81R12418 JAM-F
By: Uresti S.B. No. 1719
A BILL TO BE ENTITLED
AN ACT
relating to the delegation of certain acts of prescriptive
authority by a physician.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 157.0511(b), Occupations Code, is
amended to read as follows:
(b) A physician may delegate the carrying out or signing of
a prescription drug order for a controlled substance only if:
(1) the prescription is for a controlled substance
listed in Schedules III, IV, or V as established by the commissioner
of public health under Chapter 481, Health and Safety Code;
(2) the prescription is for a period not to exceed 90
[30] days;
(3) with regard to the refill of a prescription, the
refill is in accordance with the delegating physician's protocols
[authorized after consultation with the delegating physician] and
[the consultation] is noted in the patient's chart; and
(4) with regard to a prescription for a child less than
two years of age, the prescription is made after consultation with
the delegating physician and the consultation is noted in the
patient's chart.
SECTION 2. Section 157.053(e), Occupations Code, is amended
to read as follows:
(e) A physician's authority to delegate the carrying out or
signing of a prescription drug order is limited to:
(1) five [three] physician assistants or advanced
practice nurses or their full-time equivalents practicing at the
physician's primary practice site or at an alternate practice site
under Section 157.0541; and
(2) the patients with whom the physician has
established or will establish a physician-patient relationship.
SECTION 3. Sections 157.0541(a), (c), and (e), Occupations
Code, are amended to read as follows:
(a) In this section, "alternate site" means a practice site:
(1) where services similar to the services provided at
the delegating physician's primary practice site are provided; and
(2) located within 90 [60] miles of the delegating
physician's residence or primary practice site.
(c) Physician supervision is adequate for the purposes of
this section if the delegating physician:
(1) is on-site with the advanced practice nurse or
physician assistant at least once every 10 business days [20
percent of the time];
(2) reviews at least 10 percent of the medical charts,
which can be reviewed electronically from a remote location, of
each physician assistant or advanced practice nurse at the site;
and
(3) is available through direct telecommunication for
consultation, patient referral, or assistance with a medical
emergency.
(e) The combined number of advanced practice nurses and
physician assistants to whom a physician may delegate under this
section and at a primary practice site under Section 157.053 may not
exceed five [three] physician assistants or advanced practice
nurses or the full-time equivalent of three physician assistants or
advanced practice nurses.
SECTION 4. The Texas Medical Board shall adopt rules under
Subchapter B, Chapter 157, Occupations Code, as amended by this
Act, not later than January 31, 2010.
SECTION 5. This Act takes effect September 1, 2009.