A Texas Legislative Update: HB 1998 Increases Public Reporting Requirements for Physicians

By: John Faubion

In the recent legislative session, Texas lawmakers passed a number of new initiatives impacting the health care industry and medical providers who are licensed to practice in Texas.  One such initiative was HB 1998, which was signed into law by Governor Abbott on June 13, 2023.  State Representative Julie Johnson filed HB 1998, and, in general, the bill sought to increase public access to physician disciplinary information. 

The genesis of HB 1998 was an investigative news series by Austin NBC affiliate station KXAN focusing on whether physician disciplinary records from other jurisdictions were appropriately reported in Texas.  According to a KXAN article, State Representative Johnson explained that “KXAN uncovered a problem, brought it to my attention, . . . [w]e discussed. I met with policyholders. We’ve come together to form, I think, a piece of legislation that can make a meaningful impact into health safety and patient safety.”[1]

HB 1998 amends sections 154.006, 160.002, and 164.051 of the Texas Occupations Code in an effort to boost transparency of physician discipline for public review and consideration.  Among other issues, the new law accomplishes the following:

• Requires the Texas Medical Board (TMB) to search the National Practitioner Data Bank at least once a month and update any Texas physician profile as needed to reflect any new report of disciplinary action against the physician;
• Requires any medical peer review committee or health care entity to make a written report to the National Practitioner Data Bank outlining the results and circumstances of a medical peer review that adversely affects a physician’s clinical privileges for 30 days or less; and
• Requires the TMB to refuse a license application if the applicant held a license to practice medicine in another jurisdiction that was revoked by that licensing authority.

See Tex. Occ. Code §§ 154.006; 160.002; 164.051; see also 88(R) H.B. No. 1988, Introduced Version, https://capitol.texas.gov/tlodocs/88R/billtext/html/HB01998I.htm (last visited June 27, 2023).

The new provisions take effect on September 1, 2023.  The new law effectively mandates that the TMB review and publicly disclose some events that physicians are required to self-report.  Reportable events will be included on the public physician profile registered with the TMB.

It is important to note that, while the TMB is now statutorily obligated to review and update physician profiles monthly to reflect new disciplinary reports from the National Practitioner Data Bank, the physician self-reporting requirement is not eliminated.  Physicians licensed in Texas (and others, such as medical students and peer review committees) still are required to make confidential reports to the TMB under existing law.  For example, section 173.3 of the Texas Administrative Code requires physicians to make a report to the TMB within 30 days of certain events, including:

• incarceration;

• felony convictions, Class A or B misdemeanors, or some Class C misdemeanors;

• some charges involving a plea of no contest, deferred adjudication, or pretrial diversion;

• a guilty verdict in connection with certain use of certain controlled substances;

• disciplinary action against a license holder by another jurisdiction; and

• medical malpractice claims resulting in a liability finding and a jury award of damages.

See 22 Tex. Admin. Code § 173.3.

Hospital and peer review committees should review the details of HB 1998 and exercise caution to comply with the new requirements set forth in the Occupations Code.  Peer review organizations likely will be impacted by the new requirement to report peer review outcomes that temporarily affect physician clinical privileges for a short-term period less than 30 days. 

Likewise, Texas physicians must familiarize themselves with HB 1998 and should generally review the TMB rules and website to ensure their compliance with the obligations set forth in the Texas Occupations Code, Texas Administrative Code, and Board Rules.  The TMB website offers a number of helpful resources to licensees.  One useful resource is a legislative update summarizing new law and changes to existing laws the impact Texas license holders.  See Legislative Updates, Texas Medical Board, https://www.tmb.state.tx.us/page/agency-legislative-updates (last visited June 27, 2023). 

It is increasingly clear that physicians’ failure to report disciplinary action imposed by another jurisdiction is a growing source of TMB investigations and discipline.  Texas physicians should promptly update their public TMB profiles to reflect new reportable events.  Given the new statutory obligation for the TMB itself to conduct monthly reviews of the National Practitioner Data Bank and update Texas licensee profiles as necessary, Texas physicians would be wise to diligently review their obligations under current statute and rules, and proactively update their public profiles as needed.

Physicians who maintain licenses in other jurisdictions should be wary of the implications involved with waiver, revocation, or other discipline on their non-Texas license(s).  With the increasing prevalence of telemedicine and the widespread use of technology enabling the practice of medicine from remote locations, it is increasingly common for physicians to maintain multiple licenses.  The license holder must be aware that discipline imposed on an out-of-state licensee may result in public reporting and additional disciplinary consequences in Texas.