Texas 2023 - 88th Regular

Texas House Bill HB2078 Compare Versions

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1	1	By: Jetton H.B. No. 2078
2	2
3	3
4	4	A BILL TO BE ENTITLED
5	5	AN ACT
6	6	relating to the authority of a physician to provide and dispense and
7	7	to delegate authority to provide and dispense certain drugs.
8	8	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	9	SECTION 1. Section 151.002, Occupations Code, is amended by
10	10	adding Subdivisions (3-a) and (13-a) to read as follows:
11	11	(3-a) "Dispense" has the meaning assigned by Section
12	12	551.003.
13	13	(13-a) "Provision" means the supply of one or more
14	14	unit doses of a drug, medicine, or dangerous drug.
15	15	SECTION 2. The heading to Section 157.002, Occupations
16	16	Code, is amended to read as follows:
17	17	Sec. 157.002. GENERAL DELEGATION OF ADMINISTRATION, [AND]
18	18	PROVISION, AND DISPENSING OF DANGEROUS DRUGS.
19	19	SECTION 3. Sections 157.002(a), (b), (e), and (g),
20	20	Occupations Code, are amended to read as follows:
21	21	(a) In this section, "administering" [:
22	22	[(1) "Administering"] means the direct application of
23	23	a drug to the body of a patient by injection, inhalation, ingestion,
24	24	or any other means.
25	25	[(2) "Provision" means the supply of one or more unit
26	26	doses of a drug, medicine, or dangerous drug.]
27	27	(b) A physician may delegate to any qualified and properly
28	28	trained person acting under the physician's supervision the act of
29	29	administering [or providing] dangerous drugs in the physician's
30	30	office, as ordered by the physician, that are used or required to
31	31	meet the immediate needs of the physician's patients or the act of
32	32	providing or dispensing dangerous drugs as ordered by the physician
33	33	to the physician's patients. The administration, [or] provision,
34	34	or dispensing of the dangerous drugs must be performed in
35	35	compliance with laws relating to the practice of medicine and state
36	36	and federal laws relating to those dangerous drugs.
37	37	(e) The administration, [or] provision, or dispensing of
38	38	the drugs may be delegated through a physician's order, a standing
39	39	medical order, a standing delegation order, or another order
40	40	defined by the board.
41	41	(g) A drug or medicine provided or dispensed under
42	42	Subsection (b) or (c) must be supplied in a suitable container
43	43	labeled in compliance with applicable drug laws. A qualified and
44	44	trained person, acting under the supervision of a physician, may
45	45	specify at the time of the provision or dispensing of the drug the
46	46	inclusion on the container of the date of the provision or
47	47	dispensing and the patient's name and address.
48	48	SECTION 4. The heading to Chapter 158, Occupations Code, is
49	49	amended to read as follows:
50	50	CHAPTER 158. AUTHORITY OF PHYSICIAN TO PROVIDE OR DISPENSE CERTAIN
51	51	DRUGS AND SUPPLIES
52	52	SECTION 5. Sections 158.001(a) and (c), Occupations Code,
53	53	are amended to read as follows:
54	54	(a) A physician licensed under this subtitle may provide
55	55	[supply] a patient with any drug, remedy, or clinical supply
56	56	necessary to meet the patient's immediate needs.
57	57	(c) This chapter does not prohibit a physician from
58	58	providing [supplying] to a patient, free of charge, a drug provided
59	59	to the physician by a drug manufacturer for an indigent
60	60	pharmaceutical program if, in the physician's opinion, it is
61	61	advantageous to the patient, in adhering to a course of treatment
62	62	prescribed by the physician, to receive the drug.
63	63	SECTION 6. Section 158.002(a), Occupations Code, is amended
64	64	to read as follows:
65	65	(a) This chapter does not prohibit a physician from
66	66	providing [supplying] a pharmaceutical sample to a patient free of
67	67	charge if, in the physician's opinion, it is advantageous to the
68	68	patient, in adhering to a course of treatment prescribed by the
69	69	physician, to receive the sample.
