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  86R11824 JSC-F
 
  By: Zerwas H.B. No. 2174
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to controlled substance prescriptions under the Texas
  Controlled Substances Act; authorizing a fee.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 552.118, Government Code, is amended to
  read as follows:
         Sec. 552.118.  EXCEPTION: CONFIDENTIALITY OF OFFICIAL
  PRESCRIPTION PROGRAM INFORMATION. Information is excepted from the
  requirements of Section 552.021 if it is:
               (1)  information on or derived from an official
  prescription form filed with the Texas State Board of Pharmacy
  under Section 481.0755, Health and Safety Code, or an electronic
  prescription record filed with the Texas State Board of Pharmacy
  under Section 481.075, Health and Safety Code; or
               (2)  other information collected under Section 481.075
  or 481.0755 of that code.
         SECTION 2.  Sections 481.002(10) and (47), Health and Safety
  Code, are amended to read as follows:
               (10)  "Designated agent" means an individual
  designated under Section 481.074(b-2) [481.073] to communicate a
  practitioner's instructions to a pharmacist in an emergency.
               (47)  "Official prescription form" means a
  prescription form that is used for a Schedule II controlled
  substance under Section 481.0755 and contains the prescription
  information required by Section 481.0755(e) [481.075].
         SECTION 3.  Section 481.003(a), Health and Safety Code, is
  amended to read as follows:
         (a)  The director may adopt rules to administer and enforce
  this chapter, other than Sections [481.073,] 481.074, 481.075,
  481.0755, 481.0756, 481.076, 481.0761, 481.0762, 481.0763,
  481.07635, 481.07636, 481.0764, 481.0765, and 481.0766.  The board
  may adopt rules to administer Sections [481.073,] 481.074, 481.075,
  481.0755, 481.0756, 481.076, 481.0761, 481.0762, 481.0763,
  481.07635, 481.07636, 481.0764, 481.0765, and 481.0766.
         SECTION 4.  Section 481.074, Health and Safety Code, is
  amended by amending Subsections (b), (c), (e), (f), (g), (h), (k),
  and (q) and adding Subsections (b-1) and (b-2) to read as follows:
         (b)  Except in an emergency as defined by board rule under
  Subsection (b-1) [of the board] or as otherwise provided by
  [Subsection (o) or] Section 481.075(j) or (m) or 481.0755, a person
  may not dispense or administer a controlled substance [listed in
  Schedule II without a written prescription of a practitioner on an
  official prescription form or] without an electronic prescription
  that meets the requirements of and is completed by the practitioner
  in accordance with Section 481.075.
         (b-1)  In an emergency as defined by board rule, a person may
  dispense or administer a controlled substance [listed in Schedule
  II] on the oral or telephonically communicated prescription of a
  practitioner.  The person who administers or dispenses the
  substance shall:
               (1)  if the person is a prescribing practitioner or a
  pharmacist, promptly comply with Subsection (c); or
               (2)  if the person is not a prescribing practitioner or
  a pharmacist, promptly write the oral or telephonically
  communicated prescription and include in the written record of the
  prescription the name, address, and Federal Drug Enforcement
  Administration number issued for prescribing a controlled
  substance in this state of the prescribing practitioner, all
  information required to be provided by a practitioner under Section
  481.075(e)(1), and all information required to be provided by a
  dispensing pharmacist under Section 481.075(e)(2).
         (b-2)  In an emergency described by Subsection (b-1), an
  agent designated in writing by a practitioner defined by Section
  481.002(39)(A) may communicate a prescription by telephone. A
  practitioner who designates a different agent shall designate that
  agent in writing and maintain the designation in the same manner in
  which the practitioner initially designated an agent under this
  subsection. On the request of a pharmacist, a practitioner shall
  furnish a copy of the written designation. This subsection does not
  relieve a practitioner or the practitioner's designated agent from
  the requirement of Subchapter A, Chapter 562, Occupations Code. A
  practitioner is personally responsible for the actions of the
  designated agent in communicating a prescription to a pharmacist.
