Texas 2017 - 85th Regular

Texas House Bill HB2444 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	85R9615 EES-F
2	2	By: Roberts H.B. No. 2444
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the authority of pharmacists to furnish certain
8	8	medications and receive compensation for certain services and
9	9	procedures.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. Section 483.001(11), Health and Safety Code, is
12	12	amended to read as follows:
13	13	(11) "Practice of pharmacy" has the meaning assigned
14	14	by Section 551.003, Occupations Code [means:
15	15	[(A) provision of those acts or services
16	16	necessary to provide pharmaceutical care;
17	17	[(B) interpretation and evaluation of
18	18	prescription drug orders or medication orders;
19	19	[(C) participation in drug and device selection
20	20	as authorized by law, drug administration, drug regimen review, or
21	21	drug or drug-related research;
22	22	[(D) provision of patient counseling;
23	23	[(E) responsibility for:
24	24	[(i) dispensing of prescription drug orders
25	25	or distribution of medication orders in the patient's best
26	26	interest;
27	27	[(ii) compounding and labeling of drugs and
28	28	devices, except labeling by a manufacturer, repackager, or
29	29	distributor of nonprescription drugs and commercially packaged
30	30	prescription drugs and devices;
31	31	[(iii) proper and safe storage of drugs and
32	32	devices; or
33	33	[(iv) maintenance of proper records for
34	34	drugs and devices. In this subdivision, "device" has the meaning
35	35	assigned by Subtitle J, Title 3, Occupations Code; or
36	36	[(F) performance of a specific act of drug
37	37	therapy management for a patient delegated to a pharmacist by a
38	38	written protocol from a physician licensed by the state under
39	39	Subtitle B, Title 3, Occupations Code].
40	40	SECTION 2. Section 1451.001, Insurance Code, is amended by
41	41	adding Subdivision (13-a) to read as follows:
42	42	(13-a) "Pharmacist" means an individual licensed to
43	43	practice pharmacy by the Texas State Board of Pharmacy.
44	44	SECTION 3. Subchapter C, Chapter 1451, Insurance Code, is
45	45	amended by adding Section 1451.1261 to read as follows:
46	46	Sec. 1451.1261. REIMBURSEMENT FOR CERTAIN SERVICES AND
47	47	PROCEDURES PERFORMED BY PHARMACISTS. (a) Notwithstanding any
48	48	other law except Subsection (c), in addition to applying to a
49	49	policy, agreement, or contract described by Section 1451.102, this
50	50	section applies to any other individual or group health benefit
51	51	plan that provides benefits described by Section 1451.102,
52	52	including:
53	53	(1) a health benefit plan issued by:
54	54	(A) a group hospital service corporation
55	55	operating under Chapter 842;
56	56	(B) a health maintenance organization operating
57	57	under Chapter 843; or
58	58	(C) a multiple employer welfare arrangement that
59	59	holds a certificate of authority under Chapter 846;
60	60	(2) a small employer health benefit plan subject to
61	61	Chapter 1501;
62	62	(3) a standard health benefit plan issued under
63	63	Chapter 1507;
64	64	(4) health benefits provided by or through a church
65	65	benefits board under Subchapter I, Chapter 22, Business
66	66	Organizations Code;
67	67	(5) a regional or local health care program operated
68	68	under Section 75.104, Health and Safety Code;
69	69	(6) a self-funded health benefit plan sponsored by a
70	70	professional employer organization under Chapter 91, Labor Code;
71	71	(7) a county employee health benefit plan established
72	72	under Chapter 157, Local Government Code; and
73	73	(8) health and accident coverage provided by a risk
74	74	pool created under Chapter 172, Local Government Code.
75	75	(b) Notwithstanding Section 1451.102, except as provided by
76	76	Subsection (c), this section applies to coverage under a group
77	77	health benefit plan provided to a resident of this state regardless
78	78	of whether the group policy, agreement, or contract is delivered,
79	79	issued for delivery, or renewed in this state.
