88R2260 BEE-F
By: Oliverson, et al. H.B. No. 1240
A BILL TO BE ENTITLED
AN ACT
relating to the authority of a physician to provide and dispense and
to delegate authority to provide and dispense certain drugs.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 151.002, Occupations Code, is amended by
adding Subdivisions (3-a) and (13-a) to read as follows:
(3-a) "Dispense" has the meaning assigned by Section
551.003.
(13-a) "Provision" means the supply of one or more
unit doses of a drug, medicine, or dangerous drug.
SECTION 2. The heading to Section 157.002, Occupations
Code, is amended to read as follows:
Sec. 157.002. GENERAL DELEGATION OF ADMINISTRATION, [AND]
PROVISION, AND DISPENSING OF DANGEROUS DRUGS.
SECTION 3. Sections 157.002(a), (b), (e), and (g),
Occupations Code, are amended to read as follows:
(a) In this section, "administering" [:
[(1) "Administering"] means the direct application of
a drug to the body of a patient by injection, inhalation, ingestion,
or any other means.
[(2) "Provision" means the supply of one or more unit
doses of a drug, medicine, or dangerous drug.]
(b) A physician may delegate to any qualified and properly
trained person acting under the physician's supervision the act of
administering [or providing] dangerous drugs in the physician's
office, as ordered by the physician, that are used or required to
meet the immediate needs of the physician's patients or the act of
providing or dispensing dangerous drugs as ordered by the physician
to the physician's patients. The administration, [or] provision,
or dispensing of the dangerous drugs must be performed in
compliance with laws relating to the practice of medicine and state
and federal laws relating to those dangerous drugs.
(e) The administration, [or] provision, or dispensing of
the drugs may be delegated through a physician's order, a standing
medical order, a standing delegation order, or another order
defined by the board.
(g) A drug or medicine provided or dispensed under
Subsection (b) or (c) must be supplied in a suitable container
labeled in compliance with applicable drug laws. A qualified and
trained person, acting under the supervision of a physician, may
specify at the time of the provision or dispensing of the drug the
inclusion on the container of the date of the provision or
dispensing and the patient's name and address.
SECTION 4. The heading to Chapter 158, Occupations Code, is
amended to read as follows:
CHAPTER 158. AUTHORITY OF PHYSICIAN TO PROVIDE OR DISPENSE CERTAIN
DRUGS AND SUPPLIES
SECTION 5. Sections 158.001(a) and (c), Occupations Code,
are amended to read as follows:
(a) A physician licensed under this subtitle may provide
[supply] a patient with any drug, remedy, or clinical supply
necessary to meet the patient's immediate needs.
(c) This chapter does not prohibit a physician from
providing [supplying] to a patient, free of charge, a drug provided
to the physician by a drug manufacturer for an indigent
pharmaceutical program if, in the physician's opinion, it is
advantageous to the patient, in adhering to a course of treatment
prescribed by the physician, to receive the drug.
SECTION 6. Section 158.002(a), Occupations Code, is amended
to read as follows:
(a) This chapter does not prohibit a physician from
providing [supplying] a pharmaceutical sample to a patient free of
charge if, in the physician's opinion, it is advantageous to the
patient, in adhering to a course of treatment prescribed by the
physician, to receive the sample.
SECTION 7. The heading to Section 158.003, Occupations
Code, is amended to read as follows:
Sec. 158.003. DISPENSING OF DANGEROUS DRUGS TO CERTAIN
PATIENTS IN CERTAIN RURAL AREAS.
SECTION 8. Section 158.003, Occupations Code, is amended by
adding Subsection (a-1) to read as follows:
(a-1) This section applies only to a physician providing
care under workers' compensation insurance coverage, as defined by
Section 401.011, Labor Code.
SECTION 9. Chapter 158, Occupations Code, is amended by
adding Section 158.004 to read as follows:
Sec. 158.004. PROVISION AND DISPENSING OF DANGEROUS DRUGS.
(a) In this section, "reimbursement for cost" means an additional
charge, separate from that imposed for the physician's professional
services, that includes the cost of a drug product and all other
actual costs to the physician incidental to providing dispensing
service. The term does not include a separate fee imposed for the
act of dispensing a drug itself.
(b) This section does not apply to a physician providing
care under workers' compensation insurance coverage, as defined by
Section 401.011, Labor Code.
(c) A physician may:
(1) provide or dispense dangerous drugs to the
physician's patients; and
(2) be reimbursed for the cost of providing or
dispensing those drugs without obtaining a license under Chapter
558.
(d) A physician may not provide or dispense under this
section a controlled substance listed in Schedules II through V as
established under Subchapter B, Chapter 481, Health and Safety
Code.
(e) A physician who provides or dispenses dangerous drugs
under this section shall oversee compliance with the laws of this
state and federal law relating to those dangerous drugs.
(f) Before providing or dispensing dangerous drugs under
this section, a physician must notify the patient that the
prescription for the dangerous drug may be filled at a pharmacy.
