Texas Medical Board and the Medical Practice Act

Rules and statutes governing the practice of medicine in Texas.

Physician licensure and CME requirements, the complaint processes, electronic death registration, the treatment of and prescribing for pain, the Prescription Monitoring Program (PMP), and more.



Texas Medical Board Announcements, Contact Information, Rules, and News

The Texas Medical Board (TMB) is the state agency charged with keeping Texas patients safe through the licensure and regulation of Texas physicians. The Board consists of 12 physician members and seven public members appointed for six-year terms by the Governor and confirmed by the Texas Senate. Board business includes interviewing licensure candidates, considering disciplinary matters, and adopting procedural rules.

COVID-19 IMPORTANT ANNOUNCEMENTS (updated Oct. 19, 2021)

TMB statements regarding COVID-19 treatments
TMB President Provides COVID-19 Update at August Board Meeting (8/21/2020)
TMB Statement Regarding COVID-19 Treatments (7/31/2020)

Statewide mask mandate lifted, but physicians may still implement safety protocols - Effective March 10, 2021
Although Gov. Abbott lifted the statewide mask mandate, businesses are still allowed to implement safety protocols at their own discretion. Therefore, physicians may still require their staff, patients and visitors to wear masks while in the medical practice to protect against the continued spread of the disease.

If the COVID-19 hospitalizations in a region get above 15% of the hospital bed capacity for seven straight days, the County Judge may use COVID-19 mitigation strategies. See the Governor's March 2 press release with link to Executive Order GA-34. (03/10/2021)

From the Texas Medical Association (TMA) - TMB no longer requiring practices to follow COVID-19 safe-practice standards (3/9/2021)
From the Texas Medical Association (TMA) - FAQs - Current face mask requirements and other COVID-19 policies (6/1/2021)
From the Texas Medical Association (TMA) - Face mask poster - Your Safety Is Our Top Priority (6/9/2021)

Chronic Pain Patients - Former emergency rule regarding the issuance of certain prescriptions replaced by permanent rule - Effective Oct. 7, 2021
Refer to to rule Chapter 174.5 Telemedicine-Issue of Prescriptions for details on requirements and limitations. (10/19/2021)
Note: All prescribers must still check patients' PMP history prior to prescribing certain controlled substances. See more info on the PMP mandate,

Telemedicine 
TMB FAQs Regarding Telemedicine During Texas Disaster Declaration for COVID-19 Pandemic (updated 9/2/2020)
Gov. Abbott Waives Certain Regulations for Telemedicine Care in Texas (3/17/2020) 
For telemedicine resources and more, please refer to our Telemedicine web page.

Supervision of PAs and APRNs and PIT Permit Holders
From the Texas Medical Association - Regulations on Residents and Fellows Waived to Increase Health Care Staffing (4/13/2020)
Gov. Abbott Eases Regulations on Physicians-in-Training (PIT) to Increase Health Care Capacity in Texas (4/11/2020)
TMB FAQs Regarding Supervision - PAs, APRNs - During Texas Disaster Declaration for COVID-19 Pandemic (4/7/2020)
Gov. Abbott Waives Certain Regulations to Expand Healthcare Workforce During COVID-19 Response (4/5/2020)

Licensing 
Gov. Abbott Fast-Tracks Licensing for Out-of-State Medical Professionals (3/14/2020)
Licensing Overview - COVID-19 Disaster Response
License Renewals - COVID-19 Disaster Response - License Renewal Extensions
Physician License Retirement Options - COVID-19 Disaster Response - Retired Physicians Returning to Active Status 
From the AMA for senior and retired physicians - Senior Physician COVID-19 Resource Guide (4/1/2020)

Additional Resources
From the AMA - Ethics Guidance During a Pandemic - An Overview 
From the AMA - AMA Code of Medical Ethics - Guidance in a Pandemic
From the ABIM - American Board of Internal Medicine coronavirus updates 
From the ABMS - American Board of Medical Specialties Statement Regarding Continuing Certification During COVID-19

Contact the TMB - contact info with addresses, department mail codes, phone numbers.
Rules and Regulations - Most current TMB Laws and Rules, the Proposed Rule Changes, and FAQs for Licensees.
Newsroom - TMB Bulletins and Press Releases of recent rule changes, disciplinary action, new licenses issued, and other information.

 


Texas Medical Practice Act

The Texas Medical Practice Act, or Texas Occupations Code, Title 3 Health Professions, is where the state statutes are written that govern the practice of medicine and define the limits and responsibilities of medical practice in Texas.

