“... gical assistants, respiratory care practitioners, medical radiologic technologists, medical physicists, and perfusionists.
If you wish to complain to the Board, please do so in writing. Provide full name and practice address of practitioner. Also, provide dates and details of any incident, being as ... ”
“... physicians, physician assistants, acupuncturists, medical radiological technologists, non-certified radiologic technicians, respiratory care practitioners, medical physicists, and perfusionists licensed by the State of Texas. (This includes Physician Profiles and verifications for oth ... ”
“... icensee but not verified by the TMB (e.g. primary practice address, hospital privileges, delegation information, etc.) All verifications also include a description of any action taken by the Board against a licensee.
Data is updated daily and may be considered the most current information available. ... ”
“... rgical Physician Assistant program or a
4) a full medical school (and receipt of a physician's degree).
Worked 2000 hours within the last 3 years as a Surgical Assistant.
Taken and passed one of the three national certifying exams.
Have a current national Board Certification.
Have never been ... ”
“... es to name a few. Under the Occupations Code, the practice of a surgical assistant is limited to surgical assisting performed under the direct supervision of a physician who delegated the acts. The practice of a surgical assistant may be performed in any place authorized by a delegating licensed phy ... ”
“... rsquo;s check or money order payable to the Texas Medical Board. An additional non-refundable surcharge related to the Texas Physician Health Program ($5.25) will be assessed with the application fee. The entire fee must be submitted before your application can be assigned and proces ... ”
“
Board Rule 195.3(d), the medical director or owner/operator of the pain management clinic, must on annual basis, ensure all personnel are properly licensed and, if applicable, have the requisite training to include 10 hours of continuing medical education (CME) annually in the area of pain ma ... ”
“... hure
Provides helpful information about the Texas Medical Board, its disciplinary process, how to research a licensee, and how to file a complaint.
TMB Consumer Brochure
Consumer Guide to Health Care
This guide for consumers on the quality of healthcare and healthcare billing and pri ... ”
“... r written request to:
Open Records
Texas Medical Board
You may send your request by:
mail to: P.O. Box 2018, Austin TX 78768
e-mail to: openrecords@tmb.state.tx.us
fax to: &nbs ... ”
“TEXAS MEDICAL BOARD RESOURCE EFFICIENCY PLAN
The Texas Medical Board is committed to energy conservation by ensuring our facilities are operating in an efficient and effective manner.
Regarding energy management, the TMB’s original Resource Efficiency Plan (REP), submitted October 2002, ... ”
“... lled, the acupuncturist will no longer be able to practice in the state of Texas as an acupuncturist. In order to practice again in Texas following cancellation, a acupuncturist must file an application for relicensure and meet all requirements for licensure in effect at that time.
To r ... ”
“... limited license that allows physicians to use the medical and clinical knowledge, skill, and judgment of a fully licensed physician in ways which may affect the health and safety of the public or any person.
It does not include the authority to
pract ... ”
“Welcome to the Texas Medical Board’s (TMB) Employment Opportunities page. TMB is housed in the George H.W. Bush State Office Building at 1801 Congress Avenue, Suite 9.200, just north of the Texas State Capitol in the Capitol Complex.
We employ over 200 people in a wide variety of professional, ... ”
“... particular area.
To protect the public, the Texas Medical Board (TMB) has taken steps to standardize what “board certified” means under TMB advertising rules. In October 2010 the TMB amended its Physician Advertising rules.
According to the new rules, a physician may use the term "board ... ”
“... ng course content: that it must be related to the practice of acupuncture or oriental medicine, and be related to the knowledge and/or technical skills required to practice acupuncture or related to direct and/or indirect patient care (Board Rule 183.20(n)(1)). In addition, preferred providers must ... ”
“The answer to the question depends on the practice setting. In facility-based hospital practices and in practices that serve medically underserved populations, there are no limitations. In all other practice settings, one physician may delegate to no more than seven full time equivalent ... ”
Is there still a ratio for the number of APRNs or PAs to whom a physician may delegate prescriptive authority?
