82R5369 JSC-D
	By: Zerwas	H.B. No. 2246

	A BILL TO BE ENTITLED
	AN ACT
	relating to certain procedures applicable to electronic
	prescriptions for Schedule II controlled substances.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  Sections 481.074(b), (c), (d-1), (e), (f), (g),
	(h), and (k), Health and Safety Code, are amended to read as
	follows:
	(b)  Except in an emergency as defined by rule of the
	director or as provided by Subsection (o) or Section 481.075(j) or
	(m), a person may not dispense or administer a controlled substance
	listed in Schedule II without a [the] written prescription of a
	practitioner on an official prescription form or without an
	electronic prescription that meets the requirements of and is
	completed by the practitioner in accordance with Section 481.075.
	In an emergency, a person may dispense or administer a controlled
	substance listed in Schedule II on the oral or telephonically
	communicated prescription of a practitioner.  The person who
	administers or dispenses the substance shall:
	(1)  if the person is a prescribing practitioner or a
	pharmacist, promptly comply with Subsection (c); or
	(2)  if the person is not a prescribing practitioner or
	a pharmacist, promptly write the oral or telephonically
	communicated prescription and include in the written record of the
	prescription the name, address, department registration number,
	and Federal Drug Enforcement Administration number of the
	prescribing practitioner, all information required to be provided
	by a practitioner under Section 481.075(e)(1), and all information
	required to be provided by a dispensing pharmacist under Section
	481.075(e)(2).
	(c)  Not later than the seventh day after the date a
	prescribing practitioner authorizes an emergency oral or
	telephonically communicated prescription, the prescribing
	practitioner shall cause a written or electronic prescription,
	completed in the manner required by Section 481.075, to be
	delivered [in person or mailed] to the dispensing pharmacist at the
	pharmacy where the prescription was dispensed. A written
	prescription may be delivered in person or by mail. The envelope of
	a prescription delivered by mail must be postmarked not later than
	the seventh day after the date the prescription was authorized. On
	receipt of a written [the] prescription, the dispensing pharmacy
	shall file the transcription of the telephonically communicated
	prescription and the pharmacy copy and shall send information to
	the director as required by Section 481.075. On receipt of an
	electronic prescription, the pharmacist shall annotate the
	electronic prescription record with the original authorization and
	date of the emergency oral or telephonically communicated
	prescription.
	(d-1)  Notwithstanding Subsection (d), a prescribing
	practitioner may issue multiple prescriptions authorizing the
	patient to receive a total of up to a 90-day supply of a Schedule II
	controlled substance if:
	(1)  each separate prescription is issued for a
	legitimate medical purpose by a prescribing practitioner acting in
	the usual course of professional practice;
	(2)  the prescribing practitioner provides [written]
	instructions on each prescription to be filled at a later date
	indicating the earliest date on which a pharmacy may fill each
	prescription;
	(3)  the prescribing practitioner concludes that
	providing the patient with multiple prescriptions in this manner
	does not create an undue risk of diversion or abuse; and
	(4)  the issuance of multiple prescriptions complies
	with other applicable state and federal laws.
	(e)  The partial filling of a prescription for a controlled
	substance listed in Schedule II is permissible, if the pharmacist
	is unable to supply the full quantity called for in a written or
	electronic prescription or emergency oral prescription and the
	pharmacist makes a notation of the quantity supplied on the face of
	the written prescription, on the [or] written record of the
	emergency oral prescription, or in the electronic prescription
	record. The remaining portion of the prescription may be filled
	within 72 hours of the first partial filling; however, if the
	remaining portion is not or cannot be filled within the 72-hour
	period, the pharmacist shall so notify the prescribing individual
	practitioner. No further quantity may be supplied beyond 72 hours
	without a new prescription.
	(f)  A prescription for a Schedule II controlled substance
	[written] for a patient in a long-term care facility (LTCF) or for a
	patient with a medical diagnosis documenting a terminal illness may
	be filled in partial quantities to include individual dosage units.
