CHAPTER 204.
PHYSICIAN ASSISTANTS SUBCHAPTER A.
GENERAL PROVISIONS
§ 204.001. Short Title
This chapter may be cited as the Physician Assistant Licensing Act.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.002. Definitions
In this chapter:
(1) "Medical board" means the Texas State Board of Medical Examiners.
(2) "Physician assistant board" means the Texas State Board of Physician Assistant Examiners.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.003. Applicability
(a) A person is not required to hold a license issued under this chapter to practice as:
(1) a technician, assistant, or employee of a physician who performs delegated tasks but does not act as a physician assistant or represent that the person is a physician assistant; or
(2) any other licensed health care worker acting within the scope of that person's license if the person:
(A) does not use the title "physician assistant" or the initials "P.A."; or
(B) is not represented or designated as a physician assistant.
(b) This chapter does not limit the employment arrangement of a physician assistant licensed under this chapter.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.004. Application of Sunset Act
The Texas State Board of Physician Assistant Examiners 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 chapter expires September 1, 2005.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
SUBCHAPTER B. TEXAS STATE BOARD OF PHYSICIAN ASSISTANT EXAMINERS § 204.051. Texas State Board of Physician Assistant Examiners
The Texas State Board of Physician Assistant Examiners is an advisory board to the Texas State Board of Medical Examiners.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.052. Appointment of Board
The physician assistant board consists of nine members appointed by the governor as follows:
(1) three practicing physician assistant members who each have at least five years of clinical experience as a physician assistant;
(2) three physician members who are licensed in this state and who supervise physician assistants; and
(3) three public members who are not licensed as a physician or physician assistant.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.053. Membership Eligibility and Restrictions
(a) A person is not eligible for appointment as a public member of the physician assistant board if the person or the person's spouse:
(1) is licensed by an occupational regulatory agency in the field of health care; or
(2) is employed by or participates in the management of a business entity or other organization that provides health care services or that sells, manufactures, or distributes health care supplies or equipment.
(b) A person may not serve as a member of the physician assistant board if the person is required to register as a lobbyist under Chapter 305, Government Code.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.054. Terms; Vacancies
(a) Members of the physician assistant board are appointed for staggered six-year terms. The terms of three members expire on February 1 of each odd-numbered year.
(b) A member may not serve more than:
(1) two consecutive full terms; or
(2) a total of three full terms.
(c) If a vacancy occurs during a member's term, the governor shall appoint a new member to fill the unexpired term.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.055. Officers
The physician assistant board shall select from its membership a presiding officer and a secretary to serve one-year terms.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.056. Grounds for Removal
(a) It is a ground for removal from the physician assistant board that a member:
(1) does not have at the time of appointment the qualifications required by this subchapter for appointment to the board;
(2) does not maintain during the service on the board the qualifications required by this subchapter for appointment to the board; or
(3) fails to attend at least one-half of the regularly scheduled board meetings that the member is eligible to attend during a calendar year.
(b) The validity of an action of the physician assistant board is not affected by the fact that it is taken when a ground for removal of a board member exists.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.057. Per Diem
A member of the physician assistant board is entitled to receive a per diem as set by legislative appropriation for each day that the member engages in the business of the board. If the General Appropriations Act does not prescribe the amount of the per diem, the per diem is equal to a member's actual expenses for meals, lodging, and transportation plus $100.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.058. Open Meetings; Administrative Procedure Law
Except as otherwise provided by this chapter, the physician assistant board is subject to Chapters 551 and 2001, Government Code.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
SUBCHAPTER C. POWERS AND DUTIES OF PHYSICIAN ASSISTANT BOARD AND MEDICAL BOARD § 204.101. General Powers and Duties of Board
The physician assistant board shall:
(1) adopt rules that are reasonable and necessary for the performance of the physician assistant board's duties under this chapter, as provided by Chapter 2001, Government Code, including rules to establish:
(A) licensing and other fees;
(B) license renewal dates; and
(C) procedures for disciplinary actions;
(2) review and approve or reject each application for the issuance or renewal of a license;
(3) issue each license;
(4) deny, suspend, or revoke a license or otherwise discipline a license holder; and
(5) take any action necessary to carry out the functions and duties of the physician assistant board under this chapter.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.102. Powers and Duties of Medical Board Relating to Physician Assistants
(a) The medical board shall adopt rules consistent with this chapter to regulate physician assistants and physicians who supervise physician assistants.
