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A physician may request in writing an exemption* for the following reasons:
catastrophic illness;
military service of longer than one year's duration outside the state;
medical practice and residence of longer than one year's duration outside the United States; or
good cause shown on written ... ”
“... ME requirements. For more information, visit License Retirement Options. ”
“As a prerequisite for physician assistant registration, practitioners are required to complete continuing medical education.
As of December 2018 Physician Assistant Registrations/Renewals are on a biennial cycle (every 2 years). Even license numbers renew in even years, a ... ”
“... on specific continuing education requirements per license type, please select the proper link above.
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Does the physician's name need to be included on the prescription?
Is there still a ratio for the number of APRNs or PAs to whom a physician may delegate prescriptive authority?
Is there a waiver if a physician wants to delegate prescriptive authority to more than seven full time equivalent AP ... ”
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What constitutes a license that is in good standing for purposes of entering a prescriptive authority agreement?
Do I have to disclose information regarding investigations and discipline? If so, to whom must this information be disclosed
What must be included in a prescriptive authority a ... ”
“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 ... ”
“... ed licensing if I do not currently have an active license?
No. The Interstate Medical Licensure Compact (IMLC) is a voluntary, expedited pathway to licensure for physicians who already hold a full, unrestricted medical license in a state that is a member of the Compact, and wish to p ... ”
“The Faculty Temporary License (FTL) is a limited license that allows physicians who do not meet all the requirements for full licensure, but who have the expertise to educate Texas medical students, residents, and fellows, to practice within the confines of the sponsoring institution. The sponsoring ... ”
“Physicians, Physician Assistants, and several other types of licensure applicants are required to submit their fingerprints for state and national criminal history background checks.
Please note that having a criminal history does not automatically disqualify you from obtaining a license throu ... ”
“... 54.006(b)(9) and (10) of the Act requires that: a physician profile display a description of (1) "any conviction for an offense constituting a felony, a Class A or Class B misdemeanor, or a Class C misdemeanor involving moral turpitude" and (2) "any charges reported to the board to which the physici ... ”
“... ection 154.006(b)(12) of the Act requires that: a physician profile display a description of any disciplinary action against the physician by a medical licensing board of another state.
This section of the physician profile displays any applicable descriptions. ... ”
“... ians are required to register with the TMB if the physician supervises or delegates prescriptive authority to Physician Assistants (PAs)s. Current registered supervisions and delegations to PAs are displayed in this section of the physician profile. ... ”
“... ians are required to register with the TMB if the physician delegates prescriptive authority to Advanced Practice Registered Nurses (APRNs). Current registered delegations to APRNs are displayed in this section of the physician profile. ”
“... nt) in Texas are displayed in this section of the physician profile. ”
Description: Rule Changes January 22, 2009
Document: ... amending 165.1, Medical Records, clarifies that a physician must destroy medical records after the required time for maintenance in a manner that ensures continued confidentiality and 165.5, Transfer and Disposal of Medical Records, clarifies when a physician must notify the board of termination, re ...
Description: Rule Changes January 17, 2011
Document: ... k here for the complete board rules: Chapter 164, Physician Advertising , amendments to 164.4 Board Certification, clarify under what circumstances physicians may advertise himself or herself as "board certified." Specifically, the amendments allow physicians to advertise that they are "board certif ...
Description: Rule Changes January 09, 2005
Document: ... to §162.1 repealing requirement that supervising physician hold clinical faculty appointment and new §162.2 adding provisions of Chapter 186, Supervision of Physician Assistant Students. Chapter 166, Physician Registration: Rule review and amendments to §166.1 relating to licensees notifying board ...
Description: Rule Changes January 09, 2003
Document: ... suing postgraduate training permits. Chapter 173, Physician Profiles. Amendments to §'173.1 regarding board actions contained in the profile. Chapter 177, Certification of Non-Profit Health Organizations. Amendment to §177.16 regarding the complaint procedure notification. Chapter 184, Surgical Assi ...
Description: Rule Changes January 08, 2004
Document: ... k here for the complete board rules. Chapter 173, Physician Profiles. Rule review only - no changes to the text of the rule. Chapter 176, Health Care Liability Lawsuits and Settlements. New c hapter, §§176.1-176.9, concerning reporting responsibilities for licensees against whom a health care liabil ...