The answer to the question depends on the practice setting. In facility-based hospital practices and in practices that serve medically underserved populations, there are no limitations. In all other practice settings, one physician may delegate to no more than seven full time equivalent APRNs and PAs (1:7 FTEs).
“... rved populations. In all other settings and practice scenarios, the 1:7 FTE ratios applies. ”
Is there a waiver if a physician wants to delegate prescriptive authority to more than seven full time equivalent APRNs and PAs?
No, the waiver process no longer exists. A physician may only delegate prescriptive authority to more than seven full time equivalent APRNs and PAs in facility based hospital practices and in practices that serve medically underserved populations. In all other settings and practice scenarios, the 1:7 FTE ratios applies.
“No. The old site-based prescriptive authority system is no longer in effect. ”
Do the requirements for types of practice sites still apply?
No. The old site-based prescriptive authority system is no longer in effect.
“Yes. SB 406 clarified that it is necessary to have prescriptive authority to order these devices. In the past, it was not clear to DME suppliers that APRNs and PAs had this authority. The changes to the law as a result of the passage of SB 406 clearly indicate that APRNs and PAs ma ... ”
Is prescriptive authority required to order durable medical equipment (DME)?
Yes. SB 406 clarified that it is necessary to have prescriptive authority to order these devices. In the past, it was not clear to DME suppliers that APRNs and PAs had this authority. The changes to the law as a result of the passage of SB 406 clearly indicate that APRNs and PAs may order or prescribe this equipment provided all requirements for delegation of prescriptive authority are met.
“... authority. The law is silent regarding the practice location of the physician and its proximity to the practice site of the APRN or PA. That said, there has been no change in the law that requires that a physician must provide adequate supervision of delegates. In any given case, the distance ... ”
How many miles from my delegating physician can my practice site be?
SB 406 eliminated site based prescriptive authority. The law is silent regarding the practice location of the physician and its proximity to the practice site of the APRN or PA. That said, there has been no change in the law that requires that a physician must provide adequate supervision of delegates. In any given case, the distance between a physician’s primary practice and the practice site at which the physician’s delegates provide medical services may be an important factor in determining the quality of the physician’s supervision.
“... elegation requires adequate supervision under the Medical Practice Act. As such, a physician delegating to an APRN or PA must adequately supervise those individuals. An individual physician may serve in both the supervising and delegating role and does not need to be physically present a ... ”
What are the Texas Medical Board’s requirements for a physician who delegates to an APRN or PA?
All prescriptive delegation requires adequate supervision under the Medical Practice Act. As such, a physician delegating to an APRN or PA must adequately supervise those individuals. An individual physician may serve in both the supervising and delegating role and does not need to be physically present at all times to be considered to have adequate supervision.
“... ity from a licensed physician in order to provide medical aspects of patient care. Historically, this delegation has occurred through a protocol or other written authorization. Rather than requiring multiple documents, delegation protocols can now be included in one document the prescriptive authori ... ”
Do I need to have a protocol in addition to a prescriptive authority agreement?
APRNs and PAs are required to have delegated authority from a licensed physician in order to provide medical aspects of patient care. Historically, this delegation has occurred through a protocol or other written authorization. Rather than requiring multiple documents, delegation protocols can now be included in one document the prescriptive authority agreement. The prescriptive authority agreement need not describe the exact steps that an advanced practice registered nurse or physician assistant must take with respect to each specific condition, disease, or symptom, however.
“A physician, advanced practice registered nurse, or physician assistant must have an active license to practice that is not suspended, delinquent, or otherwise subject to a disciplinary order that specifically prohibits the licensee from entering into a prescriptive authority agreement. ... ”
What constitutes a license that is in good standing for purposes of entering a prescriptive authority agreement?
A physician, advanced practice registered nurse, or physician assistant must have an active license to practice that is not suspended, delinquent, or otherwise subject to a disciplinary order that specifically prohibits the licensee from entering into a prescriptive authority agreement.
Note that if a licensee’s authority to supervise, delegate, or prescribe devices is limited under a board order, the licensee may enter into a prescriptive authority agreement and practice under the agreement only to the extent permitted by the board order.
