88R2152 BEE-F
 
  By: Perry S.B. No. 160
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the furnishing by pharmacists and dispensing by
  physicians of certain medications.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 483.001(11), Health and Safety Code, is
  amended to read as follows:
               (11)  "Practice of pharmacy" has the meaning assigned
  by Section 551.003, Occupations Code [means:
                     [(A)  provision of those acts or services
  necessary to provide pharmaceutical care;
                     [(B)  interpretation and evaluation of
  prescription drug orders or medication orders;
                     [(C)  participation in drug and device selection
  as authorized by law, drug administration, drug regimen review, or
  drug or drug-related research;
                     [(D)  provision of patient counseling;
                     [(E)  responsibility for:
                           [(i)  dispensing of prescription drug orders
  or distribution of medication orders in the patient's best
  interest;
                           [(ii)  compounding and labeling of drugs and
  devices, except labeling by a manufacturer, repackager, or
  distributor of nonprescription drugs and commercially packaged
  prescription drugs and devices;
                           [(iii)  proper and safe storage of drugs and
  devices; or
                           [(iv)  maintenance of proper records for
  drugs and devices. In this subdivision, "device" has the meaning
  assigned by Subtitle J, Title 3, Occupations Code; or
                     [(F)  performance of a specific act of drug
  therapy management for a patient delegated to a pharmacist by a
  written protocol from a physician licensed by the state under
  Subtitle B, Title 3, Occupations Code].
         SECTION 2.  Section 157.002(f), Occupations Code, is amended
  to read as follows:
         (f)  Subsections (b) and (c) do not authorize a physician or
  a person acting under the supervision of a physician to keep a
  pharmacy, advertised or otherwise, for the retail sale of dangerous
  drugs, other than as authorized under Section 158.003 or 158.004,
  without complying with the applicable laws relating to the
  dangerous drugs.
         SECTION 3.  Subchapter C, Chapter 157, Occupations Code, is
  amended by adding Section 157.102 to read as follows:
         Sec. 157.102.  DELEGATION TO PHARMACIST TO FURNISH CERTAIN
  DRUGS. (a) In this section:
               (1)  "Acute condition" means a condition or disease
  that begins abruptly, intensifies rapidly, and is generally not
  long-lasting.
               (2)  "Pharmacist" has the meaning assigned by Section
  551.003.
               (3)  "Waived clinical laboratory test" means a clinical
  laboratory test that is classified as waived under federal
  regulations issued under the Clinical Laboratory Improvement
  Amendments of 1988 (42 U.S.C. Section 263a).
               (4)  "Written protocol" means a physician's written
  order, standing medical order, standing delegation order, or other
  order or protocol as defined by rule of the board.
         (b)  Notwithstanding any other law, a pharmacist may furnish
  to a patient a prescription drug:
               (1)  as provided by a physician's written protocol, to
  treat an acute condition that is identified through performance of
  one of the following tests, if the test is a waived clinical
  laboratory test:
                     (A)  a rapid strep test or rapid antigen detection
  test used in the identification of group A streptococcus (GAS);
                     (B)  a rapid influenza diagnostic test used in the
  identification of influenza types A and B; or
                     (C)  a rapid molecular or antigen detection test
  used in the identification of the SARS-CoV-2 (COVID-19) virus; or
               (2)  the furnishing of which is authorized by an
  emergency rule adopted under an executive order or emergency
  authorization.
         (c)  The board shall adopt rules jointly with the Texas State
  Board of Pharmacy to establish the minimum content of the written
  protocol required under Subsection (b). The written protocol may
  permit a pharmacist to furnish a prescription drug to a patient
  without an established physician-patient relationship.
         (d)  A written protocol under this section must require
  notice to the patient's primary care physician, as identified by
  the patient if the patient has a primary care physician, and
  prescribe the period for providing the notice and the form of the
  notice, in accordance with prevailing practices for the provision
  of notice to a patient's primary care physician. The period for
  providing the notice may not be later than the 14th day after the
  date the drug is furnished by the pharmacist.
         (e)  The board and the Texas State Board of Pharmacy shall
  enter into a memorandum of understanding regarding the regulation
  of pharmacists who furnish prescription drugs to patients under
  this section. The memorandum of understanding must be adopted by
  rule and provide that:
               (1)  a pharmacist who furnishes prescription drugs to a
  patient under this section is subject only to the disciplinary
  authority of the Texas State Board of Pharmacy; and
               (2)  an inspection of the practice location of a
  pharmacist who furnishes prescription drugs to a patient under this
  section must be conducted by the Texas State Board of Pharmacy.
