Cain Naturopathic Bill’s Felony Can Reach Unlicensed Health Coaches

The text as introduced · 6,277 words

89R6387 AND-D

By: Cain
H.B. No. 3979

A BILL TO BE ENTITLED

AN ACT

relating to the licensing and regulation of naturopathic

physicians; requiring an occupational license; authorizing fees;

providing penalties; creating a criminal offense.

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

SECTION 1. Subtitle C, Title 3, Occupations Code, is

amended by adding Chapter 207 to read as follows:

CHAPTER 207. NATUROPATHIC PHYSICIANS

SUBCHAPTER A. GENERAL PROVISIONS

Sec. 207.001. SHORT TITLE. This chapter may be cited as the

Naturopathic Physicians Licensing Act.

Sec. 207.002. DEFINITIONS. In this chapter:

(1) "Executive director" means the executive director

of the Texas Medical Board.

(2) "Medical board" means the Texas Medical Board.

(3) "Naturopathic board" means the Naturopathic

Medical Board.

(4) "Naturopathic childbirth attendance" means the

specialty practice of natural childbirth by a naturopathic

physician that includes the management of normal pregnancy, normal

labor and delivery, and the normal postpartum period, including

normal newborn care.

(5) "Naturopathic clinical elective" means a

specialty clinical practice consistent with naturopathic education

and training.

(6) "Naturopathic medicine" means a system of primary

health care for the prevention, diagnosis, and treatment of human

health conditions, injury, and disease through the promotion or

restoration of health and the support and stimulation of a

patient's inherent self-healing processes through patient

education and the use of naturopathic therapies and therapeutic

substances.

(7) "Naturopathic physician" means a person licensed

to practice naturopathic medicine under this chapter.

(8) "Physician" means a person licensed to practice

medicine by the medical board.

(9) "Prescription drug" has the meaning assigned by

Section 551.003.

Sec. 207.003. SCOPE OF PRACTICE. (a) For purposes of this

chapter, a person practices naturopathic medicine if the person:

(1) performs examination, diagnosis, and treatment of

disease consistent with naturopathic education and training;

(2) performs physical examinations, including

orificial examinations;

(3) orders or performs diagnostic laboratory tests or

physiological function tests;

(4) orders diagnostic imaging studies;

(5) orders or performs therapies, treatments, or

modalities, including hot or cold hydrotherapy, naturopathic

physical medicine, electromagnetic energy, colon hydrotherapy, and

therapeutic exercise;

(6) repairs or provides care incidental to superficial

lacerations or abrasions;

(7) removes foreign bodies located in the superficial

tissue;

(8) performs musculoskeletal manipulation;

(9) dispenses, administers, or prescribes:

(A) food, extracts of food, nutraceuticals,

vitamins, amino acids, minerals, enzymes, botanicals and their

extracts, botanical medicines, homeopathic medicines, or dietary

supplements and nonprescription drugs as defined by the Federal

Food, Drug, and Cosmetic Act (21 U.S.C. Section 301 et seq.);

(B) prescription drugs as approved by the

naturopathic board; or

(C) devices, including therapeutic devices,

barrier contraception, and durable medical equipment; or

(10) provides counseling, behavioral medicine, or

health education.

(b) A naturopathic physician may administer treatment using

various routes of administration, including oral, nasal,

auricular, ocular, rectal, vaginal, transdermal, intradermal,

subcutaneous, intravenous, and intramuscular routes.

(c) A naturopathic physician may practice naturopathic

childbirth attendance if the naturopathic physician is authorized

by the naturopathic board under Section 207.301.

(d) A naturopathic physician may use novel technologies,

modalities, and therapies approved by the naturopathic board.

(e) The naturopathic board may adopt rules related to the

scope of practice of a naturopathic physician that are consistent

with this section.

Sec. 207.004. APPLICABILITY. This chapter does not apply

to:

(1) a health care professional licensed under this

title acting within the scope of the person's practice;

(2) a person employed in the service of the federal

government while performing duties related to that employment;

(3) a student enrolled in an approved naturopathic

medical college who performs naturopathic medical acts under the

supervision of an instructor who is a licensed naturopathic

physician or a health care professional licensed in the area of

instruction in which the student is engaged;

(4) a person providing self-care or care to a family

member;

(5) a person who sells natural products, including

foods, dietary supplements, cosmetics, or homeopathic

preparations, and provides information to consumers about the

products, except that a person may not represent or assume the

character or appearance of a person practicing naturopathic

medicine or imply or indicate that the person is licensed to

practice naturopathic medicine; or

(6) a person who is a licensed practitioner of

naturopathic medicine in another state and who, in this state,

consults with a naturopathic physician licensed in this state,

provided that the consultation is limited to providing an

examination, recommendation, instruction, or testimony.

