The Texas Physician Assistant Board (the Board) licenses and regulates physician assistants in Texas. If a patient files a complaint against you, the Board also handles the complaint and any ensuing disciplinary proceedings. If you find yourself in this situation, you should consult a physician assistant license attorney for help.
Complaints Against Physician Assistants
As per 22 Tex. Admin. Code § 185.20, physician assistants (PAs) are subject to the same complaint procedures as other medical professionals, including physicians. If the Board determines that it has jurisdiction over the complaint and that there is probable cause to justify further investigation, it will conduct an official investigation.
Under 22 Tex. Admin. Code § 178.7, after completing the investigation, the Board will determine whether the evidence indicates a violation of the rules or laws governing PAs has occurred. If so, the Board refers the case for an Informal Show Compliance and Settlement Conference (ISC), to be scheduled within 180 days of filing the complaint, except for good cause shown.
Grounds for Disciplinary Action Against Physician Assistants
PAs may face disciplinary action under 22 Tex. Admin. Code § 185.17. This section lists actions that may be grounds for disciplinary action, following notice and a hearing, as follows:
- fraudulently or deceptively obtains or attempts to obtain a license;
- fraudulently or deceptively uses a license;
- violates the laws or rules relating to the practice of a PA;
- is convicted of a felony or receives deferred adjudication or pretrial diversion for a felony;
- habitually uses drugs or intoxicating liqueurs to the extent that, in the opinion of the Board, the person cannot safely perform as a PA;
- has been adjudicated as mentally incompetent or has a mental or physical condition that renders the person unable to perform as a PA safely;
- has committed an act of moral turpitude, or an act involving baseness, vileness, or depravity in the private and social duties one owes to others or society in general, or an act committed with knowing disregard for justice, honesty, principles, or good morals;
- represents that the person is a physician;
- acts in an unprofessional or dishonorable manner that is likely to deceive, defraud, or injure any member of the public;
- fails to practice as a PA in an acceptable manner consistent with public health and welfare;
- commits any act that violates the laws of the State of Texas if the act is connected with practice as a PA;
- has their license or other authorization to practice as a PA suspended, revoked, or restricted or who has had other disciplinary action taken by another state regarding practice as a PA or had disciplinary action taken by the uniformed services of the United States;
- fails to keep complete and accurate records of purchases and disposal of drugs as required by law;
- writes a false or fictitious prescription for a scheduled or a dangerous drug as defined by Chapters 481 and 483, Health and Safety Code;
- prescribes, dispenses, or administers a drug or treatment that is nontherapeutic or nontherapeutic in the manner the drug or treatment is prescribed, dispensed, or administered;
- unlawfully advertises in a false, misleading, or deceptive manner;
- alters, with fraudulent intent, any PA license, certificate, or diploma;
- uses any PA license, certificate, or diploma that has been fraudulently purchased, issued, or counterfeited or that has been materially altered;
- aids or abets, directly or indirectly, the practice as a PA by any person not duly licensed to practice as a PA by the board;
- is removed or suspended or has disciplinary action taken by his peers in any professional association or society or is disciplined by a licensed hospital or medical staff of a hospital if that action, in the opinion of the Board, was based on unprofessional conduct or professional incompetence that was likely to harm the public;
- has repeated or recurring meritorious health care liability claims that, in the opinion of the Board, evidence of professional incompetence likely to harm the public;
- through his practice as a PA, sexually abuses or exploits another person; or
- violates an active board order.
Potential Sanctions Against PAs
PAs can face various potential sanctions in disciplinary proceedings, including administrative penalties, license suspension, probated license suspension, and license revocation. In determining the appropriate sanction in each disciplinary proceeding, the Board uses the same aggravating and mitigating factors that the Texas Medical Board uses in disciplinary proceedings under 22 Tex. Admin. Code § 190.15. Board staff has the burden of presenting evidence in support of any aggravating factors in a particular case, which may include:
- harm to one or more patients;
- the severity of patient harm;
- one or more violations that involve more than one patient;
- economic harm to any individual or entity and the severity of such harm;
- increased potential for harm to the public;
- attempted concealment of the act constituting a violation;
- intentional, premeditated, knowing, or grossly negligent act constituting a violation;
- prior similar violations;
- previous disciplinary action by the board, any government agency, peer review organization, or health care entity;
- violation of a board order; and
- other relevant circumstances increasing the seriousness of the misconduct.
Likewise, the Board may consider mitigating factors in determining the appropriate sanction for PAs in disciplinary proceedings. The license holder has the burden of providing the existence of any mitigating factors:
- self-reported and voluntary admissions of violation(s);
- implementation of remedial measures to correct or mitigate harm from the violation(s);
- acknowledgment of wrongdoing and willingness to cooperate with the board, as evidenced by the acceptance of an Agreed Order;
- rehabilitative potential;
- prior community service and present value to the community; and
- other relevant circumstances reducing the seriousness of or lessening responsibility for the misconduct.
The Texas Medical Board’s procedural rules for imposing administrative penalties also apply to the Physician Assistant Board in disciplinary proceedings. 22 Tex. Admin. Code § 187.76 provides that if the Board wishes to impose an administrative penalty in a disciplinary proceeding, it must issue a notice to the license holder that gives information regarding the allegations, states a 30-day deadline to respond, and a description of the assessment process. Then, the license holder may pay the proposed administrative penalty, provide a written response, or request a personal appearance before the Board.
If the license holder submits a written response, the Board will consider the response at its next regular meeting and decide whether to assess the administrative penalty. If the license holder requests a personal appearance, the Board will schedule an ISC to determine whether to dismiss or impose the administrative penalty.
Under 22 Tex. Admin. Code § 185.19, the administrative penalty for a violation may not exceed $5,000. However, every day a violation continues or occurs counts as a separate violation.
We Are Here to Help You Fight Back and Protect Your License
The physician assistant license defense lawyers of Bertolino LLP, can help you navigate the complaint process and gather the evidence you need to defend your license. In addition, we can fight back against misconduct allegations and work to clear your name. Call us today at (512) 515-9518 to reach the offices of Bertolino, LLP, or contact us online.