“... 098 (2011) allows entities to be jointly owned by physicians and physician assistants subject to certain limitations, including percent of ownership by physician assistants. There are annual reporting requirements for physician and physician assistant owners.
Highlights include:
the organize ... ”
“... information as part of its licensure process for physicians, physician assistants, surgical assistants, acupuncturists, medical physicists, medical radiologic technologists, perfusionists, and respiratory care practitioners.
A. Identity and age. B. Professional education. C. Passage of pro ... ”
“... licensees. This can include legislation impacting physicians, physician assistants, acupuncturists, surgical assistants, and a variety of other license types.
Access legislative updates here: Legislative Updates
As a state agency, TMB has a number of reporting requirements to the ... ”
“... a full unrestricted medical license to qualified physicians to practice medicine in Texas. Applicants who do not qualify for a full medical license may qualify for a limited license or permit. The Licensure Department of the Texas Medical Board is committed to furthering the mission of ... ”
“... lation), (512) 463-6599
State Organizations
Physicians
TMA - Texas Medical Association, 1-800-880-7955, E-mail: knowledge@texmed.org
TOMA - Texas Osteopathic Medical Association, (512) 708-8662 or 1-800-444-TOMA
Physician Assistants
TAPA - Texas Academy of Physician Assistan ... ”
“... ust practice under the supervision of one or more supervising physicians, and if prescribing drugs, must have a prescriptive delegation agreement with their supervising physician(s).
The Licensure Department of the Texas Physician Assistant Board is committed to furthering the mission of the B ... ”
“... Dr. Anson Jones, one of the few formally trained physicians in Texas at that time. The Congress of the Republic of Texas then created the Board of Medical Censors for the purposes of administering examinations and granting medical licenses. The Board was discontinued by legislative act in 1848, but ... ”
“... tice of medicine in Texas through registration of physicians; determining a physician’s eligibility for licensure; conducting investigations based on complaints filed against physicians; and exercising authority to cancel, revoke, suspend, or otherwise limit the license of any physician upon p ... ”
“... spitals in certain circumstances to directly hire physicians.
Chief Medical Officer Designation/Contact Form
Compromise of Medical Judgement Report Form
The bill requires that a hospital directly hiring physicians appoint a chief medical officer and put in place policies to ensure th ... ”
“... ludes the enabling statutes and practice acts for physicians, physician assistants, acupuncturists, surgical assistants, medical radiologic technologists, medical physicists, perfusionists, and respiratory care practitioners. The relevant chapters are listed below.
The complete code is availa ... ”
“... blic health,
Must be incorporated and directed by physicians licensed by TMB
Those physicians must be actively engaged in the practice of medicine.
The administrative side of the corporation may be handled by non-physician officers, but all medical decisions and the overall medical policies of the o ... ”
“... blic health.
Must be incorporated and directed by physicians licensed by TMB.
Those physicians must be actively engaged in the practice of medicine.
The administrative side of the corporation may be handled by non-physician officers, but all medical decisions and the overall medical policies of the ... ”
“... tions of statute (laws/practice acts)
rules for physicians, physician assistants, acupuncturists, and other license types, including adopted rule changes by year, and
the most recent proposed rule changes as well as information about the rulemaking process.
... ”
“... Division issues various training permits such as physicians in training, visiting professor, faculty temporary licensing, national health corporation, and consulting physician approval letters.
Phone: (512) 305-7130
Fax: (512) 305-7009 or (888) 550-7516 ... ”
“... lowship program.
Faculty Temporary License allows physicians who do not meet all the requirements for full licensure, but who have the expertise to educate Texas medical students, residents, and fellows, to practice within the confines of the sponsoring institution.
Out-of-State Telemedicine License ... ”
“... bsp;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. ”
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.
“... s 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. ”
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.
“... thly basis, no matter the length of time that the physicians have been practicing with the delegates under the agreement. ”
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.
