public communication
Any written, printed, visual, or oral statement or other communication made or distributed, or intended for distribution, to a member of the public
publication
any and all public communications relating to the practitioner’s practice, including but not limited to, advertisements, announcements, invitations, press releases, journal articles, periodical articles, leaflets, news stories, materials distributed by private or by United States mail, and signs or placards placed in public view or electronic submission
Solicitation
a private communication to a person concerning the performance of a Podiatric service for such a person
supervision
responsibility for the control of quality, radiation safety and protection, and technical aspects of Podiatric radiological procedures utilized in Podiatric medicine for diagnostic purposes
How many members are on the Podiatric medical examiners advisory board? Who appoints these members?
-9 members
-the governor
How many members of the Podiatric medical examiners advisory board must be licensed practicing podiatrists?
6 members who have had at least practiced for 5 years prior to appointment
How many members of the Podiatric medical examiners advisory board are public members?
3 members
What does “Texas trade association” stand for
a cooperative and voluntarily joined statewide association of business or professional competitors in this state designed to assist its members and its industry or profession in dealing with mutual business or professional problems and promoting their common interest
Can a person be a member of the advisory board if they are requesting compensation for their activities related to the board or have family members who are involved with a similar health care board?
No
How do members of the advisory board serve their terms?
staggered 6 year terms, 3 members expiring on 2/1 of each ODD numbered year
What are grounds for dismissal of a member of Podiatric medical examiners advisory board?
-not qualified
-does not maintain qualifications
-ineligible for membership
-illness or disability which prevents member from completing their duties
-absence from more than half of the regularly scheduled advisory board meetings w/o majority vote for excused absence
What is the role of presiding officer?
calls meetings, votes before the rest of the board
Who appoints the presiding officer of the Podiatric medical examiners advisory board?
the governor
What are the duties of the advisory board?
providing advice and recommendation to the department on technical matters relevant to the administration
How many semester hours of undergrad must a candidate for a temporary residency license complete?
90 semester hours
When does a temporary podiatry license expire?
June 30th of every year
How long is a temporary residency license active?
1 year
What is the scope of practice for a temporary license holder?
a person in training who is limited by the GPME program for residency based supervised patient encounters, supervision of which is designated to protect patients and citizens of Texas
How is a temporary residency license identified in Texas
“T” followed by numerals
What document does a resident have to sign in their final year in order to apply for the podiatry license?
memorandum of understanding for conditional issuance Texas doctor of Podiatric medicine license
How long does a resident have to provide proof of residency completion for their MOU?
30 days after end of residency graduation
Can a resident who holds a doctor of Podiatric medicine license practice podiatry under the new title prior to completion of residency?
NO! while still a resident, the provider will practice under the temporary license, and will remain subject to the scope and limits of the GPME program, and shall not practice podiatry under the Doctor of Podiatric Medicine license until after successful completion and graduation from the GPME program and after providing to the department proof of such completion and graduation
How long can a temporary residency license be extended?
3 months
How many times can a temporary residency license extension be granted?
maximum of 2 times
What additional information can be required from an applicant for permanent licensure if the applicant has been out of practice for 2 years?
-additional education
-examinations
-training
How long is a doctor of Podiatric medicine license valid?
2 years
What qualifications must a sponsor for an applicant’s provisional license hold?
-5 years of good standing under the act
-ensure the applicant is working within the same office as the licensee under direct supervision
How long is a provisional license valid for?
-180 days
How many times can a provisional license be renewed?
-3 times
When can GPME requirements be waived for provisional license?
if the applicant has been practicing for at least 5 years in another state under license of that state with acceptable record from the state in which the applicant was licensed
When did Texas begin the National boards Part III/PM Lexis requirement for licensure come into effect?
1/29/1992
How many hours of CME are required every 24 months?
50 hours
How many of the 50 hours of CME is required to be ethics related?
2 hours
How many hours of CME are required to be completed regarding approved procedures of prescribing and monitoring controlled substances?
2 hours
How often does a licensed podiatrist who prescribed opioids have to attend a course covering best practices, alternative treatment options, and multi-modal approaches to pain management per CME period? How long does each session have to be?
2 times, once annually
1 hour course
What qualifies as appropriate CME crediting events?
-hospital Podiatric medical grand rounds
-APMA/APMA affiliated organizations
-TPMA
-state
-county or regional Podiatric medical association
-university sponsored pod medical meetings
-hospital Podiatric medical meetings
How many hours of home study and self-study programs will be accepted for CME credit hours?
up to 20 hrs
How many credits of CME is CPR training worth? How many CME hours is ACLS worth? Can you get credit for both?
1) 3 hours
2) 6 hours
3) no
How many CME credit hours can a practitioner receive for a published article?
1 hr
How many hours can carry over to the next CME period if there is an excess of 50 hours completed biannually?
10 credit hours
When do CME hours need to be sent to the department for review?
if audited
How does the audit process look like?
1) random selection of sample license holders
2) if selected, the license holder shall submit copies of certificates, transcripts, or other documentation satisfactory to the department, verifying the license holder’s attendance and participation and completion of the continuing education
3) failure to timely furnish this information w/in 30 days or providing false info can be grounds for disciplinary action
4) if selected for continued education during renewal period, license holder may submit renewal fees at that time for permanent licensure
Can CME required for disciplinary action be counted towards biannual CME requirements?
No
what was the Texas legislature that allowed authority to establish a 1 or 2 year license term for licensees?
Texas Legislature 85 in chapter 202
When can CME be exempted?
-hardships for the practitioner which the executive director can clear
How much time does a provider have to complete delinquent hours?
3 years
Which agency published the recommendations for HBOT care?
Undersea and Hyperbaric medical society (UHMS)
Where can HBOT be done?
In a hospital setting
What is the document that determines the scope of HBOT practice of a podiatrist?
Podiatric Medical Practice Act
How long is the HBOT certificate active and what is the cost for the certificate?
1) $25
2) 1 year
How long do certificate holders have to inform the department of any address change or change of hospital setting no later than _ days?
10 days
Define Conscious sedation?
the production, by pharmacological or non-pharmalogical methods, or a combination thereof, of an altered level of consciousness in a patient
What are the requirements of the didactic and clinical course which includes aspects of monitoring patients and the hands-on use of the gas machine?
1) directed by a licensed and certified MD, DO, DDS, or DPM in the state of Texas with advanced educational and clinical experience in NO/O2
2) minimum of 4 hours didactic work
3) minimum of 6 hours clinical works
What certifications are required to practice conscious sedation with NO/O2?
-basic CPR
-advanced CPR
Which members in the office must be trained in CPR if NO/O2 is being used?
-all of them
How much does the license for NO/O2 cost?
$25
What aspects of the patient’s medical state need to be documented prior to conscious sedation?
patient’s health and medical status to ensure that NO/O2 is medically appropriate
What equipment safety criteria must be met for gas machine?
1) 30% oxygen flow min
2) glass tubes present
3) room air flow if bag is empty
4) NO fail safe (will not flow without oxygen)
5) non-rebreathing check valve
6) O2 flush
7) auxiliary oxygen outlet with one demand valve resuscitation assembly per office
What requirements are needed for all practitioners using NO?
