Source: https://www.sos.state.tx.us/texreg/archive/September62019/Adopted%20Rules/22.EXAMINING%20BOARDS.html
Timestamp: 2020-04-07 01:30:26
Document Index: 683889727

Matched Legal Cases: ['ART 5', '§102', '§102', '§114', '§254', '§254', '§104', '§104', '§254', '§257', '§133', '§133', '§133', '§2001', '§133', '§1001', '§1001', '§1001', '§165', '§165', '§165', '§165', '§153', '§165', '§165', '§165', '§165', '§193', '§193', '§193', '§153', '§193', '§193', '§193', '§193', '§193', '§193', '§153', 'ART 15', '§281', '§281', '§551', '§551', '§554', '§281', '§281', '§281', '§281', '§281', '§281', '§551', '§551', '§554', '§281', '§551', '§481', '§551', '§554', '§481', '§481', '§281', '§281', '§281', '§281', '§554', '§281', '§551', '§551', '§554', '§281', '§554', '§721', '§721', '§554', '§721', '§283', '§283', '§291', '§291', '§291', '§561', '§295', '§295', '§295', '§559', '§295', '§295']

PART 5. STATE BOARD OF DENTAL EXAMINERS
CHAPTER 102. FEES
22 TAC §102.1
The State Board of Dental Examiners (Board) adopts an amendment to 22 TAC §102.1, concerning fees. This amendment to the existing rule will clarify the biennial nature of renewals for several license/registration types, establish a standalone nitrous oxide monitoring category for dental assistants pursuant to 22 TAC §114.4, and enable the Board to assess appropriate fees in a responsive manner for the prescription monitoring program, Texas.gov internet portal, and query and monitoring of practitioners through the National Practitioner Data Bank. This amendment is adopted with no changes to the proposed text as published in the July 19, 2019, issue of the Texas Register (44 TexReg 3603), and will not be republished.
No comments were received by the agency after publication of this rule.
This rule is adopted under Texas Occupations Code §254.001(a), which gives the Board authority to adopt rules necessary to perform its duties and ensure compliance with state laws relating to the practice of dentistry to protect the public health and safety, and Texas Occupations Code §254.004, which directs the Board to establish reasonable and necessary fees sufficient to cover the cost of administering the Board's duties.
Filed with the Office of the Secretary of State on August 23, 2019.
TRD-201902873
Proposal publication date: July 19, 2019
For further information, please call: (512) 305-9380
CHAPTER 104. CONTINUING EDUCATION
22 TAC §104.2
The State Board of Dental Examiners (Board) adopts an amendment to 22 TAC §104.2, concerning providers of continuing education. This amendment will clarify the process for addition or removal of approved providers from the Board's list, and will establish criteria for the Board or a committee of the Board to apply when considering addition, removal, or classification of providers. This amendment is adopted with no changes to the proposed text as published in the July 19, 2019, issue of the Texas Register (44 TexReg 3604), and will not be republished.
This rule is adopted under Texas Occupations Code §254.001(a), which gives the Board authority to adopt rules necessary to perform its duties and ensure compliance with state laws relating to the practice of dentistry to protect the public health and safety, and Texas Occupations Code §257.005, which directs the Board to develop a process to evaluate and approve continuing education courses and evaluate the overall effectiveness of programs.
TRD-201902876
CHAPTER 133. LICENSING
SUBCHAPTER G. EXAMINATIONS
22 TAC §133.69
The Texas Board of Professional Engineers (Board) adopts an amendment to §133.69 concerning Waiver of Examinations without changes to the proposed text as published in the July 5, 2019, issue of the Texas Register (44 TexReg 3423). The text of the rule will not be republished.
REASONED JUSTIFICATION FOR RULE ADOPTION
The examination on the Fundamentals of Engineering (FE) is considered a foundational qualification in the licensure of an engineer. The Board has authority to waive the exam for applicants who possess sufficient education and experience credentials. The adopted change to §133.69(d) limits an applicant from applying for a waiver of the FE exam if the applicant has failed the exam three or more times in any jurisdiction. This amendment does not prohibit an applicant from retaking the exam to achieve a passing score.
Pursuant to §2001.029 of the Texas Government Code, the Board gave all interested persons a reasonable opportunity to provide oral and/or written commentary concerning the adoption of the rule. The 30-day public comment period ended August 4, 2019.