SUBCHAPTER B. NATUROPATHIC MEDICAL BOARD

Sec. 207.051. NATUROPATHIC BOARD MEMBERSHIP. (a) The

Naturopathic Medical Board is composed of seven members appointed

by the governor with the advice and consent of the senate as

follows:

(1) four naturopathic physician members;

(2) one physician member who is licensed to practice

medicine in this state and who has experience working with

naturopathic doctors;

(3) one pharmacist; and

(4) one member who represents the public and who is not

licensed or trained in a health care profession.

(b) A member of the naturopathic board must be a United

States citizen and a resident of this state.

(c) Appointments to the naturopathic board shall be made

without regard to the race, color, disability, sex, gender,

religion, age, or national origin of the appointee.

Sec. 207.052. ELIGIBILITY OF PUBLIC MEMBER. A person is not

eligible for appointment as a public member of the naturopathic

board if the person or the person's spouse:

(1) is registered, certified, or licensed by an

occupational regulatory agency in the field of health care;

(2) is employed by or participates in the management

of a business entity or other organization regulated by or

receiving money from the medical board or naturopathic board;

(3) owns or controls, directly or indirectly, more

than a 10 percent interest in a business entity or other

organization regulated by or receiving money from the medical board

or naturopathic board; or

(4) uses or receives a substantial amount of tangible

goods, services, or money from the medical board or naturopathic

board, other than compensation or reimbursement authorized by law

for naturopathic board membership, attendance, or expenses.

Sec. 207.053. MEMBERSHIP AND EMPLOYEE RESTRICTIONS. (a)

In this section, "Texas trade association" means a cooperative and

voluntarily joined statewide association of business or

professional competitors in this state designed to assist its

members and its industry or profession in dealing with mutual

business or professional problems and in promoting their common

interest.

(b) A person may not be a member of the naturopathic board

and may not be a naturopathic board employee employed in a "bona

fide executive, administrative, or professional capacity," as that

phrase is used for purposes of establishing an exemption to the

overtime provisions of the federal Fair Labor Standards Act of 1938

(29 U.S.C. Section 201 et seq.) if:

(1) the person is an officer, employee, or paid

consultant of a Texas trade association in the field of health care;

or

(2) the person's spouse is an officer, manager, or paid

consultant of a Texas trade association in the field of health care.

(c) A person may not be a member of the naturopathic board or

act as the general counsel to the naturopathic board if the person

is required to register as a lobbyist under Chapter 305, Government

Code, because of the person's activities for compensation on behalf

of a profession related to the operation of the medical board or

naturopathic board.

Sec. 207.054. GROUNDS FOR REMOVAL. (a) It is a ground for

removal from the naturopathic board that a member:

(1) does not have at the time of taking office the

qualifications required by Section 207.051;

(2) does not maintain during service on the

naturopathic board the qualifications required by Section 207.051;

(3) is ineligible for membership under Section 207.052

or 207.053;

(4) cannot, because of illness or disability,

discharge the member's duties for a substantial part of the member's

term; or

(5) is absent from more than half of the regularly

scheduled naturopathic board meetings that the member is eligible

to attend during a calendar year without an excuse approved by a

majority vote of the naturopathic board.

(b) The validity of an action of the naturopathic board is

not affected by the fact that it is taken when a ground for removal

of a naturopathic board member exists.

(c) If the executive director has knowledge that a potential

ground for removal exists, the executive director shall notify the

presiding officer of the naturopathic board of the potential

ground. The presiding officer shall then notify the governor and

the attorney general that a potential ground for removal exists. If

the potential ground for removal involves the presiding officer,

the executive director shall notify the next highest ranking

officer of the naturopathic board, who shall then notify the

governor and the attorney general that a potential ground for

removal exists.

Sec. 207.055. PRESIDING OFFICER OF NATUROPATHIC BOARD. The

governor shall appoint a naturopathic board member who is a

naturopathic physician to serve as presiding officer of the

naturopathic board at the pleasure of the governor. The presiding

officer may vote on any matter before the naturopathic board.

