Texas 2023 - 88th Regular

Texas House Bill HB1240 Compare Versions

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1	1	88R2260 BEE-F
2	2	By: Oliverson, et al. H.B. No. 1240
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the authority of a physician to provide and dispense and
8	8	to delegate authority to provide and dispense certain drugs.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 151.002, Occupations Code, is amended by
11	11	adding Subdivisions (3-a) and (13-a) to read as follows:
12	12	(3-a) "Dispense" has the meaning assigned by Section
13	13	551.003.
14	14	(13-a) "Provision" means the supply of one or more
15	15	unit doses of a drug, medicine, or dangerous drug.
16	16	SECTION 2. The heading to Section 157.002, Occupations
17	17	Code, is amended to read as follows:
18	18	Sec. 157.002. GENERAL DELEGATION OF ADMINISTRATION, [AND]
19	19	PROVISION, AND DISPENSING OF DANGEROUS DRUGS.
20	20	SECTION 3. Sections 157.002(a), (b), (e), and (g),
21	21	Occupations Code, are amended to read as follows:
22	22	(a) In this section, "administering" [:
23	23	[(1) "Administering"] means the direct application of
24	24	a drug to the body of a patient by injection, inhalation, ingestion,
25	25	or any other means.
26	26	[(2) "Provision" means the supply of one or more unit
27	27	doses of a drug, medicine, or dangerous drug.]
28	28	(b) A physician may delegate to any qualified and properly
29	29	trained person acting under the physician's supervision the act of
30	30	administering [or providing] dangerous drugs in the physician's
31	31	office, as ordered by the physician, that are used or required to
32	32	meet the immediate needs of the physician's patients or the act of
33	33	providing or dispensing dangerous drugs as ordered by the physician
34	34	to the physician's patients. The administration, [or] provision,
35	35	or dispensing of the dangerous drugs must be performed in
36	36	compliance with laws relating to the practice of medicine and state
37	37	and federal laws relating to those dangerous drugs.
38	38	(e) The administration, [or] provision, or dispensing of
39	39	the drugs may be delegated through a physician's order, a standing
40	40	medical order, a standing delegation order, or another order
41	41	defined by the board.
42	42	(g) A drug or medicine provided or dispensed under
43	43	Subsection (b) or (c) must be supplied in a suitable container
44	44	labeled in compliance with applicable drug laws. A qualified and
45	45	trained person, acting under the supervision of a physician, may
46	46	specify at the time of the provision or dispensing of the drug the
47	47	inclusion on the container of the date of the provision or
48	48	dispensing and the patient's name and address.
49	49	SECTION 4. The heading to Chapter 158, Occupations Code, is
50	50	amended to read as follows:
51	51	CHAPTER 158. AUTHORITY OF PHYSICIAN TO PROVIDE OR DISPENSE CERTAIN
52	52	DRUGS AND SUPPLIES
53	53	SECTION 5. Sections 158.001(a) and (c), Occupations Code,
54	54	are amended to read as follows:
55	55	(a) A physician licensed under this subtitle may provide
56	56	[supply] a patient with any drug, remedy, or clinical supply
57	57	necessary to meet the patient's immediate needs.
58	58	(c) This chapter does not prohibit a physician from
59	59	providing [supplying] to a patient, free of charge, a drug provided
60	60	to the physician by a drug manufacturer for an indigent
61	61	pharmaceutical program if, in the physician's opinion, it is
62	62	advantageous to the patient, in adhering to a course of treatment
63	63	prescribed by the physician, to receive the drug.
64	64	SECTION 6. Section 158.002(a), Occupations Code, is amended
65	65	to read as follows:
66	66	(a) This chapter does not prohibit a physician from
67	67	providing [supplying] a pharmaceutical sample to a patient free of
68	68	charge if, in the physician's opinion, it is advantageous to the
69	69	patient, in adhering to a course of treatment prescribed by the
70	70	physician, to receive the sample.