(b) The medical board, by a majority vote, shall approve or reject each rule adopted by the physician assistant board. If approved, the rule may take effect. If the rule is rejected, the medical board shall return the rule to the physician assistant board for revision.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.103. Fees
The physician assistant board shall establish and collect fees in amounts that are reasonable and necessary to cover the cost of administering this chapter.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.104. Rural Physician Assistant Loan Reimbursement Program
(a) A program shall be established to provide student loan reimbursement for graduates of physician assistant training programs from any state who practice in rural health professional shortage areas and medically underserved areas identified by the Texas Department of Health. The physician assistant board shall fund the program by designating annually a portion of the revenue generated under this chapter from physician assistant licensing fees.
(b) The Office of Rural Community Affairs shall establish policies for and adopt rules to administer the loan program.
(c) The physician assistant board shall authorize and the medical board shall transfer annually the funds designated under Subsection (a) to the Office of Rural Community Affairs to administer the loan program.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended by Acts 2001, 77th Leg., ch. 1424, § 10, eff. Sept. 1, 2001.
SUBCHAPTER D. LICENSE REQUIREMENTS, EXEMPTIONS, AND RENEWAL § 204.151. License Required
A person may not practice as a physician assistant in this state unless the person holds a physician assistant license issued under this chapter.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.152. Issuance of License
The physician assistant board shall issue a license to an applicant who:
(1) meets the eligibility requirements of Section 204.153;
(2) submits an application on a form prescribed by the board;
(3) pays the required application fee;
(4) certifies that the applicant is mentally and physically able to function safely as a physician assistant; and
(5) submits to the board any other information the board considers necessary to evaluate the applicant's qualifications.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.153. Eligibility Requirements
(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; and
(5) meet any other requirement established by board rule.
(b) In addition to the requirements of Subsection (a), an applicant is not eligible for a license, unless the physician assistant board takes the fact into consideration in determining whether to issue the license, if the applicant:
(1) has been issued a license, certificate, or registration as a physician assistant in this state or from a licensing authority in another state that is revoked or suspended; or
(2) is subject to probation or other disciplinary action for cause resulting from the applicant's acts as a physician assistant.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.154. Exemptions From Licensing Requirement for Certain Physician Assistants
A person is not required to hold a license issued under this chapter to practice as:
(1) a physician assistant student enrolled in a physician assistant or surgeon assistant educational program accredited by the Committee on Allied Health Education and Accreditation of the American Medical Association or by successor entities as approved and designated by physician assistant board rule; or
(2) a physician assistant employed in the service of the federal government while performing duties related to that employment.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.155. Temporary License
(a) The physician assistant board may issue a temporary license to an applicant who:
(1) meets all the qualifications for a license under this chapter but is waiting for the license to be issued at the next scheduled meeting of the board;
(2) seeks to temporarily substitute for a licensed physician assistant during the license holder's absence, if the applicant:
(A) is licensed or registered in good standing in another state;
(B) submits an application on a form prescribed by the board; and
(C) pays the appropriate fee prescribed by the board; or
(3) has graduated from an educational program for physician assistants or surgeon assistants described by Section 204.153(a)(1) not later than six months before applying for a temporary license and is waiting for examination results from the National Commission on Certification of Physician Assistants.
(b) A temporary license may be valid for not more than one year after the date issued as determined by board rule.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended by Acts 2001, 77th Leg., ch. 578, § 1, eff. Sept. 1, 2001.
§ 204.156. License Renewal
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.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.1565. Informal Continuing Medical Education
(a) In this section, "site serving a medically underserved population" has the meaning assigned by Section 157.052.