Sec. 207.056. TERMS; VACANCIES. (a) Members of the

naturopathic board serve staggered six-year terms. The terms of

two or three members expire on January 31 of each odd-numbered year.

(b) A member of the naturopathic board may not serve more

than two consecutive terms.

(c) A vacancy on the naturopathic board shall be filled by

appointment of the governor.

Sec. 207.057. REIMBURSEMENT. A member of the naturopathic

board may receive reimbursement for travel expenses as provided by

the General Appropriations Act.

Sec. 207.058. MEETINGS. The naturopathic board shall meet

at least annually and at the call of the presiding officer or

executive director. The naturopathic board may also meet at the

written request of any two members.

Sec. 207.059. TRAINING. (a) A person who is appointed to

and qualifies for office as a member of the naturopathic board may

not vote, deliberate, or be counted as a member in attendance at a

meeting of the naturopathic board until the person completes a

training program that complies with this section.

(b) The training program must provide the person with

information regarding:

(1) the law governing naturopathic board operations;

(2) the programs, functions, rules, and budget of the

naturopathic board;

(3) the scope of and limitations on the rulemaking

authority of the naturopathic board;

(4) the results of the most recent formal audit of the

naturopathic board;

(5) 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

naturopathic board in performing their duties; and

(6) any applicable ethics policies adopted by the

medical board, naturopathic board, or the Texas Ethics Commission.

(c) A person appointed to the naturopathic board is entitled

to reimbursement, as provided by the General Appropriations Act,

for the travel expenses incurred in attending the training program

regardless of whether the attendance at the program occurs before

or after the person qualifies for office.

(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 naturopathic board member. On receipt of the

training manual, each naturopathic board member shall sign and

submit to the executive director a statement acknowledging receipt

of the training manual.

SUBCHAPTER C. POWERS AND DUTIES

Sec. 207.101. POWERS AND DUTIES. (a) The naturopathic

board shall:

(1) administer and enforce this chapter;

(2) establish qualifications for obtaining a license;

(3) evaluate and approve clinical, practical, or

naturopathic medicine residency requirements;

(4) approve a national naturopathic medicine

licensing examination;

(5) establish procedures for applying for or renewing

a license;

(6) evaluate the qualifications of license

applicants;

(7) establish minimum continuing education

requirements and approve continuing education courses;

(8) establish qualifications for naturopathic

clinical electives;

(9) establish qualifications and standards relating

to prescribing authority;

(10) establish requirements relating to malpractice

insurance;

(11) investigate credible complaints made against a

license holder; and

(12) deny, revoke, or suspend a license or otherwise

discipline a license holder.

(b) In addition to the advisory committee required under

this subchapter, the naturopathic board may appoint advisory

committees to perform advisory functions as determined necessary by

the naturopathic board. An advisory committee appointed under this

subsection is subject to Chapter 2110, Government Code.

Sec. 207.102. GENERAL RULEMAKING AUTHORITY. The

naturopathic board shall adopt rules as necessary to perform the

naturopathic board's duties and implement this chapter.

Sec. 207.103. ASSISTANCE BY MEDICAL BOARD. (a) The medical

board shall provide administrative and clerical employees as

necessary to enable the naturopathic board to administer this

chapter.

(b) Subject to the advice and approval of the medical board,

the naturopathic board shall develop and implement policies that

clearly separate the policy-making responsibilities of the

naturopathic board and the management responsibilities of the

executive director and the staff of the medical board.

Sec. 207.104. FEES. The naturopathic board by rule shall

set fees in amounts reasonable and necessary to cover the costs of

administering this chapter.

Sec. 207.105. NATUROPATHIC CHILDBIRTH ATTENDANCE ADVISORY

COMMITTEE. (a) The naturopathic board shall establish a

naturopathic childbirth attendance advisory committee to provide

specific recommendations to the naturopathic board about

requirements for a naturopathic physician to receive authorization

from the naturopathic board to practice naturopathic childbirth

attendance.

(b) The naturopathic childbirth attendance advisory

committee shall be composed of five members appointed by the

naturopathic board as follows:

(1) three naturopathic physician members who are

qualified to practice naturopathic childbirth attendance;

(2) one physician member who specializes or is

board-certified in obstetrics; and

(3) one licensed midwife or nurse midwife member.

