Bill Text: TX HB4023 | 2017-2018 | 85th Legislature | Introduced
Bill Title: Relating to the licensing and regulation of neurodiagnostic practitioners and neurodiagnostic technologists; requiring an occupational license; creating an offense; providing penalties and authorizing fees.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2017-03-31 - Referred to Public Health [HB4023 Detail]
Download: Texas-2017-HB4023-Introduced.html
85R13698 TSR-F | ||
By: Zedler | H.B. No. 4023 |
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relating to the licensing and regulation of neurodiagnostic | ||
practitioners and neurodiagnostic technologists; requiring an | ||
occupational license; creating an offense; providing penalties and | ||
authorizing fees. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subtitle K, Title 3, Occupations Code, is | ||
amended by adding Chapter 606 to read as follows: | ||
CHAPTER 606. NEURODIAGNOSTIC PRACTITIONERS AND NEURODIAGNOSTIC | ||
TECHNOLOGISTS | ||
SUBCHAPTER A. GENERAL PROVISIONS | ||
Sec. 606.001. DEFINITIONS. In this chapter: | ||
(1) "Autonomic reflex testing" means a test used to | ||
measure how autonomic nerves work in controlling involuntary body | ||
functions, including blood pressure, heart rate, and sweating, in | ||
response to different maneuvers, such as deep breathing, blowing | ||
into a mouthpiece, sweating, and lying for several minutes on a | ||
table that is tilted to a near standing position. | ||
(2) "Board" means the Texas Medical Board. | ||
(3) "Credentialing organization" means an accrediting | ||
organization that is recognized by the board and that administers | ||
and awards credentials in the modalities of neurodiagnostic | ||
technology. | ||
(4) "Direct supervision" means supervision by a | ||
responsible physician or neurodiagnostic practitioner or | ||
neurodiagnostic technologist who is physically present and | ||
immediately available to provide assistance and direction while a | ||
neurodiagnostic procedure is being performed. | ||
(5) "Electroencephalography" means the recording and | ||
analysis of the ongoing electrical activity of the brain using a | ||
digital or analog instrument with a minimum of 16 channels and 21 | ||
electrodes to assist in the diagnosis of epilepsy and other | ||
neurological symptoms. | ||
(6) "Electromyography" means the recording and | ||
analysis of electrical activity generated by a needle insertion | ||
into a muscle. | ||
(7) "Evoked potentials" means the recording of | ||
electrical activity from the brain, spinal nerves, or sensory | ||
receptors that occurs in direct response to auditory, visual, or | ||
electrical stimulation using surface electrodes and computer | ||
equipment to average the electrical potentials generated. | ||
(8) "Intraoperative monitoring" means the use of a | ||
neurophysiological monitoring technique during surgery that | ||
ensures the safety of a patient by: | ||
(A) providing information to the surgeon that | ||
relates to the integrity of the central and peripheral nervous | ||
systems; and | ||
(B) using real-time electrographic information | ||
or stimulus evoked recordings of auditory, visual, somatosensory, | ||
or motor pathways via surface or subdermal needle electrodes. | ||
(9) "License holder" means a person who holds a | ||
license as a neurodiagnostic practitioner or neurodiagnostic | ||
technologist under this chapter. | ||
(10) "Long-term monitoring" means the prolonged | ||
recording, by video recording or digital analysis, of the ongoing | ||
electrical activity of the brain to evaluate and diagnose epilepsy | ||
and other intermittent or infrequent neurological disturbances. | ||
(11) "Magnetoencephalography" means the use of a | ||
neuroimaging technique for mapping brain activity by recording | ||
magnetic fields, outside the head, that are produced by electrical | ||
currents that occur naturally in the brain. | ||
(12) "Nerve conduction study" means a recording | ||
obtained from electrical stimulation of peripheral nerves using | ||
surface electrodes and standard equipment with oscilloscopes for | ||
