By: Williams, Nelson S.B. No. 1643
A BILL TO BE ENTITLED
AN ACT
relating to the monitoring of prescriptions for certain controlled
substances; providing penalties.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 481.002, Health and Safety Code, is
amended by amending Subdivisions (20) and (32) and adding
Subdivision (54) to read as follows:
(20) "Hospital" means:
(A) a general or special hospital as defined by
Section 241.003 [(Texas Hospital Licensing Law)]; [or]
(B) an ambulatory surgical center licensed under
Chapter 243 [by the Texas Department of Health] and approved by the
federal government to perform surgery paid by Medicaid on patients
admitted for a period of not more than 24 hours; or
(C) a freestanding emergency medical care
facility licensed under Chapter 254.
(32) "Patient" means a human for whom or an animal for
which a drug:
(A) is administered, dispensed, delivered, or
prescribed by a practitioner; or
(B) is intended to be administered, dispensed,
delivered, or prescribed by a practitioner.
(54) "Health information exchange" means an
organization that:
(A) assists in the transmission or receipt of
health-related information among organizations transmitting or
receiving the information according to nationally recognized
standards and under an express written agreement;
(B) as a primary business function, compiles or
organizes health-related information that is designed to be
securely transmitted by the organization among physicians, health
care providers, or entities within a region, state, community, or
hospital system; or
(C) assists in the transmission or receipt of
electronic health-related information among physicians, health
care providers, or entities within:
(i) a hospital system;
(ii) a physician organization;
(iii) a health care collaborative, as
defined by Section 848.001, Insurance Code;
(iv) an accountable care organization
participating in the Pioneer Model under the initiative by the
Innovation Center of the Centers for Medicare and Medicaid
Services; or
(v) an accountable care organization
participating in the Medicare shared savings program under 42
U.S.C. Section 1395jjj.
SECTION 2. Subsections (e) and (i), Section 491.075, Health
and Safety Code, are amended to read as follows:
(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 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 the
method of payment used to pay for the prescription; 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.
(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 the method of payment used
to pay for the prescription, 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 information required by the director,
including any information required to complete an official
prescription form or electronic prescription record, to the
director by electronic transfer or another form approved by the
director not later than the seventh day after the date the
prescription is completely filled.
SECTION 3. Section 481.076, Health and Safety Code, is
amended by amending Subsections (a) and (e) and adding Subsection
(a-1) to read as follows:
(a) The director may not permit any person to have access to
information submitted to the director under Section 481.074(q) or
481.075 except:
(1) an investigator for the Texas Medical Board, the
Texas State Board of Podiatric Medical Examiners, the State Board
of Dental Examiners, the State Board of Veterinary Medical
Examiners, the Texas Board of Nursing, or the Texas State Board of
Pharmacy;
(2) an authorized officer or member of the department
engaged in the administration, investigation, or enforcement of
this chapter or another law governing illicit drugs in this state or
another state; or
(3) if the director finds that proper need has been
shown to the director:
(A) a law enforcement or prosecutorial official
engaged in the administration, investigation, or enforcement of
this chapter or another law governing illicit drugs in this state or
another state;
(B) a pharmacist or a pharmacy technician, as
defined by Section 551.003, Occupations Code, acting at the
direction of a pharmacist or a practitioner who is a physician,
dentist, veterinarian, podiatrist, or advanced practice nurse or is
a physician assistant described by Section 481.002(39)(D) or a
nurse licensed under Chapter 301, Occupations Code, acting at the
direction of a practitioner and is inquiring about a recent
Schedule II, III, IV, or V prescription history of a particular
patient of the practitioner; or
(C) a pharmacist or practitioner who is inquiring
about the person's own dispensing or prescribing activity.
(a-1) A person authorized to receive information under
Subsection (a)(3)(B) or (C) may access that information through a
health information exchange, subject to proper security measures to
ensure against disclosure to unauthorized persons.
(e) The director shall remove from the information
retrieval system, destroy, and make irretrievable the record of the
identity of a patient submitted under this section to the director
not later than the end of the 36th [12th] calendar month after the
month in which the identity is entered into the system. However,
the director may retain a patient identity that is necessary for use
in a specific ongoing investigation conducted in accordance with
this section until the 30th day after the end of the month in which
the necessity for retention of the identity ends.
SECTION 4. Subsection (a), Section 481.127, Health and
Safety Code, is amended to read as follows:
(a) A person commits an offense if the person knowingly
gives, permits, or obtains unauthorized access to information
submitted to the director under Section 481.074(q) or 481.075.
SECTION 5. Chapter 481, Health and Safety Code, is amended
by adding Subchapter I to read as follows:
SUBCHAPTER I. INTERAGENCY PRESCRIPTION MONITORING WORK GROUP
Sec. 481.351. INTERAGENCY PRESCRIPTION MONITORING WORK
GROUP. The interagency prescription monitoring work group is
created to evaluate the effectiveness of prescription monitoring
under this chapter and offer recommendations to improve the
effectiveness and efficiency of recordkeeping and other functions
related to the regulation of dispensing controlled substances by
prescription.
Sec. 481.352. MEMBERS. The work group is composed of:
(1) the director or the director's designee;
(2) the commissioner of state health services or the
commissioner's designee;
(3) the executive director of the Texas State Board of
Pharmacy or the executive director's designee;
(4) the executive director of the Texas Medical Board
or the executive director's designee; and
(5) the executive director of the Texas Board of
Nursing or the executive director's designee.
Sec. 481.353. MEETINGS. (a) The work group shall meet at
least quarterly.
(b) The work group is subject to Chapter 551, Government
Code.
(c) The work group shall proactively engage stakeholders
and solicit and take into account input from the public.
Sec. 481.354. REPORT. Not later than December 1 of each
even-numbered year, the work group shall submit to the legislature
its recommendations relating to prescription monitoring.
SECTION 6. This Act takes effect September 1, 2013.