1) functioning vacuum
2) scavenger system
3) appropriate emergency drugs and equipment for resuscitations
4) manifold to provide for protection against over-pressure with AUDIBLE alarm system
How often does the NO/O2 machine need to be service checked up?
3 year basis
What is voluntary charity care
medical care provided for no compensation to indigent populations, medically underserved areas, disaster relief
How often does the voluntary charity care status need to be renewed?
every 2 years
How many CME hours need to be completed for the voluntary charity care status?
25 hours
What are the consequences of making superior claims with advertising?
lose license, grounds for denial
How long do all practitioners need to retain records of recordings, transcripts, or copies of all public communications?
24 months
Which requirements are needed for a certifying board that is not recognized by the council on Podiatric Medical Education of the American Podiatric Medical Association?
1) written and oral examinations must be passed within speciality of pod med
2) certifying board had written proof by IRA that the board is tax exempt
3) HAS AT LEAST 100 DULY LICENSED CERTIFICANTS FROM 1/3 of states
4) has certifying board with permanent headquarters and staff
5) all practitioners who are seeking certification have completed identifiable and substantial training
Can the terms “board eligible” or “board qualified” be used for advertising?
No
If there is a change of address, how long does the practitioner have to report the changes?
10 days
Whose responsibility is it to ensure that a Podiatric medical radiological technician is trained an registered with the department?
the provider
How old do you have to be a Podiatric medical radiological technician?
18 or older
How many hours of clinical and didactic training requirements are required for proof of completion for a Podiatric medical radiological technician?
20 hrs
How many successful productions of x-rays are required for out of classroom training?
60
Does a pod medical rad tech need to be registered?
YES
How long is a Podiatric medical radiological technician license valid? When are the licenses renewed?
1 year
Sept 1 2020
How long do radiological records of Podiatric care need to be retained?
5 years after treatement
How long does a practitioner have to send records of imaging once medical records are requested?
w/in 30 days
Can the practitioner hold onto requested information until payment is received?
Yes
In the event that the payment for imaging is not routed with request for records within _ days after receiving request, the practitioner will notify the requesting party in WRITING of the need for payment and may withhold information until payment is complete
10 days
Can a practitioner give notification given before to discontinue treatment to a patient to give the patient reasonable time to secure the services of another practitioner or all Podiatric medical services actually begun have been completed and there is no contract or agreement to provide further treatment?
Yes
What constitutes sexual impropriety?
behavior, gestures, or expressions that are seductive, sexually suggestive, or sexually demeaning to a patient/staff (ex examination of genitals without gloves)
What is sexual exploitation?
breakdown of professionalism in the physical/patient/staff relationship constituting sexual abuse (ex coercive power)
What are the responsibile steps need to be taken prior to prescribing controlled substances to patients?
1) review Texas Prescription Monitoring Program (PMP) database
2) pt’s identifiers match
3) initial H&P performed and documented
4) schedule II prescription copies must be placed in records and charts
5) alternative therapies are noted as discussed and prescribed
When does PMP not need to be evaluated prior to prescribing meds?
hospice care, cancer pts
What is true about schedule 1 drugs in USA?
not prescribed because of concern for addiction
When can a podiatrist prescribe an opioid-antagonist?
a podiatrist may prescribe an opioid antagonist to a person at risk of experiencing an opioid-related drug overdose or to a family member, friend, or other person in a position to assist the person who is at risk of experiencing an opioid-related drug overdose
Define acute pain
normal, predicted, physiological response to stimulus such as trauma, disease, and operative procedures
What are conditions not considered acute pain?
-chronic pain
-cancer treatment
-hospice care
-palliative care
How many days worth of opioids can a podiatrist prescribe for acute pain?
10 days worth
Since what date have controlled substances been requested to be ordered electronically?
1//1/21
Under what circumstances can you prescribe controlled substances outside of electronic means?
1) emergency
2) if medication is filled out of state
3) if the prescriber and dispenser are in the SAME location under the SAME license
4) for a drug that the FDA requires more information that can be submitted online
5) for a non-patient-specific prescription pursuant of standing order, approved protocol for drug therapy, collaborative drug mngmt, comprehensive medication mngmt, or in response to public health emergency
6) drug for research protocol
7) practitioner with a waiver
8) if it is impractical for patient to obtain meds if prescribed electronically
If a practitioner has a waiver to prescribe meds outside of electronic means, how long does waiver last? When can renewal be started?
1 year
30 days or less from expiration of waiver
A practitioner’s waiver of electronic prescribing request form must contain sufficient evidence of one or more of the following that, in the judgment of the executive director, justify the issuance of a waiver:
1) economic hardship
2) technological limitations
3) ISSUANCE OF FIFTY OR LESS PRESCRIPTIONS FOR CONTROLLED SUBSTANCES IN THE YEAR IMMEDIATELY PRIOR TO REQUEST FOR WAIVER
4) exceptional circumstance that is shown by the practitioner
What is the cost to extend the temporary license?
$50
How much does doctor of Podiatric medicine initial license?
$750
How much does renewal of the Podiatric medicine license cost?
$700
How much does it cost to duplicate license/replacement license?
$25
How soon after a complaint or claim must information be provided and what information needs to be sent in addition?
within 30 days, copy of claim letter or petition
If a license suspension is probated, the commission or executive director may require the licensee to:
(1) report regularly to the department on matters that are the basis of the probation;
(2) limit practice to the areas prescribed by the commission or executive director; or
(3) continue or review continuing professional education until the licensee attains a degree of skill satisfactory to the department in those areas that are the basis of the probation.
What is anonymous complaints?
a complaint that lacks sufficient information to identify the source of the name of the person who filed the complaint
define insurance agent
person licensed under under chapter 4504
Define insurer
means an insurance company of other entity authorized to engage in the business of insurance
Define third-party administrator
a person required to have a certificate of authority under chapter 4151 insurance code
Can the department accept any anonymous complaints?
No
Define expert witness
a podiatrist or other qualified individual with whom the department contracts to assist the department with reviewing, investigating, or prosecuting complaints filed under the chapter
When are confidentiality wavers waved for the peer review committee?
during a peer review committee, a person reviewing the material is on a peer review committee, or if a civil action is filed as a result of participating in peer review
Except for an action involving fraud, conspiracy, or malice, a podiatric peer review committee is immune from liability and may not be subject to a suit for damages for any act arising from the performance of the committee’s duties in:
1) investigating a disagreement or complaints
2) holding a hearing to determine facts
3) making an evaluation, recommendation, decision, or award involving
- podiatrist who is a member of the Podiatric medical society or association
- another podiatrist, Podiatric patient, or third party who requests the services of the committee
When can claims be asked for defense costs?
counterclaim can be made in subsequent suit to recover defense costs, including court costs, attorney’s fees, and damages IF the original claim is determined to be frivolous or to have been brought in bad faith
Who has the power to revoke or suspend a license?
the commission or executive director
Where can an appeal be made by a person who has had their license revoked or suspended for a drug-related felony?
travis county district
When can a license be suspended for a drug-related felony?
after conviction of felony
How soon after a license has been revoked can a practitioner apply for reissuing?
