22 Tex. Admin. Code § 183.8

Current through Reg. 49, No. 49; December 6, 2024
Section 183.8 - Investigations
(a) Confidentiality. All complaints, adverse reports, investigation files, other investigation reports, and other investigative information in the possession of, received, or gathered by the board shall be confidential and no employee, agent, or member of the board may disclose information contained in such files except in the following circumstances:
(1) to the appropriate licensing authorities in other states, the District of Columbia, or a territory or country in which the acupuncturist is licensed;
(2) to appropriate law enforcement agencies if the investigative information indicates a crime may have been committed;
(3) to a health care entity upon receipt of written request. Disclosures by the board to a health care entity shall include only information about a complaint filed against an acupuncturist that was resolved after investigation by a disciplinary order of the board or by an agreed settlement, and the basis of and current status of any complaint under active investigation; and
(4) to other persons if required during the conduct of the investigation.
(b) Request for Information and Records.
(1) Patient records. Upon the request of the board or board representatives, a licensee shall furnish to the board legible copies of patient records in English or the original records within 14 days of the date of the request.
(2) Renewal of licenses. A licensee shall furnish a written explanation of his or her answer to any question asked on the application for license renewal, if requested by the medical board or acupuncture board. This explanation shall include all details as the medical board or acupuncture board may request and shall be furnished within 14 days of the date of the medical or acupuncture board's request.
(c) Professional Liability Suits and Claims. Following receipt of a notice of claim letter or a complaint filed in court against a licensee that is reported to the acupuncture board, the licensee shall furnish to the medical or acupuncture board the following information within 14 days of the date of receipt of the medical or acupuncture board's request for said information:
(1) a completed questionnaire to provide summary information concerning the suit or claim;
(2) a completed questionnaire to provide information deemed necessary in assessing the licensee's competency;
(3) true, legible, and complete copies of the licensee's office patient records and hospital records, if applicable, concerning the patient on whose behalf damages are sought; and
(4) current information on the status of any suit or claim previously reported to either board.
(d) Investigation of Professional Review Actions. A written report of a professional review action taken by a peer review committee or a health care entity provided to the acupuncture board must contain the results and circumstances of the professional review action. Such results and circumstances shall include:
(1) the specific basis for the professional review action, whether or not such action was directly related to care of individual patients; and
(2) the specific limitations imposed upon the acupuncturist's clinical privileges, upon membership in the professional society or association, and the duration of such limitations.
(e) Other Reports.
(1) Relevant information shall be reported to the acupuncture board indicating that an acupuncturist's practice poses a continuing threat to the public welfare shall include a narrative statement describing the time, date, and place of the acts or omissions on which the report is based.
(2) A report that an acupuncturist's practice constitutes a continuing threat to the public welfare shall be made to the acupuncture board as soon as possible after the peer review committee, licensed acupuncturist or acupuncture student involved reaches that conclusion and is able to assemble the relevant information.
(f) Reporting Professional Liability Claims.
(1) Reporting responsibilities. The reporting form must be completed and forwarded to the acupuncture board for each defendant acupuncturist against whom a professional liability claim or complaint has been filed. The information is to be reported by insurers or other entities providing professional liability insurance for an acupuncturist. If a nonadmitted insurance carrier does not report or if the acupuncturist has no insurance carrier, reporting shall be the responsibility of the acupuncturist.
(2) Separate reports required and identifying information. One separate report shall be filed for each defendant acupuncturist insured. When Part II is filed, it shall be accompanied by the completed Part I or other identifying information as described in paragraph (4)(A) of this subsection.
(3) Timeframes and attachments. The information in Part I of the form must be provided within 30 days of receipt of the claim or suit. A copy of the claim letter or petition must be attached. The information in Part II must be reported within 105 days after disposition of the claim. Disposed claims shall be defined as those claims where a court order has been entered, a settlement agreement has been reached, or the complaint has been dropped or dismissed.
(4) Alternate reporting formats. The information may be reported either on the form provided or in any other legible format which contains at least the requested data.
(A) If the reporter elects to use a reporting format other than the acupuncture board's form for data required in Part II, there must be enough identification data available to board staff to match the closure report to the original file. The data required to accomplish this include:
(i) name and license number of defendant acupuncturist(s); and
(ii) name of plaintiff.
(B) A court order or settlement agreement is an acceptable alternative submission for Part II. An order or settlement agreement should contain the necessary information to match the closure information to the original file. If the order or agreement is lacking some of the required data, the additional information may be legibly written on the order or agreement.
(5) Penalty. Failure by a licensed insurer to report under this section shall be referred to the State Board of Insurance. Sanctions under the Insurance Code, Article 1.10, section 7, may be imposed for failure to report.
(6) Definition. For the purposes of this subsection a professional liability claim or complaint shall be defined as a cause of action against an acupuncturist for treatment, lack of treatment, or other claimed departure from accepted standards of health care or safety which proximately results in injury to or death of the patient, whether the patient's claim or cause of action sounds in tort or contract.
(7) Claims not required to be reported. Examples of claims that are not required to be reported under this chapter but which may be reported include, but are not limited to, the following:
(A) product liability claims (i.e. where an acupuncturist invented a device which may have injured a patient but the acupuncturist has had no personal acupuncturist-patient relationship with the specific patient claiming injury by the device);
(B) antitrust allegations;
(C) allegations involving improper peer review activities;
(D) civil rights violations; or
(E) allegations of liability for injuries occurring on an acupuncturist's property, but not involving a breach of duty to the patient (i.e. slip and fall accidents).
(8) Claims that are not required to be reported under this chapter may, however, be voluntarily reported.
(9) The reporting form shall be as follows:

Attached Graphic

22 Tex. Admin. Code § 183.8

The provisions of this §183.8 adopted to be effective March 6, 2003, 28 TexReg 1883