TITLE 22. EXAMINING BOARDS

PART 9. TEXAS MEDICAL BOARD

CHAPTER 160. MEDICAL PHYSICISTS

22 TAC §160.31

The Texas Medical Board (Board) adopts new §160.31, concerning exemption from licensure for certain military spouses for medical physicists. The new rule is being adopted without changes to the proposed text as published in the September 6, 2019, issue of the Texas Register (44 TexReg 4814). The adopted will not be republished.

The new rule is mandated by the passage of SB 1200 (86th Regular Legislative Session) and relates to exemption from licensure for certain military spouses. This rule allows qualified military spouses to practice medical physics without obtaining a medical physicist license during the time the military service member to whom the military spouse is married is stationed at a military installation in Texas. The exemption cannot exceed three years, and practice must be authorized by the Board after verifying that the military spouse holds an active license in good standing in another state with substantially equivalent requirements for licensure as Texas.

The Board has determined that the public benefit anticipated as a result of enforcing this section will be to increase patient accessibility to properly licensed, trained, and educated providers.

Written comments were received from The American Association of Physicists in Medicine regarding the new rule.

The American Association of Physicists in Medicine's comments identified two issues. The first issue was seeking clarity as the term "advisory committee," related to determining substantial equivalence. The second issue was the concern that licensing should be required.

The Texas Medical Board's response to AAPM was that the "advisory committee" is understood to the Medical Physicist Committee. The Board declined to make the clarification as unnecessary The statute is clear as to the authority related to educational standards is vested in the Medical Physicists Committee. The second change is declined because the exemption is statutory and cannot be changed by rule. No one appeared in person to testify regarding the rules at the public hearing on October 18, 2019.

Consistent with the reasoning stated above, the Board did not make the recommended changes and clarifications to the rule and submits the rule herein and proceeds with the adoption of §160.31.

The new rule is adopted under the authority of SB 1200 Texas Occupations Code §153.001 which provides authority for the Board to adopt rules necessary to administer and enforce the Medical Practice Act, and to adopt rules necessary to regulate medical physicists. The new rule is also proposed under Texas Occupations Code §602.151 which mandates the Board to adopt rules to implement that section.

The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on October 28, 2019.

TRD-201903991

Scott Freshour

General Counsel

Texas Medical Board

Effective date: November 17, 2019

Proposal publication date: September 6, 2019

For further information, please call: (512) 305-7016


CHAPTER 161. GENERAL PROVISIONS

The Texas Medical Board (Board) adopts amendments to 22 TAC §161.1, concerning Introduction, §161.2, concerning Purpose and Functions, §161.3, concerning Organization and Structure, §161.4, concerning Officers of the Board, §161.5, concerning Meetings, §161.6, concerning Committees of the Board and the repeal of §§161.8, 161.9, 161.11 - 161.13, without changes to the proposed text as published in the September 13, 2019, issue of the Texas Register (44 TexReg 4930). The adopted rules will not be republished.

The Board determined that the amendments and deletions were necessary to accurately reflect the operations of the board and eliminate obsolete committees and their related functions.

The Board has determined that the public benefit anticipated as a result of enforcing this adoption will be to simplify and clarify the functions and operations of the board that are not otherwise clearly set out in statute. This increases public ability to understand the functions and duties of the board.

The adopted amendment to §161.1, relating to Introduction, adds language to recognize and include all advisory board and committees under TMB authority. The proposed amendment also deleted unnecessary repetitive statutory language.

The adopted amendment to §161.2, relating to Purpose and Functions, adds language to recognize and include all advisory board and committees under TMB authority, and the role of the board in determining qualifications and eligibility criteria for certain licenses and permits.

The adopted amendment to §161.3, relating to Organization and Structure, deletes unnecessary repetitive statutory language. The proposed amendment simplified rules relating to standards of eligibility, conduct, and potential grounds for removal of board members.

The adopted amendment to §161.4, relating to Officers of the Board, removes an incorrect word.

The adopted amendment to §161.5, relating to Meetings, deletes reference to certain committees that are disbanded, obsolete or unnecessary.

The adopted amendment to §161.6, relating to Committees of the Board, deletes unnecessary repetitive statutory language.

The repeal of §161.8, relating to Chief of Staff, deletes unnecessary repetitive statutory language.

The repeal of §161.9, relating to Medical Director, deletes unnecessary repetitive statutory language.

The repeal of §161.11, relating to Rule Changes, deletes unnecessary repetitive statutory language.

The repeal of §161.12, relating to Compliance with Non-Discrimination Laws, deletes unnecessary repetitive statutory language.

The repeal of §161.13, relating to General Considerations, deletes unnecessary repetitive statutory language.

No written comments were received and no one appeared in person to testify regarding the rules at the public hearing on October 18, 2019.

22 TAC §§161.1 - 161.6

The amendments are adopted under the authority of the Texas Occupations Code Annotated, 153.001, which provides authority for the Board to adopt rules necessary to administer and enforce the Medical Practice Act.

The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on October 25, 2019.

TRD-201903976

Scott Freshour

General Counsel

Texas Medical Board

Effective date: November 14, 2019

Proposal publication date: September 13, 2019

For further information, please call: (512) 305-7016


22 TAC §§161.8, 161.9, 161.11 - 161.13

The repeals are adopted under the authority of the Texas Occupations Code Annotated, 153.001, which provides authority for the Board to adopt rules necessary to administer and enforce the Medical Practice Act.

The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on October 25, 2019.

TRD-201903977

Scott Freshour

General Counsel

Texas Medical Board

Effective date: November 14, 2019

Proposal publication date: September 13, 2019

For further information, please call: (512) 305-7016


CHAPTER 163. LICENSURE

22 TAC §163.3

The Texas Medical Board (Board) adopts new rule §163.3, concerning exemption from licensure for certain military spouses for physicians. The new rule is being adopted without changes to the proposed text as published in the September 6, 2019, issue of the Texas Register (44 TexReg 4815). The adopted rule will not be republished.

The new rule is mandated by the passage of SB 1200 (86th Regular Legislative Session) and relates to exemption from licensure for certain military spouses who are physicians. New rule, §163.3 Exemption from Licensure for Certain Military Spouses regarding Physicians, allows qualified military spouses to practice medicine without obtaining a license during the time the military service member to whom the military spouse is married is stationed at a military installation in Texas. The exemption cannot exceed three years, and practice must be authorized by the Board after verifying that the military spouse holds an active license in good standing in another state with substantially equivalent requirements for licensure as Texas.

The Board has determined that the public benefit anticipated as a result of enforcing this proposal will be to increase patient accessibility to properly licensed, trained, and educated providers.

No written comments were received and no one appeared in person to testify regarding the rules at the public hearing on October 18, 2019.

The new rule is adopted under the authority of SB 1200 Texas Occupations Code §153.001, which provides authority for the Board to adopt rules necessary to administer and enforce the Medical Practice Act, and to adopt rules necessary to regulate physicians. The new rule is also proposed under Texas Occupations Code §55.0041, which mandates the Board to adopt rules to implement that section.

The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on October 28, 2019

TRD-201903994

Scott Freshour

General Counsel

Texas Medical Board

Effective date: November 17, 2019

Proposal publication date: September 6, 2019

For further information, please call: (512) 305-7016


CHAPTER 183. ACUPUNCTURE

22 TAC §183.27

The Texas Medical Board (Board) adopts new rule §183.27, concerning exemption from licensure for certain military spouses for acupuncturists. The new rule is being adopted without changes to the proposed text as published in the September 6, 2019, issue of the Texas Register (44 TexReg 4819). The adopted rule will not be republished.

The new rule is mandated by the passage of SB 1200 (86th Regular Legislative Session) and relates to exemption from licensure for certain military spouses. New rule §183.27, Exemption from Licensure for Certain Military Spouses regarding acupuncturists, allows qualified military spouses to practice acupuncture without obtaining a license during the time the military service member to whom the military spouse is married is stationed at a military installation in Texas. The exemption cannot exceed three years, and practice must be authorized by the Board after verifying that the military spouse holds an active license in good standing in another state with substantially equivalent requirements for licensure as Texas.

The Board has determined that the public benefit anticipated as a result of enforcing this proposal will be to increase patient accessibility to properly licensed, trained, and educated providers.

No written comments were received and no one appeared in person to testify regarding the rules at the public hearing on October 19, 2019.

The new rule is adopted under the authority of SB 1200 Texas Occupations Code §153.001, which provides authority for the Board to adopt rules necessary to administer and enforce the Medical Practice Act and to adopt rules necessary to regulate acupuncturists. The new rule is also proposed under Texas Occupations Code §205.101, which mandates the Board to adopt rules to implement that section.

The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on October 28, 2019

TRD-201903995

Scott Freshour

General Counsel

Texas Medical Board

Effective date: November 17, 2019

Proposal publication date: September 6, 2019

For further information, please call: (512) 305-7016


CHAPTER 185. PHYSICIAN ASSISTANTS

22 TAC §185.33

The Texas Medical Board (Board) adopts new rule §185.33, concerning exemption from licensure for certain military spouses for physician assistants. The new rule is being adopted without changes to the proposed text as published in the September 6, 2019, issue of the Texas Register (44 TexReg 4821). The adopted rule will not be republished.

The new rule is mandated by the passage of SB 1200 (86th Regular Legislative Session) and relates to exemption from licensure for certain military spouses. New rule §185.33, Exemption from Licensure for Certain Military Spouses, allows qualified military spouses to practice as a physician assistant without obtaining a license during the time the military service member to whom the military spouse is married is stationed at a military installation in Texas. The exemption cannot exceed three years, and practice must be authorized by the Board after verifying that the military spouse holds an active license in good standing in another state with substantially equivalent requirements for licensure as Texas.

The Board has determined that the public benefit anticipated as a result of enforcing this proposal will be to increase patient accessibility to properly licensed, trained, and educated providers.

No written comments were received and no one appeared in person to testify regarding the rules at the public hearing on October 18, 2019.