The Board received one comment regarding the change to §133.69(d). A commenter asked for a delay to enact this rule change. The Board disagrees with the comment and responds that an additional delay is not necessary for the implementation of this rule as it has been under consideration by the Board since November 2018. No changes were made to the rule as proposed.
STATEMENT OF AUTHORITY
This amendment is adopted pursuant to Texas Occupations Code §1001.202, which authorizes the Board to adopt and enforce any rules, regulations or bylaws necessary to perform its duties, the governance of its own proceedings, and the regulation of the practice of engineering in this state. It is also adopted under the authority of §1001.304, which authorizes the Board to administer examinations and §1001.305, which authorizes the Board to waive, by rule, all or part of an examination.
Filed with the Office of the Secretary of State on August 26, 2019.
TRD-201902888
Lance Kinney, Ph.D., P.E.
Proposal publication date: July 5, 2019
CHAPTER 165. MEDICAL RECORDS
22 TAC §165.5
The Texas Medical Board (Board) adopts amendments to §165.5, concerning Transfer and Disposal of Medical Records with non-substantive changes, described below, to the proposed text as published in the July 5, 2019, issue of the Texas Register (44 TexReg 3424).
The amendments to §165.5 update and modernize the notice requirements when a physician leaves from or relocates a practice by giving physicians options as to methods of patient notification. Specifically, in subsection (b)(2), additional language is added to allow notices to be posted on the physician's website and for the use of electronic communications to notify patients. In subsection (f), the amendments provide exceptions from notice provisions for certain types of medical providers.
These adopted amendments to §165.5 help modernize the existing rule and allow physicians various mechanisms to notify patients, which promotes continuity of care, and eliminates the notice requirement for certain physicians.
The Board received public written comments from the Texas Medical Association (TMA).
TMA complains that the rule still requires physicians to utilize more than one method of notice and that certain forms of notice may not be feasible due to the lack of an office, as in telemedicine.
The Board's response: The Board understands, but has determined that allowing physicians multiple options under each notice requirement will better serve the public by ensuring adequate notice to patients while causing little inconvenience to the physician. Therefore, the Board declines making additional changes in this regard.
TMA also suggests that additional language should be added to subsection (b)(2)(C), relating to email notices to patients, to ensure that such notice is transmitted confidentially and in a manner that is compliant with HIPAA and state and federal law.
The Board's response: The Board agrees with TMA that the words "in a manner that is compliant with state and federal law" should be added to subsection b(2)(C)(ii) and adopts the rule amendment with the non-substantive change as described.
TMA requests that the Board include a safe harbor provision for physicians who make a "good faith effort" to notify patients in the manner required, but who are prevented from complying with the requirements by the owners of the practice.
The Board's response: The Board declines TMA's request to create such provision, as subsection (c) already provides a prohibition against interference by remaining physicians. Additionally, if a physician is found to be in violation of the notice requirements and is subject to investigation, the physician may present evidence of any "good faith efforts" that may have been thwarted by remaining physicians. Therefore, no additional carve out provision is necessary.
TMA asserts that the exceptions delineated in subsection (f)(2) and (3) will be construed by courts to mean that only those providing specific services described in (f)(3) will be deemed as exempt from providing notice in the settings described under subsection (f)(2).
The Board's response: The Board believes that the proposed amendment, as written, is clear and the TMA's argument about judicial interpretation is speculative. The Board maintains that there is an "or" separating subsection (f)(2) and (f)(3), which clearly refutes TMA's argument and no further clarification is necessary.
TMA suggests further clarification that an outpatient clinic, associated with a hospital, is not included in the exception under subsection (f)(2)(A).
The Board's response: The Board disagrees with TMA because the definition of "hospital" as defined in the Texas Occupations Code and the Texas Health & Safety Code, clearly does not include out-patient clinics associated with the hospital. Therefore, no additional language is necessary.
Lastly, TMA requests that "pathology services in a setting described in paragraph (2) of this subsection" be added to subsection (f)(3) as an exception.
The Board's response: The Board agrees with TMA's suggestion and adopts the rule amendment with the additional language, a non-substantive change, as described.
