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“... nsure they have submitted all the forms necessary for their application to be processed. Note: This list 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; ... ”
“... IDGE UNIVERSITY, HONOLULU, HI
0523
ORIENTAL MEDICAL INST OF HAWAII, HONOLULU, HI
0524
UNIV. OF HEALTH SCIENCE, HONOLULU, HI
0525
UNIVERSITY OF SCIENCES, BATON ROUGE, LA
0526
NEW ENGLAND SCHOOL OF ACUP, WATERTOWN, MA
0527
MINSHEW ACUP SCH, COLUMBIA FALLS, MT
0528
I ... ”
“... hich supporting documents you will need to submit for your application to be complete.
You begin collecting and submitting the supporting documents needed.We recommend using one of the private overnight delivery services that allow tracking to submit all required items. These services require d ... ”
“... in which you have ever held a license or applied for a license as a health care professional and request that they furnish you a verification in a sealed envelope with the state board seal across the outside of the envelope. Some states may require that the verification be sent directly to the Texa ... ”
“... plete 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 includes a clean needle ... ”
“... Requirements
Duties of Permit Holders to Report Form
Duties of Program Director to Report Form
FAQs ”
“
Full Texas Medical License
Physician in Training Permit
Faculty Temporary License
Out-of-State Telemedicine License
Administrative Medicine License
Provisional License
Medical License Limited to Underserved Areas
Visiting Physician Temporary Permit
Visiting Professor Temporary License
Conceded Emin ... ”
“... plete a training program in auricular acupuncture for the treatment of alcoholism, substance abuse, or chemical dependency, which:
is approved by the Medical Board
is 70 hours in length
includes a clean needle technique course or equivalent universal infection control precaution procedures course a ... ”
“... eed to complete at least 40 credits of continuing medical education every 24 months. (24 month timeline is in relation to the biennial registration period, not the calendar year).
Physician Assistant CME Requirements (biennial)
Of the 40 credit hours required:
At least 20 credit ... ”
“... IN THESE SECTIONS HAVE BEEN VERIFIED BY THE TEXAS MEDICAL BOARD
Verified Information
Current Board Action
Medical Malpractice Investigations
THE INFORMATION IN THESE SECTIONS WAS REPORTED BY THE LICENSEE AND MAY HAVE NOT BEEN VERIFIED BY THE TEXAS MEDICAL BOARD
Self-Reported Informat ... ”
“What is this? A request for evaluation of your criminal history and potential eligibility for licensure prior to application for licensure as a physician, physician assistant, acupuncturist, medical radiologic technologist, non-certified radiological technician, respiratory care practitio ... ”
“... efore You Apply
Individuals considering applying for an acupuncturist license should use the links to the left to for more information about eligibility, the application process, and the required documentation and fees before submitting their applications. The TSBAE meets and grants permanent licen ... ”
“... mation is seen, processed, or stored by the Texas Medical Board.
The payment portion of the online registration system is handled by Texas.gov, the official website of Texas. The price of this service includes funds that support the ongoing operations and enhancements of Texas.gov, w ... ”
“... Physicians,
Physician Assistants,
Acupuncturists,
Medical Radiologic Technologists,
Respiratory Care Practitioners,
Medical Physicists,
Perfusionists and
Surgical Assistants.
Nurses: TMB does not have the authority to investigate a nurse for care provided within the scope of nursing. If your ... ”
“Search our databases for license and permit information on physicians, physician assistants, acupuncturists, medical radiological technologists, non-certified radiologic technicians, respiratory care practitioners, medical physicists, and perfusionists licensed by the State of Texas. ... ”
Description: Rule Changes April 27, 2003
Document: ... 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. Chapter 167, Reinstatement and Reissuance. Rule review and amendments to §§167.1-.2 and .4-.6 regarding procedu ...
Description: Rule Changes May 01, 2006
Document: ... ges that are effective on May 1, 2006. Click here for the complete board rules. Chapter 175, Fees, Penalties, and Forms. Increased registration fees for Physician Assistants. Chapter 183, Acupuncture. Amendments adds a more extensive list of functions of the Acupuncture board; update the citation to ...
Description: Rule Changes February 28, 1999
Document: ... new rules that are effective 02-2899. Click here for the complete board rules. Chapter 163, Licensure, section 163.1, regarding definition number 8, examinations accepted by the board for licensure by endorsement. Paragraph H is amended to include additional combinations of examinations acceptable ...
Description: Rule Changes January 25, 2006
Document: ... at were effective on January 25, 2006. Click here for the complete board rules. Chapter 161, General Provisions. Amendments change "Texas State Board of Medical Examiners" to "Texas Medical Board" and "Texas State Board of Physician Assistant Examiners" to "Texas Physician Assistant Board;" the numb ...
