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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 as ordered by the physician |
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to the physician's patients. The administration, [or] provision, |
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or dispensing of the dangerous drugs must be performed in |
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compliance with laws relating to the practice of medicine and state |
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and federal laws relating to those 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. The heading to Section 158.003, Occupations |
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Code, is amended to read as follows: |
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Sec. 158.003. DISPENSING OF DANGEROUS DRUGS TO CERTAIN |
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PATIENTS IN CERTAIN RURAL AREAS. |
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SECTION 8. Section 158.003, Occupations Code, is amended by |
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adding Subsection (a-1) to read as follows: |
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(a-1) This section applies only to a physician providing |
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care under workers' compensation insurance coverage, as defined by |
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Section 401.011, Labor Code. |
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SECTION 9. Chapter 158, Occupations Code, is amended by |
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adding Section 158.004 to read as follows: |
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Sec. 158.004. PROVISION AND DISPENSING OF DANGEROUS DRUGS. |
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(a) In this section, "reimbursement for cost" means an additional |
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charge, separate from that imposed for the physician's professional |
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services, that includes the cost of a drug product and all other |
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actual costs to the physician incidental to providing dispensing |
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service. The term does not include a separate fee imposed for the |
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act of dispensing a drug itself. |
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(b) This section does not apply to a physician providing |
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care under workers' compensation insurance coverage, as defined by |
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Section 401.011, Labor Code. |
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(c) A physician may: |
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(1) provide or dispense dangerous drugs to the |
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physician's patients; and |
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(2) be reimbursed for the cost of providing or |
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dispensing those drugs without obtaining a license under Chapter |
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558. |
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(d) 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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(e) A physician who provides or dispenses dangerous drugs |
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under this section shall oversee compliance with the laws of this |
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state and federal law relating to those dangerous drugs. |
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(f) 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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With respect to dangerous drugs provided or dispensed in a |
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physician's office, the notification requirement of this |
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subsection may be satisfied by a written notice placed |
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conspicuously in the office. |
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(g) Not later than the 30th day after the date a physician |
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first provides or dispenses dangerous drugs under this section, the |
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physician shall notify the Texas State Board of Pharmacy and the |
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board that the physician is providing or dispensing dangerous drugs |
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under this section. The Texas State Board of Pharmacy and the board |
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shall jointly adopt a form by which a physician may provide |
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notification as required by this subsection. |
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(h) A physician who notifies the board under Subsection (g) |
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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 10. 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 location where: |
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(i) a physician provides or dispenses a |
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dangerous drug under Section 158.003 or 158.004; or |
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(ii) a person provides or dispenses a |
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dangerous drug under a physician's supervision in accordance with |
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Section 157.002(b). |
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SECTION 11. Section 551.004, Occupations Code, is amended |
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by 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) or |
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158.004(a). |
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(b) This subtitle does not prevent: |
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(1) a practitioner from: |
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(A) administering a drug to a patient of the |
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practitioner; or |
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(B) providing or dispensing dangerous drugs |
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under Section 158.003 or 158.004; or |
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(2) a person from providing or dispensing a dangerous |
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drug under a physician's supervision in accordance with Section |
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157.002(b). |
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SECTION 12. 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), 158.003, or 158.004. |
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SECTION 13. 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 14. 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 |
|
meet the immediate needs of the physician's patients or the act of |
|
providing or dispensing dangerous drugs, 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 |
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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 15. Section 563.052, Occupations Code, is amended |
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to read as follows: |
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Sec. 563.052. SUITABLE CONTAINER REQUIRED. A drug or |
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medicine provided or dispensed under this subchapter must be |
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provided or dispensed [supplied] in a suitable container labeled in |
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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 16. The heading to Section 563.053, Occupations |
|
Code, is amended to read as follows: |
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Sec. 563.053. DISPENSING OF DANGEROUS DRUGS TO CERTAIN |
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PATIENTS IN CERTAIN RURAL AREAS. |
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SECTION 17. Section 563.053, Occupations Code, is amended |
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by adding Subsection (a-1) to read as follows: |
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(a-1) This section applies only to a physician providing |
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care under workers' compensation insurance coverage, as defined by |
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Section 401.011, Labor Code. |
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SECTION 18. The heading to Subchapter B, Chapter 563, |
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Occupations Code, is repealed. |
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SECTION 19. This Act takes effect September 1, 2023. |