For these reasons, the Board adopts the amendments with above-described non-substantive changes to the proposed text as published in the July 5, 2019, issue of the Texas Register (44 TexReg 3424), and the amendments will be republished.
The amendments are adopted under the authority of the Texas Occupations Code Annotated, §153.001, which provides authority for the Board to adopt rules and bylaws as necessary to: govern its own proceedings; perform its duties; regulate the practice of medicine in this state; enforce this subtitle; and establish rules related to licensure.
§165.5.Transfer and Disposal of Medical Records.
(a) Required Notification of Discontinuance of Practice. Except as provided for in subsection (f) of this section, when a physician retires, terminates employment, or otherwise leaves a medical practice, he or she is responsible for:
(1) ensuring that patients receive reasonable notification and are given the opportunity to obtain copies of their records or arrange for the transfer of their medical records to another physician; and
(2) notifying the board when they are terminating practice, retiring, or relocating, and therefore no longer available to patients, specifying who has custodianship of the records, and how the medical records may be obtained.
(3) Employers of the departing physician as described in §165.1(b)(6) of this chapter are not required to provide notification, however, the departing physician remains responsible for providing notification consistent with this section.
(b) Method of Notification.
(1) Except as provided for in subsection (f) of this section, when a physician retires, terminates employment, or otherwise leaves a medical practice, he or she shall provide notice to patients of when the physician intends to terminate the practice, retire or relocate, and will no longer be available to patients, and offer patients the opportunity to obtain a copy of their medical records or have their records transferred.
(2) Notification shall be accomplished by:
(i) posting such notice on the physician's or practice website; or
(ii) publishing notice in the newspaper of greatest general circulation in each county in which the physician practices or practiced and in a local newspaper that serves the immediate practice area; and
(B) placing written notice in the physician's office; and
(C) notifying patients seen in the last two years of the physician's discontinuance of practice by either:
(i) sending a letter to each patient; or
(ii) sending an email to each patient, in a manner that is compliant with state and federal law.
(3) A copy of the posted notices shall be submitted to the Board within 30 days from the date of termination, sale, or relocation of the practice.
(4) Notices placed in the physician's office shall be placed in a conspicuous location in or on the facade of the physician's office, a sign, announcing the termination, sale, or relocation of the practice. The sign shall be placed at least thirty days prior to the termination, sale or relocation of practice and shall remain until the date of termination, sale or relocation.
(c) Prohibition Against Interference.
(1) Other licensed physicians remaining in the practice may not prevent the departing physician from posting notice and the sign, unless the departing physician is excepted from providing notice of his or her departure under subsection (f) of this section.
(2) A physician, physician group, or organization described in §165.1(b)(6) of this title (relating to Medical Records) may not withhold information from a departing physician that is necessary for notification of patients, unless the departing physician is excepted from providing notice of his or her departure under subsection (f) of this section.
(d) Voluntary Surrender or Revocation of Physician's License.
(1) Except as provided for in subsection (f) of this section, physicians who have voluntarily surrendered their licenses or have had their licenses revoked by the board must notify their patients, consistent with subsection (b) of this section, within 30 days of the effective date of the voluntary surrender or revocation.
(2) Physicians who have voluntarily surrendered their licenses or have had their licenses revoked by the board must obtain a custodian for their medical records to be approved by the board within 30 days of the effective date of the voluntary surrender or revocation.
(e) Criminal Violation. A person who violates any provision of this chapter is subject to criminal penalties pursuant to §165.151 of the Act.
(f) Exceptions to Required Notification of Discontinuance of Practice. A physician is not required to provide notice of his or her discontinuation of practice to patients as required in subsection (b) of this section if the physician:
(1) treated the patient while in a locum tenens position at a practice location for a period of no longer than six months at that location. For the purpose of this section, "locum tenens" is defined as a position in which a physician is employed or contracted on a temporary or substitute basis to provide physician services;
(2) only treated the patient in the following settings:
(A) a hospital, as defined under Texas Occupations Code Section 157.051(6);
(B) an emergency room;
(C) a birthing center; or
(D) an ambulatory surgery center; or
(3) only provided the following:
(A) anesthesia services in a setting described in paragraph (2) of this subsection; or
(B) radiology services based on an order by a treating physician or in a setting described in paragraph (2) of this subsection; or
(C) pathology services in a setting described in paragraph (2) of this subsection.
