85R8303 BEE-D     By: Hinojosa, et al. S.B. No. 315       A BILL TO BE ENTITLED   AN ACT   relating to the continuation and functions of the Texas Medical   Board; authorizing a fee.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 151.004, Occupations Code, is amended to   read as follows:          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, 206,   601, 602, 603, and 604 expire September 1, 2029 [2017].          SECTION 2.  Section 152.010, Occupations Code, is amended by   amending Subsection (b) and adding Subsection (d) to read as   follows:          (b)  The training program must provide the person with   information regarding:                (1)  the law governing board operations [this   subtitle];                (2)  the programs, functions, rules, and budget of   [operated by] the board;                (3)  the scope of and limitations on the rulemaking   authority [role and functions] of the board;                (4)  [the rules of the board, with an emphasis on the   rules that relate to disciplinary and investigatory authority;                [(5)  the current budget for the board;                [(6)]  the results of the most recent formal audit of   the board;                (5) [(7)]  the requirements of:                      (A)  laws relating to open meetings, public   information, administrative procedure, and disclosing conflicts of   interest; and                      (B)  other laws applicable to members of the board   in performing their duties; and                (6) [(8)]  any applicable ethics policies adopted by   the board or the Texas Ethics Commission.          (d)  The executive director of the board shall create a   training manual that includes the information required by   Subsection (b). The executive director shall distribute a copy of   the training manual annually to each board member. On receipt of   the training manual, each board member shall sign and submit to the   executive director a statement acknowledging receipt of the   training manual.          SECTION 3.  The heading to Section 153.007, Occupations   Code, is amended to read as follows:          Sec. 153.007.  AUTHORITY TO ISSUE SUBPOENA OR ADMINISTER   OATH; SUBPOENA ENFORCEMENT.          SECTION 4.  Section 153.007, Occupations Code, is amended by   adding Subsection (e) to read as follows:          (e)  If a person fails to comply with a subpoena issued under   this section, the board, acting through the attorney general, may   file suit to enforce the subpoena in a district court in Travis   County or in a county in which a hearing conducted by the board may   be held.          SECTION 5.  Section 153.058(a), Occupations Code, is amended   to read as follows:          (a)  The board shall develop and implement a policy to   encourage the use of:                (1)  negotiated rulemaking procedures under Chapter   2008, Government Code, for the adoption of any rules by the board   [rules]; and                (2)  appropriate alternative dispute resolution   procedures under Chapter 2009, Government Code, to assist in the   resolution of internal and external disputes under the board's   jurisdiction.          SECTION 6.  Section 155.056, Occupations Code, is amended by   amending Subsection (a) and adding Subsection (a-1) to read as   follows:          (a)  Except as provided by Subsection (a-1), an [An]   applicant must pass each part of an examination within three   attempts.          (a-1)  The limit on the number of examination attempts under   Subsection (a) does not apply to the Texas medical jurisprudence   examination.          SECTION 7.  Subchapter A, Chapter 156, Occupations Code, is   amended by adding Section 156.010 to read as follows:          Sec. 156.010.  REFUSAL FOR VIOLATION OF BOARD ORDER. The   board may refuse to renew a registration permit issued under this   chapter if the license holder is in violation of a board order.          SECTION 8.  Section 162.106, Occupations Code, is amended to   read as follows:          Sec. 162.106.  INSPECTIONS. (a) The board may conduct   inspections [to enforce this subchapter, including inspections of   an office site and of documents] of a physician's equipment and   office procedures [practice] that relate to the provision of   anesthesia in an outpatient setting as necessary to enforce this   subchapter.          (b)  The board may establish a risk-based inspection process   in which the board conducts inspections based on the length of time   since:                (1)  the equipment and outpatient setting were last   inspected; and                (2)  the physician submitted to inspection.          (c)  The board may contract with another state agency or   qualified person to conduct the inspections.          (d) [(b)]  Unless it would jeopardize an ongoing   investigation, the board shall provide at least five business days'   notice before conducting an on-site inspection under this section.          (e)  The board shall maintain a record of the outpatient   settings in which physicians provide anesthesia.          (f)  A physician who provides anesthesia in an outpatient   setting shall inform the board of any other physician with whom the   physician shares equipment used to administer anesthesia.          (g) [(c)]  This section does not require the board to make an   on-site inspection of a physician's office.          SECTION 9.  Chapter 162, Occupations Code, is amended by   adding Subchapter G to read as follows:   SUBCHAPTER G. GENERAL PRACTICE PROVISIONS           Sec. 162.301.  DUTIES RELATED TO CERTAIN PRESCRIPTIONS. (a)   A physician may not prescribe a drug listed in Subsection (b) to a   patient unless the physician has reviewed the patient's   prescription history by accessing the prescription information   submitted to the Texas State Board of Pharmacy as authorized by   Section 481.076(a)(5), Health and Safety Code.          (b)  Subsection (a) applies only to the prescribing of:                (1)  opioids;                (2)  benzodiazepines;                (3)  barbiturates; or                (4)  carisoprodol.          (c)  A physician is not subject to the requirements of   Subsection (a) if:                (1)  the patient has been diagnosed with cancer or the   patient is receiving hospice care; and                (2)  the physician clearly notes in the prescription   record that the patient was diagnosed with cancer or is receiving   hospice care, as applicable.          (d)  Failure by a physician to comply with the requirements   of this section is grounds for disciplinary action under Section   164.051.          SECTION 10.  Section 164.0015(d), Occupations Code, is   amended to read as follows:          (d)  The board may not issue a remedial plan to resolve a   complaint against a license holder if the license holder has   [previously] entered into a remedial plan with the board in the   preceding five years [for the resolution of a different complaint   relating to this subtitle].          SECTION 11.  Section 164.003, Occupations Code, is amended   by amending Subsections (b) and (f) and adding Subsection (f-1) to   read as follows:          (b)  Rules adopted under this section must require that:                (1)  an informal meeting in compliance with Section   2001.054, Government Code, be scheduled not later than the 180th   day after the date the board's official investigation of the   complaint is commenced as provided by Section 154.057(b), unless   good cause is shown by the board for scheduling the informal meeting   after that date;                (2)  the board give notice to the license holder of the   time and place of the meeting not later than the 45th day before the   date the meeting is held;                (3)  the complainant and the license holder be provided   an opportunity to be heard;                (4)  at least one of the board members or district   review committee members participating in the informal meeting as a   panelist be a member who represents the public;                (5)  the board's legal counsel or a representative of   the attorney general be present to advise the board or the board's   staff; [and]                (6)  a member of the board's staff be at the meeting to   present to the board's representative the facts the staff   reasonably believes it could prove by competent evidence or   qualified witnesses at a hearing; and                (7)  if the complaint includes an allegation that the   license holder has violated the standard of care, the panel   conducting the informal proceeding consider whether the physician   was practicing complementary and alternative medicine.          (f)  The notice required by Subsection (b)(2) must be   accompanied by a written statement of the nature of the allegations   and the information the board intends to use at the meeting.  If the   board does not provide the statement or information at that time,   the license holder may use that failure as grounds for rescheduling   the informal meeting.  If the complaint includes an allegation that   the license holder has violated the standard of care, the notice   must include a copy of each [the] report prepared by an [the] expert   physician reviewer under Section 154.0561.  The license holder must   provide to the board the license holder's rebuttal at least 15   business days before the date of the meeting in order for the   information to be considered at the meeting.          (f-1)  Before providing a report to a license holder under   Subsection (f), the board must redact any identifying information   of an expert physician reviewer other than the specialty of the   expert physician reviewer.          SECTION 12.  Sections 164.005(a) and (c), Occupations Code,   are amended to read as follows:          (a)  In this section, "formal complaint" means a written   statement made by a credible person [under oath] that is filed and   presented by a board representative charging a person with having   committed an act that, if proven, could affect the legal rights or   privileges of a license holder or other person under the board's   jurisdiction.          (c)  A charge must [be in the form of a written affidavit   that]:                (1)  be [is] filed with the board's records custodian or   assistant records custodian; and                (2)  detail [details] the nature of the charge as   required by this subtitle or other applicable law.          SECTION 13.  Subchapter A, Chapter 164, Occupations Code, is   amended by adding Section 164.0105 to read as follows:          Sec. 164.0105.  MONITORING HARMFUL PRESCRIBING PATTERNS.   (a) The board shall periodically check the prescribing information   submitted to the Texas State Board of Pharmacy as authorized by   Section 481.076(a)(1), Health and Safety Code, to determine whether   a physician is engaging in potentially harmful prescribing patterns   or practices.          (b)  The board, in coordination with the Texas State Board of   Pharmacy, shall determine the conduct that constitutes a   potentially harmful prescribing pattern or practice for purposes of   Subsection (a). In determining the conduct that constitutes a   potentially harmful prescribing pattern or practice, the board   shall consider:                (1)  the number of times a physician prescribes a drug   listed in Section 162.301(b); and                (2)  for prescriptions described by Subdivision (1),   patterns of prescribing combinations of those drugs and other   dangerous combinations of drugs identified by the board.          (c)  If the board suspects that a physician may be engaging   in potentially harmful prescribing patterns or practices, the board   may notify the physician of the potentially harmful prescribing   pattern or practice.          (d)  The board may initiate a complaint against a physician   based on information obtained under this section.          SECTION 14.  Chapter 167, Occupations Code, is amended by   adding Sections 167.012 and 167.013 to read as follows:          Sec. 167.012.  MEMORANDUM OF UNDERSTANDING WITH BOARD. The   governing board and the board shall enter into a memorandum of   understanding to better coordinate services and operations of the   program.  The memorandum of understanding must be adopted by rule   and:                (1)  establish performance measures for the program,   including the number of participants who successfully complete the   program;                (2)  include a list of services the board will provide   for the program; and                (3)  require that an internal audit of the program be   conducted at least once every three years to ensure the program is   properly documenting and referring all noncompliance to the board.          Sec. 167.013.  GIFTS, GRANTS, AND DONATIONS. In addition to   any fees paid to the board or money appropriated to the board for   the program, the board may receive and accept a gift, grant,   donation, or other thing of value from any source, including the   United States or a private source, for the program.          SECTION 15.  Section 168.052, Occupations Code, is amended   to read as follows:          Sec. 168.052.  INSPECTIONS. (a) The board may inspect a   pain management clinic certified under this chapter, including the   documents of a physician practicing at the clinic, as necessary to   ensure compliance with this chapter.          (b)  The board may inspect a clinic or facility that is not   certified under this chapter to determine whether the clinic or   facility is required to be certified under Section 168.101.  The   board by rule shall establish the grounds for conducting an   inspection under this subsection, including grounds based on:                (1)  the population of patients served by the clinic or   facility;                (2)  the volume or combination of drugs prescribed to   patients served by the clinic or facility; and                (3)  any other criteria the board considers sufficient   to require an inspection of the clinic or facility.          SECTION 16.  Section 168.201, Occupations Code, is amended   by adding Subsection (a-1) to read as follows:          (a-1)  For the purposes of this section, inappropriate   prescribing includes nontherapeutic prescribing or other conduct   as specified by board rule.          SECTION 17.  Subtitle B, Title 3, Occupations Code, is   amended by adding Chapter 170 to read as follows:   CHAPTER 170. INTERSTATE MEDICAL LICENSURE COMPACT          Sec. 170.001.  INTERSTATE MEDICAL LICENSURE COMPACT. The   Interstate Medical Licensure Compact is enacted and entered into   with all other jurisdictions that legally join in the compact,   which reads as follows:   INTERSTATE MEDICAL LICENSURE COMPACT          SECTION 1.  PURPOSE          In order to strengthen access to health care, and in   recognition of the advances in the delivery of health care, the   member states of the Interstate Medical Licensure Compact have   allied in common purpose to develop a comprehensive process that   complements the existing licensing and regulatory authority of   state medical boards, and provides a streamlined process that   allows physicians to become licensed in multiple states, thereby   enhancing the portability of a medical license and ensuring the   safety of patients. The Compact creates another pathway for   licensure and does not otherwise change a state's existing Medical   Practice Act. The Compact also adopts the prevailing standard for   licensure and affirms that the practice of medicine occurs where   the patient is located at the time of the physician-patient   encounter, and therefore, requires the physician to be under the   jurisdiction of the state medical board where the patient is   located. State medical boards that participate in the Compact   retain the jurisdiction to impose an adverse action against a   license to practice medicine in that state issued to a physician   through the procedures in the Compact.          SECTION 2.  DEFINITIONS          In this compact:          (a)  "Bylaws" means those bylaws established by the   Interstate Commission pursuant to Section 11 for its governance, or   for directing and controlling its actions and conduct.          (b)  "Commissioner" means the voting representative   appointed by each member board pursuant to Section 11.          (c)  "Conviction" means a finding by a court that an   individual is guilty of a criminal offense through adjudication, or   entry of a plea of guilt or no contest to the charge by the offender.   Evidence of an entry of a conviction of a criminal offense by the   court shall be considered final for purposes of disciplinary action   by a member board.          (d)  "Expedited License" means a full and unrestricted   medical license granted by a member state to an eligible physician   through the process set forth in the Compact.          (e)  "Interstate Commission" means the interstate commission   created pursuant to Section 11.          (f)  "License" means authorization by a state for a physician   to engage in the practice of medicine, which would be unlawful   without the authorization.          (g)  "Medical Practice Act" means laws and regulations   governing the practice of allopathic and osteopathic medicine   within a member state.          (h)  "Member Board" means a state agency in a member state   that acts in the sovereign interests of the state by protecting the   public through licensure, regulation, and education of physicians   as directed by the state government.          (i)  "Member State" means a state that has enacted the   Compact.          (j)  "Practice of Medicine" means the clinical prevention,   diagnosis, or treatment of human disease, injury, or condition   requiring a physician to obtain and maintain a license in   compliance with the Medical Practice Act of a member state.          (k)  "Physician" means any person who:                (1)  Is a graduate of a medical school accredited by the   Liaison Committee on Medical Education, the Commission on   Osteopathic College Accreditation, or a medical school listed in   the International Medical Education Directory or its equivalent;                (2)  Passed each component of the United States Medical   Licensing Examination (USMLE) or the Comprehensive Osteopathic   Medical Licensing Examination (COMLEX-USA) within three attempts,   or any of its predecessor examinations accepted by a state medical   board as an equivalent examination for licensure purposes;                (3)  Successfully completed graduate medical education   approved by the Accreditation Council for Graduate Medical   Education or the American Osteopathic Association;                (4)  Holds specialty certification or a time-unlimited   specialty certificate recognized by the American Board of Medical   Specialties or the American Osteopathic Association's Bureau of   Osteopathic Specialists;                (5)  Possesses a full and unrestricted license to   engage in the practice of medicine issued by a member board;                (6)  Has never been convicted, received adjudication,   deferred adjudication, community supervision, or deferred   disposition for any offense by a court of appropriate jurisdiction;                (7)  Has never held a license authorizing the practice   of medicine subjected to discipline by a licensing agency in any   state, federal, or foreign jurisdiction, excluding any action   related to non-payment of fees related to a license;                (8)  Has never had a controlled substance license or   permit suspended or revoked by a state or the United States Drug   Enforcement Administration; and                (9)  Is not under active investigation by a licensing   agency or law enforcement authority in any state, federal, or   foreign jurisdiction.          (l)  "Offense" means a felony, gross misdemeanor, or crime of   moral turpitude.          (m)  "Rule" means a written statement by the Interstate   Commission promulgated pursuant to Section 12 of the Compact that   is of general applicability, implements, interprets, or prescribes   a policy or provision of the Compact, or an organizational,   procedural, or practice requirement of the Interstate Commission,   and has the force and effect of statutory law in a member state, and   includes the amendment, repeal, or suspension of an existing rule.          (n)  "State" means any state, commonwealth, district, or   territory of the United States.          (o)  "State of Principal License" means a member state where   a physician holds a license to practice medicine and which has been   designated as such by the physician for purposes of registration   and participation in the Compact.          SECTION 3.  ELIGIBILITY          (a)  A physician must meet the eligibility requirements as   defined in Section 2(k) to receive an expedited license under the   terms and provisions of the Compact.          (b)  A physician who does not meet the requirements of   Section 2(k) may obtain a license to practice medicine in a member   state if the individual complies with all laws and requirements,   other than the Compact, relating to the issuance of a license to   practice medicine in that state.          SECTION 4.  DESIGNATION OF STATE OF PRINCIPAL LICENSE          (a)  A physician shall designate a member state as the state   of principal license for purposes of registration for expedited   licensure through the Compact if the physician possesses a full and   unrestricted license to practice medicine in that state, and the   state is:                (1)  the state of primary residence for the physician,   or                (2)  the state where at least 25 percent of the practice   of medicine occurs, or                (3)  the location of the physician's employer, or                (4)  if no state qualifies under subsection (1),   subsection (2), or subsection (3), the state designated as state of   residence for purpose of federal income tax.          (b)  A physician may redesignate a member state as state of   principal license at any time, as long as the state meets the   requirements in subsection (a).          (c)  The Interstate Commission is authorized to develop   rules to facilitate redesignation of another member state as the   state of principal license.          SECTION 5.  APPLICATION AND ISSUANCE OF EXPEDITED LICENSURE          (a)  A physician seeking licensure through the Compact shall   file an application for an expedited license with the member board   of the state selected by the physician as the state of principal   license.          (b)  Upon receipt of an application for an expedited license,   the member board within the state selected as the state of principal   license shall evaluate whether the physician is eligible for   expedited licensure and issue a letter of qualification, verifying   or denying the physician's eligibility, to the Interstate   Commission.                (i)  Static qualifications, which include verification   of medical education, graduate medical education, results of any   medical or licensing examination, and other qualifications as   determined by the Interstate Commission through rule, shall not be   subject to additional primary source verification where already   primary source verified by the state of principal license.                (ii)  The member board within the state selected as the   state of principal license shall, in the course of verifying   eligibility, perform a criminal  background check of an applicant,   including the use of the results of fingerprint or other biometric   data checks compliant with the requirements of the Federal Bureau   of Investigation, with the exception of federal employees who have   suitability determination in accordance with U.S. C.F.R. Section   731.202.                (iii)  Appeal on the determination of eligibility shall   be made to the member state where the application was filed and   shall be subject to the law of that state.          (c)  Upon verification in subsection (b), physicians   eligible for an expedited license shall complete the registration   process established by the Interstate Commission to receive a   license in a member state selected pursuant to subsection (a),   including the payment of any applicable fees.          (d)  After receiving verification of eligibility under   subsection (b) and any fees under subsection (c), a member board   shall issue an expedited license to the physician. This license   shall authorize the physician to practice medicine in the issuing   state consistent with the Medical Practice Act and all applicable   laws and regulations of the issuing member board and member state.          (e)  An expedited license shall be valid for a period   consistent with the licensure period in the member state and in the   same manner as required for other physicians holding a full and   unrestricted license within the member state.          (f)  An expedited license obtained though the Compact shall   be terminated if a physician fails to maintain a license in the   state of principal licensure for a non-disciplinary reason, without   redesignation of a new state of principal licensure.          (g)  The Interstate Commission is authorized to develop   rules regarding the application process, including payment of any   applicable fees, and the issuance of an expedited license.          SECTION 6.  FEES FOR EXPEDITED LICENSURE          (a)  A member state issuing an expedited license authorizing   the practice of medicine in that state may impose a fee for a   license issued or renewed through the Compact.          (b)  The Interstate Commission is authorized to develop   rules regarding fees for expedited licenses.          SECTION 7.  RENEWAL AND CONTINUED PARTICIPATION          (a)  A physician seeking to renew an expedited license   granted in a member state shall complete a renewal process with the   Interstate Commission if the physician:                (1)  Maintains a full and unrestricted license in a   state of principal license;                (2)  Has not been convicted, received adjudication,   deferred adjudication, community supervision, or deferred   disposition for any offense by a court of appropriate jurisdiction;                (3)  Has not had a license authorizing the practice of   medicine subject to discipline by a licensing agency in any state,   federal, or foreign jurisdiction, excluding any action related to   non-payment of fees related to a license; and                (4)  Has not had a controlled substance license or   permit suspended or revoked by a state or the United States Drug   Enforcement Administration.          (b)  Physicians shall comply with all continuing   professional development or continuing medical education   requirements for renewal of a license issued by a member state.          (c)  The Interstate Commission shall collect any renewal   fees charged for the renewal of a license and distribute the fees to   the applicable member board.          (d)  Upon receipt of any renewal fees collected in subsection   (c), a member board shall renew the physician's license.          (e)  Physician information collected by the Interstate   Commission during the renewal process will be distributed to all   member boards.          (f)  The Interstate Commission is authorized to develop   rules to address renewal of licenses obtained through the Compact.          SECTION 8.  COORDINATED INFORMATION SYSTEM          (a)  The Interstate Commission shall establish a database of   all physicians licensed, or who have applied for licensure, under   Section 5.          (b)  Notwithstanding any other provision of law, member   boards shall report to the Interstate Commission any public action   or complaints against a licensed physician who has applied or   received an expedited license through the Compact.          (c)  Member boards shall report disciplinary or   investigatory information determined as necessary and proper by   rule of the Interstate Commission.          (d)  Member boards may report any non-public complaint,   disciplinary, or investigatory information not required by   subsection (c) to the Interstate Commission.          (e)  Member boards shall share complaint or disciplinary   information about a physician upon request of another member board.          (f)  All information provided to the Interstate Commission   or distributed by member boards shall be confidential, filed under   seal, and used only for investigatory or disciplinary matters.          (g)  The Interstate Commission is authorized to develop   rules for mandated or discretionary sharing of information by   member boards.          SECTION 9.  JOINT INVESTIGATIONS          (a)  Licensure and disciplinary records of physicians are   deemed investigative.          (b)  In addition to the authority granted to a member board   by its respective Medical Practice Act or other applicable state   law, a member board may participate with other member boards in   joint investigations of physicians licensed by the member boards.          (c)  A subpoena issued by a member state shall be enforceable   in other member states.          (d)  Member boards may share any investigative, litigation,   or compliance materials in furtherance of any joint or individual   investigation initiated under the Compact.          (e)  Any member state may investigate actual or alleged   violations of the statutes authorizing the practice of medicine in   any other member state in which a physician holds a license to   practice medicine.          SECTION 10.  DISCIPLINARY ACTIONS          (a)  Any disciplinary action taken by any member board   against a physician licensed through the Compact shall be deemed   unprofessional conduct which may be subject to discipline by other   member boards, in addition to any violation of the Medical Practice   Act or regulations in that state.          (b)  If a license granted to a physician by the member board   in the state of principal license is revoked, surrendered or   relinquished in lieu of discipline, or suspended, then all licenses   issued to the physician by member boards shall automatically be   placed, without further action necessary by any member board, on   the same status. If the member board in the state of principal   license subsequently reinstates the physician's license, a license   issued to the physician by any other member board shall remain   encumbered until that respective member board takes action to   reinstate the license in a manner consistent with the Medical   Practice Act of that state.          (c)  If disciplinary action is taken against a physician by a   member board not in the state of principal license, any other member   board may deem the action conclusive as to matter of law and fact   decided, and:                (i)  impose the same or lesser sanction(s) against the   physician so long as such sanctions are consistent with the Medical   Practice Act of that state;                (ii)  or pursue separate disciplinary action against   the physician under its respective Medical Practice Act, regardless   of the action taken in other member states.          (d)  If a license granted to a physician by a member board is   revoked, surrendered or relinquished in lieu of discipline, or   suspended, then any license(s) issued to the physician by any other   member board(s) shall be suspended, automatically and immediately   without further action necessary by the other member board(s), for   ninety (90) days upon entry of the order by the disciplining board,   to permit the member board(s) to investigate the basis for the   action under the Medical Practice Act of that state. A member board   may terminate the automatic suspension of the license it issued   prior to the completion of the ninety (90) day suspension period in   a manner consistent with the Medical Practice Act of that state.          SECTION 11.  INTERSTATE MEDICAL LICENSURE COMPACT   COMMISSION          (a)  The member states hereby create the "Interstate Medical   Licensure Compact Commission".          (b)  The purpose of the Interstate Commission is the   administration of the Interstate Medical Licensure Compact, which   is a discretionary state function.          (c)  The Interstate Commission shall be a body corporate and   joint agency of the member states and shall have all the   responsibilities, powers, and duties set forth in the Compact, and   such additional powers as may be conferred upon it by a subsequent   concurrent action of the respective legislatures of the member   states in accordance with the terms of the Compact.          (d)  The Interstate Commission shall consist of two voting   representatives appointed by each member state who shall serve as   Commissioners.  In states where allopathic and osteopathic   physicians are regulated by separate member boards, or if the   licensing and disciplinary authority is split between multiple   member boards within a member state, the member state shall appoint   one representative from each member board. A Commissioner shall be   a(n):                (1)  Allopathic or osteopathic physician appointed to a   member board;                (2)  Executive director, executive secretary, or   similar executive of a member board; or                (3)  Member of the public appointed to a member board.          (e)  The Interstate Commission shall meet at least once each   calendar year.  A portion of this meeting shall be a business   meeting to address such matters as may properly come before the   Commission, including the election of officers.  The chairperson   may call additional meetings and shall call for a meeting upon the   request of a majority of the member states.          (f)  The bylaws may provide for meetings of the Interstate   Commission to be conducted by telecommunication or electronic   communication.          (g)  Each Commissioner participating at a meeting of the   Interstate Commission is entitled to one vote.  A majority of   Commissioners shall constitute a quorum for the transaction of   business, unless a larger quorum is required by the bylaws of the   Interstate Commission.  A Commissioner shall not delegate a vote to   another Commissioner.  In the absence of its Commissioner, a member   state may delegate voting authority for a specified meeting to   another person from that state who shall meet the requirements of   subsection (d).          (h)  The Interstate Commission shall provide public notice   of all meetings and all meetings shall be open to the public.  The   Interstate Commission may close a meeting, in full or in portion,   where it determines by a two-thirds vote of the Commissioners   present that an open meeting would be likely to:                (1)  Relate solely to the internal personnel practices   and procedures of the Interstate Commission;                (2)  Discuss matters specifically exempted from   disclosure by federal statute;                (3)  Discuss trade secrets, commercial, or financial   information that is privileged or confidential;                (4)  Involve accusing a person of a crime, or formally   censuring a person;                (5)  Discuss information of a personal nature where   disclosure would constitute a clearly unwarranted invasion of   personal privacy;                (6)  Discuss investigative records compiled for law   enforcement purposes; or                (7)  Specifically relate to the participation in a   civil action or other legal proceeding.          (i)  The Interstate Commission shall keep minutes which   shall fully describe all matters discussed in a meeting and shall   provide a full and accurate summary of actions taken, including   record of any roll call votes.          (j)  The Interstate Commission shall make its information   and official records, to the extent not otherwise designated in the   Compact or by its rules, available to the public for inspection.          (k)  The Interstate Commission shall establish an executive   committee, which shall include officers, members, and others as   determined by the bylaws.  The executive committee shall have the   power to act on behalf of the Interstate Commission, with the   exception of rulemaking, during periods when the Interstate   Commission is not in session.  When acting on behalf of the   Interstate Commission, the executive committee shall oversee the   administration of the Compact including enforcement and compliance   with the provisions of the Compact, its bylaws and rules, and other   such duties as necessary.          (l)  The Interstate Commission may establish other   committees for governance and administration of the Compact.          SECTION 12.  POWERS AND DUTIES OF THE INTERSTATE COMMISSION          The Interstate Commission shall have the duty and power to:          (a)  Oversee and maintain the administration of the Compact;          (b)  Promulgate rules which shall be binding to the extent   and in the manner provided for in the Compact;          (c)  Issue, upon the request of a member state or member   board, advisory opinions concerning the meaning or interpretation   of the Compact, its bylaws, rules, and actions;          (d)  Enforce compliance with Compact provisions, the rules   promulgated by the Interstate Commission, and the bylaws, using all   necessary and proper means, including but not limited to the use of   judicial process;          (e)  Establish and appoint committees including, but not   limited to, an executive committee as required by Section 11, which   shall have the power to act on behalf of the Interstate Commission   in carrying out its powers and duties;          (f)  Pay, or provide for the payment of the expenses related   to the establishment, organization, and ongoing activities of the   Interstate Commission;          (g)  Establish and maintain one or more offices;          (h)  Borrow, accept, hire, or contract for services of   personnel;          (i)  Purchase and maintain insurance and bonds;          (j)  Employ an executive director who shall have such powers   to employ, select or appoint employees, agents, or consultants, and   to determine their qualifications, define their duties, and fix   their compensation;          (k)  Establish personnel policies and programs relating to   conflicts of interest, rates of compensation, and qualifications of   personnel;          (l)  Accept donations and grants of money, equipment,   supplies, materials and services, and to receive, utilize, and   dispose of it in a manner consistent with the conflict of interest   policies established by the Interstate Commission;          (m)  Lease, purchase, accept contributions or donations of,   or otherwise to own, hold, improve or use, any property, real,   personal, or mixed;          (n)  Sell, convey, mortgage, pledge, lease, exchange,   abandon, or otherwise dispose of any property, real, personal, or   mixed;          (o)  Establish a budget and make expenditures;          (p)  Adopt a seal and bylaws governing the management and   operation of the Interstate Commission;          (q)  Report annually to the legislatures and governors of the   member states concerning the activities of the Interstate   Commission during the preceding year. Such reports shall also   include reports of financial audits and any recommendations that   may have been adopted by the Interstate Commission;          (r)  Coordinate education, training, and public awareness   regarding the Compact, its implementation, and its operation;          (s)  Maintain records in accordance with the bylaws;          (t)  Seek and obtain trademarks, copyrights, and patents;   and          (u)  Perform such functions as may be necessary or   appropriate to achieve the purposes of the Compact.          SECTION 13.  FINANCE POWERS          (a)  The Interstate Commission may levy on and collect an   annual assessment from each member state to cover the cost of the   operations and activities of the Interstate Commission and its   staff.  The total assessment must be sufficient to cover the annual   budget approved each year for which revenue is not provided by other   sources.  The aggregate annual assessment amount shall be allocated   upon a formula to be determined by the Interstate Commission, which   shall promulgate a rule binding upon all member states.          (b)  The Interstate Commission shall not incur obligations   of any kind prior to securing the funds adequate to meet the same.          (c)  The Interstate Commission shall not pledge the credit of   any of the member states, except by, and with the authority of, the   member state.          (d)  The Interstate Commission shall be subject to a yearly   financial audit conducted by a certified or licensed public   accountant and the report of the audit shall be included in the   annual report of the Interstate Commission.          SECTION 14.  ORGANIZATION AND OPERATION OF THE INTERSTATE   COMMISSION          (a)  The Interstate Commission shall, by a majority of   Commissioners present and voting, adopt bylaws to govern its   conduct as may be necessary or appropriate to carry out the purposes   of the Compact within twelve (12) months of the first Interstate   Commission meeting.          (b)  The Interstate Commission shall elect or appoint   annually from among its Commissioners a chairperson, a   vice-chairperson, and a treasurer, each of whom shall have such   authority and duties as may be specified in the bylaws.  The   chairperson, or in the chairperson's absence or disability, the   vice-chairperson, shall preside at all meetings of the Interstate   Commission.          (c)  Officers selected in subsection (b) shall serve without   remuneration from the Interstate Commission.          (d)  The officers and employees of the Interstate Commission   shall be immune from suit and liability, either personally or in   their official capacity, for a claim for damage to or loss of   property or personal injury or other civil liability caused or   arising out of, or relating to, an actual or alleged act, error, or   omission that occurred, or that such person had a reasonable basis   for believing occurred, within the scope of Interstate Commission   employment, duties, or responsibilities; provided that such person   shall not be protected from suit or liability for damage, loss,   injury, or liability caused by the intentional or willful and   wanton misconduct of such person.                (1)  The liability of the executive director and   employees of the Interstate Commission or representatives of the   Interstate Commission, acting within the scope of such person's   employment or duties for acts, errors, or omissions occurring   within such person's state, may not exceed the limits of liability   set forth under the constitution and laws of that state for state   officials, employees, and agents.  The Interstate Commission is   considered to be an instrumentality of the states for the purposes   of any such action.  Nothing in this subsection shall be construed   to protect such person from suit or liability for damage, loss,   injury, or liability caused by the intentional or willful and   wanton misconduct of such person.                (2)  The Interstate Commission shall defend the   executive director, its employees, and subject to the approval of   the attorney general or other appropriate legal counsel of the   member state represented by an Interstate Commission   representative, shall defend such Interstate Commission   representative in any civil action seeking to impose liability   arising out of an actual or alleged act, error or omission that   occurred within the scope of Interstate Commission employment,   duties or responsibilities, or that the defendant had a reasonable   basis for believing occurred within the scope of Interstate   Commission employment, duties, or responsibilities, provided that   the actual or alleged act, error, or omission did not result from   intentional or willful and wanton misconduct on the part of such   person.                (3)  To the extent not covered by the state involved,   member state, or the Interstate Commission, the representatives or   employees of the Interstate Commission shall be held harmless in   the amount of a settlement or judgment, including attorney's fees   and costs, obtained against such persons arising out of an actual or   alleged act, error, or omission that occurred within the scope of   Interstate Commission employment, duties, or responsibilities, or   that such persons had a reasonable basis for believing occurred   within the scope of Interstate Commission employment, duties, or   responsibilities, provided that the actual or alleged act, error,   or omission did not result from intentional or willful and wanton   misconduct on the part of such persons.          SECTION 15.  RULEMAKING FUNCTIONS OF THE INTERSTATE   COMMISSION          (a)  The Interstate Commission shall promulgate reasonable   rules in order to effectively and efficiently achieve the purposes   of the Compact. Notwithstanding the foregoing, in the event the   Interstate Commission exercises its rulemaking authority in a   manner that is beyond the scope of the purposes of the Compact, or   the powers granted hereunder, then such an action by the Interstate   Commission shall be invalid and have no force or effect.          (b)  Rules deemed appropriate for the operations of the   Interstate Commission shall be made pursuant to a rulemaking   process that substantially conforms to the "Model State   Administrative Procedure Act" of 2010, and subsequent amendments   thereto.          (c)  Not later than thirty (30) days after a rule is   promulgated, any person may file a petition for judicial review of   the rule in the United States District Court for the District of   Columbia or the federal district where the Interstate Commission   has its principal offices, provided that the filing of such a   petition shall not stay or otherwise prevent the rule from becoming   effective unless the court finds that the petitioner has a   substantial likelihood of success. The court shall give deference   to the actions of the Interstate Commission consistent with   applicable law and shall not find the rule to be unlawful if the   rule represents a reasonable exercise of the authority granted to   the Interstate Commission.          SECTION 16.  OVERSIGHT OF INTERSTATE COMPACT          (a)  The executive, legislative, and judicial branches of   state government in each member state shall enforce the Compact and   shall take all actions necessary and appropriate to effectuate the   Compact's purposes and intent. The provisions of the Compact and   the rules promulgated hereunder shall have standing as statutory   law but shall not override existing state authority to regulate the   practice of medicine.          (b)  All courts shall take judicial notice of the Compact and   the rules in any judicial or administrative proceeding in a member   state pertaining to the subject matter of the Compact which may   affect the powers, responsibilities or actions of the Interstate   Commission.          (c)  The Interstate Commission shall be entitled to receive   all service of process in any such proceeding, and shall have   standing to intervene in the proceeding for all purposes.  Failure   to provide service of process to the Interstate Commission shall   render a judgment or order void as to the Interstate Commission, the   Compact, or promulgated rules.          SECTION 17.  ENFORCEMENT OF INTERSTATE COMPACT          (a)  The Interstate Commission, in the reasonable exercise   of its discretion, shall enforce the provisions and rules of the   Compact.          (b)  The Interstate Commission may, by majority vote of the   Commissioners, initiate legal action in the United States District   Court for the District of Columbia, or, at the discretion of the   Interstate Commission, in the federal district where the Interstate   Commission has its principal offices, to enforce compliance with   the provisions of the Compact, and its promulgated rules and   bylaws, against a member state in default.  The relief sought may   include both injunctive relief and damages.  In the event judicial   enforcement is necessary, the prevailing party shall be awarded all   costs of such litigation including reasonable attorney's fees.          (c)  The remedies herein shall not be the exclusive remedies   of the Interstate Commission. The Interstate Commission may avail   itself of any other remedies available under state law or the   regulation of a profession.          SECTION 18.  DEFAULT PROCEDURES          (a)  The grounds for default include, but are not limited to,   failure of a member state to perform such obligations or   responsibilities imposed upon it by the Compact, or the rules and   bylaws of the Interstate Commission promulgated under the Compact.          (b)  If the Interstate Commission determines that a member   state has defaulted in the performance of its obligations or   responsibilities under the Compact, or the bylaws or promulgated   rules, the Interstate Commission shall:                (1)  Provide written notice to the defaulting state and   other member states, of the nature of the default, the means of   curing the default, and any action taken by the Interstate   Commission.  The Interstate Commission shall specify the conditions   by which the defaulting state must cure its default; and                (2)  Provide remedial training and specific technical   assistance regarding the default.          (c)  If the defaulting state fails to cure the default, the   defaulting state shall be terminated from the Compact upon an   affirmative vote of a majority of the Commissioners and all rights,   privileges, and benefits conferred by the Compact shall terminate   on the effective date of termination. A cure of the default does not   relieve the offending state of obligations or liabilities incurred   during the period of the default.          (d)  Termination of membership in the Compact shall be   imposed only after all other means of securing compliance have been   exhausted. Notice of intent to terminate shall be given by the   Interstate Commission to the governor, the majority and minority   leaders of the defaulting state's legislature, and each of the   member states.          (e)  The Interstate Commission shall establish rules and   procedures to address licenses and physicians that are materially   impacted by the termination of a member state, or the withdrawal of   a member state.          (f)  The member state which has been terminated is   responsible for all dues, obligations, and liabilities incurred   through the effective date of termination including obligations,   the performance of which extends beyond the effective date of   termination.          (g)  The Interstate Commission shall not bear any costs   relating to any state that has been found to be in default or which   has been terminated from the Compact, unless otherwise mutually   agreed upon in writing between the Interstate Commission and the   defaulting state.          (h)  The defaulting state may appeal the action of the   Interstate Commission by petitioning the United States District   Court for the District of Columbia or the federal district where the   Interstate Commission has its principal offices. The prevailing   party shall be awarded all costs of such litigation including   reasonable attorney's fees.          SECTION 19.  DISPUTE RESOLUTION          (a)  The Interstate Commission shall attempt, upon the   request of a member state, to resolve disputes which are subject to   the Compact and which may arise among member states or member   boards.          (b)  The Interstate Commission shall promulgate rules   providing for both mediation and binding dispute resolution as   appropriate.          SECTION 20.  MEMBER STATES, EFFECTIVE DATE AND AMENDMENT          (a)  Any state is eligible to become a member state of the   Compact.          (b)  The Compact shall become effective and binding upon   legislative enactment of the Compact into law by no less than seven   (7) states. Thereafter, it shall become effective and binding on a   state upon enactment of the Compact into law by that state.          (c)  The governors of non-member states, or their designees,   shall be invited to participate in the activities of the Interstate   Commission on a non-voting basis prior to adoption of the Compact by   all states.          (d)  The Interstate Commission may propose amendments to the   Compact for enactment by the member states. No amendment shall   become effective and binding upon the Interstate Commission and the   member states unless and until it is enacted into law by unanimous   consent of the member states.          SECTION 21.  WITHDRAWAL          (a)  Once effective, the Compact shall continue in force and   remain binding upon each and every member state; provided that a   member state may withdraw from the Compact by specifically   repealing the statute which enacted the Compact into law.          (b)  Withdrawal from the Compact shall be by the enactment of   a statute repealing the same, but shall not take effect until one   (1) year after the effective date of such statute and until written   notice of the withdrawal has been given by the withdrawing state to   the governor of each other member state.          (c)  The withdrawing state shall immediately notify the   chairperson of the Interstate Commission in writing upon the   introduction of legislation repealing the Compact in the   withdrawing state.          (d)  The Interstate Commission shall notify the other member   states of the withdrawing state's intent to withdraw within sixty   (60) days of its receipt of notice provided under subsection (c).          (e)  The withdrawing state is responsible for all dues,   obligations and liabilities incurred through the effective date of   withdrawal, including obligations, the performance of which extend   beyond the effective date of withdrawal.          (f)  Reinstatement following withdrawal of a member state   shall occur upon the withdrawing state reenacting the Compact or   upon such later date as determined by the Interstate Commission.          (g)  The Interstate Commission is authorized to develop   rules to address the impact of the withdrawal of a member state on   licenses granted in other member states to physicians who   designated the withdrawing member state as the state of principal   license.          SECTION 22.  DISSOLUTION          (a)  The Compact shall dissolve effective upon the date of   the withdrawal or default of the member state which reduces the   membership in the Compact to one (1) member state.          (b)  Upon the dissolution of the Compact, the Compact becomes   null and void and shall be of no further force or effect, and the   business and affairs of the Interstate Commission shall be   concluded and surplus funds shall be distributed in accordance with   the bylaws.          SECTION 23.  SEVERABILITY AND CONSTRUCTION          (a)  The provisions of the Compact shall be severable, and if   any phrase, clause, sentence, or provision is deemed unenforceable,   the remaining provisions of the Compact shall be enforceable.          (b)  The provisions of the Compact shall be liberally   construed to effectuate its purposes.          (c)  Nothing in the Compact shall be construed to prohibit   the applicability of other interstate compacts to which the states   are members.          SECTION 24.  BINDING EFFECT OF COMPACT AND OTHER LAWS          (a)  Nothing herein prevents the enforcement of any other law   of a member state that is not inconsistent with the Compact.          (b)  All laws in a member state in conflict with the Compact   are superseded to the extent of the conflict.          (c)  All lawful actions of the Interstate Commission,   including all rules and bylaws promulgated by the Commission, are   binding upon the member states.          (d)  All agreements between the Interstate Commission and   the member states are binding in accordance with their terms.          (e)  In the event any provision of the Compact exceeds the   constitutional limits imposed on the legislature of any member   state, such provision shall be ineffective to the extent of the   conflict with the constitutional provision in question in that   member state.          Sec. 170.002.  RULES. The board may adopt rules necessary to   implement this chapter.          SECTION 18.  Subchapter B, Chapter 204, Occupations Code, is   amended by adding Section 204.0585 to read as follows:          Sec. 204.0585.  EXECUTIVE SESSION. After hearing all   evidence and arguments in an open meeting, the physician assistant   board may conduct deliberations relating to a license application   or disciplinary action in an executive session. The board shall   vote and announce its decision in open session.          SECTION 19.  Section 204.059, Occupations Code, is amended   by amending Subsection (b) and adding Subsection (d) to read as   follows:          (b)  The training program must provide the person with   information regarding:                (1)  the law governing physician assistant board   operations;                (2)  the [this chapter and the physician assistant   board's] programs, functions, rules, and budget of the physician   assistant board;                (3)  the scope of and limitations on the rulemaking   authority of the physician assistant board;                (4) [(2)]  the results of the most recent formal audit   of the physician assistant board;                (5) [(3)]  the requirements of:                      (A)  laws relating to open meetings, public   information, administrative procedure, and disclosing conflicts of   interest; and                      (B)  other laws applicable to members of the   physician assistant board in performing their duties; and                (6) [(4)]  any applicable ethics policies adopted by   the physician assistant board or the Texas Ethics Commission.          (d)  The executive director of the medical board shall create   a training manual that includes the information required by   Subsection (b). The executive director shall distribute a copy of   the training manual annually to each physician assistant board   member. On receipt of the training manual, each board member shall   sign and submit to the executive director a statement acknowledging   receipt of the training manual.          SECTION 20.  Subchapter D, Chapter 204, Occupations Code, is   amended by adding Section 204.1525 to read as follows:          Sec. 204.1525.  CRIMINAL HISTORY RECORD INFORMATION   REQUIREMENT FOR LICENSE ISSUANCE. (a) The physician assistant   board shall require that an applicant for a license submit a   complete and legible set of fingerprints, on a form prescribed by   the board, to the board or to the Department of Public Safety for   the purpose of obtaining criminal history record information from   the Department of Public Safety and the Federal Bureau of   Investigation.          (b)  The physician assistant board may not issue a license to   a person who does not comply with the requirement of Subsection (a).          (c)  The physician assistant board shall conduct a criminal   history record information check of each applicant for a license   using information:                (1)  provided by the individual under this section; and                (2)  made available to the board by the Department of   Public Safety, the Federal Bureau of Investigation, and any other   criminal justice agency under Chapter 411, Government Code.          (d)  The physician assistant board may:                (1)  enter into an agreement with the Department of   Public Safety to administer a criminal history record information   check required under this section; and                (2)  authorize the Department of Public Safety to   collect from each applicant the costs incurred by the Department of   Public Safety in conducting the criminal history record information   check.          SECTION 21.  Section 204.153(a), Occupations Code, is   amended to read as follows:          (a)  To be eligible for a license under this chapter, an   applicant must:                (1)  successfully complete an educational program for   physician assistants or surgeon assistants accredited by the   Committee on Allied Health Education and Accreditation or by that   committee's predecessor or successor entities;                (2)  pass the Physician Assistant National Certifying   Examination administered by the National Commission on   Certification of Physician Assistants;                (3)  hold a certificate issued by the National   Commission on Certification of Physician Assistants;                (4)  [be of good moral character;                [(5)]  meet any other requirement established by   physician assistant board rule; and                (5) [(6)]  pass a jurisprudence examination approved   by the physician assistant board as provided by Subsection (a-1).          SECTION 22.  Section 204.156, Occupations Code, is amended   by amending Subsection (a) and adding Subsection (a-1) to read as   follows:          (a)  A license issued under this chapter is valid for a term   of one or two years, as determined by physician assistant board   rule.          (a-1)  On notification from the physician assistant board, a   person who holds a license under this chapter may renew the license   by:                (1)  paying the required renewal fee;                (2)  submitting the appropriate form; and                (3)  meeting any other requirement established by board   rule.          SECTION 23.  Subchapter D, Chapter 204, Occupations Code, is   amended by adding Section 204.1561 to read as follows:          Sec. 204.1561.  CRIMINAL HISTORY RECORD INFORMATION   REQUIREMENT FOR RENEWAL. (a) An applicant for renewal of a license   issued under this chapter shall submit a complete and legible set of   fingerprints for purposes of performing a criminal history record   information check of the applicant as provided by Section 204.1525.          (b)  The physician assistant board may administratively   suspend or refuse to renew the license of a person who does not   comply with the requirement of Subsection (a).          (c)  A license holder is not required to submit fingerprints   under this section for the renewal of the license if the holder has   previously submitted fingerprints under:                (1)  Section 204.1525 for the initial issuance of the   license; or                (2)  this section as part of a prior renewal of a   license.          SECTION 24.  Subchapter D, Chapter 204, Occupations Code, is   amended by adding Section 204.158 to read as follows:          Sec. 204.158.  REFUSAL FOR VIOLATION OF BOARD ORDER. The   physician assistant board may refuse to renew a license issued   under this chapter if the license holder is in violation of a   physician assistant board order.          SECTION 25.  Subchapter E, Chapter 204, Occupations Code, is   amended by adding Section 204.210 to read as follows:          Sec. 204.210.  DUTIES RELATED TO CERTAIN PRESCRIPTIONS. (a)   A physician assistant authorized to prescribe a drug may not   prescribe a drug listed in Subsection (b) to a patient unless the   physician assistant has reviewed the patient's prescription   history by accessing the prescription information submitted to the   Texas State Board of Pharmacy as authorized by Section   481.076(a)(5), Health and Safety Code.          (b)  Subsection (a) applies only to the prescribing of:                (1)  opioids;                (2)  benzodiazepines;                (3)  barbiturates; or                (4)  carisoprodol.          (c)  A physician assistant is not subject to the requirements   of Subsection (a) if:                (1)  the patient has been diagnosed with cancer or the   patient is receiving hospice care; and                (2)  the physician assistant clearly notes in the   prescription record that the patient was diagnosed with cancer or   is receiving hospice care, as applicable.          (d)  Failure by a physician assistant to comply with the   requirements of this section is grounds for disciplinary action   under Section 204.301.          SECTION 26.  Subchapter G, Chapter 204, Occupations Code, is   amended by adding Section 204.305 to read as follows:          Sec. 204.305.  MONITORING HARMFUL PRESCRIBING PATTERNS. (a)   The physician assistant board shall periodically check the   prescribing information submitted to the Texas State Board of   Pharmacy as authorized by Section 481.076(a)(1), Health and Safety   Code, to determine whether a physician assistant licensed under   this chapter is engaging in potentially harmful prescribing   patterns or practices.          (b)  The physician assistant board, in coordination with the   Texas State Board of Pharmacy, shall determine the conduct that   constitutes a potentially harmful prescribing pattern or practice   for purposes of Subsection (a). In determining the conduct that   constitutes a potentially harmful prescribing pattern or practice,   the physician assistant board shall consider:                (1)  the number of times a physician assistant   prescribes a drug listed in Section 204.210(b); and                (2)  for prescriptions described by Subdivision (1),   patterns of prescribing combinations of those drugs and other   dangerous combinations of drugs identified by the physician   assistant board.          (c)  If the physician assistant board suspects that a   physician assistant may be engaging in potentially harmful   prescribing patterns or practices, the physician assistant board   may notify the physician assistant of the potentially harmful   prescribing pattern or practice.          (d)  The physician assistant board may initiate a complaint   against a physician assistant based on information obtained under   this section.          SECTION 27.  Section 204.313(a), Occupations Code, is   amended to read as follows:          (a)  In an informal meeting under Section 204.312, at least   two panelists shall be appointed to determine whether an informal   disposition is appropriate. At least one of the panelists must be a   licensed physician assistant.          SECTION 28.  Section 205.057, Occupations Code, is amended   by amending Subsection (b) and adding Subsection (d) to read as   follows:          (b)  The training program must provide the person with   information regarding:                (1)  the law governing acupuncture board operations   [this chapter];                (2)  the programs, [operated by the acupuncture board;                [(3)  the role and] functions, rules, and budget of the   acupuncture board;                (3) [(4)]  the scope of and limitations on the   rulemaking authority [rules] of the acupuncture board;                (4) [(5)  the current budget for the acupuncture board;                [(6)]  the results of the most recent formal audit of   the acupuncture board;                (5) [(7)]  the requirements of:                      (A)  laws relating to open meetings, public   information, administrative procedure, and disclosing conflicts of   interest; and                      (B)  other laws applicable to members of the   acupuncture board in performing their duties; and                (6) [(8)]  any applicable ethics policies adopted by   the acupuncture board or the Texas Ethics Commission.          (d)  The executive director shall create a training manual   that includes the information required by Subsection (b). The   executive director shall distribute a copy of the training manual   annually to each acupuncture board member. On receipt of the   training manual, each board member shall sign and submit to the   executive director a statement acknowledging receipt of the   training manual.          SECTION 29.  Subchapter E, Chapter 205, Occupations Code, is   amended by adding Section 205.2025 to read as follows:          Sec. 205.2025.  CRIMINAL HISTORY RECORD INFORMATION   REQUIREMENT FOR LICENSE ISSUANCE. (a) The acupuncture board shall   require that an applicant for a license submit a complete and   legible set of fingerprints, on a form prescribed by the board, to   the board or to the Department of Public Safety for the purpose of   obtaining criminal history record information from the Department   of Public Safety and the Federal Bureau of Investigation.          (b)  The acupuncture board may not issue a license to a   person who does not comply with the requirement of Subsection (a).          (c)  The acupuncture board shall conduct a criminal history   record information check of each applicant for a license using   information:                (1)  provided by the individual under this section; and                (2)  made available to the board by the Department of   Public Safety, the Federal Bureau of Investigation, and any other   criminal justice agency under Chapter 411, Government Code.          (d)  The acupuncture board may:                (1)  enter into an agreement with the Department of   Public Safety to administer a criminal history record information   check required under this section; and                (2)  authorize the Department of Public Safety to   collect from each applicant the costs incurred by the Department of   Public Safety in conducting the criminal history record information   check.          SECTION 30.  The heading to Section 205.251, Occupations   Code, is amended to read as follows:          Sec. 205.251.  [ANNUAL] RENEWAL REQUIRED.          SECTION 31.  Section 205.251(a), Occupations Code, is   amended to read as follows:          (a)  The medical board by rule shall provide for the annual   or biennial renewal of a license to practice acupuncture.          SECTION 32.  Subchapter F, Chapter 205, Occupations Code, is   amended by adding Section 205.2515 to read as follows:          Sec. 205.2515.  CRIMINAL HISTORY RECORD INFORMATION   REQUIREMENT FOR RENEWAL. (a)  An applicant for renewal of a license   issued under this chapter shall submit a complete and legible set of   fingerprints for purposes of performing a criminal history record   information check of the applicant as provided by Section 205.2025.          (b)  The acupuncture board may administratively suspend or   refuse to renew the license of a person who does not comply with the   requirement of Subsection (a).          (c)  A license holder is not required to submit fingerprints   under this section for the renewal of the license if the holder has   previously submitted fingerprints under:                (1)  Section 205.2025 for the initial issuance of the   license; or                (2)  this section as part of a prior renewal of a   license.            SECTION 33.  Subchapter F, Chapter 205, Occupations Code, is   amended by adding Section 205.256 to read as follows:          Sec. 205.256.  REFUSAL FOR VIOLATION OF BOARD ORDER. The   acupuncture board may refuse to renew a license issued under this   chapter if the license holder is in violation of an acupuncture   board order.            SECTION 34.  Subchapter E, Chapter 206, Occupations Code, is   amended by adding Section 206.2025 to read as follows:          Sec. 206.2025.  CRIMINAL HISTORY RECORD INFORMATION   REQUIREMENT FOR LICENSE ISSUANCE. (a)  The medical board shall   require that an applicant for a license submit a complete and   legible set of fingerprints, on a form prescribed by the board, to   the board or to the Department of Public Safety for the purpose of   obtaining criminal history record information from the Department   of Public Safety and the Federal Bureau of Investigation.          (b)  The medical board may not issue a license to a person who   does not comply with the requirement of Subsection (a).          (c)  The medical board shall conduct a criminal history   record information check of each applicant for a license using   information:                (1)  provided by the individual under this section; and                (2)  made available to the board by the Department of   Public Safety, the Federal Bureau of Investigation, and any other   criminal justice agency under Chapter 411, Government Code.          (d)  The medical board may:                (1)  enter into an agreement with the Department of   Public Safety to administer a criminal history record information   check required under this section; and                (2)  authorize the Department of Public Safety to   collect from each applicant the costs incurred by the Department of   Public Safety in conducting the criminal history record information   check.            SECTION 35.  Section 206.203(a), Occupations Code, is   amended to read as follows:          (a)  Except as provided by Section 206.206, to be eligible   for a license, a person must:                (1)  [be of good moral character;                [(2)]  have not been convicted of a felony or a crime   involving moral turpitude;                (2) [(3)]  not use drugs or alcohol to an extent that   affects the applicant's professional competency;                (3) [(4)]  not have had a license or certification   revoked by a licensing agency or by a certifying professional   organization; and                (4) [(5)]  not have engaged in fraud or deceit in   applying for a license under this chapter.          SECTION 36.  Subchapter E, Chapter 206, Occupations Code, is   amended by adding Section 206.2105 to read as follows:          Sec. 206.2105.  CRIMINAL HISTORY RECORD INFORMATION   REQUIREMENT FOR RENEWAL. (a)  An applicant for renewal of a license   issued under this chapter shall submit a complete and legible set of   fingerprints for purposes of performing a criminal history record   information check of the applicant as provided by Section 206.2025.          (b)  The medical board may administratively suspend or   refuse to renew the license of a person who does not comply with the   requirement of Subsection (a).          (c)  A license holder is not required to submit fingerprints   under this section for the renewal of the license if the holder has   previously submitted fingerprints under:                (1)  Section 206.2025 for the initial issuance of the   license; or                (2)  this section as part of a prior renewal of a   license.            SECTION 37.  Subchapter E, Chapter 206, Occupations Code, is   amended by adding Section 206.215 to read as follows:          Sec. 206.215.  REFUSAL FOR VIOLATION OF BOARD ORDER. The   medical board may refuse to renew a license issued under this   chapter if the license holder is in violation of a medical board   order.            SECTION 38.  Section 601.002, Occupations Code, is amended   by adding Subdivisions (10-a) and (10-b) to read as follows:                (10-a)  "Radiologist" means a physician specializing   in radiology certified by or board-eligible for the American Board   of Radiology, the American Osteopathic Board of Radiology, the   Royal College of Radiologists, or the Royal College of Physicians   and Surgeons of Canada.                (10-b)  "Radiologist assistant" means an   advanced-level medical radiologic technologist who is certified   as:                      (A)  a registered radiologist assistant by the   American Registry of Radiologic Technologists; or                      (B)  a radiology practitioner assistant by the   Certification Board for Radiology Practitioner Assistants.            SECTION 39.  