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“... by the Texas State Board of Acupuncture Examiners based on a review and recommendation of the course content by the Education Committee of the board (see “List of Current Approved Courses” below),
are offered by Approved Providers (see “List of Current Approve ... ”
“... edication assisted tapering and weaning, computer-based training pain coaching, acupuncture, chiropractic, physical therapy, massage, and exercise/movement; or
collaborative care or other behavioral health integration services such as evidenced-based cognitive behavioral therapy interventions for me ... ”
Description: TMB disciplines 78 physicians at June meeting, adopts rule changes
Document: ... training for Applicants with military experience, based on the passage
of SB 0162 (83rd Legislature, Regular Session). The change to subsection (c)(2)(A) deletes the word "either" to make the
sentence grammatically correct.
§183.5, Annual Renewal of Li
cense
The amendment to
§183.5, concern ...
Description: Medical Board 2016 - June - Licensure Committee Minutes
Document: ... eligible for a license
.
This recommendation is based on disciplinary
action taken
by a health care entity and unprofessional conduct.
Dr. Simonson
seconded the motion. All
voted in favor.
The motion passed.
Applicant #1809
appeared
before the C
ommittee
,
with counsel
,
in exec ...
Description: TMB restricts Throckmorton physician (Beasley)
Document: ... ve for an illicit drug.
The Board panel found based on the evidence presented, Dr. Beasley’s care and treatment
demonstrates a pattern of nontherapeutic prescribing for his chronic pain pat
ients
. Specifically,
Dr. Beasley failed to adequately document that he performed physical examination ...
Description: TMB Legislative Appropriations Request FY 18-19
Document: ... r Fiscal Years 20Submitted to the Governor’s Office of Budget, Planning & Policyand the Legislative Budget BoardbytheTexas Medical Board Submission: August, 201
T
able of Contents
Title
Schedule
#
Page #
Administrator’s Statement
p. 1
Org ...
Description: TMB suspends Houston physician (Pierre)
Document: ... ective immediately.
The Board panel found
that based on the evidence presented, Dr. Pierre is operating an
unlicensed pain management clinic and has failed to adequately supervise his midlevel
practitioner who nontherapeutically presc
ribed controlled substances to multiple patients.
The te ...
Description: Medical Radiologic Technology Board Full Board Agenda
Document: ... bility should contact Alicia Freeman at the Board office phone 512-971-7205 or alicia.freeman@tmb.state.tx.us
at least five (5) working days prior to the Board meeting.
Description: TMB disciplines 45 physicians at August meeting, adopts rule changes
Document: ... er resolves a formal complaint filed at the State Office of Administrative Hearings.
UNPROFESSIONAL CONDUCT
Durrani, Omar Hayat, M.D., Lic. No. M1648, Houston
On August 26, 2016, the Board and Omar Hayat Durrani, M.D., entered into an Agreed Order re
quiring him to within a
year and three ...
Description: Medical Board 2016 - June - Full Board Minutes
Document: ... ocess
and to continue
a full cycle of
offi
ce based anesthesia in
spections with e
gregious
violations
reported
through the disciplinary
process
.
Ms.
Tuthill provided an
overview of
the
increasing
number of
inquiries from physicians
who
report
using
n
itrous oxide
in an
...
Description: Medical Board 2016 - August - Licensure Committee Minutes
Document: ... under Board Rule 166.2.
This recommendation is based on the licensee’s time out of the active practice medicine.
During
discuss
ion Mr. Denton stated that he was going to oppose the motion and should the motion fail
he would make an alternative motion that included the licensee passing the ...
Description: TMB FY 15 Annual Internal Audit Report
Document: ... plications to Licensure Analysts.The assignmentis based on current workload as well as potential complexity of the applicationbased on responses to questions and the skill level of the Licensures AnalystThe Licensure Department uses the “Training Stage” system based on analysts’ skill ...
Description: TMB FY 16 Internal Audit Plan
Document: ...
auditable unit’s
financial
materiality
based onthe dollar amount
per year of assets,
receiptsor disbursements
for which the unit is
responsible; or, financial
materiality based on
the number of licensees for which the unit is
responsible, or the magnitude of its responsibility related ...
Description: TMB FY 16 Annual Internal Audit Report
Document: ... nternal audit
s
and
of
the
Comptroller’s Office
post
-
payment audit dated
October 13, 2015
;
and
,
meet
s the
State of Texas
Internal Audit
Annual
Report requirements
.
TEXAS MEDICAL BOARD
Annual Internal Audit Report
Fiscal Year 2016
3
INTERNAL AUDIT OBJECTIVES
In ...