80	80	(c) This section does not apply to:
81	81	(1) a group health benefit plan that is offered or
82	82	administered by:
83	83	(A) the Teacher Retirement System of Texas under
84	84	Chapter 1575 or 1579; or
85	85	(B) the Employees Retirement System of Texas
86	86	under Chapter 1551; or
87	87	(2) a Medicaid managed care program operated under
88	88	Chapter 533, Government Code, or a Medicaid program operated under
89	89	Chapter 32, Human Resources Code.
90	90	(d) An insurer or other health benefit plan issuer to which
91	91	this section applies or a third-party administrator or pharmacy
92	92	benefit manager of a health benefit plan to which this section
93	93	applies may not deny reimbursement to a pharmacist for the
94	94	provision of a service or procedure within the scope of the
95	95	pharmacist's license that:
96	96	(1) would be covered by the insurance policy or other
97	97	coverage agreement or an evidence of coverage if the service or
98	98	procedure were provided by:
99	99	(A) a physician;
100	100	(B) an advanced practice nurse; or
101	101	(C) a physician assistant; and
102	102	(2) is performed by the pharmacist in strict
103	103	compliance with laws and rules related to the pharmacist's license.
104	104	SECTION 4. Subchapter C, Chapter 157, Occupations Code, is
105	105	amended by adding Section 157.102 to read as follows:
106	106	Sec. 157.102. DELEGATION TO PHARMACIST TO FURNISH CERTAIN
107	107	DRUGS. (a) In this section:
108	108	(1) "Acute condition" means a condition or disease
109	109	that begins abruptly, intensifies rapidly, and is generally not
110	110	long-lasting.
111	111	(2) "Pharmacist" has the meaning assigned by Section
112	112	551.003.
113	113	(3) "Smoking cessation drug" means a prescription drug
114	114	approved by the United States Food and Drug Administration for use
115	115	in the treatment of nicotine or smoking addiction.
116	116	(4) "Travel drug" means a prescription drug
117	117	recommended by the federal Centers for Disease Control and
118	118	Prevention for individuals traveling outside of the United States
119	119	for the prevention and management of a disease before a diagnosis of
120	120	the disease.
121	121	(5) "Waived clinical laboratory test" means a clinical
122	122	laboratory test that is classified as waived under federal
123	123	regulations issued under the Clinical Laboratory Improvement
124	124	Amendments of 1988 (42 U.S.C. Section 263a).
125	125	(6) "Written protocol" means a physician's written
126	126	order, standing medical order, standing delegation order, or other
127	127	order or protocol as defined by rule of the board.
128	128	(b) Notwithstanding any other law, a physician may delegate
129	129	to a pharmacist the authority, as provided by the physician's
130	130	written protocol, to initiate a prescription drug order for and to
131	131	furnish to a patient a prescription drug that is:
132	132	(1) a drug to treat an acute condition that is
133	133	identified through performance of one of the following tests, if
134	134	the test is a waived clinical laboratory test:
135	135	(A) a rapid strep test or rapid antigen detection
136	136	test used in the identification of group A streptococcus (GAS); or
137	137	(B) a rapid influenza diagnostic test used in the
138	138	identification of influenza types A and B;
139	139	(2) a hormonal contraceptive;
140	140	(3) a travel drug;
141	141	(4) a prenatal vitamin supplement;
142	142	(5) a smoking cessation drug;
143	143	(6) a vitamin D supplement; or
144	144	(7) a drug identified by the executive commissioner of
145	145	the Health and Human Services Commission by rule as necessary for
146	146	pharmacists to furnish to patients for public health purposes.
147	147	(c) The board shall adopt rules jointly with the Texas State
148	148	Board of Pharmacy to establish the minimum content of the written
149	149	protocol required under Subsection (b). The written protocol may
150	150	permit a pharmacist to initiate a prescription drug order and
151	151	furnish a prescription drug.
