Texas Healthcare & Telehealth Compliance Guide
Texas has a strict Corporate Practice of Medicine (CPOM) doctrine, prohibiting non-physicians from owning medical practices or employing physicians. The Texas Medical Board actively enforces these rules. However, there are exceptions, such as for non-profit health organizations and hospitals, and physicians can enter into joint ventures with certain other professionals.
- Corporate Practice of Medicine (CPOM): Strict
- Telehealth prescribing permitted: Yes
- In-person exam required first: No
- Audio-only visits allowed: Yes
- Nurse practitioner authority: Restricted
- Collaborative practice agreement required: Yes
- Good Faith Exam required: Yes
Telehealth prescribing in Texas
Telehealth prescribing is permitted in Texas, but the standard of care must be equivalent to an in-person visit. A valid practitioner-patient relationship must be established. Prescriptions for non-controlled substances are generally allowed, while there are specific rules and limitations for controlled substances.
Controlled substances in Texas
Prescribing controlled substances via telehealth is allowed in Texas, subject to federal and state regulations. The DEA has extended the flexibility for prescribing controlled substances via telemedicine without a prior in-person exam. However, physicians must adhere to specific rules for chronic pain management and other conditions.
Medical director requirements in Texas
Texas requires a licensed physician to act as a medical director for facilities where medical services are provided by non-physicians. The medical director is responsible for the supervision of medical staff and ensuring quality of care. The physician must have clinical control over medical decisions.
Nurse practitioner scope and collaborative practice in Texas
Texas requires a collaborative practice agreement (CPA) between a nurse practitioner and a supervising physician. The CPA must outline the scope of the NP's practice and the process for consultation with the physician. NPs in Texas have restricted practice authority.
Key operating notes for Texas
Texas requires informed consent from patients before providing telehealth services. Providers must also comply with HIPAA and other state privacy laws. A Good Faith Exam is required before certain medical treatments, which can be performed via telehealth.
Recent regulatory changes in Texas
Texas continues to see legislative updates and rule changes related to telehealth, so providers should stay informed of the latest developments.
Frequently asked questions
How does Texas's strict CPOM doctrine affect my healthcare business?
Texas enforces strict Corporate Practice of Medicine laws, meaning non-physician entities cannot directly employ physicians or control clinical decisions. You'll need a properly structured PC-MSO arrangement to operate compliantly. TrueEval can guide you through the entity formation and management services agreements required.
Do I need a medical director for my medspa or IV therapy clinic in Texas?
Yes — Texas requires physician oversight for medical procedures performed in medspas, IV therapy clinics, and similar brick-and-mortar healthcare establishments. A medical director develops protocols, provides clinical oversight, and ensures regulatory compliance. TrueEval places board-certified medical directors licensed in Texas who understand both telehealth and in-person practice requirements.
Are Collaborative Practice Agreements required for NPs in Texas?
Yes, Texas requires Collaborative Practice Agreements (CPAs) between nurse practitioners and supervising physicians. NPs in Texas have restricted practice authority, meaning a CPA is necessary for prescriptive authority. TrueEval provides Texas-specific CPA templates and matches NPs with qualified collaborating physicians.
What are the Good Faith Exam requirements for prescribing in Texas?
Texas requires a Good Faith Exam before prescribing medications via telehealth. The GFE can be conducted via telehealth — no in-person visit is required first. Audio-only telehealth is permitted. TrueEval's physician network conducts compliant GFEs for Texas patients.
What compliance requirements apply to cash-pay healthcare businesses in Texas?
Cash-pay healthcare operations in Texas — including telehealth, medspas, IV therapy, and wellness clinics — must still comply with all state medical practice acts, CPOM laws, prescribing regulations, and scope of practice requirements. The main difference is you won't deal with insurance billing compliance, but you must still maintain proper corporate structure, physician oversight, and clinical documentation. TrueEval specializes in cash-pay compliance frameworks for Texas.