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. 

165.1(a) (10) now requires the following:

"All non-biographical populated fields, contained in a patient's electronic medical record, must contain accurate data and information pertaining to the patient based on actual findings, assessments, evaluations, diagnostics or assessments as documented by the physician."

Non-biographical data/information is data that will typically change from visit to visit. For example, many EMR systems bring forward from the previous encounter non-biographical information such as symptoms, diagnosis, vitals, lab levels, history, previous treatments etc... However, because symptoms often resolve between encounters (as result of treatment), diagnoses may no longer be active or present (because of previous treatments), and vitals fluctuate, such data fields should not contain inaccurate, non-current, or irrelevant data that is not pertinent to the present illness/issue. Such information may be part of the patient’s history, but should not be reflected as current/present unless such symptoms/diagnoses are ongoing. Such information may become part of the patient’s historical data/information contained in the electronic medical record. Non-biographical information/data contained in a medical record for each encounter should be based on actual assessment, evaluations or other diagnostics that are documented by the physician.

Also see: EMR Position Statement

No, fingerprint cards are not automatically sent out to applicants. Because not all applicants reside at the mailing address of record when they submit their online applications, it is the responsibility of the applicant to verify whether or not they can be live-scanned. If that is not an option, they must request a fingerprint card by contacting the Texas Medical Board at Screen-CIC@tmb.state.tx.us if they are an applicant, or at Registrations@tmb.state.tx.us if they are a licensee. When emailing the request, please include a current mailing address.

As part of the “My TMB” system, we are now able to offer the ability to update mailing and practice addresses online for the majority of our licensees.

To update your mailing or practice address online click the “My TMB” link in the upper right hand corner of our website (near the “search” box), and create an account if you do not have one already.

Renewal notices are sent out to the mailing address of record 60-90 days prior to the expiration date of a permit.  Currently, extensions are not granted on the basis of not receiving a renewal reminder in the mail.

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.

Currently, each individual physician who needs a waiver will have to apply for their own individual waiver. Although this may change in the future, TMB is currently unable to track waivers by group.      

No, TMB is not currently notifying prescribers when their waiver expires.  This may change in the future. 

Email renewal reminders are sent 60-90 days before the expiration date, from no.reply@tmb.state.tx.us. We recommend that you add this email address to your contacts list so they will not be lost.  Please check your junk and spam mail for these notices if you are not receiving them.  If you have any questions about the fingerprint requirements or the renewal process, please contact us at Registrations@tmb.state.tx.us.