Legislative and Regulatory Agencies

The practice of nurse anesthetists is regulated and impacted by several statutes. The following list provides links to the controlling provisions includes pertinent agency updates related to APRN and CRNA practice matters. 

Board of Nursing

Texas Nursing Practice Act

Rule 221.16: Provision of Anesthesia Services by Nurse Anesthetists in Outpatient Settings

Position Statements of the Texas BON
-15.8: The Role of the Nurse in Moderate Sedation
-15.18: RNs Carrying Out Orders from APNs
-15.22: APNs Providing medical Aspects of Care for Themselves or Others With Whom There is a Close Personal Relationship

Changes to DEA Renewal Applications (BON, January 2017):

Starting January 1, 2017, DEA will only send out one renewal notification in accordance with Title 21, Code of Federal Regulations, Section 1301.13(e)(3). The renewal notification will be sent to the “mail to” address for each DEA registrant approximately 65 days prior to the expiration date. No other reminders to renew the DEA registration will be mailed.

This is to also advise you that the online capability to renew a DEA registration after the expiration date will no longer be available. You will have to complete an application for a new DEA registration if you do not renew by midnight Eastern Time of the expiration date. The original DEA registration will not be reinstated.

Paper renewal applications will not be accepted the day after the expiration date. If DEA has not received the paper renewal application by the day of the expiration date, mailed in renewal applications will be returned and the registrant will have to apply for a new DEA registration.

DEA Form 224a – Retail Pharmacy, Hospital/Clinic, Practitioner, Teaching Institution, or Mid-Level Practitioner
DEA Form 225a – Manufacturer, Distributor, Researcher, Analytical Laboratory, Importer, Exporter
DEA Form 363a – Narcotic Treatment Programs
DEA Form 510a – Domestic Chemical

Please remember, if the DEA registration expires, an APRN cannot prescribe controlled substances until a new DEA number is issued. Link to DEA’s website announcement can be found here.

Texas Medical Act

Texas Medical Practice Act
Texas Occupations Code (Chapter 157)

Texas Medical Board 

Texas Medical Board Rules and Regulations
Texas Administrative Code, Title 22 (Examining Boards), Part 9 (Texas Medical Board)
-Chapter 192.2: Provision of Anesthesia Services in Outpatient Setting
-Chapter 193.6: Delegation of Prescribing and Ordering Drugs and Devices

Texas State Board of Dental Examiners

Texas Dental Practice Act
Texas Occupations Code, Title 3 (Health Professions), Chapter 251-261 (Dental Practice Act)
-§251.003: Practice of Dentistry
-§258.001: Impermissible Delegations
-§258.151: Definition
-§258.152: Applicability
-§258.155: Annual Permit

Texas Board of Dental Examiners Rules & Regulations
Texas Administrative Code, Title 22 (Examining Boards), Part 5 (State Board of Dental Examiners), Chapter 10 (Sedation and Anesthesia)

Texas State Board of Podiatric Medical Examiners

CRNAs Practicing with Podiatrists
Podiatric Practice Act
Texas State Board of Podiatric Medical Examiners Texas Administrative Code, Title 22, Part 18, Chapters 371-390

Texas Board of Chiropractic Examiners

CRNAs Practicing with Chiropractors
Chiropractic Practice Act: Texas Occupations Code, Title 3, Chapter 201. -§201.002(c) -§201.154

Related Licensing Laws

Texas Hospital Licensing Law
Texas Hospital Licensing Rules: Texas Administrative Code, Title 25 (Health Services), Part 1 (DSHS), Chapter 133.Texas Ambulatory Surgical Center Licensing Act Texas Ambulatory Surgical Center Rules: Texas Administrative Code, Title 25, Part 1, Chapter 135