CHAPTER 151. GENERAL PROVISIONS
OCCUPATIONS CODE
TITLE 3. HEALTH PROFESSIONS
SUBTITLE B. PHYSICIANS
CHAPTER 151. GENERAL PROVISIONS
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 151.001. SHORT TITLE. This subtitle may be cited as the
Medical Practice Act.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 151.002. DEFINITIONS. (a) In this subtitle:
(1) "Board" means the Texas Medical Board.
(2) "Continuing threat to the public welfare" means a real
danger to the health of a physician's patients or to the public
from the acts or omissions of the physician caused through the
physician's lack of competence, impaired status, or failure to
care adequately for the physician's patients, as determined by:
(A) the board;
(B) a medical peer review committee in this state;
(C) a physician licensed to practice medicine in this state or
otherwise lawfully practicing medicine in this state;
(D) a physician engaged in graduate medical education or
training; or
(E) a medical student.
(3) "Disciplinary order" means an action taken under Section
164.001, 164.053, 164.058, or 164.101.
(4) "Doctor of osteopathic medicine" includes a doctor of
osteopathy, an osteopath, an osteopathic physician, and an
osteopathic surgeon.
(5) "Health care entity" means:
(A) a hospital licensed under Chapter 241 or 577, Health and
Safety Code;
(B) an entity, including a health maintenance organization,
group medical practice, nursing home, health science center,
university medical school, hospital district, hospital authority,
or other health care facility, that:
(i) provides or pays for medical care or health care services;
and
(ii) follows a formal peer review process to further quality
medical care or health care;
(C) a professional society or association of physicians, or a
committee of such a society or association, that follows a formal
peer review process to further quality medical care or health
care; or
(D) an organization established by a professional society or
association of physicians, hospitals, or both, that:
(i) collects and verifies the authenticity of documents and
other information concerning the qualifications, competence, or
performance of licensed health care professionals; and
(ii) acts as a health care facility's agent under the Health
Care Quality Improvement Act of 1986 (42 U.S.C. Section 11101 et
seq.).
(6) "Legally authorized representative" of a patient means:
(A) a parent or legal guardian if the patient is a minor;
(B) a legal guardian if the patient has been adjudicated
incompetent to manage the patient's personal affairs;
(C) an agent of the patient authorized under a durable power of
attorney for health care;
(D) an attorney ad litem appointed for the patient;
(E) a guardian ad litem appointed for the patient;
(F) a personal representative or statutory beneficiary if the
patient is deceased; or
(G) an attorney retained by the patient or by another person
listed by this subdivision.
(7) "Medical peer review" or "professional review action" means
the evaluation of medical and health care services, including
evaluation of the qualifications and professional conduct of
professional health care practitioners and of patient care
provided by those practitioners. The term includes evaluation of
the:
(A) merits of a complaint relating to a health care practitioner
and a determination or recommendation regarding the complaint;
(B) accuracy of a diagnosis;
(C) quality of the care provided by a health care practitioner;
(D) report made to a medical peer review committee concerning
activities under the committee's review authority;
(E) report made by a medical peer review committee to another
committee or to the board as permitted or required by law; and
(F) implementation of the duties of a medical peer review
committee by a member, agent, or employee of the committee.
(8) "Medical peer review committee" or "professional review
body" means a committee of a health care entity, the governing
board of a health care entity, or the medical staff of a health
care entity, that operates under written bylaws approved by the
policy-making body or the governing board of the health care
entity and is authorized to evaluate the quality of medical and
health care services or the competence of physicians, including
evaluation of the performance of those functions specified by
Section 85.204, Health and Safety Code. The term includes:
(A) an employee or agent of the committee, including an
assistant, investigator, intervenor, attorney, and any other
person or organization that serves the committee; and
(B) the governing body of a public hospital owned or operated by
a governmental entity, the governing body of a hospital authority
created under Chapter 262 or 264, Health and Safety Code, and the
governing body of a hospital district created under Article IX,
Texas Constitution, but only:
(i) in relation to the governing body's evaluation of the
competence of a physician or the quality of medical and health
care services provided by the public hospital, hospital
authority, or hospital district; and
(ii) to the extent that the evaluation under Subparagraph (i)
involves discussions or records that specifically or necessarily
identify an individual patient or physician.