70	70	SECTION 7. The heading to Section 158.003, Occupations
71	71	Code, is amended to read as follows:
72	72	Sec. 158.003. DISPENSING OF DANGEROUS DRUGS TO CERTAIN
73	73	PATIENTS IN CERTAIN RURAL AREAS.
74	74	SECTION 8. Section 158.003, Occupations Code, is amended by
75	75	adding Subsection (a-1) to read as follows:
76	76	(a-1) This section applies only to a physician providing
77	77	care under workers' compensation insurance coverage, as defined by
78	78	Section 401.011, Labor Code.
79	79	SECTION 9. Chapter 158, Occupations Code, is amended by
80	80	adding Section 158.004 to read as follows:
81	81	Sec. 158.004. PROVISION AND DISPENSING OF DANGEROUS DRUGS.
82	82	(a) In this section, "reimbursement for cost" means an additional
83	83	charge, separate from that imposed for the physician's professional
84	84	services, that includes the cost of a drug product and all other
85	85	actual costs to the physician incidental to providing dispensing
86	86	service. The term does not include a separate fee imposed for the
87	87	act of dispensing a drug itself.
88	88	(b) This section does not apply to a physician providing
89	89	care under workers' compensation insurance coverage, as defined by
90	90	Section 401.011, Labor Code.
91	91	(c) A physician may:
92	92	(1) provide or dispense dangerous drugs to the
93	93	physician's patients; and
94	94	(2) be reimbursed for the cost of providing or
95	95	dispensing those drugs without obtaining a license under Chapter
96	96	558.
97	97	(d) A physician may not provide or dispense under this
98	98	section a controlled substance listed in Schedules II through V as
99	99	established under Subchapter B, Chapter 481, Health and Safety
100	100	Code.
101	101	(e) A physician who provides or dispenses dangerous drugs
102	102	under this section shall oversee compliance with the laws of this
103	103	state and federal law relating to those dangerous drugs.
104	104	(f) Before providing or dispensing dangerous drugs under
105	105	this section, a physician must notify the patient that the
106	106	prescription for the dangerous drug may be filled at a pharmacy.
107	107	With respect to dangerous drugs provided or dispensed in a
108	108	physician's office, the notification requirement of this
109	109	subsection may be satisfied by a written notice placed
110	110	conspicuously in the office.
111	111	(g) Not later than the 30th day after the date a physician
112	112	first provides or dispenses dangerous drugs under this section, the
113	113	physician shall notify the Texas State Board of Pharmacy and the
114	114	board that the physician is providing or dispensing dangerous drugs
115	115	under this section. The Texas State Board of Pharmacy and the board
116	116	shall jointly adopt a form by which a physician may provide
117	117	notification as required by this subsection.
118	118	(h) A physician who notifies the board under Subsection (g)
119	119	that the physician is providing or dispensing dangerous drugs under
120	120	this section and who intends to continue to provide or dispense
121	121	dangerous drugs under this section shall include notice of that
122	122	intent in any subsequent registration permit renewal application
123	123	submitted to the board. The board by rule shall prescribe the form
124	124	of a registration permit renewal application in accordance with
125	125	this subsection.
126	126	SECTION 10. Section 551.003(31), Occupations Code, is
127	127	amended to read as follows:
128	128	(31) "Pharmacy" means a facility at which a
129	129	prescription drug or medication order is received, processed, or
130	130	dispensed under this subtitle, Chapter 481 or 483, Health and
131	131	Safety Code, or the Comprehensive Drug Abuse Prevention and Control
132	132	Act of 1970 (21 U.S.C. Section 801 et seq.). The term does not
133	133	include:
134	134	(A) a narcotic drug treatment program that is
135	135	regulated under Chapter 466, Health and Safety Code; or
136	136	(B) a location where:
137	137	(i) a physician provides or dispenses a
138	138	dangerous drug under Section 158.003 or 158.004; or
139	139	(ii) a person provides or dispenses a
140	140	dangerous drug under a physician's supervision in accordance with
141	141	Section 157.002(b).