Other sections of the Texas Constitution and Statutes include the Health and Safety Code and Family Code.


Texas Register and Texas Administrative Code

The Texas Register is a weekly publication from the TX Secretary of State that serves as the journal of state agency rule-making, including those involving the TMB.

After adoption, these actions are codified into the Texas Administrative Code, Title 22 Examining Boards, Part 9 Texas Medical Board, known as the TMB Rules.


Texas Physician Health Program (TXPHP)

This state program serves physicians affected by substance use disorders, physical illnesses and impairment, or psychiatric conditions through a recovery program. The TXPHP is covered under TMB rules Chapter 180. For more information, refer to the TXPHP website.


Physician TMB Profile

The public is able to access any Texas physician’s TMB profile and look up licensure, specialty, medical school of graduation, graduate medical education, practice address, hospital privileges, and more. Physicians should periodically review their TMB profile to ensure their information is accurate and current.


Complaint Processes

Information on the TMB's processes for handling complaints and enforcement procedures.

Notices:

Physicians and health organizations must post in their offices the TMB Notice Concerning Complaints, in English and Spanish, that advises how to file a complaint with the TMB.
Notice to Patients Concerning Complaints for posting.
The complaint notification rules are explained in Chapter 178.3.

For patients and the public:

Complaint Process
Enforcement Process

For physicians:

Refer to Flowcharts of the TMB Complaint Investigation Process.
For the most current TMB rules, see sections Complaints, Investigations, and Procedural Rules.
The Texas Medical Association (TMA) has developed an excellent publication, for CME credit, that walks physicians through the TMB investigation process in Texas Medical Board Investigations: A Physician's Guide Through the Disciplinary Process.


Electronic Death Registrar - TxEVER

A physician who would ever be called upon to sign a death certificate must be registered with TxEVER, the Department of State Health Services (DSHS) Texas Electronic Vital Events Registrar. To enroll, see the TxEVER Welcome page and click on the User Enrollment link.

The medical certification of an electronic death certificate must be completed not later than five days after receiving it Health and Safety Code 193.005(b).
If a physician does not complete the death certificate within the required time frame, a complaint could be filed with TMB and disciplinary action could be taken. For information from the TMB.


Licensure, CME Requirements, DEA Registration, and more

Renewing a medical license, CME requirements, changing an address, retirement options, DEA information, and more.

Continuing Medical Education (CME): Licensure: Additional information:
  • Change of address - Notify TMB of change of address either online or via form.
  • Name change request form - TMB application for name change.
  • Retirement options - TMB provides licensure options for physicians who are retiring from medical practice. Note: The TMB allows retired physicians to use either a home address or a PO Box for the personal mailing address; however, PO Boxes are not allowed to be used as a 'practice' address.
  • Controlled Substances Registration (CSR) - The requirement to hold a CSR was eliminated in 2016, and the state will NOT replace it with another process. However, physicians must still maintain a current federal DEA registration.
  • DEA registration - For Drug Enforcement Administration (DEA) new and renewing registration online forms. Note: The DEA does not allow the use of PO Boxes for the registration address. A PO Box may only be used as an additional contact address.
  • DEA contact information - For various DEA departments and offices.
  • Scams targeting DEA registrants - TMB alert regarding scammers impersonating the TMB and other state and federal agencies.
  • Ordering Prescription Forms - The Texas State Board of Pharmacy is responsible for issuing the Official (CII) Prescription Forms. To learn about electronic prescribing, including the e-prescribing of controlled substances, see our e-prescribing page.
  • KSTAR Physician Assessments - Through TAMHSC-Rural and Community Health Institute, these assessments are designed to help physicians who want to re-enter practice, have a perceived practice issue, or are under medical board order and need an assessment to demonstrate their knowledge base.

Pain Management Treatment, Prescribing and the Prescription Monitoring Program (PMP)

The treatment of pain is a vital part of the practice of medicine. Chapter 170 Prescription of Controlled Substances defines acute and chronic pain and explains the requirement to check the Texas Prescription Monitoring Program (PMP).

For the treatment of chronic pain, Chapter 170.3 describes the minimum requirements that have been set forth. Telemedicine medical services used for the treatment of chronic pain with scheduled drugs by any means other than via audio and video two-way communication is prohibited unless certain circumstances are met, as explained in Chapter 174.5 Telemedicine-Issuance of Prescriptions.