         (c)  Not later than the seventh day after the date a
  prescribing practitioner authorizes an emergency oral or
  telephonically communicated prescription, the prescribing
  practitioner shall cause an [a written or] electronic prescription,
  completed in the manner required by Section 481.075, to be
  delivered to the dispensing pharmacist at the pharmacy where the
  prescription was dispensed. [A written prescription may be
  delivered in person or by mail. The envelope of a prescription
  delivered by mail must be postmarked not later than the seventh day
  after the date the prescription was authorized. On receipt of a
  written prescription, the dispensing pharmacy shall file the
  transcription of the telephonically communicated prescription and
  the pharmacy copy and shall send information to the board as
  required by Section 481.075.] On receipt of the [an] electronic
  prescription, the pharmacist shall annotate the electronic
  prescription record with the original authorization and date of the
  emergency oral or telephonically communicated prescription.
         (e)  The partial filling of a prescription for a controlled
  substance listed in Schedule II is permissible in accordance with
  applicable federal law[, if the pharmacist is unable to supply the
  full quantity called for in a written or electronic prescription or
  emergency oral prescription and the pharmacist makes a notation of
  the quantity supplied on the face of the written prescription, on
  the written record of the emergency oral prescription, or in the
  electronic prescription record. The remaining portion of the
  prescription may be filled within 72 hours of the first partial
  filling; however, if the remaining portion is not or cannot be
  filled within the 72-hour period, the pharmacist shall so notify
  the prescribing individual practitioner. No further quantity may
  be supplied beyond 72 hours without a new prescription].
         (f)  A prescription for a Schedule II controlled substance
  for a patient in a long-term care facility (LTCF) or for a patient
  with a medical diagnosis documenting a terminal illness may be
  filled in partial quantities to include individual dosage units.
  If there is any question about whether a patient may be classified
  as having a terminal illness, the pharmacist must contact the
  practitioner before partially filling the prescription. Both the
  pharmacist and the practitioner have a corresponding
  responsibility to assure that the controlled substance is for a
  terminally ill patient. The pharmacist must record the
  prescription [on an official prescription form or] in the
  electronic prescription record and must indicate [on the official
  prescription form or] in the electronic prescription record whether
  the patient is "terminally ill" or an "LTCF patient." A
  prescription that is partially filled and does not contain the
  notation "terminally ill" or "LTCF patient" is considered to have
  been filled in violation of this chapter. For each partial filling,
  the dispensing pharmacist shall record [on the back of the official
  prescription form or] in the electronic prescription record the
  date of the partial filling, the quantity dispensed, the remaining
  quantity authorized to be dispensed, and the identification of the
  dispensing pharmacist. Before any subsequent partial filling, the
  pharmacist must determine that the additional partial filling is
  necessary. The total quantity of Schedule II controlled substances
  dispensed in all partial fillings may not exceed the total quantity
  prescribed. Schedule II prescriptions for patients in a long-term
  care facility or patients with a medical diagnosis documenting a
  terminal illness are valid for a period not to exceed 60 days
  following the issue date unless sooner terminated by discontinuance
  of the medication.
         (g)  A person may not dispense a controlled substance in
  Schedule III or IV that is a prescription drug under the Federal
  Food, Drug, and Cosmetic Act (21 U.S.C. Section 301 et seq.) without
  a [written, electronic, oral, or telephonically communicated]
  prescription of a practitioner defined by Section 481.002(39)(A) or
  (D), except that the practitioner may dispense the substance
  directly to an ultimate user. A prescription for a controlled
  substance listed in Schedule III or IV may not be filled or refilled
  later than six months after the date on which the prescription is
  issued and may not be refilled more than five times, unless the
  prescription is renewed by the practitioner. A prescription under
  this subsection must comply with other applicable state and federal
  laws.
         (h)  A pharmacist may dispense a controlled substance listed
  in Schedule III, IV, or V under a [written, electronic, oral, or
  telephonically communicated] prescription issued by a practitioner
  defined by Section 481.002(39)(C) [and] only if the pharmacist
  determines that the prescription was issued for a valid medical
  purpose and in the course of professional practice. A prescription
  described by [issued under] this subsection may not be filled or
  refilled later than six months after the date the prescription is
  issued and may not be refilled more than five times, unless the
  prescription is renewed by the practitioner.
