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“... se may decide to obtain an “inactive” registration status. Current regulations state that a PA license may remain on an inactive status for no longer than 5 years.
Please read the relevant board rule, Tex. Admin. Code, Sec. 185.8, regarding the inactive physician assistant l ... ”
“... tes
Please check the spreadsheet below to confirm registration of a pain management clinic. The pain management clinic registration information below is updated regularly.
Pain Management Clinics - Spreadsheet of Current Certificate status
... ”
“... count to access the “Online Supervision and Prescriptive Delegation System”, the same username and password will work.)
Change of Address
Now that there is an online option for licensees to update their mailing and practice addresses, the hard copy Change of Address forms w ... ”
“As a prerequisite for physician registration, practitioners are required to complete continuing medical education. Current requirements for physicians are summarized below. If you would like to review the current rule, these requirements are currently listed Board rule 166.2 available on our w ... ”
“... ity. This exemption is valid for a maximum of one registration.
Maintenance of Certification (MOC)
Per Board rule 166.2(d), a licensee shall be presumed to have complied with the formal and informal hours requirement of this section if the licensee:
is meeting the Maintenance of Certificatio ... ”
“... he license. An exemption may not exceed one registration period, but may be renewed, subject to approval.
Continuing Education Exemption Request Form - Physician
”
“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 ... ”
“... 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 APRNs and PAs?
How many delegating physicians may one APRN or PA have?
Do the requirements for types of pr ... ”
“... at 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 agreement?
Can we skip conducti ... ”
“... all vital events operations, including reporting, registration, and amendments of births and death records.
To register for electronic filing, follow this link to TxEVER: https://txever.dshs.texas.gov/TxEverUI/Welcome.htm and click on “User Enrollment”
If you have problems ... ”
“... plete the Jurisprudence (JP) exam and the initial registration for your license which will include providing us with information that is statutorily required for us to have for your online physician profile. This includes a fee that is paid directly to the Texas Medical Board and can be completed on ... ”
“... 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. ”
“... 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. ”
“... ered canceled.
The Board assigns the first registration period. These initial permits will be either 12 or 24 months in length. First time registration fees are prorated accordingly. Subsequent registrations will be two years in length and will be due on the same day each time. Even number li ... ”
“Online registration:
No financial information is seen, processed, or stored by the Texas Medical Board.
The payment portion of the online registration system is handled by Texas.gov, the official website of Texas. The price of this service includes funds that support the ongoing operation ... ”
Description: Rule Changes September 14, 2003
Document: ... uing acupuncture education. Chapter 193, Standing Delegation Orders: Amendments to §§193.2 and 193.6 regarding the delegation of prescriptive authority as mandated by House Bill 1095 of the 78th Legislature.
Description: Rule Changes September 12, 2004
Document: ... to §175.1 related to increases in application and registration fees mandated by the Texas Online Authority and increase in physician-in-training fee relating to the length of the permit. Chapter 183, Acupuncture. Amendments to §§183.2 and 183.16 clarifying that certificates and diplomas are acceptab ...
Description: Rule Changes September 10, 2009
Document: ... ication fees to cover the agency's costs; §175.2, Registration and Renewal Fees, to increase certain registration and renewal fees to cover the agency's costs, and establish a charge for the review of continuing acupuncture education courses on a per course basis; and §175.5, Payments of Fees or Pen ...
Description: Rule Changes August 10, 2008
Document: ... in the active practice of medicine. Chapter 166, Registration, with amendments to §166.1, Physician Registration, updates rule to conform with biennial registration; §166.2, Continuing Medical Education, updates rule to conform with biennial registration and amends provisions related to administra ...
Description: Rule Changes July 04, 2012
Document: ... ed while in medical school. Chapter 166 PHYSICIAN REGISTRATION 22 TAC §166.1, §166.3 The amendment to §166.1 provides that a physician will not be eligible for a registration permit if the physician has violated §170.002 or Chapter 171, Texas Health and Safety Code, consistent with HB15 that was pas ...
Description: Rule Changes July 03, 2007
Document: ... ising a medical specialty. Chapter 166, Physician Registration, proposed amendments to 166.5, Relicensure Following Cancellation for Nonpayment of Registration Fee, to refer to provisions of Chapter 196 for cancellation upon non -payment, relinquishment, or surrender. Chapter 172, Temporary and Limi ...
Description: Rule Changes July 02, 2000
Document: ... ng licensure documentation. Chapter 193, Standing Delegation Orders - new §193.9, regarding pronouncement of death.
Description: Rule Changes June 29, 2006
Document: ... and general rule cleanup. Chapter 166, Physician Registration, to include the addition of continuing medical education in forensic evidence collection, modifications to voluntary charity care practice by retired physicians, and general rule cleanup. Chapter 171, Postgraduate Training Permits , to i ...
