury.  Deletes text
specifying that said fees are required, if not specified, to be placed into
the medical licensing fund in the state treasury. 

(t)  Requires the board, on the request of a licensee, to issue
certification of the licensee's state board examination grades to the
Federation of State Medical Boards and to charge a reasonable fee for the
issuance of that certificate. 

(bb)  Requires the executive director of the  Texas State Board of Medical
Examiners  (executive director) to file a surety bond with the board and
the board to pay the premium on the bond.  Provides the bond must be in an
amount no less than $10,000, in compliance with the insurance laws of this
state, and payable to the state for the state's use if the executive
director does not faithfully discharge the executive director's duties
under this Act. 

SECTION 2.  Amends Subchapter C, Article 4495b, V.T.C.S. (Medical Practice
Act), by adding Section 3.015, as follows: 

Sec. 3.015.  ANNUAL REGISTRATION OF PHYSICIANS.  (a)  Requires a person
qualified to practice medicine in this state or who is licensed to practice
medicine by the board to register annually as a practitioner with the
board.  Requires the initial annual registration permit (permit) to be
issued with the license. 

(b)  Requires the permit fee as set by board rule to apply to each
physician licensed by the board, whether or not the physician is practicing
in this state, other than a retired physician or one licensed by the board
whose only practice is voluntary care exempted as provided by rules adopted
by the board. 

(c)  Requires the board to mail a permit renewal application to each
practitioner at the practitioner's last known address according to the
records of the board no later than the 30th day before the expiration date
of the permit. 

(d)  Requires the board to allow a 30-day grace period for renewing the
permit.  Provides that this period begins on the date of the expiration of
the permit. 

(e) Authorizes a licensee to renew the permit by submitting to the board,
on or before the expiration date, the required renewal application and
renewal fee.  Provides that each renewal application must include the name
and mailing address of the licensee, the address of each place where the
licensee is engaged in the practice of medicine, and other necessary
information required by the board. 

(f)  Provides that if the licensee is licensed to practice medicine by
another state, the District of Columbia, a territory of the United States,
another country, or the uniformed services of the United States, the
renewal application must include a description of any investigations the
licensee knows are in progress and of any sanctions imposed by or
disciplinary matters pending in the respective area of service.  

(g)  Requires the board to issue a permit to a licensee certifying that the
licensee has filed the renewal application and has paid the annual permit
fee for that year and has completed the requirements for registration on
receipt of the application and appropriate fee and after ascertaining from
records or from other reliable sources that the applicant is a licensed
practitioner of medicine in this state. 

(h)  Authorizes a licensee to renew a permit by submitting to the board the
required renewal application, renewal fee, and a $50 late fee if the
licensee's permit has expired for 90 days or less. 

(i)  Authorizes the licensee to renew a permit by submitting to the board
the required renewal application, renewal fee, and a $100 late fee is the
licensee's permit has been expired for longer than 90 days but less than
one year. 

(j)  Provides that if a licensee's permit has been expired for more than
one year, that permit is canceled.  Prohibits a licensee from renewing a
permit in this instance. Authorizes a physician whose license is canceled
to obtain a new license by submitting to reexamination and completing with
the requirements, fees, and procedures for obtaining a license.  Authorizes
the board to issue a new license without examination to a person whose
license is canceled for less than two years. 

(k)  Authorizes the board, by rule, to adopt a system under which permits
expire on  various dates during the year.  Requires a permit fee to be
prorated for the year in which the expiration date is changed.  Provides
that on renewal of the registration on the new expiration date, the total
fee is payable. 

(l)  Provides that the filing of the renewal application, payment of the
appropriate fee, and issuance of the permit do not entitle a registration
applicant to practice medicine in this state.  Provides that the applicant
must also have previously been licensed as a practitioner by the board, as
prescribed by law, and that the applicant's license to practice medicine
must be in full force and effect.  Prohibits the permit required by this
Act from being treated as evidence that the permit holder is lawfully
entitled to practice medicine in a prosecution for the unlawful practice of

(m)  Makes practicing medicine as defined in this Act without a permit for
the current year subject to all penalties under this Act for practicing
medicine without a license. 

SECTION 3.  Amends Subchapter C, Article 4495b, V.T.C.S. (Medical Practice
Act), by adding Section 3.021, as follows: 

Sec. 3.021.  PHYSICIAN-IN-TRAINING PERMITS.  Authorizes a physician not
licensed by the board who participates in a graduate training program that
is board-approved to be issued a physician-in-training permit as provided
by board rule.  Provides that this permit does not authorize the
performance of medical acts unless performed as part of a graduate medical
education training program and under the supervision of a licensed
practitioner of medicine.  Authorizes the board to discipline a physician
whose permit has expired if the violation of the law occurred during the
time the permit was valid.  Authorizes the board to retain jurisdiction
over the investigation if it is pending on the date the permit expires. 

