These disciplinary sanction guidelines are designed to provide guidance in assessing sanctions for violations of the Medical Practice Act. The ultimate purpose of disciplinary sanctions is to protect the public, deter future violations, offer opportunities for rehabilitation if appropriate, punish violators, and deter others from violations. These guidelines are intended to promote consistent sanctions for similar violations, facilitate timely resolution of cases, and encourage settlements.
  (1) The standard sanctions outlined in paragraph (9) of this section provide a range from "Low Sanction" to "High Sanction" based upon any aggravating or mitigating factors that are found to apply in a particular case. The board may impose more restrictive sanctions when there are multiple violations of the Act. The board may impose more or less severe or restrictive sanctions, based on any aggravating and/or mitigating factors listed in §190.15 of this chapter (relating to Aggravating and Mitigating Factors) that are found to apply in a particular case.
  (2) The minimum sanctions outlined in paragraph (9) of this section are applicable to first time violators. In accordance with §164.001(g)(2) of the Act, the board shall consider revoking the person's license if the person is a repeat offender.
  (3) The sanctions outlined in paragraph (9) of this section are based on the conclusion stated in §164.001(j) of the Act that a violation related directly to patient care is more serious than one that involves only an administrative violation. An administrative violation may be handled informally in accordance with §187.14(7) of this title (relating to Informal Resolutions of Violations). Administrative violations may be more or less serious, depending on the nature of the violation. Administrative violations that are considered by the board to be more serious are designated as being an "aggravated administrative violation."
  (4) The maximum sanction in all cases is revocation of the licensee's license, which may be accompanied by an administrative penalty of up to $5,000 per violation. In accordance with §165.003 of the Act, each day the violation continues is a separate violation.
  (5) Each statutory violation constitutes a separate offense, even if arising out of a single act.
  (6) If the licensee acknowledges a violation and agrees to comply with terms and conditions of remedial action through an agreed order, the standard sanctions may be reduced.
  (7) Any panel action that falls outside the guideline range shall be reviewed and voted on individually by the board at a regular meeting.
  (8) For any violation of the Act that is not specifically mentioned in this rule, the board shall apply a sanction that generally follows the spirit and scheme of the sanctions outlined in this rule.
  (9) The following standard sanctions shall apply to violations of the Act:
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Source Note: The provisions of this §190.14 adopted to be effective November 30, 2003, 28 TexReg 10496; amended to be effective January 25, 2006, 31 TexReg 396; amended to be effective January 20, 2009, 34 TexReg 342; amended to be effective November 29, 2009, 34 TexReg 8536; amended to be effective May 2, 2010, 35 TexReg 3280; amended to be effective December 18, 2011, 36 TexReg 8378; amended to be effective December 23, 2012, 37 TexReg 9774; amended to be effective July 9, 2013, 38 TexReg 4319; amended to be effective August 3, 2014, 39 TexReg 5750; amended to be effective December 15, 2015, 40 TexReg 8898; amended to be effective July 22, 2018, 43 TexReg 4750; amendedto be effective November 13, 2018, 43 TexReg 7461