The new rule is adopted under the authority of SB 1200 (86th Regular Legislative Session), Texas Occupations Code §153.001 which provides authority for the Board to adopt rules necessary to administer and enforce the Medical Practice Act and to adopt rules necessary to regulate physician assistants. The new rule is also proposed under Texas Occupations Code §204.101 which mandates the Board to adopt rules to implement that section.

The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on October 28, 2019

TRD-201903990

Scott Freshour

General Counsel

Texas Medical Board

Effective date: November 17, 2019

Proposal publication date: September 6, 2019

For further information, please call: (512) 305-7016


CHAPTER 186. RESPIRATORY CARE PRACTITIONERS

22 TAC §186.30

The Texas Medical Board (Board) adopts new rule §186.30, concerning exemption from licensure for certain military spouses for respiratory care practitioners. The new rule is being adopted without changes to the proposed text as published in the September 6, 2019, issue of the Texas Register (44 TexReg 4822). The adopted rule will not be republished.

The new rule is mandated by the passage of SB 1200 (86th Regular Legislative Session) and relates to exemption from licensure for certain military spouses. New rule §186.30, Exemption from Licensure for Certain Military Spouses regarding respiratory care practitioners, allows qualified military spouses to practice as a respiratory care practitioner without obtaining a license during the time the military service member to whom the military spouse is married is stationed at a military installation in Texas. The exemption cannot exceed three years, and practice must be authorized by the Board after verifying that the military spouse holds an active license in good standing in another state with substantially equivalent requirements for licensure as Texas.

The Board has determined that the public benefit anticipated as a result of enforcing this proposal will be to increase patient accessibility to properly licensed, trained, and educated providers.

No written comments were received and no one appeared in person to testify regarding the rules at the public hearing on October 18, 2019.

The new rule is adopted under the authority of SB 1200 Texas Occupations Code §153.001 which provides authority for the Board to adopt rules necessary to administer and enforce the Medical Practice Act and to adopt rules necessary to regulate respiratory care practitioners. The new rule is also proposed under Texas Occupations Code §604.052 which mandates the Board to adopt rules to implement that section.

The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on October 28, 2019.

TRD-201903998

Scott Freshour

General Counsel

Texas Medical Board

Effective date: November 17, 2019

Proposal publication date: September 6, 2019

For further information, please call: (512) 305-7016


CHAPTER 188. PERFUSIONISTS

22 TAC §188.30

The Texas Medical Board (Board) adopts new rule §188.30, concerning exemption from licensure for certain military spouses for perfusionists. The new rule is being adopted without changes to the proposed text as published in the September 6, 2019, issue of the Texas Register (44 TexReg 4823). The adopted rule will not be republished.

The adopted new rule is mandated by the passage of SB 1200 (86th Regular Legislative Session) and relates to exemption from licensure for certain military spouses. New rule §188.30, Exemption from Licensure for Certain Military Spouses regarding perfusionists, allows qualified military spouses to practice as a perfusionist without obtaining a license during the time the military service member to whom the military spouse is married is stationed at a military installation in Texas. The exemption cannot exceed three years, and practice must be authorized by the Board after verifying that the military spouse holds an active license in good standing in another state with substantially equivalent requirements for licensure as Texas.

The Board has determined that the public benefit anticipated as a result of enforcing this proposal will be to increase patient accessibility to properly licensed, trained, and educated providers.

No written comments were received and no one appeared in person to testify regarding the rules at the public hearing on October 18, 2019.

The new rule is adopted under the authority of SB 1200 Texas Occupations Code §153.001 which provides authority for the Board to adopt rules necessary to administer and enforce the Medical Practice Act and to adopt rules necessary to regulate perfusionists. The new rule is also proposed under Texas Occupations Code §603.151 which mandates the Board to adopt rules to implement that section.

The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on October 28, 2019

TRD-201903997

Scott Freshour

General Counsel

Texas Medical Board

Effective date: November 17, 2019

Proposal publication date: September 6, 2019

For further information, please call: (512) 305-7016


CHAPTER 194. MEDICAL RADIOLOGICAL TECHNOLOGY

SUBCHAPTER A. CERTIFICATE HOLDERS, NON-CERTIFIED TECHNICIANS, AND OTHER AUTHORIZED INDIVIDUALS OR ENTITIES

22 TAC §§194.2, 194.6, 194.7, 194.10, 194.21, 194.34

The Texas Medical Board (Board) adopts amendments to Subchapter A, Certificate Holders, Non-Certified Technicians, and Other Authorized Individuals or Entities regarding §194.2, concerning Definitions, §194.6, concerning Procedural Rules and Minimum Eligibility Requirements for Applicants for a Certificate or Placement on the Board's Non-Certified Technician Registry, §194.7, concerning Biennial Renewal of Certificate or Placement on the Board's Non-Certified Technician Registry, §194.10, concerning Retired Certificate or NCT Registration, §194.21, concerning Scope of Practice, and new §194.34, Exemption from Licensure for Certain Military Spouses.

The amendments to §§194.2, 194.6, 194.7, 194.10, 194.21, and new §194.34, are being adopted with changes to the proposed text as published in the September 6, 2019, issue of the Texas Register (44 TexReg 4825), incorporating stakeholder feedback. The adopted rules will be republished.

The adopted amendment to §194.2, relating to Definitions, is amended with new definitions for "Certification Board for Radiology Practitioner Assistants", "radiologist", and "radiologist assistant." The amended section is adopted with changes to the proposed text as published in the September 6, 2019, issue of the Texas Register (44 TexReg 4825), amending the definitions for "podiatrist" so that the licensing entity is accurately reflected to be the Texas Department of Licensing and Regulation, and podiatric medical degree accurately described.

The adopted amendment to §194.6, relating to Procedural Rules and Minimum Eligibility Requirements for Applicants for a Certificate or Placement on the Board's Non-Certified Technician General Registry, is adopted with non-substantive changes to the proposed text as published in the September 6, 2019, issue of the Texas Register (44 TexReg 4825), so that individuals performing radiologic procedures under the supervision of a podiatrist are not required to register with the Texas Board of Medical Radiologic Technology (MRT Board). The language is added in accordance with HB 2847 (86th Legislature), which transferred the authority for registering such individuals from the MRT Board to the Texas Department of Licensure and Regulation. In addition, the adopted new language establishes eligibility requirements that must be met in order for an applicant to obtain a temporary or regular radiologist assistant certificate, pursuant to HB 1504 (86th Legislature). Other amendments delete references to the NCT "general" registry, a distinction no longer required after the passage of SB 674 (85th Regular Session), which eliminated the NCT secondary registry with the Texas Medical Board. Finally, adopted amendments represent changes necessitated by the new language to maintain consistency and clarity throughout the section.

The adopted amendments to §194.7, relating to Biennial Renewal of Certificate or Placement on the Board's General Registry for Non-Certified Technicians Generally, contain new language establishing continuing education requirements that must be met in order for a radiologist assistant certificate holder to renew a certificate, in accordance with HB 1504.

The adopted amendments are further added to clarify that certificate holders and NCTs are required to "complete activities" meeting the RCEEM or RCEEM+ designation, as opposed to "attendance and participation in formal activities", reflecting that web-based courses are formats that comply with the continuing education requirements.

The adopted amendments are made to language mandating the denial of an application for renewal of a certificate or NCT registration upon notice of a Texas Guaranteed Student Loan Corporation guaranteed student loan is proposed for repeal, in accordance with SB 37 (86th Legislature).

Other adopted amendments delete references to the NCT "general" registry, a distinction no longer required after the passage of SB 674 (85th Regular Session), which eliminated the NCT secondary registry with the Texas Medical Board. Remaining amendments represent changes necessitated by the new language related to radiologist assistant certificates, to maintain consistency and clarity throughout the section.

The adopted amendment to §194.10, relating to Retired Certificate or NCT General Registration Permit, is amended so that references to the NCT "general" registry are eliminated throughout, a distinction no longer required after the passage of SB 674 (85th Regular Session). Language is added with a reference to the Certification Board for Radiology Practitioner Assistants (CBRPA) related to possible certification renewal requirements for a radiologist assistant with a retired certificate, who desires to return to active practice and who had initially obtained eligibility for a Texas certificate through CBRPA national certification. The proposed language reflects the new radiologist assistant eligibility requirements established by HB 1504 (86th Legislature).

The adopted amendment to §194.21, relating to Scope of Practice, includes proposed changes to more precisely outline the allowed scope of practice for an individual holding a limited certificate.

New §194.34, Exemption from Licensure for Certain Military Spouses (regarding Medical Radiologic Technologists), allows qualified military spouses to practice medical radiological technology without obtaining a license during the time the military service member to whom the military spouse is married is stationed at a military installation in Texas. The exemption cannot exceed three years, and practice must be authorized by the Board after verifying that the military spouse holds an active license in good standing in another state with substantially equivalent requirements for licensure as Texas. The adopted new rule is mandated by the passage of SB 1200 (86th Legislature).

The Board has determined that the public benefit anticipated as a result of enforcing this adoption will be to have rules implementing and defining the requirements set forth by HB 1504, HB 2847, and SB 37 (86th Legislature). Further the adopted amendments will reflect compliance with SB 674 (85th Regular Session), which eliminated the NCT secondary registry. The public will also benefit from having rules that contain language accurately reflecting current laws and board processes.

One written comment was received from the Texas Department of Licensing and Regulation, recommending changes to §194.2 and §194.6 as published in the September 6, 2019, issue to reflect HB 2847's passage. The Board agreed with the recommended changes and adopted the amendments as outlined in the above summary. No one appeared in person to testify regarding the rules at the public hearing on October 18, 2019.

The amendments and new rule are adopted under the authority of the Texas Occupations Code Annotated, §153.001, which provides authority for the Board to adopt rules necessary to administer and enforce the Medical Practice Act. The amendments and new rule are also adopted under the authority of HB 1504 (86th Legislature), SB 37 (86th Legislature), HB 2847 (86th Legislature), SB 37 (86th Legislature), and SB 674 (85th R.S.).

