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“... Care Entities as defined by Section 151.002(a)(5) of the Texas Occupations Code (Also referred to as the Texas Medical Practice Act or "MPA") are entitled to receive limited investigative information as authorized by Sect. 154.054. Any request by a Health-Care Entity that has registered with the Boa ... ”
“... fied the TMB that you are not actively practicing medicine, or
you hold a temporary physician, temporary PA, or Faculty Temporary License.
You are not eligible to delegate prescriptive authority if:
you are a physician licensed under Voluntary Charity Care Status, or
you hold a Telemedicine, Publi ... ”
“... urist uses the title in accordance with section 4 of the Healing Art Identification Act.’
Section 4 of the Healing Art Identification Act has been since codified as Sec. 104.004 of the Tex. Occ. Code Ch. 104. That section provides that:
In using the title "doctor" as a trade or pro ... ”
“... be prescribing controlled substances in the State of Texas need to be aware of changes to the laws regarding prescribing and ordering these drugs.
Controlled Substance Electronic Prescribing Requirement
Effective January 1, 2021, Texas Health and Safety Code, §§481.0755 requir ... ”
“This section of the physician profile contains self-reported physician identifying information including gender, country or state of birth, and race. Also displayed is the physician reported current primary practice and information on the number of years that the physician has been in practice ... ”
“... Does the alleged violation fall under the Medical Practice Act? Complaints that are non-jurisdictional may be referred to another agency.
Place a Complaint
If the complaint is jurisdictional, the board begins the process of determining whether there is evidence to support an allegation that there ha ... ”
“... onna S. Guthery, L.Ac.
Donna S. Guthery, L.Ac.
of Bellaire, is the Presiding Officer of the Texas 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 Or ... ”
“The Texas State Board 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: ... ”
“... 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 ... ”
“... f Z. Zaafran, M.D.
Sherif Z. Zaafran, M.D., of Houston, is 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 Governan ... ”
“... and Reissuance) must submit the following:
Proof of Identity. Copy of birth certificate or passport.
Diploma. Copy of Acupuncture Diploma.
Dean's Certification (Form D) and certified acupuncture school transcript. These forms can be found by clicking the Supplemental Forms link to the l ... ”
“... e school code and paste it into the correct field of the online application.
If you are unable to locate your school on this list, you may enter the code 9999, however, please be aware that this will delay the processing of your application.
Code
Name
Texas Schools ... ”
“Overview of the Acupuncture Application Process
You submit your application online. Note which 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 delive ... ”
“... rogram 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 technique course o ... ”
“... 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
Physician Public Health License
Conceded Eminence ... ”
Description: TMB Bulletin Spring 2000
Document: Medical Board Report
Newsletter of the Texas State Board of Medical Examiners Spring 2000 Volume 21, Number 2 Downloadable versions: Medical Board Report Spring 2000 PDF Medical Board Report Spring 2000 Word Doc
CONTENTS: Texas to Begin Physician Profiling Dr. Levy to Leave Board; Dr. Frank Langley ...
Description: TMB Bulletin Spring 2005
Document: ... has named Roberta M. Kalafut, D.O., as president of the Board. Dr. Kalafut, of Abilene, earned her medical degree from Ohio University College of Osteopathic Medicine and completed her residency in physical medicine and rehabilitation at Johns Hopkins Hospital and Sinai Hospital of Baltimore, Maryl ...
Description: TMB Bulletin Spring 2006
Document: ... df)
Texas Medical Board Bulletin
The newsletter of the Texas Medical Board Spring 2006 Volume 3, Number 2
Dr. Oswalt Appointed to Board; Dr. Kirksey's Exemplary Tenure Ends Governor Rick Perry has appointed Charles E. Oswalt, M.D., F.A.C.S., to the Board. Dr. Oswalt graduated from Texas Christian ...
Description: TMB Bulletin Spring 2007
Document: ... pdf)
Texas Medical Board Bulletin The newsletter of the Texas Medical Board Spring 2007 Volume 4, No. 2
Governor Appoints New Board Member
Governor Rick Perry has appointed Michael Arambula, M.D., Pharm. D., to the board. Dr. Arambula is a San Antonio physician. He received a Doctor of Pharmacy f ...
Description: TMB Bulletin Spring 2004
Document: ... erms. They include Christine L. Canterbury, M.D., of Corpus Christi; Melinda S. Fredricks, of Conroe; Amanullah Khan, M.D., of Dallas; Keith E. Miller, M.D., of Center; Annette P. Raggette, of Austin; and Timothy J. Turner, of Bellaire. Dr. Canterbury is an obstetrician/gynecologist at the Corpus Ch ...
Description: TMB Bulletin Spring 2010
Document: 47
SPRING 2010
46
by using the title of Dr. As a mitigating factor, the
Board considered that the fax did include information
that Mr. Butler was an acupuncturist, although the
information was not in the proper form required.
Liu, H.L. Helen, L.Ac., Lic. No. AC00259, Austin TX
On May 14, 2010 ...
