H.B. No. 278
AN ACT
relating to the frequency and location of certain meetings required
by a prescriptive authority agreement.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Sections 157.0512(e) and (f), Occupations Code,
are amended to read as follows:
(e) A prescriptive authority agreement must, at a minimum:
(1) be in writing and signed and dated by the parties
to the agreement;
(2) state the name, address, and all professional
license numbers of the parties to the agreement;
(3) state the nature of the practice, practice
locations, or practice settings;
(4) identify the types or categories of drugs or
devices that may be prescribed or the types or categories of drugs
or devices that may not be prescribed;
(5) provide a general plan for addressing consultation
and referral;
(6) provide a plan for addressing patient emergencies;
(7) state the general process for communication and
the sharing of information between the physician and the advanced
practice registered nurse or physician assistant to whom the
physician has delegated prescriptive authority related to the care
and treatment of patients;
(8) if alternate physician supervision is to be
utilized, designate one or more alternate physicians who may:
(A) provide appropriate supervision on a
temporary basis in accordance with the requirements established by
the prescriptive authority agreement and the requirements of this
subchapter; and
(B) participate in the prescriptive authority
quality assurance and improvement plan meetings required under this
section; and
(9) describe a prescriptive authority quality
assurance and improvement plan and specify methods for documenting
the implementation of the plan that include the following:
(A) chart review, with the number of charts to be
reviewed determined by the physician and advanced practice
registered nurse or physician assistant; and
(B) [if the agreement is between a physician and
an advanced practice registered nurse,] periodic [face-to-face]
meetings between the advanced practice registered nurse or
physician assistant and the physician [at a location determined by
the physician and the advanced practice registered nurse; and
[(C) if the agreement is between a physician and
a physician assistant, periodic meetings between the physician
assistant and the physician].
(f) The periodic [face-to-face] meetings described by
Subsection (e)(9)(B) must:
(1) include:
(A) the sharing of information relating to
patient treatment and care, needed changes in patient care plans,
and issues relating to referrals; and
(B) discussion of patient care improvement;
[and]
(2) be documented; and
(3) take place at least once a month in a manner
determined by the physician and the advanced practice registered
nurse or physician assistant [occur:
[(A) except as provided by Paragraph (B):
[(i) at least monthly until the third
anniversary of the date the agreement is executed; and
[(ii) at least quarterly after the third
anniversary of the date the agreement is executed, with monthly
meetings held between the quarterly meetings by means of a remote
electronic communications system, including videoconferencing
technology or the Internet; or
[(B) if during the seven years preceding the date
the agreement is executed the advanced practice registered nurse
for at least five years was in a practice that included the exercise
of prescriptive authority with required physician supervision:
[(i) at least monthly until the first
anniversary of the date the agreement is executed; and
[(ii) at least quarterly after the first
anniversary of the date the agreement is executed, with monthly
meetings held between the quarterly meetings by means of a remote
electronic communications system, including videoconferencing
technology or the Internet].
SECTION 2. Section 157.0512(f-1), Occupations Code, is
repealed.
SECTION 3. Section 157.0512, Occupations Code, as amended
by this Act, applies only to a prescriptive authority agreement
entered into on or after the effective date of this Act. An
agreement entered into before the effective date of this Act is
governed by the law in effect on the date the agreement was entered
into, and the former law is continued in effect for that purpose.
SECTION 4. This Act takes effect September 1, 2019.
______________________________ ______________________________
President of the Senate Speaker of the House
I certify that H.B. No. 278 was passed by the House on April
12, 2019, by the following vote: Yeas 143, Nays 0, 2 present, not
voting.
______________________________
Chief Clerk of the House
I certify that H.B. No. 278 was passed by the Senate on May 3,
2019, by the following vote: Yeas 31, Nays 0.
______________________________
Secretary of the Senate
APPROVED: _____________________
Date
_____________________
Governor