86R6080 BEE-F
 
  By: Oliverson H.B. No. 1622
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the authority of a physician to provide and dispense and
  to delegate authority to provide and dispense certain drugs.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 151.002, Occupations Code, is amended by
  adding Subdivisions (3-a) and (13-a) to read as follows:
               (3-a)  "Dispense" has the meaning assigned by Section
  551.003.
               (13-a)  "Provision" means the supply of one or more
  unit doses of a drug, medicine, or dangerous drug.
         SECTION 2.  The heading to Section 157.002, Occupations
  Code, is amended to read as follows:
         Sec. 157.002.  GENERAL DELEGATION OF ADMINISTRATION, [AND]
  PROVISION, AND DISPENSING OF DANGEROUS DRUGS.
         SECTION 3.  Sections 157.002(a), (b), (e), and (g),
  Occupations Code, are amended to read as follows:
         (a)  In this section, "administering" [:
               [(1)  "Administering"] means the direct application of
  a drug to the body of a patient by injection, inhalation, ingestion,
  or any other means.
               [(2)     "Provision" means the supply of one or more unit
  doses of a drug, medicine, or dangerous drug.]
         (b)  A physician may delegate to any qualified and properly
  trained person acting under the physician's supervision the act of
  administering [or providing] dangerous drugs in the physician's
  office, as ordered by the physician, that are used or required to
  meet the immediate needs of the physician's patients or the act of
  providing or dispensing dangerous drugs in the physician's office,
  as ordered by the physician, to the physician's patients. The
  administration, [or] provision, or dispensing of the dangerous
  drugs must be performed in compliance with laws relating to the
  practice of medicine and state and federal laws relating to those
  dangerous drugs.
         (e)  The administration, [or] provision, or dispensing of
  the drugs may be delegated through a physician's order, a standing
  medical order, a standing delegation order, or another order
  defined by the board.
         (g)  A drug or medicine provided or dispensed under
  Subsection (b) or (c) must be supplied in a suitable container
  labeled in compliance with applicable drug laws.  A qualified and
  trained person, acting under the supervision of a physician, may
  specify at the time of the provision or dispensing of the drug the
  inclusion on the container of the date of the provision or
  dispensing and the patient's name and address.
         SECTION 4.  The heading to Chapter 158, Occupations Code, is
  amended to read as follows:
  CHAPTER 158. AUTHORITY OF PHYSICIAN TO PROVIDE OR DISPENSE CERTAIN
  DRUGS AND SUPPLIES
         SECTION 5.  Sections 158.001(a) and (c), Occupations Code,
  are amended to read as follows:
         (a)  A physician licensed under this subtitle may provide
  [supply] a patient with any drug, remedy, or clinical supply
  necessary to meet the patient's immediate needs.
         (c)  This chapter does not prohibit a physician from
  providing [supplying] to a patient, free of charge, a drug provided
  to the physician by a drug manufacturer for an indigent
  pharmaceutical program if, in the physician's opinion, it is
  advantageous to the patient, in adhering to a course of treatment
  prescribed by the physician, to receive the drug.
         SECTION 6.  Section 158.002(a), Occupations Code, is amended
  to read as follows:
         (a)  This chapter does not prohibit a physician from
  providing [supplying] a pharmaceutical sample to a patient free of
  charge if, in the physician's opinion, it is advantageous to the
  patient, in adhering to a course of treatment prescribed by the
  physician, to receive the sample.
         SECTION 7.  Section 158.003, Occupations Code, is amended to
  read as follows:
         Sec. 158.003.  PROVISION AND DISPENSING OF DANGEROUS DRUGS
  [IN CERTAIN RURAL AREAS]. (a) In this section, "reimbursement for
  cost" means an additional charge, separate from that imposed for
  the physician's professional services, that includes the cost of
  the drug product and all other actual costs to the physician
  incidental to providing the dispensing service. The term does not
  include a separate fee imposed for the act of dispensing the drug
  itself.
         (b)  [This section applies to an area located in a county
  with a population of 5,000 or less, or in a municipality or an
  unincorporated town with a population of less than 2,500, that is
  within a 15-mile radius of the physician's office and in which a
  pharmacy is not located. This section does not apply to a
  municipality or an unincorporated town that is adjacent to a
  municipality with a population of 2,500 or more.
         [(c)]  A physician [who practices medicine in an area
  described by Subsection (b)] may:
               (1)  provide or dispense [maintain a supply of]
  dangerous drugs in the physician's office to [be dispensed in the
  course of treating] the physician's patients; and
               (2)  be reimbursed for the cost of providing or
  dispensing [supplying] those drugs without obtaining a license
  under Chapter 558.
         (c)  A physician may not provide or dispense under this
  section a controlled substance listed in Schedules II through V as
  established under Subchapter B, Chapter 481, Health and Safety
  Code.
