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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 Responding to Gov. Abbott’s State Disaster Declaration
Document: ... s suspension is in effect until terminated by the Office of the Gove
rnor or until the March 13,
2020 disaster declaration is lifted or expires.
Pursuant to this development,
t
he following
new
procedures are in effect
duri
ng the declared
disaster period:
Allowing Phone Consult ...
Description: TMB Waiver for Chronic Pain Patients Granted by Governor Abbott
Document: ... h
direction and assistance from the Governor’s Office, is implementing procedures to waive
certain requirements to help the state’s physicians, physician assistants and other health care
professionals respond to COVID
-
19.
Governor Abbott approved TMB’s request to
temporarily suspend
...
Description: TMB COVID-19 Telemedicine FAQs
Document: ... sit?
The medical record standards do not change based on the setting by which the
patient is seen.
I
tems such as relevant findings, tests ordered, treatment
recommendations, and consent
should be documented
. Verification of a patient’s
identity is extremely important in a telephone
-
...
Description: TMB Adopts Emergency Rule Related to Gov. Abbott's Executive Order GA-19
Document: ... ach public area and treatment room or area of the office, practice, or facility.
Th
e Executive Committee also withdrew
emergency rules
related to Executive Order GA
-
15
effecti
ve
May 1, 2020
at
12:0
0
a.m.
The Board
will publish
guidance
related to
Executive Order
GA
-
1 ...
Description: Emergency Rule 178.4
Document: ... emergency basis
without prior notice and comment based upon a determination
of imminent peril to the public
health, safety or welfare.
The statute
s affected by this rule: Texas Medical Practice
Act, Chapters
151 and
164
,
Texas
Occupations Code.
This agency hereby certifies tha ...
Description: Emergency Rule 187.57
Document: ... emergency basis
without prior notice and comment based upon a d
etermination of imminent peril to the public
health, safety or welfare.
The statute
s affected by this rule: Texas Medical Practice
Act, Chapters
151 and
164
,
Texas
Occupations Code.
This agency hereby certifies that ...
Description: TMB COVID-19 Supervision FAQs
Document: ... milarly to how it currently works in a facility
-
based
practice setting.
3.
Does the prescriptive authority agreement have to be in writing?
No,
during the disaster declaration a verbal agreement between physician
and delegate is sufficient to establish and maintain the relationship. ...
Description: TMB restricts Marshall physician (Kelehan)
Document: ...
encounters
.
The Board panel found
that
based on evidence,
Dr.
Kelehan engaged in nonconsensual sexual
encounters with a patient and administered medications to the patient during these encounters.
On the date o
f the alleged sexual assault, there is no record of the treatment provide ...
Description: TMB disciplines 19 physicians at October meeting
Document: ... r resolves a
formal complaint filed at the State Office of Administrative Hearings.
Puig, Carlos Eduardo,
M.D., Lic. No. N6588, McAllen
On October 16, 2020, the Board and Carlos Eduardo Puig, M.D., entered into an Agreed Order publicly reprimanding Dr.
Puig and requiring him to have his pra ...
Description: TMB FY 20 Operating Budget
Document: ...
for Fiscal Year 20
bmitted to theGovernor’s Office Budget Division, and the Legislative Budget Board
the
exas Medical Board
anuary , 20
Agency Code: 503 FUND/ACCOUNT 5105 Public Assurance Beginning Balance (Unencumbered): Estimated Revenue: 3572 Health Rel ProfFees-HBll, GR Iner Subtotal: Es ...
Description: TMB Adopts Emergency Rule Related to Issuance of Prescriptions
Document: ... with advice and direction from the Governor’s
Office,
today adopted rules on an emergency basis
related to the issuance of certain
prescriptions during the COVID
-
19
disaster
.
The Governor previously extended the
waiver
to temporarily suspend
Title 22,
Chapter 174.5 (e)
(2)(A) ...
Description: TMB Strategic Plan FY 21-25 (2020)
Document: ... modernizing, upgrading and expanding the system
based on legislative requirements, to improve customer service, and to improve efficiency.
Electronic Document Management System (eDMS)
The agency uses electronic document management to centrally store, organize and access
huge volumes of el ...
Description: TMB disciplines 46 physicians at June meeting, adopts rule changes
Document: ... tlement Agreement issued by the U.S. Attorney’s Office for the Western District of Texas on August 28,
2019. The Board found Dr. Moreno entered into a settlement agreement which arose from submitting false billing claims
to federal health car
e programs.
Novak, Jacob John, M.D., Lic. No. K27 ...
Description: TMB Extends Emergency Rule Related to Issuance of Prescriptions
Document: ... with advice and direction from the Governor’s
Office,
today adopted rules on an emergency basis
related to the issuance of certain
prescriptions during the COVID
-
19
disaster
.
The Board
previously adopted
emergency amendments
to
Title 22, Chapter 174.5
, which are
set to exp ...
Description: TMB President Zaafran Provides COVID-19 Update at August Board Meeting
Document: ... e Board has also
worked with
the
Governor’s Office to
help expand the use
of telem
edicine
and
relieve administrative requirements of licensees by extending deadlines for
licensure renewals and in
-
person continuing medical education.
During
his
board meeting update,
President Z ...
“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.