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A BILL TO BE ENTITLED
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AN ACT
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relating to the authority of a physician to provide and dispense and |
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to delegate authority to provide and dispense certain drugs. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 151.002, Occupations Code, is amended by |
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adding Subdivisions (3-a) and (13-a) to read as follows: |
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(3-a) "Dispense" has the meaning assigned by Section |
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551.003. |
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(13-a) "Provision" means the supply of one or more |
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unit doses of a drug, medicine, or dangerous drug. |
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SECTION 2. The heading to Section 157.002, Occupations |
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Code, is amended to read as follows: |
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Sec. 157.002. GENERAL DELEGATION OF ADMINISTRATION, [AND] |
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PROVISION, AND DISPENSING OF DANGEROUS DRUGS. |
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SECTION 3. Sections 157.002(a), (b), (e), and (g), |
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Occupations Code, are amended to read as follows: |
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(a) In this section, "administering" [:
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[(1) "Administering"] means the direct application of |
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a drug to the body of a patient by injection, inhalation, ingestion, |
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or any other means. |
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[(2)
"Provision" means the supply of one or more unit
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doses of a drug, medicine, or dangerous drug.] |
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(b) A physician may delegate to any qualified and properly |
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trained person acting under the physician's supervision the act of |
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administering [or providing] dangerous drugs in the physician's |
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office, as ordered by the physician, that are used or required to |
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meet the immediate needs of the physician's patients or the act of |
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providing or dispensing dangerous drugs in the physician's office, |
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as ordered by the physician, to the physician's patients. The |
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administration, [or] provision, or dispensing of the dangerous |
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drugs must be performed in compliance with laws relating to the |
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practice of medicine and state and federal laws relating to those |
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dangerous drugs. |
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(e) The administration, [or] provision, or dispensing of |
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the drugs may be delegated through a physician's order, a standing |
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medical order, a standing delegation order, or another order |
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defined by the board. |
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(g) A drug or medicine provided or dispensed under |
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Subsection (b) or (c) must be supplied in a suitable container |
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labeled in compliance with applicable drug laws. A qualified and |
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trained person, acting under the supervision of a physician, may |
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specify at the time of the provision or dispensing of the drug the |
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inclusion on the container of the date of the provision or |
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dispensing and the patient's name and address. |
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SECTION 4. The heading to Chapter 158, Occupations Code, is |
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amended to read as follows: |
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CHAPTER 158. AUTHORITY OF PHYSICIAN TO PROVIDE OR DISPENSE CERTAIN |
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DRUGS AND SUPPLIES |
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SECTION 5. Sections 158.001(a) and (c), Occupations Code, |
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are amended to read as follows: |
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(a) A physician licensed under this subtitle may provide |
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[supply] a patient with any drug, remedy, or clinical supply |
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necessary to meet the patient's immediate needs. |
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(c) This chapter does not prohibit a physician from |
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providing [supplying] to a patient, free of charge, a drug provided |
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to the physician by a drug manufacturer for an indigent |
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pharmaceutical program if, in the physician's opinion, it is |
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advantageous to the patient, in adhering to a course of treatment |
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prescribed by the physician, to receive the drug. |
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SECTION 6. Section 158.002(a), Occupations Code, is amended |
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to read as follows: |
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(a) This chapter does not prohibit a physician from |
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providing [supplying] a pharmaceutical sample to a patient free of |
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charge if, in the physician's opinion, it is advantageous to the |
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patient, in adhering to a course of treatment prescribed by the |
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physician, to receive the sample. |
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SECTION 7. Section 158.003, Occupations Code, is amended to |
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read as follows: |
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Sec. 158.003. PROVISION AND DISPENSING OF DANGEROUS DRUGS |
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[IN CERTAIN RURAL AREAS]. (a) In this section, "reimbursement for |
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cost" means an additional charge, separate from that imposed for |
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the physician's professional services, that includes the cost of |
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the drug product and all other actual costs to the physician |
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incidental to providing the dispensing service. The term does not |
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include a separate fee imposed for the act of dispensing the drug |
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itself. |
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(b) [This section applies to an area located in a county
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with a population of 5,000 or less, or in a municipality or an
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unincorporated town with a population of less than 2,500, that is
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within a 15-mile radius of the physician's office and in which a
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pharmacy is not located. This section does not apply to a
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municipality or an unincorporated town that is adjacent to a
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municipality with a population of 2,500 or more.
