| Violation Description |
Statutory/Rule Citation | Low Sanction | High Sanction |
|---|---|---|---|
| Abusive or Disruptive Behavior |
§164.052(a)(5) (unprofessional conduct likely to injure public); Rule §190.8(2)(K), (P) |
Remedial Plan: Anger management and communications CME, JP exam, medical ethics |
Agreed Order with IME or Public Referral to PHP; CME in medical ethics, anger management, communications with colleagues, JP exam. For multiple orders or egregious actions- -interfering with patient care: public reprimand, suspension with terms and conditions |
| Aiding in unlicensed practice |
§164.052(a)(17) (directly or indirectly aids or abets unlicensed practice) |
Remedial Plan: Directed CME in supervision or delegation if applicable; 8 hours CME in medical ethics, 8 hours CME in risk management; must pass JP within 1 year |
Agreed Order: Public reprimand, all sanctions in low category, plus $2,000 admin penalty |
| Bad faith mediation by a licensee in relation to an out-of- network health benefit claim |
§1467.101 and 1467.102 of the Texas Insurance Code (bad faith in out-of-network claim dispute resolution)--"except for good cause shown, the regulatory agency shall impose an administrative penalty" |
Good cause shown: Remedial Plan: 8 hours of medical ethics; otherwise, admin penalty is statutorily required |
Agreed Order: Public reprimand; $5,000 admin penalty, "except for good cause shown" per §1467.102; plus all sanctions in low category |
| Boundary Violation: Engaging in sexual contact with a patient or engaging in sexually inappropriate behavior or comments directed towards a patient |
§164.052(a)(5) (unprofessional conduct likely to injure public); Rule §190.8(2)(E)-(F) |
RP is statutorily prohibited Verbal remarks, or inappropriate behavior, but not involving touching: Agreed Order: Public reprimand; Vanderbilt or PACE boundaries course; JP exam; CME in ethics; chaperone |
Cases involving physical contact: Agreed Order: Low sanctions plus IME, Replace chaperone with may not treat patient of the affected gender; or suspension or revocation |
| Boundary Violation: Becoming financially or personally involved with a patient in an inappropriate manner |
§164.052(a)(5)(unprofessional conduct likely to injure public); Rule §190.8(2)(G) |
RP is statutorily prohibited Single incident: Agreed Order: CME in ethics, JP exam; if financial involvement, restitution if appropriate; and/or admin penalty |
More than one incident (more than one patient, or occasion): Agreed Order: Low Sanctions plus: Public reprimand; Vanderbilt or PACE boundaries course; JP exam; CME in ethics; administrative penalty; or suspension or revocation |
| Breach of Confidentiality |
§164.052(a)(5) (unprofessional conduct likely to injure public); Rule §190.8(2)(N) |
Remedial Plan: 8 hours risk management CME to include HIPAA, $500 administration fee |
Agreed Order: Public reprimand, CME in risk management and in HIPAA requirements; $3,000 per occurrence; JP exam |
| Cease and desist order--issuance of: See "Unlicensed practice of medicine" |
§164.002 (Board's general authority to dispose of "any complaint or matter" unless precluded by another statute) §165.052 (power to issue cease and desist orders against unlicensed persons) |
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| Cease and desist order (existing), violation of |
§165.052(b) (violation of (c) and (d) is grounds for imposing admin penalty) |
Administrative penalty $2,000 - $5,000 per offense |
Referral to Attorney General for civil penalty and costs or criminal prosecution. §165.101 (civil)and §165.152 (criminal) |
| Change in practice or mailing address, failure to notify the board of |
§164.051(a)(3) Rule §166.1(d) (notify Board within 30 days of change of mailing or practice address or professional name on file) |
Remedial Plan: 4 hours of ethics/risk management and $500 administration fee |
Agreed Order: 8 hours of ethics/risk management; $2,000 admin penalty; JP exam |
| CME - Failure to obtain or document CME |
§164.051(a)(3) (forbids breaking or attempting to break a Board rule); Rule §166.2 (48 credits each 24 months + other requirements and accreditation of CME req'ts) |
