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“... he physician supervises or delegates prescriptive authority to Physician Assistants (PAs)s. Current registered supervisions and delegations to PAs are displayed in this section of the physician profile. ”
“... h the TMB if the physician delegates prescriptive authority to Advanced Practice Registered Nurses (APRNs). Current registered delegations to APRNs are displayed in this section of the physician profile. ”
“... 104 (2003) fee per registration, the $13.48 Prescription Monitoring Program (PMP) fee, and a $5 Office of Patient Protection fee for the first year, with an additional $1 charged for any subsequent year. These fees are required by statute and cannot be pro-rated. The remaining amount is requir ... ”
“... mplaints filed against physicians; and exercising authority to cancel, revoke, suspend, or otherwise limit the license of any physician upon proof of violation of the Texas Occupations Code (the Medical Practice Act) and/or the Board's rules.
Mission
The mission of the Texas Medical B ... ”
“... PDF | Word
Chapter 157 -
Authority of Physician to Delegate Certain Medical Acts: HTML | PDF | Word
Chapter 158 -
Authority of Physician to Provide Certain Drugs and Supplies: HTML | PDF | Word
Chapter 159 -
Physician-Patient C ... ”
“... stances, or delegate medical acts or prescriptive authority.
Provisional License is available only to applicants for a full medical license and allows the applicant to practice for 270 days in a medically underserved or health professionals shortage area.
Medical License Limited to Underserved Area ... ”
“... and/or the Board's rules; and exercising the authority to cancel, revoke, restrict, suspend or otherwise limit the license of any physician assistant upon proof of violation.
Mission
The Texas Physician Assistant Board’s mission is to protect and enhance the public’s health, safety, ... ”
“... f PAs and physicians AND to register prescriptive authority, prior to beginning to practice.
Supervision & Prescriptive Delegation System - Click Here
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“...
The initial registration fee includes the $13.48 Prescription Monitoring Program (PMP) fee, and a $5 Office of Patient Protection fee for the first year, with an additional $1 charged for any subsequent year. These fees are required by statute and cannot be pro-rated. The remaining amount is requir ... ”
“... he biennial registration fee includes the $13.48 Prescription Monitoring Program (PMP) fee, $15.00 for the Physician Health Program (PHP) and a $2 Office of Patient Protection fee. These fees are required by statute. The remaining $535 is the fee required by the TMB.
These fees are explained ... ”
“... ; a medical license, permit, or other authority to practice medicine that is currently restricted for cause, canceled for cause, suspended for cause, revoked or subject to another form of discipline in a state or territory of the United States, Canada, or a uniformed service of Uni ... ”
“... ed a facility-based practice?
Is a prescriptive authority agreement required in a hospital or long term care facility-based practice?
At how many facilities can one physician delegate prescriptive authority through protocols?
Who may delegate prescriptive authority in a hospital facility-based ... ”
“... p;
Use the online system to register prescriptive authority AND to file the notice of intent to practice/supervise as required of PAs and physicians. Hard copy supervision and delegation forms are no longer accepted (except as required).
Review the eligibility requirements for system usage t ... ”
“... ature of the prescribing practitioner, unless the prescription is called into the pharmacy
”
“... des an $80 Senate Bill 104 (2003) fee, the $13.48 Prescription Monitoring Program (PMP) fee, $11.00 for the National Practitioner Data Bank (NPDB), $15.00 for the Physician Health Program (PHP), and a $2 Office of Patient Protection fee. These fees are required by statute. The remaining $3 ... ”
Description: Rule Changes March 09, 2009
Document: ... , Purpose and Scope, adds a citation to statutory authority authorizing the Board to promulgate rules regulated to the development of a program to monitor compliance of license holders who are subject to disciplinary action, and �189.2, Definitions, updates the names of the Texas Medical Board and t ...
Description: Rule Changes April 16, 2008
Document: ... ecutive Director to delegate responsibilities and authority to other staff members,. Chapter 166, Physician Registration, amending 166.4 Expired Registration Permits, Interprets �156.005, Occ. Code, as providing an exclusive penalty for practicing medicine after the expiration of a permit and within ...
Description: Rule Changes April 27, 2003
Document: ... atement and reissuance of a license. Chapter 169, Authority of Physicians to Supply Drugs. Rule review and amendments to ��169.1-.5 and 169.7 for general cleanup of the chapter. Chapter 171, Postgraduate Training Permits. Amendments to �171.1 regarding reporting requirements relating to postgraduate ...