1 year after initial revocation date
How much refund can the executive director order for a penalty?
the amount paid by the patient, cannot exceed that amount to damages
When can the department, under reasonable business hours, enter a business premises?
1) to investigate a complaint filed with the department
2) determine the compliance with an order of the commission or executive director issued
How much is the cost of a civil penalty for each day of violation?
Min $50 max $500
What is the punishment for general criminal penalty for practicing without a license?
1) min $50 and max $500
2) confinement in county jail for NOT less than 30 days and NOT MORE than 6 months
3) both fine and confinement
What is the criminal penalty for amputation of a foot?
1) a fine not less than $100 or more than $500
2) confinement for not less than 30 days and not more than 6 months
3) both fine and confinement
Define podiatry
the treatment of or offer to treat any disease, disorder, physical injury, deformity, or ailment of the human foot by any system or method
Claims that are not required to be reported under the 202 chapter include, but are not limited to, the following:
1) civil violations
2) product liability claims
3) antitrust alligations
4) allegations regarding improper peer review activities
5) business disputes
6) allegations of liability of injuries occurring on Podiatric physician’s property, but not involving breach of duty in the podiatric physician-patient relationship
public communication
Any written, printed, visual, or oral statement or other communication made or distributed, or intended for distribution, to a member of the public
publication
any and all public communications relating to the practitioner’s practice, including but not limited to, advertisements, announcements, invitations, press releases, journal articles, periodical articles, leaflets, news stories, materials distributed by private or by United States mail, and signs or placards placed in public view or electronic submission
Solicitation
a private communication to a person concerning the performance of a Podiatric service for such a person
supervision
responsibility for the control of quality, radiation safety and protection, and technical aspects of Podiatric radiological procedures utilized in Podiatric medicine for diagnostic purposes
How many members are on the Podiatric medical examiners advisory board? Who appoints these members?
-9 members
-the governor
How many members of the Podiatric medical examiners advisory board must be licensed practicing podiatrists?
6 members who have had at least practiced for 5 years prior to appointment
How many members of the Podiatric medical examiners advisory board are public members?
3 members
What does “Texas trade association” stand for
a cooperative and voluntarily joined statewide association of business or professional competitors in this state designed to assist its members and its industry or profession in dealing with mutual business or professional problems and promoting their common interest
Can a person be a member of the advisory board if they are requesting compensation for their activities related to the board or have family members who are involved with a similar health care board?
No
How do members of the advisory board serve their terms?
staggered 6 year terms, 3 members expiring on 2/1 of each ODD numbered year
What are grounds for dismissal of a member of Podiatric medical examiners advisory board?
-not qualified
-does not maintain qualifications
-ineligible for membership
-illness or disability which prevents member from completing their duties
-absence from more than half of the regularly scheduled advisory board meetings w/o majority vote for excused absence
What is the role of presiding officer?
calls meetings, votes before the rest of the board
Who appoints the presiding officer of the Podiatric medical examiners advisory board?
the governor
What are the duties of the advisory board?
providing advice and recommendation to the department on technical matters relevant to the administration
How many semester hours of undergrad must a candidate for a temporary residency license complete?
90 semester hours
When does a temporary podiatry license expire?
June 30th of every year
How long is a temporary residency license active?
1 year
What is the scope of practice for a temporary license holder?
a person in training who is limited by the GPME program for residency based supervised patient encounters, supervision of which is designated to protect patients and citizens of Texas
How is a temporary residency license identified in Texas
“T” followed by numerals
What document does a resident have to sign in their final year in order to apply for the podiatry license?
memorandum of understanding for conditional issuance Texas doctor of Podiatric medicine license
How long does a resident have to provide proof of residency completion for their MOU?
30 days after end of residency graduation
Can a resident who holds a doctor of Podiatric medicine license practice podiatry under the new title prior to completion of residency?
NO! while still a resident, the provider will practice under the temporary license, and will remain subject to the scope and limits of the GPME program, and shall not practice podiatry under the Doctor of Podiatric Medicine license until after successful completion and graduation from the GPME program and after providing to the department proof of such completion and graduation
How long can a temporary residency license be extended?
3 months
How many times can a temporary residency license extension be granted?
maximum of 2 times
What additional information can be required from an applicant for permanent licensure if the applicant has been out of practice for 2 years?
-additional education
-examinations
-training
How long is a doctor of Podiatric medicine license valid?
2 years
What qualifications must a sponsor for an applicant’s provisional license hold?
-5 years of good standing under the act
-ensure the applicant is working within the same office as the licensee under direct supervision
How long is a provisional license valid for?
-180 days
How many times can a provisional license be renewed?
-3 times
When can GPME requirements be waived for provisional license?
if the applicant has been practicing for at least 5 years in another state under license of that state with acceptable record from the state in which the applicant was licensed
When did Texas begin the National boards Part III/PM Lexis requirement for licensure come into effect?
1/29/1992
How many hours of CME are required every 24 months?
50 hours
How many of the 50 hours of CME is required to be ethics related?
2 hours
How many hours of CME are required to be completed regarding approved procedures of prescribing and monitoring controlled substances?
2 hours
How often does a licensed podiatrist who prescribed opioids have to attend a course covering best practices, alternative treatment options, and multi-modal approaches to pain management per CME period? How long does each session have to be?
2 times, once annually
1 hour course
What qualifies as appropriate CME crediting events?
-hospital Podiatric medical grand rounds
-APMA/APMA affiliated organizations
-TPMA
-state
-county or regional Podiatric medical association
-university sponsored pod medical meetings
-hospital Podiatric medical meetings
How many hours of home study and self-study programs will be accepted for CME credit hours?
up to 20 hrs
How many credits of CME is CPR training worth? How many CME hours is ACLS worth? Can you get credit for both?
1) 3 hours
2) 6 hours
3) no
How many CME credit hours can a practitioner receive for a published article?
1 hr
How many hours can carry over to the next CME period if there is an excess of 50 hours completed biannually?
10 credit hours
When do CME hours need to be sent to the department for review?
if audited
How does the audit process look like?
1) random selection of sample license holders
2) if selected, the license holder shall submit copies of certificates, transcripts, or other documentation satisfactory to the department, verifying the license holder’s attendance and participation and completion of the continuing education
3) failure to timely furnish this information w/in 30 days or providing false info can be grounds for disciplinary action
4) if selected for continued education during renewal period, license holder may submit renewal fees at that time for permanent licensure
Can CME required for disciplinary action be counted towards biannual CME requirements?
No
what was the Texas legislature that allowed authority to establish a 1 or 2 year license term for licensees?
Texas Legislature 85 in chapter 202
When can CME be exempted?
-hardships for the practitioner which the executive director can clear
How much time does a provider have to complete delinquent hours?
3 years
Which agency published the recommendations for HBOT care?
Undersea and Hyperbaric medical society (UHMS)
Where can HBOT be done?
