Enrolled Bill Summary

Senate Bill 406	Senate Author:  Nelson et al.
Effective:  11-1-13	House Sponsor:  Kolkhorst et al.

            Senate Bill 406 amends provisions of the Occupations Code, Government Code, Health and Safety Code, and Human Resources Code relating to the practice of advanced practice registered nurses and physician assistants and the delegation of prescriptive authority by physicians to and the supervision by physicians of certain advanced practice registered nurses and physician assistants.  The bill authorizes a physician to delegate to an advanced practice registered nurse or physician assistant the act of prescribing or ordering a drug or device through a prescriptive authority agreement, sets out eligibility requirements for a physician and an advanced practice registered nurse or physician assistant to enter into or be parties to the agreement and minimum requirements for the agreement, and provides for the regulation of agreements by the Texas Medical Board, the Texas Board of Nursing, and the Texas Physician Assistant Board.

            Senate Bill 406 revises the limitations on delegating authority and specifies the circumstances under which a physician may delegate the prescribing or ordering of a Schedule II controlled substance. The bill includes provisions relating to a physician's authority to delegate the administration or provision of a drug and the prescribing and ordering of a drug or device at certain facility-based practice sites, a physician's authority to delegate the administration or provision of controlled substances during intrapartum and immediate postpartum care, physician assistant scope of practice and supervision requirements, advanced practice registered nursing scope of practice and specialized training requirements, and physician delegation and supervision under the pilot program to make available nurse practitioners or physician assistants in certain state office complexes. The bill repeals statutory provisions relating to a physician's delegating authority at sites serving certain medically underserved populations, physician primary practice sites, and certain alternate sites.

            Senate Bill 406 modifies certain Medicaid managed care program contract requirements, establishes requirements regarding the availability of advanced practice registered nurses and physician assistants to recipients under the Medicaid and Medicaid managed care programs, and authorizes an advanced practice registered nurse or physician assistant to order and prescribe durable medical equipment and supplies under the Medicaid program under certain circumstances.