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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: 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: Surgical Assistant License Application
Document: ... ther surgical assistant program, medical
school, registered nurse first assistant program, or surgical physician assistant program)
submitted directly to the board from the
program/school in a sealed envelope with the signature of an official of the program/school over the sealed flap.
Exami ...
Description: Pain Management Clinics - Current
Document: ... n alphabetical order by last name of the clinic's registered physician owner. You can use Ctrl+F to search for an individual. Hold down Ctrl and F at the same time. Disciplinary Actions Current status date Hotline info PMC00389 PMC00388 PMC00387 PMC00386 PMC00385 PMC00384 PMC00383 PMC00 ...
Description: Rule Changes Effective November 7, 2013
Document: ... d limits the combined number of advanced practice registered nurses and physician assistants with
whom a physician may enter into a prescriptive authority agreement to se
ven. The section sets forth an
exclusion to the limit of seven prescriptive authority agreements for prescriptive authority agr ...
Description: Pain Management Clinics - Spreadsheet of Current Certificate status
Document: ... n alphabetical order by last name of the clinic's registered physician owner. You can use Ctrl+F to search for an individual. Hold down Ctrl and F at the same time. Current owner/operator Pain Management Certificate # Clinic Name Clinic City Certificate Issue Date Certificate Expiration Dat ...
Description: ... . In order to change the name and/or address of a registered clinic, please complete this form and submit with the required materials. *If the business is owned by more than one physician, the primary physician owner listed on the certificate must be the one to complete and sign this form. ...
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Description: ... supervision of a licensed Texas physician must be registered with the Texas Medical Board as required under Chapter 194 of the board rules. The physician must also be registered with the board to supervise the non-certified technician.
Document:
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Description: Medical Board 2014 - May 2 - Full Board Minutes
Document: ... esented
information on whether Advanced Practice Registered Nurses were eligible for certification from
the Board to p
ractice as acudetox specialists. After discussion,
Mr. Webb moved, Ms.
Attebury seconded,
and the motion passed to not pursue rulemaking
due to the statutory
limitations
...
Description: Medical Board 2014 - August - Full Board Minutes
Document: ... esia encountered during inspections of physicians registered with the Board as providing
off
ice
-
based anesthesia services.
After discussion,
as relates to EMS Transfer Agreements
and Emergency plans
the Board directed staff
to include in board rule 192, the
requirement that those operati ...
Description: PA Board 2016 April - Licensure Committee Minutes
Document: ... at
9:
0
2
a.m. by
the
Chair, Teralea Jones, PA
-
C. Committee
members present were
Karrie L. Crosby,
PA
-
C, Jennifer L. Clarner, PA
-
C, Raymond B
.
Rush,
Michael D. Reis, M.D. and Victor Shen
-
Pou Ho, M.D.
Agenda
Item 2
–
Discussion, recommendation, and possible action rega ...
Description: Medical Board 2015 - April - Licensure Committee Minutes
Document: ... asic
and clinical sciences coursework;
(ii) a registered nurse first assistant program that is approved or
recognized by an organization recognized by the Texas Board of Nursing
for purposes of lic
ensure as a registered nurse first assistant; or
(iii) a post graduate clinical physician ass ...
Description: Medical Board 2015 - August - Licensure Committee Minutes
Document: ... ons concerning
Agenda
item
2a
.
The motion pa
ssed.
Dr. Arambula
announced that the meeting would be closed
for deliberations at
11:07
a.m. concerning licensure applications and the character and
fitness of applicants under the authority of The Medical Practice Act Sections 152.009 a ...
“... 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.