152	152	(d) A written protocol under this section must require
153	153	notice to the patient's primary care physician, as identified by
154	154	the patient if the patient has a primary care physician, and
155	155	prescribe the period for providing the notice and the form of the
156	156	notice, in accordance with prevailing practices for the provision
157	157	of notice to a patient's primary care physician. The period for
158	158	providing the notice for furnishing a drug under Subsection (b)(1)
159	159	may not be later than the 14th day after the date the drug is
160	160	furnished by the pharmacist.
161	161	SECTION 5. Section 551.003(33), Occupations Code, is
162	162	amended to read as follows:
163	163	(33) "Practice of pharmacy" means:
164	164	(A) providing an act or service necessary to
165	165	provide pharmaceutical care;
166	166	(B) interpreting or evaluating a prescription
167	167	drug order or medication order;
168	168	(C) participating in drug or device selection as
169	169	authorized by law, and participating in drug administration, drug
170	170	regimen review, or drug or drug-related research;
171	171	(D) providing patient counseling;
172	172	(E) being responsible for:
173	173	(i) dispensing a prescription drug order or
174	174	distributing a medication order;
175	175	(ii) compounding or labeling a drug or
176	176	device, other than labeling by a manufacturer, repackager, or
177	177	distributor of a nonprescription drug or commercially packaged
178	178	prescription drug or device;
179	179	(iii) properly and safely storing a drug or
180	180	device; or
181	181	(iv) maintaining proper records for a drug
182	182	or device;
183	183	(F) performing for a patient a specific act of
184	184	drug therapy management delegated to a pharmacist by a written
185	185	protocol from a physician licensed in this state in compliance with
186	186	Subtitle B; [or]
187	187	(G) administering an immunization or vaccination
188	188	under a physician's written protocol; or
189	189	(H) initiating a prescription drug order for and
190	190	furnishing a prescription drug to a patient under a physician's
191	191	written protocol under Section 157.102.
192	192	SECTION 6. Subchapter B, Chapter 562, Occupations Code, is
193	193	amended by adding Sections 562.058 and 562.059 to read as follows:
194	194	Sec. 562.058. TRAINING REQUIRED TO INITIATE DRUG ORDER OR
195	195	FURNISH CERTAIN DRUGS. (a) A pharmacist may not initiate a
196	196	prescription drug order or furnish a prescription drug under
197	197	Section 157.102 unless the pharmacist has completed a training
198	198	program that is approved by the board and is relevant to the
199	199	condition treated by the drug.
200	200	(b) The training program required by Subsection (a) may
201	201	include:
202	202	(1) a training program approved by the Accreditation
203	203	Council for Pharmacy Education;
204	204	(2) a curriculum-based program offered by a college of
205	205	pharmacy that is accredited by the Accreditation Council for
206	206	Pharmacy Education; or
207	207	(3) any other training program recognized by the
208	208	board.
209	209	Sec. 562.059. FEES FOR CERTAIN PROFESSIONAL SERVICES. A
210	210	pharmacist may charge a fee for providing a professional service
211	211	under Section 157.102 that is within the pharmacist's scope of
212	212	practice in addition to a fee charged for dispensing a drug.
213	213	SECTION 7. Section 1451.1261, Insurance Code, as added by
214	214	this Act, applies only to a health benefit plan that is delivered,
215	215	issued for delivery, or renewed on or after January 1, 2018. A plan
216	216	delivered, issued for delivery, or renewed before January 1, 2018,
217	217	is governed by the law as it existed immediately before the
218	218	effective date of this Act, and that law is continued in effect for
219	219	that purpose.
220	220	SECTION 8. Not later than January 1, 2018, the Texas State
221	221	Board of Pharmacy and the Texas Medical Board shall adopt the rules
222	222	required under Section 157.102, Occupations Code, as added by this
223	223	Act.
224	224	SECTION 9. (a) Except as provided by Subsection (b) of this
225	225	section, this Act takes effect January 1, 2018.
226	226	(b) Section 8 of this Act takes effect September 1, 2017.