         (k)  A prescription for a controlled substance must show:
               (1)  the quantity of the substance prescribed:
                     (A)  [numerically, followed by the number written
  as a word, if the prescription is written;
                     [(B)]  numerically, if the prescription is
  electronic; or
                     (B) [(C)]  if the prescription is communicated
  orally or telephonically, as transcribed by the receiving
  pharmacist;
               (2)  the date of issue;
               (2-a)  if the prescription is issued for a Schedule II
  controlled substance to be filled at a later date under Subsection
  (d-1), the earliest date on which a pharmacy may fill the
  prescription;
               (3)  the name, address, and date of birth or age of the
  patient or, if the controlled substance is prescribed for an
  animal, the species of the animal and the name and address of its
  owner;
               (4)  the name and strength of the controlled substance
  prescribed;
               (5)  the directions for use of the controlled
  substance;
               (6)  the intended use of the substance prescribed
  unless the practitioner determines the furnishing of this
  information is not in the best interest of the patient; and
               (7)  the name, address, Federal Drug Enforcement
  Administration number, and telephone number of the practitioner at
  the practitioner's usual place of business[, which must be legibly
  printed or stamped on a written prescription; and
               [(8)     if the prescription is handwritten, the signature
  of the prescribing practitioner].
         (q)  Each dispensing pharmacist shall send all required
  information[, including any information required to complete the
  Schedule III through V prescription forms,] to the board by
  electronic transfer or another form approved by the board not later
  than the next business day after the date the prescription is
  completely filled.
         SECTION 5.  The heading to Section 481.075, Health and
  Safety Code, is amended to read as follows:
         Sec. 481.075.  SCHEDULE II PRESCRIPTIONS [OFFICIAL
  PRESCRIPTION PROGRAM].
         SECTION 6.  Sections 481.075(a), (e), (g), (h), (i), and
  (j), Health and Safety Code, are amended to read as follows:
         (a)  A practitioner who prescribes a controlled substance
  listed in Schedule II shall, except as provided by Section
  481.074(b-1) or 481.0755 or a rule adopted under Section 481.0761,
  record the prescription [on an official prescription form or] in an
  electronic prescription that includes the information required by
  this section.
         (e)  Each [official prescription form or electronic]
  prescription used to prescribe a Schedule II controlled substance
  must contain:
               (1)  information provided by the prescribing
  practitioner, including:
                     (A)  the date the prescription is issued;
                     (B)  the controlled substance prescribed;
                     (C)  the quantity of controlled substance
  prescribed, shown[:
                           [(i)]  numerically[, followed by the number
  written as a word, if the prescription is written; or
                           [(ii)     numerically, if the prescription is
  electronic];
                     (D)  the intended use of the controlled substance,
  or the diagnosis for which the controlled substance [it] is
  prescribed, and the instructions for use of the substance;
                     (E)  the practitioner's name, address, and
  Federal Drug Enforcement Administration number issued for
  prescribing a controlled substance in this state;
                     (F)  the name, address, and date of birth or age of
  the person for whom the controlled substance is prescribed; and
                     (G)  if the prescription is issued to be filled at
  a later date under Section 481.074(d-1), the earliest date on which
  a pharmacy may fill the prescription;
               (2)  information provided by the dispensing
  pharmacist, including the date the prescription is filled; and
               (3)  [for a written prescription, the signatures of the
  prescribing practitioner and the dispensing pharmacist or for an
  electronic prescription,] the prescribing practitioner's
  electronic signature or other secure method of validation
  authorized by federal law.
         (g)  Except for an emergency oral or telephonically
  communicated prescription described by [prescribed under] Section
  481.074(b-1) [481.074(b)], the prescribing practitioner shall:
               (1)  record [legibly fill in,] or direct a designated
  agent to record [legibly fill in, on the official prescription form
  or] in the electronic prescription[,] each item of information
  required to be provided by the prescribing practitioner under
  Subsection (e)(1), unless the practitioner determines that:
                     (A)  under rule adopted by the board for this
  purpose, it is unnecessary for the practitioner or the
  practitioner's agent to provide the patient identification number;
  or
                     (B)  it is not in the best interest of the patient
  for the practitioner or practitioner's agent to provide information
  regarding the intended use of the controlled substance or the
  diagnosis for which it is prescribed; and
               (2)  [sign the official prescription form and give the
  form to the person authorized to receive the prescription or, in the
  case of an electronic prescription,] electronically sign or
  validate the electronic prescription as authorized by federal law
  and transmit the prescription to the dispensing pharmacy.
