Figure: 22 TAC §190.14(9)
Violation Description Statutory/Rule Citation Low Sanction High Sanction
Abusive Behavior §164.052(a)(5)
(unprofessional conduct
likely to injure public);
Rule §190.8(2)(K)
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;
$2,000 penalty
Public reprimand plus all
sanctions in low category
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
Public reprimand; $5,000
admin penalty, "except for
good cause shown" per
§1467.102; plus all
sanctions in low category
Boundary Violation (close
friendship, intimacy or
financial involvement with
patient)
§164.052(a)(5)
(unprofessional conduct
likely to injure public)
Rule §190.8(2)(E) and (F)
Single incident:
Boundaries course, CME
in ethics, JP exam
Several incidents: Public
reprimand; Vanderbilt or
PACE boundaries course;
JP exam; chaperone;
CME in ethics; may not
treat patient of the
affected gender
Breach of Confidentiality §164.052(a)(5)
(unprofessional conduct
likely to injure public);
Rule §190.8(2)(N)
(specifies violation)
Remedial Plan: 8 hours
risk management CME to
include HIPAA, $500
administration fee
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)
   
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
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)
Public Reprimand; must
pass JP within 1 year;
$5,000 admin penalty
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)
Restriction of license,
chaperone; may not treat
pediatric patients
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
suspension with or
without notice per Rule
§190.8(6)(A)(iv) and
§164.057(a)(1)(A)
Revocation is statutorily
required on final
conviction - §164.057(b)
Crime: Felony deferred
adjudication
§204.303(a)(2) of the
Physician Assistant Act;
§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)
Appropriate sanction such
as referral to PHP, anger
management, IME, restrictions on practice,
CME
Revocation is statutorily
required on final
conviction - §164.057(b)
Crime: Misdemeanor
conviction or deferred
adjudication of crime
involving moral turpitude
§205.351(a)(7) of the
Acupuncture Act;
§164.051(a)(2)(B) of the
Medical Practice Act
(authorizes sanctions for
either conviction or
deferred adjudication;
Rule §190.8(6)(B)(v)
defines moral turpitude)
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 after 90 days;
(-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
§164.053(a)(1) and (b)
(authorizes sanctions
without conviction)
Rule §190.8(6)(B)(v)
defines moral turpitude
Anger management or
other appropriate course;
JP exam; admin penalty;
CME in communication
with appropriate group
(patients, colleagues)
Suspension with terms
and conditions OR
Revocation for repeat or
egregious offenses or
when patient care is
affected or threatened
Crime: Misdemeanor
deferred adjudication or
conviction not involving
moral turpitude that is not
connected with
physician's practice of
medicine and not an
offense under Chapter 22
or 25 of the Penal Code
§164.052(a)(5), as
defined by Rule
§190.8(2)(R)(iv), (vi), (vii),
(ix), (x), (xi), and (xii)
(authorizes sanctions
based upon
unprofessional conduct
that would include
commission of violations
of federal and state law,
whether or not there is a
complaint, indictment, or
conviction)
Appropriate sanction such
as referral to PHP, anger
management, IME,
restrictions on practice,
CME
Suspension with terms
and conditions OR
Revocation for repeat or
egregious offenses
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 Crim. Proc. 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
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)
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.
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) 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
§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
§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
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: 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: Admin
penalty; CME in medical
ethics; JP exam
Multiple or egregious: Low
category sanctions plus
public reprimand and
$5,000 admin penalty
Failure to Pay Sl / 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
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
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 remedial plan
or 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)
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
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 - no more than
$25 for the first 20 pages
and $0.50 per page
thereafter)
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
with regard to board
certification
§164.052(6) (prohibits
false advertising);
Rule §164.4(e) (defines
the offense re: board
certification)
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
JP exam; cease operating
pharmacy; CME - ethics
and risk management
Overbilling: See
fraudulent, improper
billing
     
Peer review action: See
Discipline by peers
     
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,
nontherapeutic--or
dispensing, or
administering of drugs
nontherapeutically
§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: chart
monitor, directed CME,
restrictions on practice,
including prescribing,
administering controlled
substances and
dangerous drugs
Low sanctions plus
restrictions on practice,
including prescribing and
administering controlled
substances and
dangerous drugs;
proficiency testing;
directed CME; and
administrative penalty of
$3,000 per violation. If
there are aggravating
factors, revocation should
be considered.
Prescribing to self §164.051(a)(6);
Rule §190.8(1)(M)
Agreed Order: CME - 8
hours drug-seeking
behavior, 8 hours risk
management; consider
chart monitor at least 8
cycles; admin penalty
Low sanctions plus:
restrictions on practice
including restrictions on
prescribing and
administering controlled
substances and
dangerous drugs;
proficiency testing;
directed CME; and
administrative penalty of
$3,000 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
inconsistent with public
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; admin penalty
Low sanctions plus:
restrictions on practice
including restrictions on
prescribing and
administering controlled
substances and
dangerous drugs;
proficiency testing;
directed CME; and
administrative penalty of
$3,000 per violation.
Refusal to respond to
board subpoena
§160.009 of the Act and
Rule §179.4 of this title
(relating to Request for
Information and Records
from Physicians);
§164.052(a)(5) (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,
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.
Self-Prescribing: See
"Prescribing to self."
     
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: 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
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; directed CME
Limiting the practice of the
person or excluding one
or more specified
activities of medicine;
proficiency testing;
directed CME; monitoring
of the practice; public
reprimand; and
administrative penalty of
$3,000 per violation.
Standard of care - one
patient, multiple 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 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: Proficiency
testing; directed CME;
monitoring of the practice;
administrative penalty of
$3,000 per violation
Agreed Order: K-STAR or
PACE proficiency testing;
directed CME; chart
monitoring, restricting the
practice; withdrawal of
prescribing privileges or
delegating privileges;
public reprimand;
administrative penalty of
$3,000 per violation
Standard of care -
multiple patients, 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)
Remedial Plan*: Chart
Monitor for 8 cycles; CME
in appropriate area; $500
administration fee per
year
*No RP if case concerns a
patient death
Proficiency testing;
directed CME; chart
monitor 12 cycles; public
reprimand; and
administrative penalty of
$3,000 per violation
Standard of care -
multiple patients, multiple
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
$3,000 per violation.
Suspension and
revocation
Supervision of midlevels,
failure to perform: See
"Failing to adequately
supervise subordinates
and improper delegation."
     
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-
Administrative Penalty of
$1,000; Substantive in
nature-extension of order
and increase the terms of
the original 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,
must pass JP exam and 8
hours of risk
management/ethics
(remedial plan or agreed
order)
Agreed Order: public
reprimand; restriction of
license; surrender of
controlled substance
privileges; plus low
sanctions