| (a) As a prerequisite to the registration of a physician's
permit a physician must complete 48 credits of continuing medical
education (CME) every 24 months. CME credits must be completed in
the following categories and topics:
(1) At least 24 credits every 24 months are to be from
formal courses that are:
(A) designated for AMA/PRA Category 1 credit by a CME
sponsor accredited by the Accreditation Council for Continuing Medical
Education or a state medical society recognized by the Committee for
Review and Recognition of the Accreditation Council for Continuing
Medical Education;
(B) approved for prescribed credit by the American
Academy of Family Physicians;
(C) designated for AOA Category 1-A credit required
for osteopathic physicians by an accredited CME sponsor approved by
the American Osteopathic Association;
(D) approved by the Texas Medical Association based
on standards established by the AMA for its Physician's Recognition
Award; or
(E) approved by the board for medical ethics and/or
professional responsibility courses only.
(2) At least two of the 24 formal credits of CME which
are required by paragraph (1) of this subsection must involve the
study of medical ethics and/or professional responsibility. Whether
a particular credit of CME involves the study of medical ethics and/or
professional responsibility shall be determined by the organizations
which are enumerated in paragraph (1) of this subsection as part of
their course planning.
(3) At least two of the 24 formal credits of CME which
are required by paragraph (1) of this subsection must involve the
study of the following topics:
(A) best practices, alternative treatment options,
and multi-modal approaches to pain management that may include physical
therapy, psychotherapy, and other treatments;
(B) safe and effective pain management related to the
prescription of opioids and other controlled substances, including
education regarding:
(i) standards of care;
(ii) identification of drug-seeking behavior in patients;
and
(iii) effectively communicating with patients regarding
the prescription of an opioid or other controlled substances; and
(C) prescribing and monitoring of controlled substances.
(D) For physicians practicing in pain clinics, the
hours required under this subparagraph shall be credited towards the
10 hours of required continuing medical education related to pain
management required under 22 TAC Chapter 195.4(e), relating to Operation
of Pain Management Clinics.
(E) The hours required under this subparagraph may
be designated for medical ethics or professional responsibility credit
for purposes of compliance with paragraph (2) of this subsection.
(4) As part of the 24 formal credits of CME required
under paragraph (1) of this subsection, a course in human trafficking
prevention approved by the executive commissioner of the Texas Health
and Human Services Commission must be completed. The course shall
be designated by the board for medical ethics or professional responsibility
credit for the purposes of compliance with paragraph (2) of this subsection.
(5) The remaining 24 credits for the 24-month period
may be composed of informal self-study, attendance at hospital lectures,
grand rounds, or case conferences not approved for formal CME, and
shall be recorded in a manner that can be easily transmitted to the
board upon request.
(6) A physician who performs sexual assault forensic
examinations must have basic forensic evidence collection training
or the equivalent education. A physician who completes a CME course
in forensic evidence collection that:
(A) meet the requirements described in paragraph (1)(A)
- (C) of this subsection; or
(B) is approved or recognized by the Texas Board of
Nursing, is considered to have the basic forensic evidence training
required by the Health and Safety Code, §323.0045.
(7) A physician may complete one credit of formal continuing
medical education, as required by paragraph (1) of this subsection,
for each hour of time spent up to 12 hours, based on participation
in a program sponsored by the board and approved for CME credit for
the evaluation of a physician competency or practice monitoring.
(8) A physician whose practice includes the treatment
of tick-borne diseases should complete CME in the treatment of tick-borne
diseases that meet the requirements described in paragraph (1)(A)
- (E) of this subsection.
(b) A physician must report on the registration permit
application if she or he has completed the required CME during the
previous 2 years.
(1) A physician may carry forward CME credits earned
prior to a registration report which are in excess of the 48-credit
biennial requirement and such excess credits may be applied to the
following years' requirements, except that excess credits may not
be applied to requirements set forth under paragraphs (2) and (3)
of subsection (a).
(2) A maximum of 48 total excess credits may be carried
forward and shall be reported according to the categories set out
in subsection (a) of this section, subject to the limitations established
under paragraph (1) of this subsection.
(3) Excess CME credits of any type may not be carried
forward or applied to a report of CME more than two years beyond the
date of the registration following the period during which the credits
were earned.
(c) A physician shall be presumed to have complied
with this section if in the preceding 36 months the physician becomes
board certified or recertified by a specialty board approved by the
American Board of Medical Specialties (ABMS) or the American Osteopathic
Association Bureau of Osteopathic Specialists (AOA). This provision
exempts the physician from all CME requirements, including the requirement
for two credits involving the study of medical ethics and/or professional
responsibility, as outlined in subsection (a)(2) of this section.
This exemption is valid for one registration period only.
(d) Maintenance of Certification, Presumption of Compliance.
(1) Except as otherwise provided in this subsection,
a physician shall be presumed to have complied with subsection (a)(1)
and (5) of this section if the physician is meeting the Maintenance
of Certification (MOC) program requirements set forth by a specialty
or subspecialty member board of the ABMS or the Osteopathic Continuous
Certification (OCC) program requirements set forth by the AOA, and
the member board's MOC or OCC program mandates completion of CME credits
that meet the minimum criteria set forth under subsection (a)(1) of
this section.
(2) Notwithstanding paragraph (1) of this subsection,
a physician's compliance with an MOC program will not be credited
toward the requirements set forth under paragraphs (2), (3), and (4)
of subsection (a).
(e) A physician may request in writing an exemption
for the following reasons:
(1) the physician's catastrophic illness;
(2) the physician's military service of longer than
one year's duration outside the state;
(3) the physician's medical practice and residence
of longer than one year's duration outside the United States; or
(4) good cause shown submitted in writing by the physician,
which provides satisfactory evidence to the board that the physician
is unable to comply with the requirement for CME.
(f) Exemptions are subject to the approval of the executive
director or medical director and must be requested in writing at least
30 days prior to the expiration date of the permit.
(g) A temporary exemption under subsection (d) of this
section may not exceed one year but may be renewed, subject to the
approval of the board.
(h) Subsection (a) of this section does not apply to
a physician who is retired and has been exempted from paying the registration
fee under §166.3 of this title (relating to Retired Physician
Exception).
(i) This section does not prevent the board from taking
board action with respect to a physician or an applicant for a license
by requiring additional credits of CME or of specific course subjects.
(j) The board may require written verification of both
formal and informal credits from any physician within 30 days of request.
Failure to provide such verification may result in disciplinary action
by the board.
(k) Residency or Fellowship Training Completion, Presumption
of Compliance.
(1) Except as otherwise provided in this subsection,
physicians in residency/fellowship training or who have completed
such training within six months prior to the registration expiration
date will satisfy the requirements of subsection (a)(1) and (2) of
this section by their residency or fellowship program.
Cont'd... |
