| 1 | 1 | | 86R3016 KKR-D |
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| 2 | 2 | | By: Buckingham S.B. No. 1666 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to the provision of pharmacy services through a |
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| 8 | 8 | | telepharmacy system. |
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| 9 | 9 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 10 | 10 | | SECTION 1. Section 562.110(e), Occupations Code, is amended |
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| 11 | 11 | | to read as follows: |
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| 12 | 12 | | (e) The board shall adopt rules regarding the use of a |
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| 13 | 13 | | telepharmacy system under this section, including: |
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| 14 | 14 | | (1) the types of health care facilities at which a |
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| 15 | 15 | | telepharmacy system may be located under Subsection (d)(1), which |
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| 16 | 16 | | must include the following facilities: |
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| 17 | 17 | | (A) a clinic designated as a rural health clinic |
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| 18 | 18 | | regulated under 42 U.S.C. Section 1395x(aa); [and] |
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| 19 | 19 | | (B) a health center as defined by 42 U.S.C. |
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| 20 | 20 | | Section 254b; |
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| 21 | 21 | | (C) a federally qualified health center as |
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| 22 | 22 | | defined by 42 U.S.C. Section 1396d(l)(2)(B); |
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| 23 | 23 | | (D) an ambulatory surgical center; |
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| 24 | 24 | | (E) a birthing center; |
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| 25 | 25 | | (F) a community health center; |
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| 26 | 26 | | (G) a hospital; |
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| 27 | 27 | | (H) an outpatient clinic; and |
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| 28 | 28 | | (I) a public health clinic; |
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| 29 | 29 | | (2) the locations eligible to be licensed as remote |
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| 30 | 30 | | dispensing sites, which must include locations in medically |
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| 31 | 31 | | underserved areas, areas with a medically underserved population, |
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| 32 | 32 | | and health professional shortage areas determined by the United |
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| 33 | 33 | | States Department of Health and Human Services; |
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| 34 | 34 | | (3) licensing and operating requirements for remote |
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| 35 | 35 | | dispensing sites, including: |
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| 36 | 36 | | (A) a requirement that a remote dispensing site |
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| 37 | 37 | | license identify the provider pharmacy that will provide pharmacy |
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| 38 | 38 | | services at the remote dispensing site; |
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| 39 | 39 | | (B) a requirement that a provider pharmacy be |
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| 40 | 40 | | allowed to provide pharmacy services at not more than two remote |
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| 41 | 41 | | dispensing sites; |
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| 42 | 42 | | (C) a requirement that a pharmacist employed by a |
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| 43 | 43 | | provider pharmacy make at least monthly on-site visits to a remote |
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| 44 | 44 | | dispensing site or more frequent visits if specified by board rule; |
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| 45 | 45 | | (D) a requirement that each month the perpetual |
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| 46 | 46 | | inventory of controlled substances at the remote dispensing site be |
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| 47 | 47 | | reconciled to the on-hand count of those controlled substances at |
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| 48 | 48 | | the site by a pharmacist employed by the provider pharmacy; |
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| 49 | 49 | | (E) a requirement that a pharmacist employed by a |
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| 50 | 50 | | provider pharmacy be physically present at a remote dispensing site |
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| 51 | 51 | | when the pharmacist is providing services requiring the physical |
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| 52 | 52 | | presence of the pharmacist, including immunizations; |
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| 53 | 53 | | (F) a requirement that a remote dispensing site |
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| 54 | 54 | | be staffed by an on-site pharmacy technician who is under the |
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| 55 | 55 | | continuous supervision of a pharmacist employed by the provider |
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| 56 | 56 | | pharmacy; |
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| 57 | 57 | | (G) a requirement that all pharmacy technicians |
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| 58 | 58 | | at a remote dispensing site be counted for the purpose of |
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| 59 | 59 | | establishing the pharmacist-pharmacy technician ratio of the |
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| 60 | 60 | | provider pharmacy, which, notwithstanding Section 568.006, may not |
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| 61 | 61 | | exceed three pharmacy technicians for each pharmacist providing |
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| 62 | 62 | | supervision; |
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| 63 | 63 | | (H) a requirement that, before working at a |
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| 64 | 64 | | remote dispensing site, a pharmacy technician must: |
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| 65 | 65 | | (i) have worked at least one year at a |
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| 66 | 66 | | retail pharmacy during the three years preceding the date the |
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| 67 | 67 | | pharmacy technician begins working at the remote dispensing site; |
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| 68 | 68 | | and |
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| 69 | 69 | | (ii) have completed a board-approved |
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| 70 | 70 | | training program on the proper use of a telepharmacy system; |
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| 71 | 71 | | (I) a requirement that pharmacy technicians at a |
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| 72 | 72 | | remote dispensing site may not perform extemporaneous sterile or |
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| 73 | 73 | | nonsterile compounding but may prepare commercially available |
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| 74 | 74 | | medications for dispensing, including the reconstitution of orally |
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| 75 | 75 | | administered powder antibiotics; and |
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| 76 | 76 | | (J) any additional training or practice |
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| 77 | 77 | | experience requirements for pharmacy technicians at a remote |
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| 78 | 78 | | dispensing site; |
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| 79 | 79 | | (4) the areas that qualify under Subsection (f); |
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| 80 | 80 | | (5) recordkeeping requirements; and |
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| 81 | 81 | | (6) security requirements. |
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| 82 | 82 | | SECTION 2. Sections 562.110(g), (h), and (i) Occupations |
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| 83 | 83 | | Code, as added by Chapter 485 (H.B. 2561), Acts of the 85th |
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| 84 | 84 | | Legislature, Regular Session, 2017, are repealed. |
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| 85 | 85 | | SECTION 3. This Act takes effect September 1, 2019. |
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