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TITLE 22EXAMINING BOARDS
PART 24TEXAS BOARD OF VETERINARY MEDICAL EXAMINERS
CHAPTER 573RULES OF PROFESSIONAL CONDUCT
SUBCHAPTER GOTHER PROVISIONS
RULE §573.74Management Services Organizations in Veterinary Practice

(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.


Source Note: The provisions of this §573.74 adopted to be effective June 14, 2012, 37 TexReg 4229; amended to be effective December 23, 2014, 39 TexReg 10018

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