This presentation summarizes the executive orders enacted by Governor Greg Abbott and enforced by the Texas Medical Board for physicians and medical practices in Texas as of April 16, 2020.

1. WHAT EVERY PHYSICIAN
NEEDS TO KNOW:
TEXAS COVID-19
REGULATORY CHANGES

2. COVID-19 IN
TEXAS
This presentation summarizes
the executive orders enacted by
Governor Greg Abbott and enforced
by the Texas Medical Board for
physicians and medical practices in
Texas as of April 16, 2020.
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3. TELEMEDICINE
RULES RELAXED
During the state disaster declaration, physicians can
temporarily use telephone-only encounters to establish
a physician-patient relationship. This includes using
telemedicine for diagnosis, treatment, ordering of tests, and
prescribing conditions.
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4. The standard of care still applies to a virtual visit and is no different from
an in-person visit, says the Texas Medical Board.
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TELEMEDICINE
RULES RELAXED

5. Physicians with established chronic pain patients can provide
telephone prescription refills until May 8, 2020.
PRESCRIPTION RULES
WAIVED FOR CHRONIC PAIN
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According to the TMB, “This waiver follows the Drug Enforcement Agency
announcement that health care professionals can prescribe controlled
substances, including opioids, via telemedicine during the current
coronavirus public health emergency.”
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PRESCRIPTION RULES
WAIVED FOR CHRONIC PAIN

7. DELEGATION RULES
TEMPORARILY WAIVED
Certain regulations for physicians and the physician
assistants and advanced practice registered nurses they
supervise are being waived. For the duration of the disaster:
• Physicians do not need to register their delegating
relationships with PAs and APRNs.
• The prescriptive authority of a PA or APRN does not have to
be in writing.
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8. DELEGATION RULES
TEMPORARILY WAIVED
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(continued)
• The limit of seven full-time PAs or APRNs has been suspended.
• The supervising physician does not have to be at the same location
as the delegates, but the supervising physician must be available to
answer questions.
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9. BAN OF NON-URGENT AND
ELECTIVE PROCEDURES
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Non-urgent elective surgeries and procedures that are not
immediately medically necessary must be postponed until
April 21, 2020.

10. BAN OF NON-URGENT AND
ELECTIVE PROCEDURES
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The TMB says, physicians who violate this order may be considered
a “continuing threat to the public welfare” and may face “a temporary
suspension hearing with or without notice depending on the
circumstances.”
Additionally, failure to comply with an executive order issued by the
governor related to the COVID-19 disaster can result in penalties of up to
$1,000 or 180 days of jail time.

11. BAN OF NON-URGENT AND
ELECTIVE PROCEDURES
Physicians who receive a TMB notice or action for violating this order will
have only seven days to respond to the allegations.
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12. HIPAA ENFORCEMENT
DISCRETION
The Health and Human Services (HHS) Office for Civil Rights
(OCR) will waive potential HIPAA penalties against health
care providers using telehealth services to care for patients
during the national public health emergency.
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13. HIPAA ENFORCEMENT
DISCRETION
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According to the OCR, “This exercise of discretion applies to widely
available communications apps, such as FaceTime or Skype, when
used in good faith for any telehealth treatment or diagnostic purpose,
regardless of whether the telehealth service is directly related to
COVID-19.”
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14. SOURCES
1. Texas Medical Board
http://www.tmb.state.tx.us/page/coronavirus
2. TMLT Resource Hub
https://hub.tmlt.org/coronavirus
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15. PROTECTION FOR A
NEW ERA OF MEDICINE
ABOUT TMLT:
With more than 36,000 health care professionals in its care, Texas Medical
Liability Trust (TMLT) provides malpractice insurance and related products
to physicians. Our purpose is to make a positive impact on the quality of
health care for patients by educating, protecting, and defending physicians.
www.tmlt.org
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