HB4051 - Relating to the authority of certain healthcare providers to order and provide or dispense limited prescription drugs.

      By: Frank H.B. No. 4051       A BILL TO BE ENTITLED   AN ACT   relating to the authority of certain healthcare providers to order   and provide or dispense limited prescription drugs.          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 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 3.  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 4.  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 :           (1)     supplied in a child-resistant container unless the   patient request it not be in a child-resistant container or the   product is exempt from requirements of the Poison Prevention   Packaging Act of 1970;           (2)     dispensed in a container with a label on the container   that contains the name of the drug, the date the prescription is   dispensed, the name of the prescribing practitioner, the quantity   dispensed, dosage and route of administration, date after which the   prescription should not be used or beyond-use-date, and appropriate   ancillary instructions such as storage instructions or cautionary   statements printed in an easily readable font size;           (3)     stored prior to dispensing in a location with a   temperature range compatible with the proper storage of each drug,   including refrigeration where required, and secured against theft   or diversion of prescription drugs and locked to prohibit   unauthorized access when the physician is not on-site; and           (4)     dispensed with written consumer information or written   directions to obtain written information online that provides the   therapeutic use of the drug and the names of generically equivalent   drugs.           (h)     A physician dispensing a drug under this subchapter   must:           (1)     complete a drug utilization review prior to dispensing   for therapeutic duplication, drug-to-disease contraindications,   drug-to-drug interactions, correct dosage, and drug-to-allergy   interactions;           (2)     maintain records of dispensed medications including   patient information, prescription details and dispensing   information including the dispensing physicians name and office   address where drugs were dispensed from;           (3)     counsel the patient on proper use of a prescription drug   or device; and           (4)     perform a final check on all prescriptions filled onsite   for the accuracy and completeness of the prescription.          [ 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 5.  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 6.  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 7.  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 8.  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 9.  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 10.  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 t [Text truncated for display. Full text available on Congress.gov.]