(b) The physician assistant board by rule shall permit a license holder to complete half of any informal continuing medical education hours required to renew a license under this chapter by providing volunteer medical services at a site serving a medically underserved population, other than a site that is a primary practice site of the license holder.
Added by Acts 2001, 77th Leg., ch. 1420, § 14.053(a), eff. Sept. 1, 2001.
§ 204.157. Inactive Status
(a) A person licensed under this chapter may place the person's license on inactive status by applying to the physician assistant board. A person whose license is on inactive status is excused from paying renewal fees for the license.
(b) The holder of a license on inactive status may not practice as a physician assistant. A violation of this subsection is considered to be practicing without a license.
(c) A person whose license is on inactive status under this section may return the person's license to active status by:
(1) applying to the physician assistant board; and
(2) satisfying the requirements of Section 204.156.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
SUBCHAPTER E. PRACTICE BY LICENSE HOLDER § 204.201. Notice of Intent to Practice
(a) Before beginning practice, each physician assistant licensed under this chapter shall submit on a form prescribed by the physician assistant board notice of the license holder's intent to practice. The notice must include:
(1) the name, business address, license number, and telephone number of the physician assistant; and
(2) the name, business address, Texas license number, and telephone number of the physician assistant's supervising physician.
(b) A physician assistant shall notify the physician assistant board of any change in, or addition to, the person acting as a supervising physician for the physician assistant not later than the 30th day after the date the change or addition occurs.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.202. Scope of Practice
(a) The practice of a physician assistant includes providing medical services delegated by a supervising physician that are within the education, training, and experience of the physician assistant.
(b) Medical services provided by a physician assistant may include:
(1) obtaining patient histories and performing physical examinations;
(2) ordering or performing diagnostic and therapeutic procedures;
(3) formulating a working diagnosis;
(4) developing and implementing a treatment plan;
(5) monitoring the effectiveness of therapeutic interventions;
(6) assisting at surgery;
(7) offering counseling and education to meet patient needs;
(8) requesting, receiving, and signing for the receipt of pharmaceutical sample prescription medications and distributing the samples to patients in a specific practice setting in which the physician assistant is authorized to prescribe pharmaceutical medications and sign prescription drug orders as provided by Section 157.052, 157.053, 157.054, 157.0541, or 157.0542 or as otherwise authorized by physician assistant board rule;
(9) signing or completing a prescription as provided by Subchapter B, Chapter 157; and
(10) making appropriate referrals.
(c) The activities listed by Subsection (b) may be performed in any place authorized by a supervising physician, including a clinic, hospital, ambulatory surgical center, patient home, nursing home, or other institutional setting.
(d) A physician assistant's signature attesting to the provision of a service the physician assistant is legally authorized to provide satisfies any documentation requirement for that service established by a state agency.
(e) A physician assistant is the agent of the physician assistant's supervising physician for any medical services that are delegated by that physician and that:
(1) are within the physician assistant's scope of practice; and
(2) are delineated by protocols, practice guidelines, or practice directives established by the supervising physician.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended by Acts 2001, 77th Leg., ch. 112, § 3, eff. May 11, 2001; Acts 2001, 77th Leg., ch. 178, § 1, eff. Sept. 1, 2001; Acts 2001, 77th Leg., ch. 1420, § 14.054(a), eff. Sept. 1, 2001.
§ 204.203. Identification Requirements
A physician assistant shall:
(1) keep the physician assistant's license available for inspection at the physician assistant's primary place of business; and
(2) when engaged in the physician assistant's professional activities, wear a name tag identifying the license holder as a physician assistant.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.204. Supervision Requirements
(a) A physician assistant shall be supervised by a supervising physician. A physician assistant may have more than one supervising physician. The supervising physician oversees the activities of, and accepts responsibility for, medical services provided by the physician assistant.
