Texas 2019 - 86th Regular

Texas Senate Bill SB1233 Compare Versions

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

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1	1	86R11824 JSC-F
2	2	By: Kolkhorst S.B. No. 1233
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to controlled substance prescriptions under the Texas
8	8	Controlled Substances Act; authorizing a fee.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 552.118, Government Code, is amended to
11	11	read as follows:
12	12	Sec. 552.118. EXCEPTION: CONFIDENTIALITY OF OFFICIAL
13	13	PRESCRIPTION PROGRAM INFORMATION. Information is excepted from the
14	14	requirements of Section 552.021 if it is:
15	15	(1) information on or derived from an official
16	16	prescription form filed with the Texas State Board of Pharmacy
17	17	under Section 481.0755, Health and Safety Code, or an electronic
18	18	prescription record filed with the Texas State Board of Pharmacy
19	19	under Section 481.075, Health and Safety Code; or
20	20	(2) other information collected under Section 481.075
21	21	or 481.0755 of that code.
22	22	SECTION 2. Sections 481.002(10) and (47), Health and Safety
23	23	Code, are amended to read as follows:
24	24	(10) "Designated agent" means an individual
25	25	designated under Section 481.074(b-2) [481.073] to communicate a
26	26	practitioner's instructions to a pharmacist in an emergency.
27	27	(47) "Official prescription form" means a
28	28	prescription form that is used for a Schedule II controlled
29	29	substance under Section 481.0755 and contains the prescription
30	30	information required by Section 481.0755(e) [481.075].
31	31	SECTION 3. Section 481.003(a), Health and Safety Code, is
32	32	amended to read as follows:
33	33	(a) The director may adopt rules to administer and enforce
34	34	this chapter, other than Sections [481.073,] 481.074, 481.075,
35	35	481.0755, 481.0756, 481.076, 481.0761, 481.0762, 481.0763,
36	36	481.07635, 481.07636, 481.0764, 481.0765, and 481.0766. The board
37	37	may adopt rules to administer Sections [481.073,] 481.074, 481.075,
38	38	481.0755, 481.0756, 481.076, 481.0761, 481.0762, 481.0763,
39	39	481.07635, 481.07636, 481.0764, 481.0765, and 481.0766.
40	40	SECTION 4. Section 481.074, Health and Safety Code, is
41	41	amended by amending Subsections (b), (c), (e), (f), (g), (h), (k),
42	42	and (q) and adding Subsections (b-1) and (b-2) to read as follows:
43	43	(b) Except in an emergency as defined by board rule under
44	44	Subsection (b-1) [of the board] or as otherwise provided by
45	45	[Subsection (o) or] Section 481.075(j) or (m) or 481.0755, a person
46	46	may not dispense or administer a controlled substance [listed in
47	47	Schedule II without a written prescription of a practitioner on an
48	48	official prescription form or] without an electronic prescription
49	49	that meets the requirements of and is completed by the practitioner
50	50	in accordance with Section 481.075.
51	51	(b-1) In an emergency as defined by board rule, a person may
52	52	dispense or administer a controlled substance [listed in Schedule
53	53	II] on the oral or telephonically communicated prescription of a
54	54	practitioner. The person who administers or dispenses the
55	55	substance shall:
56	56	(1) if the person is a prescribing practitioner or a
57	57	pharmacist, promptly comply with Subsection (c); or
58	58	(2) if the person is not a prescribing practitioner or
59	59	a pharmacist, promptly write the oral or telephonically
60	60	communicated prescription and include in the written record of the
61	61	prescription the name, address, and Federal Drug Enforcement
62	62	Administration number issued for prescribing a controlled
63	63	substance in this state of the prescribing practitioner, all
64	64	information required to be provided by a practitioner under Section
65	65	481.075(e)(1), and all information required to be provided by a
66	66	dispensing pharmacist under Section 481.075(e)(2).
