CHAPTER 154. PUBLIC INTEREST INFORMATION AND COMPLAINT PROCEDURES
OCCUPATIONS CODE
TITLE 3. HEALTH PROFESSIONS
SUBTITLE B. PHYSICIANS
CHAPTER 154. PUBLIC INTEREST INFORMATION AND COMPLAINT PROCEDURES
SUBCHAPTER A. PUBLIC INTEREST INFORMATION
Sec. 154.001. PUBLIC INTEREST INFORMATION. (a) The board shall
prepare information of public interest describing the functions
of the board and the procedures by which complaints are filed
with and resolved by the board.
(b) The board shall make the information available to the public
and appropriate state agencies.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 154.002. INFORMATION FOR PUBLIC DISSEMINATION. (a) The
board shall prepare:
(1) an alphabetical list of the names of the license holders;
(2) an alphabetical list of the names of the license holders by
the county in which the license holder's principal place of
practice is located;
(3) a summary of the board's functions;
(4) a copy of this subtitle and a list of other laws relating to
the practice of medicine;
(5) a copy of the board's rules;
(6) a statistical report each fiscal year to the legislature and
the public that provides aggregate information about all
complaints received by the board categorized by type of
complaint, including administrative, quality of care, medical
error, substance abuse, other criminal behavior, and the
disposition of those complaints by category; and
(7) other information considered appropriate by the board.
(b) The board shall provide:
(1) a copy of the information prepared under Subsection (a) to
each person who requests a copy; and
(2) copies of the information prepared under Subsection (a) to
each public library in this state that requests the copies.
(c) The board shall make available on the board's Internet
website a consumer guide to health care. The board shall include
information in the guide concerning the billing and reimbursement
of health care services provided by physicians, including
information that advises consumers that:
(1) the charge for a health care service or supply will vary
based on:
(A) the person's medical condition;
(B) any unknown medical conditions of the person;
(C) the person's diagnosis and recommended treatment protocols;
and
(D) other factors associated with performance of the health care
service;
(2) the charge for a health care service or supply may differ
from the amount to be paid by the consumer or the consumer's
third-party payor;
(3) the consumer may be personally liable for payment for the
health care service or supply depending on the consumer's health
benefit plan coverage; and
(4) the consumer should contact the consumer's health benefit
plan for accurate information regarding the plan structure,
benefit coverage, deductibles, copayments, coinsurance, and other
plan provisions that may impact the consumer's liability for
payment for the health care services or supplies.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Amended by Acts 2003, 78th Leg., ch. 202, Sec. 6, eff. June 10,
2003.
Amended by:
Acts 2007, 80th Leg., R.S., Ch.
997, Sec. 7, eff. September 1, 2007.
Sec. 154.003. INFORMATION FOR PHYSICIANS. (a) The board shall
disseminate at least twice a year and at other times determined
necessary by the board information of significant interest to the
physicians of this state. The information must include summaries
of:
(1) disciplinary orders made against physicians licensed in this
state;
(2) board activities and functions;
(3) pertinent changes in this subtitle or board rules; and
(4) attorney general opinions.
(b) The requirements of this section are in addition to the
reporting requirements imposed under Section 164.060.
(c) The board shall disseminate the information to:
(1) each physician practicing in this state;
(2) each health care entity and other board-designated health
care institution operating in this state;
(3) each member of a health-related legislative committee;
(4) a member of the public who submits a written request; and
(5) public libraries throughout this state.
(d) Except as provided by this subsection, the board shall
publish information regarding errors in and reversals of
disciplinary actions taken by the board. The information to be
published under this subsection includes instances in which a
disciplinary action initiated by the board is overturned by a
court. The board shall disseminate the information under this
subsection in the same format, size, style, and manner as the
information regarding the original action by the board was
disseminated. The board may not publish information under this
subsection if the physician who was the subject of the
disciplinary action requests that the information not be
published.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Amended by:
Acts 2005, 79th Leg., Ch.
269, Sec. 1.14, eff. September 1, 2005.
Sec. 154.004. DISCLOSURE OF DISCIPLINARY ORDERS. (a) On
written request the board shall make available to the general
public on payment of a reasonable fee to cover expenses and to
appropriate state agencies information that includes:
(1) a summary of any previous disciplinary order by the board
against a specific physician licensed in this state;
(2) the date of the order; and
(3) the current status of the order.
(b) If the board is not required under other state law to
establish a toll-free telephone number, the board shall establish
an eight-hour toll-free telephone number to make the information
required by this section immediately available to any caller.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 154.005. PUBLIC PARTICIPATION. (a) The board shall
develop and implement policies that provide the public with a
reasonable opportunity to appear before the board and to speak on
any issue under the board's jurisdiction.
