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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, and 157.0543, or under board rules. The |
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board may not waive the limitation on the number of primary or |
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alternate practice sites at which a physician may delegate the |
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carrying out or signing of prescription drug orders or the number of |
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advanced practice nurses or physician assistants to whom a |
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physician may delegate the carrying out or signing of prescription |
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drug orders, except as provided by Subsection (b-1)(1). |
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SECTION 2. Subchapter B, Chapter 157, Occupations Code, is |
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amended by adding Section 157.0543 to read as follows: |
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Sec. 157.0543. PRESCRIBING AT OTHER SITES. (a) This |
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section applies only to the delegation of prescriptive authority |
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at: |
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(1) 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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(2) a hospital, including any outpatient facility or |
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clinic of a hospital; |
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(3) a hospice established under 40 T.A.C. Section |
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97.403 or defined by 42 C.F.R. Section 418.3; |
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(4) a facility maintained or operated by this state; |
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(5) a clinic maintained or operated by the United |
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States; and |
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(6) a clinic owned or operated by a physician who |
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treats patients within the physician's area of specialty and who |
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uses other forms of treatment, including surgery, with the issuance |
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of a prescription for a majority of the patients. |
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(b) Notwithstanding Section 157.0511(b), at a location |
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described by Subsection (a), a physician may delegate to one or more |
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physician assistants acting under adequate physician supervision |
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the administering, providing, carrying out, or signing of a |
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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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(c) 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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(d) 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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(e) 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 a location described |
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by Subsection (a) in which the physician 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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SECTION 3. This Act takes effect September 1, 2011. |