Message from the TMB President: Expedited Out-Of-State Licensure
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Message From the TMB President: Expedited Out - of- State Licensure, Opioid Rules, Boundaries Taskforce, HB 810 (Stem Cells) & SB 1264 (Balance Billing) Following the 2019 legislative ses- We’re hopeful that the new expediting process will help sion, the Texas Medical Board has Texas better recruit qualified, out-of-state physicians to been engaged in rulemaking, working meet our growing state’s health care needs. to implement a number of pieces of legislation affecting physicians and the practice of medicine in our state. Opioid Rules Zaafran Earlier this month, the Board adopt- The Medical Board is continuing to analyze other key ed rules authorizing a new process legislation from the recent legislative session related to for out-of-state physicians to more easily obtain licen- requirements around opioid prescribing, the Prescription sure in Texas, helping to ease the issue of physician Monitoring Program, and Continuing Medical Education shortages throughout our state. The new rules imple- requirements concerning opioids. th ment licensure provisions in House Bill 1504 (86 Regu- To aid and inform the Board and staff as we work to im- lar Legislative Session). plement these pieces of legislation, an Opioid Taskforce The Board’s Expedited Licensure rules will now include was formed, which held an input session in October to applicants who hold a full physician license in good hear from a broad range of individuals and stakeholders, standing in another U.S. state or Canada. The out-of- state physician must be actively practicing medicine and meet certain criteria, including no history of negative (Continued on page 2) peer review actions, license disciplinary history, or be under investigation by any licensing or law enforcement agency. I NSIDE THIS I SSUE : The new expediting rule does not include applicants ARTICLES 2-6 with a training license, permit, or any other form of au- BOARD RULES 7-10 thority to practice medicine while the person is com- CONTINUING EDUCATION 11 pleting or enrolled in a residency, fellowship, or other supervised training program. FORMAL COMPLAINTS 12-14 DISCIPLINARY ACTIONS 15-44 LICENSES ISSUED 45-54 1 TMB President’s Message, Cont. including patients, physician groups, hospital systems, sault, harassment and exploitation, behavior analysis, health care regulatory agencies and elected officials. victimology and outlined several case studies. There was a long list of topics for discussion focused on Board members are grateful for the work and efforts by definitions of types of pain, 10-day prescribing for acute TAASA in helping the Board be better informed on sexual pain, Prescription Monitoring Program checks upon hos- assault and victim response to trauma as it continues its pital admissions, e-prescribing, and CME hours related work on these complex issues. to opioids and how best to apply the requirements to Regardless of potential challenges, the Board is focused make them easily understood among the regulated on stopping licensees who are a danger to the public and community. will continue to do so through its enforcement process. The Board will hold another meeting of the Opioid Task- force in early 2020 to further these discussions and con- tinue our work on these issues. House Bill 810 (Stem Cells) The Board appreciates all of the feedback received in As a reminder, House Bill (HB) 810 set the requirements these areas as we work towards developing applicable for using stem cells pursuant to Institutional Review rules as needed and we will strive towards clarity to best Boards (IRBs) in specific instances. However, HB 810 benefit the health of our patients and Texas physicians. does not prohibit or determine the use of or administra- tion of United States Food and Drug Administration We encourage the public and our licensees to continue (FDA) approved treatments or products, or off-label uses reading Board communications and checking the of FDA approved treatments or products that meet the Board’s website for future updates. standard of care. TMB will thoroughly investigate all complaints regarding Boundaries Taskforce the use of stem cells. Each investigation will check for The Texas Medical Board takes issues of physician mis- compliance with all applicable state and federal laws and conduct very seriously and continues its ongoing discus- the standard of care. sions and efforts regarding boundaries issues and physi- TMB cannot render legal opinions or give legal advice to cian sexual misconduct. licensees on the use of stem cells. If a licensee has ques- (In this previous bulletin the Board addressed steps phy- tions on the use of stem cells for treating patients, then sicians should be taking during physical examinations to TMB recommends for that licensee to seek private, insti- benefit their patients and reduce risk by utilizing chaper- tutional, or employer-provided legal counsel. ones.) Earlier this year, the Board formed a Boundaries Task- Senate Bill 1264 (Balance Billing) force Committee chaired by Board Member Ms. Linda Earlier