“Yes, potentially. Although physicians are not required to supervise CRNA’s for delegated tasks, they nonetheless remain subject to potential liability for violations of the standard of care by CRNAs, depending on federal and state statutes and regulations. The degree to which a physician is re ... ”
Are physicians potentially subject to discipline for violations of the standard of care by CRNAs to whom they have delegated the selection or administration of anesthesia or the care of an anesthetized patient?
Yes, potentially. Although physicians are not required to supervise CRNA’s for delegated tasks, they nonetheless remain subject to potential liability for violations of the standard of care by CRNAs, depending on federal and state statutes and regulations. The degree to which a physician is required to supervise a CRNA during the performance of a task in anesthesia services is left to the “physician’s professional judgment in light of other relevant federal and state laws, facility policies, medical staff bylaws, and ethical standards.” (Texas Attorney General Opinion No. JC-0117). However, physician supervision during the medical management of a patient while undergoing an anesthetic may require supervision dependent on federal and state statutes and regulations.
Additionally, Texas Attorney General Opinion No. KP-0353 found “In authorizing physicians to delegate the administration of anesthesia to CRNAs, the Legislature did not expressly limit the liability of the delegating physician. See TEX. OCC. CODE § 157.058; cf. id. § 157.004(c) (providing that in specified circumstances a physician who issues a standing delegation under chapter 203 generally “is not liable in connection with an act performed under that standing delegation order”). Thus, we cannot conclude that the liability of a physician delegating the administration of anesthesia to a CRNA is limited solely to the determination of competency. Questions of physician liability in any specific context are highly factual and not an appropriate determination for the opinion process. See Tex. Att’y Gen. Op. No. GA-0446 (2006) at 18 (“Questions of fact are not appropriate to the opinion process.”) (Page 4 with emphasis added.)
“For physicians only:If another state board requires your examination grades, please be advised that most physicians will have to contact the Federation of State Medical Boards to obtain examination scores.Federation of State Medical Boards 400 Fuller Wiser Rd. Suite 300 Euless, TX 76039-3855 Tel. (8 ... ”
How do I get a copy of my examination scores sent to another state?
For physicians only:
If another state board requires your examination grades, please be advised that most physicians will have to contact the Federation of State Medical Boards to obtain examination scores.
Federation of State Medical Boards
400 Fuller Wiser Rd.
Suite 300
Euless, TX 76039-3855
Tel. (817) 868-4000
A small percentage of physicians can obtain verification of examination scores from TMB.
please call the Pre-Licensure, Registration and Consumer Services at (512) 305-7030 to confirm the location of your scores.
There is no fee for this verification.
“Physicians and anesthesiologists shall maintain current competency in ACLS, PALS, or a course approved by the board. In all settings under Chapter 173, at a minimum, at least two persons, including the surgeon or anesthesiologist, shall maintain current competency in basic life support. ... ”
What are the standards for anesthesia services relating to OBA?
Physicians and anesthesiologists shall maintain current competency in ACLS, PALS, or a course approved by the board. In all settings under Chapter 173, at a minimum, at least two persons, including the surgeon or anesthesiologist, shall maintain current competency in basic life support.
“OBA registration does not apply to physicians who practice in the following settings: An outpatient setting in which only local anesthesia, peripheral nerve blocks, or both are used. Any setting physically located outside the State of Texas. A licensed hospital, including an outpatient facility of t ... ”
Who does not need to register for office-based anesthesia?
OBA registration does not apply to physicians who practice in the following settings:
Note: physicians that provide only level I services, must still meet all other requirements under Chapter 173.
“... no longer required to register NCTs who work for physicians. What remains is the requirement that NCTs obtain placement on the MRT Board’s general registry, or have an approved a hardship exemption, prior to starting practice. ”
Why was the NCT permit eliminated?
In the 2017 legislative session, SB 674 changed the law so that the Texas Medical Board is no longer required to register NCTs who work for physicians. What remains is the requirement that NCTs obtain placement on the MRT Board’s general registry, or have an approved a hardship exemption, prior to starting practice.
