88R748 KKR-D     By: Shaheen H.B. No. 594       A BILL TO BE ENTITLED   AN ACT   relating to the provision of telepharmacy services.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 562.110(e), Occupations Code, is amended   to read as follows:          (e)  The board shall adopt rules regarding the use of a   telepharmacy system under this section, including:                (1)  [the types of health care facilities at which a   telepharmacy system may be located under Subsection (d)(1), which   must include the following facilities:                      [(A)  a clinic designated as a rural health clinic   regulated under 42 U.S.C. Section 1395x(aa);                      [(B)  a health center as defined by 42 U.S.C.   Section 254b; and                      [(C)  a federally qualified health center as   defined by 42 U.S.C. Section 1396d(l)(2)(B);                [(2)  the locations eligible to be licensed as remote   dispensing sites, which must include locations in medically   underserved areas, areas with a medically underserved population,   and health professional shortage areas determined by the United   States Department of Health and Human Services;                [(3)]  licensing and operating requirements for remote   dispensing sites, including:                      (A)  a requirement that a remote dispensing site   license identify the provider pharmacy that will provide pharmacy   services at the remote dispensing site;                      (B)  a requirement that a provider pharmacy be   allowed to provide pharmacy services at not more than two remote   dispensing sites;                      (C)  [a requirement that a pharmacist employed by   a provider pharmacy make at least monthly on-site visits to a remote   dispensing site or more frequent visits if specified by board rule;                      [(D)]  a requirement that each month the perpetual   inventory of controlled substances at the remote dispensing site be   reconciled to the on-hand count of those controlled substances at   the site by a pharmacist employed by the provider pharmacy;                      (D) [(E)]  a requirement that a pharmacist   employed by a provider pharmacy be physically present at a remote   dispensing site when the pharmacist is providing services requiring   the physical presence of the pharmacist, including immunizations;                      (E) [(F)]  a requirement that a remote dispensing   site be staffed by an on-site pharmacy technician who is under the   continuous supervision of a pharmacist employed by the provider   pharmacy;                      (F) [(G)]  a requirement that all pharmacy   technicians at a remote dispensing site be counted for the purpose   of establishing the pharmacist-pharmacy technician ratio of the   provider pharmacy, which, notwithstanding Section 568.006, may not   exceed three pharmacy technicians for each pharmacist providing   supervision;                      (G) [(H)]  a requirement that, before working at a   remote dispensing site, a pharmacy technician must:                            (i)  have worked at least one year at a   retail pharmacy during the three years preceding the date the   pharmacy technician begins working at the remote dispensing site;   and                            (ii)  have completed a board-approved   training program on the proper use of a telepharmacy system;                      (H) [(I)]  a requirement that pharmacy   technicians at a remote dispensing site may not perform   extemporaneous sterile or nonsterile compounding but may prepare   commercially available medications for dispensing, including the   reconstitution of orally administered powder antibiotics; and                      (I) [(J)]  any additional training or practice   experience requirements for pharmacy technicians at a remote   dispensing site;                (2) [(4)]  the areas that qualify under Subsection (f);                (3) [(5)]  recordkeeping requirements; and                (4) [(6)]  security requirements.          SECTION 2.  The following provisions of the Occupations Code   are repealed:                (1)  Sections 562.110(g) and (h), as added by Chapter   485 (H.B. 2561), Acts of the 85th Legislature, Regular Session,   2017;                (2)  Sections 562.110(g) and (h), as added by Chapter   929 (S.B. 1633), Acts of the 85th Legislature, Regular Session,   2017; and                (3)  Sections 562.110(i) and (j).          SECTION 3.  This Act takes effect September 1, 2023.