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Texas Medical Board Delegation Agreement

Supervisory/delegation or termination authorizations should be updated in our system within 30 days. Please note that updates submitted more than 30 days after the change do not affect the liability you may have for incorrectly recording surveillance or delegation information for ongoing or future investigations. Use the online system to register the prescribed authority AND to submit the Memorandum of Understanding on Practice/Monitoring, as requested by PAs and physicians. Monitoring and delegation forms are no longer accepted (unless necessary). Senate Act 406, effective 11/1/2013, requires a normative authority agreement between a doctor and an AFN, which has been delegated mandatory authority. Senate Bill 406 (including new rules) on the online registration system will be available in January 2014. You can register a new supervisor via the online registration system supervision and prescriptive delegation. Please note that this is a two-step process and the attending physician must complete the registration. Yes, the PAs supervisory physician must delegate the standard-setting authority that allows a PA to sign prescriptions for controlled substances, also called programmed drugs, as well as dangerous drugs.

However, PAAs are generally limited to Match III – V sheets (Schedule IIs are allowed in very limited circumstances). All prescription drugs, which are not controlled substances, fall into the category of „dangerous drugs.“ Standardization medical assistants must have their own AED numbers to prescribe controlled substances. In addition, medical assistants must have the name of their current delegated physician, who presents the standardization power to the DEA. The addition of a new supervisory physician does not end another supervision that currently exists. Any current medical assistance relationship may be terminated with the registration system for supervision and pre-registering delegation. Please note that on April 5, 2020, Governor Greg Abbott temporarily waived certain provisions in support of Texas` COVID-19 response. During the governor`s disaster declaration, physicians and their delegates can establish and maintain surveillance relationships with increased flexibility to respond more effectively to the COVID-19 emergency. In particular, during the duration of the disaster declaration, the limit on the number of delegates required has been removed and surveillance relationships should not be recorded in writing or with the TMB. Senate Act 532, effective 1/31/2010, requires physicians to register with the TMB if doctors delegate the prescriptive authority to APA or LES APNs.

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