71	71	SECTION 7. The heading to Section 158.003, Occupations
72	72	Code, is amended to read as follows:
73	73	Sec. 158.003. DISPENSING OF DANGEROUS DRUGS TO CERTAIN
74	74	PATIENTS IN CERTAIN RURAL AREAS.
75	75	SECTION 8. Section 158.003, Occupations Code, is amended by
76	76	adding Subsection (a-1) to read as follows:
77	77	(a-1) This section applies only to a physician providing
78	78	care under workers' compensation insurance coverage, as defined by
79	79	Section 401.011, Labor Code.
80	80	SECTION 9. Chapter 158, Occupations Code, is amended by
81	81	adding Section 158.004 to read as follows:
82	82	Sec. 158.004. PROVISION AND DISPENSING OF DANGEROUS DRUGS.
83	83	(a) In this section, "reimbursement for cost" means an additional
84	84	charge, separate from that imposed for the physician's professional
85	85	services, that includes the cost of a drug product and all other
86	86	actual costs to the physician incidental to providing dispensing
87	87	service. The term does not include a separate fee imposed for the
88	88	act of dispensing a drug itself.
89	89	(b) This section does not apply to a physician providing
90	90	care under workers' compensation insurance coverage, as defined by
91	91	Section 401.011, Labor Code.
92	92	(c) A physician may:
93	93	(1) provide or dispense dangerous drugs to the
94	94	physician's patients; and
95	95	(2) be reimbursed for the cost of providing or
96	96	dispensing those drugs without obtaining a license under Chapter
97	97	558.
98	98	(d) A physician may not provide or dispense under this
99	99	section a controlled substance listed in Schedules II through V as
100	100	established under Subchapter B, Chapter 481, Health and Safety
101	101	Code.
102	102	(e) A physician who provides or dispenses dangerous drugs
103	103	under this section shall oversee compliance with the laws of this
104	104	state and federal law relating to those dangerous drugs.
105	105	(f) Before providing or dispensing dangerous drugs under
106	106	this section, a physician must notify the patient that the
107	107	prescription for the dangerous drug may be filled at a pharmacy.
108	108	With respect to dangerous drugs provided or dispensed in a
109	109	physician's office, the notification requirement of this
110	110	subsection may be satisfied by a written notice placed
111	111	conspicuously in the office.
112	112	(g) Not later than the 30th day after the date a physician
113	113	first provides or dispenses dangerous drugs under this section, the
114	114	physician shall notify the Texas State Board of Pharmacy and the
115	115	board that the physician is providing or dispensing dangerous drugs
116	116	under this section. The Texas State Board of Pharmacy and the board
117	117	shall jointly adopt a form by which a physician may provide
118	118	notification as required by this subsection.
119	119	(h) A physician who notifies the board under Subsection (g)
120	120	that the physician is providing or dispensing dangerous drugs under
121	121	this section and who intends to continue to provide or dispense
122	122	dangerous drugs under this section shall include notice of that
123	123	intent in any subsequent registration permit renewal application
124	124	submitted to the board. The board by rule shall prescribe the form
125	125	of a registration permit renewal application in accordance with
126	126	this subsection.
127	127	SECTION 10. Section 551.003(31), Occupations Code, is
128	128	amended to read as follows:
129	129	(31) "Pharmacy" means a facility at which a
130	130	prescription drug or medication order is received, processed, or
131	131	dispensed under this subtitle, Chapter 481 or 483, Health and
132	132	Safety Code, or the Comprehensive Drug Abuse Prevention and Control
133	133	Act of 1970 (21 U.S.C. Section 801 et seq.). The term does not
134	134	include:
135	135	(A) a narcotic drug treatment program that is
136	136	regulated under Chapter 466, Health and Safety Code; or
137	137	(B) a location where:
138	138	(i) a physician provides or dispenses a
139	139	dangerous drug under Section 158.003 or 158.004; or
140	140	(ii) a person provides or dispenses a
141	141	dangerous drug under a physician's supervision in accordance with
142	142	Section 157.002(b).