	If there is any question about whether a patient may be classified
	as having a terminal illness, the pharmacist must contact the
	practitioner before partially filling the prescription. Both the
	pharmacist and the practitioner have a corresponding
	responsibility to assure that the controlled substance is for a
	terminally ill patient. The pharmacist must record the
	prescription on an official prescription form or in the electronic
	prescription record and must indicate on the official prescription
	form or in the electronic prescription record whether the patient
	is "terminally ill" or an "LTCF patient." A prescription that is
	partially filled and does not contain the notation "terminally ill"
	or "LTCF patient" is considered to have been filled in violation of
	this chapter. For each partial filling, the dispensing pharmacist
	shall record on the back of the official prescription form or in the
	electronic prescription record the date of the partial filling, the
	quantity dispensed, the remaining quantity authorized to be
	dispensed, and the identification of the dispensing pharmacist.
	Before any subsequent partial filling, the pharmacist must
	determine that the additional partial filling is necessary. The
	total quantity of Schedule II controlled substances dispensed in
	all partial fillings may not exceed the total quantity prescribed.
	Schedule II prescriptions for patients in a long-term care facility
	or patients with a medical diagnosis documenting a terminal illness
	are valid for a period not to exceed 60 days following the issue
	date unless sooner terminated by discontinuance of the medication.
	(g)  A person may not dispense a controlled substance in
	Schedule III or IV that is a prescription drug under the Federal
	Food, Drug, and Cosmetic Act (21 U.S.C. Section 301 et seq.) without
	a written, electronic, oral, or telephonically [or electronically]
	communicated prescription of a practitioner defined by Section
	481.002(39)(A) or (D), except that the practitioner may dispense
	the substance directly to an ultimate user.  A prescription for a
	controlled substance listed in Schedule III or IV may not be filled
	or refilled later than six months after the date on which the
	prescription is issued and may not be refilled more than five times,
	unless the prescription is renewed by the practitioner.  A
	prescription under this subsection must comply with other
	applicable state and federal laws.
	(h)  A pharmacist may dispense a controlled substance listed
	in Schedule III, IV, or V under a written, electronic, oral, or
	telephonically [or electronically] communicated prescription
	issued by a practitioner defined by Section 481.002(39)(C) and only
	if the pharmacist determines that the prescription was issued for a
	valid medical purpose and in the course of professional practice.  A
	prescription issued under this subsection may not be filled or
	refilled later than six months after the date the prescription is
	issued and may not be refilled more than five times, unless the
	prescription is renewed by the practitioner.
	(k)  A prescription for a controlled substance must show:
	(1)  the quantity of the substance prescribed:
	(A)  numerically, followed by the number written
	as a word, if the prescription is written; [or]
	(B)  numerically, if the prescription is
	electronic; or
	(C)  if the prescription is communicated orally or
	telephonically, as transcribed by the receiving pharmacist;
	(2)  the date of issue;
	(2-a)  if the prescription is issued for a Schedule II
	controlled substance to be filled at a later date under Subsection
	(d-1), the earliest date on which a pharmacy may fill the
	prescription;
	(3)  the name, address, and date of birth or age of the
	patient or, if the controlled substance is prescribed for an
	animal, the species of the animal and the name and address of its
	owner;
	(4)  the name and strength of the controlled substance
	prescribed;
	(5)  the directions for use of the controlled
	substance;
	(6)  the intended use of the substance prescribed
	unless the practitioner determines the furnishing of this
	information is not in the best interest of the patient;
	(7)  the [legibly printed or stamped] name, address,
	Federal Drug Enforcement Administration registration number, and
	telephone number of the practitioner at the practitioner's usual
	place of business, which must be legibly printed or stamped on a
	written prescription;
	(8)  if the prescription is handwritten, the signature
	of the prescribing practitioner; and
	(9)  if the prescribing practitioner is licensed in
	this state, the practitioner's department registration number.
	SECTION 2.  Sections 481.075(a), (e), (g), (h), (i), and
	(j), Health and Safety Code, are amended to read as follows:
	(a)  A practitioner who prescribes a controlled substance
	listed in Schedule II shall, except as provided by rule adopted
	under Section 481.0761, record the prescription on an official
	prescription form or in an electronic prescription that includes
	the information required by this section.