67	67	(b-2) In an emergency described by Subsection (b-1), an
68	68	agent designated in writing by a practitioner defined by Section
69	69	481.002(39)(A) may communicate a prescription by telephone. A
70	70	practitioner who designates a different agent shall designate that
71	71	agent in writing and maintain the designation in the same manner in
72	72	which the practitioner initially designated an agent under this
73	73	subsection. On the request of a pharmacist, a practitioner shall
74	74	furnish a copy of the written designation. This subsection does not
75	75	relieve a practitioner or the practitioner's designated agent from
76	76	the requirement of Subchapter A, Chapter 562, Occupations Code. A
77	77	practitioner is personally responsible for the actions of the
78	78	designated agent in communicating a prescription to a pharmacist.
79	79	(c) Not later than the seventh day after the date a
80	80	prescribing practitioner authorizes an emergency oral or
81	81	telephonically communicated prescription, the prescribing
82	82	practitioner shall cause an [a written or] electronic prescription,
83	83	completed in the manner required by Section 481.075, to be
84	84	delivered to the dispensing pharmacist at the pharmacy where the
85	85	prescription was dispensed. [A written prescription may be
86	86	delivered in person or by mail. The envelope of a prescription
87	87	delivered by mail must be postmarked not later than the seventh day
88	88	after the date the prescription was authorized. On receipt of a
89	89	written prescription, the dispensing pharmacy shall file the
90	90	transcription of the telephonically communicated prescription and
91	91	the pharmacy copy and shall send information to the board as
92	92	required by Section 481.075.] On receipt of the [an] electronic
93	93	prescription, the pharmacist shall annotate the electronic
94	94	prescription record with the original authorization and date of the
95	95	emergency oral or telephonically communicated prescription.
96	96	(e) The partial filling of a prescription for a controlled
97	97	substance listed in Schedule II is permissible in accordance with
98	98	applicable federal law[, if the pharmacist is unable to supply the
99	99	full quantity called for in a written or electronic prescription or
100	100	emergency oral prescription and the pharmacist makes a notation of
101	101	the quantity supplied on the face of the written prescription, on
102	102	the written record of the emergency oral prescription, or in the
103	103	electronic prescription record. The remaining portion of the
104	104	prescription may be filled within 72 hours of the first partial
105	105	filling; however, if the remaining portion is not or cannot be
106	106	filled within the 72-hour period, the pharmacist shall so notify
107	107	the prescribing individual practitioner. No further quantity may
108	108	be supplied beyond 72 hours without a new prescription].
109	109	(f) A prescription for a Schedule II controlled substance
110	110	for a patient in a long-term care facility (LTCF) or for a patient
111	111	with a medical diagnosis documenting a terminal illness may be
112	112	filled in partial quantities to include individual dosage units.
113	113	If there is any question about whether a patient may be classified
114	114	as having a terminal illness, the pharmacist must contact the
115	115	practitioner before partially filling the prescription. Both the
116	116	pharmacist and the practitioner have a corresponding
117	117	responsibility to assure that the controlled substance is for a
118	118	terminally ill patient. The pharmacist must record the
119	119	prescription [on an official prescription form or] in the
120	120	electronic prescription record and must indicate [on the official
121	121	prescription form or] in the electronic prescription record whether
122	122	the patient is "terminally ill" or an "LTCF patient." A
123	123	prescription that is partially filled and does not contain the
124	124	notation "terminally ill" or "LTCF patient" is considered to have
125	125	been filled in violation of this chapter. For each partial filling,
126	126	the dispensing pharmacist shall record [on the back of the official
127	127	prescription form or] in the electronic prescription record the
128	128	date of the partial filling, the quantity dispensed, the remaining
129	129	quantity authorized to be dispensed, and the identification of the
130	130	dispensing pharmacist. Before any subsequent partial filling, the
131	131	pharmacist must determine that the additional partial filling is
132	132	necessary. The total quantity of Schedule II controlled substances
133	133	dispensed in all partial fillings may not exceed the total quantity
134	134	prescribed. Schedule II prescriptions for patients in a long-term
135	135	care facility or patients with a medical diagnosis documenting a
136	136	terminal illness are valid for a period not to exceed 60 days
137	137	following the issue date unless sooner terminated by discontinuance
138	138	of the medication.
