Relating to the supervision by allopathic or osteopathic physicians of certain persons performing certain procedures.
Summary
HB 5504 would create the “Texas Interventional Pain Management and Treatment Act” and add definitions for “fluoroscope,” “interventional pain management,” and a category of post-surgical or post-procedure persistent non-chronic pain. The bill focuses on procedures used to diagnose and treat chronic pain, including nerve ablation, spinal injections, implantable devices, and minimally invasive spine interventions.
The bill would make it unlawful to practice or offer interventional pain management in Texas unless the person is licensed to practice medicine by the Texas Medical Board. It also preserves a narrow role for certified advanced practice providers (APPs) to perform certain non-fluoroscopically guided lumbar epidural injections, peripheral nerve blocks, and peripheral joint injections when requested by a physician and supervised by a Texas-licensed allopathic or osteopathic physician with timely on-site consultation available. In addition, APPs would be barred from operating an interventional pain management clinic; only a qualified pain management physician recognized by the Texas Medical Board could do so, and APPs could perform only specified procedures under direct supervision by a board-certified or board-eligible pain management physician.
The bill would therefore tighten state regulation of interventional pain management by reserving most of these procedures and clinic operations to physicians, while allowing limited supervised practice by certain advanced practice providers. It would affect the Texas Medical Board’s regulatory framework, pain management clinics, physicians, and APPs involved in chronic pain treatment. The effective date is September 1, 2025.
Because the bill was referred to the House Public Health Committee and there are no recorded votes or committee transcripts provided, there is no documented floor or committee debate to gauge broader sentiment. Based on the bill’s structure, it appears to reflect a regulatory and patient-safety approach favoring physician oversight, but the available record does not show direct support or opposition from legislators or stakeholders.
The main point of contention is likely the scope of authority given to advanced practice providers versus physicians. The bill restricts APPs from independently operating pain management clinics and limits them to certain procedures under physician supervision, which could be viewed as protecting patients and standardizing care by supporters, but as limiting provider flexibility and access to pain treatment by opponents. Another likely issue is whether the bill’s physician-only requirement for interventional pain management is too broad given existing APP roles in some pain care settings.
Impact
HB 5504 would amend Texas Administrative Code provisions governing interventional pain management by defining key terms and restricting the practice to physicians licensed by the Texas Medical Board, with limited supervised exceptions for certified advanced practice providers. It would also prohibit APPs from operating interventional pain management clinics and require physician oversight by allopathic or osteopathic physicians, particularly those board certified or board eligible in pain management. The bill would affect pain management clinics, physicians, advanced practice providers, and the Texas Medical Board’s enforcement and licensing framework.
Sentiment
No committee transcript or vote record is available, so there is no direct evidence of legislative sentiment in the provided materials. The bill’s language suggests a generally cautious, physician-supervision-oriented approach to pain management regulation, but the record does not show whether that approach was broadly supported or opposed in committee.
Contention
The central controversy is the balance between physician control and advanced practice provider autonomy. Supporters would likely argue that interventional pain procedures are invasive and should be limited to licensed physicians with pain-management expertise to protect patient safety and ensure consistent standards. Opponents may argue that the bill unnecessarily narrows access to pain treatment, especially in underserved areas, by preventing APPs from independently operating clinics and by limiting the procedures they may perform even under supervision. The bill also raises questions about how strictly the Texas Medical Board would define “qualified pain management physician” and enforce supervision requirements.
Health care; authorizing Certified Registered Nurse Anesthetist to provide interventional pain management services and operate certain facilities under specified conditions. Effective date.
Health care; authorizing Certified Registered Nurse Anesthetist to provide interventional pain management services and operate certain facilities under specified conditions. Effective date.
Relating to authorizing the Board of Osteopathic Medicine to promulgate a legislative rule relating to licensing procedures for osteopathic physicians.
Mandates cosmetic medical procedures be performed by a physician, PA, APRN, or delegated to a qualified non-physician, non-PA or non-APRN under the supervision of a physician, physician assistant, or advanced practice registered nurse.
Mandates cosmetic medical procedures be performed by a physician, PA, APRN, or delegated to a qualified non-physician, non-PA or non-APRN under the supervision of a physician, physician assistant, or advanced practice registered nurse.