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A BILL TO BE ENTITLED
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AN ACT
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relating to the delegation of certain acts of prescriptive |
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authority by a physician. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 157.0511(b), Occupations Code, is |
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amended to read as follows: |
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(b) A physician may delegate the carrying out or signing of |
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a prescription drug order for a controlled substance only if: |
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(1) the prescription is for a controlled substance |
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listed in Schedules III, IV, or V as established by the commissioner |
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of public health under Chapter 481, Health and Safety Code; |
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(2) the prescription is for a period not to exceed 90 |
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[30] days; |
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(3) with regard to the refill of a prescription, the |
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refill is in accordance with the delegating physician's protocols |
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[authorized after consultation with the delegating physician] and |
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[the consultation] is noted in the patient's chart; and |
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(4) with regard to a prescription for a child less than |
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two years of age, the prescription is made after consultation with |
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the delegating physician and the consultation is noted in the |
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patient's chart. |
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SECTION 2. Section 157.053(e), Occupations Code, is amended |
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to read as follows: |
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(e) A physician's authority to delegate the carrying out or |
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signing of a prescription drug order is limited to: |
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(1) five [three] physician assistants or advanced |
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practice nurses or their full-time equivalents practicing at the |
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physician's primary practice site or at an alternate practice site |
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under Section 157.0541; and |
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(2) the patients with whom the physician has |
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established or will establish a physician-patient relationship. |
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SECTION 3. Sections 157.0541(a), (c), and (e), Occupations |
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Code, are amended to read as follows: |
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(a) In this section, "alternate site" means a practice site: |
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(1) where services similar to the services provided at |
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the delegating physician's primary practice site are provided; and |
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(2) located within 90 [60] miles of the delegating |
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physician's residence or primary practice site. |
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(c) Physician supervision is adequate for the purposes of |
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this section if the delegating physician: |
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(1) is on-site with the advanced practice nurse or |
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physician assistant at least once every 10 business days [20
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percent of the time]; |
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(2) reviews at least 10 percent of the medical charts, |
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which can be reviewed electronically from a remote location, of |
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each physician assistant or advanced practice nurse at the site; |
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and |
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(3) is available through direct telecommunication for |
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consultation, patient referral, or assistance with a medical |
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emergency. |
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(e) The combined number of advanced practice nurses and |
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physician assistants to whom a physician may delegate under this |
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section and at a primary practice site under Section 157.053 may not |
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exceed five [three] physician assistants or advanced practice |
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nurses or the full-time equivalent of three physician assistants or |
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advanced practice nurses. |
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SECTION 4. The Texas Medical Board shall adopt rules under |
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Subchapter B, Chapter 157, Occupations Code, as amended by this |
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Act, not later than January 31, 2010. |
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SECTION 5. This Act takes effect September 1, 2009. |