TMB Rolls Out "Gold Designated" Plan for Pain Management Medical Practices to Improve Access to Care

A law change in November 2022 has eased the compliance for Texas medical clinics that prescribe opioids. The creation of the "Gold Designated" Practice lets Texas pain management clinics (PMCs) qualify for a five year period free from Texas Medical Board compliance check investigations or audits, unless there is a specific triggering event such as a complaint or change of ownership.

Starting in 2011, the Texas Medical Board assumed responsibility for certification of pain management clinics. This brought about a special regulatory oversight program that has been burdensome for medical clinics engaged in pain management. Authorities have had to strike a difficult balance between maintaining access to pain medications and preventing prescribing practices that resulted in drug abuse and patient deaths. Certain non-registered medical practices could be forced to be certified as pain management clinics, triggering strict oversight by the medical board. The practical effect of these laws, as reported in the media and seen in the community, was to discourage medical practices from treating chronic pain. An unintended consequence of the regulatory framework was that it became more difficult for patients to obtain treatment for chronic pain.

To qualify as a Gold Designated Practice, a Texas pain management clinic (PMC) must prepare and submit the Texas Medical Board approved Gold Designated Practice application form (released on April 18, 2023). The application packet must include a sample of the Medical Home Agreement utilized by the practice, or, a collaborative care agreement or memorandum of understanding. The collaborative agreement may be between a primary care physician and the PMC or between the prescribing physician and a pain specialist, depending on whether the practice is exempt from PMC registration or is currently certified as a PMC. The application also requires a copy of the most recent Board certification for each operating physician. The Gold Designated Practice qualifying audit is conducted as an off-site document review.

As of the writing of this article, TMB has not released a list of Gold Designated Practices on its website. A spreadsheet of current PMC certificate statuses is available online. The vast majority of PMC certificates that have been issued have expired or been cancelled by the clinics, leading to the needed regulatory change.

Ray & Weinstein, PC, administrative law attorneys, defend professional licensees and licensed businesses, provide advice for regulatory compliance, and can help with business transactions for state regulated business. Contact us for help with your practice's state compliance issues.