waveform analysis to evaluate and diagnose a disorder of the | ||
peripheral nervous system. | ||
(13) "Neurodiagnostic practitioner" means a person | ||
who holds a doctoral degree approved by the board and a license | ||
issued under this chapter to: | ||
(A) perform the duties of a neurodiagnostic | ||
technologist; | ||
(B) perform intraoperative monitoring under the | ||
general supervision of a physician; and | ||
(C) supervise the performance of intraoperative | ||
monitoring and interpret intraoperative monitoring data under the | ||
delegated authority and general supervision of a physician. | ||
(14) "Neurodiagnostic student" means a person who is | ||
enrolled in a neurodiagnostics program. | ||
(15) "Neurodiagnostic technologist" means a person | ||
who holds a license issued under this chapter to: | ||
(A) use specialized equipment to record and | ||
analyze physiological data and electrical activity from the central | ||
and peripheral nervous systems; and | ||
(B) perform one or more of the following | ||
neurodiagnostic procedures under the appropriate level of | ||
supervision by a physician or a neurodiagnostic practitioner: | ||
(i) electroencephalography; | ||
(ii) evoked potentials; | ||
(iii) continuous electroencephalography | ||
monitoring; | ||
(iv) intraoperative neuromonitoring; | ||
(v) long-term monitoring; | ||
(vi) magnetoencephalography; | ||
(vii) nerve conduction studies; | ||
(viii) polysomnography; or | ||
(ix) autonomic reflex testing. | ||
(16) "Neurodiagnostic trainee" means a license holder | ||
who performs a neurodiagnostic procedure that the person does not | ||
have a credential to perform while under the direct supervision of a | ||
physician or neurodiagnostic practitioner or neurodiagnostic | ||
technologist who does have a credential to perform the procedure. | ||
(17) "Polysomnography" means the recording of the | ||
biophysiological changes that occur during sleep by monitoring the | ||
ongoing electrical activity of the brain, eye movements, muscle | ||
activity, heart rhythm, and respiratory effort to diagnose and | ||
treat sleep disorders. | ||
Sec. 606.002. EXEMPTIONS. This chapter does not apply to: | ||
(1) a physician licensed in this state; | ||
(2) a person performing a neurodiagnostic procedure: | ||
(A) for research if the results of the procedure | ||
are not used to diagnose or treat a patient; | ||
(B) as a neurodiagnostic student or | ||
neurodiagnostic trainee under the direct supervision of a physician | ||
or a neurodiagnostic practitioner or neurodiagnostic technologist; | ||
(C) as an employee under the direct supervision | ||
of a physician as part of the employee's job training; or | ||
(D) as an audiologist or physical therapist | ||
licensed in this state while performing only a procedure that the | ||
audiologist or physical therapist is authorized to perform as | ||
determined by board rule; or | ||
(3) a faculty member of an accredited school or | ||
university with a neurodiagnostics, allied health, or health | ||
education program. | ||
SUBCHAPTER B. POWERS AND DUTIES OF BOARD | ||
Sec. 606.051. GENERAL POWERS AND DUTIES; RULES. (a) The | ||
board shall administer and enforce this chapter. | ||
(b) The board shall adopt rules necessary to implement this | ||
chapter. | ||
Sec. 606.052. FEES. (a) The board by rule shall establish | ||
reasonable and necessary fees in amounts sufficient to cover the | ||
costs of administering and enforcing this chapter. | ||
(b) The board may modify the fee for the issuance or renewal | ||
of a license as necessary to cover the costs of enforcing this | ||
chapter. | ||
SUBCHAPTER C. LICENSE REQUIREMENTS | ||
Sec. 606.101. LICENSE REQUIRED. (a) A person may not act | ||
as or offer to act as a neurodiagnostic practitioner or | ||
neurodiagnostic technologist unless the person holds the | ||
applicable license issued under this chapter. | ||
(b) A person who is not licensed under this chapter, or | ||
whose license has been suspended or revoked, may not: | ||
(1) use the word "neurodiagnostic" on a sign, name | ||
