SRC-JEC S.B. 612 78(R)   BILL ANALYSIS


Senate Research Center   S.B. 612
78R4637 YDB-FBy: Nelson
Health & Human Services
4/5/2003
As Filed


DIGEST AND PURPOSE 

Currently, physicians may delegate the authority to write prescriptions
for "dangerous drugs" to advanced practice nurses and physician
assistants.  As proposed, S.B. 612 expands the law to allow physicians to
delegate the authority to write prescriptions for "controlled substances,"
a different category of prescription drug, to advanced practice nurses and
physician assistants.  It also requires insurers and hospitals to use the
same credentialing form for advanced practice nurses and physician
assistants as they currently use for physicians. 

RULEMAKING AUTHORITY

This bill does not expressly grant any additional rulemaking authority to
a state officer, institution, or agency. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Section 157.051, Occupations Code, by adding
Subdivisions (2-a) and (2b), to define "controlled substance" and
"dangerous drug." 

SECTION 2.  Amends Chapter 157B, Occupations Code, by adding Section
157.0511, as follows: 

Sec. 157.0511.  PRESCRIPTION DRUG ORDERS.  (a)  Limits a physician's
authority to delegate the carrying out or signing of a prescription drug
order under this chapter to dangerous drugs and controlled substances. 

(b)  Authorizes a physician to delegate the carrying out or signing of a
prescription drug order for a controlled substance only if the
prescription meets certain criteria. 

(c)  Provides that this subchapter does not modify the authority granted
by law for a licensed registered nurse or physician assistant to
administer or provide a medication, including a controlled substance
listed in Schedule II as established by the commissioner of public health
under Chapter 481, Health and Safety Code, that is authorized by a
physician under a physician's order, standing medical order, standing
delegation order, or protocol.   

SECTION 3.  Amends Section 157.052(c), Occupations Code, to delete
language referring to a physician's authority to delegate the carrying out
or signing of prescription drug orders being limited to dangerous drugs. 

SECTION  4.  Amends Section 157.053(b), Occupations Code, to make
conforming changes. 

SECTION  5.  Amends Section 157.054(b), Occupations Code, to make
conforming changes. 

SECTION  6.  Amends Section 157.0541(b), Occupations Code, to make
conforming changes. 

SECTION  7.  Amends Section 157.059, Occupations Code, by adding
Subsection (j) to provide that this section does not limit the authority
of a physician to delegate the carrying out or signing of a prescription
drug order involving a controlled substance under this chapter. 
 
SECTION  8.  Amends Section 551.003(34), Occupations Code, to make a
conforming change. 

SECTION  9.  Amends Section 481.002(39), Health and Safety Code, to
redefine "practitioner" to include an advanced practice nurse or physician
assistant to whom a physician has delegated the authority to carry out or
sign prescription drug orders under Section 157.0511, 157.052, 157.053,
157.054, 157.0541, or 157.0542, Occupations Code. 

SECTION  10.  Amends Section 483.001(12), Health and Safety Code, to make
a conforming change. 

SECTION  11.  Amends Article 21.58D, Insurance Code, as follows:

Art. 21.58D.  New heading:  STANDARDIZED FORM FOR VERIFICATION OF CERTAIN
CREDENTIALS 

Sec. 1. New heading:  DEFINITIONS.  Defines "advanced practice nurse" and
"physician assistant." 

Sec. 2.  (a)  Requires the commissioner of insurance by rule to adopt a
standardized form for the verification of the credentials of an advanced
practice nurse or physician assistant. 

(b)  Requires the commissioner of insurance, in adopting a form under
Subsection (a) of this section, to consider any credentialing application
form that is widely used in this state or a form currently used by the
Texas Department of Insurance. 

SECTION  12.  Effective date:  upon passage or September 1, 2003.