(a) Definitions. The following words and terms, when
used in this section, shall have the following meanings, unless the
context clearly indicates otherwise:
(1) Control--the ability to order or dictate the delivery
or the manner of delivery of any services or tasks. Consulting with
another person regarding a service or task, or assisting in the performance
of a service or task, does not constitute control.
(2) Intervene--directly altering the practice of veterinary
medicine. Recommending or providing a service or supply or performing
management services under this section does not constitute intervention.
(3) Management services--those services and activities
relating to the operation of a veterinary practice exclusive of the
practice of veterinary medicine.
(4) Management services organization--a person or entity
that provides management services.
(5) Veterinary medical personnel--persons under the
direct or general supervision, as defined by the Veterinary Licensing
Act, Texas Occupations Code, §801.002, of a veterinarian who
perform duties directly related to the practice of veterinary medicine.
(b) Management Services Contracts. A veterinarian or
group of veterinarians, whether or not incorporated, may contract
with a management services organization to provide management services.
(c) Prohibited Practices. A management services organization
shall not control or intervene in a veterinarian's practice of veterinary
medicine. Prohibited activities by a management services organization,
whether or not authorized by contract, include but are not limited
to:
(1) employing a veterinarian to practice veterinary
medicine;
(2) determining the compensation of a veterinarian
for the practice of veterinary medicine;
(3) controlling or intervening in a veterinarian's
diagnosis, treatment, correction, change, manipulation, relief, or
prevention of animal disease, deformity, defect, injury or other physical
condition, including the prescription or administration of a drug,
biologic, anesthetic, apparatus, or other therapeutic or diagnostic
substance or technique;
(4) controlling or intervening in a veterinarian's
selection or use of type or quality of medical supplies and pharmaceuticals
to be used in the practice of veterinary medicine;
(5) determining the amount of time a veterinarian may
spend with a patient;
(6) owning drugs, unless the drugs are owned in compliance
with applicable Texas or federal law;
(7) owning and controlling the records of patients
of the veterinarian;
(8) determining the fees to be charged by the veterinarian
for the veterinarian's practice of veterinary medicine;
(9) mandating compliance with specific professional
standards, protocols or practice guidelines relating to the practice
of veterinary medicine;
(10) placing limitations or conditions upon communications
that are clinical in nature with the veterinarian's clients;
(11) requiring a veterinarian to make referrals in
violation of Texas Occupations Code §801.402(11); or
(12) penalizing a veterinarian for reporting violations
of a law regulating the practice of veterinary medicine.
(d) Veterinarians, and entities in which veterinarians
are the sole owner, shareholders or partners, are not prohibited from
performing the activities set out in subsection (c)(1) - (10) of this
section.
(e) Permitted Management Services. Permitted activities
by a management services organization include but are not limited
to:
(1) providing by lease, ownership or other arrangement:
(A) the facility used by the veterinarian in the practice
of veterinary medicine;
(B) the medical equipment, instruments and supplies
used by the veterinarian in the practice of veterinary medicine; and
(C) the business, office and similar non-medical equipment
used by the veterinarian.
(2) providing for the repair, maintenance, renovation,
replacement or otherwise of any facility or equipment used by the
veterinarian in the practice of veterinary medicine;
(3) providing accounting, financial, payroll, bookkeeping,
budget, investment, tax compliance and similar financial services
to the veterinarian;
(4) providing information and information systems and
services for the veterinarian so long as any patient records in these
systems are clearly owned and freely accessed by the veterinarian;
(5) providing the services of billing and collection
of the veterinarian's fees and charges;
(6) arranging for the collection or sale of the veterinarian's
accounts receivable;
(7) providing advertising, marketing and public relations
services in compliance with §§573.30 - 573.37 of this title
(relating to Advertising, Endorsements and Certificates) pertaining
to the practice of veterinary medicine;
(8) providing contract negotiation, drafting and similar
services for the veterinarian;
(9) providing receptionist, scheduling, messaging and
similar coordination services for the veterinarian;
(10) obtaining all licenses and permits necessary to
operate a practice of veterinary medicine that may be obtained by
a non-veterinarian, and assisting veterinarians in obtaining licenses
and permits necessary to operate a practice of veterinary medicine
that may be obtained only by a veterinarian, provided that the Executive
Director of the Board approves the method of payment for veterinary
license renewals paid by the management services organization;
(11) assisting in the recruiting, continuing education,
training and legal and logistical peer review services for the veterinarian;
(12) providing insurance, purchasing and claims services
for the veterinarian, and including the veterinarian and veterinary
medical personnel on the same insurance policies and benefit plans
as the management services organization;
(13) providing consulting, business and financial planning
and business practice and other advice;
(14) establishing the price to be charged to the veterinary
client for the goods and supplies provided or managed by the management
services organizations;
(15) employing and controlling persons who:
(A) perform management services;
(B) are veterinarians employed by a management services
organization to perform management services but not the practice of
veterinary medicine; or
(C) perform management, administrative, clerical, receptionist,
secretarial, bookkeeping, accounting, payroll, billing, collection,
boarding, cleaning and other functions; or
(16) employing veterinary medical and other personnel,
if a veterinarian present at the practice location who is in charge
of veterinary medicine for that practice location at which the veterinary
medical and other personnel work has the right to:
(A) control the medically related procedures, duties,
and performance of the veterinary medical and other personnel; and
(B) suspend for medically related reasons the veterinary
medical and other personnel unless the suspension is contrary to law,
regulation or other legal requirements.
(f) Disclosure of Contracts.
(1) A veterinarian or a group of veterinarians that
contract with a management services organization shall:
(A) make available for inspection by the Board at the
main office of the veterinarian or group of veterinarians, pursuant
to §573.66 of this title (relating to Disciplinary Action for
Non-Compliance with Continuing Education Requirements), copies of
the contracts with the management services organizations; and
(B) if the Board opens an investigation against a veterinarian
or a group of veterinarians, make available to the Board copies of
the contracts with the management services organizations.
(2) Verbal contracts will not be considered evidence
of compliance with this rule.
(3) Copies of contracts produced under this subsection
shall be governed by the Veterinary Licensing Act, Texas Occupations
Code, §801.207.
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