The Texas Medical Board (TMB) enforces stringent regulations on pain management clinics and medical professionals who work in pain clinics. Recently the TMB adopted new rules regarding pain management and utilization of opioid antagonists. These rules became effective as of July 8, 2018.
The Texas Administrative Code chapter on Pain Management is now split into two subchapters: Pain Management and Utilization of Opioid Antagonists.
Subchapter (A) on Pain Management describes the Texas legislature’s purpose and includes the minimum requirements for the treatment of chronic pain. 22 TAC §170.1-170.3. This subchapter is for the existing rules regarding pain management, and was created because of the creation of subchapter B.
Subchapter (B) describes the Texas legislature’s recognition of “the importance of preventing opioid-related overdose death through the ready availability of opioid antagonists.” 22 TAC §170.4. The subchapter establishes guidelines for the prescription of opioid antagonists, guidelines for use in identifying individuals at risk of opioid related drug overdose, and clarifies liability issues for physicians who prescribe opioid antagonists with good faith and reasonable care.

  • Opioid Antagonist Prescription Guidelines: sets out the guidelines describing the individuals to whom opioid antagonists may be prescribed, as well as additional guidelines identifying individuals at risk of an opioid overdose. 22 TAC § 170.6.
  • Liability for Act or Omission with Respect to Prescribing an Opioid Antagonist: makes clear prescribers acting in good faith and in accordance with the standard of care will not be subject to civil or criminal liability, or licensure disciplinary action for prescribing or failing to prescribe an opioid antagonist. 22 TAC § 170.7.
  • Documentation: spells out the requirement that prescribers of opioid antagonists must document the prescription in the medical record of the person at risk of an opioid overdose. 22 TAC § 170.8.

Unfortunately, the increased focus on regulating pain management and the heightened scrutiny of pain management doctors can have negative unintended consequences for both patients and the practice of medicine. Further, the increasingly politicized climate surrounding prescription drugs and pain management clinics may put the medical licenses of innocent doctors in jeopardy.
If You Are Targeted by the Texas Medical Board
If you are a physician or owner/operator of a pain management clinic who is being targeted by the Texas Medical Board for violations of Texas Medical Practices Act or other malfeasance regarding your medical license, contact the medical license defense attorneys of BERTOLINO LLP.
Do not let the increased scrutiny of doctors treating patients with chronic pain jeopardize your Texas medical license. The attorneys at BERTOLINO LLP know how to build a compelling case to protect your license. We know how to navigate the TMB enforcement process, gather evidence, question witnesses, show a proactive approach toward compliance, and prepare powerful defenses against allegations of misconduct.
BERTOLINO LLP represents licensed professionals across the entire State of Texas. If you are facing disciplinary action from a professional licensing board, contact us today or call (512) 476-5757 and schedule a case evaluation.

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