(b) Supervision of a physician assistant by a supervising physician must be continuous. The supervision does not require the constant physical presence of the supervising physician where physician assistant services are being performed, but, if a supervising physician is not present, the supervising physician and the physician assistant must be, or must be able to easily be, in contact with one another by radio, telephone, or another telecommunication device.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.205. Requirements for Supervising Physician
A supervising physician must:
(1) hold an unrestricted and active license as a physician in this state;
(2) notify the medical board of the physician's intent to supervise a physician assistant;
(3) submit to the medical board a statement that the physician will:
(A) supervise the physician assistant according to medical board rule; and
(B) retain professional and legal responsibility for the care provided by the physician assistant; and
(4) receive approval from the medical board to supervise the physician assistant.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.206. Establishment of Certain Functions and Standards
Each physician assistant and the physician assistant's supervising physician shall ensure that:
(1) the physician assistant's scope of function is identified;
(2) delegation of medical tasks is appropriate to the physician assistant's level of competence;
(3) the relationship between the physician assistant and the supervising physician and the access of the physician assistant to the supervising physician are defined; and
(4) a process is established for evaluating the physician assistant's performance.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.207. Assumption of Professional Liability
(a) Each supervising physician retains legal responsibility for a physician assistant's patient care activities, including the provision of care and treatment to a patient in a health care facility.
(b) If a physician assistant is employed by an entity, including a health care facility, the entity shares the legal responsibility for the physician assistant's acts or omissions with the physician assistant's supervising physician.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.208. Duty to Report; Medical Peer Review
(a) A medical peer review committee in this state, physician assistant, physician assistant student, or physician lawfully practicing medicine in this state shall report relevant information to the physician assistant board related to the acts of a physician assistant in this state if, in the person's opinion, a physician assistant poses a continuing threat to the public welfare through practice as a physician assistant. The duty to report under this section may not be nullified through contract.
(b) Sections 160.002, 160.003, 160.006, 160.007(d), 160.009, 160.013, 160.014, and 160.015 apply to medical peer review relating to the practice of a physician assistant.
(c) A person, including a health care entity or medical peer review committee, that without malice furnishes records, information, or assistance to the physician assistant board is immune from any civil liability arising from that act.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999. Amended by Acts 2001, 77th Leg., ch. 1420, § 14.055, eff. Sept. 1, 2001.
SUBCHAPTER F. COMPLAINTS AND INVESTIGATIVE INFORMATION § 204.251. Complaint Information and Status
(a) The physician assistant board shall keep information on file about each complaint filed with the board.
(b) If a written complaint is filed with the physician assistant board relating to a person licensed by the board, the board, as often as quarterly and until final determination of the action to be taken on the complaint, shall notify the parties to the complaint of the status of the complaint unless the notice would jeopardize an active investigation.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.252. License Holder Access to Complaint Information
(a) The physician assistant board shall provide a license holder who is the subject of a formal complaint filed under this chapter with access to all information in its possession that the board intends to offer into evidence in presenting its case in chief at the contested hearing on the complaint, subject to any other privilege or restriction established by rule, statute, or legal precedent. The board shall provide the information not later than the 30th day after receipt of a written request from the license holder or the license holder's counsel, unless good cause is shown for delay.
(b) Notwithstanding Subsection (a), the board is not required to provide:
(1) board investigative reports;
(2) investigative memoranda;
(3) the identity of a nontestifying complainant;
(4) attorney-client communications;
(5) attorney work product; or
(6) other material covered by a privilege recognized by the Texas Rules of Civil Procedure or the Texas Rules of Evidence.
(c) The provision of information does not constitute a waiver of privilege or confidentiality under this chapter or other law.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.253. Health Care Entity Request for Information
On the written request of a health care entity, the physician assistant board shall provide to the entity:
(1) information about 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.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.254. Confidentiality of Investigative Information
A complaint, adverse report, investigation file, other report, or other investigative information in the possession of or received or gathered by the physician assistant board or a board employee or agent relating to a license holder, a license application, or a criminal investigation or proceeding is privileged and confidential and is not subject to discovery, subpoena, or other means of legal compulsion for release to any person other than the board or a board employee or agent involved in license holder discipline.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.255. Permitted Disclosure of Investigative Information
(a) Investigative information in the possession of a physician assistant board employee or agent that relates to the discipline of a license holder may be disclosed to:
(1) a licensing authority in another state or country in which the license holder is licensed or has applied for a license; or
(2) a peer review committee reviewing:
(A) an application for privileges; or
(B) the qualifications of the license holder with respect to retaining privileges.
