TBCE Proposes Amending Rules 75.2, and 75.5
Written by Editor   
Wednesday, September 09, 2015 01:55 PM

The Texas Board of Chiropractic Examiners (Board) proposes amending Chapter 75, §75.2 and §75.5, concerning Application for Licensure.  Red indicates newly added language.  Strikethrough indicates language to be deleted.

§75.2.Renewal of Chiropractic License.

(a) Annual renewal.

(1) Annual renewal of a licensee's license shall be accomplished on or before the first day of the licensee's birth month (first day of the birth month) by submitting:

(A) the license renewal form provided by the board;

(B) the renewal fee for an active license as provided in §78.6 of this title (relating to Required Fees and Charges);

(C) any late fees, if applicable, as provided in subsection (h) of this section; and

(D) verification of continuing education attendance as required by §75.5 of this title (relating to Continuing Education).

(2) Except as provided in §75.6 of this title (relating to Failure to Meet Continuing Education Requirements), incomplete submission of any of the information required for renewal shall not constitute a completed annual renewal and an annual renewal certificate shall not be issued.

(3) Prior to the due date for an annual renewal, a licensee may instead apply for inactive status in accordance with §75.4 of this title (relating to Inactive Chiropractic License Status).

(4) A military service member who holds a license is entitled to two (2) years of additional time to complete:

(A) any continuing education requirements; and

(B) any other requirement related to the renewal of the military service member's license.

(b) Locum tenens information.

(1) A licensee who substitutes as the treating doctor for another licensee in the facility of the absent licensee shall, along with the information required for annual renewal, provide a list of facilities in which they served as a locum tenens doctor during the past twelve month period.

(2) A licensee serving as a locum tenens doctor shall have proof of licensure readily available when requested. Proof of licensure may include:

(A) a copy of the current license renewal certificate; or

(B) a copy of the wallet size license.

(3) The locum tenens list shall include the following for each facility:

(A) licensee's name;

(B) facility physical address; and

(C) facility registration number displayed on the current facility registration card.

(4) If a facility registration number is not provided, a locum tenens doctor shall report the facility registration number as "not available." Licensees for whom facility numbers are reported as "not available" may be subject to investigation for the operation of an unregistered facility.

(c) Licensees in default of TGSLC student loan or repayment agreement.

(1) The board shall not renew a license of a licensee who is in default of a loan guaranteed by the Texas Guaranteed Student Loan Corporation (TGSLC) or a repayment agreement with the corporation except as provided in paragraphs (2) and (3) of this subsection.

(2) For a licensee in default of a loan, the board shall renew the license if:

(A) the renewal is the first renewal following notice to the board that the licensee is in default; or

(B) the licensee presents to the board a certificate issued by the corporation certifying that:

(i) the licensee has entered into a repayment agreement on the defaulted loan; or

(ii) the licensee is not in default on a loan guaranteed by the corporation.

(3) For a licensee who is in default of a repayment agreement, the board shall renew the license if the licensee presents to the board a certificate issued by the corporation certifying that:

(A) The licensee has entered into another repayment agreement on the defaulted loan; or

(B) the licensee is not in default on a loan guaranteed by the corporation or on a repayment agreement.

(4) This subsection does not prohibit the board from issuing an initial license to a person who is in default of a loan or repayment agreement but is otherwise qualified for licensure. However, the board shall not renew the license of such a licensee, if at the time of renewal, the licensee is in default of a loan or repayment agreement except as provided in paragraph (2)(B) or (3) of this subsection.

(d) Licensees in default of other student loans or scholarship obligations.

(1) This subsection applies to a licensee in default of a student loan other than a loan guaranteed by the TGSLC, in breach of a loan repayment agreement other than one related to a TGSLC loan, or in breach of any scholarship contract.

(2) The board may refuse to renew a chiropractic license if it receives information from an administering entity that the licensee has defaulted on a student loan or has breached a student loan repayment contract, or a scholarship contract by failing to perform his or her service obligation under the contract. The board may rescind a denial of renewal under this subsection upon receipt of information from an administering entity that the licensee whose renewal was denied is now in good standing, as provided in §72.3(b) of this title (relating to Qualifications of Applicants).

(e) Upon notice that a licensee is again in default or breach of any loan or agreement relating to a student loan or scholarship agreement under subsections (c) or (d) of this section, the board may suspend the license or take other disciplinary action as provided in §77.6 of this title (relating to Default on Student Loans and Scholarship Agreements).

(f) Opportunity for hearing.

(1) The board shall notify a licensee, in writing, of the nonrenewal of a license under subsection (c) or (d) of this section and of the opportunity for a hearing under paragraph (2) of this subsection prior to or at the time the annual renewal application is sent.

