Relating to the issuance by the Texas Medical Board of certain licenses to practice medicine and the authority of an insured to select certain license holders under the insured's health policy; requiring an occupational license; authorizing fees.

Contracts

• Supervising Practice Agreements (SPA): You must draft a standardized SPA for Physician Graduates. This is a mandatory contract between the Sponsoring Physician and the Graduate that must be executed *prior* to patient care.
• Employment Agreements: Insert immediate termination clauses triggered by the revocation of a provisional license or the termination of the SPA. For Foreign Provisional licensees, the license is tied to the specific employment offer; if employment ends, the license is void.
• Malpractice Riders: Review policies immediately. Section 155.208 imposes strict liability on the Sponsoring Physician. You must ensure "Physician Graduates" are explicitly defined as covered providers under the Sponsor’s policy.

Hiring/Training

• Credentialing Updates:
• *Foreign Applicants:* Verify 5+ years of licensure in good standing in the home country and secure a formal offer of employment.
• *Physician Graduates:* Verify passage of USMLE Steps 1 and 2 and confirm they are *not* currently enrolled in a residency program.
• Mandatory Disclosure Scripting: Staff must be trained to disclose the provider's status to patients *before* treatment. Badges must clearly state "Physician Graduate."
• Geographic Restrictions: HR must flag that Physician Graduates can only be deployed in counties with a population under 100,000 (rural focus).

Reporting & Record-Keeping

• TMB Profile Updates: Both Sponsoring Physicians and Graduates must update their public TMB profiles to reflect the active Supervising Practice Agreement.
• Delegation Logs: If a Sponsoring Physician delegates supervision to another physician within the group, this authorization must be in writing and kept on file. Verbal delegation is non-compliant.

Fees & Costs

• Licensing Fees:
• Foreign Provisional: Estimated $552 (one-time application).
• Physician Graduate: Estimated $487 (application + registration).
• Insurance Costs: Expect potential premium increases for Sponsoring Physicians due to the assumption of liability for non-residency trained graduates.