Description: Rule Changes January 22, 2009
Document: ... changes effective on January 22, 2009. Click here for the complete board rules. Chapter 163 Licensure, amending 163.5,Licensure Documentation, adds additional credentialing organizations that are recognized for the purpose of an international medical school graduate to prove that the medical school ...
Description: Rule Changes January 17, 2011
Document: ... he changes effective January 17, 2011. Click here for the complete board rules: Chapter 164, Physician Advertising , amendments to 164.4 Board Certification, clarify under what circumstances physicians may advertise himself or herself as "board certified." Specifically, the amendments allow physicia ...
Description: Rule Changes January 09, 2005
Document: ... hat were effective on January 9, 2005. Click here for the complete board rules. Chapter 162, Supervision of Medical Students: Amendments to §162.1 repealing requirement that supervising physician hold clinical faculty appointment and new §162.2 adding provisions of Chapter 186, Supervision of Physic ...
Description: Rule Changes January 09, 2003
Document: ... hat were effective on January 9, 2003. Click here for the complete board rules. Chapter 163, Licensure. Amendments to §§163.1 and 163.3-.5 regarding examinations accepted by the board and general clean-up of the chapter. Chapter 171, Postgraduate Training Permits. Amendments to §§171.2 regarding str ...
Description: Rule Changes January 06, 2002
Document: ... and these chapters in your rule book. Click here for the complete board rules. Chapter 163, Licensure. Proposed new 163.13, regarding expedited licensure process. Chapter 166, Physician Registration. Rule review and proposed amendments to 166.1-166.6 regarding general cleanup, CME temporary license ...
Description: Rule Changes January 04, 2007
Document: ... t became effective on January 4, 2007. Click here for the complete board rules. Chapter 163, Licensure - (60) days extension of emergency rule currently in effect, adding 163.14 Interpretation of Section 1.51(d), S.B. 419, relating to exam attempt requirements for those applicants in TMB Licensure s ...
Description: Rule Changes January 02, 2013
Document: ... rogram to delete that residency training required for certification must be acceptable for board certification. The amendment to §163.2 amends the rule to clarify that licensure applicants who are foreign medical school graduates, including Fifth pathways, must demonstrate board certification at tim ...
Description: Rule Changes December 22 and 25, 2011
Document: ... cember 22, 2011 and December 25, 2011. Click here for the complete board rules: The following is a summary of the changes effective December 22, 2011 and December 25, 2011. Click here for the complete board rules: Effective December 22, 2011: CHAPTER 177. BUSINESS ORGANIZATIONS 22 TAC §177.12 and ne ...
Description: Press Release January 6, 2011
Document: Texas Medical Board Press Release FOR IMMEDIATE RELEASE Thursday, January 6, 2011
Media contact: Public Information Officer Leigh Hopper at leigh.hopper@tmb.state.tx.us or (512) 305-7018. Non-media contact: (512) 305-7030 or (800) 248-4062.
Texas Medical Board Announces New Medical Director
The Tex ...
Description: Press Release January 18, 2011 (PDF File)
Document: Texas Medical Board Press Release FOR IMMEDIATE RELEASE Wednesday, January 18, 2011
Media contact: Public Information Officer Leigh Hopper at leigh.hopper@tmb.state.tx.us or (512) 305-7018. Non-media contact: (512) 305-7030 or (800) 248-4062.
Houston doctor Julia Ward, M.D., suspended for illegal o ...
Description: Press Release January 12, 2010 B (Pdf File)
Document: Texas Medical Board Press Release FOR IMMEDIATE RELEASE Tuesday, January 12, 2010
Media contact: Public Information Officer Leigh Hopper at leigh.hopper@tmb.state.tx.us or (512) 305-7018. Non-media contact: (512) 305-7030 or (800) 248-4062.
Medical Board Suspends License of Dr. Timothy N. Marks, Li ...
“... clinics do not apply to the following settings: a medical or dental school or an outpatient clinics associated with a medical or dental school; a hospital, including any outpatient facility or clinic of a hospital; a hospice established under 40 TAC §97.403 (relating to Standards Specific to Ag ... ”
Who does not need to register a pain management clinic?
Regulations regarding the registration and operation of pain management clinics do not apply to the following settings:
Note: The TMB cannot give legal advice. Please consult an attorney if you have questions regarding whether or not your clinic meets one of the exemptions listed above. However, the Board does have inspection authority, and owners of clinics that have not been properly registered can be investigated.
“... exas unless the clinic is owned and operated by a medical director who: • is a physician who practices in Texas • has an unrestricted medical license • holds a certificate of registration for that pain management clinic In addition, the owner/operator of a pain management clini ... ”
Who can own or operate a pain management clinic?