(b) If investigative information in the possession of the physician assistant board or a board employee or agent indicates that a crime may have been committed, the board shall report the information to the proper law enforcement agency. The board shall cooperate with and assist each law enforcement agency conducting a criminal investigation of a license holder by providing information relevant to the investigation. Confidential information disclosed by the board to a law enforcement agency under this subsection remains confidential and may not be disclosed by the law enforcement agency except as necessary to further the investigation.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
SUBCHAPTER G. DISCIPLINARY PROCEEDINGS § 204.301. Disciplinary Authority of Board
(a) Except as provided by Section 204.305, on a determination that an applicant or license holder committed an act described in Section 204.302, 204.303, or 204.304, the physician assistant board by order shall take any of the following actions:
(1) deny the person's license application or revoke the person's license or other authorization;
(2) require the person to submit to the care, counseling, or treatment of a health care practitioner designated by the physician assistant board;
(3) stay enforcement of an order and place the person on probation;
(4) require the person to complete additional training;
(5) suspend, limit, or restrict the person's license, including:
(A) limiting the practice of the person to, or excluding from the practice, one or more specified activities of the practice as a physician assistant; or
(B) stipulating periodic physician assistant board review;
(6) assess an administrative penalty against the person under Section 204.351;
(7) order the person to perform public service; or
(8) administer a public reprimand.
(b) If the physician assistant board stays enforcement of an order and places a person on probation, the board retains the right to vacate the probationary stay and enforce the original order for noncompliance with the terms of probation or impose any other remedial measure or sanction authorized by this section.
(c) The physician assistant board may restore or reissue a license or remove any disciplinary or corrective measure that the board has imposed.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.302. Conduct Related to Fraud or Misrepresentation
The physician assistant board may take action under Section 204.301 against an applicant or license holder who:
(1) fraudulently or deceptively obtains or attempts to obtain a license;
(2) fraudulently or deceptively uses a license;
(3) falsely represents that the person is a physician;
(4) acts in an unprofessional or dishonorable manner that is likely to deceive, defraud, or injure the public;
(5) fraudulently alters a physician assistant license, certificate, or diploma;
(6) uses a physician assistant license, certificate, or diploma that has been fraudulently purchased, issued, or counterfeited or that has been materially altered;
(7) directly or indirectly aids or abets a person not licensed to practice as a physician assistant in practicing as a physician assistant; or
(8) unlawfully advertises in a false, misleading, or deceptive manner, as described by Section 101.201.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.303. Conduct Related to Violation of Law
(a) The physician assistant board may take action under Section 204.301 against an applicant or license holder who:
(1) violates this chapter or a rule adopted under this chapter;
(2) is convicted of a felony, placed on deferred adjudication, or placed in a pretrial diversion program;
(3) violates state law if the violation is connected with practice as a physician assistant;
(4) fails to keep complete and accurate records of the purchase and disposal of drugs as required by Chapter 483, Health and Safety Code, or any subsequent rules; or
(5) writes a false or fictitious prescription for a dangerous drug as defined by Chapter 483, Health and Safety Code.
(b) A complaint, indictment, or conviction of a law violation is not necessary for the physician assistant board to act under Subsection (a)(3). Proof of the commission of the act while in practice as a physician assistant or under the guise of practice as a physician assistant is sufficient for action by the physician assistant board.