(2) Upon written request for a hearing by a licensee, the board shall set the matter for hearing before the State Office of Administrative Hearings in accordance with §78.8(d) of this title (relating to Complaint Procedures). A licensee shall file a request for a hearing with the board within 30 days from the date of receipt of the notice provided in paragraph (1) of this subsection.

(g) A license which is not renewed under subsection (c) or (d) of this section is considered expired. Subsections (h) and (i) of this section apply to a license not renewed under subsection (c) or (d) of this section.

(h) Expired license.

(1) If an active or inactive license is not renewed on or before the first day of the licensee's birth month of each year, it expires.

(2) If a person's license has expired for 90 days or less, the person may renew the license by paying to the board the required renewal fee and a late fee, as provided in §78.6 of this title (relating to Required Fees and Charges).

(3) If a person's license has expired for longer than 90 days, but less than one year, the person may renew the license by paying to the board the required renewal fee and a late fee, as provided in §78.6 of this title.

(4) Except as provided by paragraphs (5) and (6) of this subsection, if a person's license has expired for one year or longer, the person may not renew the license but may obtain a new license by submitting to reexamination and complying with the current requirements and procedures for obtaining an initial license.

(5) At the board's discretion, a person whose license has expired for one year or longer may renew without complying with paragraph (4) of this subsection if the person moved to another state or foreign country and is currently licensed in good standing and has been in practice in the other state or foreign country for two years preceding application for renewal. The person must also pay the board a fee equal to the examination fee, as provided in §78.6 of this title. A person is considered "currently licensed" if such person is licensed by another licensing board recognized by the Board. The Board shall recognize another licensing board that:

(A) has licensing requirements substantially equivalent to the requirements of the Chiropractic Act; and

(B) maintains professional standards considered by the Board to be equivalent to the standards under the Chiropractic Act.

(6) At the board's discretion, a person whose license has expired for one year but not more than three years may renew without complying with paragraph (4) of this subsection if the board determines that the person has shown good cause for the failure to renew the license and pays to the board:

(A) the required renewal fee for each year in which the licensee was expired; and

(B) an additional fee in an amount equal to the sum of:

(i) the jurisprudence examination fee, multiplied by the number of years the license was expired, prorated for fractional years; and

(ii) two times the jurisprudence examination fee.

(7) Good cause for the purposes of paragraph (6) of this subsection means extenuating circumstances beyond the control of the applicant which prevented the person from complying timely with subsection (a) of this section, such as extended personal illness or injury, extended illness of the immediate family, or military duty outside the United States where communication for an extended period is impossible. Good cause is not shown if the applicant was practicing chiropractic during the period of time that the applicant's license was expired. With the renewal application, an applicant must submit a notarized sworn affidavit and supporting documents that demonstrate good cause, in the opinion of the board.

(8) The Board shall exempt a person who holds a license issued by the Board from any increased fee or penalty imposed by the Board for failing to renew the license in a timely manner if the person establishes to the satisfaction of the Board that the failure to renew the license in a timely manner is because the person was serving as a military service member. For purposes of this section, "military service member" means a person who is on active duty.

(i) Practicing with an expired license. Practicing chiropractic with an expired license constitutes practicing chiropractic without a license. A licensee whose license expires shall not practice chiropractic until the license is renewed or a new license is obtained as provided by subsection (h) of this section, except for a license which is not renewed under subsection (c) or (d) of this section if the licensee has timely requested a hearing under subsection (f) of this section.

(j) 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 board. This explanation shall include all details as the board may request and shall be furnished within two weeks of the date of the board's request.  


§75.5.Continuing Education.

(a) Condition of Renewal. A licensee is required to attend continuing education courses as a condition of renewal of a license.

(b) Requirements.

(1) Every licensee shall attend and complete 16 hours of continuing education each year unless a licensee is exempted under subsection (d) of this section. Each licensee's reporting year shall begin on the first day of the month in which his or her birthday occurs.

(2) The 16 hours of continuing education may be completed at any course or seminar elected by the licensee, which has been approved under §75.7 of this title (relating to Approved Continuing Education Courses).

(A) A licensee must attend any course designated as a "TBCE Required Course," and the course may be counted as part of the 16 hour requirement. Effective with all doctor of chiropractic licenses renewed on or after July 1, 2009, a minimum of four of the 16 required hours of continuing education shall include topics designated by the board.

(i) A minimum of three hours of the total required continuing education shall consist of a course specifically related to the Board's rules including the Board's code of ethics, recordkeeping, documentation, and coding. This continuing education may be taken online through a course offered by the board. In addition to the requirements in §75.7 of this title, an instructor for this continuing education must meet one of the following criteria:

(I) possess a doctorate degree and possess either an active license to practice chiropractic or law;

(II) is part of the full-time faculty of a chiropractic college accredited by the Council of Chiropractic Education;

(III) is some other qualified health care provider; or

(IV) is an individual with substantial knowledge, skills and abilities in chiropractic practice.

