(a) Medical records. Upon the request by the board or board representatives, a licensee shall furnish to the board copies of medical records or the original records within a reasonable time period, as prescribed at the time of the request. "Reasonable time," as used in this section, shall mean fourteen calendar days or a shorter time if required by the urgency of the situation or the possibility that the records may be lost, damaged, or destroyed.
(b) Application for license renewal and registration permits. A licensee shall furnish a written explanation of his or her answer to any question asked on the application for license renewal or registration permit, if requested by the board. This explanation shall include all details as the board may request and shall be furnished within two weeks of the date of receipt of the board's request.
(c) Impaired licensees/applicants.
  (1) Pursuant to §164.056 of the Medical Practice Act, the Board is required to adopt guidelines to enable the Board to evaluate circumstances in which a physician or an applicant may be required to submit to an examination for mental or physical heath conditions, alcohol and substance abuse, or professional behavior problems.
  (2) A licensee shall report to the board if the licensee is aware of another licensee who poses a continuing threat to the public welfare because the said licensee is unable to practice medicine with reasonable skill and safety to patients because of illness; drunkenness; excessive use of drugs, narcotics, chemicals, or another substance; or a mental or physical condition.
  (3) If the board has probable cause to believe that a licensee/applicant is impaired, the board shall require a licensee/applicant to submit to a mental and/or physical examination by a physician or physicians designated by the board. Under the Act, an impaired licensee/applicant is considered to be one who is unable to practice within his field with reasonable skill and safety to patients by reason of age, illness, drunkenness, excessive use of drugs, narcotics, chemicals, or any other type of material; or as a result of any mental or physical condition. Probable cause may include, but is not limited to, any one of the following:
    (A) sworn statements from two people, willing to testify before the board, that a certain licensee/applicant is impaired;
    (B) a sworn statement from a representative of the Texas Medical Association's or the Texas Osteopathic Medical Association's impaired physician program, stating that the representative is willing to testify before the board that a certain licensee/applicant is impaired;
    (C) evidence that a licensee/applicant left a treatment program for alcohol or chemical dependency before a completion of that program;
    (D) evidence that a licensee/applicant has engaged in the intemperate use of drugs or alcohol at a time and under circumstances that would lead a reasonable person to believe that the licensee is impaired;
    (E) evidence of repeated arrests of a licensee/applicant for intoxication or drug use;
    (F) evidence of recurring temporary commitments to a mental institution of a licensee/applicant;
    (G) medical records showing that a licensee/applicant has an illness or condition that results in the inability to function properly in his or her practice; or
    (H) actions or statements by a licensee/applicant at a hearing conducted by the Board that gives the Board reason to believe that the licensee has an impairment.
  (4) Upon presentation to the Executive Director of probable cause, the Board authorizes the Executive Director to write the licensee/applicant requesting that the licensee/applicant submit to a physical or mental examination within 30 days of the receipt of the letter from the Executive Director. The letter shall state the reasons for the request for the mental or physical examination, the physician or physicians the Executive Director has approved to conduct such examinations, and the date by which the examination and the results are to be received by the Board.
  (5) If the licensee/applicant to whom a letter requiring a mental or physical examination is sent refuses to submit to the examination, the Board, through its Executive Director, shall issue an order requiring the licensee/applicant to show cause why the licensee/applicant should not be required to submit to the examination and shall schedule a hearing on the order not later than the 30 days after the date on which the notice of the hearing is provided to the licensee. The licensee/applicant shall be notified by either personal service or certified mail with return receipt requested.
  (6) At the show cause hearing provided in for in paragraph (5) of this subsection, a panel of the Board's representatives shall determine whether the licensee/applicant shall submit to an evaluation or that the matter shall be closed with no examination required.
    (A) At the hearing, the licensee/applicant and the licensee/applicant's attorney, if any, are entitled to present testimony and other evidence showing that the licensee/applicant should not be required to submit to the examination.
    (B) If, after consideration of the evidence presented at the show cause hearing, the panel determines that the licensee/applicant shall submit to an examination, the Board's representatives shall, through its Executive Director, issue an order requiring the examination within 60 days after the date of the entry of the order requiring examination. A licensee is entitled to cross-examine an expert who offers testimony at hearing before the Board.
    (C) If the panel determines that no such examination is necessary, the panel will withdraw the request for examination.
    (D) The results of any Board-ordered mental or physical examination are confidential shall be presented to the Board under seal for it to take whatever action is deemed necessary and appropriate based on the results of the mental or physical examination. A licensee shall be provided the results of an examination and given the opportunity to provide a response at least 30 days before the Board takes action.
  (7) In fulfilling its obligations under §164.056 of the Act, the Board shall refer the licensee/applicant to the most appropriate medical specialist for evaluation. The Board may not require a licensee/applicant to submit to an examination by a physician having a specialty specified by the Board unless medically indicated. The Board may not require a licensee/applicant to submit to an examination to be conducted an unreasonable distance from the person's home or place of business unless the licensee/applicant resides and works in an area in which there are a limited number of physicians able to perform an appropriate examination.
  (8) The guidelines adopted under this subsection do not impair or remove the Board's power to make an independent licensing or disciplinary decision unless a temporary suspension is convened.
(d) Prescription drugs and controlled substances. The board or its authorized representative shall have the power to inspect a licensee's inventory of prescription drugs and obtain samples of those substances, and to inspect and copy records of purchases and disposals of drugs, including those listed in the Texas Controlled Substances Act or controlled substances scheduled in the Federal Comprehensive Drug Abuse Prevention and Control Act of 1970.
(e) Response to Board Requests. In addition to the requirements of responding or reporting to the board under this section, a physician or license holder of the board shall respond in writing to all written board requests for information within 10 days of receipt of such request. Failure to timely respond may be grounds for disciplinary action by the board.

Source Note: The provisions of this §179.4 adopted to be effective November 30, 2003, 28 TexReg 10491; amended to be effective January 25, 2006, 31 TexReg 390; amended to be effective January 20, 2009, 34 TexReg 339; amended to be effective November 29, 2009, 34 TexReg 8534; amended to be effective September 19, 2010, 35 TexReg 8354