Description: Rule Changes January 07, 2001
Document: ... with Disabilities Act requirements. Chapter 173, Physician Profiles - proposed amendments to §173.1 regarding information to be released on the physician profiles. Chapter 199, Public Information - rule review and proposed amendments to §§ 199.1-.4 to correct the name of the Public Information Comm ...
Description: Rule Changes January 06, 2002
Document: ... garding expedited licensure process. Chapter 166, Physician Registration. Rule review and proposed amendments to 166.1-166.6 regarding general cleanup, CME temporary licenses, SB1300 (30-day grace period to practice with an expired permit) and voluntary charity care provided to indigent populations. ...
Description: Rule Changes January 04, 2007
Document: ... cture in the United State or Canada; 183.5 Annual Renewal of License, to provide for the automatic cancellation of a license that has been expired for more than one year; 183.15, Use of Professional Titles, to delete the requirement to include "Texas" in the title; and 183.20, Continuing Acupuncture ...
Description: Rule Changes January 02, 2013
Document: ... nsure during the licensure application process if physician intends to use board certification as an alternate grounds for eligibility. The amendment to §163.11 amends the rule to provide remedies for out of active practice issues and to allow for granting a license under a remedial plan. Chapter 17 ...
Description: Rule Changes December 22 and 25, 2011
Document: ... m jointly owned entities. New §177.16, concerning Physician Assistants, provides that physicians and physician assistants may form jointly owned entities. New §177.17, concerning Exceptions to Corporate Practice of Medicine Doctrine, sets out exceptions to the corporate practice of medicine doctrine ...
Description: Press Release January 6, 2011
Document: ... that if the agency's executive director is a non-physician, a medical director be hired. -30-
Description: Press Release January 18, 2011 (PDF File)
Document: ... s Medical Board temporarily suspended the medical license of Julia Renee Ward, M.D., Lic. No. M5571, of Houston, after determining that Dr. Ward's continuation in the practice of medicine presents a continuing threat to the public welfare. The suspension is effective immediately. The Order of Tempor ...
Description: Press Release January 12, 2010 B (Pdf File)
Document: ... 5-7030 or (800) 248-4062.
Medical Board Suspends License of Dr. Timothy N. Marks, Lic. # J-3719, of Dallas
On Jan. 8, 2010, the Board entered an automatic Order of Suspension against Timothy N. Marks, M.D., due to his incarceration in a federal correctional facility following his conviction for fai ...
Description: Press Release January 11, 2007 (PDF File)
Document: ... 05-7030 or (800) 248-4062
Medical Board Suspends License of Michael Lee Williams, M.D., of Palestine
A panel of the Texas Medical Board temporarily suspended the license of Michael Lee Williams, M.D., license #H5995, of Palestine, after determining that Dr. Williams continuation in the practice of ...
Description: Press Release January 16, 2011 (PDF File)
Document: ... that if the agency's executive director is a non-physician, a medical director be hired. -30-
“... te audit of the clinic, or during the certificate renewal process. The Board does have the authority to conduct audits and inspections at clinics to ensure compliance with all requirements and regulations pertaining to registered pain clinics, including audits of CME training as required. ... ”
What are the continuing education requirements for pain management clinics?
Per Board Rule 195.4(e), the medical director or owner/operator of the pain management clinic, must on annual basis, ensure all personnel are properly licensed and, if applicable, have the requisite training to include 10 hours of continuing medical education (CME) annually in the area of pain management. This CME requirement applies to all personnel providing medical services to the patients (including, but not limited to: PAs, x-ray techs, phlebotomists, RNs, MAs, etc.). Office staff, such as managers, janitors, etc. who do not provide medical services, would not be required to meet the CME requirement, but would need to be listed in response to a pain clinic audit which requires listing all clinic personnel for that clinic. Documentation of the completed CME course shall be required to be made available upon request by Board Staff, including, but not limited to, during an on-site audit of the clinic, or during the certificate renewal process. The Board does have the authority to conduct audits and inspections at clinics to ensure compliance with all requirements and regulations pertaining to registered pain clinics, including audits of CME training as required.
“Yes, the physician’s name, address and telephone number are required to be included on the prescription drug order. If the prescription is for a controlled substance, the physician’s DEA number is also required to be included on the prescription. SB 406 did not change the req ... ”
Does the physician's name need to be included on the prescription?