         (h)  In the case of an emergency oral or telephonically
  communicated prescription described by [prescribed under] Section
  481.074(b-1) [481.074(b)], the prescribing practitioner shall give
  the dispensing pharmacy the information needed to complete the
  [official prescription form or] electronic prescription record.
         (i)  Each dispensing pharmacist shall:
               (1)  [fill in on the official prescription form or]
  note in the electronic prescription record each item of information
  given orally to the dispensing pharmacy under Subsection (h) and
  the date the prescription is filled[,] and[:
                     [(A)     for a written prescription, fill in the
  dispensing pharmacist's signature; or
                     [(B)  for an electronic prescription,]
  appropriately record the identity of the dispensing pharmacist in
  the electronic prescription record;
               (2)  retain with the records of the pharmacy for at
  least two years:
                     (A)  [the official prescription form or] the
  electronic prescription record[, as applicable]; and
                     (B)  the name or other patient identification
  required by Section 481.074(m) or (n); and
               (3)  send all required information, including any
  information required to complete an [official prescription form or]
  electronic prescription record, to the board by electronic transfer
  or another form approved by the board not later than the next
  business day after the date the prescription is completely filled.
         (j)  A medication order written for a patient who is admitted
  to a hospital at the time the medication order is written and filled
  is not required to be recorded [on an official prescription form or]
  in an electronic prescription record that meets the requirements of
  this section.
         SECTION 7.  Subchapter C, Chapter 481, Health and Safety
  Code, is amended by adding Sections 481.0755 and 481.0756 to read as
  follows:
         Sec. 481.0755.  WRITTEN, ORAL, AND TELEPHONICALLY
  COMMUNICATED PRESCRIPTIONS. (a) Notwithstanding Sections 481.074
  and 481.075, a prescription for a controlled substance is not
  required to be issued electronically and may be issued in writing if
  the prescription is issued:
               (1)  by a veterinarian;
               (2)  in circumstances in which electronic prescribing
  is not available due to temporary technological or electronic
  failure, as prescribed by board rule;
               (3)  by a practitioner to be dispensed by a pharmacy
  located outside this state, as prescribed by board rule;
               (4)  when the prescriber and dispenser are in the same
  location or under the same license;
               (5)  in circumstances in which necessary elements are
  not supported by the most recently implemented national data
  standard that facilitates electronic prescribing;
               (6)  for a drug for which the United States Food and
  Drug Administration requires additional information in the
  prescription that is not possible with electronic prescribing;
               (7)  for a non-patient-specific prescription pursuant
  to a standing order, approved protocol for drug therapy,
  collaborative drug management, or comprehensive medication
  management, in response to a public health emergency or in other
  circumstances in which the practitioner may issue a
  non-patient-specific prescription;
               (8)  for a drug under a research protocol;
               (9)  by a practitioner who has received a waiver under
  Section 481.0756 from the requirement to use electronic
  prescribing;
               (10)  under circumstances in which the practitioner has
  the present ability to submit an electronic prescription but
  reasonably determines that it would be impractical for the patient
  to obtain the drugs prescribed under the electronic prescription in
  a timely manner and that a delay would adversely impact the
  patient's medical condition; or
               (11)  before January 1, 2021.
         (b)  A dispensing pharmacist who receives a controlled
  substance prescription in a manner other than electronically is not
  required to verify that the prescription is exempt from the
  requirement that it be submitted electronically.  The pharmacist
  may dispense a controlled substance pursuant to an otherwise valid
  written, oral, or telephonically communicated prescription
  consistent with the requirements of this subchapter.
