Oliverson Bill Licenses Medical Grads Without A Residency

The text as introduced · 1,324 words

89R8422 BEE-F

By: Oliverson
H.B. No. 1685

A BILL TO BE ENTITLED

AN ACT

relating to the licensing and regulation of physician graduates and

the authority of an insured to select a physician graduate under the

insured's health insurance policy; requiring an occupational

license; authorizing fees.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Chapter 155, Occupations Code, is amended by

adding Subchapter E to read as follows:

SUBCHAPTER E. PHYSICIAN GRADUATE

Sec. 155.201. DEFINITIONS. In this subchapter:

(1) "Physician graduate" means an individual issued a

limited license under this subchapter to practice medicine under a

supervising practice agreement with a sponsoring physician.

(2) "Sponsoring physician" means a physician who

enters into a supervising practice agreement with a physician

graduate.

(3) "Supervising practice agreement" means an

agreement between a sponsoring physician and a physician graduate

regarding the sponsoring physician's supervision of the physician

graduate's practice of medicine.

Sec. 155.202. RULES. The board shall adopt rules in

accordance with this subchapter relating to the licensing and

regulation of physician graduates, including rules relating to:

(1) procedures and fees for the issuance, term, and

renewal of a license under this subchapter, including continuing

medical education requirements for renewal of the license;

(2) practices and requirements for the supervision of

physician graduates; and

(3) any other matter necessary to ensure protection of

the public, including disciplinary procedures.

Sec. 155.203. LICENSE ISSUANCE. On application, the board

shall issue a limited license to practice medicine under this

subchapter to an applicant who:

(1) is a resident of this state and is:

(A) a United States citizen;

(B) a legal permanent resident; or

(C) otherwise authorized under federal law to

work in the United States;

(2) has proficiency in the English language;

(3) has graduated:

(A) in the two years preceding the date that the

applicant initially applies for a physician graduate license, from:

(i) a board-recognized accredited medical

school or osteopathic medical school in the United States or

Canada; or

(ii) a medical school located outside of

the United States and Canada that the board recognizes as

acceptable; or

(B) if the applicant is licensed in good standing

to practice medicine in another country, from a medical school

located outside of the United States and Canada that the board

recognizes as acceptable;

(4) has passed the first and second components of the

United States Medical Licensing Examination or equivalent

components of another board-approved licensing examination

described by Section 155.0511;

(5) is not enrolled in a board-approved postgraduate

residency program; and

(6) meets any other requirement prescribed by board

rule.

Sec. 155.204. FEES. The amount of a fee for the issuance or

renewal of a license under this subchapter may not exceed the amount

of a fee for the issuance or renewal of a physician assistant

license under Chapter 204.

Sec. 155.205. SPONSORING PHYSICIAN. (a) A physician is

eligible to enter into a supervising practice agreement as a

sponsoring physician if the physician:

(1) holds a full and unrestricted license to practice

medicine issued under this subtitle;

(2) has not been and is not currently the subject of

disciplinary action by the board or the medical licensing authority

of any other jurisdiction;

(3) is certified by a medical specialty member board

of:

(A) the American Board of Medical Specialties; or

(B) the American Osteopathic Association Bureau

of Osteopathic Specialists; and

(4) practices medicine in the specialty for which the

physician is certified under Subdivision (3).

(b) A sponsoring physician who enters into a supervising

practice agreement with a physician graduate shall comply with all

board rules related to the supervision of physician graduates.

(c) The board by rule shall establish the maximum number of

physician graduates that a sponsoring physician may supervise under

supervising practice agreements.

Sec. 155.206. SUPERVISING PRACTICE AGREEMENT REQUIRED. (a)

A physician graduate shall enter into a supervising practice

agreement with a sponsoring physician.

(b) A physician graduate who has not entered into a

supervising practice agreement may not practice or attempt to

practice medicine.