(c) The naturopathic board must consult with the

naturopathic childbirth attendance advisory committee and consider

the committee's recommendations before adopting rules establishing

the requirements to receive authorization from the naturopathic

board to practice naturopathic childbirth attendance.

(d) At least once each year or on the request of the

naturopathic board, the naturopathic childbirth attendance

advisory committee shall review the rules for naturopathic

childbirth attendance and recommend changes to the requirements to

receive authorization from the naturopathic board to practice

naturopathic childbirth attendance.

SUBCHAPTER D. PUBLIC INTEREST INFORMATION AND COMPLAINT

PROCEDURES

Sec. 207.151. PUBLIC INTEREST INFORMATION. (a) The

naturopathic board shall prepare information of public interest

describing the functions of the naturopathic board and the

procedures by which complaints are filed with and resolved by the

naturopathic board.

(b) The naturopathic board shall make the information

available to the public and appropriate state agencies.

Sec. 207.152. COMPLAINTS. (a) The naturopathic board by

rule shall establish methods by which consumers and service

recipients are notified of the name, mailing address, and telephone

number of the naturopathic board for the purpose of directing

complaints to the naturopathic board. The naturopathic board may

provide for that notice:

(1) on each registration form, application, or written

contract for services of a person regulated by the naturopathic

board;

(2) on a sign prominently displayed in the place of

business of a person regulated by the naturopathic board; or

(3) in a bill for services provided by a person

regulated by the naturopathic board.

(b) The naturopathic board shall list with its regular

telephone number any toll-free telephone number that may be called

to present a complaint about a person regulated by the naturopathic

board.

Sec. 207.153. INFORMATION ABOUT COMPLAINT ACTIONS. (a)

The naturopathic board shall maintain a system to promptly and

efficiently act on complaints filed with the naturopathic board.

The naturopathic board shall maintain information about parties to

the complaint, the subject matter of the complaint, a summary of the

results of the review or investigation of the complaint, and its

disposition.

(b) The naturopathic board shall make information available

describing its procedures for complaint investigation and

resolution.

(c) The naturopathic board shall periodically notify the

parties to a complaint of the status of the complaint until final

disposition of the complaint.

Sec. 207.154. GENERAL RULES REGARDING COMPLAINT

INVESTIGATION. (a) The naturopathic board shall adopt rules

concerning the investigation of a complaint filed with the

naturopathic board. The rules adopted under this section must:

(1) distinguish between categories of complaints;

(2) ensure that a complaint is not dismissed without

appropriate consideration;

(3) require that the naturopathic board be advised of

a complaint that is dismissed and that a letter be sent to the

person who filed the complaint explaining the action taken on the

complaint;

(4) ensure that the person who files a complaint has an

opportunity to explain the allegations made in the complaint; and

(5) prescribe guidelines concerning the categories of

complaints that require the use of a private investigator and

prescribe the procedures for the naturopathic board to obtain the

services of a private investigator.

(b) The naturopathic board shall:

(1) dispose of a complaint in a timely manner; and

(2) establish a schedule for conducting each phase of

the disposition of a complaint that is under the control of the

naturopathic board not later than the 30th day after the date the

naturopathic board receives the complaint.

(c) The naturopathic board shall notify the parties to a

complaint of the projected time requirements for pursuing the

complaint.

(d) The naturopathic board shall notify the parties to a

complaint of any change in the schedule not later than the seventh

day after the date the change is made.

(e) The executive director shall notify the naturopathic

board of a complaint that is unresolved after the time prescribed by

the naturopathic board for resolving the complaint so that the

naturopathic board may take necessary action on the complaint.

(f) The naturopathic board shall assign priorities and

investigate complaints based on:

(1) the severity of the conduct alleged in the

complaint; and

(2) the degree of harm to public health and safety.

Sec. 207.155. CONFIDENTIALITY OF COMPLAINT INFORMATION.

(a) Except as provided by Subsection (b), a complaint and

investigation and all information and materials compiled by the

naturopathic board in connection with the complaint and

investigation are not subject to:

(1) disclosure under Chapter 552, Government Code; or

(2) disclosure, discovery, subpoena, or other means of

legal compulsion for release of information to any person.

