Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 9 - TEXAS MEDICAL BOARD › Chapter 179 - INVESTIGATIONS › Section 179.4 - Request for Information and Records from Physicians

Current through Reg. 49, No. 28; July 12, 2024
(a) Medical records. Upon the request by the
				board or board representatives, a licensee shall furnish to the board copies of
				medical records or the original records within a reasonable time period, as
				prescribed at the time of the request. "Reasonable time," as used in this
				section, shall mean fourteen calendar days or a shorter time if required by the
				urgency of the situation or the possibility that the records may be lost,
				damaged, or destroyed.
(b)
				Application for license renewal and registration permits. A licensee shall
				furnish a written explanation of his or her answer to any question asked on the
				application for license renewal or registration permit, if requested by the
				board. This explanation shall include all details as the board may request and
				shall be furnished within two weeks of the date of receipt of the board's
				request.
(c) Impaired
				licensees/applicants.
(1) Pursuant to §
				164.056 of the Medical Practice Act, the Board is required to adopt guidelines
				to enable the Board to evaluate circumstances in which a physician or an
				applicant may be required to submit to an examination for mental or physical
				heath conditions, alcohol and substance abuse, or professional behavior
				problems.
(2) A licensee shall
				report to the board if the licensee is aware of another licensee who poses a
				continuing threat to the public welfare because the said licensee is unable to
				practice medicine with reasonable skill and safety to patients because of
				illness; drunkenness; excessive use of drugs, narcotics, chemicals, or another
				substance; or a mental or physical condition.
(3) If the board has probable cause to
				believe that a licensee/applicant is impaired, the board shall require a
				licensee/applicant to submit to a mental and/or physical examination by a
				physician or physicians designated by the board. Under the Act, an impaired
				licensee/applicant is considered to be one who is unable to practice within his
				field with reasonable skill and safety to patients by reason of age, illness,
				drunkenness, excessive use of drugs, narcotics, chemicals, or any other type of
				material; or as a result of any mental or physical condition. Probable cause
				may include, but is not limited to, any one of the following:
(A) sworn statements from two people, willing
				to testify before the board, that a certain licensee/applicant is
				impaired;
(B) a sworn statement
				from a representative of the Texas Medical Association's or the Texas
				Osteopathic Medical Association's impaired physician program, stating that the
				representative is willing to testify before the board that a certain
				licensee/applicant is impaired;
(C)
				evidence that a licensee/applicant left a treatment program for alcohol or
				chemical dependency before a completion of that program;
(D) evidence that a licensee/applicant has
				engaged in the intemperate use of drugs or alcohol at a time and under
				circumstances that would lead a reasonable person to believe that the licensee
				is impaired;
(E) evidence of
				repeated arrests of a licensee/applicant for intoxication or drug
				use;
(F) evidence of recurring
				temporary commitments to a mental institution of a
				licensee/applicant;
(G) medical
				records showing that a licensee/applicant has an illness or condition that
				results in the inability to function properly in his or her practice;
				or
(H) actions or statements by a
				licensee/applicant at a hearing conducted by the Board that gives the Board
				reason to believe that the licensee has an impairment.
(4) Upon presentation to the Executive
				Director of probable cause, the Board authorizes the Executive Director to
				write the licensee/applicant requesting that the licensee/applicant submit to a
				physical or mental examination within 30 days of the receipt of the letter from
				the Executive Director. The letter shall state the reasons for the request for
				the mental or physical examination, the physician or physicians the Executive
				Director has approved to conduct such examinations, and the date by which the
				examination and the results are to be received by the Board.
(5) If the licensee/applicant to whom a
				letter requiring a mental or physical examination is sent refuses to submit to
				the examination, the Board, through its Executive Director, shall issue an
				order requiring the licensee/applicant to show cause why the licensee/applicant
				should not be required to submit to the examination and shall schedule a
				hearing on the order not later than the 30 days after the date on which the
				notice of the hearing is provided to the licensee. The licensee/applicant shall
				be notified by either personal service or certified mail with return receipt
				requested.
(6) At the show cause
				hearing provided in for in paragraph (5) of this subsection, a panel of the
				Board's representatives shall determine whether the licensee/applicant shall
				submit to an evaluation or that the matter shall be closed with no examination
				required.
(A) At the hearing, the
				licensee/applicant and the licensee/applicant's attorney, if any, are entitled
				to present testimony and other evidence showing that the licensee/applicant
				should not be required to submit to the examination.
(B) If, after consideration of the evidence
				presented at the show cause hearing, the panel determines that the
				licensee/applicant shall submit to an examination, the Board's representatives
				shall, through its Executive Director, issue an order requiring the examination
				within 60 days after the date of the entry of the order requiring examination.
				A licensee is entitled to cross-examine an expert who offers testimony at
				hearing before the Board.
(C) If
				the panel determines that no such examination is necessary, the panel will
				withdraw the request for examination.
(D) The results of any Board-ordered mental
				or physical examination are confidential shall be presented to the Board under
				seal for it to take whatever action is deemed necessary and appropriate based
				on the results of the mental or physical examination. A licensee shall be
				provided the results of an examination and given the opportunity to provide a
				response at least 30 days before the Board takes action.
(7) In fulfilling its obligations under
				§ 164.056 of the Act, the Board shall refer the licensee/applicant to the
				most appropriate medical specialist for evaluation. The Board may not require a
				licensee/applicant to submit to an examination by a physician having a
				specialty specified by the Board unless medically indicated. The Board may not
				require a licensee/applicant to submit to an examination to be conducted an
				unreasonable distance from the person's home or place of business unless the
				licensee/applicant resides and works in an area in which there are a limited
				number of physicians able to perform an appropriate examination.
(8) The guidelines adopted under this
				subsection do not impair or remove the Board's power to make an independent
				licensing or disciplinary decision unless a temporary suspension is
				convened.