(c) A physician graduate who enters into a supervising

practice agreement may practice under the delegation and

supervision of another physician if:

(1) the sponsoring physician authorizes the practice

of the physician graduate under the delegation and supervision of

the other physician in a written document that identifies the other

physician by name; and

(2) the other physician is:

(A) part of the sponsoring physician's physician

group or facility; and

(B) certified in the same specialty as the

sponsoring physician by a medical specialty member board of:

(i) the American Board of Medical

Specialties; or

(ii) the American Osteopathic Association

Bureau of Osteopathic Specialists.

(d) The physician profile under Section 154.006 of a

sponsoring physician or physician graduate must indicate in the

manner prescribed by board rule that the sponsoring physician or

physician graduate has entered into a supervising practice

agreement.

Sec. 155.207. LIMITED PRACTICE BY LICENSE HOLDER. (a) A

physician graduate may provide only medical services in the

specialty in which the physician graduate's sponsoring physician is

certified as described by Section 155.205(a)(3) under supervision

in accordance with a supervising practice agreement.

(b) Before a license holder under this subchapter provides a

treatment, consultation, or other medical service, the license

holder must disclose to the patient:

(1) that the license holder is a physician graduate;

and

(2) if asked, that the license holder has not

completed any formal specialized postgraduate or resident

training.

(c) A physician graduate may not prescribe a Schedule II

controlled substance.

Sec. 155.208. LIABILITY OF SPONSORING PHYSICIAN. A

sponsoring physician who enters into a supervising practice

agreement with a physician graduate is responsible at all times for

the oversight of and is liable for any medical act performed or the

omission of any medical act by the physician graduate in the

provision of medical services.

Sec. 155.209. IDENTIFICATION REQUIREMENTS; USE OF TITLE.

(a) The holder of a license issued under this subchapter shall at

all times while practicing as a physician graduate display a

personal identification document identifying the license holder as

a physician graduate.

(b) A physician graduate may use the following titles or

abbreviations:

(1) "doctor"; or

(2) "Dr." or "doc."

Sec. 155.210. STATUS OF PHYSICIAN GRADUATE. A physician

graduate license holder is considered a general practitioner for

purposes of regulations of the federal Centers for Medicare and

Medicaid Services.

Sec. 155.211. LICENSE RENEWAL. The board may not renew a

license issued under this subchapter unless:

(1) the board verifies that the license holder has

practiced in accordance with this subchapter under a supervising

practice agreement with a sponsoring physician in the license term

preceding the application for renewal; and

(2) the license holder satisfies the continuing

medical education requirements established by board rule.

Sec. 155.212. DENIAL, SUSPENSION, OR REVOCATION OF LICENSE.

The board may deny an application for licensure or suspend or revoke

a license issued under this subchapter:

(1) for any ground provided by Chapter 164 or board

rule; and

(2) in the manner provided by Chapter 164 and board

rule.

SECTION 2. Section 1451.001, Insurance Code, is amended by

adding Subdivision (16-a) to read as follows:

(16-a) "Physician graduate" has the meaning assigned

by Section 155.201, Occupations Code.

SECTION 3. Subchapter C, Chapter 1451, Insurance Code, is

amended by adding Section 1451.129 to read as follows:

Sec. 1451.129. SELECTION OF PHYSICIAN GRADUATE. An insured

may select a physician graduate to provide the services scheduled

in the health insurance policy that are within the scope of the

physician graduate's license under Subchapter E, Chapter 155,

Occupations Code.

SECTION 4. Not later than January 1, 2026, the Texas Medical

Board shall adopt rules as necessary to implement Subchapter E,

Chapter 155, Occupations Code, as added by this Act.

SECTION 5. Section 1451.129, Insurance Code, as added by

this Act, applies only to a health insurance policy that is

delivered, issued for delivery, or renewed on or after January 1,

2026.

SECTION 6. This Act takes effect September 1, 2025.