(b) A complaint or investigation subject to Subsection (a)

and all information and materials compiled by the naturopathic

board in connection with the complaint may be disclosed to:

(1) the naturopathic board, the naturopathic board's

employees or agents, or the medical board's employees or agents

involved in license holder discipline;

(2) a party to a disciplinary action against the

license holder or that party's designated representative;

(3) a law enforcement agency;

(4) a governmental agency, if:

(A) the disclosure is required or permitted by

law; and

(B) the agency obtaining the disclosure protects

the identity of any patient whose records are examined; or

(5) a person engaged in bona fide research, if all

information identifying a specific individual has been deleted.

(c) Unless good cause for delay is shown to the presiding

officer at the hearing, the naturopathic board shall provide the

license holder with access to all information that the naturopathic

board intends to offer into evidence at the hearing not later than

the 30th day after the date the naturopathic board receives a

written request from a license holder who is entitled to a hearing

under this chapter or from the license holder's attorney of record.

(d) The naturopathic board shall protect the identity of any

patient whose records are examined in connection with a

disciplinary investigation or proceeding against a license holder,

except a patient who:

(1) initiates the disciplinary action; or

(2) has submitted a written consent to release the

records.

Sec. 207.156. SUBPOENAS. (a) In the investigation of a

complaint filed with the naturopathic board, the executive director

or the presiding officer of the naturopathic board may issue a

subpoena to compel the attendance of a relevant witness or the

production, for inspection or copying, of relevant evidence that is

in this state.

(b) A subpoena may be served personally or by certified

mail.

(c) If a person fails to comply with a subpoena, the

naturopathic board, acting through the attorney general, may file

suit to enforce the subpoena in a district court in Travis County or

in the county in which a hearing conducted by the naturopathic board

may be held.

(d) On finding that good cause exists for issuing the

subpoena, the court shall order the person to comply with the

subpoena. The court may punish a person who fails to obey the court

order.

(e) The naturopathic board shall pay a reasonable fee for

photocopies subpoenaed under this section in an amount not to

exceed the amount the naturopathic board may charge for copies of

its records.

(f) The reimbursement of the expenses of a witness whose

attendance is compelled under this section is governed by Section

2001.103, Government Code.

(g) Information and materials subpoenaed or compiled by the

naturopathic board in connection with the investigation of a

complaint may be disclosed only as provided by Section 207.155.

Sec. 207.157. PUBLIC PARTICIPATION. The naturopathic board

shall develop and implement policies that provide the public with a

reasonable opportunity to appear before the naturopathic board and

to speak on any issue under the jurisdiction of the naturopathic

board.

SUBCHAPTER E. LICENSE REQUIREMENTS

Sec. 207.201. LICENSE REQUIRED. (a) A person may not

practice as a naturopathic physician unless the person holds a

license under this chapter.

(b) A person may not use the title "naturopath,"

"naturopathic physician," "physician of naturopathic medicine,"

"naturopathic doctor," "doctor of naturopathic medicine," or

"doctor of naturopathy" or the abbreviation "N.D." or "N.M.D."

unless the person is licensed under this chapter.

Sec. 207.202. LICENSE APPLICATION. Each applicant for a

license under this chapter must submit to the naturopathic board an

application on a form required by the naturopathic board and the

required application fee.

Sec. 207.203. REQUIREMENTS FOR LICENSE. An applicant for a

license to practice naturopathic medicine must present to the

naturopathic board sufficient evidence that the applicant:

(1) graduated from a naturopathic medical program that

meets the requirements of Section 207.205;

(2) passed the licensing examination required by

Section 207.206;

(3) has not been denied a license to practice

naturopathic medicine or another health care profession in this

state or another state or had the license suspended or revoked based

on the license holder's ability to safely practice the health care

profession; and

(4) is physically and mentally capable of safely

practicing naturopathic medicine with or without reasonable

accommodation.

Sec. 207.204. ISSUANCE OF LICENSE. The naturopathic board

shall issue a license as a naturopathic physician to an applicant

who:

(1) complies with the requirements of this chapter;

(2) meets any additional requirements the

naturopathic board establishes by rule; and

(3) pays the license fee required by the naturopathic

board.

