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 process, electronic death registration, the treatment of and prescribing for pain, the Prescription Monitoring Program (PMP), and more.

Texas Medical Board Announcements, Contact Info, 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  

Postponing Certain Surgeries and Procedures -
From the Texas Medical Association (TMA) - TMA White Paper Explains Non-Urgent Surgeries and Procedures Rule (updated 3/29/2020) as well as a resources document to find state, federal and specialty society guidance (3/30/2020)
TMB FAQs Regarding Non-Urgent Elective Surgeries and Procedures During Texas Disaster Declaration for COVID-19 Pandemic with tips (updated 3/29/2020)
---- Circumcision at childbirth - TMA has spoken to the TMB, which said that circumcision is considered an "incidental" service in connection with delivering a baby and therefore permissible. (4/2/2020)
TMB Passes Emergency Rules to Enforce Gov. Abbott's Executive Oder GA-09 (3/24/2020) 
Gov. Abbott Issues Executive Order Increasing Hospital Capacity, Postponing Certain Surgeries (3/22/2020)
From the Texas Medical Association (TMA) - Gov. Abbott: No Nonessential Surgeries (3/23/2020) 

Chronic Pain Patients -
TMB Waiver for Chronic Pain Patients Granted by Gov. Abbott (3/19/2020)
Note: All prescribers must still check patients' PMP history prior to prescribing certain controlled substances. See more info on the PMP mandate, 
From the Texas Medical Association (TMA) - How to Prescribe Controlled Substances Under COVID-19 Waivers (updated 3/25/2020)

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

Licensing -
Gov. Abbott Fast-Tracks Licensing for Out-of-State Medical Professionals (3/14/2020)
Licensing Overview - COVID-19 Disaster Response - Licensing for Out-of-State Providers
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)

Disaster Declaration Due to COVID-19 -
Governor Extends Essential Services Executive Order Until April 30 (TMA, 3/31/2020)
TMB Responding to Gov. Abbott's State Disaster Declaration (3/14/2020)

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: For patients and the public: For physicians:

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.

CME: Licensure: Additional information:
  • Change of address
  • Name change request form
  • 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 including local offices.
  • Scam targeting DEA registrants - A TMB alert regarding criminals claiming to be DEA agents or TMB employees.
  • 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 and the Prescription Monitoring Program (PMP)

For the treatment of chronic pain, refer to the current TMB rules, including those involving minimum requirements, under Chapter 170 Pain Management.
NOTICE: COVID-19 TMB waiver for chronic pain patients granted by Gov. Abbott (March 19, 2020)  The mandate to check patients' PMP history continues.
For the treatment of acute pain, refer to the below info effective Sept. 1, 2019, regarding the Health and Safety Code limitations on the prescribing of opioids.

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 copy of the PMP check may be used to document the patient's medical record. 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 - 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. 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.
  • 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, within one year of their license issuance, to complete two hours of CME related to approved procedures of prescribing and monitoring controlled substances. Practitioners who were authorized to dispense a controlled substance before Sept. 1, 2020, must complete the course by Sept. 1, 2021. 2019 HB 3285 requires annual one-hour CME in best practices, alternate treatment options, and multi-modal approaches to pain management. (Note: The requirements for these CME courses have not yet been finalized; however, TMB has provided some guidance. Refer to the Resources section below.)
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.
  • A copy of the PMP check may be placed in a patient's medical record. Although the TMB does not require any specific words be used for documenting that the PMP was checked, it does want to ensure the physician reviewed the patient's PMP record and, based on that information, provided appropriate care.
  • Refer to the Resources section below for TMB guidance (Feb 21, 2020) on the requirements for checking the PMP in an office or ambulatory surgery setting, or when a patient has been discharged from an in-patient or ER setting, or during an in-patient stay. Note: TMB anticipates bringing a proposed rule to the Board consistent with this guidance for possible publication as soon as early March.
Effective Jan. 1, 2021:
  • Requirement for controlled substances to be prescribed electronically, except in certain circumstances described in 2019 HB 2174. See Health and Safety Code 481.075. To learn about electronic prescribing, including the e-prescribing of controlled substances, see our e-prescribing page.
  • Continuing Education - 2019 HB 2454 requires physicians practicing direct patient care to complete two hours of CME in safe/effective pain management and opioid prescribing by the next registration period. (Note: The requirements for this CME course have not yet been finalized; however, TMB has provided some guidance. Refer to the Resources section below.)
Resources:

Pain Management Clinics and Office-Based Anesthesia

Board rules, registration, inspections, FAQs, and forms.