143	143	SECTION 11. Section 551.004, Occupations Code, is amended
144	144	by adding Subsection (a-1) and amending Subsection (b) to read as
145	145	follows:
146	146	(a-1) For purposes of Subsection (a)(1), "retailing of
147	147	prescription drugs" does not include the collection of a
148	148	reimbursement for cost, as defined by Section 158.003(a) or
149	149	158.004(a).
150	150	(b) This subtitle does not prevent:
151	151	(1) a practitioner from:
152	152	(A) administering a drug to a patient of the
153	153	practitioner; or
154	154	(B) providing or dispensing dangerous drugs
155	155	under Section 158.003 or 158.004; or
156	156	(2) a person from providing or dispensing a dangerous
157	157	drug under a physician's supervision in accordance with Section
158	158	157.002(b).
159	159	SECTION 12. Section 558.001, Occupations Code, is amended
160	160	by amending Subsection (c) and adding Subsection (d) to read as
161	161	follows:
162	162	(c) Except as provided by Subsection (d), a [A] person may
163	163	not dispense or distribute prescription drugs unless the person:
164	164	(1) is a pharmacist; or
165	165	(2) is otherwise authorized by this subtitle to
166	166	dispense or distribute prescription drugs.
167	167	(d) A physician or person acting under the physician's
168	168	supervision may provide or dispense dangerous drugs in accordance
169	169	with Section 157.002(b), 158.003, or 158.004.
170	170	SECTION 13. The heading to Chapter 563, Occupations Code,
171	171	is amended to read as follows:
172	172	CHAPTER 563. [PRESCRIPTION REQUIREMENTS;] DELEGATION OF
173	173	ADMINISTRATION, [AND] PROVISION, AND DISPENSING OF DANGEROUS DRUGS
174	174	SECTION 14. Sections 563.051(a) and (c), Occupations Code,
175	175	are amended to read as follows:
176	176	(a) A physician may delegate to any qualified and properly
177	177	trained person acting under the physician's supervision the act of
178	178	administering [or providing] dangerous drugs in the physician's
179	179	office, as ordered by the physician, that are used or required to
180	180	meet the immediate needs of the physician's patients or the act of
181	181	providing or dispensing dangerous drugs, as ordered by the
182	182	physician, to the physician's patients. The administration, [or]
183	183	provision, or dispensing of the dangerous drugs must be performed
184	184	in compliance with laws relating to the practice of medicine and
185	185	state and federal laws relating to those dangerous drugs.
186	186	(c) The administration, [or] provision, or dispensing of
187	187	the drugs may be delegated through a physician's order, a standing
188	188	medical order, a standing delegation order, or another order
189	189	defined by the Texas Medical [State] Board [of Medical Examiners].
190	190	SECTION 15. Section 563.052, Occupations Code, is amended
191	191	to read as follows:
192	192	Sec. 563.052. SUITABLE CONTAINER REQUIRED. A drug or
193	193	medicine provided or dispensed under this subchapter must be
194	194	provided or dispensed [supplied] in a suitable container labeled in
195	195	compliance with applicable drug laws. A qualified and trained
196	196	person, acting under the supervision of a physician, may specify at
197	197	the time of the provision or dispensing of the drug the inclusion on
198	198	the container of the date of the provision or dispensing and the
199	199	patient's name and address.
200	200	SECTION 16. The heading to Section 563.053, Occupations
201	201	Code, is amended to read as follows:
202	202	Sec. 563.053. DISPENSING OF DANGEROUS DRUGS TO CERTAIN
203	203	PATIENTS IN CERTAIN RURAL AREAS.
204	204	SECTION 17. Section 563.053, Occupations Code, is amended
205	205	by adding Subsection (a-1) to read as follows:
206	206	(a-1) This section applies only to a physician providing
207	207	care under workers' compensation insurance coverage, as defined by
208	208	Section 401.011, Labor Code.
209	209	SECTION 18. The heading to Subchapter B, Chapter 563,
210	210	Occupations Code, is repealed.
211	211	SECTION 19. This Act takes effect September 1, 2023.