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.

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.

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.

Yes. A patient, the patient’s parent or legal guardian if the patient is a minor, or the patient’s legal guardian if the patient is an incapacitated person, may receive a copy of the patient’s PMP record, including a list of who has accessed that record.

For more information on how to submit a request, please review the Pharmacy Board’s Patient Access Program page, found here: https://www.pharmacy.texas.gov/patient-access/

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.      

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.

Email renewal reminders are sent 60-90 days before the expiration date, from no.reply@tmb.state.tx.us. We recommend that you add this email address to your contacts list so they will not be lost.  Please check your junk and spam mail for these notices if you are not receiving them.  If you have any questions about the fingerprint requirements or the renewal process, please contact us at Registrations@tmb.state.tx.us.