Texas Medical Board (TMB) Frequently Asked Questions (FAQs)

Regarding Notice and Compliance Requirements Concerning

COVID-19 Minimum Standards of Safe Practice

May 1, 2020

*Disclaimer – The COVID-19 Disaster is a fluid and rapidly

evolving situation. Please check these FAQs often as events may

warrant frequent updates.

Executive Order (EO) GA-19 discusses one aspect of the plan to re-open Texas put

forth by Governor Abbott. The implementation of re-opening Texas is now possible

due to prior actions that increased, and have maintained, hospital bed availability for

Texas patients. Texas has also enhanced the available supply of personal protective

equipment (PPE) and strengthened supply chains for vital medical resources to

address COVID-19.

The need to minimize potential exposure of patients and healthcare professionals to

COVID-19 continues to be paramount and critical as we move towards re-opening

by, and must comply with, any emergency rules promulgated by their

respective licensing agencies dictating minimum standards for safe

practice during the COVID-19 disaster.

• Every hospital licensed under Chapter 241 of the Texas Health and

Safety Code shall reserve at least (15%) percent of its hospital capacity

for treatment of COVID-19 patients, accounting for the range of clinical

severity of COVID-19 patients, as determined by the Texas Health and

Human Services Commission.

12:01 a.m. on May 1, 2020. The TMB emergency rule related to Executive Order

GA-15 will no longer be effective and will be withdrawn from the Texas Register.

3. Did the TMB pass any emergency rules pursuant to Executive Order GA-19?

The TMB Executive Committee, during an emergency meeting on April 30, 2020,

adopted an emergency rule amendment to 22 TAC §190.8(2)(U). This emergency

amendment describes the minimum standards for safe practice that physicians and

their delegates must follow at this time.

It also requires that providers post notice of these minimum standards in specific

4. What are the minimum standards for safe practice for physicians and their

delegates under the new emergency rule?

There are four requirements for physicians and their delegates:

1. A mask must be worn by both the patient and physician or the physician’s

delegate when in proximity of the patient (meaning less than a 6-foot

distance between the patient and the physician or the physician’s delegate);

2. Everyone must follow policies that the physician, medical and healthcare

practice, or facility has in place regarding COVID-19 screening and testing

and/or screening patients;

3. Before any patient encounter, patients must be screened for potential

symptoms of COVID-19 or verified they were previously screened within

5. Do the minimum safety standards apply to care provided by physicians in

hospitals?

Yes. The minimum safety standards apply to all physicians and their delegates,

regardless of the practice setting.

6. Does TMB have any role in the Executive Order GA-19 requirement for a

hospital to reserve 15 percent of its capacity for treatment of COVID-19

patients?

No. This requirement will be facilitated and implemented by HHSC and not TMB.

8. Can I schedule and perform office-based visits for my patients?

Yes, as long as you comply with minimum standards for safe practice requirements

set out in 22 TAC Section 190.8(2)(U) and post the required notice.

The key for all patient visits or encounters is that they be conducted in accordance

with the minimum safe practice requirements set forth in 22 TAC Section

190.8(2)(U). TMB encourages healthcare practitioners to consider taking all

of Texas to safely progress.

notice has been created for your convenience: COVID-19 Notice - Minimum

Standards of Safe Practice

10. Are doctor offices responsible for providing masks and gloves to patients

The rule does not require gloves. Offices may set their own policy on mask and glove

requirements. If a patient does not have a mask, the practice must provide a mask or

some type of face covering, especially to protect other patients. There are no

requirements specific to the type of mask patients must wear.

11. Are physicians allowed to refuse treatment to a patient who is not wearing

a mask?

Yes. The decision to treat/see any patient is at the discretion of the

physician/practice.

12. How would I treat and/or examine a patient if they are required to wear a

mask?

The patient does not have to be wearing a mask if it needs to be removed during the

course of examination and/or during treatment including a procedure or surgery.

However, a physician should be wearing a mask and appropriate PPE. If there is a

14. If a patient has screened negative for COVID-19, does the physician still

need to require them to wear a mask?

Yes. All requirements in the rule still apply even if a patient has previously been

screened.

15. If I report a violation, will it be confidential?

Yes. While the law does not allow for the TMB to accept anonymous

complaints, a complainant’s identity will remain confidential. This means that

the TMB will know the complainant’s identity, but no one else will.

Texas law prohibits retaliation against any complainant, regardless of the

complainant’s identity as a physician, patient, family member or concerned

citizen.

All complaints to TMB are confidential, and your identity will not be

Documentation is key. While there is no requirement to document your compliance,

you should consider documenting that you informed the patient of safe practice

copy of office protocols standings, orders, or policies regarding the minimum

standards for safe practice.

procedures and surgeries that involve the mucous membranes, including the

respiratory tract, with a high risk of aerosol transmission. These procedures and

surgeries require minimum safety equipment standards to be used by a physician or

physician’s delegate that include N95 masks, or an equivalent protection from

aerosolized particles, and face shields.

18. If a complaint is received, how will the TMB determine if a physician met

Further, TMB will determine whether or not the standard of care (SOC) was met