Figure: 22 TAC §190.14(9)
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:
Boundaries course,
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)		    
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
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)		 Agreed Order:
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		 Agreed Order:
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)		 Agreed Order:
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 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 of the 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 Government 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
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 ethics;
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); Rules §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, §164.4		 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		      
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:
Agreed Order: 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, 8
hours risk
management, 8
hours appropriate
prescribing of
controlled
substances, 8 hours
ethics; JP Exam;
chart monitoring at
least 8 cycles; and
administrative
penalty of $3,000
per violation		 Agreed Order
Low sanctions plus public
reprimand, proficiency
testing, chart monitoring
at least 12 cycles,
restrictions on practice
including restrictions on
prescribing and
administering controlled
substances and
dangerous drugs;
restrictions on prescribing
to self, family, and others
in which there is a close
personal relationship
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, 8
hours risk
management; JP
Exam		 Agreed Order: Low
sanctions plus chart
monitoring, directed CME;
restrictions on prescribing
to self, family, and others
in which there is a close
personal relationship 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		 Agreed Order
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,
nontherapeutic--or
dispensing, or
administering of
drugs
nontherapeutically,
one patient, no prior
board history		 §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:
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		 §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
information to the
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."		      
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; 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, 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 -
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)		 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 -
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 $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 - 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 or $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
(remedial plan or
agreed order)		 Agreed Order: public
reprimand; restriction of
license; surrender of
controlled substance
privileges; plus low
sanctions