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A BILL TO BE ENTITLED
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AN ACT
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relating to a physician's authority to delegate prescribing acts to |
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physician assistants. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 157.0542(a), Occupations Code, is |
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amended to read as follows: |
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(a) On determining that the conditions of Subsection (b) |
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have been met, the board may waive or modify any of the site or |
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supervision requirements for a physician to delegate the carrying |
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out or signing of prescription drug orders to an advanced practice |
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nurse or physician assistant under Sections 157.052, 157.053, |
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157.054, [and] 157.0541, 157.0543, and 157.0544, or under board |
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rules. The board may not waive the limitation on the number of |
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primary or alternate practice sites at which a physician may |
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delegate the carrying out or signing of prescription drug orders or |
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the number of advanced practice nurses or physician assistants to |
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whom a physician may delegate the carrying out or signing of |
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prescription drug orders, except as provided by Subsection |
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(b-1)(1). |
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SECTION 2. (a) This section takes effect only if the Act of |
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the 82nd Legislature, Regular Session, 2011, relating to |
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nonsubstantive additions to and corrections in enacted codes |
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becomes law. |
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(b) Subchapter B, Chapter 157, Occupations Code, is amended |
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by adding Section 157.0543 to read as follows: |
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Sec. 157.0543. PRESCRIBING AT CERTAIN PRACTICE SITES. |
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(a) At certain practice sites a physician may delegate to |
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one or more physician assistants acting under adequate physician |
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supervision the administering, providing, carrying out, or signing |
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of a prescription drug order for a controlled substance listed in |
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Schedule II, as established by the commissioner of state health |
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services under Chapter 481, Health and Safety Code. |
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(b) Physician supervision of the carrying out and signing of |
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prescription drug orders must conform to what a reasonable, prudent |
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physician would find consistent with sound medical judgment but may |
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vary with the education and experience of the particular physician |
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assistant. A physician shall provide continuous supervision, but |
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the constant physical presence of the physician is not required. |
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(c) An alternate physician may provide appropriate |
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supervision on a temporary basis as defined and established by |
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board rule. |
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(d) A physician's authority to delegate under Subsection |
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(b) is limited as follows: |
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(1) the delegation must be made under a physician's |
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order, standing medical order, or standing delegation order, or |
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another order or protocol as defined by the board; |
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(2) the delegation must occur in the certain practice |
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sites, identified in Sec. 157.0544, in which the physician |
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practices; and |
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(3) the delegation may not permit the carrying out or |
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signing of prescription drug orders for the care or treatment of the |
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patients of any other physician without the prior consent of that |
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physician. |
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Sec. 157.0544. In the following certain practice sites, a |
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physician may delegate to one or more physician assistants acting |
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under adequate physician supervision the administering, providing, |
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carrying out, or signing of a prescription drug order for a |
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controlled substance listed in Schedule II. |
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(a) a medical school or dental school or an outpatient |
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clinic associated with a medical or dental school; |
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(b) a hospital, including any outpatient facility, or |
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clinic of a hospital; |
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(c) a hospice established under 40 T.A.C. Section 97.403 or |
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defined by 42 C.F.R. Section 418.3; |
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(d) a facility maintained or operated by this state; |
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(e) a clinic maintained or operated by the United States; |
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(f) a clinic owned or operated by a physician who treats |
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patients within the physician's area of specialty and who uses |
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other forms of treatment, including surgery, with the issuance of a |
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prescription for a majority of the patients. |
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SECTION 3. (a) This section takes effect only if the Act of |
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the 82nd Legislature, Regular Session, 2011, relating to |
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nonsubstantive additions to and corrections in enacted codes does |
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not become law. |
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SECTION 4. This Act takes effect September 1, 2011. |