139	139	(g) A person may not dispense a controlled substance in
140	140	Schedule III or IV that is a prescription drug under the Federal
141	141	Food, Drug, and Cosmetic Act (21 U.S.C. Section 301 et seq.) without
142	142	a [written, electronic, oral, or telephonically communicated]
143	143	prescription of a practitioner defined by Section 481.002(39)(A) or
144	144	(D), except that the practitioner may dispense the substance
145	145	directly to an ultimate user. A prescription for a controlled
146	146	substance listed in Schedule III or IV may not be filled or refilled
147	147	later than six months after the date on which the prescription is
148	148	issued and may not be refilled more than five times, unless the
149	149	prescription is renewed by the practitioner. A prescription under
150	150	this subsection must comply with other applicable state and federal
151	151	laws.
152	152	(h) A pharmacist may dispense a controlled substance listed
153	153	in Schedule III, IV, or V under a [written, electronic, oral, or
154	154	telephonically communicated] prescription issued by a practitioner
155	155	defined by Section 481.002(39)(C) [and] only if the pharmacist
156	156	determines that the prescription was issued for a valid medical
157	157	purpose and in the course of professional practice. A prescription
158	158	described by [issued under] this subsection may not be filled or
159	159	refilled later than six months after the date the prescription is
160	160	issued and may not be refilled more than five times, unless the
161	161	prescription is renewed by the practitioner.
162	162	(k) A prescription for a controlled substance must show:
163	163	(1) the quantity of the substance prescribed:
164	164	(A) [numerically, followed by the number written
165	165	as a word, if the prescription is written;
166	166	[(B)] numerically, if the prescription is
167	167	electronic; or
168	168	(B) [(C)] if the prescription is communicated
169	169	orally or telephonically, as transcribed by the receiving
170	170	pharmacist;
171	171	(2) the date of issue;
172	172	(2-a) if the prescription is issued for a Schedule II
173	173	controlled substance to be filled at a later date under Subsection
174	174	(d-1), the earliest date on which a pharmacy may fill the
175	175	prescription;
176	176	(3) the name, address, and date of birth or age of the
177	177	patient or, if the controlled substance is prescribed for an
178	178	animal, the species of the animal and the name and address of its
179	179	owner;
180	180	(4) the name and strength of the controlled substance
181	181	prescribed;
182	182	(5) the directions for use of the controlled
183	183	substance;
184	184	(6) the intended use of the substance prescribed
185	185	unless the practitioner determines the furnishing of this
186	186	information is not in the best interest of the patient; and
187	187	(7) the name, address, Federal Drug Enforcement
188	188	Administration number, and telephone number of the practitioner at
189	189	the practitioner's usual place of business[, which must be legibly
190	190	printed or stamped on a written prescription; and
191	191	[(8) if the prescription is handwritten, the signature
192	192	of the prescribing practitioner].
193	193	(q) Each dispensing pharmacist shall send all required
194	194	information[, including any information required to complete the
195	195	Schedule III through V prescription forms,] to the board by
196	196	electronic transfer or another form approved by the board not later
197	197	than the next business day after the date the prescription is
198	198	completely filled.
199	199	SECTION 5. The heading to Section 481.075, Health and
200	200	Safety Code, is amended to read as follows:
201	201	Sec. 481.075. SCHEDULE II PRESCRIPTIONS [OFFICIAL
202	202	PRESCRIPTION PROGRAM].
203	203	SECTION 6. Sections 481.075(a), (e), (g), (h), (i), and
204	204	(j), Health and Safety Code, are amended to read as follows:
205	205	(a) A practitioner who prescribes a controlled substance
206	206	listed in Schedule II shall, except as provided by Section
207	207	481.074(b-1) or 481.0755 or a rule adopted under Section 481.0761,
208	208	record the prescription [on an official prescription form or] in an
209	209	electronic prescription that includes the information required by
210	210	this section.
