Texas 2019 - 86th Regular

Texas Senate Bill SB1233 Latest Draft

Bill / Introduced Version Filed 02/27/2019

                            86R11824 JSC-F
 By: Kolkhorst S.B. No. 1233


 A BILL TO BE ENTITLED
 AN ACT
 relating to controlled substance prescriptions under the Texas
 Controlled Substances Act; authorizing a fee.
 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 SECTION 1.  Section 552.118, Government Code, is amended to
 read as follows:
 Sec. 552.118.  EXCEPTION: CONFIDENTIALITY OF OFFICIAL
 PRESCRIPTION PROGRAM INFORMATION. Information is excepted from the
 requirements of Section 552.021 if it is:
 (1)  information on or derived from an official
 prescription form filed with the Texas State Board of Pharmacy
 under Section 481.0755, Health and Safety Code, or an electronic
 prescription record filed with the Texas State Board of Pharmacy
 under Section 481.075, Health and Safety Code; or
 (2)  other information collected under Section 481.075
 or 481.0755 of that code.
 SECTION 2.  Sections 481.002(10) and (47), Health and Safety
 Code, are amended to read as follows:
 (10)  "Designated agent" means an individual
 designated under Section 481.074(b-2) [481.073] to communicate a
 practitioner's instructions to a pharmacist in an emergency.
 (47)  "Official prescription form" means a
 prescription form that is used for a Schedule II controlled
 substance under Section 481.0755 and contains the prescription
 information required by Section 481.0755(e) [481.075].
 SECTION 3.  Section 481.003(a), Health and Safety Code, is
 amended to read as follows:
 (a)  The director may adopt rules to administer and enforce
 this chapter, other than Sections [481.073,] 481.074, 481.075,
 481.0755, 481.0756, 481.076, 481.0761, 481.0762, 481.0763,
 481.07635, 481.07636, 481.0764, 481.0765, and 481.0766.  The board
 may adopt rules to administer Sections [481.073,] 481.074, 481.075,
 481.0755, 481.0756, 481.076, 481.0761, 481.0762, 481.0763,
 481.07635, 481.07636, 481.0764, 481.0765, and 481.0766.
 SECTION 4.  Section 481.074, Health and Safety Code, is
 amended by amending Subsections (b), (c), (e), (f), (g), (h), (k),
 and (q) and adding Subsections (b-1) and (b-2) to read as follows:
 (b)  Except in an emergency as defined by board rule under
 Subsection (b-1) [of the board] or as otherwise provided by
 [Subsection (o) or] Section 481.075(j) or (m) or 481.0755, a person
 may not dispense or administer a controlled substance [listed in
 Schedule II without a written prescription of a practitioner on an
 official prescription form or] without an electronic prescription
 that meets the requirements of and is completed by the practitioner
 in accordance with Section 481.075.
 (b-1)  In an emergency as defined by board rule, a person may
 dispense or administer a controlled substance [listed in Schedule
 II] on the oral or telephonically communicated prescription of a
 practitioner.  The person who administers or dispenses the
 substance shall:
 (1)  if the person is a prescribing practitioner or a
 pharmacist, promptly comply with Subsection (c); or
 (2)  if the person is not a prescribing practitioner or
 a pharmacist, promptly write the oral or telephonically
 communicated prescription and include in the written record of the
 prescription the name, address, and Federal Drug Enforcement
 Administration number issued for prescribing a controlled
 substance in this state of the prescribing practitioner, all
 information required to be provided by a practitioner under Section
 481.075(e)(1), and all information required to be provided by a
 dispensing pharmacist under Section 481.075(e)(2).
 (b-2)  In an emergency described by Subsection (b-1), an
 agent designated in writing by a practitioner defined by Section
 481.002(39)(A) may communicate a prescription by telephone. A
 practitioner who designates a different agent shall designate that
 agent in writing and maintain the designation in the same manner in
 which the practitioner initially designated an agent under this
 subsection. On the request of a pharmacist, a practitioner shall
 furnish a copy of the written designation. This subsection does not
 relieve a practitioner or the practitioner's designated agent from
 the requirement of Subchapter A, Chapter 562, Occupations Code. A
 practitioner is personally responsible for the actions of the
 designated agent in communicating a prescription to a pharmacist.