(b) The 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 board's programs.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 154.006. PHYSICIAN PROFILES. (a) The board shall create a
profile of each physician licensed under this subtitle. The
profile must:
(1) include the information required by Subsection (b); and
(2) be compiled in a format that makes the information contained
in the profile easily available to the public.
(b) A profile must contain the following information on each
physician:
(1) the name of each medical school attended and the dates of:
(A) graduation; or
(B) Fifth Pathway designation and completion of the Fifth
Pathway Program;
(2) a description of all graduate medical education in the
United States or Canada;
(3) any specialty certification held by the physician and issued
by a medical licensing board that is a member of the American
Board of Medical Specialties or the Bureau of Osteopathic
Specialists;
(4) the number of years the physician has actively practiced
medicine in:
(A) the United States or Canada; and
(B) this state;
(5) the name of each hospital in this state in which the
physician has privileges;
(6) the physician's primary practice location;
(7) the type of language translating services, including
translating services for a person with impairment of hearing,
that the physician provides at the physician's primary practice
location;
(8) whether the physician participates in the Medicaid program;
(9) a description of any conviction for a felony, a Class A or
Class B misdemeanor, or a Class C misdemeanor involving moral
turpitude;
(10) a description of any charges reported to the board to which
the physician has pleaded no contest, for which the physician is
the subject of deferred adjudication or pretrial diversion, or in
which sufficient facts of guilt were found and the matter was
continued by a court;
(11) a description of any disciplinary action against the
physician by the board;
(12) a description of any disciplinary action against the
physician by a medical licensing board of another state;
(13) a description of the final resolution taken by the board on
medical malpractice claims or complaints required to be opened by
the board under Section 164.201;
(14) whether the physician's patient service areas are
accessible to disabled persons, as defined by federal law;
(15) a description of any formal complaint against the physician
initiated and filed under Section 164.005 and the status of the
complaint; and
(16) a description of any medical malpractice claim against the
physician, not including a description of any offers by the
physician to settle the claim, for which the physician was found
liable, a jury awarded monetary damages to the claimant, and the
award has been determined to be final and not subject to further
appeal.
(c) Information required to be included under Subsection (b)
that is not maintained by the board in the ordinary course of the
board's duties shall be obtained from a physician at the time the
physician renews the physician's license. In requesting
information from the physician, the board shall:
(1) inform the physician that compliance with the request for
information is mandatory;
(2) inform the physician of the date the information will be
made available to the public; and
(3) instruct the physician about the requirements under
Subsection (f) for the physician to obtain a copy of the
physician's profile to make corrections.
(d) This section does not:
(1) prevent the board from providing explanatory information
regarding the significance of categories in which malpractice
settlements are reported; or
(2) require the board to disclose confidential settlement
information.
(e) A pending malpractice claim or complaint, other than a claim
disclosed under Subsection (b)(13), may not be disclosed to the
public by the board. This subsection does not prevent the board
from investigating and disciplining a physician on the basis of a
pending medical malpractice claim or complaint.
(f) The board shall provide a physician with a copy of the
physician's profile if the physician requests a copy at the time
the physician renews the physician's license. If a copy is
requested by a physician, the board shall provide the physician
one month from the date the copy is provided to the physician to
correct factual errors in the physician's profile.
(g) The board shall update the information contained in a
physician's profile annually, except that information provided
under Subsection (i) shall be updated not later than the 10th
working day after the date the formal complaint is filed or the
board's order is issued. The board shall adopt a form that allows
a physician to update information contained in a physician's
profile. The form shall be made available on the Internet and in
other formats as prescribed by board rule. The board may adopt
rules concerning the type and content of additional information
that may be included in a physician's profile.
(h) The board shall adopt rules as necessary to implement this
section.
(i) In addition to the information required by Subsection (b), a
profile must contain the text of a formal complaint filed under
Section 164.005 against the physician or of a board order related
to the formal complaint.
(j) Information included in a physician's profile under
Subsections (b) and (i) may not include any patient identifying
information.
(k) In the annual update of a physician's profile under
Subsection (g), the board shall remove any record of a formal
complaint required under Subsection (b)(15) or (i) if the
complaint was dismissed more than five years before the date of
the update and the complaint was dismissed as baseless,
unfounded, or not supported by sufficient evidence that a
violation occurred, or no action was taken against the
physician's license as a result of the complaint. The board
shall also remove any record of the investigation of medical
malpractice claims or complaints required to be investigated by
the board under Section 164.201 if the investigation was resolved
more than five years before the date of the update and no action
was taken against the physician's license as a result of the
investigation.
Added by Acts 2001, 77th Leg., ch. 1420, Sec. 14.026(a), eff.
