Physician Supervision Bill Bars Nurse Practitioners From Running Pain Clinics

The text as introduced · 454 words

By: Raymond
H.B. No. 5504

A BILL TO BE ENTITLED

AN ACT

relating to the supervision by allopathic or osteopathic physicians

of certain persons performing certain procedures.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. This Act may be cited as the Texas Interventional

Pain Management and Treatment Act.

SECTION 2. Section 172.1(2), Administrative Code, is

amended by adding Subsections (3) and (4) to read as follows:

(3) "Fluoroscope" is a radiologic instrument equipped with

a fluorescent screen on which opaque internal structures can be

viewed as moving shadow images formed by the differential

transmission of X-rays throughout the body; and

(4) "Interventional pain management" means the practice of

medicine devoted to the diagnosis and treatment of chronic pain,

through the use of techniques such as:

(A) Ablation of targeted nerves,

(B) Percutaneous precision needle placement within

the spinal column with placement of drugs such as local

anesthetics, steroids, analgesics in targeted areas of the spinal

column,

(C) Surgical techniques, such as laser or endoscopic

discectomy, intrathecal infusion pumps and spinal cord

stimulators, peripheral nerve stimulation; or

(D) Minimally invasive surgical spine interventions.

(3) (5) Post-surgical, post-procedure, persistent

non-chronic pain--pain that occurs due to trauma caused by the

surgery or procedure; or an underlying condition, disease, or

injury causing persistent non-chronic pain. These types of pain

last 90 days or less, but more than 30 days, from the date of initial

prescriptions for opioids during a period of treatment.

SECTION 3. Section 169.26(b), Administrative Code, is

amended by adding Subsections (1), (2) and (3) to read as follows:

(1) It shall be unlawful to practice or offer to practice

interventional pain management in the state of Texas unless such a

person is licensed to practice medicine by the Texas Medical Board.

(2) Nothing in this section shall be construed to forbid the

administration of non-fluoroscopically guided lumbar interlaminar

epidural injections, peripheral nerve blocks and peripheral joint

injections by a certified Advanced Practice Provider when requested

to do so by a physician and under the supervision of an allopathic

or osteopathic physician licensed in Texas and under conditions in

which timely on-site consultation by an allopathic or osteopathic

physician is available.

(3) A certified Advanced Practice Provider shall not

operate an interventional pain management clinic, specializing in

diagnosing and treating chronic pain-related disorders. Only a

qualified pain management physician, as recognized by the Texas

Medical Board, can operate an interventional pain management

clinic. A certified Advanced Practice Providers may only perform

procedures listed in item 2c under the direct supervision of a

licensed physician who is Board Certified or Board Eligible in Pain

Management as recognized by the Texas Medical Board.

SECTION 4. This Act takes effect September 1, 2025.