Remedial Plan: All missing hours of CME and 4 hours of ethics/risk management and $500 administration fee |
Agreed Order: 8 hours of CME in ethics/risk management plus complete all missing hours; $1,000 admin penalty; JP exam |
| Crime: Abortion - performing a criminal abortion. Health and Safety Code §170.002 and Chapter 171 (§170.002 prohibits third-trimester abortions, with exceptions; Chapter 171 requires physicians to make available certain materials to abortion patients and restricts how informed consent is obtained; the criminal offense (§171.018) is an unspecified class of misdemeanor punishable only by a $10,000 fine) |
§164.052(a)(16) (prohibits performing, procuring, aiding, or abetting in procuring a criminal abortion); §164.055 (requires "appropriate disciplinary action" against a physician who violates Health and Safety Code §170.002 or Chapter 171) |
Agreed Order: Public Reprimand; must pass JP within 1 year; $5,000 admin penalty |
Agreed Order: Suspension, probated with terms, or revocation |
| Crime: Arrest for offense under Penal Code §§21.02; 21.11; 22.011(a)(2); 22.021(a)(1)(B); (assaultive offenses against children) |
§164.0595 (Temporary suspension or restriction of license for certain arrests) |
Agreed Order: Restriction of license, chaperone; may not treat pediatric patients |
Agreed Order: Suspension of license, no probation |
| Crime: Deferred adjudication community supervision for offense under Penal Code §§21.11; 22.011(a)(2); 22.021(a)(1)(B); (assaultive offenses against children) |
§164.057(c) (mandates revocation upon proof of deferred adjudication community supervision) |
Revocation is statutorily required |
|
| Crime: Felony conviction |
§204.303(a)(2) of the Physician Assistant Act; §205.351(a)(7) of the Acupuncture Act; §164.057(a)(1)(A) of the Medical Practice Act (requires suspension on initial conviction for a felony) |
Initial conviction: Statutorily required §190.8(6)(A)(iv) and §164.057(a)(1)(A); suspension to occur by operation of law pursuant to §187.72 |
Revocation is statutorily required on final conviction - §164.057(b) |
| Crime: Felony deferred adjudication; Misdemeanor involving moral turpitude deferred adjudication |
§204.303(a)(2) & (3) of the Physician Assistant Act; Board Rule 185.17(7)& (11); §205.351(a)(7) of the Acupuncture Act; §164.051(a)(2)(A) of the Medical Practice Act (authorizes sanctions for initial convictions and deferred adjudications for felonies and misdemeanors involving moral turpitude) |
Agreed Order: Appropriate sanction such as referral to PHP, anger management, IME, restrictions on practice, CME in appropriate area |
Suspension or Revocation; §164.001(a); Revocation is statutorily required on final conviction of a felony- §164.057(b) |
| Crime: Misdemeanor conviction of crime involving moral turpitude |
§204.303(a)(2) of the Physician Assistant Act; §205.351(a)(7) of the Acupuncture Act; §164.051(a)(2)(B) of the Medical Practice Act (authorizes suspension on initial conviction for misdemeanor of moral turpitude, and revocation upon final conviction) |
If the offense is not related to the duties and responsibilities of the licensed occupation, the standard sanction shall require: (-a-) Suspension of license, which may be probated; (-b-) compliance with all restrictions, conditions and terms imposed by any order of probation or deferred adjudication; (-c-) public reprimand; and (-d-) administrative penalty of $2,000 per violation. |
If the offense is related to the duties and responsibilities of the licensed occupation, the standard sanction shall be revocation of the license. |
| Crime: Misdemeanor conviction not involving moral turpitude that is connected with the physician's practice of medicine |
Texas Occupations Code §53.021; Rule §190.8(6)(B)(iv) stating Chapter 53 of applies to misdemeanor convictions not involving moral turpitude but connected with the physicians practice of medicine and setting out factors showing connection to practice of medicine |
Suspension | Revocation |
| Crime: Misdemeanor initial conviction under Penal Code Chapter 22 (assaultive offenses - see also: arrest or deferred adjudication for assaultive offenses against children) of crime punishable by more than a fine; OR Penal Code §25.07 (violation of court order re: family violence); OR §25.071 (violation of court order re: crime of bias or prejudice); OR one requiring registration as a sex offender under Code of Criminal Procedures Chapter 62 |
