Risk Management

Working to identify and reduce potential risk exposures is an ongoing process.

Below is information on a variety of topics to assist with managing risk and remaining compliant with rules and regulations.

Advertising and the Use of Patient Testimonials

The Texas Medical Board (TMB) rules on Chapter 164 Physician Advertising include prohibitions on 164.3 Misleading or Deceptive Advertising and limitations on the use of patient testimonials, as does 164.5(c) Advertising Records and Responsibility.

The Medical Practice Act Code 164.052(6) includes as a prohibited practice false, deceptive or misleading advertising.

A Texas Medical Association (TMA) General Counsel whitepaper discusses Advertising Restrictions, including a special caution for testimonials.

Also, refer to the TMA whitepaper The Regulation of Physician Advertising (members only).

The TMA Board of Councilors provides an opinion on advertising and the use of testimonials.

The AMA Code of Medical Ethics covers Professional Self-Regulation Opinion 9.6.1 Advertising and Publicity.

Charity Care - Disaster Liability - Volunteer Protection Act

How can a physician's liability be limited for providing charity care or when providing care during a disaster?

Find guidance on Limiting Liability for Providing Charity Health Care in this TMA General Counsel whitepaper (members only).

TMA also provides a sample Consent Form for Charity Care.

Regarding Disaster Liability, the TMA General Counsel discusses 2019 SB 752 that expanded civil liberty protection to volunteer health professionals providing care during a disaster.

Compassionate Use Program and Prescribing Low-THC Cannabis

The Texas Compassionate Use Act (2015 SB 339) requires the Texas Department of Public Safety (DPS) to maintain a registry of physicians who are allowed to prescribe low-THC cannabis to patients with certain medical conditions. It also requires DPS to maintain a list of the licensed dispensing organizations that cultivate, process and dispense low-THC cannabis to a patient for whom it is prescribed. For more from DPS.

In 2019, the Texas Legislature expanded patient eligibility for these prescriptions. 2019 HB 3703 allows certain board-certified, licensed physicians to prescribe low-THC cannabis to patients with epilepsy, a seizure disorder, multiple sclerosis, spasticity, amyotrophic lateral sclerosis, autism, terminal cancer, or an incurable neurodegenerative disease, and the physician determines the risk of the medical use of low-THC cannabis by the patient is reasonable in light of the potential benefit for the patient.

In 2021, the Texas Legislature again expanded patient eligibility. Effective Sept. 1, 2021, 2021 HB 1535 allows prescribing for patients suffering from cancer (not just terminal), post-traumatic stress disorder, or a medical condition that is approved for a research program under Subchapter F, Chapter 487, Health and Safety Code, and for which the patient is receiving treatment under that program.

The Medical Practice Act-Texas Occupations Code, Title 3 Health Professions, Subtitle B Physicians, Chapter 169 Authority to Prescribe Low-THC Cannabis to Certain Patients for Compassionate Use explains who is authorized to prescribe and under what circumstances.

Before a physician may prescribe or renew a prescription for low-THC cannabis for a patient, the physician must register as the prescriber for that patient in the compassionate-use registry defined in Texas Health & Safety Code, Title 6, Subtitle C, Chapter 487 Texas Compassionate-Use Act.

The Texas Medical Association (TMA) provides guidance regarding the expanded Compassionate Use Program, including a whitepaper from TMA General Counsel.

Conflicts of Interest - Self Referral and Physician Ownership

The Centers for Medicare & Medicaid Services (CMS) explains Section 1877 of the Social Security Act, known as the Physician Self-Referral law and commonly referred to as the Stark Law.

The Medical Practice Act/Texas Occupations Code Sect 162.052 Notice of Certain Ownership Interests requires physicians who hold an ownership interest in certain specialized (niche) hospitals to notify the Texas Department of State Health Services, as well as to disclose the fact to the patient Sect 105.002.

Refer to the AMA Code of Medical Ethics, Professional Self-Regulation - Opinion 9.6.9 Physician Self-Referral.
As well as the TMA Board of Councilors Opinion on Disclosure of Conflicts to Patients.

TMA has several articles on physician ownership.
TMA advises Four Stark Law tips worth noting.
See the TMA publication Navigating the Referral Minefield: Stark and Antikickback Rules
TMLT also discusses Stark: How to stay on the right side of the law in The Reporter, Volume 5 2013, beginning on page 6.

EMTALA

Find information from the TMA General Counsel on EMTLA (members only).

End of Life Care

TMA provides several resources on end of life care, including links to the DNR form, a Medical Power of Attorney, and Advance Directives.

Handguns

A TMA General Counsel whitepaper provides answers to frequently asked questions regarding Texas' public handgun-carrying policies and the rights of certain businesses and private property owners to prohibit the carrying of handguns.

Informed Consent

The TMA General Counsel whitepaper provides guidance on Informed Consent (members only).
Also, refer to the TMA article Informed Consent: A Process of Communication.
For Official Consent Forms from the Texas Medical Disclosure Panel (TMDP) - TX Health and Human Services (HHS).

Liability Protection

Find articles and guidance on liability protection from TMA.

Out-of-state patients - Texas physicians may wish to have patients from out-of-state sign a consent agreement that would include "choice of law and forum" language that all health care rendered shall be governed exclusively and only by Texas law and that any legal action that relates to the care shall be brought only in a Texas court. The Texas Alliance for Patient Access (TAPA) provides example consent language for emergency care and non-emergency care.

Patient-Physician Communications and Relations

See information on communicating with patients, the patient-physician relationship, reputation management, and treating minors, self, family, and friends.

Reporting Duties

Resources, guidance, and links to Texas statutes for reporting situations involving abuse or neglect of a child or the elderly or disabled, communicable diseases, impaired drivers, or threats of violence.

Rules and Ethics

For Texas Medical Board and Medical Practice Act regulations and other resources, see rules and ethics information.

Subpoenas

Find guidance and resources involving the proper handing of subpoenas.

Texas Medical Association (TMA) and Texas Medical Liability Trust (TMLT) Resources

TMA discusses 20 Everyday HIPAA tips to help you stay compliant.
TMA helps your practice Stop embezzlement before it starts.
Discover more TMA articles and resources on risk management.

TMLT discusses The top 5 things that get physicians sued.
Find even more risk management help from TMLT.
Check out TMLT's Practice Review.
TMLT also provides Privacy and Security Toolkits for your practice.