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[(c)] A physician [who practices medicine in an area
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described by Subsection (b)] may: |
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(1) provide or dispense [maintain a supply of] |
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dangerous drugs in the physician's office to [be dispensed in the
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course of treating] the physician's patients; and |
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(2) be reimbursed for the cost of providing or |
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dispensing [supplying] those drugs without obtaining a license |
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under Chapter 558. |
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(c) A physician may not provide or dispense under this |
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section a controlled substance listed in Schedules II through V as |
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established under Subchapter B, Chapter 481, Health and Safety |
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Code. |
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(d) A physician who provides or dispenses dangerous drugs |
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under this section [Subsection (c)] shall [:
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[(1)
comply with each labeling provision under
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Subtitle J applicable to that class of drugs; and
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[(2)] oversee compliance with the laws of this state |
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and federal law relating to those dangerous [packaging and
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recordkeeping provisions applicable to that class of] drugs. |
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(e) Before providing or dispensing dangerous drugs under |
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this section, a physician must notify the patient that the |
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prescription for the dangerous drug may be filled at a pharmacy. |
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The notification requirement of this subsection may be satisfied by |
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a written notice placed conspicuously in the physician's office. |
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(f) Not later than the 30th day after the date a physician |
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first provides or dispenses [(e)
A physician who desires to
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dispense] dangerous drugs under this section, the physician shall |
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notify both the Texas State Board of Pharmacy and the board that the |
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physician is providing or dispensing dangerous drugs under this |
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section. The Texas State Board of Pharmacy and the board shall |
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jointly adopt a form by which a physician may provide notification |
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as required by this subsection [practices in an area described by
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Subsection (b). The physician may continue to dispense dangerous
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drugs in the area until the Texas State Board of Pharmacy
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determines, after notice and hearing, that the physician no longer
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practices in an area described by Subsection (b)]. |
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(g) A physician who notifies the board under Subsection (f) |
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that the physician is providing or dispensing dangerous drugs under |
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this section and who intends to continue to provide or dispense |
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dangerous drugs under this section shall include notice of that |
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intent in any subsequent registration permit renewal application |
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submitted to the board. The board by rule shall prescribe the form |
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of a registration permit renewal application in accordance with |
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this subsection. |
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SECTION 8. Section 551.003(31), Occupations Code, is |
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amended to read as follows: |
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(31) "Pharmacy" means a facility at which a |
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prescription drug or medication order is received, processed, or |
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dispensed under this subtitle, Chapter 481 or 483, Health and |
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Safety Code, or the Comprehensive Drug Abuse Prevention and Control |
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Act of 1970 (21 U.S.C. Section 801 et seq.). The term does not |
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include: |
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(A) a narcotic drug treatment program that is |
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regulated under Chapter 466, Health and Safety Code; or |
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(B) a physician's office in which a dangerous |
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drug is provided or dispensed under Section 158.003. |
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SECTION 9. Section 551.004, Occupations Code, is amended by |
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adding Subsection (a-1) and amending Subsection (b) to read as |
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follows: |
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(a-1) For purposes of Subsection (a)(1), "retailing of |
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prescription drugs" does not include the collection of a |
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reimbursement for cost as defined by Section 158.003(a). |
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(b) This subtitle does not prevent a practitioner from: |
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(1) administering a drug to a patient of the |
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practitioner; or |
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(2) providing or dispensing dangerous drugs under |
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Section 158.003. |
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SECTION 10. Section 558.001, Occupations Code, is amended |
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by amending Subsection (c) and adding Subsection (d) to read as |
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follows: |
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(c) Except as provided by Subsection (d), a [A] person may |
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not dispense or distribute prescription drugs unless the person: |
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(1) is a pharmacist; or |
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(2) is otherwise authorized by this subtitle to |
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dispense or distribute prescription drugs. |
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(d) A physician or person acting under the physician's |
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supervision may provide or dispense dangerous drugs in accordance |
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with Section 157.002(b) or 158.003. |
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SECTION 11. The heading to Chapter 563, Occupations Code, |
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|
is amended to read as follows: |
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CHAPTER 563. [PRESCRIPTION REQUIREMENTS;] DELEGATION OF |
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ADMINISTRATION, [AND] PROVISION, AND DISPENSING OF DANGEROUS DRUGS |
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SECTION 12. Sections 563.051(a) and (c), Occupations Code, |
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are amended to read as follows: |
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(a) A physician may delegate to any qualified and properly |
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trained person acting under the physician's supervision the act of |
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administering [or providing] dangerous drugs in the physician's |
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office, as ordered by the physician, that are used or required to |
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meet the immediate needs of the physician's patients or the act of |
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providing or dispensing dangerous drugs in the physician's office, |
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|
as ordered by the physician, to the physician's patients. The |
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|
administration, [or] provision, or dispensing of the dangerous |
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|
drugs must be performed in compliance with laws relating to the |
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|
practice of medicine and state and federal laws relating to those |
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|
dangerous drugs. |
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|
(c) The administration, [or] provision, or dispensing of |
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the drugs may be delegated through a physician's order, a standing |
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medical order, a standing delegation order, or another order |
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defined by the Texas Medical [State] Board [of Medical Examiners]. |
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SECTION 13. Section 563.052, Occupations Code, is amended |
|
|
to read as follows: |
|
|
Sec. 563.052. SUITABLE CONTAINER REQUIRED. A drug or |
|
|
medicine provided or dispensed under this subchapter must be |
|
|
provided or dispensed [supplied] in a suitable container labeled in |
|
|
compliance with applicable drug laws. A qualified and trained |
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|
person, acting under the supervision of a physician, may specify at |
|
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the time of the provision or dispensing of the drug the inclusion on |
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the container of the date of the provision or dispensing and the |
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patient's name and address. |
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SECTION 14. (a) The heading to Subchapter B, Chapter 563, |
|
|
Occupations Code, is repealed. |
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(b) Section 563.053, Occupations Code, is repealed. |
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SECTION 15. This Act takes effect September 1, 2019. |