85R9615 EES-F
By: Roberts H.B. No. 2444
A BILL TO BE ENTITLED
AN ACT
relating to the authority of pharmacists to furnish certain
medications and receive compensation for certain services and
procedures.
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 1451.001, Insurance Code, is amended by
adding Subdivision (13-a) to read as follows:
(13-a) "Pharmacist" means an individual licensed to
practice pharmacy by the Texas State Board of Pharmacy.
SECTION 3. Subchapter C, Chapter 1451, Insurance Code, is
amended by adding Section 1451.1261 to read as follows:
Sec. 1451.1261. REIMBURSEMENT FOR CERTAIN SERVICES AND
PROCEDURES PERFORMED BY PHARMACISTS. (a) Notwithstanding any
other law except Subsection (c), in addition to applying to a
policy, agreement, or contract described by Section 1451.102, this
section applies to any other individual or group health benefit
plan that provides benefits described by Section 1451.102,
including:
(1) a health benefit plan issued by:
(A) a group hospital service corporation
operating under Chapter 842;
(B) a health maintenance organization operating
under Chapter 843; or
(C) a multiple employer welfare arrangement that
holds a certificate of authority under Chapter 846;
(2) a small employer health benefit plan subject to
Chapter 1501;
(3) a standard health benefit plan issued under
Chapter 1507;
(4) health benefits provided by or through a church
benefits board under Subchapter I, Chapter 22, Business
Organizations Code;
(5) a regional or local health care program operated
under Section 75.104, Health and Safety Code;
(6) a self-funded health benefit plan sponsored by a
professional employer organization under Chapter 91, Labor Code;
(7) a county employee health benefit plan established
under Chapter 157, Local Government Code; and
(8) health and accident coverage provided by a risk
pool created under Chapter 172, Local Government Code.
(b) Notwithstanding Section 1451.102, except as provided by
Subsection (c), this section applies to coverage under a group
health benefit plan provided to a resident of this state regardless
of whether the group policy, agreement, or contract is delivered,
issued for delivery, or renewed in this state.
(c) This section does not apply to:
(1) a group health benefit plan that is offered or
administered by:
(A) the Teacher Retirement System of Texas under
Chapter 1575 or 1579; or
(B) the Employees Retirement System of Texas
under Chapter 1551; or
(2) a Medicaid managed care program operated under
Chapter 533, Government Code, or a Medicaid program operated under
Chapter 32, Human Resources Code.
(d) An insurer or other health benefit plan issuer to which
this section applies or a third-party administrator or pharmacy
benefit manager of a health benefit plan to which this section
applies may not deny reimbursement to a pharmacist for the
provision of a service or procedure within the scope of the
pharmacist's license that:
(1) would be covered by the insurance policy or other
coverage agreement or an evidence of coverage if the service or
procedure were provided by:
(A) a physician;
(B) an advanced practice nurse; or
(C) a physician assistant; and
(2) is performed by the pharmacist in strict
compliance with laws and rules related to the pharmacist's license.
SECTION 4. 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) "Smoking cessation drug" means a prescription drug
approved by the United States Food and Drug Administration for use
in the treatment of nicotine or smoking addiction.
(4) "Travel drug" means a prescription drug
recommended by the federal Centers for Disease Control and
Prevention for individuals traveling outside of the United States
for the prevention and management of a disease before a diagnosis of
the disease.
(5) "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).
(6) "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 physician may delegate
to a pharmacist the authority, as provided by the physician's
written protocol, to initiate a prescription drug order for and to
furnish to a patient a prescription drug that is:
(1) a drug 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); or
(B) a rapid influenza diagnostic test used in the
identification of influenza types A and B;
(2) a hormonal contraceptive;
(3) a travel drug;
(4) a prenatal vitamin supplement;
(5) a smoking cessation drug;
(6) a vitamin D supplement; or
(7) a drug identified by the executive commissioner of
the Health and Human Services Commission by rule as necessary for
pharmacists to furnish to patients for public health purposes.
(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 initiate a prescription drug order and
furnish a prescription drug.
(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 for furnishing a drug under Subsection (b)(1)
may not be later than the 14th day after the date the drug is
furnished by the pharmacist.
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) initiating a prescription drug order for and
furnishing a prescription drug to a patient under a physician's
written protocol under Section 157.102.
SECTION 6. Subchapter B, Chapter 562, Occupations Code, is
amended by adding Sections 562.058 and 562.059 to read as follows:
Sec. 562.058. TRAINING REQUIRED TO INITIATE DRUG ORDER OR
FURNISH CERTAIN DRUGS. (a) A pharmacist may not initiate a
prescription drug order or 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 training program required by Subsection (a) may
include:
(1) a training program approved by the Accreditation
Council for Pharmacy Education;
(2) a curriculum-based program offered by a college of
pharmacy that is accredited by the Accreditation Council for
Pharmacy Education; or
(3) any other training program recognized by the
board.
Sec. 562.059. FEES FOR CERTAIN PROFESSIONAL SERVICES. A
pharmacist may charge a fee for providing a professional service
under Section 157.102 that is within the pharmacist's scope of
practice in addition to a fee charged for dispensing a drug.
SECTION 7. Section 1451.1261, Insurance Code, as added by
this Act, applies only to a health benefit plan that is delivered,
issued for delivery, or renewed on or after January 1, 2018. A plan
delivered, issued for delivery, or renewed before January 1, 2018,
is governed by the law as it existed immediately before the
effective date of this Act, and that law is continued in effect for
that purpose.
SECTION 8. Not later than January 1, 2018, the Texas State
Board of Pharmacy and the Texas Medical Board shall adopt the rules
required under Section 157.102, Occupations Code, as added by this
Act.
SECTION 9. (a) Except as provided by Subsection (b) of this
section, this Act takes effect January 1, 2018.
(b) Section 8 of this Act takes effect September 1, 2017.