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“... his can include legislation impacting physicians, physician assistants, acupuncturists, surgical assistants, and a variety of other license types.
Access legislative updates here: Legislative Updates
As a state agency, TMB has a number of reporting requirements to the legislature ... ”
“FY 25 Staff and Board Meeting License Issuance Dates
Day
Licensing Date
Date File Must be Completed to be Licensed
Friday
09/13/2024
09/06/2024
Friday
09/27/2024
09/20/2024
Friday
10/18/2024 (Board meeting)
10/11/2024
Friday
11/01/2024
10/2 ... ”
“... ation will require you to download a supplemental form and submit it. Some of the forms must be sent to a third party, such as your medical school or liability carrier. Applicants must also take and pass the Jurisprudence Exam and submit their fingerprints for state and national criminal ... ”
“... nline click here
Name Change Request Form
Verification Request Form
Printable Tanning Advisory
Complaint Notice Poster - Private Autopsy Facility
Consent Form for Abortion Procedure on a Minor
Health Care Liability Claims Report - Update ... ”
“... hool of Osteopathic Medicine (San Antonio)
Texas Physician Assistant Programs
Baylor College of Medicine Physician Assistant Program
Interservice Physician Assistant Program - Fort Sam Houston
Texas Tech University - School of Health Professionals - Physician Assistant Program
University of North ... ”
“... ation checklist, or licensure staff. Although the form may be designed for your license type, it may not be required.
Adobe Acrobat Reader is needed to view PDF files.
Additional Licensure forms are available under Forms. ”
“If you're a physician and you will EVER be called upon to sign a death certificate, state law requires you to register with the Texas Department of State Health Services (DSHS) to file the certificate electronically.
You cannot wait until a death has occurred in order to register; that’s too l ... ”
“The Texas Physician Assistant Board issues a physician assistant license to qualified individuals to practice in Texas. In addition to a license, physician assistants in Texas must practice under the supervision of one or more supervising physicians, and if prescribing drugs, must have a presc ... ”
“... Examiners was formed in 1907. It consisted of 11 physician members appointed biennially by the governor and confirmed by the senate.
In 1931, the legislature increased the number to 12 physicians appointed for six year terms. Sunset legislation passed in 1981 provided that nine physician members be ... ”
“
The Texas Medical Board consists of 12 physician members and seven public members appointed for six-year terms by the Governor and confirmed by the Senate. The full Board convenes five times a year. Typical Board business includes interviewing licensure candidates, considering disciplinary matters, ... ”
“...
Chief Medical Officer Designation/Contact Form
Compromise of Medical Judgement Report Form
The bill requires that a hospital directly hiring physicians appoint a chief medical officer and put in place policies to ensure that a physician employed by the hospital exercises the physicia ... ”
“... abling statutes and practice acts for physicians, physician assistants, acupuncturists, surgical assistants, medical radiologic technologists, medical physicists, perfusionists, and respiratory care practitioners. The relevant chapters are listed below.
The complete code is available here:&nb ... ”
“... ive side of the corporation may be handled by non-physician officers, but all medical decisions and the overall medical policies of the organization must be made by physicians.
162.001(b) Biennial Report Instructions Checklist
162.001(b) Biennial Recertification application
The secon ... ”
“... ive side of the corporation may be handled by non-physician officers, but all medical decisions and the overall medical policies of the organization must be made by physicians.
162.001(b) Initial - Instructions, Checklist
162.001(b) Initial application
The second type of organization ... ”
“... tute (laws/practice acts)
rules for physicians, physician assistants, acupuncturists, and other license types, including adopted rule changes by year, and
the most recent proposed rule changes as well as information about the rulemaking process.
... ”
Description: Press Release February 21, 2007 A (PDF File)
Document: ... e action based on inappropriate conduct involving physician-patient relationships; seven actions based on inadequate medical records; one action based on impairment due to alcohol or drugs; two actions based on other states' actions; one action based on inadequate supervision; four actions based on ...