In a hospital setting
What is the document that determines the scope of HBOT practice of a podiatrist?
Podiatric Medical Practice Act
How long is the HBOT certificate active and what is the cost for the certificate?
1) $25
2) 1 year
How long do certificate holders have to inform the department of any address change or change of hospital setting no later than _ days?
10 days
Define Conscious sedation?
the production, by pharmacological or non-pharmalogical methods, or a combination thereof, of an altered level of consciousness in a patient
What are the requirements of the didactic and clinical course which includes aspects of monitoring patients and the hands-on use of the gas machine?
1) directed by a licensed and certified MD, DO, DDS, or DPM in the state of Texas with advanced educational and clinical experience in NO/O2
2) minimum of 4 hours didactic work
3) minimum of 6 hours clinical works
What certifications are required to practice conscious sedation with NO/O2?
-basic CPR
-advanced CPR
Which members in the office must be trained in CPR if NO/O2 is being used?
-all of them
How much does the license for NO/O2 cost?
$25
What aspects of the patient’s medical state need to be documented prior to conscious sedation?
patient’s health and medical status to ensure that NO/O2 is medically appropriate
What equipment safety criteria must be met for gas machine?
1) 30% oxygen flow min
2) glass tubes present
3) room air flow if bag is empty
4) NO fail safe (will not flow without oxygen)
5) non-rebreathing check valve
6) O2 flush
7) auxiliary oxygen outlet with one demand valve resuscitation assembly per office
What requirements are needed for all practitioners using NO?
1) functioning vacuum
2) scavenger system
3) appropriate emergency drugs and equipment for resuscitations
4) manifold to provide for protection against over-pressure with AUDIBLE alarm system FASE (functioning vacuum, audible alarm system, scavenger system, emergency drugs)
How often does the NO/O2 machine need to be service checked up?
3 year basis
What is voluntary charity care
medical care provided for no compensation to indigent populations, medically underserved areas, disaster relief
How often does the voluntary charity care status need to be renewed?
every 2 years
How many CME hours need to be completed for the voluntary charity care status?
25 hours
What are the consequences of making superior claims with advertising?
lose license, grounds for denial
How long do all practitioners need to retain records of recordings, transcripts, or copies of all public communications?
24 months
Which requirements are needed for a certifying board that is not recognized by the council on Podiatric Medical Education of the American Podiatric Medical Association?
1) written and oral examinations must be passed within speciality of pod med
2) certifying board had written proof by IRA that the board is tax exempt
3) HAS AT LEAST 100 DULY LICENSED CERTIFICANTS FROM 1/3 of states
4) has certifying board with permanent headquarters and staff
5) all practitioners who are seeking certification have completed identifiable and substantial training
Can the terms “board eligible” or “board qualified” be used for advertising?
No
If there is a change of address, how long does the practitioner have to report the changes?
10 days
Whose responsibility is it to ensure that a Podiatric medical radiological technician is trained an registered with the department?
the provider
How old do you have to be a Podiatric medical radiological technician?
18 or older
How many hours of clinical and didactic training requirements are required for proof of completion for a Podiatric medical radiological technician?
20 hrs
How many successful productions of x-rays are required for out of classroom training?
60
Does a pod medical rad tech need to be registered?
YES
How long is a Podiatric medical radiological technician license valid? When are the licenses renewed?
1 year
Sept 1 2020
How long do radiological records of Podiatric care need to be retained?
5 years after treatement
How long does a practitioner have to send records of imaging once medical records are requested?
w/in 30 days
Can the practitioner hold onto requested information until payment is received?
Yes
In the event that the payment for imaging is not routed with request for records within _ days after receiving request, the practitioner will notify the requesting party in WRITING of the need for payment and may withhold information until payment is complete
10 days
Can a practitioner give notification given before to discontinue treatment to a patient to give the patient reasonable time to secure the services of another practitioner or all Podiatric medical services actually begun have been completed and there is no contract or agreement to provide further treatment?
Yes
What constitutes sexual impropriety?
behavior, gestures, or expressions that are seductive, sexually suggestive, or sexually demeaning to a patient/staff (ex examination of genitals without gloves)
What is sexual exploitation?
breakdown of professionalism in the physical/patient/staff relationship constituting sexual abuse (ex coercive power)
What are the responsibile steps need to be taken prior to prescribing controlled substances to patients?
1) review Texas Prescription Monitoring Program (PMP) database
2) pt’s identifiers match
3) initial H&P performed and documented
4) schedule II prescription copies must be placed in records and charts
5) alternative therapies are noted as discussed and prescribed
P I T H S-> TPMP, pt’s identifiers, alternative therapies, schedule II prescription, alternative therapy
When does PMP not need to be evaluated prior to prescribing meds?
hospice care, cancer pts
What is true about schedule 1 drugs in USA?
not prescribed because of concern for addiction
When can a podiatrist prescribe an opioid-antagonist?
a podiatrist may prescribe an opioid antagonist to a person at risk of experiencing an opioid-related drug overdose or to a family member, friend, or other person in a position to assist the person who is at risk of experiencing an opioid-related drug overdose
Define acute pain
normal, predicted, physiological response to stimulus such as trauma, disease, and operative procedures
What are conditions not considered acute pain?
-chronic pain
-cancer treatment
-hospice care
-palliative care
How many days worth of opioids can a podiatrist prescribe for acute pain?
10 days worth
Since what date have controlled substances been requested to be ordered electronically?
1//1/21
Under what circumstances can you prescribe controlled substances outside of electronic means?
1) emergency
2) if medication is filled out of state
3) if the prescriber and dispenser are in the SAME location under the SAME license
4) for a drug that the FDA requires more information that can be submitted online
5) for a non-patient-specific prescription pursuant of standing order, approved protocol for drug therapy, collaborative drug mngmt, comprehensive medication mngmt, or in response to public health emergency
6) drug for research protocol
7) practitioner with a waiver
8) if it is impractical for patient to obtain meds if prescribed electronically
If a practitioner has a waiver to prescribe meds outside of electronic means, how long does waiver last? When can renewal be started?
1 year
30 days or less from expiration of waiver
A practitioner’s waiver of electronic prescribing request form must contain sufficient evidence of one or more of the following that, in the judgment of the executive director, justify the issuance of a waiver:
1) economic hardship
2) technological limitations
3) ISSUANCE OF FIFTY OR LESS PRESCRIPTIONS FOR CONTROLLED SUBSTANCES IN THE YEAR IMMEDIATELY PRIOR TO REQUEST FOR WAIVER
4) exceptional circumstance that is shown by the practitioner
What is the cost to extend the temporary license?
$50
How much does doctor of Podiatric medicine initial license?
$750
How much does renewal of the Podiatric medicine license cost?
$700
How much does it cost to duplicate license/replacement license?
$25
How soon after a complaint or claim must information be provided and what information needs to be sent in addition?
within 30 days, copy of claim letter or petition
If a license suspension is probated, the commission or executive director may require the licensee to:
(1) report regularly to the department on matters that are the basis of the probation;
(2) limit practice to the areas prescribed by the commission or executive director; or
(3) continue or review continuing professional education until the licensee attains a degree of skill satisfactory to the department in those areas that are the basis of the probation.
