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A BILL TO BE ENTITLED
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AN ACT
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relating to the prescribing of opioids for acute pain. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter C, Chapter 481, Health and Safety |
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Code, is amended by adding Section 481.07635 to read as follows: |
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Sec. 481.07635. PRESCRIPTIONS OF OPIOIDS FOR ACUTE PAIN. |
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(a) In this section, "acute pain" means pain with abrupt onset that |
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is caused by an injury or other process that is not ongoing. |
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(b) For the initial treatment of acute pain, a prescriber |
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may not issue a prescription for an opioid in an amount that exceeds |
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a seven-day supply. |
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(c) Before issuing an initial opioid prescription for acute |
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pain, a prescriber shall: |
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(1) take and document the results of a thorough |
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medical history, including: |
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(A) the patient's experience with medication |
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other than opioids and pain management approaches described by |
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Subsection (d); and |
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(B) any history of substance abuse; |
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(2) conduct and document the results of a physical |
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examination, as appropriate; |
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(3) develop a treatment plan focused on determining |
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the cause of the patient's pain; and |
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(4) comply with the requirements of Section 481.0764. |
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(d) A prescriber may refer or prescribe any of the following |
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pain management services to a patient, based on the prescriber's |
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clinical judgment and the availability of the treatment, when |
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issuing an opioid prescription for acute pain: |
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(1) physical therapies; |
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(2) occupational therapies; |
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(3) chiropractic treatment; |
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(4) physical medicine and rehabilitation; or |
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(5) osteopathic manipulation. |
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(e) This section does not apply to: |
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(1) patients with pain related to: |
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(A) progressive functional neurological deficit; |
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(B) fracture; |
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(C) tumor; |
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(D) infection; or |
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(E) immediate postsurgical recovery; |
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(2) patients with chronic pain that, based on the |
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prescriber's clinical judgment, is caused by a disease, illness, or |
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injury that would not improve under the therapies and treatments |
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described by Subsection (d); or |
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(3) patients receiving: |
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(A) treatment for cancer; |
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(B) emergency or trauma care; |
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(C) hospice care; |
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(D) palliative care; |
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(E) long-term care; or |
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(F) treatment for substance abuse or opioid |
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dependence. |
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(f) This section does not require that all of the treatments |
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under Subsection (d) be exhausted before the patient may receive a |
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prescription for an opioid. |
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SECTION 2. Section 481.003(a), Health and Safety Code, is |
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amended to read as follows: |
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(a) The director may adopt rules to administer and enforce |
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this chapter, other than Sections 481.073, 481.074, 481.075, |
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481.076, 481.0761, 481.0762, 481.0763, 481.07635, 481.0764, |
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481.0765, and 481.0766. The board may adopt rules to administer |
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Sections 481.073, 481.074, 481.075, 481.076, 481.0761, 481.0762, |
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481.0763, 481.07635, 481.0764, 481.0765, and 481.0766. |
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SECTION 3. Section 554.051(a-1), Occupations Code, is |
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amended to read as follows: |
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(a-1) The board may adopt rules to administer Sections |
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481.073, 481.074, 481.075, 481.076, 481.0761, 481.0762, 481.0763, |
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481.07635, 481.0764, 481.0765, and 481.0766, Health and Safety |
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Code. |
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SECTION 4. Section 565.003, Occupations Code, is amended to |
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read as follows: |
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Sec. 565.003. ADDITIONAL GROUNDS FOR DISCIPLINE REGARDING |
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APPLICANT FOR OR HOLDER OF NONRESIDENT PHARMACY LICENSE. Unless |
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compliance would violate the pharmacy or drug statutes or rules in |
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the state in which the pharmacy is located, the board may discipline |
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an applicant for or the holder of a nonresident pharmacy license if |
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the board finds that the applicant or license holder has failed to |
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comply with: |
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(1) Section 481.073, 481.074, [or] 481.075, 481.076, |
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481.0761, 481.0762, 481.0763, 481.07635, 481.0764, 481.0765, or |
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481.0766, Health and Safety Code; |
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(2) Texas substitution requirements regarding: |
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(A) the practitioner's directions concerning |
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generic substitution; |
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(B) the patient's right to refuse generic |
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substitution; or |
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(C) notification to the patient of the patient's |
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right to refuse substitution; |
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(3) any board rule relating to providing drug |
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information to the patient or the patient's agent in written form or |
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by telephone; or |
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(4) any board rule adopted under Section 554.051(a) |
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and determined by the board to be applicable under Section |
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554.051(b). |
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SECTION 5. Section 481.07635, Health and Safety Code, as |
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added by this Act, applies only to a prescription issued on or after |
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the effective date of this Act. A prescription issued before the |
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effective date of this Act is governed by the law in effect on the |
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date the prescription is issued, and the former law is continued in |
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effect for that purpose. |
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SECTION 6. This Act takes effect September 1, 2019. |