Filed with the Office of the Secretary of State on August 21, 2019.
TRD-201902835
CHAPTER 193. STANDING DELEGATION ORDERS
22 TAC §193.8
The Texas Medical Board approves the adoption of the repeal of §193.8, concerning Prescriptive Authority Agreements: Minimum Requirements. The repealed rule is being adopted as published in the July 5, 2019, issue of the Texas Register (44 TexReg 3426). The repealed rule is not being republished.
No written comments were received regarding the repeal of §193.8. No one appeared in person to testify regarding the rules at the public hearing on August 16, 2019.
The repeal is adopted under the authority of the Texas Occupations Code Annotated, §153.001.
Filed with the Office of the Secretary of State on August 20, 2019.
TRD-201902821
22 TAC §193.17
The Texas Medical Board (Board) adopts amendments to §193.17, concerning Nonsurgical Medical Cosmetic Procedures. The amendments to §193.17 are being adopted without changes to the proposed text as published in the July 5, 2019, issue of the Texas Register (44 TexReg 3427). The adopted amendments will not be republished.
The amendments require posting of notice to patients of the identity and license number of the physician supervisor at a facility providing nonsurgical cosmetic procedures. It also requires posting of notice of how and where to file a complaint against a physician or physician assistant involved at these facilities. The rule enhances patient safety and awareness through increased transparency and accountability of the medical professionals involved in these types of medical procedures and facilities.
Written comments were received regarding the amendments to §193.17. No one appeared in person to testify regarding the rules at the public hearing on August 16, 2019.
Two written comments were received regarding §193.17. One comment was from Texas Aesthetic Nurses Coalition and supported the rule. One comment was from the Texas Medical Association (TMA). TMA generally supported the posting of notice to patients. But TMA claimed the rule, as written, creates confusion and a burden on a physician.
TMA complains that the rule could be viewed as requiring two different types of notice based on a reference to Chapter 178 in one section and Rule 178.3 in another section.
The Board's response: The Board understands, but has determined that when read as whole the rule is easily understood. The text clearly delineates the notice serving a two-fold purpose, how to file a complaint and identifying the practitioner who would be subject of a complaint.
TMA also suggests that the terms "each public area and treatment room or area" is vague. TMA urges posting in an "prominent location."
The Board's response: The Board disagrees with TMA. The rule provides more clarity as to where posting is required than "a prominent location." The rule insures that notices will be posted with increased visibility and in areas most likely to be seen by patients.
TMA complains that the rule requires posting by the facility rather physician. TMA states the rule lacks clarity and could expose physicians to violations for "technical insufficiencies."
The Board's response: The Board does not understand what TMA means by technical insufficiencies. But Board disagrees with TMA. TMA is correct that TMB regulates physicians and not facilities. However, these facilities cannot operate with having a supervising physician. When a physician agrees to become involved at these facilities they assume responsibility for all medical procedures, including non-surgical cosmetic procedures, performed at the facility. The rule is very clear that if a physician chooses to become involved with a facility that information must be made readily known to the patients, so in the event of untoward events or other potential violation the responsible physician is readily identified.
Rule §193.17 is adopted under the authority of the Texas Occupations Code Annotated, §153.001, which provides authority for the Board to adopt rules and bylaws as necessary to: govern its own proceedings; perform its duties; regulate the practice of medicine in this state; enforce this subtitle; and establish rules related to licensure.
TRD-201902823
PART 15. TEXAS STATE BOARD OF PHARMACY
CHAPTER 281. ADMINISTRATIVE PRACTICE AND PROCEDURES
22 TAC §281.14
The Texas State Board of Pharmacy adopts a new rule §281.14, concerning Vendor Protest Procedures. The new rule is adopted without changes to the proposed text as published in the June 28, 2019, issue of the Texas Register (44 TexReg 3216). The rule will not be republished.
The new rule establishes policy and procedures for resolving vendor protests relating to purchasing issues, as required by section 2155.076 of the Government Code.
The rule is adopted under §§551.002 and 554.051 of the Texas Pharmacy Act (Chapters 551 - 569, Texas Occupations Code). The Board interprets §551.002 as authorizing the agency to protect the public through the effective control and regulation of the practice of pharmacy. The Board interprets §554.051(a) as authorizing the agency to adopt rules for the proper administration and enforcement of the Act.
