By: Oliverson, et al. (Senate Sponsor - Perry)	H.B. No. 278
	(In the Senate - Received from the House April 15, 2019;
	April 16, 2019, read first time and referred to Committee on Health &
	Human Services; April 24, 2019, reported favorably by the
	following vote:  Yeas 9, Nays 0; April 24, 2019, sent to printer.)
Click here to see the committee vote

	A BILL TO BE ENTITLED
	AN ACT
	relating to the frequency and location of certain meetings required
	by a prescriptive authority agreement.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  Sections 157.0512(e) and (f), Occupations Code,
	are amended to read as follows:
	(e)  A prescriptive authority agreement must, at a minimum:
	(1)  be in writing and signed and dated by the parties
	to the agreement;
	(2)  state the name, address, and all professional
	license numbers of the parties to the agreement;
	(3)  state the nature of the practice, practice
	locations, or practice settings;
	(4)  identify the types or categories of drugs or
	devices that may be prescribed or the types or categories of drugs
	or devices that may not be prescribed;
	(5)  provide a general plan for addressing consultation
	and referral;
	(6)  provide a plan for addressing patient emergencies;
	(7)  state the general process for communication and
	the sharing of information between the physician and the advanced
	practice registered nurse or physician assistant to whom the
	physician has delegated prescriptive authority related to the care
	and treatment of patients;
	(8)  if alternate physician supervision is to be
	utilized, designate one or more alternate physicians who may:
	(A)  provide appropriate supervision on a
	temporary basis in accordance with the requirements established by
	the prescriptive authority agreement and the requirements of this
	subchapter; and
	(B)  participate in the prescriptive authority
	quality assurance and improvement plan meetings required under this
	section; and
	(9)  describe a prescriptive authority quality
	assurance and improvement plan and specify methods for documenting
	the implementation of the plan that include the following:
	(A)  chart review, with the number of charts to be
	reviewed determined by the physician and advanced practice
	registered nurse or physician assistant; and
	(B)  [if the agreement is between a physician and
	an advanced practice registered nurse,] periodic [face-to-face]
	meetings between the advanced practice registered nurse or
	physician assistant and the physician [at a location determined by
	the physician and the advanced practice registered nurse; and
	[(C)     if the agreement is between a physician and
	a physician assistant, periodic meetings between the physician
	assistant and the physician].
	(f)  The periodic [face-to-face] meetings described by
	Subsection (e)(9)(B) must:
	(1)  include:
	(A)  the sharing of information relating to
	patient treatment and care, needed changes in patient care plans,
	and issues relating to referrals; and
	(B)  discussion of patient care improvement;
	[and]
	(2)  be documented; and
	(3)  take place at least once a month in a manner
	determined by the physician and the advanced practice registered
	nurse or physician assistant [occur:
	[(A)  except as provided by Paragraph (B):
	[(i)     at least monthly until the third
	anniversary of the date the agreement is executed; and
	[(ii)     at least quarterly after the third
	anniversary of the date the agreement is executed, with monthly
	meetings held between the quarterly meetings by means of a remote
	electronic communications system, including videoconferencing
	technology or the Internet; or
	[(B)     if during the seven years preceding the date
	the agreement is executed the advanced practice registered nurse
	for at least five years was in a practice that included the exercise
	of prescriptive authority with required physician supervision:
	[(i)     at least monthly until the first
	anniversary of the date the agreement is executed; and
	[(ii)     at least quarterly after the first
	anniversary of the date the agreement is executed, with monthly
	meetings held between the quarterly meetings by means of a remote
	electronic communications system, including videoconferencing
	technology or the Internet].
	SECTION 2.  Section 157.0512(f-1), Occupations Code, is
	repealed.
	SECTION 3.  Section 157.0512, Occupations Code, as amended
	by this Act, applies only to a prescriptive authority agreement
	entered into on or after the effective date of this Act. An
	agreement entered into before the effective date of this Act is
	governed by the law in effect on the date the agreement was entered
	into, and the former law is continued in effect for that purpose.
	SECTION 4.  This Act takes effect September 1, 2019.
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