(ii) A minimum of one hour of the total required continuing education shall relate to risk management relating to the practice of chiropractic in Texas. For the purpose of this rule, risk management refers to the identification, investigation, analysis, and evaluation of risks and the selection of the most advantageous method of correcting, reducing, or eliminating, identifiable risks. This continuing education may be taken online through a course offered by the board. In addition to the requirements in §75.7 of this title, an instructor for this continuing education must meet one of the following criteria:

(I) possess a doctorate degree and possess either an active license to practice chiropractic or law;

(II) is part of the full-time faculty of a chiropractic college accredited by the Council of Chiropractic Education;

(III) is some other qualified health care provider; or

(IV) is an individual with substantial knowledge, skills and abilities in chiropractic practice.

(iii) Notwithstanding the requirements in this clause, licensees who were initially licensed on or after September 1, 2012, must complete at least eight hours of continuing education in coding and documentation for Medicare claims no later than their second renewal period unless they are in exempted status as noted in subsection (d) of this section. The eight hours of required continuing education in coding and documentation for Medicare claims may be counted as part of the total of 16 continuing education hours required during the year in which the eight hours were completed.

(iv) In addition, from time to time, the board may issue public memoranda regarding urgent or significant public health issues that licensees need to be aware of. The board will publish such memoranda on the board's web site and distribute the memoranda to the major continuing education providers.

(B) A licensee who serves as an examiner for the National Board of Chiropractic Examiners' Part IV Examination may receive credit for this activity, not to exceed eight (8) hours each year.

(C) No more than ten hours or credit may be obtained through online courses. This provision will become effective on or after January 1, 2016.

(3) A list of approved courses, including TBCE Required Courses, is available on the board's website, www.tbce.state.tx.us, as provided in §75.7(g) of this title. The board will also provide notice of a TBCE Course in its newsletter.

(4) A licensee who is unable to travel for the purpose of attending a continuing education course or seminar due to a mental or physical illness or disability may satisfy the board's continuing education requirements by completing 16 hours of approved continuing education courses online. Video courses will no longer qualify for credit.

(A) If the licensee is unable to take an online course, the licensee must submit a request for special accommodations to complete their continuing education requirements.

(B) In order for an online course to be accepted by the board, a licensee must submit a letter from a licensed doctor of chiropractic, medicine, or osteopathy who is not associated with the licensee in any manner. In the letter, the doctor must state the nature of the illness or disability and certify that the licensee was ill or disabled, and unable to travel for the purpose of obtaining continuing education hours due to the illness or disability.

(C) A licensee is required to submit a new certificate for each year an exemption is sought. An untrue certification submitted to the board shall subject the licensee to disciplinary action as authorized by the Chiropractic Act, Occupations Code §201.501 and §201.502.

(D) The ten hour limit provided in subsection (b)(2) of this section for online courses does not apply to a licensee who submits a certification under this subsection. This provision will become effective on or after January 1, 2016.

(c) Verification.

(1) At the request of the Board, a licensee shall submit, to the board, written verification from each sponsor, of the licensee's attendance at and completion of each continuing education course which is used in the fulfillment of the required hours for all years requested.

(2) A licensee submitting hours as a National Boards examiner must submit written verification of the licensee's participation from the National Boards, on National Boards letterhead. The verification must include the licensee's name, board license number, and the date, time, and place of each examination attended by the licensee as an examiner.

(3) Failure to submit verification as required by paragraph (1) of this subsection shall be considered the same as failing to meet the continuing education requirements of subsection (b) of this section.

(d) Qualifying exemption. The following persons are exempt from the requirements of subsection (b) of this section:

(1) a licensee who holds an inactive Texas license. However, if at any time during the reporting year for which such exemption applies such person desires to practice chiropractic, such person shall not be entitled to practice chiropractic in Texas until all required hours of continuing education credits are obtained and the executive director has been notified of completion of such continuing education requirements;

(2) a licensee who is military service member, military veteran, or military spouse [served in the regular armed forces] of the United States during part of the 12 months immediately preceding the annual license renewal date;

(3) a licensee who submits proof satisfactory to the board that the licensee suffered a mental or physical illness or disability which prevented the licensee from complying with the requirements of this section during the 12 months immediately preceding the annual license renewal date; or

(4) a licensee who is in their first renewal period.

(e) A military service member who holds a license is entitled to two (2) years of additional time to complete:

(1) any continuing education requirements; and 

(2) any other requirement related to the renewal of the military service member's license.