142	142	SECTION 11. Section 551.004, Occupations Code, is amended
143	143	by adding Subsection (a-1) and amending Subsection (b) to read as
144	144	follows:
145	145	(a-1) For purposes of Subsection (a)(1), "retailing of
146	146	prescription drugs" does not include the collection of a
147	147	reimbursement for cost, as defined by Section 158.003(a) or
148	148	158.004(a).
149	149	(b) This subtitle does not prevent:
150	150	(1) a practitioner from:
151	151	(A) administering a drug to a patient of the
152	152	practitioner; or
153	153	(B) providing or dispensing dangerous drugs
154	154	under Section 158.003 or 158.004; or
155	155	(2) a person from providing or dispensing a dangerous
156	156	drug under a physician's supervision in accordance with Section
157	157	157.002(b).
158	158	SECTION 12. Section 558.001, Occupations Code, is amended
159	159	by amending Subsection (c) and adding Subsection (d) to read as
160	160	follows:
161	161	(c) Except as provided by Subsection (d), a [A] person may
162	162	not dispense or distribute prescription drugs unless the person:
163	163	(1) is a pharmacist; or
164	164	(2) is otherwise authorized by this subtitle to
165	165	dispense or distribute prescription drugs.
166	166	(d) A physician or person acting under the physician's
167	167	supervision may provide or dispense dangerous drugs in accordance
168	168	with Section 157.002(b), 158.003, or 158.004.
169	169	SECTION 13. The heading to Chapter 563, Occupations Code,
170	170	is amended to read as follows:
171	171	CHAPTER 563. [PRESCRIPTION REQUIREMENTS;] DELEGATION OF
172	172	ADMINISTRATION, [AND] PROVISION, AND DISPENSING OF DANGEROUS DRUGS
173	173	SECTION 14. Sections 563.051(a) and (c), Occupations Code,
174	174	are amended to read as follows:
175	175	(a) A physician may delegate to any qualified and properly
176	176	trained person acting under the physician's supervision the act of
177	177	administering [or providing] dangerous drugs in the physician's
178	178	office, as ordered by the physician, that are used or required to
179	179	meet the immediate needs of the physician's patients or the act of
180	180	providing or dispensing dangerous drugs, as ordered by the
181	181	physician, to the physician's patients. The administration, [or]
182	182	provision, or dispensing of the dangerous drugs must be performed
183	183	in compliance with laws relating to the practice of medicine and
184	184	state and federal laws relating to those dangerous drugs.
185	185	(c) The administration, [or] provision, or dispensing of
186	186	the drugs may be delegated through a physician's order, a standing
187	187	medical order, a standing delegation order, or another order
188	188	defined by the Texas Medical [State] Board [of Medical Examiners].
189	189	SECTION 15. Section 563.052, Occupations Code, is amended
190	190	to read as follows:
191	191	Sec. 563.052. SUITABLE CONTAINER REQUIRED. A drug or
192	192	medicine provided or dispensed under this subchapter must be
193	193	provided or dispensed [supplied] in a suitable container labeled in
194	194	compliance with applicable drug laws. A qualified and trained
195	195	person, acting under the supervision of a physician, may specify at
196	196	the time of the provision or dispensing of the drug the inclusion on
197	197	the container of the date of the provision or dispensing and the
198	198	patient's name and address.
199	199	SECTION 16. The heading to Section 563.053, Occupations
200	200	Code, is amended to read as follows:
201	201	Sec. 563.053. DISPENSING OF DANGEROUS DRUGS TO CERTAIN
202	202	PATIENTS IN CERTAIN RURAL AREAS.
203	203	SECTION 17. Section 563.053, Occupations Code, is amended
204	204	by adding Subsection (a-1) to read as follows:
205	205	(a-1) This section applies only to a physician providing
206	206	care under workers' compensation insurance coverage, as defined by
207	207	Section 401.011, Labor Code.
208	208	SECTION 18. The heading to Subchapter B, Chapter 563,
209	209	Occupations Code, is repealed.
210	210	SECTION 19. This Act takes effect September 1, 2023.