 (c)  Not later than the seventh day after the date a
 prescribing practitioner authorizes an emergency oral or
 telephonically communicated prescription, the prescribing
 practitioner shall cause an [a written or] electronic prescription,
 completed in the manner required by Section 481.075, to be
 delivered to the dispensing pharmacist at the pharmacy where the
 prescription was dispensed. [A written prescription may be
 delivered in person or by mail. The envelope of a prescription
 delivered by mail must be postmarked not later than the seventh day
 after the date the prescription was authorized. On receipt of a
 written prescription, the dispensing pharmacy shall file the
 transcription of the telephonically communicated prescription and
 the pharmacy copy and shall send information to the board as
 required by Section 481.075.] On receipt of the [an] electronic
 prescription, the pharmacist shall annotate the electronic
 prescription record with the original authorization and date of the
 emergency oral or telephonically communicated prescription.
 (e)  The partial filling of a prescription for a controlled
 substance listed in Schedule II is permissible in accordance with
 applicable federal law[, if the pharmacist is unable to supply the
 full quantity called for in a written or electronic prescription or
 emergency oral prescription and the pharmacist makes a notation of
 the quantity supplied on the face of the written prescription, on
 the written record of the emergency oral prescription, or in the
 electronic prescription record. The remaining portion of the
 prescription may be filled within 72 hours of the first partial
 filling; however, if the remaining portion is not or cannot be
 filled within the 72-hour period, the pharmacist shall so notify
 the prescribing individual practitioner. No further quantity may
 be supplied beyond 72 hours without a new prescription].
 (f)  A prescription for a Schedule II controlled substance
 for a patient in a long-term care facility (LTCF) or for a patient
 with a medical diagnosis documenting a terminal illness may be
 filled in partial quantities to include individual dosage units.
 If there is any question about whether a patient may be classified
 as having a terminal illness, the pharmacist must contact the
 practitioner before partially filling the prescription. Both the
 pharmacist and the practitioner have a corresponding
 responsibility to assure that the controlled substance is for a
 terminally ill patient. The pharmacist must record the
 prescription [on an official prescription form or] in the
 electronic prescription record and must indicate [on the official
 prescription form or] in the electronic prescription record whether
 the patient is "terminally ill" or an "LTCF patient." A
 prescription that is partially filled and does not contain the
 notation "terminally ill" or "LTCF patient" is considered to have
 been filled in violation of this chapter. For each partial filling,
 the dispensing pharmacist shall record [on the back of the official
 prescription form or] in the electronic prescription record the
 date of the partial filling, the quantity dispensed, the remaining
 quantity authorized to be dispensed, and the identification of the
 dispensing pharmacist. Before any subsequent partial filling, the
 pharmacist must determine that the additional partial filling is
 necessary. The total quantity of Schedule II controlled substances
 dispensed in all partial fillings may not exceed the total quantity
 prescribed. Schedule II prescriptions for patients in a long-term
 care facility or patients with a medical diagnosis documenting a
 terminal illness are valid for a period not to exceed 60 days
 following the issue date unless sooner terminated by discontinuance
 of the medication.
 (g)  A person may not dispense a controlled substance in
 Schedule III or IV that is a prescription drug under the Federal
 Food, Drug, and Cosmetic Act (21 U.S.C. Section 301 et seq.) without
 a [written, electronic, oral, or telephonically communicated]
 prescription of a practitioner defined by Section 481.002(39)(A) or
 (D), except that the practitioner may dispense the substance
 directly to an ultimate user. A prescription for a controlled
 substance listed in Schedule III or IV may not be filled or refilled
 later than six months after the date on which the prescription is
 issued and may not be refilled more than five times, unless the
 prescription is renewed by the practitioner. A prescription under
 this subsection must comply with other applicable state and federal
 laws.
 (h)  A pharmacist may dispense a controlled substance listed
 in Schedule III, IV, or V under a [written, electronic, oral, or
 telephonically communicated] prescription issued by a practitioner
 defined by Section 481.002(39)(C) [and] only if the pharmacist
 determines that the prescription was issued for a valid medical
 purpose and in the course of professional practice. A prescription
 described by [issued under] this subsection may not be filled or
 refilled later than six months after the date the prescription is
 issued and may not be refilled more than five times, unless the
 prescription is renewed by the practitioner.