§194.2.Definitions.

The following words and terms, when used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise.

(1) ABHES--Accrediting Bureau of Health Education Schools.

(2) Act--The Medical Radiologic Technologist Certification Act, Texas Occupations Code, Chapter 601.

(3) Active duty--A person who is currently serving as full-time military service member in the armed forces of the United States or active duty military service as a member of the Texas military forces, as defined by §437.001, Government Code, or similar military service of another state.

(4) Agency--The divisions, departments, and employees of the board, Texas Medical Board, Texas Physician Assistant Board, Texas State Board of Acupuncture Examiners, Medical Physicist Licensure Advisory Committee; Perfusionist Licensure Advisory Committee; and Texas Board of Respiratory Care.

(5) APA--The Administrative Procedure Act, Texas Government Code, Chapter 2001 as amended.

(6) Applicant--A person who files an application with the board for a certificate, including a temporary certificate, general, limited, or a provisional certificate; or a person or program who files an application with the board for approval to act as an instructor or educational program.

(7) Armed forces of the United States--Army, Navy, Air Force, Coast Guard, or Marine Corps of the United States or a reserve unit of one of those branches of the armed forces.

(8) ARRT--The American Registry of Radiologic Technologists and its predecessor or successor organizations.

(9) ASRT--The American Society of Radiologic Technologists and its predecessor or successor organizations.

(10) Board--The Texas Board of Medical Radiologic Technology.

(11) Cardiovascular (CV)--Limited to radiologic procedures involving the use of contrast media and or ionizing radiation for the purposes of diagnosing or treating a disease or condition of the cardiovascular system.

(12) CBRPA--Certification Board for Radiology Practitioner Assistants.

(13) Certificate--A medical radiologic technologist certificate, general, limited or provisional, issued by the board.

(14) Chiropractor--A person who is licensed by the Texas Board of Chiropractic Examiners as a doctor of chiropractic.

(15) Dentist--A person who is licensed by the Texas State Board of Dental Examiners as a doctor of dentistry.

(16) Direct supervision--Supervision and control by a medical radiologic technologist or a practitioner who:

(A) assumes legal liability for a student employed to perform a radiologic procedure and enrolled in a program that meets the requirements adopted under Texas Occupations Code Section 601.052; and

(B) is physically present during the performance of the radiologic procedure to provide consultation or direct the action of the student.

(17) Education program--Clinical training or any other program offered by an organization approved by the advisory board that:

(A) has a specified objective;

(B) includes planned activities for participants; and

(C) uses an approved method for measuring the progress of participants.

(18) Executive director--The executive director of the Agency or the authorized designee of the executive director.

(19) Federally qualified health center (FQHC)--A health center as defined by 42 United States Code, §1396d(L)(2)(B).

(20) Fluorography--Hard copy of a fluoroscopic image; also known as spot films.

(21) Fluoroscopy--The practice of examining tissues using a fluorescent screen, including digital and conventional methods.

(22) General certification--An authorization to perform radiologic procedures.

(23) Good professional character--An applicant for licensure must not be in violation of or have committed any act described in the Medical Radiologic Technologist Certification Act, §§601.302-.303, Texas Occupations Code Annotated.

(24) Hospital--A facility that:

(A) is:

(i) a general hospital or a special hospital, as those terms are defined by §241.003, Health and Safety Code, including a hospital maintained or operated by the state; or

(ii) a mental hospital licensed under Chapter 577, Health and Safety Code; and

(B) has an organized medical staff.

(25) Instructor--An individual approved by the board to provide instruction and training in the discipline of medical radiologic technology in an educational setting.

(26) JRCCVT--The Joint Review Committee on Education in Cardiovascular Technology.

(27) JRCERT--The Joint Review Committee on Education in Radiologic Technology.

(28) JRCNMT--The Joint Review Committee on Educational Programs in Nuclear Medicine Technology.

(29) Limited certification--An authorization to perform radiologic procedures that are limited to specific parts of the human body.

(30) Limited medical radiologic technologist (LMRT)--A person who holds a limited certificate issued under the Act, and who under the direction of a practitioner, intentionally administers radiation to specific parts of the bodies of other persons for a medical purpose. The limited categories are the skull, chest, spine, extremities, podiatric, chiropractic and cardiovascular. The term does not include a practitioner.

(31) Medical Board--The Texas Medical Board.

(32) Medical radiologic technologist (MRT)--A person who holds a general certificate issued under the Act, and who under the direction of a practitioner, intentionally administers radiation to other persons for medical purpose. The term does not include a practitioner.

(33) Military service member--A person who is on active duty.

(34) Military spouse--A person who is married to a military service member.

(35) Military veteran--A person who served on active duty and who was discharged or released from active duty.

(36) Mobile service operation--The provision of radiation machines and personnel at temporary sites for limited time periods. The radiation machines may be fixed inside a motorized vehicle or may be a portable radiation machine that may be removed from the vehicle and taken into a facility for use.

(37) NMTCB--Nuclear Medicine Technology Certification Board and its successor organizations.

(38) Non-certified technician (NCT)--A person who has completed a training program approved by the board and who is registered with the board under this chapter. An NCT may not perform a radiologic procedure which has been identified as dangerous or hazardous.

(39) Open Meetings Act--Texas Government Code Annotated, Chapter 551 as amended.

(40) Party--The board and each person named or admitted as a party in a hearing before the State Office of Administrative Hearings.

(41) Pediatric--Pertaining to radiologic procedures performed on a person who is between the age range of fetus to age 18 or as otherwise defined by Texas law, when the growth and developmental processes are generally complete. These rules do not prohibit a practitioner from taking into account the individual circumstances of each patient and determining if the upper age limit requires variation by not more than two years.

(42) Physician--A person licensed by the Texas Medical Board as a doctor of medicine or osteopathy.

(43) Physician assistant--A person licensed by the Texas Physician Assistant Board to practice as a physician assistant.

(44) Podiatrist--A person licensed by the Texas State Board of Podiatric Medical Examiners as a doctor of podiatry.

(45) Practitioner--A chiropractor, dentist, physician, or podiatrist who prescribes radiologic procedures for other persons.

(46) Presiding Officer--The person designated by the Governor to serve as the presiding officer of the board.

(47) Provisional medical radiologic technologist (PMRT)--A person who holds a provisional certificate issued under the Act, and who, under the direction of a practitioner, intentionally administers radiation to other persons for a medical purpose. The authorization to perform radiologic procedures under the provisional certificate shall not exceed 180 days from date of the certificate's issuance. The term does not include a practitioner.

(48) Radiation--Ionizing radiation:

(A) in amounts beyond normal background levels; and

(B) from a source such as a medical or dental radiologic procedure.

(49) Radiologic procedure--A procedure or article, including a diagnostic X-ray or a nuclear medicine procedure, that:

(A) is intended for use in:

(i) the diagnosis of disease or other medical or dental conditions in humans; or

(ii) the cure, mitigation, treatment, or prevention of disease in humans; and

(B) achieves its intended purpose through the emission of ionizing radiation.

(50) Radiologic technology--The administration of radiation to a person for a medical purpose.

(51) Radiologist--a physician specializing in radiology certified by or board-eligible for the American Board of Radiology, the American Osteopathic Board of Radiology, the Royal College of Radiologists, or the Royal College of Physicians and Surgeons of Canada.

(52) Radiologist assistant (RA)--an advanced-level medical radiologic technologist who is certified as:

(A) a registered radiologist assistant by the American Registry of Radiologic Technologists; or

(B) a radiology practitioner assistant by the Certification Board for Radiology Practitioner Assistants.

(53) Registered nurse--A person licensed by the Texas Board of Nursing to practice professional nursing.

(54) Registry--A list of names and other identifying information of non-certified technicians registered with the board.

(55) SACS--The Southern Association of Colleges and Schools, Commission on Colleges.

(56) Sponsoring institution--A hospital, educational, other facility, or a division thereof, that offers or intends to offer a course of study in medical radiologic technology.

(57) State--Any state, territory, or insular possession of the United States and the District of Columbia.

(58) Submit--The term used to indicate that a completed item has been actually received and date-stamped by the board along with all required documentation and fees, if any.

(59) Supervision--Responsibility for and control of quality, radiation safety and protection, and technical aspects of the application of ionizing radiation to human beings for diagnostic and/or therapeutic purposes.

(60) Temporary certification, general or limited--An authorization to perform radiologic procedures for a limited period, not to exceed one year.

(61) X-ray equipment--An x-ray system, subsystem, or component thereof. For the purposes of this rule, the types of X-ray equipment are as follows:

(A) portable X-ray equipment--X-ray equipment mounted on a permanent base with wheels and/or casters for moving while completely assembled. Portable X-ray equipment may also include equipment designed to be hand-carried;

(B) stationary X-ray equipment--X-ray equipment that is installed in a fixed location; or

(C) mobile stationary X-ray equipment--X-ray equipment that is permanently affixed to a motor vehicle or trailer with appropriate shielding.

§194.6.Procedural Rules and Minimum Eligibility Requirements for Applicants for a Certificate or Placement on the Board's Non-Certified Technician Registry.

(a) Except as otherwise provided in this chapter, an individual must be certified or hold a temporary certificate as a radiologist assistant, medical radiologic technologist or limited radiologic technologist, or be placed by the board on the registry for non-certified technicians before the individual may perform a radiologic procedure.

(b) Types of Certificates. The board shall issue general certificates, limited certificates, temporary certificates (general or limited), or provisional certificates.

(c) General Requirements.