The statutes affected by these amendments: Texas Pharmacy Act, Chapters 551 - 569, Texas Occupations Code.
TRD-201902847
Allison Vordenbaumen Benz, R.Ph., M.S.
Proposal publication date: June 28, 2019
For further information, please call: (512) 305-8010
22 TAC §281.15
The Texas State Board of Pharmacy repeals §281.15, concerning Vehicle Inscription Information. The rule is repealed without changes to the text as published in the June 28, 2019, issue of the Texas Register (44 TexReg 3218) and the rules will not be republished.
The repeal of §281.15 provides for a more organized subchapter by moving the language from the previous §281.15 to an amended §281.19, allowing the agency to adopt a new §281.15, concerning Negotiated Rulemaking.
The rule is repealed under §§551.002 and 554.051 of the Texas Pharmacy Act (Chapters 551 - 569, Texas Occupations Code). The Board interprets §551.002 as authorizing the agency to protect the public through the effective control and regulation of the practice of pharmacy. The Board interprets §554.051(a) as authorizing the agency to adopt rules for the proper administration and enforcement of the Act.
The statutes affected by the repeal: Texas Pharmacy Act, Chapters 551 - 569, Texas Occupations Code.
TRD-201902848
The Texas State Board of Pharmacy adopts new rule §281.15, concerning Negotiated Rulemaking. The new rule is adopted without changes to the proposed text as published in the June 28, 2019, issue of the Texas Register (44 TexReg 3218).
The new rule establishes policy and procedures for the use of negotiated rulemaking for the adoption of board rules in appropriate situations, as required by section 554.0011 of the Pharmacy Act.
The new rule is adopted under §§551.002 and 554.051 of the Texas Pharmacy Act (Chapters 551 - 569, Texas Occupations Code) and §481.003 of the Texas Controlled Substances Act (Chapter 481, Texas Health and Safety Code). The Board interprets §551.002 as authorizing the agency to protect the public through the effective control and regulation of the practice of pharmacy. The Board interprets §554.051(a) as authorizing the agency to adopt rules for the proper administration and enforcement of the Act. The Board interprets §481.003 of the Texas Controlled Substances Act as authorizing the agency to adopt rules to administer §§481.075 - 481.0766 of the Texas Controlled Substances Act.
TRD-201902849
22 TAC §281.16
The Texas State Board of Pharmacy adopts new rule §281.16, concerning Alternative Dispute Resolution. The new rule is adopted without changes to the proposed text as published in the June 28, 2019, issue of the Texas Register (44 TexReg 3219).
The new rule establishes policy and procedures for the use of alternative dispute resolution to resolve internal and external disputes, as required by section 554.0011 of the Pharmacy Act.
TRD-201902850
22 TAC §281.19
The Texas State Board of Pharmacy adopts amendments to §281.19, concerning Restrictions on Assignment of Vehicles. These amendments are adopted with changes to the proposed text as published in the June 28, 2019, issue of the Texas Register (44 TexReg 3220). The Board corrected the agency that vehicles may be registered to under §554.009 to be the Texas Department of Motor Vehicles.
The amendments, if adopted, update the section title, add updated vehicle inscription information (formerly located in §281.15), and remove outdated references to an agency pool car.
The amendments are adopted under §§551.002 and 554.051 of the Texas Pharmacy Act (Chapters 551 - 569, Texas Occupations Code). The Board interprets §551.002 as authorizing the agency to protect the public through the effective control and regulation of the practice of pharmacy. The Board interprets §554.051(a) as authorizing the agency to adopt rules for the proper administration and enforcement of the Act.
§281.19.Vehicles.
(a) Vehicle Inscription Information.
(1) Exemption. As specified in §554.009 of the Act and §721.003 of the Transportation Code, vehicles assigned to or used by the compliance or investigation divisions for enforcement of pharmacy laws and rules are exempt from bearing the inscription required by §721.002 of the Transportation Code. These vehicles are to be used primarily in the inspection of pharmacies and the investigation of violations of state and federal laws and rules relating to the practice of pharmacy. In addition, as specified in §554.009 of the Act, the vehicles may be registered with the Texas Department of Motor Vehicles in an alias name for investigative personnel.