 (k)  A prescription for a controlled substance must show:
 (1)  the quantity of the substance prescribed:
 (A)  [numerically, followed by the number written
 as a word, if the prescription is written;
 [(B)]  numerically, if the prescription is
 electronic; or
 (B) [(C)]  if the prescription is communicated
 orally or telephonically, as transcribed by the receiving
 pharmacist;
 (2)  the date of issue;
 (2-a)  if the prescription is issued for a Schedule II
 controlled substance to be filled at a later date under Subsection
 (d-1), the earliest date on which a pharmacy may fill the
 prescription;
 (3)  the name, address, and date of birth or age of the
 patient or, if the controlled substance is prescribed for an
 animal, the species of the animal and the name and address of its
 owner;
 (4)  the name and strength of the controlled substance
 prescribed;
 (5)  the directions for use of the controlled
 substance;
 (6)  the intended use of the substance prescribed
 unless the practitioner determines the furnishing of this
 information is not in the best interest of the patient; and
 (7)  the name, address, Federal Drug Enforcement
 Administration number, and telephone number of the practitioner at
 the practitioner's usual place of business[, which must be legibly
 printed or stamped on a written prescription; and
 [(8)     if the prescription is handwritten, the signature
 of the prescribing practitioner].
 (q)  Each dispensing pharmacist shall send all required
 information[, including any information required to complete the
 Schedule III through V prescription forms,] to the board by
 electronic transfer or another form approved by the board not later
 than the next business day after the date the prescription is
 completely filled.
 SECTION 5.  The heading to Section 481.075, Health and
 Safety Code, is amended to read as follows:
 Sec. 481.075.  SCHEDULE II PRESCRIPTIONS [OFFICIAL
 PRESCRIPTION PROGRAM].
 SECTION 6.  Sections 481.075(a), (e), (g), (h), (i), and
 (j), Health and Safety Code, are amended to read as follows:
 (a)  A practitioner who prescribes a controlled substance
 listed in Schedule II shall, except as provided by Section
 481.074(b-1) or 481.0755 or a rule adopted under Section 481.0761,
 record the prescription [on an official prescription form or] in an
 electronic prescription that includes the information required by
 this section.
 (e)  Each [official prescription form or electronic]
 prescription used to prescribe a Schedule II controlled substance
 must contain:
 (1)  information provided by the prescribing
 practitioner, including:
 (A)  the date the prescription is issued;
 (B)  the controlled substance prescribed;
 (C)  the quantity of controlled substance
 prescribed, shown[:
 [(i)]  numerically[, followed by the number
 written as a word, if the prescription is written; or
 [(ii)     numerically, if the prescription is
 electronic];
 (D)  the intended use of the controlled substance,
 or the diagnosis for which the controlled substance [it] is
 prescribed, and the instructions for use of the substance;
 (E)  the practitioner's name, address, and
 Federal Drug Enforcement Administration number issued for
 prescribing a controlled substance in this state;
 (F)  the name, address, and date of birth or age of
 the person for whom the controlled substance is prescribed; and
 (G)  if the prescription is issued to be filled at
 a later date under Section 481.074(d-1), the earliest date on which
 a pharmacy may fill the prescription;
 (2)  information provided by the dispensing
 pharmacist, including the date the prescription is filled; and
 (3)  [for a written prescription, the signatures of the
 prescribing practitioner and the dispensing pharmacist or for an
 electronic prescription,] the prescribing practitioner's
 electronic signature or other secure method of validation
 authorized by federal law.