(1) Except as otherwise required in this section, an applicant for temporary or regular certification as an RA, MRT, or LMRT, or registration as an NCT must:

(A) graduate from high school or its equivalent as determined by the Texas Education Agency;

(B) attain at least 18 years of age;

(C) submit an application on a form prescribed by the board;

(D) pay the required application fee, as set forth under Chapter 175 of this title (relating to Fees and Penalties);

(E) provide a complete and legible set of fingerprints, on a form prescribed by the board, to the board or to the Department of Public Safety for the purpose of obtaining criminal history record information from the Department of Public Safety and the Federal Bureau of Investigation;

(F) certify that the applicant is mentally and physically able to perform radiologic procedures;

(G) not have a license, certification, or registration in this state or from any other licensing authority or certifying professional organization that is currently revoked or suspended;

(H) not have proceedings that have been instituted against the applicant for the restriction, cancellation, suspension, or revocation of certificate, license, or authority to perform radiologic procedures in the state, a Canadian province, or the uniformed service of the United States in which it was issued;

(I) not have pending any prosecution against applicant in any state, federal, or international court for any offense that under the laws of this state is a felony, or an offense that is a misdemeanor of moral turpitude;

(J) be of good professional character as defined under §194.2 of this title (relating to Definitions);

(K) submit to the board any other information the board considers necessary to evaluate the applicant's qualifications; and

(L) meet any other requirement established by rules adopted by the board.

(2) The board retains the discretion to consider the nature of any final disciplinary action, other than suspension or revocation, when determining whether to issue the certificate or other authorization.

(d) Additional Requirements for Specific Certificate Types or Placement on the Board's Non-Certified Technician Registry.

(1) Radiologist Assistant Certificate. In addition to meeting requirements under subsection (c) of this section, an applicant must pass the jurisprudence examination in accordance with subsection (e) of this section, and meet the following requirements:

(A) possess current national certification and registration as a radiologist assistant by ARRT;

(B) possess current national certification as a radiology practitioner assistant by CBRPA; or

(C) be currently licensed, certified, or registered as a radiologist assistant in another state, the District of Columbia, or a territory of the United States whose requirements are more stringent than or are substantially equivalent to the requirements for Texas radiologist assistant certification.

(2) General Medical Radiologic Technologist Certificate. In addition to meeting requirements under subsection (c) of this section, to qualify for a general certificate, an applicant must pass the jurisprudence examination in accordance with subsection (e) of this section, and meet at least one of the following requirements:

(A) possession of current national certification as a registered technologist, radiographer, radiation therapist, or nuclear medicine technologist by ARRT;

(B) successful completion of the ARRT's examination in radiography, radiation therapy, or nuclear medicine technology;

(C) possession of current national certification as a nuclear medicine technologist by the NMTCB;

(D) successful completion of the NMTCB's examination in nuclear medicine technology; or

(E) current licensure, certification, or registration as a medical radiologic technologist in another state, the District of Columbia, or a territory of the United States whose requirements are more stringent than or are substantially equivalent to the requirements for Texas general certification.

(3) Limited Medical Radiologic Technologist Certificate. In addition to meeting requirements under subsection (c) of this section, to qualify for a limited certificate, an applicant must meet at least one of the following requirements:

(A) the successful completion of a limited program as set out in §194.12 of this title (relating to Standards for the Approval of Certificate Program Curricula and Instructors) and the successful completion of the jurisprudence examination and appropriate limited examination in accordance with subsection (e) of this section;

(B) current licensure, certification, or registration as an LMRT in another state, the District of Columbia, or a territory of the United States of America whose requirements are more stringent than or substantially equivalent to the requirements for Texas limited certification and successful completion of the jurisprudence examination in accordance with subsection (e) of this section; or

(C) current general certification as an MRT issued by the board. The MRT must surrender the general certificate and submit a written request for a limited certificate indicating the limited categories requested.

(4) Temporary Radiologist Assistant Certificate.

(A) The board may issue a temporary radiologist assistant certificate to an applicant who, in addition to meeting the requirements of subsection (c) of this section:

(i) has successfully completed a course of study in an ARRT or CBRPA-recognized radiologist assistant program;

(ii) is approved by ARRT or CBRPA as examination eligible;

(iii) meets all the qualifications for a radiologist certificate and has signed an agreed order or remedial plan but is waiting for the next scheduled meeting of the board for the agreed order or remedial plan to be approved and the radiologist certificate to be issued; or

(iv) has not on a full-time basis actively practiced as defined under subsection (i) of this section, but meets guidelines set by the board addressing factors that include, but are not limited to, length of time out of active practice and duration of temporary certificates. In order to be determined eligible for a temporary radiologist assistant certificate to remedy active practice issues, the applicant must:

(I) be supervised by a radiologist (as defined under §194.2 of this title) who:

(-a-) holds an active, unrestricted license in Texas;

(-b-) has not been the subject of a disciplinary order, unless the order was administrative in nature; and

(-c-) is not a relative or family member of the applicant; and

(II) present written verification from the radiologist that he or she will:

(-a-) provide on-site, continuous supervision of the applicant and provide reports of such supervision to the board according to rules adopted by the board; and

(-b-) retain professional and legal responsibility for the care rendered by the applicant while practicing under the temporary certificate.

(B) A temporary radiologist assistant certificate granted under this paragraph may be valid for not more than one year from the date issued. A temporary radiologist assistant certificate may be revoked at any time the board deems necessary.

(C) An individual who practices after the expiration of the temporary certificate will be considered to be practicing without a certificate and may be subject to disciplinary action.

(5) Temporary General Medical Radiologic Technologist Certificate.

(A) The board may issue a temporary general certificate to an applicant who, in addition to meeting the requirements of subsection (c) of this section:

(i) has successfully completed a course of study in radiography, radiation therapy, or nuclear medicine technology which is accredited by an agency which is recognized by:

(I) the Council for Higher Education Accreditation, including but not limited to: the Joint Committee on Education in Nuclear Medicine Technology (JRCNMT); or

(II) the United States Secretary of Education, including, but not limited to: the Joint Review Committee on Education in Radiologic Technology (JRCERT), Accrediting Bureau of Health Education Schools, or the Southern Association of Colleges and Schools, Commission on Colleges;

(ii) is approved by the ARRT as examination eligible;

(iii) is approved by the NMTCB as examination eligible;

(iv) has completed education, training and clinical experience which is substantially equivalent to that of an accredited educational program as listed in clause (i) of this subparagraph;

(v) meets all the qualifications for a general certificate and has signed an agreed order or remedial plan but is waiting for the next scheduled meeting of the board for the agreed order or remedial plan to be approved and the general certificate to be issued; or

(vi) has not on a full-time basis actively practiced as defined under subsection (i) of this section, but meets guidelines set by the board addressing factors that include, but are not limited to, length of time out of active practice and duration of temporary certificates. In order to be determined eligible for a temporary general certificate to remedy active practice issues, the applicant must:

(I) be supervised by a general certificate holder or practitioner (as defined under §194.2 of this title) who:

(-a-) holds an active, unrestricted license or certificate in Texas;

(-b-) has not been the subject of a disciplinary order, unless the order was administrative in nature; and

(-c-) is not a relative or family member of the applicant; and

(II) present written verification from the general certificate holder or practitioner that he or she will:

(-a-) provide on-site, continuous supervision of the applicant and provide reports of such supervision to the board according to rules adopted by the board; and

(-b-) retain professional and legal responsibility for the care rendered by the applicant while practicing under the temporary certificate.

(B) A temporary general certificate granted under this paragraph may be valid for not more than one year from the date issued. A temporary general certificate may be revoked at any time the board deems necessary.

(C) An individual who practices after the expiration of the temporary certificate will be considered to be practicing without a certificate and may be subject to disciplinary action.

(6) Temporary Limited Medical Radiologic Technologist Certificate.

(A) The board may issue a temporary limited certificate to an applicant who, in addition to meeting requirements under subsection (c) of this section:

(i) has successfully completed a limited certificate program in the categories of skull, chest, spine, abdomen or extremities, approved in accordance with §194.12 of this title;

(ii) meets all the qualifications for a limited certificate and has signed an agreed order or remedial plan but is waiting for the next scheduled meeting of the board for the agreed order or remedial plan to be approved and the limited certificate to be issued; or

(iii) has not on a full-time basis actively practiced as defined under subsection (i) of this section, but meets guidelines set by the board addressing factors that include, but are not limited to, length of time out of active practice and duration of temporary certificates. In order to be determined eligible for a temporary limited certificate to remedy active practice issues, the applicant must:

(I) be supervised by a general certificate holder or practitioner ("practitioner" is defined under §194.2 of this title) who:

(-a-) holds an active, unrestricted license or certificate in Texas;

(-b-) has not been the subject of a disciplinary order, unless the order was administrative in nature; and

(-c-) is not a relative or family member of the applicant; and

(II) present written verification from the general certificate holder or practitioner that he or she will:

(-a-) provide on-site, continuous supervision of the applicant and provide reports of such supervision to the board; and

(-b-) retain professional and legal responsibility for the care rendered by the applicant while practicing under the temporary certificate.

(B) A temporary limited certificate granted based upon successful completion of approved programs under subparagraph (A)(i) of this paragraph may not be valid for more than six months from the date issued, unless the applicant has met all qualifications for the limited certificate, and is on the agenda for the next scheduled meeting of the board for the limited certificate to be issued.

(C) Temporary limited certificates granted for the purpose of remedying active practice deficiencies under subparagraph (A)(iii) of this paragraph may not be valid for more than 12 months from the date of issue.

(D) A temporary limited certificate may be revoked at any time the board deems necessary.

(E) An individual who practices after the expiration of the temporary certificate will be considered to be practicing without a certificate and may be subject to disciplinary action.

(7) Provisional Medical Radiologic Technologist Certificate.

(A) To qualify for a provisional general certificate, an applicant must:

(i) be currently licensed or certified in another jurisdiction;

(ii) have been licensed or certified in good standing as a MRT for at least two years in another jurisdiction, including a foreign country, that has licensing or certification requirements substantially equivalent to the requirements of the Act;

(iii) pass a national or other examination recognized by the board relating to the practice of radiologic technology;

(iv) provide a complete and legible set of fingerprints, on a form prescribed by the board, to the board or to the Department of Public Safety for the purpose of obtaining criminal history record information from the Department of Public Safety and the Federal Bureau of Investigation; and

(v) be sponsored by a medical radiologic technologist certified by the board under the Act with whom the provisional certificate holder will practice during the time the person holds a provisional certificate.