What is anonymous complaints?
a complaint that lacks sufficient information to identify the source of the name of the person who filed the complaint
define insurance agent
person licensed under under chapter 4504
Define insurer
means an insurance company of other entity authorized to engage in the business of insurance
Define third-party administrator
a person required to have a certificate of authority under chapter 4151 insurance code
Can the department accept any anonymous complaints?
No
Define expert witness
a podiatrist or other qualified individual with whom the department contracts to assist the department with reviewing, investigating, or prosecuting complaints filed under the chapter
When are confidentiality wavers waved for the peer review committee?
during a peer review committee, a person reviewing the material is on a peer review committee, or if a civil action is filed as a result of participating in peer review
Except for an action involving fraud, conspiracy, or malice, a podiatric peer review committee is immune from liability and may not be subject to a suit for damages for any act arising from the performance of the committee’s duties in:
1) investigating a disagreement or complaints
2) holding a hearing to determine facts
3) making an evaluation, recommendation, decision, or award involving
- podiatrist who is a member of the Podiatric medical society or association
- another podiatrist, Podiatric patient, or third party who requests the services of the committee
When can claims be asked for defense costs?
counterclaim can be made in subsequent suit to recover defense costs, including court costs, attorney’s fees, and damages IF the original claim is determined to be frivolous or to have been brought in bad faith
Who has the power to revoke or suspend a license?
the commission or executive director
Where can an appeal be made by a person who has had their license revoked or suspended for a drug-related felony?
travis county district
When can a license be suspended for a drug-related felony?
after conviction of felony
How soon after a license has been revoked can a practitioner apply for reissuing?
1 year after initial revocation date
How much refund can the executive director order for a penalty?
the amount paid by the patient, cannot exceed that amount to damages
When can the department, under reasonable business hours, enter a business premises?
1) to investigate a complaint filed with the department
2) determine the compliance with an order of the commission or executive director issued
How much is the cost of a civil penalty for each day of violation?
Min $50 max $500
What is the punishment for general criminal penalty for practicing without a license?
1) min $50 and max $500
2) confinement in county jail for NOT less than 30 days and NOT MORE than 6 months
3) both fine and confinement
What is the criminal penalty for amputation of a foot?
1) a fine not less than $100 or more than $500
2) confinement for not less than 30 days and not more than 6 months
3) both fine and confinement
Define podiatry
the treatment of or offer to treat any disease, disorder, physical injury, deformity, or ailment of the human foot by any system or method
Claims that are not required to be reported under the 202 chapter include, but are not limited to, the following:
1) civil violations
2) product liability claims
3) antitrust alligations
4) allegations regarding improper peer review activities
5) business disputes
6) allegations of liability of injuries occurring on Podiatric physician’s property, but not involving breach of duty in the podiatric physician-patient relationship (CAP DAI)
Moral Turpitude
Simple misdemeanors with MORAL TURPITUDE (e.g. driving under the influence and have possession of illegal drugs) must be reported within 30 daysNOTE: Name or address changes must be reported within 30 days
Practicing medicine without a license
Third degree felony
Selling a child
third degree felony
Sexual abuse of nursing home or mental institution patient
second degree felony
failure to report elder abuse (outside or inside of a nursing home)
class a misdemeanor
failure to report child abuse
class b misdemeanor (oddly less severe than for old people)
violating the medical practice act (such as dangerous prescribing)
class A misdemeanor
what type of misdemeanor is soliciting patients
class A misdemeanor
receiving kickbacks for referrals
class A misdemeanor
promoting a suicide
state jail felony if the patient hurts /hills themselves. Its class C misdeameanor if they dont follow through
for the test, if someone sounds awful, you should guess __
third degree felony
if something seems sketchy but not a huge deal, you shoudl guess __
class A misdemeanor
sexual abuse of a nursing home or mental institution patient
one heinous exception gets upgraded to a 2nd degree felony
successful malpractice
duty existed (established physician patient relationship)
duty breached (i.e negligence)
duty existed (established physician patient relationsjip)
patient is harmed
Breach caused the harm
common ways to cause harm
failure to diagnose or. order appropriate tests when standard of care
failure to follow up on lab results
negligence during surgery
failure to disclose risks/benefits
failure to treat a condition properly
good samaritan law
you are also exempt from liability when providing when providing on scene emergency care unless:
you charge or are compensated
- you are grossly negligent (hard to do)
- You caused the emergency )oops)
- Within scope of practice at moment: random person keels over in hospital hallway ( not protected). Random person keels over at the mall (protected)
Abdandonment
Refers to unilaterally terminating the doctor patient relationwithout 30 days written notice
To legitametaly terminate a physician/patient relationship:
- Send written notification in mail (use “certifided mail) with receipt to have proof it was delivered)
- State reason
- Set termination date
- PRovide a 30 day grace period of continued treatment until a new doc is found
- Provide help finding a new doc
- Offer to transfer records
- There are of course situations in which you can’t terminate the physician patient relationshp, including things like during the period of typical post operative care/ follow up or if you’re so rural that there are no alternative physicians available
Statute of limitations
Adult: 2 yrs
Minors: 2 yrs after become 18
EMTALA
Anti dumping rule
ER must: screen emergency cases
Stabilize/treat acute conditions prior to discharge
Take care of women in active labor and deliver their babies
Transfer unstable patients only if the benefits outweight the risks and secondary to patient request
Benefit> Risk examples would include: unstable STEMI patient to a facility with a cath lab
Stroke patient to a stroke center
Emergency care is required regardless of ability to pay
Emergency care obviously does not mean definitive care. Hence the patient who present to the country ER for “follow up” of their splinted fractured extremity
emtala violations
up to 50 k fine per violation
can lose medicare/medicaid reimbursement
Only hospitals (not individual physicians) have civic liability (i.e. patients harmed by EMTALA failures can only sue the hospital, not the actual physician)
Texas divides many common procedures into two categories
List A: procedures that require specific risk/hazard disclosures by the person “doing” the treatment
List B: procedures that require no specific risk disclosures (local anesthesia)
Exceptions: emergency patient declines, risks disclosure would threaten well being (i.e. invoking therapeutic privelege), blood draws in the setting of a DUI arrest
Minors may consent in the following situations
- Active duty military
- 16 and emancipated (live separate from parents and managing their own affairs)
- For any STD or other reportable disease treatment
- For addiction treatment
- Abuse or suicide prevention
- For pregnancy treatment except abortion
For minors- surrogate consents
- Parent-> grandparents-> adult sibling-> aunt/uncle -> educational institutions with written authorization-> any adult with written authorixation-> court if there is an active suite affecting parent/child relationship-> peace officer who has taken custody
For adults- surrogate consents
Spouse-> adult child who is sole decision maker-> majority of adult children-> parent(s) -> adult sibling -> person clearly designated by the patient prior to incapacitation-> nearest relative-> clergy