Sec. 207.205. NATUROPATHIC MEDICAL PROGRAM. A naturopathic

medical program may be approved by the naturopathic board if the

program is:

(1) an institution or part of an institution of higher

education that is accredited or is a candidate for accreditation by

a regional or national institutional accrediting agency recognized

by the United States secretary of education that:

(A) offers a degree of doctor of naturopathy or

doctor of naturopathic medicine that includes graduate-level

full-time didactic and supervised clinical training; and

(B) is accredited or has candidacy status for

accreditation by the Council on Naturopathic Medical Education or

an equivalent federally recognized accrediting agency for

naturopathic medical programs approved by the naturopathic board;

(2) a degree-granting college or university that:

(A) before the existence of the Council on

Naturopathic Medical Education, offered doctoral-level

naturopathic medical education that:

(i) provided a full-time structured

curriculum in basic sciences and supervised patient care; and

(ii) required the completion of not less

than 132 weeks of education within 35 months; and

(B) either:

(i) is found by the naturopathic board to

have been reputable and in good standing; or

(ii) if still in existence, has current

programmatic accreditation by the Council on Naturopathic Medical

Education or another federally recognized accrediting agency;

(3) a diploma-granting, degree-equivalent college or

university in Canada that:

(A) offers graduate-level full-time didactic and

supervised clinical training;

(B) is accredited or has candidacy status for

accreditation by the Council on Naturopathic Medical Education or

an equivalent federally recognized naturopathic medical program

accrediting agency that is approved by the naturopathic board; and

(C) has provincial approval for participation in

government-funded student aid programs; or

(4) a diploma-granting, degree-equivalent college or

university in Canada that:

(A) before the existence of the Council on

Naturopathic Medical Education, offered doctoral-level

naturopathic medical education that:

(i) provided a full-time structured

curriculum in basic sciences and supervised patient care; and

(ii) required the completion of not less

than 132 weeks of education within 35 months; and

(B) either:

(i) is found by the naturopathic board to

have been reputable and in good standing; or

(ii) if still in existence, has current

programmatic accreditation by the Council on Naturopathic Medical

Education or another federally recognized accrediting entity and

has provincial approval for participation in a government-funded

student aid program.

Sec. 207.206. EXAMINATION. To receive a license, an

applicant must pass a competency-based national naturopathic

physician licensing examination and a naturopathic physician

pharmacology examination that are approved by the naturopathic

board and administered by the North American Board of Naturopathic

Examiners or its successor organization.

Sec. 207.207. CRIMINAL HISTORY RECORD INFORMATION

REQUIREMENT FOR LICENSE ISSUANCE. (a) The naturopathic board

shall require that an applicant for a license submit a complete and

legible set of fingerprints, on a form prescribed by the

naturopathic board, to the naturopathic 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 naturopathic board may not issue a license to a

person who does not comply with the requirement of Subsection (a).

(c) The naturopathic 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 naturopathic 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 naturopathic 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.

Sec. 207.208. RECIPROCITY. The naturopathic board shall

issue a license to a person who:

(1) is licensed in good standing as a naturopathic

physician in another state that has licensing requirements

substantially equivalent to the requirements of this chapter;

(2) has not been the subject of a final disciplinary

action and is not the subject of a pending disciplinary action in

any jurisdiction in which the naturopathic physician is or has been

licensed;

(3) pays the fee set by the naturopathic board; and

(4) meets any additional criteria established by

naturopathic board rule.

SUBCHAPTER F. LICENSE RENEWAL

Sec. 207.251. LICENSE EXPIRATION. A license issued under

this chapter expires on the second anniversary of the date of

issuance.

Sec. 207.252. LICENSE RENEWAL. Before the expiration of a

license, a license may be renewed by:

(1) submitting an application for renewal;

(2) paying the renewal fee set by the naturopathic

board; and

(3) providing verification to the naturopathic board

that the applicant for renewal has met the continuing education

requirements established by the naturopathic board.

Sec. 207.253. 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 207.207.

(b) The naturopathic 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 207.207 for the initial issuance of the

license; or

(2) this section as part of a prior renewal of a

license.

Sec. 207.254. CONTINUING EDUCATION. The naturopathic board

shall recognize, prepare, or administer continuing education

programs for license holders. A license holder must participate in

the programs to the extent required by the naturopathic board to

keep the person's license.

SUBCHAPTER G. PRACTICE BY LICENSE HOLDER

Sec. 207.301. NATUROPATHIC CHILDBIRTH ATTENDANCE. (a) The

naturopathic board shall establish qualifications required for the

naturopathic board to authorize a naturopathic physician to

practice naturopathic childbirth attendance.