(B) A provisional certificate is valid until the date the board approves or denies the provisional certificate holder's application for a certificate.

(C) The board must approve or deny a provisional certificate holder's application for a certificate not later than the 180th day after the date the provisional certificate is issued. The board may extend the 180-day period if the results of an examination have not been received by the board before the end of that period.

(8) Placement on the Non-Certified Technician Registry.

(A) Registration Required. In accordance with §601.202 of the Act, a person who intentionally uses radiologic technology, other than a certificate holder, physician assistant, registered nurse, or person performing procedures under the supervision of a dentist, must register with the board prior to performing any procedures.

(B) In addition to meeting the requirements under subsection (c) of this section, to qualify for placement on the board's NCT Registry, an applicant must successfully complete a training program approved by the board in accordance with §194.13 of this title (relating to Mandatory Training Programs for Non-Certified Technicians) and pass the jurisprudence examination in accordance with subsection (e) of this section.

(e) Examinations Required.

(1) Jurisprudence examination. An applicant must pass the jurisprudence examination ("JP exam"), which shall be conducted on the laws, rules, or regulations applicable to the practice of medical radiologic technology in this state. The JP exam shall be developed and administered as follows:

(A) The staff of the Medical Board shall prepare questions for the JP exam and provide a facility by which applicants can take the examination.

(B) An examinee shall not be permitted to bring books, compends, notes, journals, calculators or other documents or devices into the examination room, nor be allowed to communicate by word or sign with another examinee while the examination is in progress without permission of the presiding examiner, nor be allowed to leave the examination room except when so permitted by the presiding examiner.

(C) Irregularities during an examination, such as giving or obtaining unauthorized information or aid as evidenced by observation or subsequent statistical analysis of answer sheets, shall be sufficient cause to terminate an applicant's participation in an examination, invalidate the applicant's examination results, or take other appropriate action.

(D) Applicants must pass the JP exam with a score of 75 or better.

(E) A person who has passed the JP exam shall not be required to retake the exam for re-licensure, except as a specific requirement of the board as part of an order.

(2) Additional Examinations Required for Certification.

(A) Radiologist Assistant Certificate. The following examinations are accepted for a radiologist assistant application:

(i) the ARRT Registered Radiologist Assistant examination; or

(ii) the CBRPA Radiology Practitioner Assistant examination.

(B) General Certificate. The following examinations are accepted for a general certificate application:

(i) NMTCB examination in nuclear medicine technology; or

(ii) The appropriate ARRT examination in radiography, nuclear medicine technology, or radiation therapy. Determination of the appropriate examination shall be made on the basis of the type of educational program completed by the applicant for a general certificate.

(C) Limited Certificate.

(i) The following examinations are accepted for a limited certificate application: Successful completion of the appropriate examination, including the core knowledge component, as follows:

(I) skull--the ARRT examination for the limited scope of practice in radiography (skull);

(II) chest--the ARRT examination for the limited scope of practice in radiography (chest);

(III) spine--the ARRT examination for the limited scope of practice in radiography (spine);

(IV) extremities--the ARRT examination for the limited scope of practice in radiography (extremities);

(V) chiropractic--the ARRT examinations for the limited scope of practice in radiography (spine and extremities);

(VI) podiatric--the ARRT examination for the limited scope of practice in radiography (podiatry); or

(VII) cardiovascular--the Cardiovascular Credentialing International invasive registry examination.

(ii) Limited Certification Exam Attempt Authorization.

(I) Individuals enrolled or who have completed an approved limited medical radiologic program, as set forth under §194.12 of this title, must apply to the board and obtain authorization in order to attempt passage of accepted examination(s) set forth under subparagraph (B) of this paragraph.

(II) In order to obtain authorization to attempt passage of the exam, an individual must provide the following documentation:

(-a-) Evidence of current enrollment in an approved limited program as set forth by §194.12 of this title and an attestation stating that the individual has completed the education components necessary for qualifying the individual to pass the appropriate limited scope examination, signed by the program director or registrar; or

(-b-) a copy of a certificate of completion or official transcript showing completion of an approved limited program, as set out in §194.12 of this title.

(III) Approval to attempt passage of the limited scope examination is not authorization to perform limited medical radiologic technology procedures. An individual must apply for and be granted a temporary or limited or general certificate prior to performing limited medical radiologic technology procedures or meet an exception to such certification requirements provided for under the Act.

(iii) Individuals approved to sit for the limited certification examination will be allowed three attempts to pass the examination within one year from the date of the initial authorization granted by the board. Individuals who fail to pass within the required number of attempts or one-year-period will not be eligible for additional attempts, except as provided in clause (iv) of this subparagraph.

(iv) Notwithstanding clause (iii) of this subparagraph, an individual who fails to pass the examination within the required number of attempts or within the one-year-period may obtain approval for one additional attempt, if the individual successfully completes a review course of no less than 60 hours of continuing education in length, offered by an approved limited program under §194.12 of this title. The additional attempt must be made no later than one year from the date of the board's approval granted. Those failing to pass the examination within the additional one-year period allowed shall no longer be eligible for additional attempts at passage, and shall only be eligible for state examination attempts for the purpose of state limited certification by again meeting the requirements for approval of exam attempt authorization set forth under clause (ii)(II) of this subparagraph.

(3) Examination schedules. A schedule of examinations indicating the date(s), location(s), fee(s) and application procedures shall be provided by the board or organization administering the examination(s).

(4) Standards of acceptable performance. The scaled score to determine pass or fail performance shall be 75. For the cardiovascular limited certificate, the Cardiovascular Credentialing International examinations (Cardiovascular Science Examination and/or the Invasive Registry Examination as required to obtain the Registered Cardiovascular Invasive Specialist RCIS credential) the scaled score to determine pass or fail performance shall be 70.

(5) Completion of examination application forms. Each applicant shall be responsible for completing and transmitting appropriate examination application forms and paying appropriate examination fees by the deadlines set by the board or organization administering the examinations prescribed by the board.

(6) Examination Results.

(A) Notification to examinees. Results of an examination prescribed by the board but administered under the auspices of another organization will be communicated to the applicant by the board, unless the contract between the board and that organization provides otherwise.

(B) Score release. The applicant is responsible for submitting a signed score release to the examining agency or organization or otherwise arranging to have examination scores forwarded to the board.

(C) Deadlines. The board shall notify each examinee of the examination results within 14 days of the date the board receives the results. If notice of the examination results will be delayed for longer than 90 days after the examination date, the board shall notify the person of the reason for the delay before the 90th day. The board may require a testing service to notify a person of the results of the person's examination.

(7) Refunds. Examination fee refunds will be in accordance with policies and procedures of the board or the organization prescribed by the board to administer an examination. No refunds will be made to examination candidates who fail to appear for an examination.

(f) Documentation. The following documentation shall be submitted as a part of the certification application process:

(1) Name Change. Any applicant who submits documentation showing a name other than the name under which the applicant has applied must present certified copies of marriage licenses, divorce decrees, or court orders stating the name change. In cases where the applicant's name has been changed by naturalization the applicant should send the original naturalization certificate by certified mail to the board for inspection.

(2) ARRT, CBRPA, or NMTCB-Certified or Considered Exam Eligible. For applicants certified by ARRT, CBRPA, or NMTCB or considered examination eligible by such organizations, the applicant must provide a letter of verification of current certification or examination eligibility sent directly from ARRT, CBRPA or NMTCB, as applicable.

(3) Training Program Certification. For applicants who are graduates of a program accepted by the board for certification under §194.12 or §194.13 of this title, each applicant must have a certificate of successful completion of an educational program submitted directly from a program accepted by the board for certification, on a form provided by the board.

(4) Examination Scores. Each applicant for certification must have a certified transcript of grades submitted directly from the appropriate testing service to the board for all examinations accepted by the board for certification.

(5) Verification from other states. On request of board staff, an applicant must have any state, in which he or she has ever been registered, certified, or licensed as any type of healthcare provider regardless of the current status of the registration, certification, or license, submit to the board a letter verifying the status of the registration, certification, or license and a description of any sanctions or pending disciplinary matters. The information must be sent directly to the board from the state licensing entities.

(6) Arrest Records. If an applicant has ever been arrested, a copy of the arrest and arrest disposition must be requested by the applicant to arresting authority, and that authority must submit copies directly to the board.

(7) Malpractice. If an applicant has ever been named in a malpractice claim filed with any liability carrier or if an applicant has ever been named in a malpractice suit, the applicant must:

(A) have each liability carrier complete a form furnished by this board regarding each claim filed against the applicant's insurance, as applicable;

(B) for each claim that becomes a malpractice suit, have the attorney representing the applicant in each suit submit a letter directly to the board explaining the allegation, dates of the allegation, and current status of the suit. If the suit has been closed, the attorney must state the disposition of the suit, and if any money was paid, the amount of the settlement. The letter shall be accompanied by supporting documentation including court records if applicable. If such letter is not available, the applicant will be required to furnish a notarized affidavit explaining why this letter cannot be provided; and

(C) compose and provide a statement explaining the circumstances pertaining to patient care in defense of the allegations.

(8) Additional Documentation. An applicant must submit additional documentation as is deemed necessary to facilitate the investigation of any application for certification.

(g) Review and Recommendations by the Executive Director.

(1) The executive director or designee shall review applications for certification or other authorization and may determine whether an applicant is eligible for certification or other authorization, or refer an application to a committee of the board for review.

(2) If the executive director or designee determines that the applicant clearly meets all requirements, the executive director or designee, may issue a certificate or other authorization to the applicant, to be effective on the date issued without formal board approval, as authorized by §601.052 of the Act.

