www.tmb.state.tx.us Follow TMB on Facebook September 2017 Update from the 85th Legislative Session A wide variety of legislation passed in both the Regular history before prescribing or dispensing the four catego- and First Called (Special) Sessions of the 85th Legislature ries of drugs listed above. The bill also provides excep- impacting the Medical Board, physician regulation, and tions for cancer patients and those in hospice care. the practice of medicine. Key changes are highlighted below. Detailed information on TMB’s Sunset-related legislation and recommendations is available in the Sunset Advisory A detailed listing of priority legislation from both the Commission’s Staff Report with Final Results. Regular and First Called Sessions is available in the Legis- lative Update published on the TMB website. Legislation impacting medical practice Proposed rules to implement legislation are made avail- Senate Bill 1107 provides a new regulatory structure able for public comment after the Medical Board has for establishing a valid practitioner-patient relation- approved publication in the Texas Register. Links to pro- ship via telemedicine. The bill also requires that a posed rules are available on the TMB website. health care service provided via telemedicine meet the standard of care that would apply to the provi- Sunset Review sion of the same health care service in an in-person setting. TMB and its associated boards and statutes were contin- ued until Sept. 1, 2019 with the enactment of Senate Bill Senate Bill 507 provides additional recourse to pa- 20 in the First Called Session of the 85th Legislature. tients when they receive unexpected medical bills. The legislation expands the balance billing mediation In the regular session, the majority of Sunset recom- process at the Texas Department of Insurance to in- mendations related to TMB and its associated boards clude all types of out-of-network providers treating were ultimately passed in four separate bills due to the patients at in-network hospitals and other facilities, failure of House Bill 3040, the original Sunset bill, to including freestanding emergency departments. It pass. allows mediation for emergent care balance bills Two of these bills, Senate Bill 315 and House Bill 2561, address a major concern for the Sunset Advisory Com- (Continued on page 2) mission to combat opioid abuse in Texas. SB 315 ad- dresses nontherapeutic prescribing of opioids by clarify- NSIDE THIS SSUE ing TMB’s authority to investigate and inspect unregis- I I : tered pain management clinics. ARTICLES 2 HB 2561 requires boards regulating all types of licensed CONTINUING EDUCATION 3 prescribers to develop guidelines on responsible pre- BOARD RULES 4 scribing of opioids, benzodiazepines, barbituates, and carisoprodol. It also requires periodic monitoring of li- FORMAL COMPLAINTS 4-7 censees' prescribing information to identify potentially DISCIPLINARY ACTIONS 8-26 harmful prescribing practices. Beginning Sept. 1, 2019, all relevant licensees will be required to check patient LICENSES ISSUED 27-44 1 Update from 85th Legislative Session, Cont. over $500 at any healthcare facility, whether in or ed living facility, or in hospice settings. The bill sets out of network. requirements for notification of family members or surrogates and sets a penalty (Class A misdemeanor) The bill requires health care providers and facilities for health care professionals committing an offense to include the following statement to patients on by intentionally concealing, canceling, etc., a DNR eligible balance bills: “You may be able to reduce order. Specifies that a health care professional and/ some of your out-of-pocket costs for an out-of- or facility is subject to disciplinary action by the ap- network medical or health care claim that is eligible propriate regulatory agency for intentionally failing for mediation by contacting the Texas Department to effectuate a DNR order or issuing a DNR order in of Insurance at …” violation of the bill’s requirements. Senate Bill 11 (First Called Session) clarifies require- ments for the authorization, execution, and revoca- tion of do not resuscitate (DNR) orders used in a health care facility, including a hospital or an assist- New TXPHP Director Dr. David Karney began his new position as Executive Medical Director of the Texas Physician Health Program in July. Case Review Experts N e e d e d David H. Karney, M.D., M.P.H., of San Antonio, practices psychiatry and ad- diction medicine. He serves as a TMB is calling for physicians in the following special- Board Member of the San Antonio Council on Alcohol and Drug Abuse ty areas to serve as experts in reviewing standard of and is a past member of the Bexar care cases: Interventional Radiology, Neurological County Medical Society, Physician Surgery, Oncology, Orthopedic Surgery, Pain Man- Health and Rehabilitation Com- agement, and Pulmonary Disease. Karney mittee. He retired as a Colonel in the United States Army after an exten- As an