With respect to dangerous drugs provided or dispensed in a
physician's office, the notification requirement of this
subsection may be satisfied by a written notice placed
conspicuously in the office.
(g) Not later than the 30th day after the date a physician
first provides or dispenses dangerous drugs under this section, the
physician shall notify the Texas State Board of Pharmacy and the
board that the physician is providing or dispensing dangerous drugs
under this section. The Texas State Board of Pharmacy and the board
shall jointly adopt a form by which a physician may provide
notification as required by this subsection.
(h) A physician who notifies the board under Subsection (g)
that the physician is providing or dispensing dangerous drugs under
this section and who intends to continue to provide or dispense
dangerous drugs under this section shall include notice of that
intent in any subsequent registration permit renewal application
submitted to the board. The board by rule shall prescribe the form
of a registration permit renewal application in accordance with
this subsection.
SECTION 10. Section 551.003(31), Occupations Code, is
amended to read as follows:
(31) "Pharmacy" means a facility at which a
prescription drug or medication order is received, processed, or
dispensed under this subtitle, Chapter 481 or 483, Health and
Safety Code, or the Comprehensive Drug Abuse Prevention and Control
Act of 1970 (21 U.S.C. Section 801 et seq.). The term does not
include:
(A) a narcotic drug treatment program that is
regulated under Chapter 466, Health and Safety Code; or
(B) a location where:
(i) a physician provides or dispenses a
dangerous drug under Section 158.003 or 158.004; or
(ii) a person provides or dispenses a
dangerous drug under a physician's supervision in accordance with
Section 157.002(b).
SECTION 11. Section 551.004, Occupations Code, is amended
by adding Subsection (a-1) and amending Subsection (b) to read as
follows:
(a-1) For purposes of Subsection (a)(1), "retailing of
prescription drugs" does not include the collection of a
reimbursement for cost, as defined by Section 158.003(a) or
158.004(a).
(b) This subtitle does not prevent:
(1) a practitioner from:
(A) administering a drug to a patient of the
practitioner; or
(B) providing or dispensing dangerous drugs
under Section 158.003 or 158.004; or
(2) a person from providing or dispensing a dangerous
drug under a physician's supervision in accordance with Section
157.002(b).
SECTION 12. Section 558.001, Occupations Code, is amended
by amending Subsection (c) and adding Subsection (d) to read as
follows:
(c) Except as provided by Subsection (d), a [A] person may
not dispense or distribute prescription drugs unless the person:
(1) is a pharmacist; or
(2) is otherwise authorized by this subtitle to
dispense or distribute prescription drugs.
(d) A physician or person acting under the physician's
supervision may provide or dispense dangerous drugs in accordance
with Section 157.002(b), 158.003, or 158.004.
SECTION 13. The heading to Chapter 563, Occupations Code,
is amended to read as follows:
CHAPTER 563. [PRESCRIPTION REQUIREMENTS;] DELEGATION OF
ADMINISTRATION, [AND] PROVISION, AND DISPENSING OF DANGEROUS DRUGS
SECTION 14. Sections 563.051(a) and (c), Occupations Code,
are amended to read as follows:
(a) A physician may delegate to any qualified and properly
trained person acting under the physician's supervision the act of
administering [or providing] dangerous drugs in the physician's
office, as ordered by the physician, that are used or required to
meet the immediate needs of the physician's patients or the act of
providing or dispensing dangerous drugs, as ordered by the
physician, to the physician's patients. The administration, [or]
provision, or dispensing of the dangerous drugs must be performed
in compliance with laws relating to the practice of medicine and
state and federal laws relating to those dangerous drugs.
(c) The administration, [or] provision, or dispensing of
the drugs may be delegated through a physician's order, a standing
medical order, a standing delegation order, or another order
defined by the Texas Medical [State] Board [of Medical Examiners].
SECTION 15. Section 563.052, Occupations Code, is amended
to read as follows:
Sec. 563.052. SUITABLE CONTAINER REQUIRED. A drug or
medicine provided or dispensed under this subchapter must be
provided or dispensed [supplied] in a suitable container labeled in
compliance with applicable drug laws. A qualified and trained
person, acting under the supervision of a physician, may specify at
the time of the provision or dispensing of the drug the inclusion on
the container of the date of the provision or dispensing and the
patient's name and address.
SECTION 16. The heading to Section 563.053, Occupations
Code, is amended to read as follows:
Sec. 563.053. DISPENSING OF DANGEROUS DRUGS TO CERTAIN
PATIENTS IN CERTAIN RURAL AREAS.
SECTION 17. Section 563.053, Occupations Code, is amended
by adding Subsection (a-1) to read as follows:
(a-1) This section applies only to a physician providing
care under workers' compensation insurance coverage, as defined by
Section 401.011, Labor Code.
SECTION 18. The heading to Subchapter B, Chapter 563,
Occupations Code, is repealed.
SECTION 19. This Act takes effect September 1, 2023.