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“... sued to avoid penalty fees. If you have not registered your license within 90 days of your license issue date, a penalty fee equal to ½ the registration fee will be assessed. If you have not registered your license within 120 days of your license issue date, the penalty fee will i ... ”
“... ees
Initial Registration - If you have not registered your license within 90 days of your license issue date, a $75 penalty fee will be assessed. If you have not registered your license within 120 days of your license issue date, the penalty fee will increase to $150. If you do no ... ”
“... r the complete regulations.
Inspections of registered OBA locations in Texas.
In order that we may ensure compliance with Board Rule 173 regarding the provision of anesthesia services in outpatient settings, the Board implemented, starting January 2014, a program to inspect registered OBA loc ... ”
“... forms will be sent out to both the clinic’s registered physician owner as well as the pain management clinic address at least 90 days in advance of the expiration date.
At this time, registered pain management clinics are not able to use the online Change of Address option. To sub ... ”
“... bsp;
Initial Registration – If you have not registered your license within 90 days of your license issue date, a penalty fee equal to ½ the registration fee will be assessed. If you have not registered your license within 120 days of your license issue date, the penalty fee will i ... ”
“... exas requires pain management clinics (PMC) to be registered with Texas Medical Board.
A “pain management clinic” is a publicly or privately owned facility for which a majority of patients are issued on a monthly basis a prescription for opioids, benzodiazepines, barbiturates, or carisop ... ”
“... d to determine and verify if a clinic needs to be registered, is properly registered, or is exempt. Also, audits and inspections are both non-disciplinary verification processes.
You may view the Board Rules on pain management clinic in detail on our website under Board Rules, ... ”
“... ANCES
Where and when may a physician assistant (PA) or advanced practice registered nurse (APRN) prescribe a Schedule II Controlled Substance?
Properly authorized APRNs and PAs may issue prescriptions for Schedule II controlled substances to patients who are admitted to a hospital for an intended ... ”
“... Function Technologist (CPFT) examination or NBRC Registered Pulmonary Function Technologist (RPFT) examination - 10 contact hours
Board of Registered Polysomnographic Technologists (BRPT) registration examination - 10 contact hours
National Asthma Educator Certification Board (NAECB) Certified Asth ... ”
“... MRT
Jennifer Brandt, MRT, of Fort Worth is a registered radiologist assistant at The University of Texas Southwestern Medical Center. She is a member of the Texas Society of Radiologic Technologists, Society of Radiology Physician Extenders and American Society of Radiologic Technologists. Bran ... ”
“... s in an automated email sent to the email address registered with the application the next business day. Please check your spam or junk folders for this email. You may call Consumer Services at (512) 305-7030 to request this number if you do not have a copy of this notice with your provided ID numbe ... ”
“... radiologic technologist who is certified as:
a registered radiologist assistant by the American Registry of Radiologic Technologists; or
a radiology practitioner assistant by the Certification Board for Radiology Practitioner Assistants.
RA licenses expire twice a year, February 28 ... ”
Description: Acupuncture 2008 February, EC AI 4 CAE Action Taken
Document: ... Directors and Administrators
1
Ethics
1
NADA Registered Trainers Workshop
General
7
General 7
NADA Annual Conference
General
National Acupuncture NADA Annual Detoxification Assn, PO Box Conference 1972, Vancouver, WA 98668 nadaoffice@acudet ox.com (888) 765 6232
Ethics
Nefeli Corp, 319 ...
Description: Medical Board 2008 - June - Full board Committee Meeting Minutes
Document: ... ns for Licensure, clarifies what is an acceptable registered nurse first assisting program and a surgical physician assistant program, deletes surgical assistant programs that are not CAAHEP accredited from being acceptable for purposes of licensure, and updates name of LCC-ST; 184.5, Procedural Rul ...
Description: Medical Board 2008 - June - Standing Orders Committee Meeting Minutes
Document: ... isit every twenty business days, by any physician registered to supervise the PA that staffs the clinic. The substitute motion failed to garner a second, and the motion failed. The Committee voted on the original motion. Dr. Oswalt and Ms. Fredricks voted in favor. Ms. Raggette was opposed. The moti ...
Description: Medical Board 2009 - February - Full Board Committee Meeting Minutes
Document: ... owners to be a licensed physician and the clinic registered and inspected with a fee to administer this program. Ms. Robinson gave a report on a proposed state-wide physician health and rehabilitation program overseen by this board, but separate, to encourage physicians to seek rehabilitation and c ...
Description: Medical Board 2009 - May - Finance Committee Meeting Minutes
Document: ... on Acupuncturists is a fee for each course being registered. Currently, there is a flat registration fee, regardless of how many
courses are submitted. Ms. Garanflo advised the Acupuncture Board has already approved these changes in fees. Mari Robinson added that all of the above mentioned increa ...