211	211	(e) Each [official prescription form or electronic]
212	212	prescription used to prescribe a Schedule II controlled substance
213	213	must contain:
214	214	(1) information provided by the prescribing
215	215	practitioner, including:
216	216	(A) the date the prescription is issued;
217	217	(B) the controlled substance prescribed;
218	218	(C) the quantity of controlled substance
219	219	prescribed, shown[:
220	220	[(i)] numerically[, followed by the number
221	221	written as a word, if the prescription is written; or
222	222	[(ii) numerically, if the prescription is
223	223	electronic];
224	224	(D) the intended use of the controlled substance,
225	225	or the diagnosis for which the controlled substance [it] is
226	226	prescribed, and the instructions for use of the substance;
227	227	(E) the practitioner's name, address, and
228	228	Federal Drug Enforcement Administration number issued for
229	229	prescribing a controlled substance in this state;
230	230	(F) the name, address, and date of birth or age of
231	231	the person for whom the controlled substance is prescribed; and
232	232	(G) if the prescription is issued to be filled at
233	233	a later date under Section 481.074(d-1), the earliest date on which
234	234	a pharmacy may fill the prescription;
235	235	(2) information provided by the dispensing
236	236	pharmacist, including the date the prescription is filled; and
237	237	(3) [for a written prescription, the signatures of the
238	238	prescribing practitioner and the dispensing pharmacist or for an
239	239	electronic prescription,] the prescribing practitioner's
240	240	electronic signature or other secure method of validation
241	241	authorized by federal law.
242	242	(g) Except for an emergency oral or telephonically
243	243	communicated prescription described by [prescribed under] Section
244	244	481.074(b-1) [481.074(b)], the prescribing practitioner shall:
245	245	(1) record [legibly fill in,] or direct a designated
246	246	agent to record [legibly fill in, on the official prescription form
247	247	or] in the electronic prescription[,] each item of information
248	248	required to be provided by the prescribing practitioner under
249	249	Subsection (e)(1), unless the practitioner determines that:
250	250	(A) under rule adopted by the board for this
251	251	purpose, it is unnecessary for the practitioner or the
252	252	practitioner's agent to provide the patient identification number;
253	253	or
254	254	(B) it is not in the best interest of the patient
255	255	for the practitioner or practitioner's agent to provide information
256	256	regarding the intended use of the controlled substance or the
257	257	diagnosis for which it is prescribed; and
258	258	(2) [sign the official prescription form and give the
259	259	form to the person authorized to receive the prescription or, in the
260	260	case of an electronic prescription,] electronically sign or
261	261	validate the electronic prescription as authorized by federal law
262	262	and transmit the prescription to the dispensing pharmacy.
263	263	(h) In the case of an emergency oral or telephonically
264	264	communicated prescription described by [prescribed under] Section
265	265	481.074(b-1) [481.074(b)], the prescribing practitioner shall give
266	266	the dispensing pharmacy the information needed to complete the
267	267	[official prescription form or] electronic prescription record.
268	268	(i) Each dispensing pharmacist shall:
269	269	(1) [fill in on the official prescription form or]
270	270	note in the electronic prescription record each item of information
271	271	given orally to the dispensing pharmacy under Subsection (h) and
272	272	the date the prescription is filled[,] and[:
273	273	[(A) for a written prescription, fill in the
274	274	dispensing pharmacist's signature; or
275	275	[(B) for an electronic prescription,]
276	276	appropriately record the identity of the dispensing pharmacist in
277	277	the electronic prescription record;
278	278	(2) retain with the records of the pharmacy for at
279	279	least two years:
280	280	(A) [the official prescription form or] the
281	281	electronic prescription record[, as applicable]; and
282	282	(B) the name or other patient identification
283	283	required by Section 481.074(m) or (n); and
284	284	(3) send all required information, including any
285	285	information required to complete an [official prescription form or]
286	286	electronic prescription record, to the board by electronic transfer
287	287	or another form approved by the board not later than the next
288	288	business day after the date the prescription is completely filled.
289	289	(j) A medication order written for a patient who is admitted
290	290	to a hospital at the time the medication order is written and filled
291	291	is not required to be recorded [on an official prescription form or]
292	292	in an electronic prescription record that meets the requirements of
293	293	this section.
