Patient safety bill, sparked by KXAN, goes to governor

AUSTIN (KXAN) — A major bipartisan bill aimed at protecting patients from dangerous doctors — filed in direct response to KXAN's "Still Practicing" investigations — received final approval from the House on Friday with a vote of 120-16. It now goes to the governor.

"I am pleased that we were able to achieve meaningful reform to the Texas Medical Board," said the bill's author, Rep. Julie Johnson, D-Farmer's Branch. "We have closed a loophole that allowed for situations like Dr. Death cases to happen and gave the TMB necessary tools to propely credential and investigate physician malpractice. Texas patients will have greater protection and transparency going forward."

What the bill does

The bill was championed for its strong patient safety measures and received overwhelming support from Republicans, Democrats and even the Texas Medical Board. If Gov. Greg Abbott signs it into law, it will address many of the problems KXAN uncovered.

Here's how HB 1998 will protect patients:

• Make it a Class A misdemeanor to lie on a medical license application. If the intent is to "defraud or harm another," it is a state jail felony.
• Prevent doctors who had their medical licenses revoked in another state from practicing in Texas. This applies to doctors currently practicing in Texas as well as those applying for a license who had their licenses revoked for a reason that would be grounds for the same action in Texas.
• Prevent doctors from practicing in Texas if their license in another state is currently restricted, suspended or canceled for cause or there is a pending investigation into the matter. This also applies to pending prosecutions for felonies and misdemeanors involving moral turpitude.
• Require monthly monitoring of Texas doctors with the National Practitioner Data Bank to learn about arrests, malpractice lawsuits, out-of-state disciplinary actions, etc. in "real time." Licensees will be required to pay a nominal fee to help cover the cost.
• Ensure physician profiles are up to date and any new information found is added within 10 business days.
• The board shall require fingerprints from each applicant and submit to the Department of Public Safety for a criminal background check.
• The board will appoint an expert physician panel to assist with complaints and investigations related to medical competency.

The bill does not appropriate any funds but could provide the legal basis for that in order to implement the provisions of the bill, according to a Legislative Budget Board analysis. It estimates it will cost $750,000 a year to continuously monitor the NPDB and require the TMB to hire five full-time staff members.

An estimated 73,500 physicians will need to be re-fingerprinted.

"HB 1998 will save lives in our state, protecting patients and healthcare professionals alike," said patient safety advocate Ware Wendell with the nonprofit Texas Watch. "We commend lawmakers for putting safety first and hope the governor will sign this vital legislation into law as soon as possible."

'Still Practicing'

In February 2022, KXAN began airing what would turn into a series of investigations into the TMB, spanning more than a year. Five years after the infamous Dallas surgeon, Dr. Christopher Duntsch, nicknamed "Dr. Death," was sentenced to life in prison for killing or injuring more than 30 patients — highlighted in the popular podcast and NBC Peacock miniseries — we wanted to see what, if anything, had changed.

Our investigation found, among other things: Some physician discipline records kept secret; a lack of transparency for patients looking to research their doctors; physicians allowed to keep practicing despite the TMB determining that they were a "threat to the public welfare;" and at least 49 doctors still practicing in Texas, or able to, despite having their licenses revoked, suspended or surrendered in other states.

KXAN identified the doctors by cross-checking out-of-state disciplinary actions with their public TMB profiles.

We brought our findings to stakeholders and lawmakers, including Johnson, who watched our reporting and said addressing the problems we uncovered would be her top priority.

"I think that the reporting you did where you uncovered all of the physicians who have lost their licenses in other states and that was not disclosed on the Texas Medical Board's website is Exhibit A to the problem," Johnson said in March 2022. "Patient safety is an important issue and it's something that the legislature needs to take a look at. The Texas Medical Board has completely failed in its job so we're going to step in and do it for them."

The TMB said the majority of doctors are honest about their pasts when applying for a license here but the board failed to make those disciplinary actions public, which is required by state law. Because license applications in Texas are not public record — like they are in Florida, for example — KXAN could not independently verify how many were up front about the discipline they faced in other states, including having their licenses revoked. In some cases, patients died.

The president of the TMB, Dr. Sherif Zaafran, said if HB 1998 had been law in November of last year, the board would have learned "in real time" about a Texas doctor who was arrested on child pornography charges. Instead, the TMB learned about the arrest in March of this year from a news article, Zaafran said.

The doctor's license was suspended in April.

“So, a lot of the concerns you had raised in the past about physicians out there potentially violating the law, and us not acting on it in time,” Zaafran said, “this would help take care of that by us knowing about it in real-time.”

'It wasn't until KXAN'

On the floor of the Texas Senate last month, KXAN investigative reporter Matt Grant testified in front lawmakers about the findings of our "Still Practicing" investigation. He told members of the Senate Health and Human Services Committee what we have been reporting for more than a year: Texas patients lack the transparency needed to make informed healthcare decisions.

“The Texas Medical Board’s goal is to ‘protect and enhance the public’s health, safety and welfare,’” Grant told members of the committee. “But, we’ve discovered, in case after case, the board has instead prioritized protecting physicians over patients.”

Serving on the committee was Sen. Bob Hall, R-Edgewood. Hall introduced his own bill aimed at reforming the TMB. That bill passed the Senate but stalled in the House.

Hall sponsored Johnson's bill. Both referred to wanting to prevent another "Dr. Death" in their remarks to lawmakers. Last year, before HB 1998 was introduced, the Dallas surgeon who helped stop Duntsch, Dr. Robert Henderson, told KXAN what we found suggests the odds are "pretty darn high" it could happen again.

"We had 50 doctors that were just given a cursory, ‘OK, come on in,'” Hall said during the hearing, referencing our reporting. “And, it wasn’t until KXAN and their investigations [that we learned] hey, these guys came to Texas because they lost their license in another state.”

Johnson, and patient advocates, say this bill will give the TMB the tools it needs to better meet its mission and protect patients from doctors who shouldn't be practicing.

“KXAN uncovered a problem, brought it to my attention,” Johnson said in March. “We discussed. I met with policy holders. We’ve come together to form, I think, a piece of legislation that can make a meaningful impact into health safety and patient safety.”

If the governor signs it, the new law would take effect Sept. 1.