The fingerprint background check is required prior to the completion of your initial TMB registration/renewal, per the new statutory requirement set out in Texas Occupations Code, Sec 602.2101.

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. 

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.

As with all medical records documentation, the notation must be contemporaneous, legible and provide complete information.  In this case, complete information would include the date of the review and the identity of the provider who reviewed the information.

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.      

If the supervising physician has a waiver, then the prescribing delegate is also covered under that waiver. So long as the prescribing delegate is prescribing under the authority of a physician who has been granted a waiver, then the prescribing delegate may use non-electronic prescribing means.  If a prescribing delegate is issuing a prescription under the authority of a physician who does not have a waiver, then the prescribing delegate must issue the prescription via e-prescribing. 

If an individual wants to look up whether a prescribing delegate has a waver they can do so as listed below:

For physician assistants:  A PA’s waiver status will not be viewable on their TMB public profile.  Each PA’s public profile has a link to their supervising physician’s profile page.  The physician’s profile page will list the waiver status. 

For nurse practitioners: APRN waivers are determined by the Texas Board of Nursing. Information on the waiver process for the APRNs is available on the Texas Board of Nursing Website.

The Board understands that medical or mental health treatment is a normal part of many people's lives and receiving treatment such as counseling or therapy does not alone disqualify a licensee.  However, the Board is obligated to determine whether a licensee is physically and mentally fit to practice and, therefore, must inquire to the extent necessary to make this determination.  While the application does include a question pertaining to impairment, the question has been thoughtfully written to limit overly broad probing language that might dissuade health professionals from seeking treatment and reporting their conditions.

The Board understands that medical or mental health treatment is a normal part of many people's lives and receiving treatment such as counseling or therapy does not alone disqualify a licensee.  However, the Board is obligated to determine whether a licensee is physically and mentally fit to practice and, therefore, must inquire to the extent necessary to make this determination.  While the renewal process does include a question pertaining to impairment, the question has been thoughtfully written to limit overly broad probing language that might dissuade health professionals from seeking treatment and reporting their conditions.