Description: TMB Bulletin Spring 2002
Document: Medical Board Report
Newsletter of the Texas State Board of Medical Examiners Spring 2002 Volume 24, Number 1 Downloadable versions: Medical Board Report Spring02 (spring02.doc MS Word 2000, 107 KB) Medical Board Report Spring02 (spring02.pdf, PDF file, 100 KB) CONTENTS: Governor Appoints New Board ...
Description: TMB Bulletin Spring 1997
Document: Medical Board Report
Newsletter of the Texas State Board of Medical Examiners Spring 1997 Volume 18, Number 2 Downloadable versions: Medical Board Report Spring 97 (spring97.doc, MS Word 97, 166KB)
CONTENTS: Announcement Board Initiates CME Audits Chapter 194. Non-Certified Radiologic Technicians E ...
Description: TMB Bulletin Spring 2008
Document: ... pdf)
Texas Medical Board Bulletin The newsletter of the Texas Medical Board Spring 2008 Volume 5, No. 2
Dr. Shulkin appointed to Board Governor Rick Perry has appointed Allan Shulkin, M.D., to the board. Dr. Shulkin has been a physician in private practice at Pulmonary and Critical Care Medicine i ...
Description: TMB Bulletin Spring 1999
Document: Medical Board Report
Newsletter of the Texas State Board of Medical Examiners Spring 1999 Volume 20, Number 2 CONTENTS: Frequently Asked Questions District Review Committees Formal Complaints Disciplinary Actions Texas Medicaid Drug Review Mammography Info Controlled Substances Fees Texas Docs in th ...
Description: TMB Bulletin Spring 1998
Document: Medical Board Report
Newsletter of the Texas State Board of Medical Examiners Spring 1998 Volume 19, Number 2 Downloadable versions: Medical Board Report Spring 9 (spring98.doc, MS Word 97, 101KB)
CONTENTS: ABMS Provides Website Information Acupuncture Rule Changes Guidelines for Anesthesiologists ...
Description: TMB Bulletin January 2011
Document: The quarterly newsletter of the Texas Medical Board, Texas Physician Assistant Board and Texas State Board of Acupuncture Examiners
January 2011
New rules expand access, set standards for telemedicine in Texas
Pain Clinic Update
Houston is the "dark heart" of Texas' growing prescription drug abuse ...
Description: TMB Bulletin May 2011
Document: The quarterly newsletter of the Texas Medical Board, Texas Physician Assistant Board and Texas State Board of Acupuncture Examiners May 2011
Illegal pain clinic crackdown continues:
The Texas Medical Board's initiative to shut down illegal pain pill mills continues. The most recent highprofile crac ...
Description: TMB Bulletin Spring 2009
Document: ... pdf)
Texas Medical Board Bulletin The newsletter of the Texas Medical Board Spring 2009 Volume 6, No. 2
Governor Appoints, Reappoints Board Members
Governor Rick Perry has made the following appointments and reappointments to the Board: David Baucom, of Sulphur Springs, is president of Baucom Ins ...
Description: TMB Bulletin July 2012
Document: The newsletter of the Texas Medical Board, Texas Physician Assistant Board and Texas State Board of Acupuncture Examiners
July 2012
Pain prescribing:
An important and legitimate part of medicine
By Irvin E. Zeitler Jr., D.O. President, Texas Medical Board The United States is experiencing an epid ...
“... ing permit holder is restricted to the supervised practice of medicine that is part of and approved by the training program. The permit does not allow for the practice of medicine that is outside of the approved program. ”
Can I moonlight with a PIT permit?
No, a physician-in-training permit holder is restricted to the supervised practice of medicine that is part of and approved by the training program. The permit does not allow for the practice of medicine that is outside of the approved program.
“A Family Medicine resident could reasonably be approved by his or her program director to internally moonlight with a PIT permit in the ER, maternity ward, or ambulatory clinic. An Internal Medicine resident could reasonably be approved by his or her program director to internally moonlight in the E ... ”
What are some examples of acceptable internal moonlighting under a PIT permit for training areas related to the specialty?
A Family Medicine resident could reasonably be approved by his or her program director to internally moonlight with a PIT permit in the ER, maternity ward, or ambulatory clinic. An Internal Medicine resident could reasonably be approved by his or her program director to internally moonlight in the ER, ICU, or on the Critical Care service. However, a Family Medicine or Internal Medicine resident should not internally moonlight with a PIT permit on the Surgery service as it is not related to the specialty.
“... s. TMB will only be concerned with the supervised practice of medicine under a PIT permit. ”
Does conference attendance or observation count as internal moonlighting under a PIT permit?
Not for our purposes. TMB will only be concerned with the supervised practice of medicine under a PIT permit.
“... tants 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 t ... ”
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
“... 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.
“... 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.
“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 opinio ... ”
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.
“... 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.
“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 ... ”
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.
“... 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 193. ... ”
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 193.
“... 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. ”
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.
“... oard 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.
“... 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 b ... ”
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.