Sept. 1, 2001. Amended by Acts 2003, 78th Leg., ch. 202, Sec. 7,
eff. June 10, 2003.
Amended by:
Acts 2009, 81st Leg., R.S., Ch.
607, Sec. 1, eff. September 1, 2009.
SUBCHAPTER B. COMPLAINT PROCEDURES
Sec. 154.051. COMPLAINT INITIATION. (a) The board by rule
shall establish methods by which members of the public and
license holders are notified of the name, mailing address, and
telephone number of the board for the purpose of directing
complaints to the board. The board may provide for that notice:
(1) on each registration form, application, or written contract
for services of a person or entity regulated under this subtitle;
(2) on a sign prominently displayed in the place of business of
each person or entity regulated under this subtitle; or
(3) in a bill for service provided by a person or entity
regulated under this subtitle.
(b) The 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 health professional.
(c) A person, including a partnership, association, corporation,
or other entity, may file a complaint against a license holder
with the board. The board may file a complaint on its own
initiative.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 154.052. RECORDS OF COMPLAINTS. The board shall maintain a
system to promptly and efficiently act on complaints filed with
the board. The board shall maintain information about:
(1) the parties to the complaint;
(2) the subject matter of the complaint;
(3) a summary of the results of the review or investigation of
the complaint; and
(4) the disposition of the complaint.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Amended by:
Acts 2005, 79th Leg., Ch.
269, Sec. 1.15, eff. September 1, 2005.
Sec. 154.053. NOTIFICATION CONCERNING COMPLAINT. (a) The board
shall notify a physician who is the subject of a complaint filed
with the board that a complaint has been filed and shall notify
the physician of the nature of the complaint unless the notice
would jeopardize an investigation.
(b) Each party shall be notified of the projected time
requirements for pursuing the complaint. Each party to the
complaint must be notified of a change in the schedule not later
than the 14th day after the date the change is made unless the
notice would jeopardize an investigation.
(c) The board shall periodically notify the parties to the
complaint of the status of the complaint until final disposition
unless the notice would jeopardize an investigation.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Amended by:
Acts 2005, 79th Leg., Ch.
269, Sec. 1.16, eff. September 1, 2005.
Sec. 154.054. COMPLAINT INFORMATION TO HEALTH CARE ENTITY. On
written request, the board shall provide information to a health
care entity regarding:
(1) a complaint filed against a license holder that was resolved
after investigation by:
(A) a disciplinary order of the board; or
(B) an agreed settlement; and
(2) the basis of and current status of any complaint under
active investigation that has been assigned by the executive
director to a person authorized by the board to pursue legal
action.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Amended by Acts 2003, 78th Leg., ch. 202, Sec. 8, eff. June 10,
2003.
Sec. 154.055. RELEASE OF COMPLAINT INFORMATION TO LEGISLATIVE
COMMITTEE. (a) On request from a legislative committee created
under Subchapter B, Chapter 301, Government Code, the board shall
release all information regarding a complaint against a physician
to aid in a legitimate legislative inquiry. The board may release
the information only to the members of the committee.
(b) In complying with a request under Subsection (a), the board
may not identify the complainant or the patient and may reveal
the identity of the affected physician only to the members of the
committee.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 154.056. GENERAL RULES REGARDING COMPLAINT INVESTIGATION;
DISPOSITION. (a) The board shall adopt rules concerning the
investigation and review of a complaint filed with the board. The
rules adopted under this section must:
(1) distinguish among categories of complaints and give priority
to complaints that involve sexual misconduct, quality of care,
and impaired physician issues;
(2) ensure that a complaint is not dismissed without appropriate
consideration;
(3) require that the board be advised of the dismissal of a
complaint and that a letter be sent to the person who filed the
complaint and to the physician who was the subject of the
complaint explaining the action taken on the complaint;
(4) ensure that a person who files a complaint has an
opportunity to explain the allegations made in the complaint;
(5) prescribe guidelines concerning the categories of complaints
that require the use of a private investigator and the procedures
for the board to obtain the services of a private investigator;
(6) provide for an expert physician panel authorized under
Subsection (e) to assist with complaints and investigations
relating to medical competency; and
(7) require the review of reports filed with the National
Practitioner Data Bank for any report of the termination,
limitation, suspension, limitation in scope of practice, or
probation of clinical or hospital staff privileges of a physician
by:
(A) a hospital;
(B) a health maintenance organization;
(C) an independent practice association;
(D) an approved nonprofit health corporation certified under
Section 162.001; or
(E) a physician network.
(b) The board shall:
(1) dispose of each complaint in a timely manner; and
(2) establish a schedule for conducting each phase of a
complaint that is under the control of the board not later than
the 30th day after the date the board receives the complaint.
