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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: Rule Changes June 24, 2009
Document: ... sional relationship has been established, for the prescription of drugs for a partner of a patient who may have a sexually transmitted disease. The Board has determined that the amendment to the rule addresses a serious public health issue and is intended to allow physicians to treat persons with se ...
Description: Rule Changes May 09, 1999
Document: ... f intent to practice forms. Chapter 193, Standing Delegation Orders, sections 193.2, relating to the definition of the word "submit."
Description: Rule Changes May 09, 2002
Document: ... ce. Effec tive May 9, 2002. Chapter 193, Standing Delegation Orders. Amendment to section 193.6 regarding the delegation of prescriptive authority to alternate practice sites as specified in SB1166. Effective May 9, 2002.
Description: Rule Changes March 04, 1998
Document: ... a patient may request and receive a contact lens prescription and under which a physician shall provide such prescription, as mandated by the 75th Legislature through the Texas Contact Lens Prescription Act Chapter 183, Acupuncture, repeal of current 183.17 and new sections 183.17 and 183.23, to im ...
Description: Rule Changes March 08, 2001
Document: ... fficient reports, and fees. Chapter 193, Standing Delegation Orders - proposed amendment to 193.6(h) to correct a cite to the Texas Occupations Code Annotated.
Description: Rule Changes March 06, 2003
Document: ... al clean-up of the chapter. Chapter 193, Standing Delegation Orders. Amendments to '193.6 regarding supervision waiver requests.
Description: Rule Changes January 25, 2006
Document: ... quality of care violations. Chapter 193, Standing Delegation Orders. Amendments delete the reference to registration of delegation of prescriptive authority with the Board; set out rules requiring a physician who delegates prescriptive authority to document when and to whom a delegation is made; and ...
Description: Rule Changes January 09, 2005
Document: ... tudents. Repeal of chapter. Chapter 193, Standing Delegation Orders. Amendment to §193.6 regarding delegation of carrying out or signing of prescription drug orders to Physician Assistants and Advanced Nurse Practitioners.
Description: Rule Changes January 08, 2004
Document: ... es to the text of the rule. Chapter 193, Standing Delegation Orders. Amendments to §193.6 concerning the procedure for considering waiver requests for prescriptive delegation. Chapter 194, Non-Certified Radiologic Technicians. Amendments to §§194.1194.4, and 194.6; the repeal of §§194.7-194.10 and n ...
Description: Rule Changes January 02, 2013
Document: ... ent to §190.8 provides the standard for physician delegation of the performance of nerve conduction studies by individuals who are not licensed as physicians or physical therapists. The amendment to §190.14 amends the range and scope of sanctions for violations of the Medical Practice Act. CHAPTER 1 ...
Description: Press Release January 11, 2007 (PDF File)
Document: ... Williams has also been arrested and charged with prescription fraud.
The temporary suspension hearing took place Wednesday, January 10, and the suspension was effective immediately. The length of a temporary suspension order is indefinite but it remains in effect until the board takes further acti ...
Description: Press Release January 24, 2005 (PDF File)
Document: ... ing: Dr. Elder diverted an associate's triplicate prescription pad to prescribe medications to himself and family members; he wrote false and fictitious prescriptions; and his hospital staff privileges were summarily suspended. Based on these findings, the panel found that Dr. Elder is a real danger ...
Description: Press Release February 09, 2005 (PDF File)
Document: ... der's diversion of another physician's triplicate prescription pad to prescribe medications to himself and family members; his resignation from Green Oaks Hospital while under investigation; his improper termination of a physician-patient relationship (the patient was a minor child whom he was treat ...
Description: Press Release February 10, 2009 A (PDF File)
Document: ... ation's action against Dr. Gilmore for allowing a prescription to be issued under her name to a patient she did not see. Kobs, Darcey Gus Jr., M.D., Lic. #D2565, Hattiesburg MS On February 6, 2009, the board and Dr. Kobs entered into an agreed order of voluntary surrender. The action was based on ac ...
Description: Press Release February 11, 2000 (PDF File)
Document: ... of physicians providing, or overseeing by proper delegation, anesthesia services in outpatient settings. The proposed rules will also outline the minimum acceptable standards for the provision of anesthesia services in outpatient settings, as mandated by
Senate Bill 1340, 76th Legislature. The Bo ...
“... 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.