         SECTION 4.  Chapter 158, Occupations Code, is amended by
  adding Section 158.004 to read as follows:
         Sec. 158.004.  DISPENSING OF CERTAIN DRUGS. (a) In this
  section, "acute condition" and "waived clinical laboratory test"
  have the meanings assigned by Section 157.102.
         (b)  Notwithstanding any other law, a physician may dispense
  to the physician's patient a prescription drug:
               (1)  to treat an acute condition that is identified
  through performance of one of the following tests, if the test is a
  waived clinical laboratory test:
                     (A)  a rapid strep test or rapid antigen detection
  test used in the identification of group A streptococcus (GAS);
                     (B)  a rapid influenza diagnostic test used in the
  identification of influenza types A and B; or
                     (C)  a rapid molecular or antigen detection test
  used in the identification of the SARS-CoV-2 (COVID-19) virus;
               (2)  that is an antibiotic; or
               (3)  the dispensing of which is authorized by an
  emergency rule adopted under an executive order or emergency
  authorization.
         (c)  The board and the Texas State Board of Pharmacy shall
  enter into a memorandum of understanding regarding the regulation
  of physicians who dispense prescription drugs to the physicians'
  patients under this section. The memorandum of understanding must
  be adopted by rule and provide that:
               (1)  a physician who dispenses prescription drugs to
  the physician's patient under this section is subject only to the
  disciplinary authority of the board; and
               (2)  an inspection of the practice location of a
  physician who dispenses prescription drugs to the physician's
  patient under this section must be conducted by the board.
         SECTION 5.  Section 551.003(33), Occupations Code, is
  amended to read as follows:
               (33)  "Practice of pharmacy" means:
                     (A)  providing an act or service necessary to
  provide pharmaceutical care;
                     (B)  interpreting or evaluating a prescription
  drug order or medication order;
                     (C)  participating in drug or device selection as
  authorized by law, and participating in drug administration, drug
  regimen review, or drug or drug-related research;
                     (D)  providing patient counseling;
                     (E)  being responsible for:
                           (i)  dispensing a prescription drug order or
  distributing a medication order;
                           (ii)  compounding or labeling a drug or
  device, other than labeling by a manufacturer, repackager, or
  distributor of a nonprescription drug or commercially packaged
  prescription drug or device;
                           (iii)  properly and safely storing a drug or
  device; or
                           (iv)  maintaining proper records for a drug
  or device;
                     (F)  performing for a patient a specific act of
  drug therapy management delegated to a pharmacist by a written
  protocol from a physician licensed in this state in compliance with
  Subtitle B; [or]
                     (G)  administering an immunization or vaccination
  under a physician's written protocol; or
                     (H)  furnishing a prescription drug to a patient
  under a physician's written protocol under Section 157.102.
         SECTION 6.  Section 551.004(b), Occupations Code, is amended
  to read as follows:
         (b)  This subtitle does not prevent a practitioner from:
               (1)  administering a drug to a patient of the
  practitioner; or
               (2)  dispensing a prescription drug to a patient as
  provided by Section 158.004.
         SECTION 7.  Subchapter B, Chapter 562, Occupations Code, is
  amended by adding Section 562.058 to read as follows:
         Sec. 562.058.  TRAINING REQUIRED TO FURNISH CERTAIN DRUGS.
  (a) A pharmacist may not furnish a prescription drug under Section
  157.102 unless the pharmacist has completed a training program that
  is approved by the board and is relevant to the condition treated by
  the drug.
         (b)  The board shall adopt rules jointly with the Texas
  Medical Board to establish the minimum content of the training
  program required under Subsection (a).
         SECTION 8.  Section 563.051(d), Occupations Code, is amended
  to read as follows:
         (d)  This section does not authorize a physician or a person
  acting under the supervision of a physician to keep a pharmacy,
  advertised or otherwise, for the retail sale of dangerous drugs,
  other than as authorized under Section 158.003 or 158.004, without
  complying with the applicable laws relating to the dangerous drugs.
         SECTION 9.  Not later than January 1, 2024, the Texas State
  Board of Pharmacy and the Texas Medical Board shall adopt the rules
  required under Sections 157.102, 158.004, and 562.058, Occupations
  Code, as added by this Act.
         SECTION 10.  This Act takes effect September 1, 2023.