Description: Press Release February 22, 2011 (PDF File)
Medical Board suspends license of doctor in Forney
Document: ... uthority granted by the Medical Practice Act. The physician has the opportunity to have a Temporary Suspension Hearing With Notice at least 10 days after notice of the suspension just taken. ###
Description: Press Release February 22, 2011 B (PDF File)
Medical Board suspends four pain clinics in Houston, Highlands
Document: ... the clinics were not owned by Graham or any other physician, a violation of state law. The clinics are:
Imed Clinic Inc., 6806 Longpoint Rd. Suite G in Houston, owned by Danny A. Muhammad, a non-physician. Preferred Medical Clinic, 1314 Federal Rd. in Houston, owned by Durce Muhammad, a non-phy ...
Description: Press Release March 02, 2006 (PDF File)
Document: ... that Dr. Brown immediately cease practicing as a physician in the state of Texas and that he shall not again practice in the state until authorized to do so by the Board. -30-
The Texas Medical Board, the state agency that regulates physicians, physician assistants, surgical assistants and acupunc ...
Description: Press Release March 09, 2011 (PDF File)
Document: ... or 800-248-4062
Medical Board suspends Santa Fe physician John Stafford, M.D.
On March 7, 2011, a disciplinary panel of the Texas Medical Board temporarily suspended, without notice, the medical license of John Sullivan Stafford, M.D., of Santa Fe, Texas, after determining that Dr. Stafford's cont ...
Description: Press Release March 10, 2003 (PDF File)
Document: ... March 10, 2003
Board Suspends License of Austin Physician
After a lengthy hearing that took place Monday, March 3, Tuesday, March 4 and Saturday, March 8, the Texas State Board of Medical Examiners has temporarily suspended the license of Philip J. Leonard, M.D., license number E8662. The temporar ...
Description: Press Release March 10, 2005 (PDF File)
Document: ... er the Board's authority to suspend or restrict a physician's license when it determines the physician's continuation in practice would constitute a continuing threat to the public welfare. The suspensions are effective immediately. Dr. Howard's temporary suspension was based on her failure to compl ...
Description: Press Release March 15, 2011 (PDF File)
Document: ... 48-4062
Medical Board Suspends License of Denton Physician
On March 14, 2011, a disciplinary panel of the Texas Medical Board temporarily suspended, with notice, the medical license of Ramon A. Cruz, M.D., of Denton, after determining that Dr. Cruz's continuation in the practice of medicine constit ...
Description: Press Release March 18, 2005 (PDF File)
Document: ... of the 78th Legislature, to suspend or restrict a physician's license without notice when it determines the physician's continuation in practice would con stitute a continuing threat to the public welfare. The suspension is effective immediately. The action was based on the following: On May 24, 200 ...
Description: Press Release March 18, 2010 (PDF File)
Document: ... he Medical Practice Act, to suspend or restrict a physician's license without notice when it determines the physician's continuation in practice would constitute a continuing threat to the public welfare. The suspension is effective immediately. The action was based on the following findings: On Dec ...
Description: Press Release March 18, 2011 (PDF File)
Document: ... r 800-248-4062
Medical Board Suspends License of Physician in Paris, Texas
On March 18, 2011, a disciplinary panel of the Texas Medical Board temporarily suspended, without notice, the medical license of Rick Alan Szumlas, M.D., of Paris, Texas, after determining that Dr. Szumlas' continuation in t ...
Description: Press Release March 19, 2008 A (PDF File)
Document: ... of the 78th Legislature, to suspend or restrict a physician's license without notice when it determines the physician's continuation in practice would constitute a continuing threat to the public welfare. The suspension is effective immediately. The action was based on Dr. Roberts' abuse of anesthes ...
Description: Press Release March 23, 2004 (PDF File)
Document: ... of the 78th Legislature, to suspend or restrict a physician's license without notice when it determines the physician's continuation in practice would constitute a continuing threat to the public welfare. The suspension is effective immediately. The length of a temporary suspension order is indefini ...
