All Roll Calls
Yes: 302 • No: 33
TexasHB 203889th Legislature Regular SessionHouse
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.
Sponsored By: Elizabeth "Liz" Campos, Caroline Harris Davila, Suleman Lalani, Tom Oliverson, Vincent Perez, Kevin Sparks (Republican)
Signed by Governor
Intergovernmental RelationsMilitary & VeteransOccupational Regulation--Health OccupationsDECREASING OCCUPATIONAL CERTIFICATION TIMELINES, OBSTACLES, AND REGULATIONS (DOCTOR) ACTPHYSICIANSMEDICAL BOARD, TEXAS
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Bill Overview
Analyzed Economic Effects
3 provisions identified: 1 benefits, 0 costs, 2 mixed.
Foreign-trained doctors gain limited Texas licenses
Beginning September 1, 2025, eligible foreign-trained doctors gain a provisional Texas license lasting two years. Applicants need a qualifying medical degree, a foreign license in good standing without pending discipline, and their licensing country's required postgraduate training. They must pass medical exam Steps 1 and 2 and the Texas medical law exam, speak English, and have federal work authorization. They also need a Texas physician job offer in a facility or group practice and must meet additional Board rules. The law bars specified applicants from countries identified as national-security risks or subject to arms-export restrictions. Initial practice is limited to approved residency-program settings or related affiliated settings. Renewal requires the specified exams and a valid Educational Commission for Foreign Medical Graduates certificate. Renewed licenses allow practice outside residency-affiliated settings but only in rural or designated underserved areas with current physician shortages. The law provides a full-license path after required exams, but bars applicants facing Board investigation or discipline for provisional-license conduct or specified criminal convictions, including deferred dispositions. The Texas Medical Board sets license fees and must adopt implementing rules by January 1, 2026.
Medical graduates gain supervised practice licenses
Beginning September 1, 2025, eligible Texas residents can get a limited physician graduate license. Applicants need federal work authorization, English skills, qualifying medical education, and medical exam Steps 1 and 2 or approved equivalents. They cannot be enrolled in an approved residency program and must meet additional Board requirements. Practice requires a written agreement with a sponsoring physician who has an unrestricted Texas license, no current discipline, and recognized specialty certification. Graduates may practice only in counties with fewer than 100,000 people and within the sponsor's certified specialty. Any physician assigned to supervise them must belong to the sponsor's group or facility and hold certification in that same specialty. Before treatment, graduates must disclose their license status and lack of formal specialized postgraduate or residency training; they must display identification but may use the title doctor. Sponsors remain legally responsible for patient care, and the Board limits how many graduates each sponsor supervises. At renewal, the Board verifies supervised practice during the prior term; it may require continuing education and deny, suspend, or revoke licenses. Issuance and renewal fees cannot exceed the matching physician assistant license fees; the law states no dollar amounts. The Board must adopt implementing rules by January 1, 2026.
Patients can choose covered physician graduates
Patients with qualifying Texas health policies can choose physician graduates for covered services within those providers' license scope. This applies to policies delivered, issued for delivery, or renewed on or after January 1, 2026. Beginning September 1, 2025, the law also classifies physician graduates as general practitioners for federal Medicare and Medicaid agency regulations. These provisions do not set payment rates or change premiums, copays, or benefit levels.
Sponsors & Cosponsors
Sponsors
Elizabeth "Liz" Campos
House
Caroline Harris Davila
House
Suleman Lalani
House
Tom Oliverson
House
Vincent Perez
House
Kevin Sparks
Republican • Senate
Cosponsors
Katrina Pierson
House
Roll Call Votes
House vote • 5/29/2025
Record vote
Yes: 108 • No: 31
Senate vote • 5/26/2025
Record vote
Yes: 0 • No: 0
Senate vote • 5/26/2025
Record vote
Yes: 30 • No: 1
House vote • 5/6/2025
Record vote
Yes: 144 • No: 0
Senate vote • Unknown
Committee vote: Health & Human Services
Yes: 8 • No: 0
House vote • Unknown
Committee vote: Public Health
Yes: 12 • No: 1
Actions Timeline
Effective on 9/1/25
6/20/2025HouseSigned by the Governor
6/20/2025HouseSent to the Governor
6/1/2025HouseSigned in the Senate
6/1/2025SenateSigned in the House
5/31/2025HouseReported enrolled
5/30/2025HouseHouse concurs in Senate amendment(s)-reported
5/29/2025SenateText of Senate Amendment(s)
5/29/2025HouseStatement(s) of vote recorded in Journal
5/29/2025HouseRecord vote (RV#4025)
5/29/2025HouseHouse concurs in Senate amendment(s)
5/29/2025HouseSenate Amendments Analysis distributed
5/28/2025HouseSenate Amendments distributed
5/28/2025HouseSenate passage as amended reported
5/26/2025HouseRecord vote
5/26/2025SenatePassed
5/26/2025SenateRead 3rd time
5/26/2025SenateRecord vote
5/26/2025SenateThree day rule suspended
5/26/2025SenateVote recorded in Journal
5/26/2025SenatePassed to 3rd reading as amended
5/26/2025SenateVote recorded in Journal
5/26/2025SenateAmended
5/26/2025SenateAmendment(s) offered (FA1 Sparks)
5/26/2025SenateRead 2nd time
5/26/2025Senate
Bill Text
Engrossed
Enrolled
House Committee Report
Introduced
Senate Committee Report
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