tag, or any form of advertising unless the person is expressly | ||
exempt from the licensing requirements of this chapter; | ||
(2) use in connection with the person's practice any | ||
abbreviations or credentials indicating or implying that the person | ||
is a neurodiagnostic practitioner or neurodiagnostic technologist; | ||
or | ||
(3) directly or by implication represent in any way | ||
that the person is a neurodiagnostic practitioner or | ||
neurodiagnostic technologist. | ||
(c) A license: | ||
(1) is valid only with respect to the person named on | ||
the license; and | ||
(2) authorizes the license holder to engage in the | ||
neurodiagnostic procedure for which the license holder has a | ||
credential issued by a credentialing organization. | ||
(d) A license issued under this chapter is not transferable | ||
or assignable. | ||
Sec. 606.102. LICENSING APPLICATION. (a) An applicant for | ||
a license must: | ||
(1) apply to the board on a form prescribed by the | ||
board and under rules adopted by the board; | ||
(2) submit with the application a nonrefundable | ||
application fee in an amount set by the board; and | ||
(3) pass a credentialing organization examination | ||
administered or accepted by the board. | ||
(b) The board by rule shall specify the information that | ||
must be included on an application submitted to the board. The | ||
rules must require: | ||
(1) each application to include the name and address | ||
of the applicant; and | ||
(2) each applicant for a license by examination to | ||
present satisfactory evidence to the board that the applicant is: | ||
(A) at least 18 years of age; and | ||
(B) of good moral character. | ||
Sec. 606.103. CRIMINAL BACKGROUND CHECKS. (a) On receipt | ||
of an application for a license under this chapter, the board shall | ||
conduct a criminal background check on the applicant. | ||
(b) An applicant is not eligible for a license under this | ||
chapter if the applicant, in the 10 years preceding the date of the | ||
application, has been finally convicted of a misdemeanor involving | ||
moral turpitude or a felony. | ||
Sec. 606.104. EXAMINATIONS ADMINISTERED OR ACCEPTED BY | ||
BOARD. The board may administer or accept for licensing a | ||
credentialing organization examination as determined by rule. | ||
Sec. 606.1041. REDUCED LICENSE REQUIREMENTS. (a) A person | ||
who applies for a license under this chapter not later than July 1, | ||
2017, is exempt from the examination required under this chapter if | ||
the person presents satisfactory evidence to the board that the | ||
person has been actively performing neurodiagnostic procedures | ||
since before January 1, 2017. | ||
(b) Satisfactory evidence under Subsection (a) must be in | ||
the form of a signed letter submitted by the employer or supervising | ||
physician of the applicant. | ||
(c) A person who qualifies under this section for an | ||
exemption from the requirement to take the examination required | ||
under this chapter must comply with all other requirements under | ||
this chapter for the issuance and renewal of a license. | ||
(d) This section expires July 1, 2018. | ||
Sec. 606.105. TEMPORARY LICENSES. (a) The board may adopt | ||
rules and set fees relating to granting temporary licenses. | ||
(b) A temporary license under this chapter expires on the | ||
second anniversary of the date the temporary license is issued or | ||
the date the applicant presents satisfactory evidence to the board | ||
that the applicant has passed the examination required under this | ||
chapter, whichever date occurs first. | ||
(c) The board by rule may extend the expiration date of a | ||
temporary license by not more than an additional 12 months. | ||
SUBCHAPTER D. LICENSE RENEWAL | ||
Sec. 606.151. LICENSE RENEWAL. (a) A license is valid for | ||
two years from the date of issuance and may be renewed biennially. | ||
(b) The board by rule may adopt a system under which | ||
licenses expire on various dates during the year. | ||
(c) A person may renew an unexpired license by paying the | ||