Description: Respiratory Care Board Full Board Agenda
Document: ... bility should contact Alicia Freeman at the Board office phone 512-971-7205 or alicia.freeman@tmb.state.tx.us
at least five (5) working days prior to the Board meeting.
Description: Rule Changes Effective July 7, 2016
Document: ... training for Applicants with military experience, based
on the passage of SB 0162 (83rd Legislature, Regular Session). The change to subsection (c)(2)(A) deletes
the word "either" to make the sentence grammatically correct.
§183.5, Annual Renewal of Li
cense
The amendment to
§183.5, concern ...
Description: Physician Statistics 2016 Sept - Physicians by Specialty
Document: ... UTRITION
7
0
0
7
OBSTETRICAL ANESTHESIA
0
1
0
1
OBSTETRICS
23
2
0
25
OBSTETRICS & GYNECOLOGICAL SURGERY
121
16
0
137
OBSTETRICS AND GYNECOLOGY
2969
209
0
3178
OCCUPATIONAL ENVIRONMENTAL MEDICINE
38
6
0
44
OCCUPATIONAL MEDICINE
244
30
0
274
ONCOL ...
“No, while the selection and administration of anesthesia is a medical act, if such an act was validly delegated to a CNRA by a physician, the act is considered to be within the practice of nursing and governed by the Nursing Practice Act. Any discipline for a violation of the standard of care ... ”
Is a CRNA under a valid delegation order, subject to discipline by the Texas Medical Board under the Medical Practice Act for a violation of the standard of care in the selection and administration of anesthesia or the care of an anesthetized patient?
No, while the selection and administration of anesthesia is a medical act, if such an act was validly delegated to a CNRA by a physician, the act is considered to be within the practice of nursing and governed by the Nursing Practice Act. Any discipline for a violation of the standard of care by a CRNA would be carried out by the Texas Board of Nursing under the authority of the Nursing Practice Act. Ultimate responsibility and accountability for the medical management of a patient under anesthesia remains with the delegating physician who may be subject to discipline for improper delegation dependent upon the facts and circumstances of each case, and how state statutes and regulations apply in those situations.
“... te data and information pertaining to the patient based on actual findings, assessments, evaluations, diagnostics or assessments as documented by the physician."Non-biographical data/information is data that will typically change from visit to visit. For example, many EMR systems bring forward from ... ”
What is "non-biographical" information as it pertains to an Electronic Medical Record (EMR)?
165.1(a) (10) now requires the following:
"All non-biographical populated fields, contained in a patient's electronic medical record, must contain accurate data and information pertaining to the patient based on actual findings, assessments, evaluations, diagnostics or assessments as documented by the physician."
Non-biographical data/information is data that will typically change from visit to visit. For example, many EMR systems bring forward from the previous encounter non-biographical information such as symptoms, diagnosis, vitals, lab levels, history, previous treatments etc... However, because symptoms often resolve between encounters (as result of treatment), diagnoses may no longer be active or present (because of previous treatments), and vitals fluctuate, such data fields should not contain inaccurate, non-current, or irrelevant data that is not pertinent to the present illness/issue. Such information may be part of the patient’s history, but should not be reflected as current/present unless such symptoms/diagnoses are ongoing. Such information may become part of the patient’s historical data/information contained in the electronic medical record. Non-biographical information/data contained in a medical record for each encounter should be based on actual assessment, evaluations or other diagnostics that are documented by the physician.
Also see: EMR Position Statement
“... nts can be rejected by either DPS or the FBI. Our office will not communicate that a reprint is needed until we receive your unique reference code, which you may then use on the IdentoGo site to waive the fee for a required reprint. ”
I just found out that my fingerprints were rejected. May I immediately request new fingerprint cards?
Applicants are informed of their fingerprints being rejected by IdentoGo prior to that information being sent to the TMB. Fingerprints can be rejected by either DPS or the FBI. Our office will not communicate that a reprint is needed until we receive your unique reference code, which you may then use on the IdentoGo site to waive the fee for a required reprint.
“... that alleviate pain, but not including non-opioid based drugs such as acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs).Anxiolytics--Dangerous or scheduled drugs used to provide sedation and/or to treat episodes of anxiety. ”
What is the TMB definition of an analgesic and anxiolytics?
Board rule 173 defines analgesic and anxiolytics as shown below:
Narcotic Analgesics-- Opioid or opioid-like dangerous or scheduled drugs that alleviate pain, but not including non-opioid based drugs such as acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs).
Anxiolytics--Dangerous or scheduled drugs used to provide sedation and/or to treat episodes of anxiety.
“... s 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 prope ... ”
Are CRNA’s authorized to practice independent of physician supervision and delegation?
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.