 (g)  Except for an emergency oral or telephonically
 communicated prescription described by [prescribed under] Section
 481.074(b-1) [481.074(b)], the prescribing practitioner shall:
 (1)  record [legibly fill in,] or direct a designated
 agent to record [legibly fill in, on the official prescription form
 or] in the electronic prescription[,] each item of information
 required to be provided by the prescribing practitioner under
 Subsection (e)(1), unless the practitioner determines that:
 (A)  under rule adopted by the board for this
 purpose, it is unnecessary for the practitioner or the
 practitioner's agent to provide the patient identification number;
 or
 (B)  it is not in the best interest of the patient
 for the practitioner or practitioner's agent to provide information
 regarding the intended use of the controlled substance or the
 diagnosis for which it is prescribed; and
 (2)  [sign the official prescription form and give the
 form to the person authorized to receive the prescription or, in the
 case of an electronic prescription,] electronically sign or
 validate the electronic prescription as authorized by federal law
 and transmit the prescription to the dispensing pharmacy.
 (h)  In the case of an emergency oral or telephonically
 communicated prescription described by [prescribed under] Section
 481.074(b-1) [481.074(b)], the prescribing practitioner shall give
 the dispensing pharmacy the information needed to complete the
 [official prescription form or] electronic prescription record.
 (i)  Each dispensing pharmacist shall:
 (1)  [fill in on the official prescription form or]
 note in the electronic prescription record each item of information
 given orally to the dispensing pharmacy under Subsection (h) and
 the date the prescription is filled[,] and[:
 [(A)     for a written prescription, fill in the
 dispensing pharmacist's signature; or
 [(B)  for an electronic prescription,]
 appropriately record the identity of the dispensing pharmacist in
 the electronic prescription record;
 (2)  retain with the records of the pharmacy for at
 least two years:
 (A)  [the official prescription form or] the
 electronic prescription record[, as applicable]; and
 (B)  the name or other patient identification
 required by Section 481.074(m) or (n); and
 (3)  send all required information, including any
 information required to complete an [official prescription form or]
 electronic prescription record, to the board by electronic transfer
 or another form approved by the board not later than the next
 business day after the date the prescription is completely filled.
 (j)  A medication order written for a patient who is admitted
 to a hospital at the time the medication order is written and filled
 is not required to be recorded [on an official prescription form or]
 in an electronic prescription record that meets the requirements of
 this section.
 SECTION 7.  Subchapter C, Chapter 481, Health and Safety
 Code, is amended by adding Sections 481.0755 and 481.0756 to read as
 follows:
 Sec. 481.0755.  WRITTEN, ORAL, AND TELEPHONICALLY
 COMMUNICATED PRESCRIPTIONS. (a) Notwithstanding Sections 481.074
 and 481.075, a prescription for a controlled substance is not
 required to be issued electronically and may be issued in writing if
 the prescription is issued:
 (1)  by a veterinarian;
 (2)  in circumstances in which electronic prescribing
 is not available due to temporary technological or electronic
 failure, as prescribed by board rule;
 (3)  by a practitioner to be dispensed by a pharmacy
 located outside this state, as prescribed by board rule;
 (4)  when the prescriber and dispenser are in the same
 location or under the same license;
 (5)  in circumstances in which necessary elements are
 not supported by the most recently implemented national data
 standard that facilitates electronic prescribing;
 (6)  for a drug for which the United States Food and
 Drug Administration requires additional information in the
 prescription that is not possible with electronic prescribing;
 (7)  for a non-patient-specific prescription pursuant
 to a standing order, approved protocol for drug therapy,
 collaborative drug management, or comprehensive medication
 management, in response to a public health emergency or in other
 circumstances in which the practitioner may issue a
 non-patient-specific prescription;
 (8)  for a drug under a research protocol;
 (9)  by a practitioner who has received a waiver under
 Section 481.0756 from the requirement to use electronic
 prescribing;
 (10)  under circumstances in which the practitioner has
 the present ability to submit an electronic prescription but
 reasonably determines that it would be impractical for the patient
 to obtain the drugs prescribed under the electronic prescription in
 a timely manner and that a delay would adversely impact the
 patient's medical condition; or
 (11)  before January 1, 2021.
 (b)  A dispensing pharmacist who receives a controlled
 substance prescription in a manner other than electronically is not
 required to verify that the prescription is exempt from the
 requirement that it be submitted electronically.  The pharmacist
 may dispense a controlled substance pursuant to an otherwise valid
 written, oral, or telephonically communicated prescription
 consistent with the requirements of this subchapter.