         (c)  Except in an emergency, a practitioner must use a
  written prescription to submit a prescription described by
  Subsection (a). In an emergency, the practitioner may submit an
  oral or telephonically communicated prescription as authorized
  under Section 481.074(b-1).
         (d)  A written prescription for a controlled substance other
  than a Schedule II controlled substance must include the
  information required under Section 481.074(k) and the signature of
  the prescribing practitioner.
         (e)  A written prescription for a Schedule II controlled
  substance must be on an official prescription form and include the
  information required for an electronic prescription under Section
  481.075(e), the signature of the practitioner, and the signature of
  the dispensing pharmacist after the prescription is filled.
         (f)  The board by rule shall authorize a practitioner to
  determine whether it is necessary to obtain a particular patient
  identification number and to provide that number on the official
  prescription form.
         (g)  On request of a practitioner, the board shall issue
  official prescription forms to the practitioner for a fee covering
  the actual cost of printing, processing, and mailing the forms.
  Before mailing or otherwise delivering prescription forms to a
  practitioner, the board shall print on each form the number of the
  form and any other information the board determines is necessary.
         (h)  Each official prescription form must be sequentially
  numbered.
         (i)  A person may not obtain an official prescription form
  unless the person is a practitioner as defined by Section
  481.002(39)(A) or an institutional practitioner.
         (j)  Not more than one Schedule II prescription may be
  recorded on an official prescription form.
         (k)  Not later than the 30th day after the date a
  practitioner's Federal Drug Enforcement Administration number or
  license to practice has been denied, suspended, canceled,
  surrendered, or revoked, the practitioner shall return to the board
  all official prescription forms in the practitioner's possession
  that have not been used for prescriptions.
         (l)  Each prescribing practitioner:
               (1)  may use an official prescription form only to
  submit a prescription described by Subsection (a);
               (2)  shall date or sign an official prescription form
  only on the date the prescription is issued; and
               (3)  shall take reasonable precautionary measures to
  ensure that an official prescription form issued to the
  practitioner is not used by another person to violate this
  subchapter or a rule adopted under this subchapter.
         (m)  In the case of an emergency oral or telephonically
  communicated prescription described by Section 481.074(b-1), the
  prescribing practitioner shall give the dispensing pharmacy the
  information needed to complete the official prescription form if
  the pharmacy is not required to use the electronic prescription
  record.
         (n)  Each dispensing pharmacist receiving an oral or
  telephonically communicated prescription under Subsection (m)
  shall:
               (1)  fill in on the official prescription form each
  item of information given orally to the dispensing pharmacy under
  Subsection (m) and the date the prescription is filled and fill in
  the dispensing pharmacist's signature;
               (2)  retain with the records of the pharmacy for at
  least two years:
                     (A)  the official prescription form; and
                     (B)  the name or other patient identification
  required by Section 481.074(m) or (n); and
               (3)  send all required information, including any
  information required to complete an official prescription form, to
  the board by electronic transfer or another form approved by the
  board not later than the next business day after the date the
  prescription is completely filled.
         Sec. 481.0756.  WAIVERS FROM ELECTRONIC PRESCRIBING. (a)  
  The appropriate regulatory agency that issued the license,
  certification, or registration to a prescriber is authorized to
  grant a prescriber a waiver from the electronic prescribing
  requirement under the provisions of this section.
         (b)  The board shall convene an interagency workgroup that
  includes representatives of each regulatory agency that issues a
  license, certification, or registration to a prescriber.
         (c)  The work group described by Subsection (b) shall
  establish recommendations and standards for circumstances in which
  a waiver from the electronic prescribing requirement is appropriate
  and a process under which a prescriber may request and receive a
  waiver.
         (d)  The board shall adopt rules establishing the
  eligibility for a waiver, including:
               (1)  economic hardship;
               (2)  technological limitations not reasonably within
  the control of the prescriber; or
               (3)  other exceptional circumstances demonstrated by
  the prescriber.
         (e)  Each regulatory agency that issues a license,
  certification, or registration to a prescriber shall adopt rules
  for the granting of waivers consistent with the board rules adopted
  under Subsection (d).
         (f)  A waiver may be issued to a prescriber for a period of
  one year. On expiration of the waiver, the prescriber may reapply
  for a waiver if the circumstances that necessitated the waiver
  continue.