Description: Press Release March 28, 2006 (PDF File)
Document: ... oard, the state agency that regulates physicians, physician assistants, surgical assistants and acupuncturists, provides consumer protection through licensure, investigation and disciplinary action. The Board, under President Roberta M. Kalafut, D.O., and Executive Director Donald W. Patrick, M.D., ...
Description: Press Release April 01, 2005 (PDF File)
Document: ... of the 78th Legislature, to suspend or restrict a physician's license without notice when it determines the physician's continuation in practice would constitute a continuing threat to the public welfare. The suspension was effective immediately. The action was based on the following: On February 18 ...
“... 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 periodi ... ”
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.
“... r 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 dete ... ”
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.
“... d under the delegated prescriptive authority of a physician under a prescriptive authority agreement includes the amount of time practiced under the delegated prescriptive authority of that same physician prior to November 1, 2013. For agreements entered on or after September 1, 2019, the lengt ... ”
Is credit given for time practiced in a supervised prescriptive authority arrangement prior to November 1, 2013?
It depends upon when the agreement was executed. For prescriptive authority agreements entered into prior to September 1, 2019, factors such as the type of delegate licensure and amount of time spent practicing under an agreement determined the required frequency and manner of meetings. For such agreements, the amount of time an APRN or PA practiced under the delegated prescriptive authority of a physician under a prescriptive authority agreement includes the amount of time practiced under the delegated prescriptive authority of that same physician prior to November 1, 2013.
For agreements entered on or after September 1, 2019, the length of time that a delegate has practiced in a supervised prescriptive authority arrangement with a physician is no longer relevant to how often parties to the prescriptive authority agreement must meet. Such participants must meet at least on a monthly basis, no matter the length of time spent practicing together under a prescriptive authority agreement.
“... 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.
“... greement designates who may serve as an alternate physician if alternate physician supervision will be utilized. If an alternate physician(s) will participate in the quality assurance and improvement meetings with the APRN or PA, this information must be included in the prescriptive authority ... ”
What if an alternate physician is involved in delegation of prescriptive authority on a temporary basis?
The prescriptive authority agreement designates who may serve as an alternate physician if alternate physician supervision will be utilized. If an alternate physician(s) will participate in the quality assurance and improvement meetings with the APRN or PA, this information must be included in the prescriptive authority agreement.
“A physician may delegate prescriptive authority via facility based protocol at no more than one licensed hospital or no more than two long term care facilities. ”
At how many facilities can one physician delegate prescriptive authority through protocols?
A physician may delegate prescriptive authority via facility based protocol at no more than one licensed hospital or no more than two long term care facilities.
“... 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. ... ”
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.
“... e statutes and regulations. The degree to which a physician is required to supervise a CRNA during the performance of a task in anesthesia services is left to the “physician’s professional judgment in light of other relevant federal and state laws, facility policies, medical staff bylaws ... ”
Are physicians potentially subject to discipline for violations of the standard of care by CRNAs to whom they have delegated the selection or administration of anesthesia or the care of an anesthetized patient?
Yes, potentially. Although physicians are not required to supervise CRNA’s for delegated tasks, they nonetheless remain subject to potential liability for violations of the standard of care by CRNAs, depending on federal and state statutes and regulations. The degree to which a physician is required to supervise a CRNA during the performance of a task in anesthesia services is left to the “physician’s professional judgment in light of other relevant federal and state laws, facility policies, medical staff bylaws, and ethical standards.” (Texas Attorney General Opinion No. JC-0117). However, physician supervision during the medical management of a patient while undergoing an anesthetic may require supervision dependent on federal and state statutes and regulations.
Additionally, Texas Attorney General Opinion No. KP-0353 found “In authorizing physicians to delegate the administration of anesthesia to CRNAs, the Legislature did not expressly limit the liability of the delegating physician. See TEX. OCC. CODE § 157.058; cf. id. § 157.004(c) (providing that in specified circumstances a physician who issues a standing delegation under chapter 203 generally “is not liable in connection with an act performed under that standing delegation order”). Thus, we cannot conclude that the liability of a physician delegating the administration of anesthesia to a CRNA is limited solely to the determination of competency. Questions of physician liability in any specific context are highly factual and not an appropriate determination for the opinion process. See Tex. Att’y Gen. Op. No. GA-0446 (2006) at 18 (“Questions of fact are not appropriate to the opinion process.”) (Page 4 with emphasis added.)