(c) The executive director shall notify the board of a complaint
that is unresolved after the time prescribed by the board for
resolving the complaint so that the board may take necessary
action on the complaint.
(d) The board shall adopt other rules as appropriate to
administer this subchapter.
(e) The board by rule shall provide for an expert physician
panel appointed by the board to assist with complaints and
investigations relating to medical competency by acting as expert
physician reviewers. Each member of the expert physician panel
must be licensed to practice medicine in this state. The rules
adopted under this subsection must include provisions governing
the composition of the panel, qualifications for membership on
the panel, length of time a member may serve on the panel,
grounds for removal from the panel, the avoidance of conflicts of
interest, including situations in which the affected physician
and the panel member live or work in the same geographical area
or are competitors, and the duties to be performed by the panel.
The board's rules governing grounds for removal from the panel
must include providing for the removal of a panel member who is
repeatedly delinquent in reviewing complaints and in submitting
reports to the board. The board's rules governing appointment of
expert physician panel members to act as expert physician
reviewers must include a requirement that the board randomly
select, to the extent permitted by Section 154.058(b) and the
conflict of interest provisions adopted under this subsection,
panel members to review a complaint.
(f) In the board rules adopted under Subsection (a)(3), the
board shall require that the letter informing the person who
filed the complaint of the dismissal of the complaint include an
explanation of the reason the complaint was dismissed.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Amended by Acts 2003, 78th Leg., ch. 202, Sec. 9, eff. June 10,
2003.
Amended by:
Acts 2005, 79th Leg., Ch.
269, Sec. 1.17, eff. September 1, 2005.
Sec. 154.0561. PROCEDURES FOR EXPERT PHYSICIAN REVIEW. (a) A
physician on the expert physician panel authorized by Section
154.056(e) who is selected to review a complaint shall:
(1) determine whether the physician who is the subject of the
complaint has violated the standard of care applicable to the
circumstances; and
(2) issue a preliminary written report of that determination.
(b) A second expert physician reviewer shall review the first
physician's preliminary report and other information associated
with the complaint. If the second expert physician agrees with
the first expert physician, the first physician shall issue a
final written report on the matter.
(c) If the second expert physician does not agree with the
conclusions of the first expert physician, a third expert
physician reviewer shall review the preliminary report and
information and decide between the conclusions reached by the
first two expert physicians. The final written report shall be
issued by the third physician or the physician with whom the
third physician concurs.
(d) In reviewing a complaint, the expert physician reviewers
assigned to examine the complaint may consult and communicate
with each other about the complaint in formulating their opinions
and reports.
Added by Acts 2005, 79th Leg., Ch.
269, Sec. 1.18, eff. September 1, 2005.
Sec. 154.057. CONDUCT OF INVESTIGATION; USE OF INVESTIGATORS AS
PEACE OFFICERS. (a) Except as otherwise provided by this
subchapter, each investigation of a complaint filed under this
subtitle shall be conducted by the board or by a person
authorized by the board to conduct the investigation.
(b) The board shall complete a preliminary investigation of the
complaint not later than the 30th day after the date of receiving
the complaint. The board shall first determine whether the
physician constitutes a continuing threat to the public welfare.
On completion of the preliminary investigation, the board shall
determine whether to officially proceed on the complaint. If the
board fails to complete the preliminary investigation in the time
required by this subsection, the board's official investigation
of the complaint is considered to commence on that date.
(c) The board may commission investigators as peace officers to
enforce this subtitle. An investigator commissioned as a peace
officer under this subsection may not carry a firearm or exercise
the powers of arrest.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Amended by:
Acts 2005, 79th Leg., Ch.
269, Sec. 1.19, eff. September 1, 2005.
Sec. 154.058. DETERMINATION OF MEDICAL COMPETENCY. (a) Each
complaint against a physician that requires a determination of
medical competency shall be reviewed initially by a board member,
consultant, or employee with a medical background considered
sufficient by the board.
(b) If the initial review under Subsection (a) indicates that an
act by a physician falls below an acceptable standard of care,
the complaint shall be reviewed by an expert physician panel
authorized under Section 154.056(e) consisting of physicians who
practice in the same specialty as the physician who is the
subject of the complaint or in another specialty that is similar
to the physician's specialty.
(c) The expert physician panel shall report in writing the
panel's determinations based on the review of the complaint under
Subsection (b). The report must specify the standard of care that
applies to the facts that are the basis of the complaint and the
clinical basis for the panel's determinations, including any
reliance on peer-reviewed journals, studies, or reports.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Amended by Acts 2003, 78th Leg., ch. 202, Sec. 10, eff. June 10,
2003.