(c) A failure to keep the records described under Subsection (a)(4) for a reasonable time is grounds for disciplinary action against a physician assistant. The physician assistant board or its representative may enter and inspect a physician assistant's place or places of practice during reasonable business hours to:
(1) verify the correctness of the records; and
(2) inventory the drugs on hand.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.304. Conduct Indicating Lack of Fitness
(a) The physician assistant board may take action under Section 204.301 against an applicant or license holder who:
(1) habitually uses drugs or intoxicating liquors to the extent that, in the board's opinion, the person cannot safely perform as a physician assistant;
(2) has been adjudicated as mentally incompetent;
(3) has a mental or physical condition that renders the person unable to safely perform as a physician assistant;
(4) has committed an act of moral turpitude;
(5) has failed to practice as a physician assistant in an acceptable manner consistent with public health and welfare;
(6) has had the person's license to practice as a physician assistant suspended, revoked, or restricted;
(7) has had other disciplinary action taken by another state or by the uniformed services of the United States regarding practice as a physician assistant;
(8) prescribes, dispenses, or administers a drug or treatment that is nontherapeutic in nature or nontherapeutic in the manner the drug or treatment is prescribed, dispensed, or administered;
(9) is removed or suspended from, or has had disciplinary action taken by the person's peers in, any professional association or society, or is being disciplined by a licensed hospital or medical staff of a hospital, including removal, suspension, limitation of privileges, or other disciplinary action, if the reason for the discipline, in the board's opinion, is unprofessional conduct or professional incompetence likely to harm the public;
(10) has repeated or recurring meritorious health care liability claims that, in the board's opinion, are evidence of professional incompetence likely to harm the public; or
(11) sexually abuses or exploits another person through the license holder's practice as a physician assistant.
(b) A certified copy of the record of the state or uniformed services of the United States taking an action described by Subsection (a)(7) is conclusive evidence of the action.
(c) An action described by Subsection (a)(9) does not constitute state action on the part of the association, society, or hospital medical staff.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.305. Rehabilitation Order
The physician assistant board, through an agreed order or after a contested proceeding, may impose a rehabilitation order on an applicant, as a prerequisite for issuing a license, or on a license holder based on:
(1) the person's intemperate use of drugs or alcohol directly resulting from habituation or addiction caused by medical care or treatment provided by a physician;
(2) the person's intemperate use of drugs or alcohol during the five years preceding the date of the report that could adversely affect the person's ability to safely practice as a physician assistant, if the person:
(A) reported the use; and
(B) has not previously been the subject of a substance abuse related order of the board;
(3) a judgment by a court that the person is of unsound mind; or
(4) the results of a mental or physical examination, or an admission by the person, indicating that the person suffers from a potentially dangerous limitation or an inability to practice as a physician assistant with reasonable skill and safety because of illness or any other physical or mental condition.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.306. Effect of Rehabilitation Order
(a) A rehabilitation order imposed under Section 204.305 is a nondisciplinary private order. If entered by agreement, the order is an agreed disposition or settlement agreement for purposes of civil litigation and is exempt from Chapter 552, Government Code.
(b) The rehabilitation order must contain findings of fact and conclusions of law. The order may impose a revocation, suspension, period of probation or restriction, or any other term authorized by this chapter or agreed to by the board and the person subject to the order.
(c) A violation of a rehabilitation order may result in disciplinary action under the provisions of this chapter relating to contested matters or under the terms of the agreed order.
(d) A violation of a rehabilitation order is grounds for disciplinary action based on:
(1) unprofessional or dishonorable conduct; or
(2) any provision of this chapter that applies to the conduct that resulted in the violation.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.307. Audit of Rehabilitation Order
(a) The physician assistant board shall keep a rehabilitation order imposed under Section 204.305 in a confidential file. The file is subject to an independent audit by a state auditor or private auditor with whom the physician assistant board contracts to perform the audit to ensure that only qualified license holders are subject to rehabilitation orders.
(b) An audit may be performed at any time at the direction of the physician assistant board. The board shall ensure that an audit is performed at least once in each three-year period.
(c) The audit results are a matter of public record and shall be reported in a manner that maintains the confidentiality of each license holder who is subject to a rehabilitation order.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.308. Subpoena
(a) The executive director or the secretary-treasurer of the medical board may issue a subpoena or subpoena duces tecum for the physician assistant board to:
(1) conduct an investigation or a contested proceeding related to:
(A) alleged misconduct by a physician assistant;
(B) an alleged violation of this chapter or other law related to practice as a physician assistant; or
(C) the provision of health care under this chapter;
(2) issue, suspend, restrict, or revoke a license under this chapter; or
(3) deny or grant an application for a license under this chapter.
