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The registration status “Suspended, Active” is a suspended status. A license in this status is not an active license to practice medicine in Texas. However, a licensee with this status has maintained their registration requirements while the license is suspended, and should that suspension be lifted, the license can return to an active status without additional registration requirements.

No, while the selection and administration of anesthesia is a medical act, if such an act was validly delegated to a CNRA by a physician, the act is considered to be within the practice of nursing and governed by the Nursing Practice Act.  Any discipline for a violation of the standard of care by a CRNA would be carried out by the Texas Board of Nursing under the authority of the Nursing Practice Act.  Ultimate responsibility and accountability for the medical management of a patient under anesthesia remains with the delegating physician who may be subject to discipline for improper delegation dependent upon the facts and circumstances of each case, and how state statutes and regulations apply in those situations. 

Yes.  Each time the patient’s PMP history is accessed, the physician or advanced practice provider must ensure that the review is documented in the patient’s medical record.

In the 2017 legislative session, SB 674 changed the law so that the Texas Medical Board is no longer required to register NCTs who work for physicians.  What remains is the requirement that NCTs obtain placement on the MRT Board’s general registry, or have an approved a hardship exemption, prior to starting practice.

In the 2017 legislative session, SB 674 changed the law so that the Texas Medical Board is no longer required to register NCTs who work for physicians.  What remains is the requirement that NCTs obtain placement on the MRT Board’s general registry, or have an approved a hardship exemption, prior to starting practice.

The NCT Registry and the NCT Permit were renewed separately. Under current rules and regulations, the NCT registry is on a biennial (2 year) renewal schedule.  Before elimination by statutory changes, the NCT permit was  an annual renewal.

You will need to continue to renew your NCT Registry listing or hardship exemption to continue to practice as an NCT in Texas. 

As part of the “My TMB” system, we are now able to offer the ability to update mailing and practice addresses online for the majority of our licensees.

To update your mailing or practice address online click the “My TMB” link in the upper right hand corner of our website (near the “search” box), and create an account if you do not have one already.

No, neither the Medical Practice Act nor the Nursing Practice Act authorize independent practice by a CRNA.  Additionally, Texas Attorney General Opinion No. KP-0266 found “A certified registered nurse anesthetist does not possess independent authority to administer anesthesia without delegation by a physician.” (Page 5). Since the selection and administration of anesthesia is a medical act, CRNAs must be properly delegated this act by a physician.  A CRNA who administers anesthesia without proper delegation from a physician would be liable for the unlicensed practice of medicine. 

To return to practice from retired status, a physician must obtain approval of the Board after submitting a written request.  If a physician has been on official retired status for two years or longer, the request must be reviewed by the Licensure Committee of the Board.  Please contact the Registration department for information on the approval procedure.

Yes, if you are a physician or a physician assistant. 

Physicians are required to register all PAs and APRNs that they supervise prior to the delegates beginning to work for them.  If there is a change to the scope of the delegation, physicians must notify the Board within 30 days of this change.

PAs are likewise required to register their supervising physicians with the Board prior to beginning to practice under the employment or prescriptive authority agreement.  They are also required to notify the Board within 30 days of any change to the scope of the delegation. 

APRNs should look to guidance provided by the Texas Board of Nursing for how to register their delegating physicians, as the Medical Board does not have licensing authority for nurses.

To return to practice from retired status, a physician must obtain approval of the Board after submitting a written request.  Please contact the Registration department for information on the approval procedure.

If the request is granted, it may be granted without conditions or subject to such conditions which the board determines are necessary to adequately protect the public.  Requests are reviewed on a case by case basis.

Below are some examples of conditions that may be required (alone or in combination) to return a retired license to an active status:

• limitation of the practice of the requestor to specified activities of medicine and/or exclusion of specified activities of medicine;
• passage of the Special Purpose Examination (SPEX);
• remedial education, including but not limited to a mini-residency, fellowship or other structured program;
• passage of the Medical Jurisprudence Examination; and/or
• such other remedial or restrictive conditions or requirements which, in the discretion of the board, are necessary to ensure protection of the public and minimal competency of the applicant to safely practice medicine.

There are three different ways you can qualify for a waiver. If you or your practice is experiencing any of the following, you may qualify for a waiver:

1. By experiencing economic hardship. When evaluating whether you are experiencing economic hardship, consider:
   1. special situational factors which affect either the cost of compliance or your ability to comply;
   2. the likely impact of compliance on profitability or viability; and
   3. the availability of measures that would mitigate the economic impact of complying.

2. If your practice has technological limitations not reasonably within your control.   
3. Other exceptional circumstances that would lead to you or your practice being unable to set up an e-prescribing process.

On the waiver form, you will have to specify any of the above categories you are experiencing. 

Currently, each individual physician who needs a waiver will have to apply for their own individual waiver. Although this may change in the future, TMB is currently unable to track waivers by group.      

No.  If you are granted a waiver, it applies to all your Texas practice locations.