(b) To obtain authorization from the naturopathic board to

practice naturopathic childbirth attendance, a naturopathic

physician must:

(1) graduate from a naturopathic midwifery or

naturopathic obstetrics program that is approved by the

naturopathic board;

(2) pass the North American Registry of Midwives

examination, American College of Naturopathic Obstetrics

examination, or another examination approved by the naturopathic

board; and

(3) meet all other requirements established by the

naturopathic board in consultation with the naturopathic

childbirth attendance advisory committee established under Section

207.105.

Sec. 207.302. COMPLIANCE WITH STATE LAW AND LOCAL

REGULATIONS: PUBLIC HEALTH; REPORTING BIRTHS AND DEATHS. A

naturopathic physician shall comply with state law and a political

subdivision's regulations concerning infectious diseases and

public health and reporting births and deaths to the same extent as

a physician.

Sec. 207.303. NATUROPATHIC CLINICAL ELECTIVE. The

naturopathic board shall establish qualifications for authorizing

a naturopathic physician to practice a naturopathic clinical

elective. The qualifications must require that a naturopathic

physician:

(1) meet the educational requirements for the

naturopathic clinical elective provided by the North American Board

of Naturopathic Examiners or another examining entity approved by

the naturopathic board;

(2) pass a competency-based national naturopathic

physician clinical elective examination approved by the

naturopathic board and administered by the North American Board of

Naturopathic Examiners or its successor agency; and

(3) meet all other requirements established by the

naturopathic board.

SUBCHAPTER H. PROHIBITED PRACTICES

Sec. 207.351. PROHIBITED PRACTICES. (a) A naturopathic

physician may not:

(1) practice or claim to practice as a physician,

dentist, podiatrist, optometrist, psychologist, advanced practice

registered nurse, physician assistant, chiropractor, physical

therapist, acupuncturist, or any other health care professional

unless the naturopathic physician holds a license for the

profession issued by this state;

(2) perform surgical procedures, including procedures

involving the eye, ear, tendons, nerves, veins, or arteries that

extend beyond superficial tissue;

(3) administer general or spinal anesthetics; or

(4) administer ionizing radioactive substances for

therapeutic purposes.

(b) A naturopathic physician may not treat a lesion that is

suspected of being malignant or that requires surgical removal. If

a naturopathic physician suspects that a lesion may be malignant or

requires surgical removal, the naturopathic physician shall refer

the patient to a physician or other appropriate health care

provider.

(c) Notwithstanding Subsection (b), a naturopathic

physician may provide adjunctive or concurrent treatment to a

person who is under the care of a physician for treatment of a

malignant lesion.

SUBCHAPTER I. LICENSE DENIAL AND DISCIPLINARY PROCEDURES

Sec. 207.401. GROUNDS FOR LICENSE DENIAL AND DISCIPLINARY

ACTION. (a) After a hearing, the naturopathic board may deny a

license to an applicant, suspend or revoke a person's license, or

place on probation a license holder if the applicant or license

holder:

(1) violates this chapter or a naturopathic board

order or rule;

(2) obtains a license by means of fraud,

misrepresentation, or concealment of a material fact;

(3) sells, barters, or offers to sell or barter a

license; or

(4) engages in unprofessional conduct that endangers

or is likely to endanger public health, welfare, or safety as

defined by naturopathic board rule.

(b) The naturopathic board may not issue or renew a person's

license if the person:

(1) has an impairment related to drugs or alcohol that

would limit the person's ability to practice naturopathic medicine

in a manner consistent with public safety; or

(2) is found mentally incompetent by a physician and

the mental incompetence impairs the person's ability to undertake

the practice of naturopathic medicine in a manner consistent with

public safety.

Sec. 207.402. INFORMAL PROCEEDINGS. (a) The naturopathic

board by rule shall adopt procedures governing:

(1) informal disposition of a contested case under

Section 2001.056, Government Code; and

(2) an informal proceeding held in compliance with

Section 2001.054, Government Code.

(b) Rules adopted under this section must:

(1) provide the complainant and the license holder an

opportunity to be heard; and

(2) require the presence of a member of the

naturopathic board's or medical board's legal staff to advise:

(A) the naturopathic board or the naturopathic

board's employees; or

(B) the medical board or the medical board's

employees.