Can a surrogate decision make cannot pick a new surrogate. If they are unwilling or unable to make decisions, _
it passes down the line
sexual misconduct
It is sexual misconduct to ever, ever have sexual contact with a patient (which includes the request/suggestion of it)
It DOES NOT matter if the patient consents or if the contact occurs outside of treatment. Even a sexual relationship with a former patient is unethical if the physician “uses or exploits trust, knoweldge, emotions, or influence derived from the professional relationshop
if a doctor has a blood borne pathogen
physicians can’t practice “exposure prone” procedures (like surgery) if they have HIV or hepatatis B or C, unless approved by an expert review panel and the patient consents. You can, however, do invasive procedures that are not deemed “exposure prone” without any restriction or obligation to inform your patients so long as you use universal precaution
Consent for HIV testing
required except when it’s necessary (needle stick; person is a suspected rapist; person is getting surgery or is a needle stick risk and they have high risk behavior/etcs)
ALl needle sticks require subsequent testing for
HIV, Hep B, Hep C
sexual assult of residents at a mental institution is a _
2nd degree felony
psychiatric inpatients cannot provide consent, any sexual relationship in this context is _
2nd degree felony
texas is not a tarasoff state
in cases where a physician becomes aware of potential harm to a third party, there is no duty to warn
In fact, it is a breach of confidentiality and thus against the law to inform a third party directly
You can, however, tell law enforcement; this is the perimissive element of the statue. This is somewhat analogous to the Texas rules regarding epilepsy, where a physician is also not obligated to report the patient’s inability to drive to the state authorities
abortion in texas
1st trimester abortions are fine
2nd trimester abortions can be limited depending on how many republicans there are in the state legislature
3rd trimester abortions are only perimissible to prevent the death or serious physical/mental impairment of the mother, for a nonviable fetus, or for a fetus with a severe abnormality
Unemancipated minors / abortion
they can get an abortion only if a parent (who is notified 48 hrs prior) consents
Two exceptions:
- Medical emergency to save mother’s life or prevent significant disability (with written justification both in the medical record and sent to the texas department of health)
Minor is granted a notification waiver by a judge via court petition
This applies when the patient convinces the judge that is not in the patient’s best interest for a parent to be informed
This is particularly applicable if there is concern that the notification will result in harm/abuse
Patient rights
Participate in Own Care
Make Informed Decisions
Request or refuse treatment
Make advance directives
Have privacy
Confidential records
HIPAA
To whom can you tell protected health information?
The patient and any doctors, nurses, or other healthcare providers directly involved in the patient’s care
Family members only with permission
Patients have the right to know to whom their PHI has been disclosed
Penalizations/fines for unauthorized disclosures
Exceptions to HIPAA
Exceptions to requiring patient permission for PHI disclosure include cases of abuse, neglect, domestic violence, for law enforcement purposes, medical exminers, and funeral directors and to avert serious harm to self/others
Patient privacy (physician-patient privelege) is waived in the case of criminal proceedings (with the exception of mental health records, which require a court ruling: mental health records are always special)
Billing records are not part of the medical record
If a patient sues you, they waive confidentiality (which is obvious if you think about it)
HIV positive results
you can share with the following:
-Spouse
- Partner notification program (which will contact partners identified by the patient without sharing identifying information)
- Potentially exposed personnel (health care, law enforcement, firefighters, EMTs, etc)
- Local and state health authorities
When a patient signs a release of medical records what does it have to include
the type of records, the reason and to whom the records should be available
You can charge patients to provide medical records, but you have to supply them within 15 days of a request
Therapeutic privelge: a physician can withhold medical records if s(he) believes that this information would be harmful to the patient; must document in the chart and notify patient; cannot include raw data like radiology films or lab tests. Can only deny for therapeutic privelege, not for nonpayment or other punitive reasons
Keeping charts
7 yrs for adults
7 yrs for minors or until age 21, whichever is longer
See an 8 yr old, keep until 71= 13 years
See a 17 year old, keep until 24
how long must hospitals hold adult inpatient charts
10 years
To amend a chart/record…
you cross out the mistake with a single line, date and initial it.
ANy additions must be clearly marked as an addendum (you can doctor your patients but not your charts)
Advance directives
(including DNR and MPOA) do not expire; they last until they are revoked or supplanted
Revoking is easy. All a patient has to do to revoke an AD is say never mind
Two witnesses are required to make an advance directive; one of which must have no vested interest (not a relative and not involved in the patient’s medical care)”. Advance directives can be given verbally to a physician as long as they fulfill the witness requirements are are subsequently documents. Notary services (for once) are not required
While you have the capacity for medical decision making to make an advance directive, you can always revoke one regardless of your mental status. Yes, a patient can undo their AD while delirious
“two doc consent”
Life sustaining treatment includes ventilation support, life sustaining medications, dialysis, artifical nutrition and hydration
Not complying with regulations for birth or death certificate
5 days birth, 10 days death
Must report death from communicable diseases
aIDS, anthrax, plague, rabies, TB, syphilis
organ donation- order of consent
written wishes of the patient followed by family (spouse-> adult child-> parent-> adult sibling)
The person who determines death cannot participate in organ procurement or transplantation (that would be an obvious conflict of interest)
Assisted suicide?
100% illegal in texas
duty to report
as has been alluded to thurs far, the take home message: if you suspect abuse or neglect of anyone or anything, you should always report it and are always protected from civil and criminal liability (i.e. people can’t sue you) for making a report in good faith that ends up being untrue (unless it isn’t in good faith and you are purposefully reporting out of malice/ lying)
child abuse or negligence
Must be reported within 48 hours and may not defer this responsibility on to others
Class B misdemeanor for failure to report (state jail felony for making a malicious report)
No parental consent is required to examine a child in the context of suspected abuse/neglect
elder abuse/ exploitation
CLASS A Misdemeanor for failure to report
Class B misdemeanor for spuriously malicious reports ( class A if the patient is in a nursing home)
Sexual abuse of a nursing home patient is a 2nd degree felony
Reporting spousal abuse is not mandatory (but you must document, provide care and offer resources/nearby shelters)
STDs and important/ communicable diseases
Emergencies (terrosit attacks with anthrax) must be reported immediately
TB pertussis 1 day
Otherwise 7 days (gonorrhea, syphilis)
Disease prevention trumps privacy (spouse needs to know about HIV right?)
Tarasoff ruling
Texas does not adhere to the Tarasoff ruling (discussed previously in the mental health chapter), which means that there is no duty to warn a person/potential victim if a patient makes threats to their wellbeing
Schedule I
no accepted medical use and high potential for abuse
Examples: heroin, LSD, ecstasy, marijuana
Yes, despite medical marijuana being a thing in multiple states and even recreational legalization sweeping the nation, marijuana is still a schedule I substance at the federal level
Schedule II
High abuse potential with potential severe psychological and or physical dependence
Examples: COCAINE, most opiated (including morphine, dilaudid, fentanyl, hydrocodone), most stimulants (including adderall, ritalin, amphetamines (including meth!)