294	294	SECTION 7. Subchapter C, Chapter 481, Health and Safety
295	295	Code, is amended by adding Sections 481.0755 and 481.0756 to read as
296	296	follows:
297	297	Sec. 481.0755. WRITTEN, ORAL, AND TELEPHONICALLY
298	298	COMMUNICATED PRESCRIPTIONS. (a) Notwithstanding Sections 481.074
299	299	and 481.075, a prescription for a controlled substance is not
300	300	required to be issued electronically and may be issued in writing if
301	301	the prescription is issued:
302	302	(1) by a veterinarian;
303	303	(2) in circumstances in which electronic prescribing
304	304	is not available due to temporary technological or electronic
305	305	failure, as prescribed by board rule;
306	306	(3) by a practitioner to be dispensed by a pharmacy
307	307	located outside this state, as prescribed by board rule;
308	308	(4) when the prescriber and dispenser are in the same
309	309	location or under the same license;
310	310	(5) in circumstances in which necessary elements are
311	311	not supported by the most recently implemented national data
312	312	standard that facilitates electronic prescribing;
313	313	(6) for a drug for which the United States Food and
314	314	Drug Administration requires additional information in the
315	315	prescription that is not possible with electronic prescribing;
316	316	(7) for a non-patient-specific prescription pursuant
317	317	to a standing order, approved protocol for drug therapy,
318	318	collaborative drug management, or comprehensive medication
319	319	management, in response to a public health emergency or in other
320	320	circumstances in which the practitioner may issue a
321	321	non-patient-specific prescription;
322	322	(8) for a drug under a research protocol;
323	323	(9) by a practitioner who has received a waiver under
324	324	Section 481.0756 from the requirement to use electronic
325	325	prescribing;
326	326	(10) under circumstances in which the practitioner has
327	327	the present ability to submit an electronic prescription but
328	328	reasonably determines that it would be impractical for the patient
329	329	to obtain the drugs prescribed under the electronic prescription in
330	330	a timely manner and that a delay would adversely impact the
331	331	patient's medical condition; or
332	332	(11) before January 1, 2021.
333	333	(b) A dispensing pharmacist who receives a controlled
334	334	substance prescription in a manner other than electronically is not
335	335	required to verify that the prescription is exempt from the
336	336	requirement that it be submitted electronically. The pharmacist
337	337	may dispense a controlled substance pursuant to an otherwise valid
338	338	written, oral, or telephonically communicated prescription
339	339	consistent with the requirements of this subchapter.
340	340	(c) Except in an emergency, a practitioner must use a
341	341	written prescription to submit a prescription described by
342	342	Subsection (a). In an emergency, the practitioner may submit an
343	343	oral or telephonically communicated prescription as authorized
344	344	under Section 481.074(b-1).
345	345	(d) A written prescription for a controlled substance other
346	346	than a Schedule II controlled substance must include the
347	347	information required under Section 481.074(k) and the signature of
348	348	the prescribing practitioner.
349	349	(e) A written prescription for a Schedule II controlled
350	350	substance must be on an official prescription form and include the
351	351	information required for an electronic prescription under Section
352	352	481.075(e), the signature of the practitioner, and the signature of
353	353	the dispensing pharmacist after the prescription is filled.
354	354	(f) The board by rule shall authorize a practitioner to
355	355	determine whether it is necessary to obtain a particular patient
356	356	identification number and to provide that number on the official
357	357	prescription form.
358	358	(g) On request of a practitioner, the board shall issue
359	359	official prescription forms to the practitioner for a fee covering
360	360	the actual cost of printing, processing, and mailing the forms.
361	361	Before mailing or otherwise delivering prescription forms to a
362	362	practitioner, the board shall print on each form the number of the
363	363	form and any other information the board determines is necessary.
364	364	(h) Each official prescription form must be sequentially
365	365	numbered.
366	366	(i) A person may not obtain an official prescription form
367	367	unless the person is a practitioner as defined by Section
368	368	481.002(39)(A) or an institutional practitioner.
369	369	(j) Not more than one Schedule II prescription may be
370	370	recorded on an official prescription form.
371	371	(k) Not later than the 30th day after the date a
372	372	practitioner's Federal Drug Enforcement Administration number or
373	373	license to practice has been denied, suspended, canceled,
374	374	surrendered, or revoked, the practitioner shall return to the board
375	375	all official prescription forms in the practitioner's possession
376	376	that have not been used for prescriptions.
