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“All of this is now in FAQ section.
Acudetox Specialist Questions
How can I reach the Board 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 ... ”
“... rements 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 ”
“Below is an explanation of the specific information available in each section of the physician profile.
THE INFORMATION IN THESE SECTIONS HAVE BEEN VERIFIED BY THE TEXAS MEDICAL BOARD
Verified Information
Current Board Action
Medical Malpractice Investigations
THE INFORMATION IN THES ... ”
“... ification Commission for Acupuncture and Oriental Medicine (formerly NCCA) http://www.nccaom.org/ 11 Canal Center Plaza Suite 300 Alexandria, VA 22314 (703) 548-9004
The Council of Colleges of Acupuncture and Oriental Medicine (CCAOM) http://www.ccaom.org/ 3909 National Dri ... ”
“... puncturists are licensed by the Texas State Board of Acupuncture Examiners (TSBAE) to practice acupuncture, which is defined as the insertion of an acupuncture needle and the application of moxibustion to specific areas of the human body as a primary mode of therapy to treat and mitigate a human con ... ”
“
Texas Statutes regarding acupuncture practice are at http://www.statutes.legis.state.tx.us/?link=OC.
Acupuncture Board Rules ”
“... cupuncture schools in Texas.
AOMA Graduate School of Integrative Medicine
4701 West Gate Blvd. Austin, Texas 78745 Phone: (512) 454-1188 Fax: (512) 454-7001 www.aoma.edu
American College of Acupuncture and Oriental Medicine
9100 Park West Drive Houston, Texas 77063 Phone: (713) 780-9777 Fax: (713) 7 ... ”
“... d, please do so in writing. Provide full name and practice address of practitioner. Also, provide dates and details of any incident, being as specific as possible. If your complaint is within the Board's jurisdiction, it will be assigned for proper study. Complainants are advised of an investigation ... ”
“... 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. ... ”
“... 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 ... ”
“... 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 ... ”
“An Administrative Medicine license is a 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
&n ... ”
“... 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, administrative, and technical positions to fulfill the mission of the agency: “to protect and enhance the public’s health ... ”
“In medicine and in lay language, the term “board-certified” is widely understood to mean a doctor who possesses exceptional expertise in a particular area.
To protect the public, the Texas Medical Board (TMB) has taken steps to standardize what “board certified” means under T ... ”
“Texas State Board of Acupuncture Examiners
Continuing Acupuncture Education:
Guidelines for Approval/Recognition of Courses for Credit
May 4, 2007
The following guidelines are used by staff to determine course approval/recognition.
Course Approval
CAE courses are recogni ... ”
Description: TMB Bulletin March 2012
Document: The newsletter of the Texas Medical Board, Texas Physician Assistant Board and Texas State Board of Acupuncture Examiners
March 2012
Physician texting trend could pose some potential problems
Text messaging has one of the highest and fastest response rates compared to phone calls and email. Anecdo ...
Description: TMB Bulletin January 2012
Document: The newsletter of the Texas Medical Board, Texas Physician Assistant Board and Texas State Board of Acupuncture Examiners
January 2012
Remedial plans replace disciplinary action in some cases
A new, non-disciplinary option improve their practices. Regives some licensees another medial Plans are pu ...
Description: TMB Bulletin December 2012
Document: The newsletter of the Texas Medical Board, Texas Physician Assistant Board and Texas State Board of Acupuncture Examiners
December 2012
Prescriptive Delegation Waiver Requests
The board has authority to waive or modify any of the site or supervision requirements for a physician delegating prescrip ...
Description: Rule Changes December 30, 2007
Document: ... 07 Board Rules Changes
The following is a summary of the changes effective on December 30, 2007. Click here for the complete board rules. Chapter 173, Physician Profiles , amending 173.1, Profile Contents, updating the name of the Board; 173.2, Profile Update and Correction Form, making it a violati ...
Description: Rule Changes December 4, 2011
Document: ... ges - December 4, 2011
The following is a summary of the changes effective December 4, 2011. Click here for the complete board rules: CHAPTER 163. LICENSURE 22 TAC §§163.1, 163.2, 163.6, 163.7, 163.11 The Texas Medical Board (Board) adopts amendments to §§163.2, 163.6, 163.7 and 163.11, concerning L ...
Description: Rule Changes November 30, 2009
Document: ... 09 Board Rules Changes
The following is a summary of the changes effective on November 30, 2009. Click here for the complete board rules. Chapter 163, Licensure , with proposed amendments to §163.1, relating to Definitions, deletes definition of "country of graduation" because the provision is no lo ...
Description: Rule Changes November 22, 1998
Document: ... 98 Board Rules Changes
The following is a summary of the new rules that are effective 11-2298 Click here for the complete board rules. Chapter 161, General Provisions, amendments to 161.1 and new section 161.4, and repeal of Chapter 189, Rules Changes, which will bring the text up to date with curre ...
Description: Rule Changes October 17, 2010
Document: ... 010 Board Rule Changes
The following is a summary of the changes effective on October 17, 2010. Click here for the complete board rules. Chapter 174, Telemedicine: Amendments to §174.1, concerning Purpose, adds statutory authority for the chapter and exempts out-of-state telemedicine license holders ...
Description: Rule Changes September 27, 2007
Document: ... 07 Board Rules Changes
The following is a summary of the changes effective on September 20, 2007. Click here for the complete board rules. Chapter 161, General Provisions, amending to 161.3, Organization and Structure, regarding standards of conduct for Board members, including prohibiting expert te ...
Description: Rule Changes September 21, 2012
Document: ... relating to deadline requirements for submission of rebuttal materials that is in conflict with other provisions of the rule and the Medical Practice Act. The amendment to §187.83 deletes language requiring a panel member to sign cease and desist order, as rule already provides for executive direct ...
Description: Rule Changes September 19, 2010
Document: ... 010 Board Rule Changes
The following is a summary of the changes effective on September 19, 2010. Click here for the complete board rules. Chapter 180, Texas Physician Health Program and Rehabilitation Orders: Amendment to §180.2, concerning Definitions, adds that the Texas Physician Health and Reha ...
Description: Rule Changes September 19, 2002
Document: ... 02 Board Rules Changes
The following is a summary of the changes that were effective on September 19, 2002. Click here for the complete board rules. Chapter 161, General Provisions. Amendment to '161.6 regarding the status and duties of the Non-Profit Health Organizations Committee and the Licensure ...
Description: Rule Changes September 18, 2011
Document: ... s - September 18, 2011
The following is a summary of the changes effective September 18, 2011. Click here for the complete board rules: CHAPTER 175, FEES AND PENALTIES: Amendment to §175.1 raises the fees for initial registration to be a non-certified radiologic technician (NCT) to $115.50 to be con ...
Description: Rule Changes August 20, 2009
Document: ... 09 Board Rules Changes
The following is a summary of the changes effective on August 9, 2009. Click here for the complete board rules. Chapter 185, Physician Assistants , with amendments to §185.4, Procedural Rules for Licensure Applicants, deletes expired language that grandfathered licensure appli ...
Description: Rule Changes August 10, 2008
Document: ... 08 Board Rules Changes
The following is a summary of the changes effective on August 10, 2008. Click here for the complete board rules. Chapter 161, General Provisions , with amendments to §161.6, Committees of the Board, updates the duties of the Licensure Committee; §161.8, Deputy Executive Direct ...
“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.
“... 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.
“... n 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 ti ... ”
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.
“... sed 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. Th ... ”
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 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)&nbs ... ”
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.
“... 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. Facto ... ”
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.
“No. Periodic meetings are required, regardless of the distance between or 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.
“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 pa ... ”
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.)