Description: Rule Changes June 28, 2011
Document: ... e year from the expiration date of the licensee's registration certificate, the licensee shall be found to have committed unprofessional conduct as defined under the Medical Practice Act. http://www.sos.state.tx.us/texreg/archive/June242011/adopted/22.EXAMINING%20BOA RDS.html#361
Chapter 195, Pain ...
Description: Rule Changes June 18, 2002
Document: ... Amendment to §175.1 changes the physician annual registration fee to $334. Effective June 18, 2002. Chapter 184 Surgical Assistants. §§184.1, .6, .8, .13, and .15 effective April 8, 2002 as emergency rules and effect ive June 18, 2002 as permanent rules. §184.4 effective May 29, 2002 as an emergenc ...
Description: Rule Changes May 13, 2012
Document: ... page for more information. Chapter 166 PHYSICIAN REGISTRATION 22 TAC §166.2 The amendment to §166.2 provides that physicians that treat tick-borne diseases should complete relevant CME as required by Senate Bill 1360. Chapter 175 FEES AND PENALTIES 22 TAC §175.5 The amendment clarifies that additio ...
Description: Rule Changes May 10, 1998
Document: ... l increase the penalty fees for delinquent annual registration in order to be consistent with the Medical Practice Act, sect ion 3.10(b)(7). The penalty fee for 31-90 days late will be $55 and the penalty fee for 90 days to 1 year late will be $110. Chapter 183, Acupuncture, amendments to 183.2, 183 ...
Description: Rule Changes May 09, 1999
Document: ... dical School Students, section 162.3, relating to registration requirements. Chapter 163, Licensure, section 163.10, distinguished professors temporary license. Chapter 166, Physician Registration, section 166.2, continuing me dical education requirements and expired permits. Chapter 171, Institutio ...
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 May 06, 2009
Document: ... the complete board rules. Chapter 166, Physician Registration, with amendments to §162.2 Continuing Medical Education, would allow members of the Board's Expert Physician Panel up to 12 hours of formal continuing Medical Education for time actually spent in reviewing standard of care cases and prov ...
“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 d ... ”
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.
“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 ph ... ”
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.
“... dical 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 n ... ”
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.
“Yes, as agreed to by the parties to the prescriptive authority agreement. You may meet more frequently than required by law. You may not meet less frequently than what is required by law. ”
Can more frequent meetings be required?
Yes, as agreed to by the parties to the prescriptive authority agreement. You may meet more frequently than required by law. You may not meet less frequently than what is required by law.
“... cally 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 und ... ”
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.
“Yes. Prior to signing a prescriptive authority agreement, you must disclose to the other party/parties to the prescriptive authority agreement if you have been disciplined in the past. This includes disciplinary action taken by licensing boards in other states. Once you are a party ... ”
Do I have to disclose information regarding investigations and discipline? If so, to whom must this information be disclosed
Yes. Prior to signing a prescriptive authority agreement, you must disclose to the other party/parties to the prescriptive authority agreement if you have been disciplined in the past. This includes disciplinary action taken by licensing boards in other states. Once you are a party to a prescriptive authority agreement, you are required to immediately notify the other party/parties to the agreement if you receive notice that you are the subject of an investigation.
“... 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 ... ”
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.
“... o 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, w ... ”
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.
“... s 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. If your a ... ”
How often are meetings required?
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. If your agreement was entered into prior to September 1, 2019, you may want to seek the advice of private legal counsel to better understand the law’s requirements.
For prescriptive authority agreements entered on or after September 1, 2019, the law changed so that all prescriptive authority agreements must be conducted on at least a monthly basis, no matter the length of time that the physicians have been practicing with the delegates under the agreement.
“... s 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 ... ”
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.
“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 ... ”
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.
“... re not considered facility based practices. Prescriptive authority agreements are required in these settings. ”
If I work in a clinic owned by the hospital, is this considered a facility-based practice?
No. Free standing clinics, centers or other medical practices that are owned or operated by or associated with a hospital or long term care facility that are not physically located within the hospital or long term care facility are not considered facility based practices. Prescriptive authority agreements are required in these settings.
“Although it is possible to use a prescriptive authority agreement in a hospital or long term care facility based practice, it is not required. You may continue to practice under protocols in these settings. APRNs and PAs must exercise prescriptive authority under one of these delegation ... ”
Is a prescriptive authority agreement required in a hospital or long term care facility-based practice?
Although it is possible to use a prescriptive authority agreement in a hospital or long term care facility based practice, it is not required. You may continue to practice under protocols in these settings. APRNs and PAs must exercise prescriptive authority under one of these delegation mechanisms.
“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.
“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. &n ... ”
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.