“... o the agreement;(3) state the nature of the practice, practice locations, or practice settings;(4) identify the types or categories of drugs or devices that may be prescribed or the types or categories of drugs or devices that may not be prescribed;(5) provide a general plan for ad ... ”
What must be included in a prescriptive authority agreement?
It depends upon when the agreement was executed. Note that there have been several changes to the law affecting this area in recent legislative sessions. To understand how the law might apply to your situation, you may want to seek the advice of private legal counsel.
For a prescriptive authority agreement executed on or after September 1, 2019, the agreement must, at a minimum:
(1) be in writing and reviewed, signed and dated by the parties to the agreement on an annual basis;
(2) state the name, address, and all professional license numbers of the parties to the agreement;
(3) state the nature of the practice, practice locations, or practice settings;
(4) identify the types or categories of drugs or devices that may be prescribed or the types or categories of drugs or devices that may not be prescribed;
(5) provide a general plan for addressing consultation and referral;
(6) provide a plan for addressing patient emergencies;
(7) state the general process for communication and the sharing of information related to the care and treatment of patients;
(8) if alternate physician supervision is to be utilized, designate one or more alternate physicians; and
(9) describe a prescriptive authority quality assurance and improvement plan and how it will be implemented. The plan must require chart reviews and periodic meetings.
“... ity agreement. The number may vary from one practice setting to another. Factors such as the length of time the APRN or PA has been in practice, the length of time the physician and APRN or PA have practiced together, whether the parties to the prescriptive authority agreement practice t ... ”
How many charts must be reviewed?
The law does not provide a specific number or percentage of charts that must be reviewed. Rather, the law provides that the number of charts to be reviewed is determined by the parties to the prescriptive authority agreement. The number may vary from one practice setting to another. Factors such as the length of time the APRN or PA has been in practice, the length of time the physician and APRN or PA have practiced together, whether the parties to the prescriptive authority agreement practice together in the same practice setting, and the complexity of patient care needs should be given consideration when making this determination. That said, there has been no change in the law that requires that a physician must provide adequate supervision of delegates. In any given case, the number or percentage of charts reviewed may be an important factor in determining the quality of the physician’s supervision.
“... locations at which the physician and delegate(s) practice. ”
Can we skip conducting periodic meetings if the physician and APRN or PA practice together at the same location?
No. Periodic meetings are required, regardless of the distance between or locations at which the physician and delegate(s) practice.
“No. Free standing clinics, centers or other medical practices that are owned or operated by or associated with a hospital or long term care facility that are not physically located within the hospital or long term care facility are not considered facility based practices. Prescriptive au ... ”
If I work in a clinic owned by the hospital, is this considered a facility-based practice?
No. Free standing clinics, centers or other medical practices that are owned or operated by or associated with a hospital or long term care facility that are not physically located within the hospital or long term care facility are not considered facility based practices. Prescriptive authority agreements are required in these settings.
“... nt in a hospital or long term care facility based practice, it is not required. You may continue to practice under protocols in these settings. APRNs and PAs must exercise prescriptive authority under one of these delegation mechanisms. ”
Is a prescriptive authority agreement required in a hospital or long term care facility-based practice?
Although it is possible to use a prescriptive authority agreement in a hospital or long term care facility based practice, it is not required. You may continue to practice under protocols in these settings. APRNs and PAs must exercise prescriptive authority under one of these delegation mechanisms.
“In a hospital facility based practice, the delegating physician may be the medical director, the chief of medical staff, the chair of the credentialing committee, a department chair, or a physician who consents to the request of the medical director or chief of the medical staff to delegate. &n ... ”
Who may delegate prescriptive authority in a hospital facility-based practice?
In a hospital facility based practice, the delegating physician may be the medical director, the chief of medical staff, the chair of the credentialing committee, a department chair, or a physician who consents to the request of the medical director or chief of the medical staff to delegate.
“In a long term care facility based practice, delegation is by the medical director. ”
Who may delegate prescriptive authority in a long term care facility based practice?
In a long term care facility based practice, delegation is by the medical director.