88R2152 BEE-F
By: Perry S.B. No. 160
A BILL TO BE ENTITLED
AN ACT
relating to the furnishing by pharmacists and dispensing by
physicians of certain medications.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 483.001(11), Health and Safety Code, is
amended to read as follows:
(11) "Practice of pharmacy" has the meaning assigned
by Section 551.003, Occupations Code [means:
[(A) provision of those acts or services
necessary to provide pharmaceutical care;
[(B) interpretation and evaluation of
prescription drug orders or medication orders;
[(C) participation in drug and device selection
as authorized by law, drug administration, drug regimen review, or
drug or drug-related research;
[(D) provision of patient counseling;
[(E) responsibility for:
[(i) dispensing of prescription drug orders
or distribution of medication orders in the patient's best
interest;
[(ii) compounding and labeling of drugs and
devices, except labeling by a manufacturer, repackager, or
distributor of nonprescription drugs and commercially packaged
prescription drugs and devices;
[(iii) proper and safe storage of drugs and
devices; or
[(iv) maintenance of proper records for
drugs and devices. In this subdivision, "device" has the meaning
assigned by Subtitle J, Title 3, Occupations Code; or
[(F) performance of a specific act of drug
therapy management for a patient delegated to a pharmacist by a
written protocol from a physician licensed by the state under
Subtitle B, Title 3, Occupations Code].
SECTION 2. Section 157.002(f), Occupations Code, is amended
to read as follows:
(f) Subsections (b) and (c) do not authorize a physician or
a person acting under the supervision of a physician to keep a
pharmacy, advertised or otherwise, for the retail sale of dangerous
drugs, other than as authorized under Section 158.003 or 158.004,
without complying with the applicable laws relating to the
dangerous drugs.
SECTION 3. Subchapter C, Chapter 157, Occupations Code, is
amended by adding Section 157.102 to read as follows:
Sec. 157.102. DELEGATION TO PHARMACIST TO FURNISH CERTAIN
DRUGS. (a) In this section:
(1) "Acute condition" means a condition or disease
that begins abruptly, intensifies rapidly, and is generally not
long-lasting.
(2) "Pharmacist" has the meaning assigned by Section
551.003.
(3) "Waived clinical laboratory test" means a clinical
laboratory test that is classified as waived under federal
regulations issued under the Clinical Laboratory Improvement
Amendments of 1988 (42 U.S.C. Section 263a).
(4) "Written protocol" means a physician's written
order, standing medical order, standing delegation order, or other
order or protocol as defined by rule of the board.
(b) Notwithstanding any other law, a pharmacist may furnish
to a patient a prescription drug:
(1) as provided by a physician's written protocol, to
treat an acute condition that is identified through performance of
one of the following tests, if the test is a waived clinical
laboratory test:
(A) a rapid strep test or rapid antigen detection
test used in the identification of group A streptococcus (GAS);
(B) a rapid influenza diagnostic test used in the
identification of influenza types A and B; or
(C) a rapid molecular or antigen detection test
used in the identification of the SARS-CoV-2 (COVID-19) virus; or
(2) the furnishing of which is authorized by an
emergency rule adopted under an executive order or emergency
authorization.
(c) The board shall adopt rules jointly with the Texas State
Board of Pharmacy to establish the minimum content of the written
protocol required under Subsection (b). The written protocol may
permit a pharmacist to furnish a prescription drug to a patient
without an established physician-patient relationship.
(d) A written protocol under this section must require
notice to the patient's primary care physician, as identified by
the patient if the patient has a primary care physician, and
prescribe the period for providing the notice and the form of the
notice, in accordance with prevailing practices for the provision
of notice to a patient's primary care physician. The period for
providing the notice may not be later than the 14th day after the
date the drug is furnished by the pharmacist.
(e) The board and the Texas State Board of Pharmacy shall
enter into a memorandum of understanding regarding the regulation
of pharmacists who furnish prescription drugs to patients under
this section. The memorandum of understanding must be adopted by
rule and provide that:
(1) a pharmacist who furnishes prescription drugs to a
patient under this section is subject only to the disciplinary
authority of the Texas State Board of Pharmacy; and
(2) an inspection of the practice location of a
pharmacist who furnishes prescription drugs to a patient under this
section must be conducted by the Texas State Board of Pharmacy.