§164.057(a)(1)(B), (C), (D), and (E) (when misdemeanor conviction requires suspension) |
Suspension is statutorily required per §164.057(a)(1)(B) |
Revocation is statutorily required on final conviction - §164.057(b) |
| Death certificate, failure to sign electronically |
§164.053(a)(1) (authorizes sanctions via §164.052(a)(5) for breaking any law that "is connected with the physician's practice of medicine"); Health and Safety Code Chapter 193 (requires electronic filing of death certificates) |
Remedial Plan: 4 hours of ethics/risk management and $500 administration fee |
Agreed Order: CME – 8 hours of risk management, 4 – 8 hours medical ethics; $2,000 admin penalty; JP exam |
| Delegation of professional medical responsibility or acts to person if the physician knows or has reason to know that the person is not qualified by training, experience, or licensure to perform the responsibility or acts |
§164.053(a)(9) (describes the violation as unprofessional conduct, allows sanctions) |
Remedial Plan: 12 hours CME in supervision and delegation, 8 hours in risk management, 8 hours in medical ethics; JP exam |
Agreed Order: Low sanctions plus no delegation or supervision authority; administrative penalty of $2,000 per violation |
| Discipline by peers, may be either an administrative violation or SOC |
§164.051(a)(7) (describes offense: includes being subjected to disciplinary action taken by peers in a local, regional, state, or national professional medical ass'n or being disciplined by a licensed hospital or medical staff of a hospital, including removal, suspension, limitation of privileges, or other action IF the board finds the action was based on unprofessional conduct or professional incompetence that was likely to harm the public and "was appropriate and reasonably supported by evidence submitted to the board." Expert panel report provides such evidence) |
Agreed Order: See the applicable sanction for the violation of the Texas Medical Practice Act that most closely relates to the basis of the disciplinary action by peers. In addition, the licensee shall comply with all restrictions, conditions and terms imposed by the disciplinary action by peers to the extent possible. |
Agreed Order: Public reprimand; comply with all restrictions, conditions and terms imposed by the disciplinary action by peers to the extent possible; and administrative penalty of $3,000 per violation, plus directed CME and, if SOC case, a chart monitor. If not SOC: IME; anger management; CME in communications |
| Disciplined by another state or military may be either an administrative violation or a patient care violation |
§164.051(a)(9) (describes the violation, requires that acts for which discipline imposed be the same or similar to acts in §164.052 or acts that are the same or similar to acts described in 164.051(a), for example rule violations, SOC violations, and all forms of impairment) Issue is only whether there was an order--no relitigation of prior facts, e.g., no new expert panel required |
If no standard of care concerns, Remedial Plan with appropriate CME and $500 administration fee; OR reciprocal Agreed Order as appropriate. |
If out-of-state order is revocation, revocation is statutorily required. |
| Drug logs - Failure to maintain (see also, violation of state or federal law connected with practice) |
§164.053(a)(2) (describes offense and refers to Chapter 481 Health and Safety Code and 21 USC §801 et seq.) |
Remedial Plan: 8 hours of ethics/risk management and $500 administration fee |
Agreed Order: Public reprimand; 8 hours of ethics/risk management; $2,000 admin penalty; JP exam |
| Employing a revoked/cancelled/ or suspended physician (see also aiding and abetting the unlicensed practice) |
§164.052(a)(14) (describes offense: "directly or indirectly employs . . .); §164.052(a)(15) (forbids associating in the practice of medicine with such a person) |
Agreed Order: Public reprimand; $3,000 admin penalty; take and pass JP exam |