required renewal fee to the board before the license expiration | ||
date. | ||
(d) To renew a license under this chapter, a person must | ||
submit proof satisfactory to the board that the person has: | ||
(1) maintained the appropriate credentials issued by a | ||
credentialing organization; and | ||
(2) complied with the continuing education | ||
requirements prescribed by the board. | ||
Sec. 606.152. CONTINUING EDUCATION. (a) The board shall | ||
establish for the renewal of a license or temporary license uniform | ||
continuing education requirements of not less than 30 continuing | ||
education hours for each renewal period. | ||
(b) The board shall adopt a procedure to assess a license | ||
holder's participation in continuing education programs. | ||
SUBCHAPTER E. PRACTICE BY LICENSE HOLDER | ||
Sec. 606.201. ADVERTISING. (a) A license holder shall | ||
include the license holder's license number in each advertisement. | ||
(b) A person who advertises that the person is a | ||
neurodiagnostic practitioner or neurodiagnostic technologist is | ||
presumed to be engaging in conduct regulated by this chapter. | ||
SUBCHAPTER F. PROHIBITED PRACTICES AND ENFORCEMENT PROVISIONS | ||
Sec. 606.251. PROHIBITED PRACTICES. (a) A license holder | ||
may not engage in a neurodiagnostic procedure for which the license | ||
holder does not hold the proper credential issued by a | ||
credentialing organization. | ||
(b) A license holder may not: | ||
(1) interpret neurodiagnostic data, including making | ||
a determination of normal or abnormal findings and identifying the | ||
presence, absence, type, severity, or likelihood of an illness, | ||
injury, or other condition; | ||
(2) provide clinical correlation of data, including | ||
making statements about the meaning of test results based on a | ||
person's symptoms, medical history, physical examination, or other | ||
clinical test results; | ||
(3) perform needle insertion electromyography in a | ||
clinical setting; or | ||
(4) meet with a patient except under the direct | ||
supervision of a physician. | ||
Sec. 606.252. INVESTIGATION OF COMPLAINTS. (a) The board | ||
shall investigate any complaint alleging that a violation of this | ||
chapter or a rule or order adopted under this chapter has occurred. | ||
(b) A complaint must be filed in a manner prescribed by the | ||
board. | ||
Sec. 606.253. SANCTIONS. The board may impose sanctions | ||
under this chapter in the same manner as provided by Chapter 164 for | ||
imposition of sanctions against a physician. | ||
SUBCHAPTER G. PENALTIES | ||
Sec. 606.301. ADMINISTRATIVE PENALTY. The board may impose | ||
an administrative penalty against a person under this chapter in | ||
the same manner as provided by Subchapter A, Chapter 165, against a | ||
physician, regardless of whether the person holds a license under | ||
this chapter, if the person violates this chapter or a rule or order | ||
adopted under this chapter. | ||
Sec. 606.302. CRIMINAL PENALTY. (a) A person commits an | ||
offense if the person violates this chapter. | ||
(b) An offense under this section is a Class A misdemeanor. | ||
SECTION 2. Not later than February 1, 2018, the Texas | ||
Medical Board shall adopt rules and forms necessary to implement | ||
Chapter 606, Occupations Code, as added by this Act. | ||
SECTION 3. The Texas Medical Board shall issue a | ||
neurodiagnostic practitioner or neurodiagnostic technologist | ||
license, as applicable, under Chapter 606, Occupations Code, as | ||
added by this Act, to an applicant who: | ||
(1) applies for the license under this section not | ||
later than July 1, 2018; | ||
(2) submits to the board the information required by | ||
rule; | ||
(3) meets the requirements of Section 606.1041, | ||
Occupations Code, as added by this Act; and | ||
(4) pays the application fee established by the board. | ||
SECTION 4. (a) Except as provided by Subsection (b) of this | ||
section, this Act takes effect September 1, 2017. | ||
(b) Section 606.101 and Subchapter G, Chapter 606, | ||
Occupations Code, as added by this Act, take effect September 1, | ||
2018. |