Note: hydrocodone (vicodin, norco, etc) was moved to schedule II in 2015
Schedule II Rx cannot be refilled. Can not be prescribed electronically but patients historically had to physically come see you to get an Rx
Require official schedule II prescription forms (previously “triplicate”) can now be done online
Rx must be filled within 21 days or void
Up to 3 30 day rx can be written per patient visit (for a total 90 day supply), each rx with its own fill by date
schedule III
lower abuse potential than schedule II with moderate to low psychological and or physical dependence
examples: things with codeine (tylenol #3), ketamine, anabolic steroids, testosterone
Prior to 2015, hydrocodone was schedule III. Now that it’s schedule II, codeine painkillers are making a comeback
Scheduel IV
Low risk for abuse and dependence
Examples: muscle relaxers like soma, Z drug sleep meds like ambien, all benzodiazepines (xanax, ativan), tramadol, modafinil
Yes per the dea, forget xanax, patients should really be knocking down your door for testosterone
It really does seem odd that many of the most notorosiously abused and addictive drugs are actually this down on the list
Schedule V
Less than Schedule IV, mostly consist of low dose opiate mixtures used as antitussives and antidiarrheals
prescribing scheduled drugs
You need a federal DEA number to prescribe controlled substances legally in Texas
DEA numbers must be renewed every 3 years. Texas used to have their own parallel system requiring a “DPS” number, but thi swas elimingated on September 1 2016
No one can write for schedule I drugs, because schedule I drugs hav no accepted medical use (including marijuana (in Texas))
schedule II is classivcally by triplicate now mostly electronic. Only physicians can prescribe schedule II drugs for typicaly outpatients.
when can midlevels prescribe schedule II drugs
midlevels can prescribe schedule II drugs in limited circumstances (hospital, ER, hospice)
Schedules III-V can be prescribed by both physicians and midlevels
when can a physician phone in a schedule II rx
a physician can only phone in a schedule II Rx in an emergency in an amount suitable to last only for the duration of the emergency (and you must mail in the actual written Rx within 7 days
Again schedule II prescriptions must be filled within 21 dys and cannot have refills
Schedule III/IV can only be refilled up to 5 times and are void after 6 months
To prevent tampering, prescriptions for scheduled drugs must contain the number of pills to be dispensed first numerically followed by the number written as a word (like acheck)
if a pharmacist can’t find you to refill a patient’s schedule III/IV medication (e.g. their xanax) they can disepsne a _
3 days supply to avoid patient suffering
T/F any one can dispense methadone or prescribe/dispense buprenorphine (suboxone) for opiod dependency treatment
false, one needs a special permit to dispense methadone or prescribe/dispense buprenorphine (suboxone) for opiod dependency treatment
any designanted person can phone in prescriptions for non-controlled substances on behalf of a physician (this is a type of delegated medical act)
t
when can doctors function as a pharmacy
county with population less than 5,000 or municipaility/town with population less than 2500 without a pharmacy and within 15 miles of your office.
In this situation, a physician can buy, rebottle, and dispense medications at cost
LLC
Limited liability company
PPO
group of providers who agree to see a group of insured patients on fee-for-service basis
HMO
providers who see patients for an insured group on a prepaid basis
physicians cant have their priveleges restricted due to an HMO association
HMO can’t pay incentive fees to docs to make them spend less money/limit patient care
No kickbacks
anti kickback law
applies to all insurers, not just medicare and medicaid
you can’t pay people (or give them things) for referring patients to you
Otherwise, bob the surgeon would pay the family docs who refer him patients a finder’s fee
stark law
anti self referral law
Stark I applies to laboratories. Stark II applied to everything else, including ancillary services such as PT/OT
This is what prevents a radiologist from ordering a scan for a patient’s follow up; the radiologist benefits financially from the repeat scan (i.e. is referring thepatient to himself)
As a result, clinicians should be careful when ordering lab tests on patients when they also have a financial interest in their own laboratory or imaging services
barratry
contacting prospective patients to solicit them as customers. You can’t cold call patients in the phone book and see if they’re in need of a new internist
False advertising can cost you your license
-Misleads or deceives
-Misrepresents facts
-Misrepresents the cost. You cannot say a service is free or inexpensive just because the patient’s portion/copay is low (but the insurance is being billed)
-Cannot use the term “board eligible”
-Cnanot use the term “board certified” without saying board certified in what
Healing arts identification act
- You have to say what kind of doctor you are, because patients deserve to know if the person operating on their foot is an MD ortho or DPM pod, the person looking into their eyes is a DO ophthalmalogist or an OD optometrist
You can advertise cost (the actual cost, not just the portion a patient with insurance is likely to pay)
No copay/deductible waiving (you aren’t an autobody shop)
No testimonials
Claims must be verifibale
how many hours of self study CME
20 hrs per 2 years (must be CPME certified)
days to tell board you changed your practice phone number
10 days
can/cannot call yourself
-Properly Identify yourself:
Doctor of Podiatric Medicine
DPM
Podiatrist
Podiatric Physician
-Properly Identify your practice:
Foot Surgeon
Podiatric Surgeon
Foot Specialist
Doctor & Surgeon of the Foot
Injuries & Diseases of the Foot
misconduct
MISCONDUCT: Sexual misconduct is behavior that exploits the physician-
patient or physician-staff member relationship in a sexual way. This behavior is non-diagnostic and non-therapeutic, may be verbal or physical, and may include expressions of thoughts and feelings or gestures that are sexual or that reasonably may be construed by a person as sexual.
sexual violation
VIOLATION: Sexual violation may include physician-patient or physician-staff member sex, whether or not initiated by the patient/staff, and engaging in any conduct with a patient/staff that is sexual or may be reasonably interpreted as sexual, including but not limited to:
(1) sexual intercourse, genital-to-genital contact; (2) oral to genital contact;(3) oral to anal contact, genital to anal contact; (4) kissing in a romantic or sexual manner;
(5) touching breasts, genitals, or any sexualized body part for any purpose other than appropriate examination or treatment, or where the patient/staff has refused or has withdrawn consent;
(6) encouraging the patient/staff to masturbate in the presence of the physician or masturbation by the physician while the patient/staff is present; and
(7) offering to provide practice-related services, such as drugs, in exchange for sexual favors.
impropriety
IMPROPRIETY: Sexual impropriety may comprise behavior, gestures, or expressions that are seductive, sexually suggestive, or sexually demeaning to a patient/staff, including but not limited to:
(1) disrobing or draping practices that reflect a lack of respect for the patient’s/staff’s privacy, deliberately watching a patient/staff dress or undress, instead of providing privacy for disrobing;
(2) subjecting a patient/staff to an intimate examination in the presence of medical students or other parties without the explicit consent of the patient/staff or when consent has been withdrawn;
(3) examination or touching of genitals without the use of gloves;
(4) inappropriate comments about or to the patient/staff, including but not limited to making sexual comments about a person’s body or underclothing, making sexualized or sexually demeaning comments to a patient/staff, criticizing the patient’s/staff’s sexual orientation (transgender, homosexual, heterosexual, or bisexual), making comments about potential sexual performance during an examination or consultation except when the examination or consultation is pertinent to the issue of sexual function or dysfunction, requesting details of sexual history or sexual likes or dislikes when not clinically indicated for the type of consultation;
(5) engaging in treatment or examination of a patient/staff for other than bona fide health care purposes or in a manner substantially inconsistent with reasonable health care practices;
(6) using the physician-patient or physician-staff member relationship under the pretext of treatment to solicit a date;
(7) initiation by the physician of conversation regarding the sexual problems, preferences, or fantasies of the physician; and
(8) examining the patient/staff intimately without consent.