377	377	(l) Each prescribing practitioner:
378	378	(1) may use an official prescription form only to
379	379	submit a prescription described by Subsection (a);
380	380	(2) shall date or sign an official prescription form
381	381	only on the date the prescription is issued; and
382	382	(3) shall take reasonable precautionary measures to
383	383	ensure that an official prescription form issued to the
384	384	practitioner is not used by another person to violate this
385	385	subchapter or a rule adopted under this subchapter.
386	386	(m) In the case of an emergency oral or telephonically
387	387	communicated prescription described by Section 481.074(b-1), the
388	388	prescribing practitioner shall give the dispensing pharmacy the
389	389	information needed to complete the official prescription form if
390	390	the pharmacy is not required to use the electronic prescription
391	391	record.
392	392	(n) Each dispensing pharmacist receiving an oral or
393	393	telephonically communicated prescription under Subsection (m)
394	394	shall:
395	395	(1) fill in on the official prescription form each
396	396	item of information given orally to the dispensing pharmacy under
397	397	Subsection (m) and the date the prescription is filled and fill in
398	398	the dispensing pharmacist's signature;
399	399	(2) retain with the records of the pharmacy for at
400	400	least two years:
401	401	(A) the official prescription form; and
402	402	(B) the name or other patient identification
403	403	required by Section 481.074(m) or (n); and
404	404	(3) send all required information, including any
405	405	information required to complete an official prescription form, to
406	406	the board by electronic transfer or another form approved by the
407	407	board not later than the next business day after the date the
408	408	prescription is completely filled.
409	409	Sec. 481.0756. WAIVERS FROM ELECTRONIC PRESCRIBING. (a)
410	410	The appropriate regulatory agency that issued the license,
411	411	certification, or registration to a prescriber is authorized to
412	412	grant a prescriber a waiver from the electronic prescribing
413	413	requirement under the provisions of this section.
414	414	(b) The board shall convene an interagency workgroup that
415	415	includes representatives of each regulatory agency that issues a
416	416	license, certification, or registration to a prescriber.
417	417	(c) The work group described by Subsection (b) shall
418	418	establish recommendations and standards for circumstances in which
419	419	a waiver from the electronic prescribing requirement is appropriate
420	420	and a process under which a prescriber may request and receive a
421	421	waiver.
422	422	(d) The board shall adopt rules establishing the
423	423	eligibility for a waiver, including:
424	424	(1) economic hardship;
425	425	(2) technological limitations not reasonably within
426	426	the control of the prescriber; or
427	427	(3) other exceptional circumstances demonstrated by
428	428	the prescriber.
429	429	(e) Each regulatory agency that issues a license,
430	430	certification, or registration to a prescriber shall adopt rules
431	431	for the granting of waivers consistent with the board rules adopted
432	432	under Subsection (d).
433	433	(f) A waiver may be issued to a prescriber for a period of
434	434	one year. On expiration of the waiver, the prescriber may reapply
435	435	for a waiver if the circumstances that necessitated the waiver
436	436	continue.
437	437	SECTION 8. Sections 481.0761(c) and (d), Health and Safety
438	438	Code, are amended to read as follows:
439	439	(c) The board by rule may:
440	440	(1) [permit more than one prescription to be
441	441	administered or dispensed and recorded on one prescription form for
442	442	a Schedule III through V controlled substance;
443	443	[(1-a)] establish a procedure for the issuance of
444	444	multiple prescriptions of a Schedule II controlled substance under
445	445	Section 481.074(d-1);
446	446	(2) remove from or return to the official prescription
447	447	program any aspect of a practitioner's or pharmacist's hospital
448	448	practice, including administering or dispensing;
449	449	(3) waive or delay any requirement relating to the
450	450	time or manner of reporting;
451	451	(4) establish compatibility protocols for electronic
452	452	data transfer hardware, software, or format, including any
453	453	necessary modifications for participation in a database described
454	454	by Section 481.076(j);
455	455	(5) establish a procedure to control the release of
456	456	information under Sections 481.074, 481.075, and 481.076; and
457	457	(6) establish a minimum level of prescription activity
458	458	below which a reporting activity may be modified or deleted.