	(e)  Each official prescription form or electronic
	prescription used to prescribe a Schedule II controlled substance
	must contain:
	(1)  information provided by the prescribing
	practitioner, including:
	(A)  the date the prescription is issued
	[written];
	(B)  the controlled substance prescribed;
	(C)  the quantity of controlled substance
	prescribed, shown:
	(i)  numerically, followed by the number
	written as a word, if the prescription is written; or
	(ii)  numerically, if the prescription is
	electronic;
	(D)  the intended use of the controlled substance
	or the diagnosis for which it is prescribed and the instructions for
	use of the substance;
	(E)  the practitioner's name, address, department
	registration number, and Federal Drug Enforcement Administration
	number;
	(F)  the name, address, and date of birth or age of
	the person for whom the controlled substance is prescribed; and
	(G)  if the prescription is issued to be filled at
	a later date under Section 481.074(d-1), the earliest date on which
	a pharmacy may fill the prescription;
	(2)  information provided by the dispensing
	pharmacist, including the date the prescription is filled; and
	(3)  for a written prescription, the signatures of the
	prescribing practitioner and the dispensing pharmacist or for an
	electronic prescription, the prescribing practitioner's electronic
	signature or other secure method of validation authorized by
	federal law.
	(g)  Except for an oral prescription prescribed under
	Section 481.074(b), the prescribing practitioner shall:
	(1)  legibly fill in, or direct a designated agent to
	legibly fill in, on the official prescription form or in the
	electronic prescription, each item of information required to be
	provided by the prescribing practitioner under Subsection (e)(1),
	unless the practitioner determines that:
	(A)  under rule adopted by the director for this
	purpose, it is unnecessary for the practitioner or the
	practitioner's agent to provide the patient identification number;
	or
	(B)  it is not in the best interest of the patient
	for the practitioner or practitioner's agent to provide information
	regarding the intended use of the controlled substance or the
	diagnosis for which it is prescribed; and
	(2)  sign the official prescription form and give the
	form to the person authorized to receive the prescription or, in the
	case of an electronic prescription, electronically sign or validate
	the electronic prescription as authorized by federal law and
	transmit the prescription to the dispensing pharmacy.
	(h)  In the case of an oral prescription prescribed under
	Section 481.074(b), the prescribing practitioner shall give the
	dispensing pharmacy the information needed to complete the official
	prescription form or electronic prescription record.
	(i)  Each dispensing pharmacist shall:
	(1)  fill in on the official prescription form or note
	in the electronic prescription record each item of information
	given orally to the dispensing pharmacy under Subsection (h) and[,]
	the date the prescription is filled, and:
	(A)  for a written prescription, fill in the
	dispensing pharmacist's signature; or
	(B)  for an electronic prescription,
	appropriately record the identity of the dispensing pharmacist in
	the electronic prescription record;
	(2)  retain with the records of the pharmacy for at
	least two years:
	(A)  the official prescription form or the
	electronic prescription record, as applicable; and
	(B)  the name or other patient identification
	required by Section 481.074(m) or (n); and
	(3)  send all information required by the director,
	including any information required to complete an official
	prescription form or electronic prescription record, to the
	director by electronic transfer or another form approved by the
	director not later than the 15th day after the last day of the month
	in which the prescription is completely filled.
	(j)  A medication order written for a patient who is admitted
	to a hospital at the time the medication order is written and filled
	is not required to be on an official prescription [a] form or in an
	electronic prescription record that meets the requirements of this
	section.
	SECTION 3.  Section 481.0761(d), Health and Safety Code, is
	amended to read as follows:
	(d)  The director by rule shall authorize a practitioner to
	determine whether it is necessary to obtain a particular patient
	identification number and to provide that number on the official
	prescription form or in the electronic prescription record.
	SECTION 4.  Section 552.118, Government Code, is amended to
	read as follows:
	Sec. 552.118.  EXCEPTION: OFFICIAL PRESCRIPTION PROGRAM
	INFORMATION [FORM]. Information is excepted from the requirements
	of Section 552.021 if it is:
	(1)  information on or derived from an official
	prescription form or electronic prescription record filed with the
	director of the Department of Public Safety under Section 481.075,
	Health and Safety Code; or
	(2)  other information collected under Section 481.075
	of that code.
	SECTION 5.  Section 157.059(c), Occupations Code, is amended
	to read as follows:
	(c)  The physician may not delegate:
	(1)  the use of a prescription sticker or the use or
	issuance of an official prescription form; or
	(2)  the authority to issue an electronic prescription
	under Section 481.075, Health and Safety Code.
	SECTION 6.  The change in law made by this Act applies only
	to the issuance of a prescription on or after the effective date of
	this Act. The issuance of a prescription before the effective date
	of this Act is covered by the law in effect when the prescription
	was issued, and the former law is continued in effect for that
	purpose.
	SECTION 7.  This Act takes effect September 1, 2011.