         SECTION 8.  Sections 481.0761(c) and (d), Health and Safety
  Code, are amended to read as follows:
         (c)  The board by rule may:
               (1)  [permit more than one prescription to be
  administered or dispensed and recorded on one prescription form for
  a Schedule III through V controlled substance;
               [(1-a)]  establish a procedure for the issuance of
  multiple prescriptions of a Schedule II controlled substance under
  Section 481.074(d-1);
               (2)  remove from or return to the official prescription
  program any aspect of a practitioner's or pharmacist's hospital
  practice, including administering or dispensing;
               (3)  waive or delay any requirement relating to the
  time or manner of reporting;
               (4)  establish compatibility protocols for electronic
  data transfer hardware, software, or format, including any
  necessary modifications for participation in a database described
  by Section 481.076(j);
               (5)  establish a procedure to control the release of
  information under Sections 481.074, 481.075, and 481.076; and
               (6)  establish a minimum level of prescription activity
  below which a reporting activity may be modified or deleted.
         (d)  The board by rule shall authorize a practitioner to
  determine whether it is necessary to obtain a particular patient
  identification number and to provide that number [on the official
  prescription form or] in the electronic prescription record.
         SECTION 9.  Subchapter C, Chapter 481, Health and Safety
  Code, is amended by adding Sections 481.07635 and 481.07636 to read
  as follows:
         Sec. 481.07635.  CONTINUING EDUCATION. (a)  A person
  authorized to receive information under Section 481.076(a)(5)
  shall, not later than the first anniversary after the person is
  issued a license, certification, or registration to prescribe or
  dispense controlled substances under this chapter, complete two
  hours of professional education related to approved procedures of
  prescribing and monitoring controlled substances.
         (b)  A person authorized to receive information may annually
  take the professional education course under this section to fulfil
  hours toward the ethics education requirement of the person's
  license, certification, or registration.
         (c)  The regulatory agency that issued the license,
  certification, or registration to a person authorized to receive
  information under Section 481.076(a)(5) shall approve professional
  education to satisfy the requirements of this section.
         Sec. 481.07636.  OPIOID PRESCRIPTION LIMITS. (a)  In this
  section, "acute pain" means pain with abrupt onset that is caused by
  an injury or other process that is not ongoing. The term does not
  include:
               (1)  chronic pain;
               (2)  pain being treated as part of cancer care;
               (3)  pain being treated as part of hospice or other
  end-of-life care; or
               (4)  pain being treated as part of palliative care.
         (b)  For the initial treatment of acute pain, a practitioner
  may not:
               (1)  issue a prescription for an opioid in an amount
  that exceeds a seven-day supply; or
               (2)  provide for a refill of an opioid.
         (c)  Subsection (b) does not apply to a prescription for an
  opioid approved by the United States Food and Drug Administration
  for the treatment of substance addiction that is issued by a
  practitioner for the treatment of substance addiction.
         (d)  A dispenser is not subject to criminal, civil, or
  administrative penalties for dispensing or refusing to dispense a
  controlled substance under a prescription that exceeds the limits
  provided by Subsection (b).
         SECTION 10.  Section 481.128(a), Health and Safety Code, is
  amended to read as follows:
         (a)  A registrant or dispenser commits an offense if the
  registrant or dispenser knowingly:
               (1)  distributes, delivers, administers, or dispenses
  a controlled substance in violation of Subchapter C [Sections
  481.070-481.075];
               (2)  manufactures a controlled substance not
  authorized by the person's Federal Drug Enforcement Administration
  registration or distributes or dispenses a controlled substance not
  authorized by the person's registration to another registrant or
  other person;
               (3)  refuses or fails to make, keep, or furnish a
  record, report, notification, order form, statement, invoice, or
  information required by this chapter;
               (4)  prints, manufactures, possesses, or produces an
  official prescription form without the approval of the board;
               (5)  delivers or possesses a counterfeit official
  prescription form;
               (6)  refuses an entry into a premise for an inspection
  authorized by this chapter;
               (7)  refuses or fails to return an official
  prescription form as required by Section 481.0755(k) [481.075(k)];
               (8)  refuses or fails to make, keep, or furnish a
  record, report, notification, order form, statement, invoice, or
  information required by a rule adopted by the director or the board;
  or
               (9)  refuses or fails to maintain security required by
  this chapter or a rule adopted under this chapter.