SECTION 4.  Amends Subchapter C, Article 4495b, V.T.C.S. (Medical Practice
Act), by adding Section 3.035, as follows: 

Sec. 3.035.  LICENSURE OF PHYSICIANS.  (a)  Authorizes the board to grant a
license to practice medicine to any physician qualifying under this Act.   

(b)  Provides that an application for a license must be in writing and on
board-prescribed forms.  Authorizes the board to allow or require, by rule,
an applicant to use the Federation of State Medical Boards' Credentials
Verification System. 

(c)  Provides that the application form must be accompanied by all fees,
documents, and photographs required by board rule. 

(d)  Provides that a license applicant must subscribe to an oath in writing
before an officer authorized by law to administer oaths.  Provides that the
written oath is part of the application. 

(e)  Makes an applicant ineligible for licensure under certain

(f) Requires each applicant to present proof satisfactory to the board that
any medical school attended by the applicant outside this state is
substantially equivalent to a medical school of this state, as determined
by board rule. 

(g)  Requires an applicant who is a graduate of a medical school located
outside the United States or Canada to present proof satisfactory to the
board that the applicant has certain qualifications. 

(h)  Provides that all medical or osteopathic medical education received by
the applicant in the United States must be accredited by an accrediting
body officially recognized by the United States Department of Education as
the accrediting body for medical education leading to the doctor of
medicine degree or the doctor of osteopathy degree in the United States.
Makes this subsection inapplicable to postgraduate medical education or
(i)  Provides that an applicant unable to comply with the requirements of
Subsection (h) of this section may be eligible for an unrestricted license
if the applicant meets certain criteria. 

(j)  Requires the executive director to review each license application and
recommend to the board each applicant eligible for licensure.  Requires the
executive director to report to the board each applicant determined to be
ineligible for a license, accompanied by the reasons for the

(k)  Authorizes an applicant considered ineligible for a license by the
executive director to review the recommendation by a committee of the board
no later than the 20th day after receiving the notice.  Authorizes the
executive director to refer any application to the committee for a
recommendation concerning eligibility.  Requires that, if the committee
finds the applicant ineligible for licensure, that recommendation, along
with the reasons for the recommendation, be submitted to the full board
unless the applicant requests a hearing no later than the 20th day after
receiving notice of the committee's determination. Requires the hearing to
be before an administrative law judge of the State Office of Administrative
Hearings and to comply with Chapter 2001 (Administrative Procedures),
Government Code, the rules of the State Office of Administrative Hearings,
and board rules.  Authorizes the committee to refer any application for
determination of eligibility to the full board.  Requires the board, after
receiving the administrative law judge's proposed findings of fact and
conclusions of law, to determine the applicant's eligibility. Requires the
board to issue a written statement containing the reasons for the board's
action to a physician whose application is denied. 

(l)  Provides that examination questions that may be used in the future,
examinations other than the one taken by the person requesting the
examination, and deliberations and records relating to the professional
character and fitness of applicants are confidential and not subject to
disclosure under Chapters 551 and 552 (Open Meetings and Public
Information, respectively), Government Code. 

(m)  Provides that a report received or information gathered by the board
on an applicant is confidential and not subject to disclosure under Chapter
552, Government Code. Authorizes the board to disclose the report to the
appropriate licensing authorities in other states and requires the board to
report all licensure actions to appropriate licensing authorities in other
states and to the Federation of State Medical Boards. 

(n)  Authorizes the board to require applicants to comply with other
requirements it considers appropriate in addition to requirements
prescribed by this section. 

SECTION 5.  Amends Subchapter C, Article 4495b, V.T.C.S. (Medical Practice
Act), by adding Section 3.038, as follows: 

Sec. 3.038.  QUALIFICATIONS OF LICENSE APPLICANT.  Provides that to be
eligible for licensure, each applicant must present certain proof to the
board regarding the applicant's qualifications. 

SECTION 6.  Amends Subchapter C, Article 4495b, V.T.C.S. (Medical Practice
Act), by adding Section 3.055, as follows: 

Sec. 3.055.  EXAMINATIONS ACCEPTED OR ADMINISTERED.  (a)  Authorizes the
board to administer or accept a specified list of examinations for
licensure as determined by rule. 

