The Texas Medical Board Rules include disciplinary sanction guidelines, designed to provide the TMB with guidance in assessing sanctions against licensees for violations of the Texas Medical Practice Act. 22 Tex. Admin. Code § 190.14. The sanction guidelines are “intended to promote consistent sanctions for similar violations, facilitate timely resolution of cases, and encourage settlements.” Id.
The purpose of enforcing sanctions is five-fold: protect the public, deter future violations, offer opportunities for rehabilitation, punish violators, and deter others from violating the Rules.
Guidelines Range from “Low” to “High” Sanctions
The outlined sanctions include a violation description, citation to the applicable Rule, and provide “a range from ‘Low Sanction’ to ‘High Sanction’ based upon any aggravating or mitigating factors that are found to apply in a particular case.” 22 Tex. Admin. Code § 190.14(1). The low or minimum sanctions are applicable to first-time violators. More severe or high sanctions are generally imposed when the Board finds multiple violations or aggravating factors.
Under the Texas Occupations Code, in determining the appropriate disciplinary action, the Board “shall consider whether the person:
(1) is being disciplined for multiple violations of this subtitle or a rule or order adopted under this subtitle;  or
(2) has previously been the subject of disciplinary action by the board.”
Tex. Occ. Code § 164.001(g)(2). When the TMB determines that multiple violations have occurred, or in cases where the licensee has been disciplined by the Board before, it will impose harsher sanctions and possibly license suspension or revocation.
Disciplinary Sanction Guidelines for Texas Doctors
A list of the sanctions subject to disciplinary action by the TMB can be viewed here. The following are examples of violations, the low sanction, then the high sanction.

  • Medical Records – failure to release or overcharging for:
    • Single Incident: Public reprimand and fine.
    • Multiple/Egregious : Suspension and/or revocation, significant administrative penalty, continuing medical education (CME) in ethics, JP exam.
  • Failure to keep proper medical records:
    • Remedial Plan: CME in appropriate area, $500 administration fine.
    • Agreed Order: 8 or more hours of medical recordkeeping, require in person attendance if practical, 8 to 12 cycles of chart monitoring, $2,000 administrative penalty, JP exam, PACE course in medical recordkeeping if prior order for inadequate record-keeping.
  • Failure to communicate with patient or other providers:
    • Single incident: Remedial Plan – 8 hours risk management CME to include patient communications, $500 administration fine.
    • Multiple instances: Agreed Order – public reprimand, risk management and communications CME, fine, counseling, IME.
  • Unregistered pain clinics, overprescribing:
    • License revocation.
  • Violation of Board Order:
    • Administrative in nature – Agreed Order: Administrative Penalty of $1,000.
    • Substantive in nature – extension of Order and increase the terms of the original Order.
    • Agreed Order: Low sanctions (above) plus – public reprimand, administrative penalty of $3,000 – $5,000.

For violations that are not specifically mentioned, the Board “shall apply a sanction that generally follows the spirit and scheme of the sanctions outlined in this rule.” 22 Tex. Admin. Code § 190.14(8).
It is important for Texas doctors to understand that alleged violations related to patient care are more serious than those involving only an administrative violation, and in some cases administrative violations will be handled informally.
Hire the Experienced Medical License Defense Attorneys of BERTOLINO LLP
If you have been notified of a complaint filed against you with the Texas Medical Board, BERTOLINO LLP can help. We are experienced medical license defense attorneys and we know how to navigate the TMB’s complaint process. Our results speak for themselves. We are prepared to represent you at any legal hearing or proceeding regarding your professional license, including:

  • Temporary Suspension Hearings
  • Informal Settlement Conferences (ISC)
  • Show Compliance Proceedings
  • State Office of Administrative Hearings (SOAH) Proceedings

BERTOLINO LLP represents licensed professionals across the entire State of Texas. If you are facing disciplinary action from a professional licensing board, contact us today or call (512) 887-7305 and schedule a case evaluation.

Call or text (512) 476-5757 or complete a Case Evaluation form