 (c)  Except in an emergency, a practitioner must use a
 written prescription to submit a prescription described by
 Subsection (a). In an emergency, the practitioner may submit an
 oral or telephonically communicated prescription as authorized
 under Section 481.074(b-1).
 (d)  A written prescription for a controlled substance other
 than a Schedule II controlled substance must include the
 information required under Section 481.074(k) and the signature of
 the prescribing practitioner.
 (e)  A written prescription for a Schedule II controlled
 substance must be on an official prescription form and include the
 information required for an electronic prescription under Section
 481.075(e), the signature of the practitioner, and the signature of
 the dispensing pharmacist after the prescription is filled.
 (f)  The board by rule shall authorize a practitioner to
 determine whether it is necessary to obtain a particular patient
 identification number and to provide that number on the official
 prescription form.
 (g)  On request of a practitioner, the board shall issue
 official prescription forms to the practitioner for a fee covering
 the actual cost of printing, processing, and mailing the forms.
 Before mailing or otherwise delivering prescription forms to a
 practitioner, the board shall print on each form the number of the
 form and any other information the board determines is necessary.
 (h)  Each official prescription form must be sequentially
 numbered.
 (i)  A person may not obtain an official prescription form
 unless the person is a practitioner as defined by Section
 481.002(39)(A) or an institutional practitioner.
 (j)  Not more than one Schedule II prescription may be
 recorded on an official prescription form.
 (k)  Not later than the 30th day after the date a
 practitioner's Federal Drug Enforcement Administration number or
 license to practice has been denied, suspended, canceled,
 surrendered, or revoked, the practitioner shall return to the board
 all official prescription forms in the practitioner's possession
 that have not been used for prescriptions.
 (l)  Each prescribing practitioner:
 (1)  may use an official prescription form only to
 submit a prescription described by Subsection (a);
 (2)  shall date or sign an official prescription form
 only on the date the prescription is issued; and
 (3)  shall take reasonable precautionary measures to
 ensure that an official prescription form issued to the
 practitioner is not used by another person to violate this
 subchapter or a rule adopted under this subchapter.
 (m)  In the case of an emergency oral or telephonically
 communicated prescription described by Section 481.074(b-1), the
 prescribing practitioner shall give the dispensing pharmacy the
 information needed to complete the official prescription form if
 the pharmacy is not required to use the electronic prescription
 record.
 (n)  Each dispensing pharmacist receiving an oral or
 telephonically communicated prescription under Subsection (m)
 shall:
 (1)  fill in on the official prescription form each
 item of information given orally to the dispensing pharmacy under
 Subsection (m) and the date the prescription is filled and fill in
 the dispensing pharmacist's signature;
 (2)  retain with the records of the pharmacy for at
 least two years:
 (A)  the official prescription form; and
 (B)  the name or other patient identification
 required by Section 481.074(m) or (n); and
 (3)  send all required information, including any
 information required to complete an official prescription form, to
 the board by electronic transfer or another form approved by the
 board not later than the next business day after the date the
 prescription is completely filled.
 Sec. 481.0756.  WAIVERS FROM ELECTRONIC PRESCRIBING. (a)
 The appropriate regulatory agency that issued the license,
 certification, or registration to a prescriber is authorized to
 grant a prescriber a waiver from the electronic prescribing
 requirement under the provisions of this section.
 (b)  The board shall convene an interagency workgroup that
 includes representatives of each regulatory agency that issues a
 license, certification, or registration to a prescriber.
 (c)  The work group described by Subsection (b) shall
 establish recommendations and standards for circumstances in which
 a waiver from the electronic prescribing requirement is appropriate
 and a process under which a prescriber may request and receive a
 waiver.
 (d)  The board shall adopt rules establishing the
 eligibility for a waiver, including:
 (1)  economic hardship;
 (2)  technological limitations not reasonably within
 the control of the prescriber; or
 (3)  other exceptional circumstances demonstrated by
 the prescriber.
 (e)  Each regulatory agency that issues a license,
 certification, or registration to a prescriber shall adopt rules
 for the granting of waivers consistent with the board rules adopted
 under Subsection (d).