(b) Failure to timely comply with a subpoena issued under this section is a ground for:
(1) disciplinary action by the physician assistant board or another licensing or regulatory agency with jurisdiction over the person subject to the subpoena; and
(2) denial of a license application.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.309. Protection of Patient Identity
In a disciplinary investigation or proceeding conducted under this chapter, the physician assistant board shall protect the identity of each patient whose medical records are examined and used in a public proceeding unless the patient:
(1) testifies in the public proceeding; or
(2) submits a written release in regard to the patient's records or identity.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.310. Required Suspension of License of Incarcerated Physician Assistant
Regardless of the offense, the physician assistant board shall suspend the license of a physician assistant serving a prison term in a state or federal penitentiary during the term of the incarceration.
Added by Acts 2001, 77th Leg., ch. 578, § 2, eff. Sept. 1, 2001.
§ 204.311. Temporary Suspension
(a) The presiding officer of the physician assistant board, with board approval, shall appoint a three-member disciplinary panel consisting of board members to determine whether a person's license to practice as a physician assistant should be temporarily suspended.
(b) If the disciplinary panel determines from the evidence or information presented to the panel that a person licensed to practice as a physician assistant would, by the person's continuation in practice, constitute a continuing threat to the public welfare, the disciplinary panel shall temporarily suspend the license of that person.
(c) A license may be suspended under this section without notice or hearing on the complaint if:
(1) institution of proceedings for a hearing before the physician assistant board is initiated simultaneously with the temporary suspension; and
(2) a hearing is held under Chapter 2001, Government Code, and this chapter as soon as possible.
(d) Notwithstanding Chapter 551, Government Code, the disciplinary panel may hold a meeting by telephone conference call if immediate action is required and convening of the panel at one location is inconvenient for any member of the disciplinary panel.
Added by Acts 2001, 77th Leg., ch. 578, § 2, eff. Sept. 1, 2001.
SUBCHAPTER H. PENALTIES § 204.351. Administrative Penalty
(a) The physician assistant board by order may impose an administrative penalty against a person licensed under this chapter who violates this chapter or a rule or order adopted under this chapter.
(b) The penalty may be in an amount not to exceed $5,000. Each day a violation continues or occurs is a separate violation for purposes of imposing a penalty.
(c) The physician assistant board shall base the amount of the penalty on:
(1) the severity of patient harm;
(2) the severity of economic harm to any person;
(3) the severity of any environmental harm;
(4) increased potential for harm to the public;
(5) any attempted concealment of misconduct;
(6) any premeditated or intentional misconduct;
(7) the motive for the violation;
(8) prior misconduct of a similar or related nature;
(9) the license holder's disciplinary history;
(10) prior written warnings or written admonishments from any government agency or official regarding statutes or regulations relating to the misconduct;
(11) violation of a board order;
(12) failure to implement remedial measures to correct or mitigate harm from the misconduct;
(13) lack of rehabilitative potential or likelihood of future misconduct of a similar nature;
(14) relevant circumstances increasing the seriousness of the misconduct; and
(15) any other matter that justice may require.
(d) The physician assistant board by rule shall prescribe the procedure by which it may impose an administrative penalty. A proceeding under this section is subject to Chapter 2001, Government Code.
(e) If the physician assistant board by order determines that a violation has occurred and imposes an administrative penalty, the board shall give notice to the person of the board's order. The notice must include a statement of the person's right to judicial review of the order.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.
§ 204.352. Criminal Penalty
(a) A person commits an offense if, without holding a license issued under this chapter, the person:
(1) holds the person out as a physician assistant;
(2) uses any combination or abbreviation of the term "physician assistant" to indicate or imply that the person is a physician assistant; or
(3) acts as a physician assistant.
(b) An offense under this section is a felony of the third degree.
Acts 1999, 76th Leg., ch. 388, § 1, eff. Sept. 1, 1999.