22 Tex. Admin. Code § 185.23

Current through Reg. 49, No. 49; December 6, 2024
Section 185.23 - Third Party Reports to the Board
(a) Any medical peer review committee in this state, any physician assistant licensed to practice in this state, any physician assistant student, or any physician licensed to practice medicine or otherwise lawfully practicing medicine in this state shall report relevant information to the board related to the acts of any physician assistant in this state if, in the opinion of the medical peer review committee, physician assistant, physician assistant student, or a physician, a physician assistant poses a continuing threat to the public welfare through his practice as a physician assistant. The duty to report under this section shall not be nullified through contract.
(b) 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 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 the care of individual patients; and
(2) the specific limitations imposed upon the physician assistant's clinical privileges, upon membership in the professional society or association, and the duration of such limitations.
(c) Reporting a Physician Assistant's Continuing Threat to the Public.
(1) Relevant information shall be reported to the board indicating that a physician assistant's practice poses a continuing threat to the public welfare and 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 a physician assistant's practice constitutes a continuing threat to the public welfare shall be made to the board as soon as possible after the peer review committee or the physician involved reaches that conclusion and is able to assemble the relevant information.
(d) Reporting Professional Liability Claims.
(1) Reporting responsibilities. The reporting form must be completed and forwarded to the board for each defendant physician assistant 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 a physician assistant. If a nonadmitted insurance carrier does not report or if the physician assistant has no insurance carrier, reporting shall be the responsibility of the physician assistant.
(2) Separate reports required and identifying information. One separate report shall be filed for each defendant physician assistant 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) Time frames 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 board's form for data required in Part II, there must be enough identification data available to staff to match the closure report to the original file. The data required to accomplish this include:
(i) name and license number of defendant physician assistant(s); and
(ii) name of plaintiff.
(B) A court order or a copy of the 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 Texas Department of Insurance.
(6) Definition. For the purposes of this subsection a professional liability claim or complaint shall be defined as a cause of action against a physician assistant 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 a physician assistant invented a device which may have injured a patient but the physician assistant has had no personal physician assistant-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
(8) Voluntary Reporting. Claims that are not required to be reported under this chapter may, however, be voluntarily reported.
(9) Reporting Form. The reporting form shall be as follows:

Attached Graphic

(10) 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 board, the licensee shall furnish to the board the following information within 14 days of the date of receipt of the board's request for said information:
(A) a completed questionnaire to provide summary information concerning the suit or claim;
(B) a completed questionnaire to provide information deemed necessary in assessing the licensee's competency;
(C) information on the status of any suit or claim previously reported to either the board or the medical board.
(e) Immunity and Reporting Requirements. A person, health care entity, medical peer review committee, or other entity that without malice furnishes records, information, or assistance to the board is immune from any civil liability arising from such act.

22 Tex. Admin. Code § 185.23

The provisions of this §185.23 adopted to be effective November 3, 2002, 27 TexReg 10027; amended to be effective June 29, 2006, 31 TexReg 5105; amended to be effective August 9, 2009, 34 TexReg 5133