Section 601.030, Occupations Code, is amended   by amending Subsection (b) and adding Subsection (d) to read as   follows:          (b)  The training program must provide the person with   information regarding:                (1)  the law governing advisory board operations;                (2)  [this chapter and] the [advisory board's]   programs, functions, rules, and budget of the advisory board;                (3)  the scope of and limitations on the rulemaking   authority of the advisory board;                (4) [(2)]  the results of the most recent formal audit   of the advisory board;                (5) [(3)]  the requirements of:                      (A)  laws relating to open meetings, public   information, administrative procedure, and disclosing conflicts of   interest; and                      (B)  other laws applicable to members of the   advisory board in performing their duties; and                (6) [(4)]  any applicable ethics policies adopted by   the advisory board or the Texas Ethics Commission.          (d)  The executive director of the medical board shall create   a training manual that includes the information required by   Subsection (b). The executive director shall distribute a copy of   the training manual annually to each advisory board member. On   receipt of the training manual, each board member shall sign and   submit to the executive director a statement acknowledging receipt   of the training manual.            SECTION 40.  Sections 601.102(b) and (c), Occupations Code,   are amended to read as follows:          (b)  The advisory board may issue to a person:                (1)  a general certificate to perform radiologic   procedures; [or]                (2)  a limited certificate that authorizes the person   to perform radiologic procedures only on specific parts of the   human body; or                (3)  a radiologist assistant certificate to a person   who meets the requirements established under Section 601.1021.          (c)  The advisory board may issue to a person a temporary   general certificate, [or] a temporary limited certificate, or a   temporary radiologist assistant certificate that authorizes the   person to perform radiologic procedures for a period not to exceed   one year.          SECTION 41.  Subchapter C, Chapter 601, Occupations Code, is   amended by adding Section 601.1021 to read as follows:          Sec. 601.1021.  RADIOLOGIST ASSISTANT CERTIFICATE. (a) The   advisory board by rule shall establish the education and training   required for a person to obtain a radiologist assistant   certificate.          (b)  A radiologist assistant certificate holder:                (1)  may perform radiologic procedures only under the   supervision of a radiologist; and                (2)  may not interpret images, make diagnoses, or   prescribe any medication or therapy.            SECTION 42.  Subchapter C, Chapter 601, Occupations Code, is   amended by adding Section 601.113 to read as follows:          Sec. 601.113.  REFUSAL FOR VIOLATION OF BOARD ORDER. The   advisory board may refuse to renew a certificate issued under this   chapter if the certificate holder is in violation of an advisory   board order.            SECTION 43.  Section 601.155, Occupations Code, is amended   to read as follows:          Sec. 601.155.  STUDENTS. A person is not required to hold a   certificate issued under this chapter [or to comply with the   registration requirements adopted under Section 601.252] if the   person:                (1)  is a student enrolled in a training program that   meets the minimum standards adopted under Section 601.201; and                (2)  is performing a radiologic procedure in an   academic or clinical setting as part of the training program.          SECTION 44.  Section 601.156, Occupations Code, is amended   to read as follows:          Sec. 601.156.  PROCEDURE PERFORMED AS PART OF CONTINUING   EDUCATION PROGRAM.  A person is not required to hold a certificate   issued under this chapter [or to comply with the registration   requirements adopted under Section 601.252] if the person is:                (1)  licensed or otherwise registered as a medical   radiologic technologist by another state, the American Registry of   Radiologic Technologists, the American Registry of Clinical   Radiography Technologists, or a professional organization or   association recognized by the advisory board;                (2)  enrolled in a continuing education program that   meets the requirements adopted under Section 601.108; and                (3)  performing a radiologic procedure as part of the   continuing education program for not more than 10 days.          SECTION 45.  Section 601.203(b), Occupations Code, is   amended to read as follows:          (b)  The following conditions are considered to be a hardship   for the purposes of Subsection (a):                (1)  that the applicant:                      (A)  reports an inability to attract and retain   medical radiologic technologists; and                      (B)  is located in a county with a population of   less than 50,000;                (2)  that the applicant is located at a great distance   from a school of medical radiologic technology;                (3)  that there is a list of qualified persons who have   applied to a school of medical radiologic technology whose   admissions are pending because of a lack of faculty or space;                (4)  that the school of medical radiologic technology   produces an insufficient number of graduates in medical radiologic   technology to meet the needs of the applicant; or                (5)  any other criteria determined by advisory board   rule.          SECTION 46.  Subchapter E, Chapter 602, Occupations Code, is   amended by adding Section 602.214 to read as follows:          Sec. 602.214.  REFUSAL FOR VIOLATION OF BOARD ORDER. The   medical board may refuse to renew a license issued under this   chapter if the license holder is in violation of a medical board   order.            SECTION 47.  Section 603.252(a), Occupations Code, is   amended to read as follows:          (a)  An applicant for a perfusionist license must submit an   [a sworn] application accompanied by the application fee.          SECTION 48.  Subchapter G, Chapter 603, Occupations Code, is   amended by adding Section 603.306 to read as follows:          Sec. 603.306.  REFUSAL FOR VIOLATION OF BOARD ORDER. The   medical board may refuse to renew a license issued under this   chapter if the license holder is in violation of a medical board   order.            SECTION 49.  Section 604.030, Occupations Code, is amended   by amending Subsection (b) and adding Subsection (d) to read as   follows:          (b)  The training program must provide the person with   information regarding:                (1)  the law governing advisory board operations;                (2)  the [this chapter and the advisory board's]   programs, functions, rules, and budget of the advisory board;                (3)  the scope of and limitations on the rulemaking   authority of the advisory board;                (4) [(2)]  the results of the most recent formal audit   of the advisory board;                (5) [(3)]  the requirements of:                      (A)  laws relating to open meetings, public   information, administrative procedure, and disclosing conflicts of   interest; and                      (B)  other laws applicable to members of the   advisory board in performing their duties; and                (6) [(4)]  any applicable ethics policies adopted by   the advisory board or the Texas Ethics Commission.          (d)  The executive director of the medical board shall create   a training manual that includes the information required by   Subsection (b). The executive director shall distribute a copy of   the training manual annually to each advisory board member. On   receipt of the training manual, each board member shall sign and   submit to the executive director a statement acknowledging receipt   of the training manual.            SECTION 50.  Subchapter D, Chapter 604, Occupations Code, is   amended by adding Section 604.158 to read as follows:          Sec. 604.158.  REFUSAL FOR VIOLATION OF BOARD ORDER. The   advisory board may refuse to renew a certificate or temporary   permit issued under this chapter if the certificate or permit   holder is in violation of an advisory board order.          SECTION 51.  Sections 601.252(c) and (d), Occupations Code,   are repealed.          SECTION 52.  (a) Except as provided by Subsection (b) of this   section, Sections 152.010, 204.059, 205.057, 601.030, and 604.030,   Occupations Code, as amended by this Act, apply to a member of the   applicable board appointed before, on, or after the effective date   of this Act.          (b)  A member of a board who, before the effective date of   this Act, completed the training program required by Section   152.010, 204.059, 205.057, 601.030, or 604.030, Occupations Code,   as the applicable law existed before the effective date of this Act,   is only required to complete additional training on the subjects   added by this Act to the training program required by Section   152.010, 204.059, 205.057, 601.030, or 604.030, Occupations Code,   as applicable. A board member described by this subsection may not   vote, deliberate, or be counted as a member in attendance at a   meeting of the applicable board held on or after December 1, 2017,   until the member completes the additional training.          SECTION 53.  Sections 162.301 and 204.210, Occupations Code,   as added by this Act, apply only to a prescription issued on or   after September 1, 2018. A prescription issued before September 1,   2018, is governed by the law in effect immediately before the   effective date of this Act, and the former law is continued in   effect for that purpose.          SECTION 54.  Not later than March 1, 2018, the Texas Medical   Board shall adopt rules necessary to implement Section 164.003(b),   Occupations Code, as amended by this Act.          SECTION 55.  Not later than January 1, 2018, the Texas   Medical Board and the governing board of the Texas Physician Health   Program by rule shall adopt the memorandum of understanding   required by Section 167.012, Occupations Code, as added by this   Act.          SECTION 56.  Not later than September 1, 2019, the Texas   Physician Assistant Board, the Texas State Board of Acupuncture   Examiners, and the Texas Medical Board shall obtain criminal   history record information on each person who, on the effective   date of this Act, holds a license issued under Chapter 204, 205, or   206, Occupations Code, as applicable, and did not undergo a   criminal history record information check based on the license   holder's fingerprints on the initial application for the license.   A board may suspend the license of a license holder who does not   provide the criminal history record information as required by the   board and this section.          SECTION 57.  Not later than January 1, 2018, the Texas   Medical Board shall approve the rules required by Section 601.1021,   Occupations Code, as added by this Act.          SECTION 58.  This Act takes effect September 1, 2017.