“... no longer required to register NCTs who work for physicians. What remains is the requirement that NCTs obtain placement on the MRT Board’s general registry, or have an approved a hardship exemption, prior to starting practice.The NCT Registry and the NCT Permit were renewed separately. ... ”
Why can’t I register my NCT permit and my NCT registry at the same time?
In the 2017 legislative session, SB 674 changed the law so that the Texas Medical Board is no longer required to register NCTs who work for physicians. What remains is the requirement that NCTs obtain placement on the MRT Board’s general registry, or have an approved a hardship exemption, prior to starting practice.
The NCT Registry and the NCT Permit were renewed separately. Under current rules and regulations, the NCT registry is on a biennial (2 year) renewal schedule. Before elimination by statutory changes, the NCT permit was an annual renewal.
You will need to continue to renew your NCT Registry listing or hardship exemption to continue to practice as an NCT in Texas.
“You must register your supervising physician with the TMB prior to applying with the DEA. For information or questions on applying for a DEA under a temporary license, please contact the DEA directly. https://www.deadiversion.usdoj.gov/index.html ... ”
Can I get a DEA number with my temporary license?
You must register your supervising physician with the TMB prior to applying with the DEA. For information or questions on applying for a DEA under a temporary license, please contact the DEA directly. https://www.deadiversion.usdoj.gov/index.html
“... ou are a physician or a physician assistant. Physicians are required to register all PAs and APRNs that they supervise prior to the delegates beginning to work for them. If there is a change to the scope of the delegation, physicians must notify the Board within 30 days of this change.PAs ... ”
Do I have to let the Medical Board know about my delegates/supervising physicians?
Yes, if you are a physician or a physician assistant.
Physicians are required to register all PAs and APRNs that they supervise prior to the delegates beginning to work for them. If there is a change to the scope of the delegation, physicians must notify the Board within 30 days of this change.
PAs are likewise required to register their supervising physicians with the Board prior to beginning to practice under the employment or prescriptive authority agreement. They are also required to notify the Board within 30 days of any change to the scope of the delegation.
APRNs should look to guidance provided by the Texas Board of Nursing for how to register their delegating physicians, as the Medical Board does not have licensing authority for nurses.
“The TMB cannot tell providers how to use the information they obtain through the PMP check. Providers should follow the standard of care and utilize the information they gain to make educated and informed prescribing decisions. ”
If I discover a patient is receiving scheduled medication from other physicians, what action must I take? For example, must I immediately terminate the patient or cease prescribing the scheduled medication?
The TMB cannot tell providers how to use the information they obtain through the PMP check. Providers should follow the standard of care and utilize the information they gain to make educated and informed prescribing decisions.
“If the supervising physician has a waiver, then the prescribing delegate is also covered under that waiver. So long as the prescribing delegate is prescribing under the authority of a physician who has been granted a waiver, then the prescribing delegate may use non-electronic prescribing means.&nbs ... ”
Do delegates who have prescribing authority have to apply for their own waiver or are they covered by the supervising physician’s waiver?
If the supervising physician has a waiver, then the prescribing delegate is also covered under that waiver. So long as the prescribing delegate is prescribing under the authority of a physician who has been granted a waiver, then the prescribing delegate may use non-electronic prescribing means. If a prescribing delegate is issuing a prescription under the authority of a physician who does not have a waiver, then the prescribing delegate must issue the prescription via e-prescribing.
If an individual wants to look up whether a prescribing delegate has a waver they can do so as listed below:
For physician assistants: A PA’s waiver status will not be viewable on their TMB public profile. Each PA’s public profile has a link to their supervising physician’s profile page. The physician’s profile page will list the waiver status.
For nurse practitioners: APRN waivers are determined by the Texas Board of Nursing. Information on the waiver process for the APRNs is available on the Texas Board of Nursing Website.