         SECTION 11.  Section 481.129(a), Health and Safety Code, is
  amended to read as follows:
         (a)  A person commits an offense if the person knowingly:
               (1)  distributes as a registrant or dispenser a
  controlled substance listed in Schedule I or II, unless the person
  distributes the controlled substance as authorized under the
  federal Controlled Substances Act (21 U.S.C. Section 801 et seq.);
               (2)  uses in the course of manufacturing, prescribing,
  or distributing a controlled substance a Federal Drug Enforcement
  Administration registration number that is fictitious, revoked,
  suspended, or issued to another person;
               (3)  issues a prescription bearing a forged or
  fictitious signature;
               (4)  uses a prescription issued to another person to
  prescribe a Schedule II controlled substance;
               (5)  possesses, obtains, or attempts to possess or
  obtain a controlled substance or an increased quantity of a
  controlled substance:
                     (A)  by misrepresentation, fraud, forgery,
  deception, or subterfuge;
                     (B)  through use of a fraudulent prescription
  form; [or]
                     (C)  through use of a fraudulent oral or
  telephonically communicated prescription; or
                     (D)  through the use of a fraudulent electronic
  prescription; or
               (6)  furnishes false or fraudulent material
  information in or omits material information from an application,
  report, record, or other document required to be kept or filed under
  this chapter.
         SECTION 12.  Section 32.024, Human Resources Code, is
  amended by adding Subsection (z-2) to read as follows:
         (z-2)  The limits on prescription drugs and medications
  under the medical assistance program provided by Subsections (z)
  and (z-1) do not apply to a prescription for an opioid for the
  initial treatment of acute pain under Section 481.07636, Health and
  Safety Code.
         SECTION 13.  Section 554.051(a-1), Occupations Code, is
  amended to read as follows:
         (a-1)  The board may adopt rules to administer Sections
  [481.073,] 481.074, 481.075, 481.0755, 481.0756, 481.076,
  481.0761, 481.0762, 481.0763, 481.07635, 481.07636, 481.0764,
  481.0765, and 481.0766, Health and Safety Code.
         SECTION 14.  Section 565.003, Occupations Code, is amended
  to read as follows:
         Sec. 565.003.  ADDITIONAL GROUNDS FOR DISCIPLINE REGARDING
  APPLICANT FOR OR HOLDER OF NONRESIDENT PHARMACY LICENSE. Unless
  compliance would violate the pharmacy or drug statutes or rules in
  the state in which the pharmacy is located, the board may discipline
  an applicant for or the holder of a nonresident pharmacy license if
  the board finds that the applicant or license holder has failed to
  comply with:
               (1)  Section 481.074, [or] 481.075, 481.0755,
  481.0756, 481.076, 481.0761, 481.0762, 481.0763, 481.07635,
  481.07636, 481.0764, 481.0765, or 481.0766, Health and Safety Code;
               (2)  Texas substitution requirements regarding:
                     (A)  the practitioner's directions concerning
  generic substitution;
                     (B)  the patient's right to refuse generic
  substitution; or
                     (C)  notification to the patient of the patient's
  right to refuse substitution;
               (3)  any board rule relating to providing drug
  information to the patient or the patient's agent in written form or
  by telephone; or
               (4)  any board rule adopted under Section 554.051(a)
  and determined by the board to be applicable under Section
  554.051(b).
         SECTION 15.  Sections 481.073, 481.074(o) and (p), and
  481.075(b), (c), (d), (f), (k), and (l), Health and Safety Code, are
  repealed.
         SECTION 16.  A person who holds a license, certification, or
  registration to prescribe or dispense a controlled substance issued
  before September 1, 2020, is required to take the continuing
  education course provided by Section 481.07635, Health and Safety
  Code, as added by this Act, not later than September 1, 2021.
         SECTION 17.  This Act takes effect September 1, 2019.