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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: TMB Strategic Plan FY 21-25 (2020)
Document: ... statutory
change resulting in
more PMCs being
registered will not only
enhance
accountability, but it
will allow Texans
seeking care from a
PMC to more easily
locate a clinic since all
PMCs registered with
the Board are listed on
the Ta.’s website.
Page
8
of
55
TMB ...
Description: Respiratory Care Board Full Board Minutes (September 24, 2020)
Document: ... the voluntary National Board for Respiratory Care Registered Respiratory Therapist certification examination. Upon submission of documentation confirming successful completion of all requirements, the applicant can be issued a Respiratory CarePractitioner certificate upon approval by the Executive D ...
Description: TMB disciplines 35 physicians at December meeting
Document: ... arez
-
Velazquez owns, directs, and serves as the registered agent of New Born Skin Medical Aesthetics, Inc., and
allegedly injected what she represented as Restylane under a patient’s
eyes causing swelling and discoloration, outside
of the scope of her agreement with a physician since they in ...
Description: TMB Strategic Plan FY 23-27 (2022)
Document: ... ION ITEMS TO ACHIEVE GOAL
•
Automation of pa
yment transactions.
*Estimated completion date
–
12/31/2022
•
Automation of application, renewal, and Letter of Qualification (LOQ) data transfer
between the
TMB
and IMLC Commission.
*Estimated completion date
–
12/31/2024
...
Description: TMB disciplines 47 physicians at June meeting
Document: ... pain, and operated a clinic that should have been registered as a pain
management clinic.
IMPROPER SUPERVISION OR DELEGATION
Baluch, Amir, M.D., Lic. No. N5550, Canton
On June 9, 2023, the Board and Amir Baluch, M.D., entered into an
Agreed Order requiring him to within one year and
thr ...
Description:
TMB disciplines 27 physicians at August meeting
Document: ... d found Dr. Collins inappropriately relied upon a registered nurse’s unqualified
misdiagnosis of a patient as having Alzheimer’s disease, failed to personally evaluate a patie
nt on admission to hospice
care, failed to appropriately supervise a nurse, participated in falsifying an Out of Hospi ...
Description: TMB disciplines 22 physicians at March meeting
Document: ... e
Medical Jurisprudence Exam; and within 60 days pa
y an administrative penalty of $5,000. The Board found Dr. Lewis
improperly delegated patient examinations and follow up care to a registered nurse who was unqualified to provide this
level of care at a med spa for which Dr. Lewis was the acting ...
Description: TMB Bulletin April 2024
Document: ... alleged vic�ms were
5r. Adugba
’
s pa�ents. A temporary suspension hearing
with no�ce will be held as soon as prac�cable with 10
days' no�ce to 5r. Adugba, unless the hearing is speci�cal-
ly waived by 5r. Adugba. The tem ...
Description: TMB Strategic Plan FY 25-29 (2024)
Document: ... icenses
6 Total Number of Business Facilities Registered
B. Goal: ENFORCE MEDICAL ACT
Protect the public by conducting investigations of allegations against licensees and taking
appropriate corrective and/or disciplinary action when necessary; by educating the public, staff, and lice ...
Description: TMB disciplines 27 physicians at June meeting, adopts rule changes
Document: ... the unlicensed practice of medicine by allowing a registered nurse to independently prescribe medications, develop treatment plans, and conduct procedures withoutsupervision and treat patients who were not evaluated by a physician, physician assistant or nurse practitioner.Quinby, Jonathan Scott, M. ...
Description: Chapter 161 Physician Licensure - Preamble and Rule
Document: ... apter 156 of the Act, a physician license must be registered with the board and renewed every two years after it is issued.(b) A renewal notice will be sent to the physician's address of record at least 60 days prior to the expiration date of the registration.(c) The physician must:(1) complete the ...
Description: Chapter 169 Physician Delegation - Preamble and Rule
Document: ... oncerning Physician Assistanand Advanced Practice Registered Nurse169.
New §169.
Scott Freshour, General Counsel for the Texas Medical Board, has determined that, for each year of the first five years the proposed repealandnew sections are in effect, the public benefit anticipated as a result of en ...
Description: Chapter 170 Investigational Agents - Preamble and Rule
Document: ... on of Human Research Protection Programs, Inc.(3) registered by the U.S. Department of Health and Human Services Office for Human Research Protection, pursuant to 21 CFR Part 56; or(4) accredited by a national accrediting organization recognized by the board.
The new rules are proposed under the aut ...
Description: Chapter 173 Office Based Anesthesia - Preamble and Rule
Document: ... ife Support, as defined by the AHA.(11) Certified registered nurse anesthetist (CRNAA person licensed by the Texas Board of Nursing (TBON) as a certified registered nurse anesthetist
(12) Dangerous drugsMedications defined by Chapter 483, Texas Health and Safety Code. Dangerous drugs require a presc ...
Description: Chapter 180 Violation and Sanction Guidelines - Preamble and Rule
Document: ... y; consider requiring registration if not already registered
Agreed Order
Lower sanctions plus: higher administrative penalty; if failed to register nonexempt entities: restricted from operating or
owning pain clinic
Failure to report
suspected abuse ofa patient by a thirdparty, when therepor ...
“... 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.