Agreed Order: Public reprimand; $5,000 admin penalty; JP exam; no delegation authority |
| Failing to adequately supervise subordinates and improper delegation |
§164.053(a)(8); §164.053(a)(9) - These sections describe the respective violations and define them as unprofessional conduct |
Remedial Plan: 12 hours CME in supervision and delegation; consider ordering Rsp to furnish ED copies of delegation orders of develop and furnish delegation orders to ED; $500 admin fee |
Agreed Order: Low category sanctions plus: monitoring of practice; no delegation or supervision authority; administrative penalty of $2,000 per violation; JP exam |
| Fails to keep proper medical records |
§164.051(a)(3) (authorizes sanctioning rule violations); §164.051(a)(6) (authorizes sanctioning failure to practice acceptably consistent with public welfare); Rule §165.1 describes contents of an adequate medical record |
Remedial Plan: CME in appropriate area; $500 administration fee |
Agreed Order: 8 or more hours of medical record- keeping, require in- person attendance if practical; chart monitor 8 – 12 cycles; $2,000 admin penalty; JP exam; PACE course in medical record- keeping if prior order for inadequate record-keeping |
| Failure to Communicate with patient or other providers |
§164.052(a)(5) (prohibits conduct that is "likely to deceive or defraud the public" and unprofessional conduct as defined by §164.053) |
Single incident: Remedial Plan--8 hours risk management CME to include patient communications, $500 administration fee |
Multiple instances: Agreed Order: Public reprimand, risk management and communications CME, fine, counseling, IME |
| Failure to display a "Notice Concerning Complaints" sign |
Rule §178.3(a)(1) (requires display of sign) |
Remedial Plan: 4 hours of ethics/risk management and $500 administration fee |
Agreed Order: 8 hours of ethics/risk management, $1,000 admin penalty; JP exam |
| Failure to report dangerous behavior to governmental body |
§164.052(a)(5) (prohibits conduct that is "likely to deceive or defraud the public" and unprofessional conduct as defined by §164.053) |
Single incident: Agreed Order: Admin penalty; CME in medical ethics; JP exam |
Multiple or egregious: Agreed Order: Low category sanctions plus public reprimand and $5,000 admin penalty |
| Failure to Pay/CS | Gov't Code; Family Code Chapter 232 (authorizes suspending licenses of any kind granted by the state to persons who do not pay support payments) |
Suspension until such time as the licensee is no longer in default is required – statutorily required |
Suspension until such time as the licensee is no longer in default - statutorily required |
| Failure to Pay Student Loan |
§56.003 of the Texas Occupations Code |
Agreed Order: public reprimand; within a certain time frame, provide proof of entering into an agreement with the loan servicing agent and/or default has been cured. Auto- suspend if violate order |
Suspension until such time as the licensee is no longer in default |
| Failure to report suspected abuse of a patient by a third party, when the report of that abuse is required by law |
§164.052(a)(5)(prohibits conduct that is “likely to deceive or defraud the public” and unprofessional conduct as defined by §164.053); Rule §190.8(2)(O) |
Remedial Plan; CME- 8 hrs risk management; JP Exam |
Agreed Order: Low sanctions plus public reprimand; administrative penalty $3,000 per violation |
| Fees, failure to provide explanation of |
§101.203 (prohibits overbilling via ref to Health and Safety Code §311.025); §101.351 (establishes requirement and excludes application of §101.351 to physicians who post a billing practice sign in their waiting room) |
Remedial Plan: 8 hours of ethics/risk management/billing practices and $500 administration fee |
Agreed Order: 8 - 16 hours of CME in ethics, risk management, billing practices, and CPT coding, $2,000 admin penalty |
| Fraud on a diploma/in an exam |
§164.052(a)(2); §164.052(a)(3) (describes offense as presenting an illegally or fraudulently obtained credential and cheating on exams) |
Misrepresentations that do not make licensee/applicant ineligible: Remedial Plan - 8 hours of ethics/risk management and $500 administration fee |
If misrepresentation makes the licensee ineligible, then revocation. |
