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“... to PAs or APNs.
Senate Bill 406 (2013), requires a prescriptive authority agreement be in place between a physician and a PA or APN that has been delegated prescriptive authority.
Eligibility requirements for physicians and physician assistants:
Full, active, and unrestricted licenses are r ... ”
“... degrees in acupuncture from another state or from a foreign country hold themselves out as “doctor” in a clinical setting?
In 1995, the Texas Medical Board requested the Attorney General to review the above question. The Attorney General issued an opinion (DM-336) that stated, in p ... ”
“... cally, except in limited circumstances, or unless a waiver has been granted by the appropriate agency.
Information on the E-prescribing requirements and wavier process is available here.
Register with Prescription Monitoring Program - Mandatory Checks Started March 1, 2020
The Texas Pre ... ”
“... splayed is the physician reported current primary practice and information on the number of years that the physician has been in practice in the US or Canada, and the number of years of practice in Texas. ”
“... Board receives and reviews about 9,000 complaints a year from patients, patient family members, health care professionals and other sources. After a complaint is received, staff analysts first determine whether the complaint is “jurisdictional.” In other words, is the complaint against s ... ”
“... State Board of Acupuncture Examiners. Guthery is a licensed acupuncturist, herbalist and family nurse practitioner in the State of Texas. She graduated from the American College of Acupuncture and Oriental Medicine in Houston, Texas with a Master’s Degree in Oriental Medicine, and received a& ... ”
“... ard of Acupuncture Examiners convenes three times a year and consists of nine members appointed by the Governor for six-year staggered terms not requiring Senate confirmation. The presiding officer of the Board is also appointed by the Governor. The Board consists of the following: four acupuncturis ... ”
“... 3, the 73rd Texas Legislature amended the Medical Practice Act to create a Texas State Board of Acupuncture Examiners. The legislators found that the "review and establishment of statewide standards for the training, education and discipline of persons performing acupuncture are in the public intere ... ”
“... s the President of the Texas Medical Board. He is a Board Certified Anesthesiologist and is the Vice-Chair of the Clinical Governance Board for US Anesthesia Partners for the Gulf Coast region as well as a member of the Clinical Governance Board for US Anesthesia Partners Texas. He serves on the Boa ... ”
“... ist is general and should in no way be considered a complete list for any one individual applicant.
It is advisable that all documentation be collected and submitted in one packet; however, the Board realizes that some examination entities and state licensing boards that will not send the docu ... ”
“... ed items. These services require delivery to a physical address and a phone number. Delivery by a private overnight service to our physical address usually allows you to obtain immediate online confirmation of delivery from the carrier.
Delivery Physical Address and Phone Texas State Board ... ”
“... nbsp; Complete a training program in auricular acupuncture for the treatment of addiction, trauma, or physical, emotional, or psychological stress, which:
o is approved by the Medical Board
o is 70 hours in length
o&nbs ... ”
“... ard staff by phone? Call (512) 305-7030 to reach a member of Pre-Licensure, Registration and Consumer Services between the hours of 8 a.m. and 5 p.m. Central Time.
What are the BASIC requirements to be certified as an acudetox specialist in Texas?
Submit application online, and pay the $52 applica ... ”
“... d processed.
Temporary License fee: If requested, a temporary license can be issued once you have met all the requirements for permanent licensure, to enable you to practice until issuance of your permanent license at the next Acupuncture Board meeting. The fee is $107.
Registration Fees ... ”
“... Actions
Physician Assistant Supervision
Advanced Practice Nurse Delegation
”
Description: Rule Changes June 28, 2011
Document: ... ard Rule Changes - June 28, 2011
The following is a summary of the changes effective June 28, 2011. Click here for the complete board rules: Chapter 172, Temporary and Limited Licenses: Amendment to 172.16 concerning Provisional Licenses for Medically Underserved Areas provides that a temporary lic ...
Description: Rule Changes May 13, 2012
Document: ... The amendment provides that mitigating factors in a matter before the Board where a licensee is in violation of the Medical Practice Act do not require that the Board dismiss the case. In cases relating to violations of treatment of tick-borne diseases, a mitigating factor to be considered by the Bo ...
Description: Rule Changes May 10, 1998
Document: ... ain wording to ensure continuity with the Medical Practice Act and to be consistent with current terminology by changing Advisory Board of Osteopathic Specialists to Bureau of Osteopathic Specialists. Chapter 175, Fees and Penalties, amendment to 175.2, which will increase the penalty fees for delin ...
Description: Rule Changes May 09, 1999
Document: 1999 Board Rules Changes
The following is a summary of the new rules that are effective 05-0999. Click here for the complete board rules. Chapter 162, Supervision of Medical School Students, section 162.3, relating to registration requirements. Chapter 163, Licensure, section 163.10, distinguished p ...