(3) If the executive director determines that the applicant does not clearly meet all certification or other authorization requirements as prescribed by the Act and this chapter, a certificate or other authorization may be issued only upon action by the board following a recommendation by the Licensure Committee, in accordance with §§601.052 of the Act and §187.13 of this title (relating to Informal Board Proceedings Relating to Licensure Eligibility). Not later than the 20th day after the date the applicant receives notice of the executive director's determination the applicant shall:

(A) request a review of the executive director's recommendation by a committee of the board conducted in accordance with §187.13 of this title; or

(B) withdraw his or her application.

(C) If an applicant fails to take timely action, as provided under this subsection, such inaction shall be deemed a withdrawal of his or her application.

(4) To promote the expeditious resolution of any matter concerning an application for certification or other authorization, the executive director, with the approval of the board, may recommend that an applicant be eligible for a certificate or other authorization under certain terms and conditions and present a proposed agreed order or remedial plan to the applicant. Not later than the 20th day after the date the applicant receives notice of the executive director's recommendation for an agreed order or remedial plan, the applicant shall do one of the following:

(A) sign the order or remedial plan and the order/remedial plan shall be presented to the board for consideration and acceptance without initiating a Disciplinary Licensure Investigation (as defined in §187.13 of this title) or appearing before a committee of the board concerning issues relating to licensure eligibility; or

(B) request a review of the executive director's recommendation by a committee of the board conducted in accordance with §187.13 of this title; or

(C) withdraw his or her application.

(D) If an applicant fails to take timely action, as provided under this subsection, such inaction shall be deemed a withdrawal of his or her application.

(h) Committee Referrals. An applicant who has either requested to appear before the licensure committee of the board or has elected to be referred to the licensure committee of the board due to a determination of ineligibility by the executive director in accordance with section, in lieu of withdrawing the application for certification, may be subject to a Disciplinary Licensure Investigation as defined in §187.13 of this title. Review of the executive director's determination by a committee of the board shall be conducted in accordance with §187.13 of this title. All reports received or gathered by the board on each applicant are confidential and are not subject to disclosure under the Public Information Act. The board may disclose such reports to appropriate licensing authorities in other states.

(i) All applicants must provide sufficient documentation to the board that the applicant has, on a full-time basis, actively practiced, been a student at an acceptable approved program under §194.12 or §194.13 of this title or been on the active teaching faculty of an acceptable approved program under §194.12 or §194.13 of this title, within one of the last two years preceding receipt of an application for certification or registration. The term "full-time basis," for purposes of this section, shall mean at least 20 hours per week for 40 weeks duration during a given year.

(j) Applicants who are unable to demonstrate active practice on a full time basis may, in the discretion of the board, be eligible for an unrestricted or restricted certificate or placement on the non-certified technician registry, subject to one or more of the following conditions or restrictions as set forth in paragraphs (1) - (5) of this subsection:

(1) completion of specified continuing education hours directly or indirectly related to the disciplines of radiologic technology and offered by an institution accredited by a regional accrediting organization such as the Southern Association of Colleges and Schools (SACS), or by agencies or organizations such as JRCERT, JRCNMT, Joint Review Committee on Education in Cardiovascular Technology (JTCCVT), the Council on Chiropractic Education (CCE), ABHES, or the American Society of Radiologic Technologists (ASRT);

(2) current certification by ARRT, CBRPA, or NMTCB;

(3) limitation and/or exclusion of the practice of the applicant to specified activities of the practice;

(4) remedial education; and

(5) such other remedial or restrictive conditions or requirements which, in the discretion of the board are necessary to ensure protection of the public and minimal competency of the applicant to safely practice.

(k) Applicants for certification, NCT registration, or other authorization:

(1) whose applications have been filed with the board in excess of one year will be considered expired. Any fee previously submitted with that application shall be forfeited unless otherwise provided by §175.5 of this title (relating to Payment of Fees or Penalties). Any further request for certification or registration will require submission of a new application and inclusion of the current fee. An extension to an application may be granted under certain circumstances, including:

(A) Delay by board staff in processing an application;

(B) Application requires Licensure Committee review after completion of all other processing and will expire prior to the next scheduled meeting;

(C) Licensure Committee requires an applicant to meet specific additional requirements for certification or registration and the application will expire prior to deadline established by the Committee;

(D) Applicant requires a reasonable, limited additional period of time to obtain documentation after completing all other requirements and demonstrating diligence in attempting to provide the required documentation;

(E) Applicant is delayed due to unanticipated military assignments, medical reasons, or catastrophic events;

(2) who in any way falsify the application may be required to appear before the board;

(3) on whom adverse information is received by the board may be required to appear before the board;

(4) shall be required to comply with the board's rules and regulations which are in effect at the time the completed application form and fee are filed with the board;

(5) may be required to sit for additional oral or written examinations that, in the opinion of the board, are necessary to determine competency of the applicant;

(6) must have the application complete in every detail at least 20 days prior to the board meeting in which they are considered for certification. Applicants may qualify for a temporary certificate prior to being considered by the board for certification, contingent upon meeting the minimum requirements for a temporary certificate under this section;

(7) who previously held a Texas health care provider license, certificate, permit, or registration may be required to complete additional forms as required.

(l) Alternative Procedures for Military Service Members, Military Veterans, and Military Spouses.

(1) An applicant who is a military service member, military veteran, or military spouse may be eligible for alternative demonstrations of competency for certain requirements related to an application for certification or placement on the board's Non-Certified Technician Registry. Unless specifically allowed in this subsection, an applicant must meet the requirements for certification as a medical radiologic technologist, limited medical radiologic technologist, or placement on the board's Non-Certified Technician Registry as specified in this chapter.

(2) To be eligible, an applicant must be a military service member, military veteran, or military spouse and meet one of the following requirements:

(A) hold an active unrestricted certificate, license, or registration as a medical radiologic technologist, limited medical radiologic technologist, or non-certified technician in another state, the District of Columbia, or a territory of the United States that has requirements that are substantially equivalent to the requirements for a Texas certificate or placement on the NCT Registry; or

(B) within the five years preceding the application date held a certificate to practice radiologic technology in this state.

(3) The executive director may waive any prerequisite to obtaining a certificate or other authorization for an applicant described in paragraph (1) of this subsection after reviewing the applicant's credentials.

(4) Applications for certification or other authorization from applicants qualifying under paragraphs (1) and (2) of this subsection shall be expedited by the board's licensure division. Such applicants shall be notified, in writing or by electronic means, as soon as practicable, of the requirements and process for renewal of the certificate.

(5) Alternative Demonstrations of Competency Allowed. Applicants qualifying under paragraphs (1) and (2) of this subsection:

(A) in demonstrating compliance with subsection (i) of this section must only provide sufficient documentation to the board that the applicant has, on a full-time basis, actively practiced, been a student at an approved program, or has been on the active teaching faculty of an approved program, within one of the last three years preceding receipt of an application for certification;

(B) notwithstanding the one-year expiration in subsection (k)(1) of this section, are allowed an additional six months to complete the application prior to it becoming inactive; and

(C) notwithstanding the 20-day deadline in subsection (k)(6) of this section, may be considered for certification up to five days prior to the board meeting.

(m) Applicants with Military Experience.

(1) The board shall, with respect to an applicant who is a military service member or military veteran as defined in §194.2 of this title, credit verified military service, training, or education toward the requirements, other than an examination requirement, for a certificate or other authorization issued by the board.

(2) This section does not apply to an applicant who:

(A) has had a license, certificate, or registration to practice radiologic technology suspended or revoked by this state, another state, a Canadian province, or another country;

(B) holds a license, certificate, or registration to practice radiologic technology issued by another state, Canadian province, or another country that is subject to a restriction, disciplinary order, or probationary order; or

(C) has an unacceptable criminal history.

(n) Re-Application for Certification or other Authorization Prohibited. A person who has been determined ineligible for a certificate or placement on the NCT Registry by the Licensure Committee may not reapply for a certificate or placement on the NCT Registry prior to the expiration of one year from the date of the board's ratification of the Licensure Committee's determination of ineligibility and denial.

(o) Request for Criminal History Evaluation Letter.

(1) In accordance with Texas Occupations Code, §53.102, prior to applying for certification or other authorization, an individual may request that board staff review the person's criminal history to determine if the person is potentially ineligible for certification or other authorization based solely on the person's criminal background.

(2) Requestors must submit their requests in writing along with appropriate fees as provided in §175.1 of this title (relating to Application and Administrative Fees).

(3) The board may require additional documentation including fingerprint cards before issuing a criminal history evaluation letter.

(4) The board shall provide criminal history evaluation letters that include the basis for potential ineligibility, if grounds for ineligibility exist to all requestors no later than the 90th day after the board receives all required documentation to allow the board to respond to a request.

(5) If a requestor does not provide all requested documentation within one year of submitting the original request, the request will be considered as withdrawn.

(6) All evaluations letters shall be based on existing law at the time of the request. All requestors remain subject to the requirements for licensure at the time of application and may be determined ineligible under existing law at the time of application. If a requestor fails to provide complete and accurate information to the board, the board may invalidate the criminal history evaluation letter.

(7) An individual shall be permitted to apply for certification or other authorization, regardless of the board's determination in a criminal history evaluation letter.

§194.7.Biennial Renewal of Certificate or Placement on the Board's Non-Certified Technician Registry.

(a) Temporary Certificates.

(1) A temporary certificate shall expire one year from the date of issue. A person whose temporary certificate has expired is not eligible to reapply for another temporary certificate.

(2) A temporary certificate is not subject to a renewal or extension for any reason.

(3) Persons who hold temporary certificates, either radiologist assistant, general, or limited, are not subject to continuing education requirements set forth under subsection (c) of this section.

(b) Biennial Registration and Fee Required.

(1) Certificate holders and NCTs registered under the Act shall renew authorization to practice biennially and pay a fee. Upon notification from the board, unexpired authorization may be renewed by submitting the required form and documents and by paying the required renewal fee to the board on or before the expiration date of the authorization.

