Tag Archives: physician license

Texas medical license defense attorneyMost Texas physicians are familiar with the Texas Medical Board. It is where they obtained licensing status, and it is a constant threat to their practice. However, few know about the Federation of State Medical Boards (FSMB) and the role it plays in their lives. Learn what it is and why it is important with help from the following information.

The Federation of State Medical Boards

Each state has its own licensing board. The Federation of State Medical Boards ties them all together. It represents the 70 medical boards in the United States and its territories, including the District of Columbia. It offers policies, education, programs, and additional services to the state boards so that they can function effectively. The FSMB also enables state-to-state sharing of physician information. By far, that sharing is likely the most concerning issue for physicians.

How FSMB Sharing Can Impact Your Practice

The FSMB sharing allows state boards to look up disciplinary actions carried out by other state boards. So, if you lose your medical license or have it suspended in one state and then try to move, you may still be barred from practicing medicine. If you come under investigation, fail to complete it and move, the new state may have access to that information as well. Patients can also use the FSMB to check licensing issues in other states. So, even if an investigation seems arbitrary, it is important that you protect your license to the best of your ability.

Protecting Your Medical License

At first glance, protecting your medical license seems simple. Stay out of trouble, conduct yourself professionally, and provide quality medical care. Unfortunately, it is not always that easy. An angry staff member, a vengeful ex-partner, or even your annoying neighbor can file a complaint against you. Even a minor criminal infraction can lead to an investigation. Sometimes, doctors and their practices are targeted for no other reason than they distribute pain medication. These challenges mean that a physician should always know when and where to find assistance.

Contact Our Experienced Texas Medical License Defense Lawyer

If you have received a letter of investigation, contact Oscar San Miguel, Attorney at Law. Backed by nearly 30 years of experience, our Texas medical license defense lawyer can represent you and protect your rights, every step of the way. No matter what the situation, we aggressively pursue the most favorable outcome. Schedule your no-cost consultation by calling 512-228-7946 today.


Texas Medical Board remedial planSeveral years ago, the Texas legislature added a method for the Texas Medical Board to resolve some complaints against physicians in a non-disciplinary manner. Under this provision, a remedial plan may be used in lieu of other available measures for resolving complaints.

Before enactment of the remedial plan provision, the Texas Medical Board could dismiss a complaint or impose disciplinary sanctions against the physician. By contrast, a remedial plan is a settlement agreement that sets forth corrective measures and is considered to be non-disciplinary. It is typically used for minor violations, such as administrative violations of the Medical Practice Act or Texas Medical Board rules.

Under the Texas Medical Board rules, a remedial plan is used only in cases of minor violations. It cannot be used in cases involving the death of a patient, the commission of a felony, or inappropriate sexual behavior or conduct or financial involvement with a patient. A physician may agree to a remedial plan only once, and a remedial plan carries a $500 administrative fee.

The main benefits of the remedial plan option are that it is considered non-disciplinary, is not reported to the National Practitioner Data Bank, and does not require an admission of guilt. However, it is still a public order, and can give the impression of wrongdoing even if it resulted from a minor administrative violation that did not pose a risk to public health.

There is also the possibility that it may be offered by counsel for the Texas Medical Board even when there has been no wrongdoing. Thus, it is important for a physician to approach a remedial plan with the assistance of an experienced professional license attorney. Before you face the Texas Medical Board as the result of a complaint or consider agreeing to a remedial plan, you should contact an experienced Texas professional license defense attorney to determine your best course of action. Contact Oscar San Miguel, Attorney at Law, at the first sign of trouble.

pain management prescribingControlled substances prescribing is an area filled with potential pitfalls that, if not avoided, can lead to serious disciplinary action for physicians licensed by the Texas Medical Board. Each month the press releases published by the TMB detail disciplinary actions involving nontherapeutic and inappropriate prescribing as well as actions involving the proper operation of pain management clinics.

Instances of inappropriate and nontherapeutic prescribing that have resulted in disciplinary actions in the recent past include the following:

  • Prescribing controlled substances to relatives and other persons with whom the physician has a close personal relationship;
  • Prescribing without adequate documentation of a clinical diagnosis;
  • Prescribing for periods of time exceeding the current needs of the patient;
  • Prescribing without conducting a physical examination;
  • Prescribing without making a proper medical record;
  • Failure to look for and respond to aberrant drug use; and
  • Self-prescribing.

These matters have resulted in sanctions including various combinations of the following:

  • Restriction from prescribing certain drugs;
  • Losing the authority to treat patients for chronic pain;
  • Completion of a physician prescribing course;
  • Completion of a specified number of hours of CME in risk management and ethics;
  • Payment of administrative penalties;
  • Passing the Medical Jurisprudence Exam within a specified time period;
  • Following all recommendations of the Texas Physician Health Program; and
  • Not obtaining DEA or DPS Controlled Substances Registrations without TMB approval.

Repeat offenses and failure to comply with the terms of any disciplinary action are met with even stiffer penalties.

Pain management and the prescription of pain medications must be undertaken in compliance with DEA requirements, Texas law, TMB rules, and ethical standards. Physicians must take the utmost care adhere to procedures that include appropriate documentation and delegation policies, as well as procedures to detect indications of patient misuse or addiction.