| Fraudulent, improper billing practices - requires that Respondent knows the service was not provided or knows was improper, unreasonable, or medically or clinically unnecessary. Should not sanction for an unknowing and isolated episode. |
§101.203 (prohibits overbilling via ref to Health and Safety Code §311.0025); §164.053(a)(7) (prohibits violation of Health and Safety Code §311.0025) |
Agreed order: Including, but not limited to: monitoring of billing practices; directed CME; restitution; and administrative penalty of $1,000, but not to exceed the amount of improper billing |
Agreed Order: Public reprimand, monitoring of practice, including billing practices; directed CME; restitution; and administrative penalty of $3,000 per violation |
| Health care liability claim, failure to report |
§160.052(b) (requires reporting health care liability claims to Board) Rule §176.2 and §176.9 (prescribes form for such reporting) |
Remedial Plan: 4 hours of ethics/risk management and $500 administration fee |
Agreed Order: 8 hours of ethics/risk management; $2,000 admin penalty; JP exam |
| Impairment (no history and no aggravating factors such as SOC, boundary violation, or felony) |
§164.051(a)(4) (authorizes sanctions for practicing by those unable because of illness, drunkenness, excessive use of substances, or a mental or physical condition); §164.052(a)(4) (forbids use of alcohol or drugs in an intemperate manner that could endanger a patient's life) |
Refer to PHP--Public referral via agreed order required if case involves discharge from PHP, otherwise private referral is OK if appropriate |
Voluntary surrender or temporary suspension |
| Impairment (with history or SOC violation or boundary violation or felony) |
§164.051(a)(4) (authorizes sanctions for practicing by those unable because of illness, drunkenness, excessive use of substances, or a mental or physical condition); §164.052(a)(4) (forbids use of alcohol or drugs in an intemperate manner that could endanger a patient's life) |
Agreed Order: IME with report to ED or to panel at re- convened ISC, restrict practice or voluntary suspension pending report; if impairment is found at ISC, suspension of license until such time as the licensee can demonstrate that the licensee is safe and competent to practice medicine, with conditions to be determined by a subsequent panel |
Agreed Order: Suspension of license until such time as the licensee can demonstrate that the licensee is safe and competent to practice medicine OR Suspension probated for 10 years with terms and conditions including but not necessarily limited to: drug testing; restrictions on practice; AA or NA attendance evidenced by logs; IME for psychiatric/ psychological evaluation and treatment; proficiency testing OR revocation. |
| Intimidation of Complainant |
§164.052(a)(5) (prohibits unprofessional conduct as defined by §164.053 or that is "likely to deceive or defraud the public") |
Single Incident: Public reprimand and fine |
Multiple/Egregious: Suspension and/or revocation; significant admin penalty; CME in ethics; JP exam |
| Medical Records: failure to release/ Overcharging for |
§159.006 of the Act (information furnished by licensee); §164.051(a)(3) (prohibits rule violations); Rule §165.2 (requires release to proper person as described therein unless release would harm the patient and prescribes allowable charges |
Remedial Plan: 4 hours of ethics/risk management and $500 administration fee |
Agreed Order: 8 hours of ethics/risk management, $2,000 admin penalty; JP exam. Also, §159.006 (Board may appoint temp or permanent custodian of patient records held by a physician) |
| Misleading advertising |
§164.051(a)(3); §164.052(6) (prohibits false advertising); Rule §164.3, §164. |
Remedial Plan: 8 hours of ethics/risk management, correct the advertisement and $500 administration fee |
Agreed Order: 16 hours of ethics/risk management in person, correct the advertisement, $5,000 admin penalty, JP exam |
| Operating an unlicensed pharmacy |
§158.001(b) (requires physicians to comply with Occupations Code Chapter 558 to operate a retail pharmacy) |
Agreed Order: Must pass JP within 1 year, $2,000 penalty, CME – medical ethics |