For the treatment of acute pain, refer to the below bulleted list effective Sept. 1, 2019, regarding the 10-day supply limit on opioid prescriptions. Chapter 174.5 allows for the use of telemedicine when prescribing for acute pain.

The Texas Prescription Monitoring Program (PMP) is under the oversight of the Texas State Board of Pharmacy and monitors Schedule II through V controlled substance prescriptions. Physicians and other prescribers must set up a PMP account, use it to view and monitor their patients' prescription history for info that might indicate drug abuse, illicit activity, drug diversion, or doctor shopping, and check a patient's PMP history prior to issuing a new or refill prescription for certain controlled substances. Refer to the below info effective March 1, 2020, for a list of these substances.

A review of the patient's PMP prescribing history must be documented in the patient's medical record, which could include placing a copy of the PMP check in the patient's file. Chapter 170.9 describes when and under what circumstances a PMP check is required as well as exceptions to that requirement.

A PMP account also allows physicians to verify that their own prescribing records are accurate, and physicians who have delegated prescribing authority to PAs or APRNs may request from the PMP info on their prescribing activity as well.

The Texas Medical Association's on-demand webinar Texas Prescription Monitoring (PMP) Requirements: Who, What, When, and How covers the statutory requirements for checking the PMP and delineates how to use the PMP to determine a patient's risk for overdose, etc. It also discusses integrating a patient's PMP history with the practice's EHR. For more details and to register for this free recorded TMA webinar. Check the latest list of EHR vendors that are integrated with the PMP.

Effective Sept. 1, 2018:
  • Pharmacy Board issued new official prescription forms with advanced security features designed to help deter fraud.
Effective June 1, 2019: Effective Sept. 1, 2019:
  • Opioid Prescription Limits for Acute Pain - 2019 HB 2174 sets limits on the prescribing of opioids for acute pain. Opioid prescriptions for acute pain may not exceed a 10-day supply and cannot include any refills. However, the patient may see the practitioner in a follow-up appointment and receive another opioid prescription for up to 10 days, if needed. TMB explains that a follow-up appointment is required for each 10-day period of opioid prescriptions for acute pain. The 10-day limitation does not apply in the treatment of chronic pain, or as part of cancer, hospice, end-of-life or palliative care, or in the treatment of substance addiction. See Health and Safety Code 481.07636-481.0765.  
  • Delegated prescribing activity - 2019 SB 683 contains a provision authorizing physicians to request information on the prescribing activity of an individual to whom the physician has delegated prescribing authority. See Health and Safety Code 481.076.
  • Continuing Education - 2019 HB 2174 requires practitioners to complete CME related to approved procedures of prescribing and monitoring controlled substances; 2019 HB 3285 requires CME in best practices, alternative treatment options, and multi-modal approaches to pain management; and 2019 HB 2454 requires physicians practicing direct patient care to complete CME in safe/effective pain management and opioid prescribing by the next registration period. These two formal hours of CME are to be completed within each license renewal period beginning with renewal on or after Sept. 1, 2020. Refer to the TMB Bulletin Oct 2020, beginning on page 3, for more CME info. For all CME requirements, see TMB's CME page or the link in the above 'Licensure, CME requirements' section.
Effective March 1, 2020:
  • Prescribers and pharmacists required to check the patient's PMP history prior to issuing or dispensing a new or refill prescription for an opioid, benzodiazepine, barbiturate, or carisoprodol. The date was formerly Sept. 1, 2019; however, the TX Legislature delayed the mandate until March 1, 2020, by passing 2019 HB 3284. See Health and Safety Code 481.0764-481.0765.
  • Refer to TX Admin Code Chapter 170.9 for details, requirements and exceptions regarding the Prescription Monitoring Program Check.
  • A copy of the PMP check may be placed in the patient's medical record to provide the required documentation that the PMP was checked and, based on that information, appropriate care was provided.
Effective Sept 1, 2020:
  •  CME requirements on Human Trafficking prevention and Pain Management-Prescription of Opioids apply to license renewal period beginning with renewal on or after Sept. 1, 2020. Refer to the TMB Bulletin Oct 2020, beginning on page 3. For all CME requirements, see TMB's CME page or the link in the above 'Licensure, CME requirements' section for more info and CME resources. 
Effective Jan. 1, 2021: Resources:

Pain Management Clinics and Office-Based Anesthesia

Board Rules, Registration, Inspection Info for Pain Management Clinics, Chapter 195
Renewal of Pain Management Clinic Registration FAQs
Continuing Education for Pain Management Clinics
Forms for Pain Management Clinics
Office Based Anesthesia