(2) Purpose. The purpose of exempting these vehicles from the inscription requirements of §721.002 of the Transportation Code is to increase the effectiveness of agency field employees in detecting and investigating violations of state and federal laws relating to the practice of pharmacy, thereby allowing compliance and investigative personnel to accomplish their tasks undetected, and to provide a greater degree of safety for these staff and the state property being used in the enforcement and a greater degree of case integrity.
(b) Restrictions on Assignments of Vehicles.
(1) Each agency vehicle will be assigned to an individual field employee.
(2) The agency may assign a vehicle to a board member or an individual administrative or executive employee:
(A) on a temporary basis if field personnel are not available to assume responsibility for the car; or
(B) on a regular basis only if the agency makes a written documented finding that the assignment is critical to the needs and mission of the agency.
TRD-201902851
CHAPTER 283. LICENSING REQUIREMENTS FOR PHARMACISTS
22 TAC §283.11
The Texas State Board of Pharmacy adopts amendments to §283.11, concerning Examination Retake Requirements. These amendments are adopted without changes to the proposed text as published in the June 28, 2019, issue of the Texas Register (44 TexReg 3221).
The amendments update the examination retake requirements and remove outdated references to an examination retake committee.
TRD-201902852
CHAPTER 291. PHARMACIES
SUBCHAPTER A. ALL CLASSES OF PHARMACIES
22 TAC §291.6
The Texas State Board of Pharmacy adopts amendments to §291.6, concerning Pharmacy License Fees. These amendments are adopted with changes to the proposed text as published in the June 28, 2019, issue of the Texas Register (44 TexReg 3222). The Board adjusted the amount of the fees based on updated information.
The amendments increase pharmacy license fees based on expected expenses.
The Board received comments from the Alliance of Independent Pharmacists of Texas requesting more information on the allocation of funds.
§291.6.Pharmacy License Fees.
(a) Initial License Fee. The fee for an initial license shall be $507 for the initial registration period.
(b) Biennial License Renewal. The Texas State Board of Pharmacy shall require biennial renewal of all pharmacy licenses provided under the Act §561.002.
(c) Renewal Fee. The fee for biennial renewal of a pharmacy license shall be $504 for the renewal period.
(d) Duplicate or Amended Certificates. The fee for issuance of a duplicate pharmacy license renewal certificate shall be $20. The fee for issuance of an amended pharmacy license renewal certificate shall be $100.
TRD-201902853
CHAPTER 295. PHARMACISTS
22 TAC §295.5
The Texas State Board of Pharmacy adopts amendments to §295.5, concerning Pharmacist License or Renewal Fees. These amendments are adopted with changes to the proposed text as published in the July 5, 2019, issue of the Texas Register (44 TexReg 3429). The Board adjusted the amount of the fees based on updated information.
The amendments increase pharmacist license fees based on expected expenses.
§295.5.Pharmacist License or Renewal Fees.
(a) Biennial Registration. The Texas State Board of Pharmacy shall require biennial renewal of all pharmacist licenses provided under the Pharmacy Act, §559.002.
(b) Initial License Fee.
(1) The fee for the initial license shall be $332 for a two-year registration.
(2) New pharmacist licenses shall be assigned an expiration date and initial fee shall be prorated based on the assigned expiration date.
(c) Renewal Fee. The fee for biennial renewal of a pharmacist license shall be $329 for a two-year registration.
(d) Exemption from fee. The license of a pharmacist who has been licensed by the Texas State Board of Pharmacy for at least 50 years or who is at least 72 years old shall be renewed without payment of a fee provided such pharmacist is not actively practicing pharmacy. The renewal certificate of such pharmacist issued by the board shall reflect an inactive status. A person whose license is renewed pursuant to this subsection may not engage in the active practice of pharmacy without first paying the renewal fee as set out in subsection (c) of this section.
TRD-201902854
22 TAC §295.8
The Texas State Board of Pharmacy adopts amendments to §295.8, concerning Continuing Education Requirements. These amendments are adopted without changes to the proposed text as published in the June 28, 2019, issue of the Texas Register (44 TexReg 3223).
The amendments clarify the definition of initial license period, remove an outdated reference to the Commission for Certification in Geriatric Pharmacy, and correct grammatical errors.
TRD-201902855