this week, the Texas Department of Insurance Molina, J.D., to look at other ways the Board can be pro- (TDI) adopted emergency rules related to Senate Bill (SB) active in this area. 1264, which was implemented to protect consumers The Committee invited representatives from the Texas who have state-regulated health plans from surprise Association Against Sexual Assault (TAASA) to present a medical bills in certain situations. TDI’s emergency rules day-long board member training in October. TAASA gave a thorough presentation on the dynamics of sexual as- (Continued on page 3) 2 TMB President’s Message, Cont. go into effect January 1, 2020, and will apply to bills for looks forward to continuing its practice of involving the medical services received on or after January 1, 2020. public and stakeholders on this important issue. Physicians and practitioners, under the authority and oversight of TMB, who seek to exercise the exceptions Dr. Sherif Zaafran, M.D., FASA to the prohibitions against balance billing must comply with all provisions of SB 1264, including as interpreted Texas Medical Board President by TDI rules. Editor’s Note: The preceding article is intended for gen- TMB issued a Guidance Statement providing more infor- eral guidance only and does not ensure compliance, con- mation on the enforcement of SB 1264 and TDI’s new stitute legal advice, or replace the text of applicable rules. Board rules or laws. TMB will work on developing rules consistent with TDI’s rules. As the rulemaking process goes forward, TMB FDA Drug Safety Resources The U.S. Food and Drug Administration (FDA) makes available a number of online resources for health professionals and the general public to keep up-to-date on the latest drug warnings and other safety information, including drug label chang- es, warnings and drug shortages. In December, for example, the FDA published warnings regarding the use of sei- zure and nerve pain medicines gabapentin. Physicians are encouraged to visit the FDA’s website regularly and sign up to receive the latest drug safety updates: https://www.fda.gov/Drugs/DrugSafety/default.htm DID YOU KNOW? You can look up licensee information online for physicians, physician assistants, acupuncturists, medical radiologic technologists, respiratory care practitioners, perfusionists, medical physicists and surgical assistants. These licensee profiles contain consumer-oriented professional background infor- mation, license status, educational background, disciplinary actions, and other helpful information. To search the database, and for more information, visit: http://www.tmb.state.tx.us/page/look-up-a-license 3 New Medical Board Members Appointed At the end of September, Governor Greg Abbott ap- member of the Society of Thoracic Surgeons, Society for pointed Arun Agarwal, Devinder S. Bhatia, M.D., Vanessa Vascular Surgery, and the Harris County Medical Society. Hicks-Callaway, Satish Nayak, M.D., and Jason Tibbels, He currently serves on the board of directors for the M.D. and reappointed Robert David Martinez, M.D. to Houston Symphony and is a former board member of the the Texas Medical Board for terms set to expire on April Health Museum. Bhatia received a Bachelor of Science in 13, 2025. chemistry from the University of Arkansas and a Doctor of Medicine from the University of Arkansas for Medical Arun Agarwal, of Dallas, is Chief Exec- Sciences. utive Officer of Nextt and has busi- ness interests in textiles, cotton trad- Vanessa F. Hicks-Callaway, of Victo- ing and real estate. He is on the ria, most recently served as a field board of the US India Friendship representative for a member of Con- Agarwal Council, Big Brother Big Sisters, Texas gress. Prior to that, she retired as a Public Policy Foundation Education Lieutenant Colonel from the United Committee, and the US Global Leadership Coalition. In Hicks-Callaway States Army after providing 26 years addition, he volunteers with the Living Dreams Founda- of honorable service as a U.S. Army tion. Agarwal received a Master’s in Business Admin- supply sergeant, U.S. Army Reserve military police istration from IMT, Ghaziabad, a Master’s in Computer officer, and finally as a U.S. Army military intelligence Information Systems from Southern New Hampshire officer, with two combat tours in support of Operations University, and a Master’s in International Business from Iraqi and Enduring Freedom respectively. Currently, she Harvard University. serves as president of the Kiwanis Club of Victoria and is a member of the Veterans of Foreign Wars, American Devinder S. Bhatia, M.D., of Houston, Legion, and Disabled American Veterans. Additionally, is a Thoracic and Cardiovascular Sur- she is a former member of the Victoria Chamber of Com- geon. He is the founder, CEO, and merce and the American Business Women’s Association. president of Southeast Texas Cardio- Hicks-Callaway received a Bachelor of Arts in political vascular P.A., and is certified by the science from Sam Houston State University and a Master Bhatia American Board of thoracic surgery of Science in human resources from Central Michigan and currently serves as chief of cardi- University.