expert to the Board, your identity for any indi- sive medical career which included assignments as Office vidual case will be confidential. The requirements for of the Army Surgeon General, Alcohol and Drug Abuse serving as an expert are: Consultant at the Pentagon and Director, United States Army Europe Alcoholism Treatment Facility. In civilian Active Texas license life, Dr. Karney has held several positions as Medical Di- Active practice in Texas (more than 20 hours per rector and Executive Director with various recovery cen- week 40 weeks per year) ters and was employed as Clinical Director for a Texas Department of Criminal Justice program for aggressive No history of negative peer action or license re- mentally ill offenders. Prior to joining the Texas Physician striction Health Program as Executive Medical Director, Dr. Kar- ney was in private practice for a number of years. He Acceptable malpractice history received an M.D. from the University of Texas South- western Medical School, an M.P.H. from the University For more information, please email: of California, Berkley, and he graduated from the United [email protected] States Armed Forces Staff College in Norfolk, VA. 2 Continuing Education Opportunities Activity Title Date(s) No. of Hours Link Ecology of Children's Envi- 1.0 AMA PRA https://www.train.org/texas/ ronmental Health Dispari- N/A Category 1 course/1069365/ ties Identifying and Treating 2.0 AMA PRA https://www.txhealthsteps.com/ Expires Oct. 27, 2017 Children with Diabetes Category 1 cms/?q=catalog/course/2181 Texas Medicaid Services 1.5 AMA PRA http://www.txhealthsteps.com/ Expires Aug. 16, 2020 for Children Category 1 cms/?q=catalog/course/2393 https://texmed.inreachce.com/ New Initiatives for Texas 1.0 AMA PRA Expires Aug. 27, 2018 Details?groupId=ec347648-7daf- Medicaid Providers Category 1 41f0-9b01-3c5c3f5dcfbd https://texmed.inreachce.com/ Details? Electronic Medical Rec- re- ords Implementation: 1.0 AMA PRA Expires Aug. 28, 2018 sultsPage=1&sortBy=&mediaType= Successful Strategies from Category 1 f60e27a5-8085-4a9e-8268- the Front Lines ecf7cd8f3830&groupId=1e740d66- 401c-4545-b49f-adae878d2e8e https://texmed.inreachce.com/ Managing Your Medical 4.0 AMA PRA Expires Dec. 17, 2018 Details/Information/79c8f0b6- Records Category 1 8599-437c-ab97-48d4fe37d721 The continuing education opportunities listed above are provided only as a courtesy. TMB makes no guarantee to the quality of the content, fulfillment of credit hours for license requirement purposes, or ensure compliance with terms of any Board order or rules. As part of its 2016-2017 review of the Board, the Sunset Advisory Commission adopted a nonstatutory management action directing the Board to dedicate one page of its quarterly newsletter bulletin to three topics in continuing medical education that the Board considers relevant; at least one of the an- nual 12 continuing medical education topics must be related to tick-borne diseases, including Lyme disease. 3 Board Rules No rules were adopted since the publication of the last bulletin. After publication in the TX Register, the rules with effective date will be posted on the TMB website: http://www.tmb.state.tx.us/page/board-rules. For full rule text in the Texas Administrative Code, visit: http://texreg.sos.state.tx.us/public/readtac$ext.viewtac Formal Complaints Name Lic. No. Date Filed Allegations Ahmed, Faiz, M.D., Houston J4683 4/18/17 Felony conviction. Patel, Nilesh Arvind, M.D., San M2744 4/27/17 Failure to meet the standard of care; inadequate medical Antonio records. Boehme, Christopher Lee, M.D., M0666 5/5/17 Impairment. Houston Edwards, Lamar Blair, P.A., Hou- PA07405 5/9/17 Failure to meet the standard of care; operation of an un- ston registered pain management clinic; nontherapeutic pre- scribing; inadequate medical records. Loftus, Thomas S., M.D., Austin L5439 5/16/17 Unprofessional conduct; Violation of Board rules; inade- quate medical records. Abdela, Ahmed Mehamed, MRT, GMR00105768 5/23/17 Felony offense; Impairment. Garland Bell, Jayson Patrick, M.D., Plano Q1088 5/31/17 Peer review action; failure to meet the standard of care; unprofessional conduct; inadequate medical records. Dailey, Warren Betrand, M.D., F8454 5/31/17 Felony conviction. Houston TMB MISSION STATEMENT Our mission is to protect and enhance the public's health, safety and wel- fare by establishing and maintaining standards of excellence used in regu- lating the practice of medicine and ensuring quality health care for the citizens of Texas through licensure, discipline and education. Visit the TMB’s Website Today! www.tmb.state.tx.us And ‘Like’ Us on Facebook www.facebook.com/texasmedicalboard 4 Formal Complaints, Cont. Name Lic. No. Date Filed Allegations Ineama, Christopher Azubuike, PA05609 5/31/17 Failure to meet the standard of care; nontherapeutic pre- P.A., Fort Worth scribing; unprofessional conduct; inadequate medical rec- ords. Miranda, Hernan Emilio, M.D., N0984 5/31/17 Peer review action; unprofessional conduct.