459	459	(d) The board by rule shall authorize a practitioner to
460	460	determine whether it is necessary to obtain a particular patient
461	461	identification number and to provide that number [on the official
462	462	prescription form or] in the electronic prescription record.
463	463	SECTION 9. Subchapter C, Chapter 481, Health and Safety
464	464	Code, is amended by adding Sections 481.07635 and 481.07636 to read
465	465	as follows:
466	466	Sec. 481.07635. CONTINUING EDUCATION. (a) A person
467	467	authorized to receive information under Section 481.076(a)(5)
468	468	shall, not later than the first anniversary after the person is
469	469	issued a license, certification, or registration to prescribe or
470	470	dispense controlled substances under this chapter, complete two
471	471	hours of professional education related to approved procedures of
472	472	prescribing and monitoring controlled substances.
473	473	(b) A person authorized to receive information may annually
474	474	take the professional education course under this section to fulfil
475	475	hours toward the ethics education requirement of the person's
476	476	license, certification, or registration.
477	477	(c) The regulatory agency that issued the license,
478	478	certification, or registration to a person authorized to receive
479	479	information under Section 481.076(a)(5) shall approve professional
480	480	education to satisfy the requirements of this section.
481	481	Sec. 481.07636. OPIOID PRESCRIPTION LIMITS. (a) In this
482	482	section, "acute pain" means pain with abrupt onset that is caused by
483	483	an injury or other process that is not ongoing. The term does not
484	484	include:
485	485	(1) chronic pain;
486	486	(2) pain being treated as part of cancer care;
487	487	(3) pain being treated as part of hospice or other
488	488	end-of-life care; or
489	489	(4) pain being treated as part of palliative care.
490	490	(b) For the initial treatment of acute pain, a practitioner
491	491	may not:
492	492	(1) issue a prescription for an opioid in an amount
493	493	that exceeds a seven-day supply; or
494	494	(2) provide for a refill of an opioid.
495	495	(c) Subsection (b) does not apply to a prescription for an
496	496	opioid approved by the United States Food and Drug Administration
497	497	for the treatment of substance addiction that is issued by a
498	498	practitioner for the treatment of substance addiction.
499	499	(d) A dispenser is not subject to criminal, civil, or
500	500	administrative penalties for dispensing or refusing to dispense a
501	501	controlled substance under a prescription that exceeds the limits
502	502	provided by Subsection (b).
503	503	SECTION 10. Section 481.128(a), Health and Safety Code, is
504	504	amended to read as follows:
505	505	(a) A registrant or dispenser commits an offense if the
506	506	registrant or dispenser knowingly:
507	507	(1) distributes, delivers, administers, or dispenses
508	508	a controlled substance in violation of Subchapter C [Sections
509	509	481.070-481.075];
510	510	(2) manufactures a controlled substance not
511	511	authorized by the person's Federal Drug Enforcement Administration
512	512	registration or distributes or dispenses a controlled substance not
513	513	authorized by the person's registration to another registrant or
514	514	other person;
515	515	(3) refuses or fails to make, keep, or furnish a
516	516	record, report, notification, order form, statement, invoice, or
517	517	information required by this chapter;
518	518	(4) prints, manufactures, possesses, or produces an
519	519	official prescription form without the approval of the board;
520	520	(5) delivers or possesses a counterfeit official
521	521	prescription form;
522	522	(6) refuses an entry into a premise for an inspection
523	523	authorized by this chapter;
524	524	(7) refuses or fails to return an official
525	525	prescription form as required by Section 481.0755(k) [481.075(k)];
526	526	(8) refuses or fails to make, keep, or furnish a
527	527	record, report, notification, order form, statement, invoice, or
528	528	information required by a rule adopted by the director or the board;
529	529	or
530	530	(9) refuses or fails to maintain security required by
531	531	this chapter or a rule adopted under this chapter.