(2) The fee shall accompany the required form which legibly sets forth the certificate or NCT registration holder's name, mailing address, business address, and other necessary information prescribed by the board. The certificate or NCT registration holder must include with the required forms and fee documentation of continuing education completed during the previous two years to the date of renewal ("biennial renewal period").

(c) Continuing education requirements.

(1) Generally.

(A) RA. As a prerequisite to the biennial renewal of a radiologist assistant certificate, a minimum of 24 hours of continuing education hours must be completed during each biennial renewal period. The hours must be in activities that are designated for Category A or A+ credits of continuing education evaluated by an organization recognized by ARRT as a Recognized Continuing Education Evaluation Mechanism (RCEEM) or RCEEM+ during the biennial renewal period.

(B) MRT. As a prerequisite to the biennial renewal of an MRT certificate, a minimum of 24 hours of continuing education hours must be completed during each biennial renewal period. The continuing education must be completed in the following categories:

(i) At least 12 hours of the required number of hours must be satisfied by completing activities that are designated for Category A or A+ credits of continuing education evaluated by an organization recognized by ARRT as a RCEEM or RCEEM+ during the biennial renewal period.

(ii) The remaining 12 credits for the biennial renewal period may be composed of self-study or courses not approved for formal CE, and shall be recorded in a manner that can be easily transmitted to the board upon request.

(iii) Any additional hours completed through self-study must be verifiable, through activities that include reading materials, audio materials, audiovisual materials, or a combination thereof.

(C) LMRT. As a prerequisite to the biennial renewal of a limited certificate, a minimum of 18 hours of continuing education acceptable to the board must be completed during each biennial renewal period. The hours completed must be in the topics of general radiation health and safety or related to the categories of limited certificate held. The continuing education must be completed in the following categories:

(i) At least nine hours of the required number of hours must be satisfied by completing activities that are designated for Category A or A+ credits of continuing education evaluated by an organization recognized by ARRT as a RCEEM or RCEEM+ during the biennial renewal period.

(ii) The remaining nine credits for the biennial renewal period may be composed of self-study or courses not approved for formal CE, and shall be recorded in a manner that can be easily transmitted to the board upon request.

(iii) Any additional hours completed through self-study must be verifiable, through activities that include reading materials, audio materials, audiovisual materials, or a combination thereof.

(D) An RA, MRT, or LMRT who also holds a current Texas license, registration, or certification in another health profession may satisfy the continuing education requirement for renewal of a certificate with hours counted toward renewal of the other license, registration, or certification, provided such hours meet all the requirements of this subsection.

(E) An RA or MRT who holds a current and active annual registration or credential card issued by ARRT indicating that the certificate holder is in good standing and not on probation satisfies the continuing education requirement for renewal of a certificate, provided the hours accepted by ARRT were completed during the certificate holder's biennial renewal period and meet or exceed the hour the requirements set out in this subsection. The board must be able to verify the status of the card presented by the certificate holder electronically or by other means acceptable to the board. The board may review documentation of the continuing education activities in accordance with paragraph (5) of this subsection.

(F) NCTs. As a prerequisite to the biennial renewal of a placement on the NCT registry, the individual must complete a minimum of 12 hours of continuing education during each biennial renewal period. The continuing education must be completed in the following categories:

(i) At least six hours of the required number of hours must be satisfied by completion of activities that are designated for Category A or A+ credits of continuing education evaluated by an organization recognized by ARRT as a RCEEM or RCEEM+ during the biennial renewal period.

(ii) The remaining six credits for the biennial renewal period may be composed of self-study or courses not approved for formal CE, and shall be recorded in a manner that can be easily transmitted to the board upon request.

(iii) Any additional hours completed through independent self-study must be verifiable, through activities that include reading materials, audio materials, audiovisual materials, or a combination thereof.

(2) Content Requirements.

(A) At least 50% of the required number of hours must be activities which are directly related to the use and application of ionizing forms of radiation to produce diagnostic images and/or administer treatment to human beings for medical purposes. For the purpose of this section, directly related topics include, but are not limited to: radiation safety, radiation biology and radiation physics; anatomical positioning; radiographic exposure technique; radiological exposure technique; emerging imaging modality study; patient care associated with a radiologic procedure; radio pharmaceutics, pharmaceutics, and contrast media application; computer function and application in radiology; mammography applications; nuclear medicine application; and radiation therapy applications.

(B) No more than 50% of the required number of hours may be satisfied by completing or participating in learning activities which are related to the use and application of non-ionizing forms of radiation for medical purposes.

(C) No more than 50% of the required number of hours may be satisfied by completing or participating in learning activities which are indirectly related to radiologic technology. For the purpose of the section, indirectly related topics include, but are not limited to, patient care, computer science, computer literacy, introduction to computers or computer software, physics, human behavioral sciences, mathematics, communication skills, public speaking, technical writing, management, administration, accounting, ethics, adult education, medical sciences, and health sciences. Other courses may be accepted for credit provided there is a demonstrated benefit to patient care.

(3) Alternative Continuing Education Accepted by the Board. The additional activities for which continuing education credit will be awarded are as follows:

(A) successful completion of an entry-level or advanced-level examination previously passed in the same discipline of radiologic technology administered by or for the ARRT during the renewal period. The examinations shall be topics dealing with ionizing forms of radiation administered to human beings for medical purposes. Such successful completion shall be limited to not more than one-half of the continuing education hours required;

(B) successful completion or recertification in a cardiopulmonary resuscitation course, basic cardiac life support course, or advanced cardiac life support course during the continuing education period. Such successful completion or recertification shall be limited to not more than:

(i) three hours credit during a renewal period for a cardiopulmonary resuscitation course or basic cardiac life support course; or

(ii) six hours credit during a renewal period for an advanced cardiac life support course;

(C) attendance and participation in tumor conferences (limited to six hours), in-service education and training offered or sponsored by Joint Commission-accredited or Medicare certified hospitals, provided the education/training is properly documented and is related to the profession of radiologic technology;

(D) teaching in a program accredited by a regional accrediting organization such as the Southern Association of Colleges and Schools; or an institution accredited by JRCERT, JRCNMT, JTCCVT, CCE, ABHES, ASRT, professional organizations or associations, or a federal, state, or local governmental entity, with a limit of one contact hour of credit for each hour of instruction per topic item once during the continuing education reporting period for up to a total of 6 hours. No credit shall be given for teaching that is required as part of one's employment. Credit may be granted in direct, indirect or non-ionizing radiation based on the topic; or

(E) developing and publishing a manuscript of at least 1,000 words in length related to radiologic technology with a limit of six contact hours of credit during a continuing education period. Upon audit by the board, the certificate holder must submit a letter from the publisher indicating acceptance of the manuscript for publication or a copy of the published work. The date of publication will determine the continuing education period for which credit will be granted. Credit may be granted in direct, indirect or non-ionizing radiation based on the topic.

(4) Reporting Requirements. A certificate holder or NCT must report on the biennial renewal application form if she or he has completed the required continuing education during the previous renewal period.

(A) A certificate holder or NCT may carry forward continuing education credit hours that meet the requirements under this subsection and earned prior to the biennial registration renewal period which are in excess of the biennial hour requirement, and apply such hours to the subsequent renewal period requirements.

(B) For RAs or MRTs, a maximum of 48 total excess credit hours meeting the requirements under this subsection may be carried forward. Excess continuing education credits may not be carried forward or applied to a report of continuing education more than two years beyond the date of the registration following the period during which the credits were earned.

(C) For LMRTs, a maximum of 24 hours meeting the requirements of this subsection may be carried forward. Excess continuing education credits may not be carried forward or applied to a report of continuing education more than two years beyond the date of the registration following the period during which the credits were earned.

(D) For NCTS, a maximum of 12 total excess credit hours meeting the requirements of this subsection may be carried forward. Excess continuing education credits may not be carried forward or applied to a report of continuing education more than two years beyond the date of the registration following the period during which the credits were earned.

(5) Exemptions.

(A) A certificate holder or NCT may request in writing an exemption for the following reasons, subject to the approval of the certification committee of the board:

(i) catastrophic illness;

(ii) military service of longer than one year's duration outside the United States;

(iii) residence of longer than one year's duration outside the United States; or

(iv) good cause shown on written application of the certificate holder that gives satisfactory evidence to the board that the certificate holder is unable to comply with the requirement for continuing medical education.

(B) An exception under paragraph (5) of this subsection may not exceed one registration period, but may be renewed biennially, subject to the approval of the board.

(6) A certificate holder or NCT who is a military service member may request an extension of time, not to exceed two years, to complete any continuing education requirements.

(7) This subsection does not prevent the board from taking disciplinary action with respect to a NCT or certificate holder or an applicant for such authorization by requiring additional hours of continuing education or of specific course subjects.

(8) The board may require written verification of continuing education credits from any certificate holder or NCT within 30 days of request. Failure to provide such verification may result in disciplinary action by the board.

(9) Unless exempted under the terms of this subsection, a certificate holder or NCT's failure to obtain and timely report required hours of continuing education as required and provided for in this subsection shall result in the nonrenewal of the authorization to practice until such time as the certificate holder or NCT obtains and reports the required continuing education hours; however, the executive director of the Medical board may issue a temporary certificate or NCT registration numbered so as to correspond to the nonrenewed certificate or NCT registration. Such a temporary authorization to practice shall be issued at the direction of the executive director for a period of no longer than 90 days. A temporary authorization to practice issued pursuant to this subsection may be issued to allow the opportunity to correct any deficiency so as not to require termination of practice.

(10) Determination of contact hour credits. A contact hour shall be defined as 50 minutes of attendance and participation. One-half contact hour shall be defined as 30 minutes of attendance and participation during a 30-minute period.

(d) Criminal History Requirement for Registration Renewal.

(1) An applicant must submit a complete and legible set of fingerprints for purposes of performing a criminal history check.

(2) The board may not renew the certificate or NCT registration of a person who does not comply with the requirement of paragraph (1) of this subsection.

