Bill Opens Three Fast Routes To Practice Medicine In Texas

The text as introduced · 2,259 words

2025S0021-1 01/10/25

By: Sparks
S.B. No. 881

A BILL TO BE ENTITLED

AN ACT

relating to the issuance by the Texas Medical Board of certain

licenses to practice medicine and the authority of an insured to

select certain license holders under the insured's health policy;

requiring an occupational license; authorizing fees.

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

ARTICLE 1. SHORT TITLE

SECTION 1.001. This Act shall be known as the Decreasing

Occupational Certification Timelines, Obstacles, and Regulations

(DOCTOR) Act.

ARTICLE 2. FOREIGN LICENSE HOLDERS

SECTION 2.001. Subchapter C, Chapter 155, Occupations Code,

is amended by adding Section 155.1015 to read as follows:

Sec. 155.1015. ISSUANCE OF PROVISIONAL LICENSE TO

CERTAIN FOREIGN MEDICAL LICENSE HOLDERS WITH OFFERS OF

EMPLOYMENT. (a) Upon receiving an application, the board shall

issue a provisional license to practice medicine to an applicant

who:

(1) has been granted a degree of doctor of medicine or

a substantially similar degree by a program of medical education

that meets eligibility requirements for the applicant to apply for

certification by the Educational Commission for Foreign Medical

Graduates;

(2) has been licensed in good standing to practice

medicine in another country in the five years preceding application

under this section and is not the subject of any pending

disciplinary action before the licensing body;

(3) either:

(A) has completed a residency or substantially

similar postgraduate medical training required by the applicant's

country of licensure and has practiced medicine as a licensed

physician in that country for at least five years after the

completion of the required postgraduate medical training; or

(B) if the applicant's country of licensure does

not require postgraduate medical training, has practiced as a

medical professional performing the duties of a physician in that

country for at least five years and has practiced medicine as a

licensed physician in that country for at least 10 years after

completing medical school;

(4) satisfies the examination requirements of Section

155.051;

(5) has proficiency in the English language;

(6) is authorized under federal law to work in the

United States; and

(7) has been offered employment in this state as a

physician by a person who provides health care services in the

normal course of business, including a health system, hospital,

hospital-based facility, freestanding emergency facility, or

urgent care clinic.

(b) A provisional license issued under this section expires

on the earlier of:

(1) the date the board issues the provisional license

holder a license under this subtitle or denies the provisional

license holder's application for a license under Subsection (c); or

(2) the third anniversary of the date the provisional

license was issued.

(c) Upon receiving an application, the board shall issue a

license under this subtitle to the holder of a provisional license

under this section if the provisional license holder:

(1) will have practiced under the provisional license

for at least three years at the time the license will be issued; and

(2) has not been and is not currently subject to board

investigation or discipline for conduct that occurred while holding

the provisional license.

ARTICLE 3. MILITARY VETERANS

SECTION 3.001. Subchapter C, Chapter 155, Occupations Code,

is amended by adding Section 155.108 to read as follows:

Sec. 155.108. LICENSE FOR MILITARY VETERAN TO PRACTICE IN

CERTAIN AREAS. (a) In this section, "active duty" and "armed

forces of the United States" have the meanings assigned by Section

55.001.

(b) The board shall issue a medical license to practice

medicine to an applicant who:

(1) is licensed in good standing as a physician in

another state;

(2) is a veteran of the armed forces of the United

States who retired from or otherwise left military service not more

than three years before the application date for a license under

this section;

(3) was, at the time of retiring from or leaving

military service:

(A) serving on active duty in this state; and

(B) authorized as a physician to treat persons

enlisted in the armed forces of the United States or veterans; and

(4) has passed the Texas medical jurisprudence

examination.

(c) The board may not issue a license under this section to

an applicant who:

(1) was discharged or separated from the armed forces

of the United States:

(A) on the basis of substandard conduct; or

(B) for any act of misconduct or moral or

professional dereliction;

(2) holds a medical license or a license to prescribe,

dispense, administer, supply, or sell a controlled substance that:

(A) is currently under active investigation; or

(B) is or was subject to a disciplinary order or

action or to denial by another jurisdiction; or

(3) has been convicted of, is on deferred adjudication

community supervision or deferred disposition for, or is under

active investigation for the commission of:

(A) a felony; or

(B) a misdemeanor involving moral turpitude.

ARTICLE 4. PHYSICIAN GRADUATES

SECTION 4.001. 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 supervision by the sponsoring physician 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. Upon receiving an

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 or a legal permanent

resident; or

(B) 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 is recognized by the board 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 is recognized

by the board 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;

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

disciplinary action by the board or the medical licensing authority

of any other jurisdiction; and

(7) 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) a medical specialty member board of the

American Board of Medical Specialties;

(B) a medical specialty member board of the

American Osteopathic Association Bureau of Osteopathic

Specialists;

(C) the American Board of Oral and Maxillofacial

Surgery; or

(D) any other medical specialty member board

recognized by the Texas Medical Board; 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:

(i) a medical specialty member board of the

American Board of Medical Specialties;

(ii) a medical specialty member board of

the American Osteopathic Association Bureau of Osteopathic

Specialists;

(iii) the American Board of Oral and

Maxillofacial Surgery; or

(iv) any other medical specialty member

board recognized by the Texas Medical Board.

(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) that the license holder has not completed any

formal specialized postgraduate or resident training.

Sec. 155.208. LIABILITY OF SUPERVISING PHYSICIAN. A

sponsoring physician who enters into a supervising practice

agreement with a physician graduate retains legal responsibility

for a physician graduate's patient care activities, including the

provision of care and treatment to a patient in a health care

facility.

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 4.002. 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 4.003. 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 4.004. 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.

ARTICLE 5. RULEMAKING

SECTION 5.001. (a) Not later than January 1, 2026, the

Texas Medical Board shall adopt rules as necessary to implement the

following provisions of the Occupations Code, as added by this Act:

(1) Sections 155.1015 and 155.108; and

(2) Subchapter E, Chapter 155.

(b) In adopting rules under Subsection (a) of

this section, the Texas Medical Board shall develop a process to

create a "whitelist" of countries whose licensure requirements

include residency or a substantially similar postgraduate medical

training under Section 155.1015(a)(3)(A), Occupations Code, as

added by this Act. The process must include a review by the Texas

Medical Board of at least 10 countries per year for inclusion on the

whitelist, and if after the review a country is not included, the

Texas Medical Board must identify, with specificity, the aspects of

the country's requirements that caused the country to not be

included.

ARTICLE 6. EFFECTIVE DATE

SECTION 6.001. This Act takes effect September 1, 2025.