The TMB (Texas Medical Board) receives over 8,000 complaints yearly, which results in thousands of dollars in fines and hundreds of Texan physicians losing their medical licenses. To stay protected, medical professionals must understand the TMB reporting requirements.
At Gardner Employment Law, we have experience assessing the TMB’s reporting requirements, including by physicians themselves. If someone has reported a complaint to the TMB against you and you need guidance about what to do, give us a call today.
What Incidents Does the TMB Require to Be Reported?
The TMB mandates the disclosure, both by the physician and by the institution or association, of specific events that could have implications for patient well-being or the integrity of the medical profession. This includes various medical errors, ethical breaches, unprofessional behavior, and other impactful incidents that could affect patient safety or the medical profession’s ethical standing in the community. Medical professionals must uphold patient safety and maintain the highest standards of care.
The TMB serves as a regulatory authority, overseeing medical practices in Texas to ensure compliance with ethical and legal guidelines. We explained the TMB enforcement process in “How Do Physicians Defend a Review at the Texas Medical Board”.
The Texas Medical Practice Act requires that a physician or peer review committee report information “relating to the acts of a physician in this state if, in the opinion of the person or committee, that physician poses a continuing threat to the public welfare through the practice of medicine.” TMB Reporting Requirements cover a broad array of possible incidents, so many and so varied that it would be difficult to list all such events specifically.
Most Common Texas Medical Practice Act Violations
As stated earlier, the Texas Medical Practice Act covers countless instances of violations, so it would be impossible to list them all. Below we detail a few of the most common violations reported to the TMB.
Prescription Drug Abuse and Diversion: Doctors who improperly prescribe controlled substances, such as opioids, or contribute to the illegal distribution of prescription drugs can be reported to the TMB.
Fraudulent Billing and Coding: Reports can accuse doctors of submitting false claims or engaging in fraudulent billing practices, such as upcoding (billing for a higher level of service than provided) or unbundling (billing separately for services that should be billed together).
Inadequate Record Keeping: Allegations can arise against doctors who fail to maintain accurate and comprehensive patient records, compromising patient safety and leading to legal action.
Inappropriate Relationships with Patients: Doctors can be reported for engaging in inappropriate relationships with patients, such as romantic or sexual involvements, which are considered unethical and unprofessional given the power dynamics involved.
Negligence and Medical Malpractice: Reports may target doctors who deliver substandard medical care that harms a patient. This includes misdiagnosis, surgical errors, medication mistakes, or other forms of medical negligence.
I had a client who was reported by a patient because the physician did not monitor his NP (nurse practitioner) closely enough. Yes, the NP sometimes was abrupt with patients and probably did not spend enough time with all of them. However, the physician was forced to endure prosecutorial procedures by the TMB attorney and then sign an agreed order to oversee his staff more closely.
Remember, the examples listed above illustrate only the most common violations of the Texas Medical Practice Act. You can read more at Texas Administrative Code 190.8 to see a more comprehensive list of reportable violations and to learn more about TMB Reporting Requirements.
What Is the Purpose of TMB Reporting Requirements?
Complying with TMB reporting requirements ensures patient safety, maintains the profession’s ethical standards, and upholds the integrity of the healthcare system. Physicians who adhere to the TMB’s reporting requirements ultimately contribute to a robust healthcare environment built on trust and accountability.
Additionally, the TMB considers aggravating and mitigating factors when analyzing a complaint filed against a physician. The list of aggravating factors includes intentional misconduct, repeated violations, or actions disregarding patient safety, necessitating swift reporting for appropriate action. Conversely, mitigating factors include self-reporting of an incident, prompt corrective measures, investigation cooperation, and a learning commitment.
A physician who takes the initiative to report a mistake that he or she has made and expresses a willingness to take corrective measures will serve to mitigate or decrease the severity of any sanctions. This approach aids the TMB in making informed and equitable decisions during the regulatory process, ensuring a just and effective healthcare environment. Section 190.15 of the Texas Administrative Code details exact aggravating and mitigating actors and their effect on physician repercussions.
Healthcare providers must be vigilant in identifying and timely reporting events which could risk a patient’s safety or the institution’s or association’s reputation. As a physician, if you comply with TMB’s reporting requirements, you contribute to a safer and more accountable medical environment, prioritizing the welfare of patients above all else.
How to Ensure TMB Compliance
Most hospitals and physician associations adopt policies designed to ensure proper reporting to the TMB. Physicians should proactively comply with these policies and the TMB reporting requirements. Here are 5 key strategies to raise awareness in your being complaint:
1. Familiarize Yourself with Reporting Obligations: The first step towards TMB compliance is understanding the TMB’s reporting obligations comprehensively. The Texas Legislature enacts new statutes during every session expanding these obligations. You must stay current on legal requirements to report incidents involving potential harm to patients, professional misconduct, unlicensed practice, or even deficiencies within your organization. Familiarity with these requirements can protect your license.
2. Follow Reporting Protocols: Know the reporting protocols established by your hospital or association. The protocols typically provide communication channels within healthcare facilities, enabling you to identify reportable incidents promptly.
3. Participate in Training and Education: Take advantage of any training and education your hospital or association provides to stay up-to-date with TMB reporting guidelines and requirements. This is a complex area that is constantly changing due to new legislation. You do not want to be caught in a situation where “you don’t know what you don’t know.”
4. Be Open in Internal Audits: Hospitals in particular tend to perform periodic internal audits to identify any gaps in TMB compliance. These audits provide an opportunity to assess reporting processes, evaluate documentation, and ensure reporting requirements are consistently met. Be sure that you do not withhold critical information if you have personal knowledge of possible TMB violations.
5. Find Collaboration and Support: If you believe that you could be involved in a situation and are wondering whether it is reportable to the TMB, many institutions and associations have established resources, such as boundary courses, which might be available. Courses such as these are eye-opening and are held in confidential environments. The course leaders and colleagues permit you to discuss problematic issues and help you to find solutions. Be proactive in seeking out such courses if you believe you could be in a precarious situation, such as a patient becoming overly friendly or offering you expensive gifts.
Consult a TMB Compliance Expert
Understanding TMB reporting requirements can be challenging. The intricate regulations and constant updates make it difficult for healthcare professionals to know whether they comply with these regulations without professional guidance. Due to the potential repercussions of non-compliance, do not attempt to go alone if you are charged with a reportable violation to the TMB.
If you are in trouble or wondering if you could face an investigation, immediately seek the expertise of a TMB compliance expert. Consulting an experienced TMB defense attorney will help you understand the reporting obligations and minimize the risk of costly mistakes and legal consequences. If you want to learn more about TMB reporting requirements, we are glad to help.