(3) A certificate holder or NCT is not required to submit fingerprints under this section for the renewal of the certificate or registration if the holder has previously submitted fingerprints for the initial issuance or prior renewal of a certificate or NCTregistration.

(e) Report of Impairment on Registration Form.

(1) A certificate holder or NCT who reports an impairment that affects his or her ability to actively practice shall be given written notice of the following:

(A) based on the individual's impairment, he or she may request:

(i) to be placed on retired status pursuant to §194.10 of this title (relating to Retired Certificate or NCT Registration);

(ii) to voluntarily surrender the certificate or NCT registration pursuant to §194.33 of this title (relating to Voluntary Relinquishment or Surrender of Certificate or Permit); or

(iii) to be referred to the Texas Physician Health Program pursuant to Chapter 180 of this title (relating to Texas Physician Health Program and Rehabilitation Orders); and

(B) that failure to respond to the written notice or otherwise not comply with paragraph (1) of this subsection within 45 days shall result in a referral to the board's investigation division for possible disciplinary action.

(2) The board shall provide written notice as described in paragraph (1) of this subsection within 30 days of receipt of the renewal application form indicating the impairment.

(f) The board shall deny an application for renewal of an authorization to practice upon notice of the certificate or NCT registration holder's default of child support payments, as provided under Chapter 232 of the Texas Family Code.

(g) The board shall deny an application for renewal of a certificate or NCT registration or take and/or impose other disciplinary action against such an individual who falsifies an affidavit or otherwise submits false information to obtain renewal of a certificate or NCT registration, pursuant to the Act, §601.302.

(h) If the renewal fee and completed application form are not received on or before the expiration date of the certificate or NCT registration, the fees set forth in Chapter 175 of this title (relating to Fees and Penalties) shall apply.

(i) Except as otherwise provided, the board shall not waive fees or penalties.

(j) The board shall stagger biennial renewal of a certificate or NCT registration proportionally on a periodic basis.

(k) Expired Biennial Renewal.

(1) Generally.

(A) If a certificate or NCT registration has been expired for less than one year, the certificate or NCT registration may be renewed by submitting to the board a completed renewal application, and the renewal and penalty fees, as set forth under Chapter 175 (relating to Fees and Penalties).

(B) If a certificate or NCT registration has been expired for one year or longer, the certificate or NCT registration will be automatically canceled, unless an investigation is pending, and the certificate or NCT registration may not be renewed.

(C) A person whose certificate or NCT registration has expired may not engage in activities that require a certificate or NCT registration until the authorization has been renewed. Performing activities requiring a certificate or NCT registration during the period in which the authority has expired has the same effect as, and is subject to all penalties of, practicing radiologic technology in violation of the Act.

(D) If a certificate or NCT registration has been expired for one year or longer, it is considered to have been canceled, unless an investigation is pending. A new certificate or NCT registration may be obtained by complying with the requirements and procedures for obtaining an original certificate or NCT registration.

(2) Renewal for technologists on active military duty with expired certificate or NCT registration. A holder of a certificate or NCT registration that has been expired for longer than a year may file a complete application for another certificate or NCT registration of the same type as that which expired.

(A) The application shall be on official board forms and be filed with required fees.

(B) An applicant shall be entitled to a certificate of the same type as that which expired based upon the applicant's previously accepted qualification and no further qualifications or examination shall be required.

(C) The application must include a copy of the official orders or other official military documentation showing that the holder was on active duty during any portion of the period for which the applicant was last certified or registered as an NCT with the board.

(D) An applicant for a different type of certificate than that which expired must meet the requirements of this chapter generally applicable to that type of certificate.

§194.10.Retired Certificate or NCT Registration.

(a) The registration fee shall not apply to retired certificate or NCT.

(b) To become exempt from the registration fee due to retirement, the individual:

(1) must not be under an investigation or order with the board or otherwise be restricted; and

(2) must request in writing on a form prescribed by the board for his or her certificate or NCT registration to be placed on official retired status.

(3) The following restrictions shall apply to a certificate or NCT registration placed under an official retired status:

(A) the certificate or NCT registration holder must not engage in clinical activities requiring a certificate or NCT registration in Texas or any state; and

(B) the certificate or permit holder's certificate or permit may not be endorsed to any other state.

(c) A retired certificate or NCT registration holder may return to active status by:

(1) applying to the board;

(2) paying an application fee equal to an application fee for a certificate or NCT registration holder;

(3) complying with the requirements for certificate or NCT registration renewal under the Act;

(4) providing current verifications from each state in which the certificate or NCT registration holder holds a license, certificate, permit, or registration, as applicable;

(5) providing current verifications of certification by ARRT, CBRPA, or NMTCB, as applicable; and

(6) complying with subsection (d) of this section.

(d) Licensure Committee or Executive Director Recommendations.

(1) The request of a certificate or NCT registration holder seeking a return to active status whose certificate or NCT registration has been placed on official retired status for two years or longer shall be submitted to the Licensure Committee of the board for consideration and a recommendation to the full board for approval or denial of the request. After consideration of the request and the recommendation of the Licensure Committee, the Licensure Committee shall make a recommendation to the full board for approval or denial. After consideration of the request and the recommendation of the Licensure Committee, the board shall grant or deny the request. After consideration of the request and the recommendation of the Licensure Committee, the board shall grant or deny the request subject to such conditions which the board determines are necessary to adequately protect the public including, but not limited to the following terms:

(A) completion of specified continuing education hours directly or indirectly related to the disciplines of radiologic technology and offered by an institution accredited by a regional accrediting organization such as SACS, or by JRCERT, JRCNMT, JTCCVT, CCE, ABHES, or ASRT;

(B) current certification by ARRT, CBRPA, or NMTCB, as applicable;

(C) limitation and/or exclusion of the practice of the applicant to specified activities of the practice;

(D) remedial education; and

(E) such other remedial or restrictive conditions or requirements which, in the discretion of the board are necessary to ensure protection of the public and minimal competency of the applicant to safely practice.

(2) The request of a certificate or NCT registration holder seeking a return to active status whose certificate has been placed on official retired status for less than two years may be approved by the executive director of the board or submitted by the executive director to the Licensure Committee of the board, for consideration and a recommendation to the full board for approval or denial of the request. In those instances in which the executive director submits the request to the Licensure Committee of the board, the Licensure Committee shall make a recommendation to the full board for approval or denial. After consideration of the request and the recommendation of the Licensure Committee, the board shall grant or deny the request subject to such conditions which the board determines are necessary to adequately protect the public including, but not limited to those options provided in paragraph (1)(A) - (E) of this subsection.

(e) In evaluating a request to return to active status, the Licensure Committee or the full board may require a personal appearance by the certificate or NCT registration holder at the offices of the board, and may also require a physical or mental examination by one or more physicians or other health care providers approved in advance and in writing by the executive director or the Licensure Committee, or other designee(s) determined by majority vote of the board.

(f) A retired certificate or NCT registration holder who has obtained an exemption from the renewal fee as provided for under this section, may be subject to disciplinary action under the Act, §601.302, based on unprofessional conduct if the certificate or NCT registration holder engages in activities requiring a certificate or NCT registration.

(g) A retired certificate or NCT registration holder who attempts to obtain an exemption from the registration fee under this section by submitting false or misleading statements to the board shall be subject to disciplinary action pursuant to the Act, §601.302, in addition to any civil or criminal actions provided for by state or federal law.

§194.21.Scope of Practice.

(a) NCTs.

(1) NCTs registered under §194.13 of this title (relating to Mandatory Training Programs for Non-Certified Technicians) may not perform a dangerous or hazardous procedure as set out in §194.17 of this title (relating to Dangerous or Hazardous Procedures).

(2) All NCTs may only perform radiologic procedures under the supervision and direction of a practitioner, and must comply with all applicable statutes and rules under the laws governing the practice of the practitioner.

(b) LMRTs. Persons holding a limited certificate in one or more categories may not perform radiologic procedures involving the use of contrast media, utilization of fluoroscopic equipment, mammography, tomography, portable radiography, nuclear medicine, and/or radiation therapy procedures. However, a person holding a limited certificate in the cardiovascular category may perform radiologic procedures involving the use of contrast media and/or ionizing radiation for the purposes of imaging a disease or condition of the cardiovascular system. Holding a limited certificate in all categories shall not be construed to mean that the holder of the limited certificate has the rights, duties, and privileges of a general certificate holder.

§194.34.Exemption from Licensure for Certain Military Spouses.

(a) The executive director of the Texas Medical Board must authorize a qualified military spouse to practice medical radiologic technology in Texas without obtaining a certificate or permit in accordance with §55.0041(a), Texas Occupations Code. This authorization to practice is valid during the time the military service member to whom the military spouse is married is stationed at a military installation in Texas, but not to exceed three years.

(b) In order to receive authorization to practice the military spouse must:

(1) hold an active medical radiologic certificate or permit in another state, territory, Canadian province, or country that:

(A) has licensing or certification requirements that are determined by the board to be substantially equivalent to the requirements for certification in Texas; and

(B) is not subject to any restriction, disciplinary order, probation, or investigation;

(2) notify the board of the military spouse's intent to practice in Texas on a form prescribed by the board; and

(3) submit proof of the military spouse's residency in this state, a copy of the spouse's military identification card, and proof of the military member's status as an active duty military service member as defined by §437.001(1), Texas Government Code (relating to Definitions).

(c) While authorized to practice medical radiologic technology in Texas, the military spouse shall comply with all other laws and regulations applicable to the practice of medical radiologic technology in Texas.

(d) Once the board receives the form containing notice of a military spouse's intent to practice in Texas, the board will verify whether the military spouse's certificate or permit in another state, territory, Canadian province, or country is active and in good standing. Additionally, the board will determine whether the licensing or certification requirements in that jurisdiction are substantially equivalent to the requirements for certification in Texas.

The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on October 21, 2019.

TRD-201903835

Scott Freshour

General Counsel

Texas Medical Board

Effective date: November 10, 2019

Proposal publication date: September 6, 2019

For further information, please call: (512) 305-7016