 (f)  A waiver may be issued to a prescriber for a period of
 one year. On expiration of the waiver, the prescriber may reapply
 for a waiver if the circumstances that necessitated the waiver
 continue.
 SECTION 8.  Sections 481.0761(c) and (d), Health and Safety
 Code, are amended to read as follows:
 (c)  The board by rule may:
 (1)  [permit more than one prescription to be
 administered or dispensed and recorded on one prescription form for
 a Schedule III through V controlled substance;
 [(1-a)]  establish a procedure for the issuance of
 multiple prescriptions of a Schedule II controlled substance under
 Section 481.074(d-1);
 (2)  remove from or return to the official prescription
 program any aspect of a practitioner's or pharmacist's hospital
 practice, including administering or dispensing;
 (3)  waive or delay any requirement relating to the
 time or manner of reporting;
 (4)  establish compatibility protocols for electronic
 data transfer hardware, software, or format, including any
 necessary modifications for participation in a database described
 by Section 481.076(j);
 (5)  establish a procedure to control the release of
 information under Sections 481.074, 481.075, and 481.076; and
 (6)  establish a minimum level of prescription activity
 below which a reporting activity may be modified or deleted.
 (d)  The board by rule shall authorize a practitioner to
 determine whether it is necessary to obtain a particular patient
 identification number and to provide that number [on the official
 prescription form or] in the electronic prescription record.
 SECTION 9.  Subchapter C, Chapter 481, Health and Safety
 Code, is amended by adding Sections 481.07635 and 481.07636 to read
 as follows:
 Sec. 481.07635.  CONTINUING EDUCATION. (a)  A person
 authorized to receive information under Section 481.076(a)(5)
 shall, not later than the first anniversary after the person is
 issued a license, certification, or registration to prescribe or
 dispense controlled substances under this chapter, complete two
 hours of professional education related to approved procedures of
 prescribing and monitoring controlled substances.
 (b)  A person authorized to receive information may annually
 take the professional education course under this section to fulfil
 hours toward the ethics education requirement of the person's
 license, certification, or registration.
 (c)  The regulatory agency that issued the license,
 certification, or registration to a person authorized to receive
 information under Section 481.076(a)(5) shall approve professional
 education to satisfy the requirements of this section.
 Sec. 481.07636.  OPIOID PRESCRIPTION LIMITS. (a)  In this
 section, "acute pain" means pain with abrupt onset that is caused by
 an injury or other process that is not ongoing. The term does not
 include:
 (1)  chronic pain;
 (2)  pain being treated as part of cancer care;
 (3)  pain being treated as part of hospice or other
 end-of-life care; or
 (4)  pain being treated as part of palliative care.
 (b)  For the initial treatment of acute pain, a practitioner
 may not:
 (1)  issue a prescription for an opioid in an amount
 that exceeds a seven-day supply; or
 (2)  provide for a refill of an opioid.
 (c)  Subsection (b) does not apply to a prescription for an
 opioid approved by the United States Food and Drug Administration
 for the treatment of substance addiction that is issued by a
 practitioner for the treatment of substance addiction.
 (d)  A dispenser is not subject to criminal, civil, or
 administrative penalties for dispensing or refusing to dispense a
 controlled substance under a prescription that exceeds the limits
 provided by Subsection (b).
 SECTION 10.  Section 481.128(a), Health and Safety Code, is
 amended to read as follows:
 (a)  A registrant or dispenser commits an offense if the
 registrant or dispenser knowingly:
 (1)  distributes, delivers, administers, or dispenses
 a controlled substance in violation of Subchapter C [Sections
 481.070-481.075];
 (2)  manufactures a controlled substance not
 authorized by the person's Federal Drug Enforcement Administration
 registration or distributes or dispenses a controlled substance not
 authorized by the person's registration to another registrant or
 other person;
 (3)  refuses or fails to make, keep, or furnish a
 record, report, notification, order form, statement, invoice, or
 information required by this chapter;
 (4)  prints, manufactures, possesses, or produces an
 official prescription form without the approval of the board;
 (5)  delivers or possesses a counterfeit official
 prescription form;
 (6)  refuses an entry into a premise for an inspection
 authorized by this chapter;
 (7)  refuses or fails to return an official
 prescription form as required by Section 481.0755(k) [481.075(k)];
 (8)  refuses or fails to make, keep, or furnish a
 record, report, notification, order form, statement, invoice, or
 information required by a rule adopted by the director or the board;
 or
 (9)  refuses or fails to maintain security required by
 this chapter or a rule adopted under this chapter.
