Where did the Texas Medical Board rules go?

Martin Merritt, JD

I was speaking with a health lawyer this week about a case, and he lamented that the entire Texas Administrative Code had disappeared. I replied, “Oh, you have been looking for the Texas Medical Board Rules?”

The rules aren’t gone; they have moved. Effective January 9, 2025, the Texas Medical Board reorganized its rules, in keeping with a legislative mandate that the board update and clean up the rules. While this is probably a good thing, it confuses the heck out of anyone (like me) who had committed to memory that the rule physicians must follow when moving or leaving a practice is the “Medical Records” chapter at 22 TAC 165.5. (It is now moved to 22 TAC 163.4)

Worse, it takes a little while for search engines, such as Google, to realize the rules have moved. When you search for a rule by the old rule number or content (perhaps by using the old title or simply the general content you might need), you may be directed to a page that no longer exists, at least according to an official-looking page published by the Texas Secretary of State. (This is where you would get the idea that the rules have simply disappeared.)

What is actually happening, is the same thing that happens when you move your physical office address. It takes a while for search engines to figure out where you went and stop leading people to the wrong address.

Not to worry, the Texas Medical Board has found a new way to keep health lawyers employed, by publishing a handy Rule Conversion Table which contains everything you need to know about the rule changes, except any mention of any rule. (Go figure.)

Instead, the table discusses where the “Chapters” moved. Which is absolutely useless, unless you know what “sub” topics are located in a given “Chapter.”I will illustrate. The old TMB rule on what a physician must do when “retiring” or “moving” a practice, was in Chapter 165 at 22 TAC 165.5. This Rule 165.5 was a “subsection” of Chapter 165 regarding “Medical Records.” If you simply search, “leaving a practice,” you might have trouble finding the rule in the TMB Rule Conversion Table (because it is not there).

Under the new Conversion Table, Chapter 165 has moved to Chapter 163. In order to use the TMB chart, you would still need to have some understanding thatRule 165.5 “what to do when leaving or retiring” was under the “medical records” chapter. Which makes some sense but isn’t exactly “intuitive.”

Other rule changes are not so opaque. For example, the Chapters on “Physician Delegation and Supervision” have moved from Rules 193 and 197 can now be found under Chapter 169. This means, that all the rules for supervising mid-levels (which is very helpful in a MedSpa practice) now can be found at rules beginning with “22 TAC 169.01.” You simply must go to the first rule, 169.01 and keep searching until you find the rule you need.

Martin Merritt is a health lawyer and health care litigator at Martin Merritt PLLC, as well as past president of the Texas Health Lawyers Association and past chairman of the Dallas Bar Association Health Law Section. He can be reached at Martin@martinmerritt.com.