86R152 BEE-D
 
  By: Oliverson H.B. No. 278
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the frequency and location of certain meetings required
  by a prescriptive authority agreement.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Sections 157.0512(e) and (f), Occupations Code,
  are amended to read as follows:
         (e)  A prescriptive authority agreement must, at a minimum:
               (1)  be in writing and signed and dated by the parties
  to the agreement;
               (2)  state the name, address, and all professional
  license numbers of the parties to the agreement;
               (3)  state the nature of the practice, practice
  locations, or practice settings;
               (4)  identify the types or categories of drugs or
  devices that may be prescribed or the types or categories of drugs
  or devices that may not be prescribed;
               (5)  provide a general plan for addressing consultation
  and referral;
               (6)  provide a plan for addressing patient emergencies;
               (7)  state the general process for communication and
  the sharing of information between the physician and the advanced
  practice registered nurse or physician assistant to whom the
  physician has delegated prescriptive authority related to the care
  and treatment of patients;
               (8)  if alternate physician supervision is to be
  utilized, designate one or more alternate physicians who may:
                     (A)  provide appropriate supervision on a
  temporary basis in accordance with the requirements established by
  the prescriptive authority agreement and the requirements of this
  subchapter; and
                     (B)  participate in the prescriptive authority
  quality assurance and improvement plan meetings required under this
  section; and
               (9)  describe a prescriptive authority quality
  assurance and improvement plan and specify methods for documenting
  the implementation of the plan that include the following:
                     (A)  chart review, with the number of charts to be
  reviewed determined by the physician and advanced practice
  registered nurse or physician assistant; and
                     (B)  [if the agreement is between a physician and
  an advanced practice registered nurse,] periodic [face-to-face]
  meetings between the advanced practice registered nurse or
  physician assistant and the physician [at a location determined by
  the physician and the advanced practice registered nurse; and
                     [(C)     if the agreement is between a physician and
  a physician assistant, periodic meetings between the physician
  assistant and the physician].
         (f)  The periodic [face-to-face] meetings described by
  Subsection (e)(9)(B) must:
               (1)  include:
                     (A)  the sharing of information relating to
  patient treatment and care, needed changes in patient care plans,
  and issues relating to referrals; and
                     (B)  discussion of patient care improvement;
  [and]
               (2)  be documented; and
               (3)  take place at least once a month in a manner
  determined by the physician and the advanced practice registered
  nurse or physician assistant [occur:
                     [(A)  except as provided by Paragraph (B):
                           [(i)     at least monthly until the third
  anniversary of the date the agreement is executed; and
                           [(ii)     at least quarterly after the third
  anniversary of the date the agreement is executed, with monthly
  meetings held between the quarterly meetings by means of a remote
  electronic communications system, including videoconferencing
  technology or the Internet; or
                     [(B)     if during the seven years preceding the date
  the agreement is executed the advanced practice registered nurse
  for at least five years was in a practice that included the exercise
  of prescriptive authority with required physician supervision:
                           [(i)     at least monthly until the first
  anniversary of the date the agreement is executed; and
                           [(ii)     at least quarterly after the first
  anniversary of the date the agreement is executed, with monthly
  meetings held between the quarterly meetings by means of a remote
  electronic communications system, including videoconferencing
  technology or the Internet].
         SECTION 2.  Section 157.0512(f-1), Occupations Code, is
  repealed.
         SECTION 3.  Section 157.0512, Occupations Code, as amended
  by this Act, applies only to a prescriptive authority agreement
  entered into on or after the effective date of this Act. An
  agreement entered into before the effective date of this Act is
  governed by the law in effect on the date the agreement was entered
  into, and the former law is continued in effect for that purpose.
         SECTION 4.  This Act takes effect September 1, 2019.