         (d)  A physician who provides or dispenses dangerous drugs
  under this section [Subsection (c)] shall [:
               [(1)     comply with each labeling provision under
  Subtitle J applicable to that class of drugs; and
               [(2)]  oversee compliance with the laws of this state
  and federal law relating to those dangerous [packaging and
  recordkeeping provisions applicable to that class of] drugs.
         (e)  Before providing or dispensing dangerous drugs under
  this section, a physician must notify the patient that the
  prescription for the dangerous drug may be filled at a pharmacy.
  The notification requirement of this subsection may be satisfied by
  a written notice placed conspicuously in the physician's office.
         (f)  Not later than the 30th day after the date a physician
  first provides or dispenses [(e)     A physician who desires to
  dispense] dangerous drugs under this section, the physician shall
  notify both the Texas State Board of Pharmacy and the board that the
  physician is providing or dispensing dangerous drugs under this
  section. The Texas State Board of Pharmacy and the board shall
  jointly adopt a form by which a physician may provide notification
  as required by this subsection [practices in an area described by
  Subsection (b). The physician may continue to dispense dangerous
  drugs in the area until the Texas State Board of Pharmacy
  determines, after notice and hearing, that the physician no longer
  practices in an area described by Subsection (b)].
         (g)  A physician who notifies the board under Subsection (f)
  that the physician is providing or dispensing dangerous drugs under
  this section and who intends to continue to provide or dispense
  dangerous drugs under this section shall include notice of that
  intent in any subsequent registration permit renewal application
  submitted to the board. The board by rule shall prescribe the form
  of a registration permit renewal application in accordance with
  this subsection.
         SECTION 8.  Section 551.003(31), Occupations Code, is
  amended to read as follows:
               (31)  "Pharmacy" means a facility at which a
  prescription drug or medication order is received, processed, or
  dispensed under this subtitle, Chapter 481 or 483, Health and
  Safety Code, or the Comprehensive Drug Abuse Prevention and Control
  Act of 1970 (21 U.S.C. Section 801 et seq.). The term does not
  include:
                     (A)  a narcotic drug treatment program that is
  regulated under Chapter 466, Health and Safety Code; or
                     (B)  a physician's office in which a dangerous
  drug is provided or dispensed under Section 158.003.
         SECTION 9.  Section 551.004, Occupations Code, is amended by
  adding Subsection (a-1) and amending Subsection (b) to read as
  follows:
         (a-1)  For purposes of Subsection (a)(1), "retailing of
  prescription drugs" does not include the collection of a
  reimbursement for cost as defined by Section 158.003(a).
         (b)  This subtitle does not prevent a practitioner from:
               (1)  administering a drug to a patient of the
  practitioner; or
               (2)  providing or dispensing dangerous drugs under
  Section 158.003.
         SECTION 10.  Section 558.001, Occupations Code, is amended
  by amending Subsection (c) and adding Subsection (d) to read as
  follows:
         (c)  Except as provided by Subsection (d), a [A] person may
  not dispense or distribute prescription drugs unless the person:
               (1)  is a pharmacist; or
               (2)  is otherwise authorized by this subtitle to
  dispense or distribute prescription drugs.
         (d)  A physician or person acting under the physician's
  supervision may provide or dispense dangerous drugs in accordance
  with Section 157.002(b) or 158.003.
         SECTION 11.  The heading to Chapter 563, Occupations Code,
  is amended to read as follows:
  CHAPTER 563. [PRESCRIPTION REQUIREMENTS;] DELEGATION OF
  ADMINISTRATION, [AND] PROVISION, AND DISPENSING OF DANGEROUS DRUGS
         SECTION 12.  Sections 563.051(a) and (c), Occupations Code,
  are amended to read as follows:
         (a)  A physician may delegate to any qualified and properly
  trained person acting under the physician's supervision the act of
  administering [or providing] dangerous drugs in the physician's
  office, as ordered by the physician, that are used or required to
  meet the immediate needs of the physician's patients or the act of
  providing or dispensing dangerous drugs in the physician's office,
  as ordered by the physician, to the physician's patients. The
  administration, [or] provision, or dispensing of the dangerous
  drugs must be performed in compliance with laws relating to the
  practice of medicine and state and federal laws relating to those
  dangerous drugs.
         (c)  The administration, [or] provision, or dispensing of
  the drugs may be delegated through a physician's order, a standing
  medical order, a standing delegation order, or another order
  defined by the Texas Medical [State] Board [of Medical Examiners].
         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
  person, acting under the supervision of a physician, may specify at
  the time of the provision or dispensing of the drug the inclusion on
  the container of the date of the provision or dispensing and the
  patient's name and address.
         SECTION 14.  (a) The heading to Subchapter B, Chapter 563,
  Occupations Code, is repealed.
         (b)  Section 563.053, Occupations Code, is repealed.
         SECTION 15.  This Act takes effect September 1, 2019.