532	532	SECTION 11. Section 481.129(a), Health and Safety Code, is
533	533	amended to read as follows:
534	534	(a) A person commits an offense if the person knowingly:
535	535	(1) distributes as a registrant or dispenser a
536	536	controlled substance listed in Schedule I or II, unless the person
537	537	distributes the controlled substance as authorized under the
538	538	federal Controlled Substances Act (21 U.S.C. Section 801 et seq.);
539	539	(2) uses in the course of manufacturing, prescribing,
540	540	or distributing a controlled substance a Federal Drug Enforcement
541	541	Administration registration number that is fictitious, revoked,
542	542	suspended, or issued to another person;
543	543	(3) issues a prescription bearing a forged or
544	544	fictitious signature;
545	545	(4) uses a prescription issued to another person to
546	546	prescribe a Schedule II controlled substance;
547	547	(5) possesses, obtains, or attempts to possess or
548	548	obtain a controlled substance or an increased quantity of a
549	549	controlled substance:
550	550	(A) by misrepresentation, fraud, forgery,
551	551	deception, or subterfuge;
552	552	(B) through use of a fraudulent prescription
553	553	form; [or]
554	554	(C) through use of a fraudulent oral or
555	555	telephonically communicated prescription; or
556	556	(D) through the use of a fraudulent electronic
557	557	prescription; or
558	558	(6) furnishes false or fraudulent material
559	559	information in or omits material information from an application,
560	560	report, record, or other document required to be kept or filed under
561	561	this chapter.
562	562	SECTION 12. Section 32.024, Human Resources Code, is
563	563	amended by adding Subsection (z-2) to read as follows:
564	564	(z-2) The limits on prescription drugs and medications
565	565	under the medical assistance program provided by Subsections (z)
566	566	and (z-1) do not apply to a prescription for an opioid for the
567	567	initial treatment of acute pain under Section 481.07636, Health and
568	568	Safety Code.
569	569	SECTION 13. Section 554.051(a-1), Occupations Code, is
570	570	amended to read as follows:
571	571	(a-1) The board may adopt rules to administer Sections
572	572	[481.073,] 481.074, 481.075, 481.0755, 481.0756, 481.076,
573	573	481.0761, 481.0762, 481.0763, 481.07635, 481.07636, 481.0764,
574	574	481.0765, and 481.0766, Health and Safety Code.
575	575	SECTION 14. Section 565.003, Occupations Code, is amended
576	576	to read as follows:
577	577	Sec. 565.003. ADDITIONAL GROUNDS FOR DISCIPLINE REGARDING
578	578	APPLICANT FOR OR HOLDER OF NONRESIDENT PHARMACY LICENSE. Unless
579	579	compliance would violate the pharmacy or drug statutes or rules in
580	580	the state in which the pharmacy is located, the board may discipline
581	581	an applicant for or the holder of a nonresident pharmacy license if
582	582	the board finds that the applicant or license holder has failed to
583	583	comply with:
584	584	(1) Section 481.074, [or] 481.075, 481.0755,
585	585	481.0756, 481.076, 481.0761, 481.0762, 481.0763, 481.07635,
586	586	481.07636, 481.0764, 481.0765, or 481.0766, Health and Safety Code;
587	587	(2) Texas substitution requirements regarding:
588	588	(A) the practitioner's directions concerning
589	589	generic substitution;
590	590	(B) the patient's right to refuse generic
591	591	substitution; or
592	592	(C) notification to the patient of the patient's
593	593	right to refuse substitution;
594	594	(3) any board rule relating to providing drug
595	595	information to the patient or the patient's agent in written form or
596	596	by telephone; or
597	597	(4) any board rule adopted under Section 554.051(a)
598	598	and determined by the board to be applicable under Section
599	599	554.051(b).
600	600	SECTION 15. Sections 481.073, 481.074(o) and (p), and
601	601	481.075(b), (c), (d), (f), (k), and (l), Health and Safety Code, are
602	602	repealed.
603	603	SECTION 16. A person who holds a license, certification, or
604	604	registration to prescribe or dispense a controlled substance issued
605	605	before September 1, 2020, is required to take the continuing
606	606	education course provided by Section 481.07635, Health and Safety
607	607	Code, as added by this Act, not later than September 1, 2021.
608	608	SECTION 17. This Act takes effect September 1, 2019.