Description: Rule Changes January 25, 2006
Document: ... nce to registration of delegation of prescriptive authority with the Board; set out rules requiring a physician who delegates prescriptive authority to document when and to whom a delegation is made; and eliminate references to and procedures for Advisory Committee on waivers of requirements for del ...
Description: Rule Changes January 22, 2009
Document: ... comport with modern language usage . Chapter 169 Authority of Physicians to Supply Drugs, amending 169.7, Record Keeping, specifies statutory authority for the board to adopt rules regarding complaints. Chapter 173 Physician Profiles , amending to 173.1, Profile Contents, adds required information ...
Description: Rule Changes January 09, 2005
Document: ... egarding delegation of carrying out or signing of prescription drug orders to Physician Assistants and Advanced Nurse Practitioners.
Description: Rule Changes January 06, 2002
Document: ... finition of acupuncture and acupuncturist and the authority of an acupuncturist to treat alcoholism and chronic pain without referral. The proposed amendments will also update Occupation Code cites. Chapter 185, Physician Assistants. Proposed amendments to 185.2, 185.7, 185.17, 185.19, 185.21, 185.3 ...
Description: Press Release January 18, 2011 (PDF File)
Document: ... aring Without Notice took place under the Board's authority, granted by the Medical Practice Act, to suspend or restrict a physician's license without notice when it determines the physician's continuation in practice would constitute a continuing threat to the public welfare. The physician has the ...
Description: Press Release January 11, 2007 (PDF File)
Document: ... Williams has also been arrested and charged with prescription fraud.
The temporary suspension hearing took place Wednesday, January 10, and the suspension was effective immediately. The length of a temporary suspension order is indefinite but it remains in effect until the board takes further acti ...
Description: Press Release January 22, 2009 A (PDF File)
Document: ... positive on even one occasion, the board had the authority to immediately suspend the license. The action took place on Wednesday, January 21. The length of an automatic suspension is indefinite and it remains in effect until the board takes further action. -30-
...
Description: Press Release January 24, 2005 (PDF File)
Document: ... ing: Dr. Elder diverted an associate's triplicate prescription pad to prescribe medications to himself and family members; he wrote false and fictitious prescriptions; and his hospital staff privileges were summarily suspended. Based on these findings, the panel found that Dr. Elder is a real danger ...
Description: Press Release January 25, 2003 (PDF File)
Document: ... . This board is committed to using its regulatory authority to protect the public, and uses a variety means to do so, including careful scrutiny of licensure applicants and swift and appropriate disciplinary actions when necessary. We have set a goal to reduce the average number of days for an inves ...
Description: Press Release February 09, 2005 (PDF File)
Document: ... line. Proposed Rule Change Withdrawn Chapter 170, Authority of Physician to Prescribe for the Treatment of Pain. Proposed repeal of existing chapter and creation of a new chapter regarding the need for patients of Texas to have optimal pain management was withdrawn for further review and comment. Pr ...
Description: Press Release February 06, 2006 (PDF File)
Document: ... ished Professor Temporary License applicants; the authority of the Texas State Board of Acupuncture Examiners to license and discipline acupuncturist applicants and licensees; and, advice from the Texas State Board of Acupuncture Examiners regarding training programs for acudetox specialists. Discip ...
Description: Press Release February 10, 2009 A (PDF File)
Document: ... ation's action against Dr. Gilmore for allowing a prescription to be issued under her name to a patient she did not see. Kobs, Darcey Gus Jr., M.D., Lic. #D2565, Hattiesburg MS On February 6, 2009, the board and Dr. Kobs entered into an agreed order of voluntary surrender. The action was based on ac ...
“... umber of physicians who may delegate prescriptive authority to an APRN or PA provided all requirements for such delegation are met. ”
How many delegating physicians may one APRN or PA have?
There is no limit to the number of physicians who may delegate prescriptive authority to an APRN or PA provided all requirements for such delegation are met.
“No. The old site-based prescriptive authority system is no longer in effect. ”
Do the requirements for types of practice sites still apply?
No. The old site-based prescriptive authority system is no longer in effect.
“... Caution: federal law prohibits dispensing without prescription” or “Rx only” or another legend that complies with federal law. Many other states use the term “legend drugs.” ”
What is a dangerous drug? Are these legend drugs?
