Texas Jurisprudence (combined sources)
What happens if your license expires after 365 days?
$145
What happens if your license is expired for more than 30 days?
$75 fee
What can be used for CME credit? (3 things)
1.) Board certification/re-certification 2.)CME from previous licensure period (only 48 hours can be carried forward). 3.) Part time volunteer service in an underserved area.
What disciplinary action the TSBME may take? (3)
1.) Denial of license 2.) Require supervision of practice 3.) Adminstrative monetary penalties
Name 3 actions the TSBME can take?
1.) It can require a physician to practice under the supervision of another physician. 2.) It can suspend a license to practice. 3.) It can require the physician to submit to treatment for psychiatric illness
Of the 24 hours of CME credit, what should it be composed of?
1.) One half of it must be from formal course (12 hours) approved by the board. 2.) At least 1 hour of it should be medical ethics or professional responsibility. 3.) The remaining can be self-study and/or volunteer in underprivileged area
Which of the prescribing practices is not consistent with public health and welfare? (3)
1.) Steroids for body building (not injury related) 2.) Failure to properly monitor blood levels of drugs as indicated 3.) Administering subtherapeutic doses of medications
The health care quality improvement act requires health care entities report an adverse action to national practitioner data bank if that action meets what criteria? (3)
1.) The action resulted from a FROM a formal peer review process 2.) The action adversely affects the physician privileges 3.) The action concerns professional incompetence or misconduct
What do these CME's consist of?
1/2 formal, 1/2 informal ( self reported like " i read a journal,volunteering at an underserved area, must also include 2 hours of education ethics/ professional responsibility
How long to issue death certificate
10 days
How many days do you have to inform the TMB of issuing a death certificate?
10 days
Fine for illegal abortion (eg. unemancipated minor)
10,000
How many days do you have to inform the TMB about supplying medical records?
15 days
How many people compose the Texas Medical Board?
19 ( 12 physicians, 9 MD, 3 DO) 7 are laypersons for 6 year terms
Who is on the Texas Medical Board?
19 people- 9MD's 3DOs 7lay people
How long must you keep records of controlled substances?
2 years
How many hours of CME are required per year?
24 hours
What kind of CME
24hrs formal and 24hrs informal; 2 hours medical ethics/professional responsibility
How long do you have to report name changes or address changes to the board?
30 days
Second offense for practicing without a license?
3rd degree felony
What happens if you practicing without a license and it causes physical or psychological harm?
3rd degree felony
How many days do you have to inform the TMB of a case of child abuse/neglect
48 hours
When do you have to report child abuse? To whom?
48 hours Department of family and protective services. Class B misdemeanor if you fail to report
How much CME do you need?
48hrs q2 years
How long to issue birth certificate
5 days
How many days do you have to inform the TMB in issuing a birth certificate
5 days
How many days do you have to report to the TMB in the case of most communicable diseases?
7 days ( 1 day for TB or pertussis)
Who is in TSBME?
9 MDs, 3 DOs, and 6 public members
DO's not being MD's, punishing a physician for working at other hospitals, only accepting certain insurances, ONLY COMPETENCY
A hospital cannot discriminate against
how long must you keep charts
Adults - 7 years Kids - 7 years or 21; the longer of the two
What happens if someone files an application for court ordered substance abuse treatment of another person?
After 2 MD's examine the patient to assess for chemical dependency the hearing is conducted within 2 weeks
2 years
After how many years do you renew your license?
Midlevels
Can have up to 7 full time outpt midlevels (or equivalent. No limit in remote/medically underserved areas though MD must be remotely available and visit every 10 days Can prescribe III, IV scheduled II IF in hospital > 24 hours or hospice
No, they must be admitted under a DO or MD
Can podiatrists admit patients?
Podiatrists
Can't admit patients must have MD/DO to do it
First offense for practicing medicine without a license?
Class A Misdemeanour
Illegal use of DEA
Class C misdemeanor
Schedule II
Cocaine MOST opiates- morphine, fentanyl, dilaudid, HYDROcodone Stimulants- adderall, ritalin, amphetamines CanNOT be refilled must fill within 21 days or void NPs can prescribe in hospital, ER, hospice
Schedule III
Codeine containing things (Tylenol #3) Ketamine Anabolic Steroids, Testosterones NPs can prescribe these Can be refilled up to 5 times Void after 6 months
What is the license criteria?
Complete college (60 credits), have an MD or DO, Pass the USMLE steps 1-3 (within the past 7 yrs) and the JP exam, complete your intern year
No, but you do need a special Texas telemedicine license
Do you need a full Texas Medical license to practice telemedicine in Texas?
Yes (usually applies to radiologists)
Do you need an additional license to transport, produce, use radioactive materials?
Continuing Medical Education (CME)
Every 24 month period, out need 48 hours of CME's
What is the Texas Medical Practice Act?
Everything doctors must adhere to hen practicing medicine in Texas. And all laws only apply to Texas licensed physicians while practicing in Texas, or outsiders providing telemedicine services to patients in Texas
The physician on whom adverse action is contemplated may surrender privileges in lieu of an investigation or action and thereby avoid a report to the national practitioner data bank.
FALSE
What is a class A misdemeanor? (violate MPA, adult)
Fine not to exceed $4,000; Jail no longer than 1 year.
What is a class B misdemeanor? (baby, child)
Fine up to $2,000; Jail up to 180 days
What is a class C misdemeanor?
Fine up to $500.