A pain management clinic may not operate in Texas unless the clinic is owned and operated by a medical director who: • is a physician who practices in Texas • has an unrestricted medical license • holds a certificate of registration for that pain management clinic In addition, the owner/operator of a pain management clinic, an employee of the clinic, or a person with whom a clinic contracts for services may not: • have been denied, by any jurisdiction, a license issued by the Drug Enforcement Agency or a state public safety agency under which the person may prescribe, dispense, administer, supply, or sell a controlled substance; • have held a license issued by the Drug Enforcement Agency or a state public safety agency in any jurisdiction, under which the person may prescribe, dispense, administer, supply, or sell a controlled substance, that has been restricted; or • have been subject to disciplinary action by any licensing entity for conduct that was a result of inappropriately prescribing, dispensing, administering, supplying, or selling a controlled substance A pain management clinic may not be owned wholly or partly by a person who has been convicted of, pled nolo contendere to, or received deferred adjudication for: • an offense that constitutes a felony; or • an offense that constitutes a misdemeanor, the facts of which relate to the distribution of illegal prescription drugs or a controlled substance as defined by Texas Occupations Code Annotated §551.003(11) The medical director of a pain management clinic must operate the clinic in compliance with Drug Prevention and Control Act, 21 U.S.C.A. 801 et.seq. and the Texas Controlled Substances Act, Chapter 481 of the Texas Health and Safety Code, relating to the prescribing and dispensing of controlled substances. The medical director of a pain management clinic must, on an annual basis, ensure that all personnel: • are properly licensed, if applicable, • are trained including 10 hours of continuing medical education related to pain management, and • are qualified for employment.
“A name change or change of address for a registered pain management clinic must be submitted in writing (by mail or fax). Please use the PMC change of address form located here. ”
How do I submit a name change or change of address for my pain management clinic?
A name change or change of address for a registered pain management clinic must be submitted in writing (by mail or fax). Please use the PMC change of address form located here.
“Per Board Rule 172.3(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 manag ... ”
What are the continuing education requirements for pain management clinics?
Per Board Rule 172.3(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 management. This CME requirement applies to all personnel providing medical services to the patients (including, but not limited to: PAs, x-ray techs, phlebotomists, RNs, MAs, etc.). Office staff, such as managers, janitors, etc. who do not provide medical services, would not be required to meet the CME requirement, but would need to be listed in response to a pain clinic audit which requires listing all clinic personnel for that clinic. Documentation of the completed CME course shall be required to be made available upon request by Board Staff, including, but not limited to, during an on-site audit of the clinic, or during the certificate renewal process. The Board does have the authority to conduct audits and inspections at clinics to ensure compliance with all requirements and regulations pertaining to registered pain clinics, including audits of CME training as required.
“... rescribe this equipment provided all requirements for delegation of prescriptive authority are met. ”
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.
“... at which the physician’s delegates provide medical services may be an important factor in determining the quality of the physician’s supervision. ”
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.
“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.
“... sed 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. ... ”
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.
“... are 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.
“... icians are not required to supervise CRNA’s for delegated tasks, they nonetheless remain subject to potential liability for violations of the standard of care by CRNAs, depending on federal and state statutes and regulations. The degree to which a physician is required to supervise a CRNA duri ... ”
Are physicians potentially subject to discipline for violations of the standard of care by CRNAs to whom they have delegated the selection or administration of anesthesia or the care of an anesthetized patient?
Yes, potentially. Although physicians are not required to supervise CRNA’s for delegated tasks, they nonetheless remain subject to potential liability for violations of the standard of care by CRNAs, depending on federal and state statutes and regulations. The degree to which a physician is required to supervise a CRNA during the performance of a task in anesthesia services is left to the “physician’s professional judgment in light of other relevant federal and state laws, facility policies, medical staff bylaws, and ethical standards.” (Texas Attorney General Opinion No. JC-0117). However, physician supervision during the medical management of a patient while undergoing an anesthetic may require supervision dependent on federal and state statutes and regulations.
Additionally, Texas Attorney General Opinion No. KP-0353 found “In authorizing physicians to delegate the administration of anesthesia to CRNAs, the Legislature did not expressly limit the liability of the delegating physician. See TEX. OCC. CODE § 157.058; cf. id. § 157.004(c) (providing that in specified circumstances a physician who issues a standing delegation under chapter 203 generally “is not liable in connection with an act performed under that standing delegation order”). Thus, we cannot conclude that the liability of a physician delegating the administration of anesthesia to a CRNA is limited solely to the determination of competency. Questions of physician liability in any specific context are highly factual and not an appropriate determination for the opinion process. See Tex. Att’y Gen. Op. No. GA-0446 (2006) at 18 (“Questions of fact are not appropriate to the opinion process.”) (Page 4 with emphasis added.)
