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“... SUPERVISION & PRESCRIPTIVE DELEGATION REGISTRATION
If you have questions regarding the log in for the Supervision and Prescriptive Delegation Registration System, please use the “HELP” options available in the the upper right hand corner on each screen. ... ”
“... rsquo;s emergency department, contingent upon the prescription being filled at the hospital’s facility-based pharmacy. A PA or APRN may also issue such prescriptions as part of the plan of care for the treatment of a person who has executed a written certification of a terminal illness, ... ”
“... nacted)
H.B. 2561 S. Thompson (V. Taylor) — Prescription Monitoring Program
S.B. 315 Hinojosa (Burkett) — Subpoena Authority and Pain Management Regulation
S.B. 674 Schwertner (S. Davis) — Licensing Provisions and Elimination of Dual Registration
S.B. 1625 Uresti (Cortez) — P ... ”
“... spital privileges, specialty board certification, delegation information, etc.)and some of which is provided and verified by the board (e.g., license status, educational background, disciplinary actions, etc.):
(1) Full name;(2) Place of birth if the physician requests that it be included in the phy ... ”
“... spital privileges, specialty board certification, delegation information, etc.) and can be updated at any time. Many updates are provided by the physician at a time of licensure renewal/registration. An update may be provided by the licensee between renewals, while certain updates MUST b ... ”
“... tmb.state.tx.us/page/supervision-and-prescriptive-delegation
Limits on Number of Delegates: waived the delegate limit of seven PAs or APRNs that a physician could supervise and delegate to regardless of location or setting.
PITs: allowed Texas hospitals and facilities associ ... ”
“... his time, the Online Supervision and Prescriptive Delegation Registration system is not set up to accept delegation locations outside of Texas.
Any physician, PA or APRN who does not have a TX practice address and needs to register prescriptive delegation, please contact the Registration Department ... ”
“... s been granted by the appropriate agency.
A prescription for a controlled substance is not required to be issued electronically and may be issued in writing if the prescription is issued:
by a veterinarian;
in circumstances in which electronic prescribing is not available due to temporary tec ... ”
“... ity of patients are issued, on a monthly basis, a prescription for opioids, benzodiazepines, barbiturates, or carisoprodol, but not including suboxone.
A pain management clinic may not operate in Texas without obtaining a certificate from the Texas Medical Board (TMB). Certain exemption ... ”
Description: Legislative Update - 87th Legislature (2021)
Document: ... ATEGORY
2
-
HEALTH CARE DELIVERY & PRACTICE (delegation, medical records
, etc.
)
HB 549 (S.
Thompson)
Disclosure of
Mental Health
Information
•
Allows certain professionals
(i.e. physicians or those
licensed or certified by this state to
diagnose, evaluate, or treat any menta ...
Description: TMB disciplines 49 physicians at March meeting
Document: ... ,
one order related to improper supervision or
delegation,
one
order
related to violation of Board rules,
two
order
s
relate
d to violation of prior order,
thirteen
order
s
re
lated to other state
s
’
action
s
,
two
order
s
related to impairment
and
two
order
s
rel ...
Description: Respiratory Care Board Full Board Minutes (September 24, 2020)
Document: ... trickseconded, and the motion passeto approve the delegation to the Licensure Manager to offer a WAR certainapplicantsAgenda Item #8 Discussion, recommendation and possible action regarding proposed orders offered by the Executive DirectorMs. Unterborn reported on one Agreed Order offered by the Exe ...
Description: TMB disciplines 27 physicians at August meeting, adopts rule changes
Document: ... ding Botox and other injections and/or the use of prescription medical devices for cosmetic purposes. Ms.
Hernandez failed to provide information regarding any supervision and indicated in her response to the Board that a
medical director is not con
tracted with her spa.
Nguyen, Kelly, No Lice ...
Description: TMB disciplines 31 physicians at March meeting
Document: ... lete at least 12 hours of CME
in supervision and delegation. The Board found Dr. Rojas was placed under a DEA Memorandum of Agreement, and
admitted to pre
-
signing prescription pads for Schedule II controlled substances for his midlevel providers while
he was
on vacation.
Sabella, Vincenzo, ...
Description: TMB disciplines 27 physicians at June meeting, adopts rule changes
Document: ... ibing
, one order related to improper supervision/delegation,
six
order
s
re
lated to other
state
s
’
actions
, two orders related to impairme
nt and
two
orders related to inadequate medical records
.
The Board also
ratified
seven
cease and desist orders
.
The Board issued 310 p
...
Description: TMB disciplines 25 physicians at August meeting
Document: ...
three
order
s
related to improper supervision/delegation,
one order related to violation of board rules
and
four
order
s
re
lated to
other state
s
’
actions.
The Board also ratified
five
cease and desist
orders
.