Agreed Order: JP exam; cease operating pharmacy; CME – ethics and risk management |
| Overbilling: See fraudulent, improper billing |
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| Peer review action: See Discipline by peers |
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| Physician-patient relationship, Improper termination of |
Rule §190.8(1)(J) (requires reasonable notice to patient of termination) |
Single incident: Remedial Plan: 8 hours CME - 4 risk management and 4 ethics, $500 administration fee |
Multiple instances: Public reprimand, risk management, fine, CME - in physician-patient communications |
| Pill mills, unregistered pain clinics, overprescribing – See Delegation, Supervision, Prescribing |
Revocation | ||
| Prescribing controlled substances to oneself, family members, or others in which there is a close personal relationship absent immediate need, without taking an adequate history, performing a proper physical examination, or creating and maintaining adequate records |
§164.051(a)(6); Rule §190.8(1)(L), (M) |
Agreed Order CME 8 hours medical recordkeeping, or risk management; 8 hours appropriate prescribing of controlled substances; JP Exam If only one prescription and no evidence of pattern, the ISC Panel may consider a remedial plan. |
Agreed Order Low sanctions plus public reprimand; restrictions on prescribing to self, family, and others in which there is a close personal relationship, restrictions on practice including restrictions on prescribing and administering controlled substances and dangerous drugs, administrative penalty of $3,000 per violation |
| Prescribing dangerous drugs to oneself, family members, or others in which there is a close personal relationship without taking an adequate history, performing a proper physical examination, or creating and maintaining adequate records |
§164.051(a)(6); Rule §190.8(1)(L), (M) |
Remedial Plan: CME - 8 hours medical recordkeeping or risk management; JP Exam |
Agreed Order: Low sanctions plus restrictions on prescribing to self, family, and others in which there is a close personal relationship and administrative penalty of $2,000 per violation |
| Prescribing, writes false or fictitious prescriptions OR prescribes or dispenses drugs to a person who is known to be an abuser of narcotic drugs, controlled substances, or dangerous drugs OR writes prescriptions for or dispenses to a person who the physician should have known was an abuser of narcotic drugs, controlled substances, or dangerous drugs OR prescribes, administers, or dispenses in a manner inconsistent with public health and welfare |
§164.053(a)(3)-(6) (defines the violations under unprofessional conduct) |
Agreed Order: CME - 8 hours drug- seeking behavior, 8 hours risk management; chart monitor at least 8 cycles; if Respondent does not use one, order to develop a pain management contract with specific provisions for termination of physician-patient relationship on a maximum of 3 violations by the patient including a positive test for a controlled substance not prescribed by Respondent, drug screens required by contract; JP Exam; admin penalty of $3,000 per violation |
Agreed Order Low sanctions plus: restrictions on practice including restrictions on prescribing and administering controlled substances and dangerous drugs; proficiency testing; directed CME; and increase administrative penalty to $5,000 per violation. If evidence of false or fictitious prescriptions, surrender DEA registration certificate for all controlled substance schedules. |
| Prescribing, nontherapeutic--or dispensing, or administering of drugs nontherapeutically, one patient, no prior board disciplinary history related to standard of care or care- related violations |
§164.053(a)(5) (prohibits prescribing or administering any drug or treatment that is nontherapeutic per se or because of the way it is administered or prescribed) |
Remedial Plan CME in appropriate area; $500 administration fee per year. |
Agreed Order: Proficiency testing, CME in appropriate area; chart monitor for 8 cycles; administrative penalty of $3,000 per violation |