definition of practice
definition of practice
the treatment of or offer to treat any disease, disorder, physical injury, deformity or ailment of the human foot by any system or method. The term includes “podiatric medicine”
schedule I drugs- used in practice?
schedule I not used in practice, abuse potential
max penalty for amping foot
a fine of not less than $100 or more than $500;(2) confinement in the county jail for not less than 30 days or more than six months; or (3) both the fine and confinement.
requirements for license
Be 21
Have good moral character;
Completed at least 90 undergraduate semester hours;
Hours must be acceptable towards a bachelors degree at UTA
Foreign undergraduates must submit to International Admissions
Center at UTA for evaluation + $100 fee
Graduated from an approved Podiatry School;
a. 4 terms of about 8 months each
Completed at least 1 year of residency or other training required by the
Board;&
Passed all National Board Exams
a. Maybe an exception for Part 3& residency requirements, if it wasn’t required when person acquired license in another state & has been practicing for 5 continuous years
- Completed hands-on course in BLS or ACLS
ad requirements
ads cannot have stats, testimonials, waived payment
trade names
(e) A practitioner must provide the department with the practitioner’s practice name, corporate name, trade name or assumed name to identify an individual practice, or a group of podiatric physicians with which he/she is practicing and the address, and notify the department of any changes.
how many hours of CME
50 every 2 years
when do you submit CME
October 31st
how many hours of ethics CME per year
2 hours per 2 years
Ethics in the Delivery of Health Care Service; or
Rules & Regulations pertaining to Podiatric Medicine in Texas
what do you provide when someone wants to make a complaint to board
The licensee must display a department-approved sign or provide to all patients and
consumers a brochure that notifies consumers or recipients of services of the name, mailing address, website, and telephone number of the department and a statement informing consumers or recipients of services that complaints against a licensee can be directed to the department.
for what purpose can you sell patient info
may disclose an individual’s protected health information: to another covered entity, as that term is defined by Section 181.001, or to a covered entity, as that term
is defined by Section 602.001, Insurance Code, for the purpose of: (A) treatment;
(B) payment;(C) health care operations; or(D) performing an insurance or health maintenance organization
function described by Section 602.053, Insurance Code; or(2) as otherwise authorized or required by state or federal law.
(b) The direct or indirect remuneration a covered entity receives for making a disclosure of protected health information authorized by Subsection (a)(1)(D) may not exceed the covered entity’s reasonable costs of preparing or transmitting the protected health information.
how many days to give copies of records to patients
30 days. Can charge reasonable fee
max penalty fine
5,000 per day
pod rad tech
Only foot/ankle with pod on premises
how much training for HBO cert
(1) A practitioner practicing hyperbaric oxygen must do so in a hospital setting.
(2) The practitioner must, in addition, show evidence of attendance and successful completion of a hyperbaric medicine team training course that is recognized by the Undersea and Hyperbaric Medical Society. That person may only utilize hyperbaric oxygen in the treatment of the foot as recognized by the Podiatric Medical Practice Act.
(3) Prior to administering hyperbaric oxygen, a practitioner must have on file with the department documentation certifying compliance with the above requirements.
universal precautions
Blood
Semen and vaginal secretions
Cerebrospinal fluid (CSF)
Synovial fluid
Pleural fluid
Pericardial fluid
Amniotic fluid
how are blood borne pathogens spread
According to the American National Red Cross: “Bloodborne pathogens, such as bacteria and viruses, are present in blood and body fluids and can cause disease in humans. The bloodborne pathogens of primary concern are hepatitis B, hepatitis C and HIV. These and other bloodborne pathogens are spread primarily through:
Direct contact. Infected blood or body fluid from one person enters another person’s body at a correct entry site, such as infected blood splashing in the eye.
Indirect contact. A person’s skin touches an object that contains the blood or body fluid of an infected person, such as picking up soiled dressings contaminated with an infected person’s blood or body fluid.
Respiratory droplet transmission. A person inhales droplets from an infected person, such as through a cough or sneeze.
Vector-borne transmission. A person’s skin is penetrated by an infectious source, such as an insect bite.
Follow standard precautions to help prevent the spread of bloodborne pathogens and other diseases whenever there is a risk of exposure to blood or other body fluids. These precautions require that all blood and other body fluids be treated as if they are infectious. Standard precautions include maintaining personal hygiene and using personal protective equipment (PPE), engineering controls, work practice controls, and proper equipment cleaning and spill cleanup procedures.”
delegation
if something is screwed, comes back to the podiatrist
Can be properly & safely performed by the person to whom the medical act is delegated;
Is performed in its customary manner;
Is not in violation of any other statue;
The person whom the act is delegated to does NOT represent to the public that the person
is authorized to perform podiatric medicine
peer reviewed journal article counts as _. do does giving.a lecture at a conference
1 CME
how frequently license renewed
license is renewed every year with CME and fees and application
when changing inactive license back to active
(1) submit a completed application on a department-approved form;
(2) pay the required fee; and
(3) complete the CME that is required for the renewal of an active license during the preceding license period. CME hours used to satisfy the requirement for changing from an inactive license status to an active license status may not also be utilized for a future renewal of an active license.
who regulates the licenses
The Texas Department of Licensing and Regulation is the primary state agency responsible for the oversight of businesses, industries, general trades, and occupations that are regulated by the state and assigned to the department by the legislature.
something about what happens when someone declines their psych eval after a sexual misconduct/impropriety charge
Violation and impropriety can lead to revocation of license
what gives authority to board
texas occupations act
bunion consent needing _
“List-A” – description of all risk/benefit
what is written on a schedule II scripts?
choices were generic and brand name/patient address/pharmacy/and a couple others
(k)AAA prescription for a controlled substance must show: (1)AAthe quantity of the substance prescribed:
(A)AA numerically, if the prescription is
electronic; or
(B)AAif the prescription is communicated orally or telephonically, as transcribed by the receiving pharmacist;
(2)AAthe date of issue;(2-a)AAif the prescription is issued for a Schedule II controlled substance to be filled at a later date under Subsection (d-1), the earliest date on which a pharmacy may fill the prescription;
(3)AAthe name, address, and date of birth or age of the patient or, if the controlled substance is prescribed for an animal, the species of the animal and the name and address of its owner;
prescribed;
substance;
(4)AAthe name and strength of the controlled substance
(5)AAthe directions for use of the controlled
(6)AAthe intended use of the substance prescribed unless the practitioner determines the furnishing of this information is not in the best interest of the patient; and
(7)AAthe name, address, Federal Drug Enforcement Administration number, and telephone number of the practitioner at the practitioner’s usual place of business.