(9) "Medical records" means all records relating to the history,
diagnosis, treatment, or prognosis of a patient.
(10) "Operation" means the application of surgery or the
performance of surgical services.
(11) "Person" means an individual, unless the term is expressly
made applicable to a partnership, association, or corporation.
(12) "Physician" means a person licensed to practice medicine in
this state.
(13) "Practicing medicine" means the diagnosis, treatment, or
offer to treat a mental or physical disease or disorder or a
physical deformity or injury by any system or method, or the
attempt to effect cures of those conditions, by a person who:
(A) publicly professes to be a physician or surgeon; or
(B) directly or indirectly charges money or other compensation
for those services.
(14) "Surgery" includes:
(A) surgical services, procedures, and operations; and
(B) the procedures described in the surgery section of the
common procedure coding system as adopted by the Health Care
Financing Administration of the United States Department of
Health and Human Services.
(b) The terms "physician" and "surgeon" are synonyms. As used in
this subtitle, the terms "practitioner" and "practitioner of
medicine" include physicians and surgeons.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 14.021(a), eff.
Sept. 1, 2001; Acts 2003, 78th Leg., ch. 202, Sec. 1, eff. June
10, 2003.
Amended by:
Acts 2005, 79th Leg., Ch.
269, Sec. 1.01, eff. September 1, 2005.
Sec. 151.003. LEGISLATIVE FINDINGS. The legislature finds that:
(1) the practice of medicine is a privilege and not a natural
right of individuals and as a matter of public policy it is
necessary to protect the public interest through enactment of
this subtitle to regulate the granting of that privilege and its
subsequent use and control; and
(2) the board should remain the primary means of licensing,
regulating, and disciplining physicians.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 151.004. APPLICATION OF SUNSET ACT. The Texas Medical
Board is subject to Chapter 325, Government Code (Texas Sunset
Act). Unless continued in existence as provided by that chapter,
the board is abolished and this subtitle and Chapters 204, 205,
and 206 expire September 1, 2017.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Amended by:
Acts 2005, 79th Leg., Ch.
269, Sec. 1.02, eff. September 1, 2005.
Sec. 151.005. GOVERNMENTAL DISCRIMINATION PROHIBITED. (a) A
program supported in whole or in part by the state or by a
political subdivision of the state may not discriminate against a
health care practitioner because the practitioner is a physician
specializing in ophthalmology.
(b) A law or policy of the state or of a political subdivision
of the state that requires or encourages a person to obtain
vision care or medical eye care that is within the scope of
practice of an optometrist or therapeutic optometrist may not
discriminate against a health care practitioner because the
practitioner is a physician specializing in ophthalmology.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
SUBCHAPTER B. APPLICATION AND CONSTRUCTION OF SUBTITLE
Sec. 151.051. DISCRIMINATION BASED ON TYPE OF ACADEMIC MEDICAL
DEGREE OR CERTAIN RELIGIOUS TENETS PROHIBITED. (a) A hospital,
institution, or program that is licensed by the state, is
operated by the state or a political subdivision of the state, or
directly or indirectly receives state financial assistance may
not differentiate in regard to a person licensed under this
subtitle solely on the basis of the academic medical degree held
by the person. The hospital, institution, program, state agency,
or political subdivision may adopt rules and requirements
relating to qualifications for medical staff appointments,
including reappointments and the termination of appointments, the
delineation of clinical privileges, or the curtailment of
clinical privileges of persons who are appointed to that medical
staff or permitted to participate in educational programs if
those rules and requirements do not differentiate solely on the
basis of the academic medical degree held by the affected
physician and are:
(1) determined on a reasonable basis, such as the professional
and ethical qualifications of the physician;
(2) based on reasonable standards;
(3) applied without irrelevant considerations;
(4) supported by sufficient evidence; and
(5) not arbitrary or capricious.
(b) The limitations imposed under this section relating to
discrimination based on the academic medical degree of a
physician do not apply to practice limitations adopted by:
(1) a medical school or college, including a program of a
medical school or college; or
(2) any office or offices of physicians, singularly or in
groups, in the conduct of their profession.