Texas is one of just a few states that use the term “dangerous drugs.” The Dangerous Drug Act defines a dangerous drug as a device or drug that is unsafe for self-medication and that is not included in Schedules I through V or Penalty Groups 1 through 4 of Chapter 481, Health and Safety Code (Texas Controlled Substances Act). The term includes a device or drug that bears, or is required to bear, the legend: “Caution: federal law prohibits dispensing without prescription” or “Rx only” or another legend that complies with federal law. Many other states use the term “legend drugs.”
“... arified that it is necessary to have prescriptive authority to order these devices. In the past, it was not clear to DME suppliers that APRNs and PAs had this authority. The changes to the law as a result of the passage of SB 406 clearly indicate that APRNs and PAs may order or prescribe ... ”
Is prescriptive authority required to order durable medical equipment (DME)?
Yes. SB 406 clarified that it is necessary to have prescriptive authority to order these devices. In the past, it was not clear to DME suppliers that APRNs and PAs had this authority. The changes to the law as a result of the passage of SB 406 clearly indicate that APRNs and PAs may order or prescribe this equipment provided all requirements for delegation of prescriptive authority are met.
“... re required to provide a copy of the prescriptive authority agreement to the board that requested it within three business days. Although SB 406 did not specifically note that facility-based protocols must also be submitted within this time frame, each licensing board has the authority to requ ... ”
Do I have to produce my prescriptive authority agreement or facility-based protocol if a licensing board asks to see it?
Yes. You are required to provide a copy of the prescriptive authority agreement to the board that requested it within three business days. Although SB 406 did not specifically note that facility-based protocols must also be submitted within this time frame, each licensing board has the authority to request this information. Failure to provide the requested information could result in disciplinary action against the professional license.
“... nd §481.002, Health and Safety Code. A prescription is an order to dispense a drug or device to a patient for self-administration as defined by §551.003, Occupations Code. ”
What is the difference between medication orders and prescriptions?
A medication order is an order for administration of a drug or device to a patient in a hospital for administration while the patient is in the hospital or for emergency use on the patient’s release from the hospital, as defined by §551.003, Occupations Code and §481.002, Health and Safety Code. A prescription is an order to dispense a drug or device to a patient for self-administration as defined by §551.003, Occupations Code.
“SB 406 eliminated site based prescriptive authority. The law is silent regarding the practice location of the physician and its proximity to the practice site of the APRN or PA. That said, there has been no change in the law that requires that a physician must provide adequate supervision of d ... ”
How many miles from my delegating physician can my practice site be?
SB 406 eliminated site based prescriptive authority. The law is silent regarding the practice location of the physician and its proximity to the practice site of the APRN or PA. 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 distance between a physician’s primary practice and the practice site at which the physician’s delegates provide medical services may be an important factor in determining the quality of the physician’s supervision.
“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 b ... ”
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.
“... , as agreed to by the parties to the prescriptive authority agreement. You may meet more frequently than required by law. You may not meet less frequently than what is required by law. ”
Can more frequent meetings be required?
Yes, as agreed to by the parties to the prescriptive authority agreement. You may meet more frequently than required by law. You may not meet less frequently than what is required by law.
“... ts 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 agreem ... ”
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.
“Yes. Prior to signing a prescriptive authority agreement, you must disclose to the other party/parties to the prescriptive authority agreement if you have been disciplined in the past. This includes disciplinary action taken by licensing boards in other states. Once you are a party ... ”
Do I have to disclose information regarding investigations and discipline? If so, to whom must this information be disclosed
Yes. Prior to signing a prescriptive authority agreement, you must disclose to the other party/parties to the prescriptive authority agreement if you have been disciplined in the past. This includes disciplinary action taken by licensing boards in other states. Once you are a party to a prescriptive authority agreement, you are required to immediately notify the other party/parties to the agreement if you receive notice that you are the subject of an investigation.
“... dvice 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 professi ... ”
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.
“... 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 pa ... ”
How many charts must be reviewed?
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.
“... he 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 ... ”
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.
“... he 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. For such agreements, t ... ”
Is credit given for time practiced in a supervised prescriptive authority arrangement prior to November 1, 2013?
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. For such agreements, the amount of time an APRN or PA practiced under the delegated prescriptive authority of a physician under a prescriptive authority agreement includes the amount of time practiced under the delegated prescriptive authority of that same physician prior to November 1, 2013.
For agreements entered on or after September 1, 2019, the length of time that a delegate has practiced in a supervised prescriptive authority arrangement with a physician is no longer relevant to how often parties to the prescriptive authority agreement must meet. Such participants must meet at least on a monthly basis, no matter the length of time spent practicing together under a prescriptive authority agreement.