“... , 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 del ... ”
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.)
“APRNs or PAs may prescribe schedule II drugs in the following situations: (1) in a hospital facility-based practice, in accordance with policies approved by the hospital's medical staff or a committee of the hospital's medical staff as provided by the hospital's bylaws to ensure patient safety ... ”
Who can prescribe Schedule II drugs under physician delegation?
APRNs or PAs may prescribe schedule II drugs in the following situations:
(1) in a hospital facility-based practice, in accordance with policies approved by the hospital's medical staff or a committee of the hospital's medical staff as provided by the hospital's bylaws to ensure patient safety and as part of care provided to a patient who:
(A) has been admitted to the hospital for an intended length of stay of 24 hours or greater; or
(B) is receiving services in the emergency department of the hospital; or
(2) as part of the plan of care for the treatment of a person who has executed a written certification of a terminal illness, has elected to receive hospice care, and is receiving hospice treatment from a qualified hospice provider.
“... or delegation of schedule II authority. The physician may only delegate authority to prescribe controlled substances in schedules III through V in this setting. Authority to prescribe dangerous drugs, nonprescription drugs and devices may be delegated in any setting. ... ”
Can schedule II authority be delegated in a free standing emergency department that is affiliated with a hospital?
No. A free standing emergency department is not located within the hospital anddoes not qualify as an eligible site for delegation of schedule II authority. The physician may only delegate authority to prescribe controlled substances in schedules III through V in this setting. Authority to prescribe dangerous drugs, nonprescription drugs and devices may be delegated in any setting.
“... sp;APRNs and PAs must consult with the delegating physician for refills of a prescription for controlled substances after the initial 90 day supply. Consultation is also required when prescribing controlled substances for children under the age of two years. In both cases, the consultati ... ”
How often is physician consultation required when prescribing controlled substances?
APRNs and PAs must consult with the delegating physician for refills of a prescription for controlled substances after the initial 90 day supply. Consultation is also required when prescribing controlled substances for children under the age of two years. In both cases, the consultation must be documented in the patient’s medical record.
“... d directly to the state board of your request.The form is avaliable under Verification Request in the "Licensee Resources" section of our website. ”
How do I get a verification of my Texas license sent to another state?
Upon written request TMB will provide a state board verification to another state board regarding licensees. The verification includes: licensee's name, license or permit number, issue date, expiration date, disciplinary status, and our board seal will be affixed.
There is no fee for state board verifications. Please allow 10 working days to process your verification. The verification will be mailed directly to the state board of your request.
The form is avaliable under Verification Request in the "Licensee Resources" section of our website.
“... outh, as prescribed for the patient on order of a physician, at a dose level low enough to allow the patient to remain ambulatory.Level II Services: Delivery of analgesics or anxiolytics by mouth in dosages greater than allowed at Level I and tumescent anesthesia, as prescribed for the patient on or ... ”
What are the different levels of anesthesia services relating to OBA?
Level I Services: Delivery of analgesics or anxiolytics by mouth, as prescribed for the patient on order of a physician, at a dose level low enough to allow the patient to remain ambulatory.
Level II Services: Delivery of analgesics or anxiolytics by mouth in dosages greater than allowed at Level I and tumescent anesthesia, as prescribed for the patient on order of a physician.
Level III Services: Delivery of analgesics or anxiolytics other than by mouth, including intravenously, intramuscularly, or rectally.
Level IV Services: Delivery of general anesthetics, including regional anesthetics and monitored anesthesia care.
“ A physician who provides level II-IV anesthesia services in an outpatient setting (including analgesics and anxiolytics). A physician who performs a procedure for which level II-IV anesthesia services are provided in an outpatient setting (including analgesics and anxiolytics). ... ”
Who has to register for office-based anesthesia?