| Prescribing, nontherapeutic--or dispensing, or administering of drugs nontherapeutically, more than one patient or prior history of disciplinary action for standard of care or care- related violations |
§164.053(a)(5) (prohibits prescribing or administering any drug or treatment that is nontherapeutic per se or because of the way it is administered or prescribed) |
Agreed Order: Proficiency testing; CME in appropriate area; chart monitor 12 cycles; administrative penalty $3,000 per violation |
Agreed Order: Low sanctions plus restrictions on practice, including prescribing and administering controlled substances and dangerous drugs; and administrative penalty of $5,000 per violation. If there are aggravating factors, revocation should be considered. |
| Referring a patient to a facility, laboratory, or pharmacy without disclosing the existence of the licensee’s ownership interest in the entity to the patient |
§164.052(a)(5) (prohibits conduct that is "likely to deceive or defraud the public" and unprofessional conduct as defined by §164.053); Rule §190.8(2)(H) |
Remedial Plan: CME 8 hrs ethics, 8 hrs risk management; within 30 days of order’s entry, provide proof of implement of form used to disclose ownership to interest |
Agreed Order: Low sanctions plus public reprimand; JP Exam; administrative penalty $3,000 per violation |
| Refusal to respond to board subpoena or request for information or action |
§160.009 of the Act and Rule §179.4 (relating to Request for Information and Records from Physicians); §164.052(a)(5), as further defined by Board Rule 190.8(2)(B) (prohibits Unprofessional conduct as defined by §164.053 or that is "likely to deceive or defraud the public") |
If records eventually received, Remedial Plan of 8 hours of ethics/risk management and $500 administration fee |
If records never received and intentionally withheld, Agreed Order: public reprimand; JP exam; admin penalty; CME in medical ethics |
| Reporting false or misleading information on an initial application for licensure or for licensure renewal |
§164.052(a)(1) (forbids submission of false or misleading statements of documents in an application for a license) |
Misrepresentations that do not make licensee/applicant ineligible: Remedial Plan - 8 hours of ethics/risk management and $500 administration fee |
If misrepresentation makes the licensee ineligible, then revocation. |
| Reporting false or misleading Board (non- licensing matter) |
§164.052(a)(5), as further defined by Rule §190.8(2)(C) |
Remedial Plan - 8 hours of ethics/risk management and $500 administration fee |
Agreed Order: 8 hours of ethics/risk management JP Exam administrative penalty of $3,000 |
| Self-Prescribing: See "Prescribing to self." |
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| Solicitation of patients/Drumming |
§165.155 (provides a Class A misdemeanor penalty) |
Agreed Order (if no conviction): 8 hours of ethics/risk management and $500 administration fee |
Egregious: Agreed Order: Public reprimand, chart sign off, $5,000 fine, JP exam, CME in medical ethics OR referral to county attorney for prosecution as Class A misdemeanor under §165.155(e) |
| Standard of Care - one patient, no prior SOC or care- related violations |
§164.051(a)(6) (fails to practice medicine in an acceptable, professional manner consistent with public health and welfare) |
Remedial Plan*: CME in appropriate area; $500 administration fee per year. *No RP if case concerns a patient death |
Agreed Order: Proficiency testing; directed CME; chart monitor for 8 cycles; administrative penalty of $3,000 per violation |
| Standard of care - one patient, one prior SOC or care-related violation |
§164.051(a)(6) (fails to practice medicine in an acceptable, professional manner consistent with public health and welfare) |
Agreed Order: Chart monitor for 8 cycles; directed CME, administrative penalty of $3,000 per violation |
Agreed Order: Limiting the practice of the person or excluding one or more specified activities of medicine; proficiency testing; directed CME; monitoring of the practice (either chart monitor for 12 cycles or supervising physician for a number of cases or specified period of time); public reprimand; and administrative penalty of $5,000 per violation. |
| Standard of care - one patient, more than one prior SOC or care- related violation |