(b)  Requires each examination used by the board for a license to practice
medicine to be given in writing in English and in a manner that is fair to
each individual and each school or system of medicine.  Requires an
applicant wishing to request a reasonable accommodation due to a disability
to submit the request upon filing the application. 
(c)  Requires the examination  to include subjects generally taught by
medical schools, a knowledge of which is commonly and generally required of
candidates for the degree of doctor of medicine or doctor of osteopathy
conferred by schools in this state. 

(d)  Requires the board to administer the Texas medical jurisprudence
examination to all applicants. 

(e)  Requires the minimum passing grade for each examination used by the
board to be determined by board rule. 

(f)  Requires examinations administered to evaluate basic medical knowledge
and clinical competency to be prepared by a national testing service or
prepared by the board and validated by qualified independent testing

(g)  Requires all questions, answers, and grades to be preserved for one
year as directed by the board by rule. 

(h)  Requires each applicant to be given notice of the date and place of
the examination if it is administered by the board. 

(i)  Requires each examinee to be notified of the results of the
examination no later than the 120th day after it is administered by the
board.  Requires the board to notify each examinee of the results no later
than the 30th day after the board receives the results, if the examination
is graded or reviewed by a national testing service. 

(j)  Provides that all parts of the National Board of Osteopathic Medical
Examiners, National Board of Medical Examiners, Medical Council of Canada,
and Federal Licensing examinations after June 1, 1985, and United States
Medical Licensing examinations must be passed no later than the seventh
anniversary of the initial attempt to pass the licensing examination. 

(k) Provides that all parts of any examination used for licensure must be
passed within three attempts. 

SECTION 7.  Amends Subchapter C, Article 4495b, V.T.C.S. (Medical Practice
Act), by adding Section 3.105, as follows: 

Sec. 3.105.  FEES.  (a)  Requires each fee, charge, and penalty received by
the board to be deposited in the medical licensing fund account in the
general revenue fund.  Authorizes these monies to be spent only for
enforcing this Act, the prohibition of the unlawful practice of medicine,
the dissemination of information to prevent the violation of laws, and the
prosecution of those who violate the laws.  Authorizes all distributions to
be made only on written approval of the executive director of the board or
the executive director's designee. 

(b)  Authorizes the board to set, charge, collect, receive, and deposit
certain fees, not to exceed a certain limit. 

(c)  Authorizes the board to set and collect a charge for making copies of
records in the office of the board and for any material it publishes. 

(d)  Provides that the board's financial transactions are subject to audit
by the state auditor in accordance with Chapter 321 (State Auditor),
Government Code. 

(e)  Requires the board to file annually with the governor and the
presiding officer of each house of the legislature a complete and detailed
written report accounting for all funds received and disbursed by the board
during the preceding fiscal year.  Provides that the annual report must be
in the form and reported in the time provided by the General Appropriations
SECTION 8.  Amends Subchapter C, Article 4495b, V.T.C.S. (Medical Practice
Act), by adding Section 3.115, as follows: 

Sec. 3.115.  DISPOSITION OF CERTAIN FEES.  (a)  Requires an additional $200
fee to apply to certain other fees. 

(b)  Requires of each fee collected that $50 be deposited to the foundation
school fund, and $150 to the general revenue fund.  Makes this subsection
applicable to the disposition of the state portion of each fee, regardless
of any other provision of law providing for a different disposition of

SECTION 9.  Repeals the following sections:  

Section 2.10, as added by Chapter 35, Acts of the 73rd Legislature, Regular
Session, 1993 (Article 4495b, V.T.C.S.) (Creation of Funds); 
Section 3.01, Article 4495b, V.T.C.S. (Registration of Practitioners and
Section 3.02, Article 4495b, V.T.C.S. (Renewals);
Section 3.03, Article 4495b, V.T.C.S. (Reciprocal Agreements); 
Section 3.0305, Article 4495b, V.T.C.S. (Temporary License for Out-of-State
Section 3.031, Article 4495b, V.T.C.S. (Temporary Reciprocal License for
Physicians Employed by Texas Department of Mental Health and Mental
Section 3.04, Article 4495b, V.T.C.S. (Qualification of Licensee);  
Section 3.05, Article 4495b, V.T.C.S. (Examination);
Section 3.10, Article 4495b, V.T.C.S. (Fees); and
Section 3.11A, Article 4495b, V.T.C.S.. (Disposition of Fees).

SECTION 10.  Effective date: September 1, 1999.

SECTION 11.  Emergency clause.