Description: Rule Changes May 09, 2002
Document: 2002 Board Rules Changes
The following is a summary of the changes that were effective May 9, 2002 unless otherwise indicated. Click here for the complete board rules. Chapter 184, Surgical Assistants. New sections 184.1-184.16, regarding the regulation of surgical assistants as mandated by HB1183 o ...
Description: Rule Changes May 06, 2013
Document: ... equiring passage of licensure examinations within a seven-year time period. 22 TAC 163.7 The amendment revises the 10-year rule for applicants who have not passed a licensure examination listed in 163.6 so that the practice of medicine for at least six months under a faculty temporary license is a ...
Description: Rule Changes May 06, 2009
Document: 2009 Board Rules Changes
The following is a summary of the changes effective on May 6, 2009. Click here for the complete board rules. Chapter 166, Physician Registration, with amendments to 162.2 Continuing Medical Education, would allow members of the Board's Expert Physician Panel up to 12 hours ...
Description: Rule Changes May 05, 2011
Document: Board Rule Changes - May 5, 2011
The following is a summary of the changes effective May 5, 2011. Click here for the complete board rules: CHAPTER 164. PHYSICIAN ADVERTISING 22 TAC 164.2, 164.4, 164.6 The Texas Medical Board (Board) adopts amendments to 164.2, concerning Definitions, 164.4, conc ...
Description: Rule Changes May 02, 2010
Document: 2010 Board Rule Changes
The following is a summary of the changes effective on May 2, 2010. Click here for the complete board rules. Chapter 183, Acupuncture: new amendments to183.4, Licensure, which increases number of attempts on Acupuncture JP exam upon showing of good cause; 183.9, Impaired Ac ...
Description: Rule Changes March 05, 2000
Document: 2000 Board Rules Changes
The following is a summary of the changes that are effective 03-0500. Click here for the complete board rules. Chapter 163, Licensure - proposed amendments to 163.1 and 163.5, regarding licensure examinations and official translations of documents. Chapter 171, Institutiona ...
Description: Rule Changes March 05, 2000
Document: 2000 Board Rules Changes
The following is a summary of the changes that are effective 03-0500. Click here for the complete board rules. Chapter 163, Licensure - proposed amendments to 163.1 and 163.5, regarding licensure examinations and official translations of documents. Chapter 171, Institutiona ...
Description: Rule Changes March 07, 2012
Document: ... ation review services are subject to reporting on a physician's profile and specifically excludes the reporting of utilization review provided in relation to worker's compensation claims. The amendment to 173.3 clarifies that changes in address to be reported to the Board by physicians within 30 da ...
Description: Rule Changes March 07, 2002
Document: 2002 Board Rules Changes
The following is a summary of the changes that were effective 3-7-02 (Chapters 161, 163, 171, 180, 181, and 185) and 3-11-02 (Chapter 173). Click here for the complete board rules. Chapter 161, General Provisions. Rule review, repeal of 161.1-161.5, and new 161.1-161.13, ...
Description: Rule Changes April 27, 2003
Document: 2003 Board Rules Changes
The following is a summary of the changes that were effective on April 27, 2003 and Chapter 200 effective May 4, 2003. Click here for the complete board rules. Chapter 163, Licensure. Amendments to 163.1 and 163.10 regarding definitions and relicensure requirements. Chapte ...
Description: Rule Changes February 28, 2011
Document: ... Rule Changes - February 28, 2011
The following is a summary of the changes effective February 28, 2011. Click here for the complete board rules: Chapter 163: Licensure, amendment to 163.13, relating to Expedited Licensure Process, deletes language that requires applicants for an expedited license t ...
“... urgical Assistants does not require that you have a license to practice as a Surgical Assistant so long as you are supervised by a physician. Please review the Occupations Code Section 206.002 for full details on applicability. Also: We are aware that many entities require that a Surgical Assistant ... ”
I need this license to practice as a surgical assistant in Texas, right?
No. The Texas Occupations Code concerning Surgical Assistants does not require that you have a license to practice as a Surgical Assistant so long as you are supervised by a physician. Please review the Occupations Code Section 206.002 for full details on applicability. Also: We are aware that many entities require that a Surgical Assistant working for them be licensed in Texas. Please be aware that this is not required by the State of Texas but instead may be the result of billing or institutional policies. Whatever the reason for applying for a license at this time, your application will be given due attention upon submission of all required documents.
“No. However, changes in mailing or practice addresses can now be updated online in most situations. For those license types that cannot use the online system, a Change of Address form is available, but not required. Information on the new Change of Address system is available at: h ... ”
Can I give my change of address over the phone?