 SECTION 11.  Section 481.129(a), Health and Safety Code, is
 amended to read as follows:
 (a)  A person commits an offense if the person knowingly:
 (1)  distributes as a registrant or dispenser a
 controlled substance listed in Schedule I or II, unless the person
 distributes the controlled substance as authorized under the
 federal Controlled Substances Act (21 U.S.C. Section 801 et seq.);
 (2)  uses in the course of manufacturing, prescribing,
 or distributing a controlled substance a Federal Drug Enforcement
 Administration registration number that is fictitious, revoked,
 suspended, or issued to another person;
 (3)  issues a prescription bearing a forged or
 fictitious signature;
 (4)  uses a prescription issued to another person to
 prescribe a Schedule II controlled substance;
 (5)  possesses, obtains, or attempts to possess or
 obtain a controlled substance or an increased quantity of a
 controlled substance:
 (A)  by misrepresentation, fraud, forgery,
 deception, or subterfuge;
 (B)  through use of a fraudulent prescription
 form; [or]
 (C)  through use of a fraudulent oral or
 telephonically communicated prescription; or
 (D)  through the use of a fraudulent electronic
 prescription; or
 (6)  furnishes false or fraudulent material
 information in or omits material information from an application,
 report, record, or other document required to be kept or filed under
 this chapter.
 SECTION 12.  Section 32.024, Human Resources Code, is
 amended by adding Subsection (z-2) to read as follows:
 (z-2)  The limits on prescription drugs and medications
 under the medical assistance program provided by Subsections (z)
 and (z-1) do not apply to a prescription for an opioid for the
 initial treatment of acute pain under Section 481.07636, Health and
 Safety Code.
 SECTION 13.  Section 554.051(a-1), Occupations Code, is
 amended to read as follows:
 (a-1)  The board may adopt rules to administer Sections
 [481.073,] 481.074, 481.075, 481.0755, 481.0756, 481.076,
 481.0761, 481.0762, 481.0763, 481.07635, 481.07636, 481.0764,
 481.0765, and 481.0766, Health and Safety Code.
 SECTION 14.  Section 565.003, Occupations Code, is amended
 to read as follows:
 Sec. 565.003.  ADDITIONAL GROUNDS FOR DISCIPLINE REGARDING
 APPLICANT FOR OR HOLDER OF NONRESIDENT PHARMACY LICENSE. Unless
 compliance would violate the pharmacy or drug statutes or rules in
 the state in which the pharmacy is located, the board may discipline
 an applicant for or the holder of a nonresident pharmacy license if
 the board finds that the applicant or license holder has failed to
 comply with:
 (1)  Section 481.074, [or] 481.075, 481.0755,
 481.0756, 481.076, 481.0761, 481.0762, 481.0763, 481.07635,
 481.07636, 481.0764, 481.0765, or 481.0766, Health and Safety Code;
 (2)  Texas substitution requirements regarding:
 (A)  the practitioner's directions concerning
 generic substitution;
 (B)  the patient's right to refuse generic
 substitution; or
 (C)  notification to the patient of the patient's
 right to refuse substitution;
 (3)  any board rule relating to providing drug
 information to the patient or the patient's agent in written form or
 by telephone; or
 (4)  any board rule adopted under Section 554.051(a)
 and determined by the board to be applicable under Section
 554.051(b).
 SECTION 15.  Sections 481.073, 481.074(o) and (p), and
 481.075(b), (c), (d), (f), (k), and (l), Health and Safety Code, are
 repealed.
 SECTION 16.  A person who holds a license, certification, or
 registration to prescribe or dispense a controlled substance issued
 before September 1, 2020, is required to take the continuing
 education course provided by Section 481.07635, Health and Safety
 Code, as added by this Act, not later than September 1, 2021.
 SECTION 17.  This Act takes effect September 1, 2019.