These disciplinary sanction guidelines are designed to provide guidance in assessing sanctions for violations of the Medical Practice Act. The ultimate purpose of disciplinary sanctions is to protect the public, deter future violations, offer opportunities for rehabilitation if appropriate, punish violators, and deter others from violations. These guidelines are intended to promote consistent sanctions for similar violations, facilitate timely resolution of cases, and encourage settlements. (1) The standard sanctions outlined below shall apply to cases involving a single violation of the Act, and in which there are no aggravating or mitigating factors that apply. The board may impose more restrictive sanctions when there are multiple violations of the Act. The board may impose more or less severe or restrictive sanctions, based on any aggravating and/or mitigating factors listed in §190.15 of this chapter (relating to Aggravating and Mitigating Factors) that are found to apply in a particular case. (2) The standard and minimum sanctions outlined below are applicable to first time violators. In accordance with §164.001(g)(2) of the Act, the board shall consider revoking the person's license if the person is a repeat offender. (3) The maximum sanction in all cases is revocation of the licensee's license, which may be accompanied by an administrative penalty of up to $5,000 per violation. In accordance with §165.003 of the Act, each day the violation continues is a separate violation. (4) Each statutory violation constitutes a separate offense, even if arising out of a single act. (5) If the licensee acknowledges a violation and agrees to comply with terms and conditions of remedial action through an agreed order, the standard sanctions may be reduced. (6) The following standard sanctions shall apply to violations of the Act: (A) Failure to timely provide copies of medical or billing records upon written request. (i) Violation of: (I) §159.006 - information furnished by licensee; and (II) §164.052(a)(2) - violation of Board Rule, to wit: §165.2 (relating to Medical Record Release and Charges). (ii) Standard Sanction: (I) furnishing medical records requested; (II) restitution; and (III) administrative penalty of $1,000 per violation. (B) Failure to timely comply with a board subpoena or request for information. (i) Violation of §160.009 and board rule §179.4 (relating to Request for Information and Records from Physicians). (ii) Standard Sanction: (I) public reprimand; (II) compliance with the subpoena or request; and (III) administrative penalty of $500 for each day of noncompliance. (C) Conviction of a criminal offense. (i) Violation of §164.051(a)(2). (ii) In accordance with §164.057 of the Act, the board shall suspend a licensee's license on proof that the licensee has been initially convicted of any felony, or a misdemeanor under Chapter 22 (other than a misdemeanor punishable by fine only), §25.07, or §25.071 of the Texas Penal Code; a misdemeanor in which the defendant is required to register as a sex offender under Chapter 62, Code of Criminal Procedure; an initial finding by the trier of fact of guilt of a felony under Chapter 481 or 483 of the Health and Safety Code; or the Comprehensive Drug Abuse Prevention and Control Act of 1970 (21 U.S.C. §801 et. seq.) (iii) On final conviction for a felony or misdemeanor described in this chapter, the board shall revoke the licensee's license. (iv) A conviction of misdemeanor involving moral turpitude, for which suspension or revocation is not mandated by the Medical Practice Act (I) If the conviction is related to the practice of medicine, the standard sanction shall be revocation of the license. (II) If the conviction is not related to the practice of medicine, the standard sanction shall require: (-a-) compliance with all restrictions, conditions and terms imposed by any order of probation or deferred adjudication; (-b-) public reprimand; and (-c-) administrative penalty of $2,000 per violation. (v) A conviction includes an adjudication of guilt or an order of deferred adjudication. (vi) In accordance with §164.058 of the Act, the board shall suspend the license of a licensee serving a prison term in a state or federal penitentiary during the term of the incarceration regardless of the offense. (D) Failure to obtain/document continuing medical education. (i) Violation of §164.051(a)(3) or violation of board rule §166.2 (relating to Continuing Medical Education). (ii) Standard Sanction: (I) directed CME; and (II) administrative penalty of $1,000 per violation. (E) Impairment of ability to practice. (i) Within the meaning of §164.051(a)(4) - inability to practice medicine with reasonable skill and safety to patients because off illness, drunkenness, excessive use of drugs, or a mental condition. (ii) Standard Sanction: suspension of license until such time as the licensee can demonstrate that the licensee is safe and competent to practice medicine. (iii) Alternate Standard Sanction: probation of suspension for 5 years under terms and conditions, including, but not limited to: (I) drug testing; (II) restrictions on practice; (III) alcoholics anonymous/narcotics anonymous attendance; (IV) psychiatric/psychological evaluation and treatment; and (V) proficiency testing. (iv) Chapter 180 of this title (relating to Rehabilitation Orders) provides guidance on whether a licensee is eligible for and should be placed under a confidential rehabilitation order. (F) Failure to maintain adequate medical records. (i) Violation of: (I) §164.051(a)(6) - professional failure to practice medicine consistent with the public health and welfare; (II) §164.054 - additional requirements regarding drug records; (III) §164.053(a)(2) - failure to keep complete and accurate records of purchases and disposals of controlled substances and dangerous drugs, and (IV) §164.051(a)(3) - violation of board rules, including: (-a-) board rule §165.1(a) (relating to Medical Records) - failure to maintain adequate medical records; and (-b-) board rule §170.3 (relating to Authority of Physician to Prescribe for the Treatment of Pain) - prescribing guidelines for the treatment of pain. (ii) Standard Sanction: probation for 2 years under terms and conditions, including, but not limited to: (I) competency testing; (II) directed CME; (III) monitoring of practice; and (IV) administrative penalty of $2,000 per violation. (G) Quality of Care. (i) Violations of: (I) §164.051(a)(6) - failure to practice medicine in a professional manner consistent with the public health and welfare; and (II) §164.051(a)(8) - repeated and meritorious medical malpractice claims. (ii) Standard Sanction: The standard sanction, which shall apply in the case of a single patient with no substantial patient harm and no other aggravating or mitigating circumstances, shall be: (I) suspension of license for 3 years; (II) suspension probated after 90 days under terms and conditions, including, but not limited to: (-a-) limiting the practice of the person, or excluding one or more specified activities of medicine; (-b-) proficiency testing; (-c-) directed CME; (-d-) monitoring of the practice; and (-e-) administrative penalty of $3,000 per violation. (H) Discipline by peers. (i) Within the meaning of §164.051(a)(7). (ii) Standard Sanction: See the applicable standard 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. (iii) Alternate Standard Sanction: (I) public reprimand; (II) comply with all restrictions, conditions and terms imposed by the disciplinary action by peers; and Cont'd... |
