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