“... nbsp; The physician retains responsibility of the medical management of the patient. Therefore, the delegating physician must consider the delegatee’s education, training, and experience prior to delegating. Additionally, delegation may be revoked by the delegating physician at any ... ”
When is Physician supervision of a CRNA required?
Regardless of the circumstances when supervision is or is not required, it is important to remember that the delegating physician must abide by all required federal and state statutes and regulations regarding delegation. The physician retains responsibility of the medical management of the patient. Therefore, the delegating physician must consider the delegatee’s education, training, and experience prior to delegating. Additionally, delegation may be revoked by the delegating physician at any time.
The Texas Attorney General has issued three opinions on CRNA supervision. The latest opinion found that although physician supervision of a CRNA is not required in Texas Occupations Code Sec. 157.058, other federal and state statutes and regulations may require physician supervision of a CRNA, a CRNA may not administer an anesthetic that is a controlled substance outside the presence of a physician, and the Legislature did not expressly limit the liability of the delegating physician.
Specifically, Texas Attorney General Opinion KP-0353 found “Section 157.058 of the Occupations Code does not, by itself, require a physician who properly delegates anesthesia-related tasks to a certified registered nurse anesthetist (“CRNA”) to supervise the performance of those acts.” (Page 5)
However, KP-0353 also found “…the language of chapter 157 is not the only relevant authority to consider in addressing the question of physician supervision over acts delegated to a CRNA. Federal regulations limiting Medicare coverage and conditioning hospital participation in Medicare and Medicaid programs require physician supervision of a CRNA when administering anesthesia in certain circumstances. See, e.g., 42 C.F.R. §§ 416.42(b)(2), 482.52(a)(4), 485.639(c)(1)(v), (2) (requiring a CRNA to operate under a physician’s supervision when administering anesthesia in certain circumstances). Furthermore, a CRNA may not administer an anesthetic that is a controlled substance outside the presence of a physician. See TEX. HEALTH & SAFETY CODE §§ 481.002(1)(A) (defining “administer” to require agent to apply controlled substance in presence of physician), .071(a) (prohibiting physician from causing controlled substance to be administered under physician’s “direction and supervision” except for valid medical purpose and in course of medical practice). And a CRNA may not obtain an anesthetic that is a dangerous drug unless a physician has listed that CRNA as the physician’s designated agent. See id. §§ 483.001(4) (defining “designated agent”), .022(a) (requiring physician to name each designated agent in writing). (Page 3 with emphasis added.)
Finally, KP-0353 found “Whether and the extent to which physician supervision is required for an act delegated to a CRNA will depend on the specific act delegated, the type of facility in which the CRNA performs the act, and any relevant regulations of that facility. And while section 157.058 authorizes a physician to delegate to a CRNA, a physician is never required to do so. If a physician is concerned about a CRNA’s ability to perform a delegated act or desires to limit the delegation, the physician retains the authority to refrain from delegating, to limit the delegation, or to supervise the delegation to whatever extent the physician determines necessary. In sum, the authority to delegate provided by section 157.058 of the Occupations Code does not eliminate the need to comply with all other applicable statutes, regulations, bylaws, ethical standards, and a physician’s own professional judgment. See TEX. OCC. CODE § 157.007 (“An act delegated by a physician under [chapter 157] must comply with other applicable laws.”). (Page 4 with emphasis added.)
“... cordance with policies approved by the hospital's medical staff or a committee of the hospital's medical staff as provided by the hospital's bylaws to ensure patient safety and as part of care provided to a patient who: (A) has been admitted to the hospital for an intended length of stay of 24 ... ”
Who can prescribe Schedule II drugs under physician delegation?
APRNs or PAs may prescribe schedule II drugs in the following situations:
(1) in a hospital facility-based practice, in accordance with policies approved by the hospital's medical staff or a committee of the hospital's medical staff as provided by the hospital's bylaws to ensure patient safety and as part of care provided to a patient who:
(A) has been admitted to the hospital for an intended length of stay of 24 hours or greater; or
(B) is receiving services in the emergency department of the hospital; or
(2) as part of the plan of care for the treatment of a person who has executed a written certification of a terminal illness, has elected to receive hospice care, and is receiving hospice treatment from a qualified hospice provider.
“... nd PAs must consult with the delegating physician for refills of a prescription for controlled substances after the initial 90 day supply. Consultation is also required when prescribing controlled substances for children under the age of two years. In both cases, the consultation must be ... ”
How often is physician consultation required when prescribing controlled substances?
APRNs and PAs must consult with the delegating physician for refills of a prescription for controlled substances after the initial 90 day supply. Consultation is also required when prescribing controlled substances for children under the age of two years. In both cases, the consultation must be documented in the patient’s medical record.