The Board issued
256
physician licenses at the
August
mee ...
Description: Medical Board 2023 - March - Licensure Committee Minutes
Document: ... multi modal approaches to Pain Management and the Prescription of Opioids.
•
At least 1 of the 48 formal hours must be a course in human trafficking prevention as
approved by Texas Health and Human Services.
Dr.
Naidu
seconded the motion. All voted in favor and the motion passed.
Age ...
Description: TMB disciplines 47 physicians at June meeting
Document: ... wo
order
s
related to improper supervision or delegation, one
order related to violation of
Board rules
,
ten
order
s
re
lated to other
state
s
’
actions
,
and two
order
s
related to
inadequate medical records
.
The Board also ratified
two
cease and desist
orders
.
Th ...
Description: The Servicemembers’ Civil Relief Act, a federal law, allows a member of the uniformed services or a servicemember’s spouse to file for recognition of a professional license from another state to practice that profession in Texas while stationed in Texas. Recognition requires proof that t ...
Document: ... e Last Date of Verification Current Supervision/Delegation Status Information current as of: Date Approve Cartwright Fugitt Shelbie Medical Radiologic Technologist MS - MRT-7044 AC - Active N/A Weaver Natalie HI - R-4478 Crissman Erin Michelle Physician Assistant Campbell James H ...
Description:
TMB disciplines 27 physicians at August meeting
Document: ... wo
order
s
related to improper supervision or delegation, one
order related to violation of
Board rules
,
and
t
wo
order
s
re
lated to other state
s
’
actions.
The Board also
ratified
one
cease and desist order
.
The Board issued
267
physician licenses at the
August
me ...
Description: TMB suspends Frisco physician (Gallagher)
Document: ... ravenous (IV) treatments, including administering prescription pharmaceutical
solutions, resulting in complications that staff
were not trained or prepared to manage, resulting
in a patient’s death.
A temporary suspension hearing with notice will be held as soon as practicable with 10 day ...
Description: TMB disciplines 24 physicians at October meeting
Document: ... f care, keep
adequate medical records, check the Prescription Monit
oring Program, and failed to have controlled substances
agreements regarding three patients.
VIOLATION OF
PRIOR ORDER
Eidman, Dan Kelly, M.D., Lic. No. E4316, Houston
On October 13, 2023, the Board and Dan Kelly Eidman, ...
Description: TMB restricts Harlingen physician (Zeitlin)
Document: ... II
controlled
substances in Texas other than a prescription written to him by a licensed provider for personal
use.
Dr. Zeitlin shall not use his Texas license in any jurisdiction to diagnose, treat, or prescribe
controlled substances to patients in Texas for chronic or post
-
surgical, post
- ...
Description: TMB disciplines 18 physicians at December meeting
Document: ... divided as follows: 12 hou
rs in
supervision and delegation, 8 hours in ethics, 8 hours in risk management, 8 hours in medical recordkeeping, 8 hours in
informed consent and four hours in lar
ge volume liposuction v. liposuction; and within 60 days pay an administrative
penalty of $3,000. The Boa ...
“... that the PMP has been checked prior to issuing a prescription. Certain electronic medical record systems, for example, may provide other ways to document that the review has been completed. ”
May I maintain a copy of the PMP history report in the patient’s medical record?
Yes. The provider may maintain a copy of the PMP history report in the patient’s medical record. There is no specific method required for documenting that the PMP has been checked prior to issuing a prescription. Certain electronic medical record systems, for example, may provide other ways to document that the review has been completed.
“Refills issued to the patient pursuant to a valid prescription and without any reauthorization from the prescriber do not require a PMP check by the prescriber. However, if a prescriber is issuing a prescription for a patient that is unchanged from a previous prescription issued to the patient ... ”
What if a prescriber is just approving a refill?
Refills issued to the patient pursuant to a valid prescription and without any reauthorization from the prescriber do not require a PMP check by the prescriber. However, if a prescriber is issuing a prescription for a patient that is unchanged from a previous prescription issued to the patient (often referred to as a refill), then this would be considered a new prescription and would require a PMP check.
“... endent 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 ... ”
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.
“... m. 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. ... ”
Do I have to let the Medical Board know about my delegates/supervising physicians?
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.
“... count any relevant information prior to issuing a prescription. ”
Is only the prescriber allowed to check the PMP, or can someone else check on behalf of the physician?
A physician, their delegated midlevel provider, or any other qualified and licensed individual delegated authority to check the PMP may do so on behalf of the prescriber. Ultimately though, it is the prescriber’s responsibility to ensure that the PMP has been checked and that they have reviewed and taken into account any relevant information prior to issuing a prescription.
“... ans. 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 ... ”
Do delegates who have prescribing authority have to apply for their own waiver or are they covered by the supervising physician’s waiver?
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.