SECTION 4. Chapter 158, Occupations Code, is amended by
adding Section 158.004 to read as follows:
Sec. 158.004. DISPENSING OF CERTAIN DRUGS. (a) In this
section, "acute condition" and "waived clinical laboratory test"
have the meanings assigned by Section 157.102.
(b) Notwithstanding any other law, a physician may dispense
to the physician's patient a prescription drug:
(1) to treat an acute condition that is identified
through performance of one of the following tests, if the test is a
waived clinical laboratory test:
(A) a rapid strep test or rapid antigen detection
test used in the identification of group A streptococcus (GAS);
(B) a rapid influenza diagnostic test used in the
identification of influenza types A and B; or
(C) a rapid molecular or antigen detection test
used in the identification of the SARS-CoV-2 (COVID-19) virus;
(2) that is an antibiotic; or
(3) the dispensing of which is authorized by an
emergency rule adopted under an executive order or emergency
authorization.
(c) The board and the Texas State Board of Pharmacy shall
enter into a memorandum of understanding regarding the regulation
of physicians who dispense prescription drugs to the physicians'
patients under this section. The memorandum of understanding must
be adopted by rule and provide that:
(1) a physician who dispenses prescription drugs to
the physician's patient under this section is subject only to the
disciplinary authority of the board; and
(2) an inspection of the practice location of a
physician who dispenses prescription drugs to the physician's
patient under this section must be conducted by the board.
SECTION 5. Section 551.003(33), Occupations Code, is
amended to read as follows:
(33) "Practice of pharmacy" means:
(A) providing an act or service necessary to
provide pharmaceutical care;
(B) interpreting or evaluating a prescription
drug order or medication order;
(C) participating in drug or device selection as
authorized by law, and participating in drug administration, drug
regimen review, or drug or drug-related research;
(D) providing patient counseling;
(E) being responsible for:
(i) dispensing a prescription drug order or
distributing a medication order;
(ii) compounding or labeling a drug or
device, other than labeling by a manufacturer, repackager, or
distributor of a nonprescription drug or commercially packaged
prescription drug or device;
(iii) properly and safely storing a drug or
device; or
(iv) maintaining proper records for a drug
or device;
(F) performing for a patient a specific act of
drug therapy management delegated to a pharmacist by a written
protocol from a physician licensed in this state in compliance with
Subtitle B; [or]
(G) administering an immunization or vaccination
under a physician's written protocol; or
(H) furnishing a prescription drug to a patient
under a physician's written protocol under Section 157.102.
SECTION 6. Section 551.004(b), Occupations Code, is amended
to read as follows:
(b) This subtitle does not prevent a practitioner from:
(1) administering a drug to a patient of the
practitioner; or
(2) dispensing a prescription drug to a patient as
provided by Section 158.004.
SECTION 7. Subchapter B, Chapter 562, Occupations Code, is
amended by adding Section 562.058 to read as follows:
Sec. 562.058. TRAINING REQUIRED TO FURNISH CERTAIN DRUGS.
(a) A pharmacist may not furnish a prescription drug under Section
157.102 unless the pharmacist has completed a training program that
is approved by the board and is relevant to the condition treated by
the drug.
(b) The board shall adopt rules jointly with the Texas
Medical Board to establish the minimum content of the training
program required under Subsection (a).
SECTION 8. Section 563.051(d), Occupations Code, is amended
to read as follows:
(d) This section does not authorize a physician or a person
acting under the supervision of a physician to keep a pharmacy,
advertised or otherwise, for the retail sale of dangerous drugs,
other than as authorized under Section 158.003 or 158.004, without
complying with the applicable laws relating to the dangerous drugs.
SECTION 9. Not later than January 1, 2024, the Texas State
Board of Pharmacy and the Texas Medical Board shall adopt the rules
required under Sections 157.102, 158.004, and 562.058, Occupations
Code, as added by this Act.
SECTION 10. This Act takes effect September 1, 2023.