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.