Description: Medical Board 2010 - June - Standing Orders Committee - Agenda Item 6 - Site-Specific Prescriptive Delegation Statute & Rule
Document: ... ons
N/A
N/A
Delegating Physician Requirements
PA/APN FTE Limits
Site Visit Requirements
Cannot supervise more than three clinics without approval of the board. Cannot supervise any number of clinics with combined regular business hours exceeding 150 concurrent hours per week without approval o ...
Description: Medical Board 2011 - August - Licensure Committee - Agenda Item 9: Modifications to Board Rules - 22 TAC 167 - Reinstatement and Reissuance
Document: ... receipt requested, overnight or express mail, or registered mail, to the last mailing address of the applicant or the applicant's attorney on file with the board. (5) The probationer show compliance proceeding shall allow: (A) the board staff to address whether it is in the best interest of the pub ...
Description: Medical Board 2011 - August - Licensure Committee - Agenda Item 9: Modifications to Board Rules - 22 TAC 184 - Surgical Assistants
Document: ... for those individuals who are exempted, including registered nurses and physician assistants, under §206.002 of the Act. §184.2. Definitions. The following words and terms, when used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise. (1) Act--Title 3, ...
Description: Medical Board 2011 - August - Licensure Committee - Agenda Item 9: Modifications to Board Rules - 22 TAC 192 - Office-Based Anesthesia Services
Document: ... fe Support, as defined by the AHA. (11) Certified registered nurse anesthetist--A person licensed by the Texas Board of Nursing (TBN) as a registered professional nurse, authorized by the TBN as an advanced practice nurse in the role of nurse anesthetist, and certified by a national certifying body ...
Description: Medical Board 2013 - February - Licensure Committee Meeting Minutes
Document: ... ation (CAAHEP); and the applicant does not hold a registered nurse degree and therefore the program is not considered substantially equivalent as a registered nurse first assist program approved by the Texas Board of Nursing. Ms. Southard seconded the motion. All voted in favor. The motion passed
A ...
Description: Medical Board 2013 - February - Licensure Committee - Agenda Item 6a: Proposed Changes to Board Rule 197
Document: ... sician licensed to practice in Texas and shall be registered as an EMS medical director with the Texas Department of State Health Services; (2) familiar with the design and operation of EMS systems; (3) experienced in prehospital emergency care and emergency management of ill and injured patients; ( ...
Description: TMB disciplines 14 physicians at October meeting, adopts rule changes
Document: ... twright, Roger Wayne, M.D., Lic. No. R8708, York, PA
On October 14, 2022, the Board and Roger Wayne Boatwright, M.D., entered into an Agreed Order on Formal Filing
publicly reprimanding Dr. Boatwright and prohibiting him from prescribing, administering, possessing or dispensing
controlled substa ...
Description: TMB disciplines 18 physicians at December meeting
Document: ... any clinics which Dr. Gomes owns or operates are: registered through the Board's Office Based Anesthesia Services (OBASprogram; or successfully accredited as an officebased surgery facility or treatment room by the Joint Commission relating to ambulatory surgical centers, the American Association fo ...
Description: Texas Medical Board - Complaint Form: The Board investigates complaints against physicians, physician assistants, acupuncturists, surgical assistants, respiratory care practitioners, medical radiologic technologists, medical physicists, and perfusionists. If you wish to complain to the Board, please ...
Document: ... THE
AGENCY RECEIVING THE REFERRAL.
Complaint Registered Against
Note:
You may use the Texas Medical Board’s
Look Up A Licensee
to determine if the
practitioner is licensed by TMB. All fields are required.
Name of Practitioner:
Phone
Number:
Address Line 1:
Address Line ...
Description:
Document: ... ent including:
•
The name of the Program as registered with the TWC
or THECB
•
The physical location of the program
(including street address, city, state, zip code)
•
The mailing address of the program
, if different from the physical location
•
The website address of th ...
“... uch as a physician assistant or advanced practice registered nurse acting under a physician’s delegated authority) prescribes opioids, benzodiazepines, barbiturates, or carisoprodol, the patient’s prescribing history must be reviewed by the physician or advanced practice professional iss ... ”
Is the Prescription Monitoring Program (PMP) check mandated each and every time a physician or authorized delegate prescribes one of the four scheduled drug types?