No. However, changes in mailing or practice addresses can now be updated online in most situations. For those license types that cannot use the online system, a Change of Address form is available, but not required. Information on the new Change of Address system is available at: http://www.tmb.state.tx.us/page/change-address
“All entities in which a physician assistant has an ownership interest, in which the physician assistant performs a professional service that falls within the scope of physician assistant practice, must register annually, regardless of percent of ownership or when they were formed. ... ”
Who has to report a joint ownership, or physician assistant ownership interest?
All entities in which a physician assistant has an ownership interest, in which the physician assistant performs a professional service that falls within the scope of physician assistant practice, must register annually, regardless of percent of ownership or when they were formed.
“Yes. All entities in which a physician assistant has an ownership interest, in which the physician assistant performs a professional service that falls within the scope of physician assistant practice, must register annually, regardless of percent of ownership or when they were formed. ... ”
Do I have to report a joint ownership or physician assistant ownership interest even if my business was formed prior to the implementation of this statute?
Yes. All entities in which a physician assistant has an ownership interest, in which the physician assistant performs a professional service that falls within the scope of physician assistant practice, must register annually, regardless of percent of ownership or when they were formed.
“... 22 of the Texas Administrative Code, Section 193. A physician is allowed to delegate certain duties to a qualified and properly trained person acting under the physician’s supervision:1) if in the opinion of the delegating physician the act can be properly and safely performed by the person to ... ”
What are the general rules related to AAs/CRNAs?
The authority to delegate is found in Chapter 157 of the Texas Occupations Code, and Title 22 of the Texas Administrative Code, Section 193. A physician is allowed to delegate certain duties to a qualified and properly trained person acting under the physician’s supervision:
1) if in the opinion of the delegating physician the act can be properly and safely performed by the person to whom the medical act is delegated;
2) the act is performed in its customary manner; and
3) the performance of the act by the delegate is not in violation of any other statute.
It is clear that AAs can be delegated certain tasks under Chapter 157. The question is the extent allowable of such delegation. The key provision that needs to be examined is likely “not in violation of any other statute.”
Although the Nursing Act describes what a CRNA can do in regard to anesthesia, there is overlap of regulation of CRNAs between the Medical Board and Nursing Board. CRNAs are subject to physician delegation under the Medical Practice Act. The delegating physician can limit what a CRNA is allowed to provide under a Prescriptive Authority Agreement (PAA) or Standing Order, despite what may be allowed under Nursing Board rules and regulations.
The level of supervision required for any AA (or any delegated provider) is determined based on training, knowledge, and experience, as determined by the physician. For CRNAs, whether any level of physician supervision is required will depend upon those same factors, in addition to applicable federal and state statutes, regulations, bylaws, and ethical standards, if any. However, AAs and CRNAs cannot practice independently and require physician delegation. A hospital or facility can set their own standards, policies, etc., related to delegation and supervision as long as it does not violate Chapter 157, board rules, or other applicable federal and state statutes and regulations. Although AAs most commonly work under an anesthesiologist physician, any physician may supervise and delegate to AAs; however, the standard of care must be met and the delegating physician remains responsible for the AA’s actions.
One difference between an AA and CRNA is the ability to order and prescribe dangerous and controlled substances to patients for anesthesia and anesthesia-related services. Under section 157.058, a CRNA pursuant to the physician’s order and in accordance with facility policies or bylaws may select, obtain, and administer those drugs appropriate to accomplish the order. The physician’s order for anesthesia or anesthesia-related services is not required to specify a drug, dose, or administration technique.
As previously stated, the Nursing Act describes what a CRNA can do in regard to anesthesia. However, the delegating physician or facility can limit what a CRNA is allowed to provide under a PAA or Standing Order, despite what may be allowed under Nursing Board rules and regulations.
While AAs are not allowed to select drugs, determine dose, or administration technique for anesthesia or anesthesia-related services without specification by the supervising physician through an order, they perform many of the other same key duties performed by CRNAs. These duties include conducting preoperative physical exams, administering medications, evaluating and responding to life-threatening situations, setting up external and internal monitors, and implementing general and site-specific anesthetic techniques.
Another area of concern relates to handing-off patient care from CRNAs to AAs. RNs have the authority to delegate certain nursing tasks to unlicensed individuals; however, a CRNA and AA do not have any specific delegation authority concerning anesthesia tasks. A physician has the authority to delegate the process of anesthesia-related patient care, including the transfer or hand-off of care from a CRNA to an AA through an order (standing or patient-specific) or protocol. A CRNA or AA cannot set-up or independently delegate a hand-off or step-down process.
While the Nursing Act places responsibility for patient hand-off on a CRNA, if the physician orders a hand-off process from CRNA to AA, and this is memorialized in orders, protocols, etc., then the CRNA does not have the authority to determine the AA is not competent. The reason is that the physician has already made the determination of competency under Chapter 157.001.