§164.051(a)(6) (fails to practice medicine in an acceptable, professional manner consistent with public health and welfare); §164.051(a)(8) (recurring meritorious healthcare liability claims that evidence professional incompetence likely to injure the public); Rule §190.8(5) (defines "recurring" as 3 or more claims awarded or settled for $50,000 in a 5-year period) |
Agreed Order: Limiting the practice of the person or excluding one or more specified activities of medicine; proficiency testing; directed CME; monitoring of the practice (either chart monitor for 12 cycles or supervising physician for a number of cases or specified period of time); administrative penalty of $ 3,000 per violation |
Agreed Order: K- STAR or PACE or equivalent proficiency testing; directed CME; chart monitoring (either chart monitor for 16 cycles or supervising physician for a number of cases or specified period of time), restricting the practice; withdrawal of prescribing privileges or delegating privileges; public reprimand; administrative penalty of $5,000 per violation |
| Standard of care - more than one patient, no prior SOC or care- related violation |
§164.051(a)(6) (fails to practice medicine in an acceptable, professional manner consistent with public health and welfare); §164.051(a)(8) (recurring meritorious healthcare liability claims that evidence professional incompetence); Rule §190.8(5) (defines "recurring" as 3 or more claims awarded or settled for $50,000 in a 5-year period) |
Agreed Order: Chart Monitor for 8 cycles; CME in appropriate area; administrative penalty of $3,000 per violation |
Agreed Order: Proficiency testing; directed CME; chart monitor 12 cycles; public reprimand; and administrative penalty of $5,000 per violation |
| Standard of care - more than one patient, prior SOC or care-related violations |
§164.051(a)(6) (fails to practice medicine in an acceptable, professional manner consistent with public health and welfare); §164.051(a)(8) (recurring meritorious healthcare liability claims that evidence professional incompetence); Rule §190.8(5) (defines "recurring" as 3 or more claims awarded or settled for $50,000 in a 5-year period) |
Agreed Order: Proficiency testing; directed CME; monitoring for 12 cycles; requiring oversight or restricting of the practice; public reprimand; and administrative penalty of $5,000 per violation. |
Suspension or revocation |
| Supervision of midlevels, failure to perform: See "Failing to adequately supervise subordinates and improper delegation." |
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| Unlicensed practice of medicine |
§165.052(a)(see definition of "practice of medicine" at §151.002(a)(13)) |
Cease and Desist Order and referral of Order to District Attorney or Attorney General |
Cease and Desist Order; referral to Attorney General's office for injunction or civil penalties |
| Unsound Mind - adjudicated (See also "Impairment') |
§164.051(a)(5) (enables Board to take action if a licensee or applicant "is found by a court to be of unsound mind") |
Suspension of license until such time as the licensee can demonstrate that the licensee is safe and competent to practice medicine; IME and return to ISC panel with results |
Temporary suspension prior to seeking revocation; show cause hearing under §164.056 |
| Violation of Board Order |
§164.052(a)(5) (enables sanctioning of unprofessional or dishonorable conduct as defined by §164.053 or conduct that injures the public) |
Administrative in nature- Agreed Order: Administrative Penalty of $1,000; Substantive in nature-extension of order and increase the terms of the original order |
Agreed Order: Low sanctions plus: public reprimand; admin penalty of $3,000 - $5,000 |
| Violation of state or federal law connected with physician's practice |
§164.053(a)(1) (authorizes sanctions via §164.052(a)(5) for breaking any law that "is connected with the physician's practice of medicine") |
If criminal law, see above under "Crime." If civil law, Agreed Order: must pass JP exam and 8 hours of risk management/ethics |
Agreed Order: public reprimand; restriction of license; surrender of controlled substance privileges; plus low sanctions |