Sec. 207.403. HEARING. A license holder is entitled to a

hearing before the State Office of Administrative Hearings before a

sanction is imposed under this subchapter.

Sec. 207.404. SCHEDULE OF SANCTIONS. (a) The naturopathic

board by rule shall adopt a broad schedule of sanctions for

violations under this chapter.

(b) The State Office of Administrative Hearings shall use

the schedule for any sanction imposed under this chapter as the

result of a hearing conducted by that office.

SUBCHAPTER J. PENALTIES AND ENFORCEMENT PROCEDURES

Sec. 207.451. ADMINISTRATIVE PENALTY. (a) The

naturopathic board 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) An administrative penalty may not exceed $200. Each day

a violation continues or occurs is a separate violation for the

purpose of imposing a penalty. The amount of the penalty shall be

based on:

(1) the seriousness of the violation, including the

nature, circumstances, extent, and gravity of any prohibited acts,

and the hazard or potential hazard created to the health, safety, or

economic welfare of the public;

(2) the history of previous violations;

(3) the amount necessary to deter a future violation;

(4) efforts to correct the violation; and

(5) any other matter that justice requires.

(c) The person may stay enforcement during the time the

order is under judicial review if the person pays the penalty to the

court clerk or files a supersedeas bond with the court in the amount

of the penalty. A person who cannot afford to pay the penalty or

file the bond may stay enforcement by filing an affidavit like that

required by the Texas Rules of Civil Procedure for a party who

cannot afford to file security for costs, except that the

naturopathic board may contest the affidavit as provided by those

rules.

(d) A proceeding to impose an administrative penalty is

subject to Chapter 2001, Government Code.

Sec. 207.452. CIVIL PENALTY. (a) A person found by a court

to have violated this chapter is liable to this state for a civil

penalty of $200 for each day the violation continues.

(b) A civil penalty may be recovered in a suit brought by the

attorney general, a district attorney, or a county attorney.

Sec. 207.453. CRIMINAL OFFENSE. (a) A person commits an

offense if the person knowingly violates this chapter.

(b) Except as provided by Subsection (c), an offense under

this section is a Class A misdemeanor.

(c) An offense under this section is a felony of the third

degree if the person:

(1) obtains a license by means of fraud,

misrepresentation, or concealment of a material fact;

(2) practices naturopathic medicine without a license

issued under this chapter; or

(3) sells, barters, or offers to sell or barter a

license.

(d) Each day a violation occurs constitutes a separate

offense.

SECTION 2. As soon as practicable after the effective date

of this Act, the governor shall appoint seven members to the

Naturopathic Medical Board in accordance with Chapter 207,

Occupations Code, as added by this Act. In making the initial

appointments, the governor shall designate two members for terms

expiring January 31, 2027, two members for terms expiring January

31, 2029, and three members for terms expiring January 31, 2031.

SECTION 3. Notwithstanding Chapter 207, Occupations Code,

as added by this Act, a person may be appointed to the Naturopathic

Medical Board as an initial naturopathic physician member if the

person does not hold a naturopathic physician license under that

chapter. A person appointed to the Naturopathic Medical Board as a

naturopathic physician member on or after June 1, 2026, must hold a

naturopathic physician license under Chapter 207, Occupations

Code, as added by this Act.

SECTION 4. Notwithstanding Chapter 207, Occupations Code,

as added by this Act, a person may be appointed to serve as a

naturopathic physician member of the naturopathic childbirth

attendance advisory committee if the person does not hold a

naturopathic physician license under that chapter. A person

appointed to the naturopathic childbirth attendance advisory

committee as a naturopathic physician member of the committee on or

after June 1, 2028, must hold a naturopathic physician license

under Chapter 207, Occupations Code, as added by this Act.

SECTION 5. Not later than January 1, 2026, the Naturopathic

Medical Board shall adopt the rules, procedures, and fees necessary

to administer Chapter 207, Occupations Code, as added by this Act.

SECTION 6. Notwithstanding Chapter 207, Occupations Code,

as added by this Act, a naturopathic physician is not required to

hold a license under that chapter to practice as a naturopathic

physician in this state before June 1, 2026.

SECTION 7. (a) Except as provided by Subsection (b) of this

section, this Act takes effect September 1, 2025.

(b) Section 207.201, Occupations Code, and Subchapter J,

Chapter 207, Occupations Code, as added by this Act, take effect

June 1, 2026.