Because the CRNA’s authority also arises through the delegating physician, and is not independent of that physician, a CRNA cannot override a physician Order related to this hand-off scenario. If this hand-off became an issue, the CRNA would have a defense (absolute) because the physician has already determined the competency of the AA to accept this patient.
“Registering a supervising physician for an NCT will no longer be required. However, an NCT will still need to obtain and maintain placement on the MRT Board’s general registry, or have an approved a hardship exemption, prior to starting practice. ... ”
Do I need to register my supervising physician?
Registering a supervising physician for an NCT will no longer be required. However, an NCT will still need to obtain and maintain placement on the MRT Board’s general registry, or have an approved a hardship exemption, prior to starting practice.
“... ere is no limitation to the number of PAs or APNs a physician may supervise. However, a physician may only delegate prescriptive authority to a maximum of seven PA's or APN's, or their full-time equivalent. The only exception relates to supervision and prescriptive delegation to a medically un ... ”
How many physician assistants can a physician supervise?
There is no limitation to the number of PAs or APNs a physician may supervise. However, a physician may only delegate prescriptive authority to a maximum of seven PA's or APN's, or their full-time equivalent. The only exception relates to supervision and prescriptive delegation to a medically underserved population or in facility based practice.
“A physician may delegate prescriptive authority to a maximum of seven PA's or APN's, or their full-time equivalent. There are some statutory exceptions for prescriptive delegation to a medically underserved population or in facility based practice. Refer to Board rule 169. ... ”
How many PAs can a physician delegate prescriptive authority to?
A physician may delegate prescriptive authority to a maximum of seven PA's or APN's, or their full-time equivalent. There are some statutory exceptions for prescriptive delegation to a medically underserved population or in facility based practice. Refer to Board rule 169.
“... if you do not register your license on time. Once a license becomes delinquent, it is considering practicing without a license to practice as a PA, which may be prosecuted by the local district attorney. The policy of the Board, however, is that the only administrative penalty is the payment of pena ... ”
Is there a grace period if I do not pay my PA registration on time?
There is no grace period if you do not register your license on time. Once a license becomes delinquent, it is considering practicing without a license to practice as a PA, which may be prosecuted by the local district attorney. The policy of the Board, however, is that the only administrative penalty is the payment of penalty fees required by statute.
“... d Rule 185.10 covers Physician Assistant Scope of Practice. ”
What are the laws or rules concerning a PA's scope of practice?
Board Rule 185.10 covers Physician Assistant Scope of Practice.
“Yes. A physician on an official retired status is exempt from the registration fee. To be eligible for retired status, a physician's license cannot be under investigation, under a Board order, or be otherwise restricted. Physicians on a retired status must not engage in clinical activities or practi ... ”
Is there a retired status for physicians in Texas?
Yes. A physician on an official retired status is exempt from the registration fee. To be eligible for retired status, a physician's license cannot be under investigation, under a Board order, or be otherwise restricted. Physicians on a retired status must not engage in clinical activities or practice in any state, must not prescribe or administer drugs to anyone, nor may the physician possess a DEA or Texas controlled substance number. Additionally, the physician's license may not be endorsed to any state. A physician whose license has been placed on official retired status must obtain the approval of the board before returning to active status. The physician should contact the board for information on the approval procedure.
“Yes. A retired physician whose only clinical practice is the provision of voluntary charity care to indigent populations shall be exempt from the registration fee but must register the license as well as report CME. The physician's practice of medicine must not include the provision of medical servi ... ”
Is there an exemption for retired physicians providing voluntary charity care?
Yes. A retired physician whose only clinical practice is the provision of voluntary charity care to indigent populations shall be exempt from the registration fee but must register the license as well as report CME. The physician's practice of medicine must not include the provision of medical services for either direct or indirect compensation which has monetary value of any kind and the physician's practice is limited to voluntary charity care to indigent populations and receives no direct or indirect compensation of any kind for medical services rendered. Also, the physician's practice cannot include the provision of medical services to family members or the self-prescribing of controlled substances or dangerous drugs. A physician who violates the provisions of this exemption may be subject to disciplinary action. Action may be based on unprofessional or dishonorable conduct likely to deceive, defraud, or injure the public if the physician engages in the compensated practice of medicine, provides medical services to members of the physician's family, or self-prescribes controlled substances or dangerous drugs. Additionally, a physician who attempts to obtain this exemption by submitting false or misleading statements shall be subject to disciplinary action pursuant to the Medical Practice Act, in addition to any civil or criminal actions provided for by the state or federal law.
“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).
“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 scena ... ”
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.