(c) This subtitle may not be construed in a manner that:
(1) discriminates against a school or system of medical
practice; or
(2) affects the use of the principles or teachings of any church
in ministering to the sick or suffering by prayer or pastoral
counseling without the use of a drug or other material substance
represented as medically effective.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 151.052. EXEMPTIONS. (a) This subtitle does not apply to:
(1) a dentist, licensed under the laws of this state, engaged
strictly in the practice of dentistry;
(2) a licensed optometrist or therapeutic optometrist engaged
strictly in the practice of optometry or therapeutic optometry as
defined by law;
(3) a licensed chiropractor engaged strictly in the practice of
chiropractic as defined by law;
(4) a registered nurse or licensed vocational nurse engaged
strictly in the practice of nursing in accordance with the
applicable licensing acts and other laws of this state;
(5) a licensed podiatrist engaged strictly in the practice of
podiatry as defined by law;
(6) a licensed or certified psychologist engaged strictly in the
practice of psychology as defined by law;
(7) a licensed physical therapist engaged strictly in the
practice of physical therapy in accordance with the law relating
to physical therapy practice;
(8) a commissioned or contract surgeon in the United States
uniformed services or Public Health Service in the performance of
that person's duties if the person is not engaged in private
practice;
(9) a person who furnishes medical assistance in an emergency or
disaster situation if no charge is made for the medical
assistance;
(10) a student in training in a board-approved medical school
while performing, under the supervision of a licensed
practitioner, the duties assigned in the course of training;
(11) a legally qualified physician of another state who is in
this state for consultation with a physician licensed in this
state but who does not:
(A) maintain an office in this state; or
(B) appoint a place in this state for seeing, examining, or
treating a patient; or
(12) any other activity that the board designates as exempt from
the application of this subtitle.
(b) Notwithstanding Subsection (a)(10), a medical resident,
intern, or fellow is required to register and is subject to the
other applicable provisions of this subtitle.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 151.053. APPLICATION TO CERTAIN PERSONS PROVIDING
NUTRITIONAL ADVICE. (a) This subtitle does not prohibit a
person from giving advice regarding the use and role of food and
food ingredients, including dietary supplements.
(b) Subsection (a) does not authorize a person to:
(1) practice medicine; or
(2) state, in violation of law, that a product might cure a
disease, disorder, or condition.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 151.054. APPLICATION TO SELF-CARE. (a) This subtitle does
not prohibit:
(1) a person from providing or seeking advice or information
relating to that person's self-care; or
(2) the dissemination of information relating to self-care.
(b) This section does not confer authority to practice medicine.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 151.055. APPLICATION TO CERTAIN INDEPENDENT CONTRACTOR
AGREEMENTS. This subtitle does not prohibit a hospital from
entering into an independent contractor agreement with a
physician to provide services at the hospital or at another
health care facility owned or operated by the hospital and:
(1) paying the physician a minimum guaranteed amount to ensure
the physician's availability;
(2) billing and collecting from patients the physician's
professional fees; or
(3) retaining the collected professional fees up to the amount
of the minimum guaranteed amount plus a reasonable collection
fee.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 151.056. APPLICATION TO TELEMEDICINE. (a) A person who is
physically located in another jurisdiction but who, through the
use of any medium, including an electronic medium, performs an
act that is part of a patient care service initiated in this
state, including the taking of an x-ray examination or the
preparation of pathological material for examination, and that
would affect the diagnosis or treatment of the patient, is
considered to be engaged in the practice of medicine in this
state and is subject to appropriate regulation by the board.
(b) This section does not apply to the act of:
(1) a medical specialist located in another jurisdiction who
provides only episodic consultation services on request to a
physician licensed in this state who practices in the same
medical specialty;
(2) a physician located in another jurisdiction who is providing
consultation services to a medical school as defined by Section
61.501, Education Code;
(3) a physician located in another jurisdiction who is providing
consultation services to an institution subject to:
(A) Subchapter C, Chapter 73, Education Code; or
(B) Subchapter K, Chapter 74, Education Code; or
(4) a physician located in another jurisdiction of a state
having borders contiguous with the borders of this state who is
the treating physician of a patient and orders home health or
hospice services for a resident of this state to be delivered by
a home and community support services agency licensed in this
state.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 14.022(a), eff.
Sept. 1, 2001.