Texas 2019 - 86th Regular

Texas House Bill HB1866 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	~~86R23872~~ JSC-F
	1	+	86R6949 JSC-F
2	2		By: Davis of Dallas H.B. No. 1866
3		-	Substitute the following for H.B. No. 1866:
4		-	By: Price C.S.H.B. No. 1866
5	3
6	4
7	5		A BILL TO BE ENTITLED
8	6		AN ACT
9	7		relating to the prescribing of opioids for acute pain.
10	8		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	9		SECTION 1. Subchapter C, Chapter 481, Health and Safety
12	10		Code, is amended by adding Section 481.07635 to read as follows:
13	11		Sec. 481.07635. PRESCRIPTIONS OF OPIOIDS FOR ACUTE PAIN.
14		-	(a) In this section, "acute pain" means the normal, predicted,
15		-	physiological response to a stimulus such as trauma, disease, and
16		-	operative procedures. Acute pain is time-limited. The term does not
17		-	include:
18		-	(1) chronic pain;
19		-	(2) pain being treated as part of cancer care;
20		-	(3) pain being treated as part of hospice or other
21		-	end-of-life care; or
22		-	(4) pain being treated as part of palliative care.
	12	+	(a) In this section, "acute pain" means pain with abrupt onset that
	13	+	is caused by an injury or other process that is not ongoing.
23	14		(b) For the initial treatment of acute pain, a prescriber
24	15		may not issue a prescription for an opioid in an amount that exceeds
25	16		a seven-day supply.
26	17		(c) Before issuing an initial opioid prescription for acute
27	18		pain, a prescriber shall:
28	19		(1) take and document the results of a thorough
29	20		medical history, including:
30	21		(A) the patient's experience with medication
31	22		other than opioids and pain management approaches described by
32	23		Subsection (d); and
33	24		(B) any history of substance abuse;
34	25		(2) conduct and document the results of a physical
35	26		examination, as appropriate;
36	27		(3) develop a treatment plan focused on determining
37	28		the cause of the patient's pain; and
38	29		(4) comply with the requirements of Section 481.0764.
39	30		(d) A prescriber may refer or prescribe any of the following
40	31		pain management services to a patient, based on the prescriber's
41	32		clinical judgment and the availability of the treatment, when
42	33		issuing an opioid prescription for acute pain:
43	34		(1) physical therapies;
44	35		(2) occupational therapies;
45	36		(3) chiropractic treatment;
46	37		(4) physical medicine and rehabilitation; or
47	38		(5) osteopathic manipulation.
48	39		(e) This section does not apply to:
49		-	(1) patients:
50		-	(A) with pain related to:
51		-	(i) progressive functional neurological
52		-	deficit;
53		-	(ii) fracture;
54		-	(iii) tumor;
55		-	(iv) infection; or
56		-	(v) immediate postsurgical recovery;
57		-	(B) with chronic pain that, based on the
	40	+	(1) patients with pain related to:
	41	+	(A) progressive functional neurological deficit;
	42	+	(B) fracture;
	43	+	(C) tumor;
	44	+	(D) infection; or
	45	+	(E) immediate postsurgical recovery;
	46	+	(2) patients with chronic pain that, based on the
58	47		prescriber's clinical judgment, is caused by a disease, illness, or
59	48		injury that would not improve under the therapies and treatments
60	49		described by Subsection (d); or
61		-	(C) receiving:
62		-	(i) treatment for cancer;
63		-	(ii) emergency or trauma care;
64		-	(iii) hospice care;
65		-	(iv) palliative care;
66		-	(v) long-term care; or
67		-	(vi) treatment for substance abuse or
68		-	opioid dependence; or
69		-	(2) a prescriber who is a veterinarian.
	50	+	(3) patients receiving:
	51	+	(A) treatment for cancer;
	52	+	(B) emergency or trauma care;
	53	+	(C) hospice care;
	54	+	(D) palliative care;
	55	+	(E) long-term care; or
	56	+	(F) treatment for substance abuse or opioid
	57	+	dependence.
70	58		(f) This section does not require that all of the treatments
71	59		under Subsection (d) be exhausted before the patient may receive a
72	60		prescription for an opioid.
73		-	(g) A dispenser is not subject to disciplinary action, civil
74		-	liability, or criminal, civil, or administrative penalties for
75		-	dispensing or refusing to dispense a controlled substance under an
76		-	otherwise valid prescription that exceeds the limits provided by
77		-	Subsection (b).
78	61		SECTION 2. Section 481.003(a), Health and Safety Code, is
79	62		amended to read as follows:
80	63		(a) The director may adopt rules to administer and enforce
81	64		this chapter, other than Sections 481.073, 481.074, 481.075,
82	65		481.076, 481.0761, 481.0762, 481.0763, 481.07635, 481.0764,
83	66		481.0765, and 481.0766. The board may adopt rules to administer
84	67		Sections 481.073, 481.074, 481.075, 481.076, 481.0761, 481.0762,
85	68		481.0763, 481.07635, 481.0764, 481.0765, and 481.0766.
86	69		SECTION 3. Section 554.051(a-1), Occupations Code, is
87	70		amended to read as follows:
88	71		(a-1) The board may adopt rules to administer Sections
89	72		481.073, 481.074, 481.075, 481.076, 481.0761, 481.0762, 481.0763,
90	73		481.07635, 481.0764, 481.0765, and 481.0766, Health and Safety
91	74		Code.
92	75		SECTION 4. Section 565.003, Occupations Code, is amended to
93	76		read as follows:
94	77		Sec. 565.003. ADDITIONAL GROUNDS FOR DISCIPLINE REGARDING
95	78		APPLICANT FOR OR HOLDER OF NONRESIDENT PHARMACY LICENSE. Unless
96	79		compliance would violate the pharmacy or drug statutes or rules in
97	80		the state in which the pharmacy is located, the board may discipline
98	81		an applicant for or the holder of a nonresident pharmacy license if
99	82		the board finds that the applicant or license holder has failed to
100	83		comply with:
101	84		(1) Section 481.073, 481.074, [or] 481.075, 481.076,
102	85		481.0761, 481.0762, 481.0763, 481.07635, 481.0764, 481.0765, or
103	86		481.0766, Health and Safety Code;
104	87		(2) Texas substitution requirements regarding:
105	88		(A) the practitioner's directions concerning
106	89		generic substitution;
107	90		(B) the patient's right to refuse generic
108	91		substitution; or
109	92		(C) notification to the patient of the patient's
110	93		right to refuse substitution;
111	94		(3) any board rule relating to providing drug
112	95		information to the patient or the patient's agent in written form or
113	96		by telephone; or
114	97		(4) any board rule adopted under Section 554.051(a)
115	98		and determined by the board to be applicable under Section
116	99		554.051(b).
117	100		SECTION 5. Section 481.07635, Health and Safety Code, as
118	101		added by this Act, applies only to a prescription issued on or after
119	102		the effective date of this Act. A prescription issued before the
120	103		effective date of this Act is governed by the law in effect on the
121	104		date the prescription is issued, and the former law is continued in
122	105		effect for that purpose.
123	106		SECTION 6. This Act takes effect September 1, 2019.