Yes, the physician’s name, address and telephone number are required to be included on the prescription drug order. If the prescription is for a controlled substance, the physician’s DEA number is also required to be included on the prescription. SB 406 did not change the requirements for what needs to be included on a prescription drug order.
“... ations. In all other practice settings, one physician may delegate to no more than seven full time equivalent APRNs and PAs (1:7 FTEs). ”
Is there still a ratio for the number of APRNs or PAs to whom a physician may delegate prescriptive authority?
The answer to the question depends on the practice setting. In facility-based hospital practices and in practices that serve medically underserved populations, there are no limitations. In all other practice settings, one physician may delegate to no more than seven full time equivalent APRNs and PAs (1:7 FTEs).
“No, the waiver process no longer exists. A physician may only delegate prescriptive authority to more than seven full time equivalent APRNs and PAs in facility based hospital practices and in practices that serve medically underserved populations. In all other settings and practice scena ... ”
Is there a waiver if a physician wants to delegate prescriptive authority to more than seven full time equivalent APRNs and PAs?
No, the waiver process no longer exists. A physician may only delegate prescriptive authority to more than seven full time equivalent APRNs and PAs in facility based hospital practices and in practices that serve medically underserved populations. In all other settings and practice scenarios, the 1:7 FTE ratios applies.
“... t in disciplinary action against the professional license. ”
Do I have to produce my prescriptive authority agreement or facility-based protocol if a licensing board asks to see it?
Yes. You are required to provide a copy of the prescriptive authority agreement to the board that requested it within three business days. Although SB 406 did not specifically note that facility-based protocols must also be submitted within this time frame, each licensing board has the authority to request this information. Failure to provide the requested information could result in disciplinary action against the professional license.
“... is silent regarding the practice location of the physician and its proximity to the practice site of the APRN or PA. 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 distance between a physician&rsqu ... ”
How many miles from my delegating physician can my practice site be?
SB 406 eliminated site based prescriptive authority. The law is silent regarding the practice location of the physician and its proximity to the practice site of the APRN or PA. 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 distance between a physician’s primary practice and the practice site at which the physician’s delegates provide medical services may be an important factor in determining the quality of the physician’s supervision.
“... under the Medical Practice Act. As such, a physician delegating to an APRN or PA must adequately supervise those individuals. An individual physician may serve in both the supervising and delegating role and does not need to be physically present at all times to be considered to have ad ... ”
What are the Texas Medical Board’s requirements for a physician who delegates to an APRN or PA?
All prescriptive delegation requires adequate supervision under the Medical Practice Act. As such, a physician delegating to an APRN or PA must adequately supervise those individuals. An individual physician may serve in both the supervising and delegating role and does not need to be physically present at all times to be considered to have adequate supervision.
“... uired to have delegated authority from a licensed physician in order to provide medical aspects of patient care. Historically, this delegation has occurred through a protocol or other written authorization. Rather than requiring multiple documents, delegation protocols can now be included in one doc ... ”
Do I need to have a protocol in addition to a prescriptive authority agreement?
APRNs and PAs are required to have delegated authority from a licensed physician in order to provide medical aspects of patient care. Historically, this delegation has occurred through a protocol or other written authorization. Rather than requiring multiple documents, delegation protocols can now be included in one document the prescriptive authority agreement. The prescriptive authority agreement need not describe the exact steps that an advanced practice registered nurse or physician assistant must take with respect to each specific condition, disease, or symptom, however.
“A physician, advanced practice registered nurse, or physician assistant must have an active license to practice that is not suspended, delinquent, or otherwise subject to a disciplinary order that specifically prohibits the licensee from entering into a prescriptive authority agreement. ... ”
What constitutes a license that is in good standing for purposes of entering a prescriptive authority agreement?
A physician, advanced practice registered nurse, or physician assistant must have an active license to practice that is not suspended, delinquent, or otherwise subject to a disciplinary order that specifically prohibits the licensee from entering into a prescriptive authority agreement.
Note that if a licensee’s authority to supervise, delegate, or prescribe devices is limited under a board order, the licensee may enter into a prescriptive authority agreement and practice under the agreement only to the extent permitted by the board order.
“... sp; 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 d ... ”
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.