HIPAA violation fine
HIPAA violation fine is $100 per violation no more than 25 grand per year
Schedule I drugs
Heroin LSD Marijuana Ecstasy
Mid levels (PA's, NP's)
Hospitals require credentials from DO's and MD's, but hospitals are not required to accept/hire
By a hospital
How can competency be relevant to credentialing ?
30 days
How many days do you have to let the board know of any name and practice changes?
Losing your license
If indicted for felony, license is suspended If convicted, it is revoked
The TMB
If the governing body of a hospital is forced to take action against a physician that affects the privileges or longer than 30 days, who must be notified?
TSBME may not grant probation to a physician whose license is restricted due to felony conviction UNDER the Texas Controlled Substances Act. However when are exceptions made?
If the probation is in the best interest of the public.
If you do not have 24 hours of CME credit in one year, what is an alternative?
If within the preceding 36 months, the licensee becomes Board certified or re-certified
Corollary
If you quit your residency after internship, you can still practice s a fully licensed physician in Texas (though not board certified in a specialty)
Any U.S. trained graduate finished with the steps an apply for a full Texas medical license after completing their
Internship
The Texas Medical Board is responsible for
Issuing licenses and all the of the disciplinary actions associated with taking them away
What action cannot be taken by TSBME?
It CANNOT suspend a SPECIALTY board certification.
What is a third degree felony?
Jail term 2-10 years; fine up to $10,000
What is a second degree felony?
Jail term 2-20 years; fine up to $10,000.
What is a first degree felony? (MURDER)
Jail term 5-99 years; fine up to $10,000
What is a capital felony?
Life or death penalty
Corollary 2
Naturopathic doctors, podiatrists, optometrists, chiropractors, dentists, are not licensed by the TMB and have their own governing bodies and rules
Radioactive material
Need a license
Contiguous states?
OK AR LA and NM MDs can order home health and hospice for TX pts without a special license
Who are public members?
Persons in non healthcare business.
What doctors are excluded from the Texas Medical Practice Act
Podiatrists, dentists, optometrists, nurses, or medical students. Non-compensated emergency care is also exempt (covered by the Good Samaritan Law)
How do you qualify to be on the board?
Practicing for 5 years, active in peer review for 3 years preceeding
Class C Misdemeanor
Promoting suicide but they don't follow through False use of DEA
Schedule V
Robitussin AC Lomotil Lyrica NPs can prescribe these
Schedule IV
Soma/muscle relaxants BZDs, Ambien Tramadol Modafinil NPs can prescribe these Can be refilled up to 5 times Void after 6 months
What (Non diseases) must be reported to TX Dpt of Health
Spinal cord injuries TBI Submersion
What happens if you practicing without a license and it causes financial harm?
State jail felony
What diseases must be reported to TX Dpt of Health and how fast?
TB, Pertussis ONE day Gonorrhea, syphilis, chlamydia, chancroid 7 days
What can surrogate decision makers NOT do?
They can't pick a new surrogate They can't do proxy consent for abortion, ECT or psychosurgery EXCEPTIONS: - court appointed guardian for ECT if pt can no longer care for basic needs - abortion for unemancipated minors where court acts as a temporary guardian - Involuntary mental health admission (psychiatrist and court determines this)
When patients are 'committed' /hospitalized, how long do they have to request hearing?
Thye have the right to request a probable cause hearing within 72 hours to try to get released
All felonies and misdemeanors are considered criminal? (T/F)
True
Texas law provides protection from liability for any person providing information to a medical peer review committee? (T/F)
True.
What must be reported to local law enforcement?
Unnatural/unnexplained death, suicide. OD and gunshots
OK,AR, LA, NM can order home health me hospice services for patients in Texas without a special telemedicine license
What are some contiguous states for telemedicine?
Taking the JP exam, license is in good standing in another state, board certified in your specialty, not actually physically or acting in the state of Texas
What does the Texas telemedicine license include?
No fine
What happens if you ware late by less than 30 days?
You have to reapply for the license and retake the JP exam
What happens if your license is expired for more than 2 years or longer?
You must reapply and pay the fees again
What happens if your license is expired for more than a year?
Apply or a new PIT permit 90 days before switching
What if you change your residency location (for example, one hospital and advanced position to another you would need to
You are practicing medicine without a license and committing a third degree felony
What if you still continue practicing 30 days after?
The ability to take care of patients
What is physician competency measured by?
Resident practice under a physician in training (PIT) and institution specific
What is the Pit permit?
No -fault no-lawsuit system for the payment of work related injuries, the employee will get money regardless of whose fault it was, where any doctor can perform a visit be you need a certificate of registration and be on he approved by the Texas Department of Insurance list to be evaluated
What is worker's comp?
Yes, only if you are in good standing and having no suspensions, restrictions, or felony charges
Will the TMB accept another state's medical licensure without requiring additional action?
By how many days should a physician challenge TSBME action in state district court?
Within 30 days of the boards final action on a board order.
Telemedicine requirements
You need a TX telemed license (needs JP exam) need to be licensed in good standing in your home stateand board certified
What type of bad is elder abuse
failure to report- Class A Misdemeanor
When must a gestational agreement be signed
gestational agreement must be signed at least 15 days bfore transfer of sperm/embryo
Supplying medical records to patients
must supply within 15 days can charge patient $25 for first 20 pages, then 50 cents per page after that
What generates a review of your license
named in 3 lawsuits within a 5 year period of time
reporting nursing home elder abuse (how long do you have)
within 48 hours orally written complaint within 5 days