Physicians should be aware of the potential consequences of noncompliance with pain management rules and requirements. Even physicians with the best of intentions can run afoul of the law. If you find yourself facing charges of inappropriate or nontherapeutic prescribing, having an experienced Texas professional license defense attorney at your side can significantly increase the likelihood of a positive outcome. Contact Oscar San Miguel, Attorney at Law, at the first sign of a problem.

National Practitioners Data Bank Most doctors have heard of the National Practitioners Data Bank (NPDB) and know that the Texas Medical Board must report disciplinary actions to it. But beyond that, there is more that physicians should know.

The NPDB is an electronic information clearinghouse that was created by Congress to provide public information about health care providers. It includes information on actions related to physicians’ state licenses, clinical practices, and membership in professional organizations, as well as state and federal actions related to participation in health care programs, criminal convictions, medical malpractice settlements and judgments, and other regulatory judgments.

Information reported to the NPDB is confidential, and cannot be disclosed to the public. However, the information is available to the following individuals and organizations:

  • Hospitals and other organizations with formal peer review;
  • Professional societies;
  • State and federal licensing boards;
  • Federal health care agencies;
  • Health insurers;
  • State and federal law enforcement;
  • Plaintiffs’ attorneys;
  • Statistical researchers; and
  • Practitioners themselves.

Physicians should be aware that their practice can be affected by a report to the NPDB. Many times the incident will also be reported in the media, alerting the public to an adverse issue with the physician. Retaining experienced legal counsel can be critical when dealing with the Texas Medical Board in disciplinary matters. The terms of any agreement or other resolution of a complaint can be specifically crafted to mitigate the negative impact on the physician when it is reported to the NPDB.

Physicians should also be aware that they should confirm the accuracy of the information reported to the NPDB. Physicians can perform a self-query to see the information that is on file with the NPDB. In addition, a copy of any report made to the NPDB is provided to the practitioner, who should review each report very carefully to check for accuracy. It is possible to contest the accuracy of the report, but this must be done within 60 days from the date the report is mailed to the physician.

If you are facing disciplinary proceedings by the Texas Medical Board, a negative outcome will be required to be reported to the NPDB. You need an experienced Texas professional license defense attorney at your side for the best outcome. Contact Oscar San Miguel, Attorney at Law, for a consultation as soon as possible.

prescription delegationIn late 2013, the Texas legislature passed SB 406, which changed the way physicians can delegate the authority to prescribe drugs or devices to midlevel practitioners, such as advanced practice registered nurses (APRNs) and physician assistants (PAs). Physicians should make sure they understand these new rules to protect their medical licenses.

The law provides that a Prescriptive Authority Agreement (PAA) is to be used to delegate prescribing authority. The new law expands the number of APRNs and PAs to whom a physician can delegate authority from four to seven, although there is no limit for doctors in facility-based practices or those that serve medically underserved populations. There is no longer a waiver procedure for a physician who wants to delegate prescriptive authority to more than seven APRNs and PAs. There is no limit on the number of physicians who are permitted to delegate prescriptive authority to one APRN or PA. The new law also eliminates site-based supervision requirements.

The Prescriptive Authority Agreement must include:

  • The names, addresses, and professional license numbers of all parties;
  • The nature of the practice, location, or setting;
  • Which types or categories of drugs or devices that may (or may not) be prescribed;
  • A plan for dealing with consultations and referrals;
  • A plan for dealing with patient emergencies;
  • How the parties will communicate and share information; and
  • Procedures for implementing a quality assurance and improvement plan, including chart reviews and periodic face-to-face meetings.

Face-to-face meetings are required at least monthly for the first three years of the agreement. However, this time period is changed to one year if the APRN or PA was in a prescriptive authority agreement with physician supervision for five of the last seven years. In either case, after the prescribed time period, face-to-face meetings are required at least quarterly, with monthly meetings to be held via videoconferencing or communication via the internet.

APRNs and PAs may prescribe Schedule II drugs only in the following circumstances:

  1. In a facility-based practice under hospital policy and bylaws, as part of the provision of care to a patient who has been admitted to the hospital for at least 24 hours, or is receiving care in the emergency department; or
  2. If the patient has executed a written certification of a terminal illness and is receiving hospice care.

More requirements are outlined in Frequently Asked Questions posted by the Texas Medical Board.

If a physician has been notified of violation of the new rules regarding delegation of prescriptive authority, the best course of action is to contact experienced Austin professional license attorney Oscar San Miguel immediately. Having a legal representative experienced in Texas Medical Board matters is the best way to protect your medical license.


Austin, Texas Professional License Defense Attorney Oscar San Miguel represents clients who are located in Austin, Houston, Dallas, San Antonio, El Paso, Fort Worth, Arlington, Amarillo, Lubbock, Brownsville, Laredo, Harlingen, McAllen, Round Rock, Longview, Travis County, Harris County, Dallas County, Tarrant County, Bexar County, Fort Bend County, Montgomery County, Cameron County, Nueces County, El Paso County, Potter County, Lubbock County, Grayson County, Collin County and throughout Texas.
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