Yes. Prior to and each and every time a physician or advanced practice professional (such as a physician assistant or advanced practice registered nurse acting under a physician’s delegated authority) prescribes opioids, benzodiazepines, barbiturates, or carisoprodol, the patient’s prescribing history must be reviewed by the physician or advanced practice professional issuing the prescription. For providers seeking information on how to access the PMP, please review Pharmacy Board PMP information at https://www.pharmacy.texas.gov/pmp/.
“... ur radiology training course, you will need to be registered with Texas Department of Licensing and Regulation (TDLR) as a Podiatric Medical Radiological Technician.Information is available on the TDLR website. ”
Am I eligible for the NCT Registry if I completed only an alternate 20 hour radiology training course for a podiatric medical assistant?
Not at this time. If you are a Podiatric Medical Assistant who completed an alternate 20 hour radiology training course, you will need to be registered with Texas Department of Licensing and Regulation (TDLR) as a Podiatric Medical Radiological Technician.
Information is available on the TDLR website.
“Please submit a written request for the contact update on letter head. Once your registration as an HCE has been verified, a letter will be sent to the address and contact of record with the username and/or password information. You may submit your written request to: Texas Medical Board Attn: HCE R ... ”
How do I update the contact name for my registered HCE for the verification system?
Please submit a written request for the contact update on letter head. Once your registration as an HCE has been verified, a letter will be sent to the address and contact of record with the username and/or password information. You may submit your written request to: Texas Medical Board Attn: HCE Registration MC-263, P.O. Box 2018 Austin, Texas 78768-2018
“... reminder that it is time to register. Permits are registered online and paid for with a credit card or electronic check. Registration forms are not available for printing from our web site. ”
How do I register/renew my NCT Registry listing?
A notice will be sent 60-90 days prior to the expiration date as a reminder that it is time to register. Permits are registered online and paid for with a credit card or electronic check. Registration forms are not available for printing from our web site.
“Effective 1/31/2010, registration by physicians of delegated prescriptive authority to PAs or APNs is required. ”
Does delegation of prescriptive authority to a PA or APN have to be registered with the TMB as well?
Effective 1/31/2010, registration by physicians of delegated prescriptive authority to PAs or APNs is required.
“... the physician performing the procedure should be registered for OBA. Statute states that each physician who administers anesthesia or performs a procedure for which anesthesia services are performed in an outpatient setting shall register for OBA and comply with current OBA regulations. Please note ... ”
I am an anesthesiologist. I contract out my services to other physicians to provide anesthesia for procedures in their offices. Since the anesthesia is not done in my office and I am only a contractor, do I need to register for Office Based Anesthesia (OBA)?
Yes, both the anesthesiologist and the physician performing the procedure should be registered for OBA. Statute states that each physician who administers anesthesia or performs a procedure for which anesthesia services are performed in an outpatient setting shall register for OBA and comply with current OBA regulations. Please note, an anesthesiologist who contracts out their services to multiple physicians is not required to register each location where they perform OBA, but only the highest level of OBA services that they provide.
“Verifications of OBA registration are available on request. Please submit a written request by mail, fax or email to: Texas Medical BoardAttn: Registration DepartmentP.O. Box 2029 MC 240Austin, TX 78768 fax - (888) 512-2581 ”
How do I verify what level of OBA services an individual is registered for?
Verifications of OBA registration are available on request. Please submit a written request by mail, fax or email to:
Texas Medical Board
Attn: Registration Department
P.O. Box 2029 MC 240
Austin, TX 78768
fax - (888) 512-2581
“... ear - $150 License is considered cancelled if not registered at one year. ”
What are the penalties for physician registering late?
There is a 30-day grace period following expiration of a registration permit. Penalties are as follows: 30 days following expiration of permit - $0 Permit expired longer than 30 days, but less than 91 - $75 Permit expired longer than 90 days, but less than one year - $150 License is considered cancelled if not registered at one year.
“... and owners of clinics that have not been properly registered can be investigated. ”
Who does not need to register a pain management clinic?
Regulations regarding the registration and operation of pain management clinics do not apply to the following settings:
Note: The TMB cannot give legal advice. Please consult an attorney if you have questions regarding whether or not your clinic meets one of the exemptions listed above. However, the Board does have inspection authority, and owners of clinics that have not been properly registered can be investigated.
“A name change or change of address for a registered pain management clinic must be submitted in writing (by mail or fax). Please use the PMC change of address form located here. ”
How do I submit a name change or change of address for my pain management clinic?
A name change or change of address for a registered pain management clinic must be submitted in writing (by mail or fax). Please use the PMC change of address form located here.
“... th 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 172.3(d), 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.
“... escribe the exact steps that an advanced practice registered nurse or physician assistant must take with respect to each specific condition, disease, or symptom, however. ”
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.
“... 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 quest ... ”
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.)
“... eral 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 delega ... ”
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.