85R9615 EES-F     By: Roberts H.B. No. 2444       A BILL TO BE ENTITLED   AN ACT   relating to the authority of pharmacists to furnish certain   medications and receive compensation for certain services and   procedures.          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 1451.001, Insurance Code, is amended by   adding Subdivision (13-a) to read as follows:                (13-a)  "Pharmacist" means an individual licensed to   practice pharmacy by the Texas State Board of Pharmacy.          SECTION 3.  Subchapter C, Chapter 1451, Insurance Code, is   amended by adding Section 1451.1261 to read as follows:          Sec. 1451.1261.  REIMBURSEMENT FOR CERTAIN SERVICES AND   PROCEDURES PERFORMED BY PHARMACISTS. (a) Notwithstanding any   other law except Subsection (c), in addition to applying to a   policy, agreement, or contract described by Section 1451.102, this   section applies to any other individual or group health benefit   plan that provides benefits described by Section 1451.102,   including:                (1)  a health benefit plan issued by:                      (A)  a group hospital service corporation   operating under Chapter 842;                      (B)  a health maintenance organization operating   under Chapter 843; or                      (C)  a multiple employer welfare arrangement that   holds a certificate of authority under Chapter 846;                (2)  a small employer health benefit plan subject to   Chapter 1501;                (3)  a standard health benefit plan issued under   Chapter 1507;                (4)  health benefits provided by or through a church   benefits board under Subchapter I, Chapter 22, Business   Organizations Code;                (5)  a regional or local health care program operated   under Section 75.104, Health and Safety Code;                (6)  a self-funded health benefit plan sponsored by a   professional employer organization under Chapter 91, Labor Code;                (7)  a county employee health benefit plan established   under Chapter 157, Local Government Code; and                (8)  health and accident coverage provided by a risk   pool created under Chapter 172, Local Government Code.          (b)  Notwithstanding Section 1451.102, except as provided by   Subsection (c), this section applies to coverage under a group   health benefit plan provided to a resident of this state regardless   of whether the group policy, agreement, or contract is delivered,   issued for delivery, or renewed in this state.          (c)  This section does not apply to:                (1)  a group health benefit plan that is offered or   administered by:                      (A)  the Teacher Retirement System of Texas under   Chapter 1575 or 1579; or                      (B)  the Employees Retirement System of Texas   under Chapter 1551; or                (2)  a Medicaid managed care program operated under   Chapter 533, Government Code, or a Medicaid program operated under   Chapter 32, Human Resources Code.          (d)  An insurer or other health benefit plan issuer to which   this section applies or a third-party administrator or pharmacy   benefit manager of a health benefit plan to which this section   applies may not deny reimbursement to a pharmacist for the   provision of a service or procedure within the scope of the   pharmacist's license that:                (1)  would be covered by the insurance policy or other   coverage agreement or an evidence of coverage if the service or   procedure were provided by:                      (A)  a physician;                      (B)  an advanced practice nurse; or                      (C)  a physician assistant; and                (2)  is performed by the pharmacist in strict   compliance with laws and rules related to the pharmacist's license.          SECTION 4.  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)  "Smoking cessation drug" means a prescription drug   approved by the United States Food and Drug Administration for use   in the treatment of nicotine or smoking addiction.                (4)  "Travel drug" means a prescription drug   recommended by the federal Centers for Disease Control and   Prevention for individuals traveling outside of the United States   for the prevention and management of a disease before a diagnosis of   the disease.                (5)  "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).                (6)  "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 physician may delegate   to a pharmacist the authority, as provided by the physician's   written protocol, to initiate a prescription drug order for and to   furnish to a patient a prescription drug that is:                (1)  a drug 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); or                      (B)  a rapid influenza diagnostic test used in the   identification of influenza types A and B;                (2)  a hormonal contraceptive;                (3)  a travel drug;                (4)  a prenatal vitamin supplement;                (5)  a smoking cessation drug;                (6)  a vitamin D supplement; or                (7)  a drug identified by the executive commissioner of   the Health and Human Services Commission by rule as necessary for   pharmacists to furnish to patients for public health purposes.          (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 initiate a prescription drug order and   furnish a prescription drug.          (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 for furnishing a drug under Subsection (b)(1)   may not be later than the 14th day after the date the drug is   furnished by the pharmacist.          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)  initiating a prescription drug order for and   furnishing a prescription drug to a patient under a physician's   written protocol under Section 157.102.          SECTION 6.  Subchapter B, Chapter 562, Occupations Code, is   amended by adding Sections 562.058 and 562.059 to read as follows:          Sec. 562.058.  TRAINING REQUIRED TO INITIATE DRUG ORDER OR   FURNISH CERTAIN DRUGS. (a) A pharmacist may not initiate a   prescription drug order or 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 training program required by Subsection (a) may   include:                (1)  a training program approved by the Accreditation   Council for Pharmacy Education;                (2)  a curriculum-based program offered by a college of   pharmacy that is accredited by the Accreditation Council for   Pharmacy Education; or                (3)  any other training program recognized by the   board.          Sec. 562.059.  FEES FOR CERTAIN PROFESSIONAL SERVICES. A   pharmacist may charge a fee for providing a professional service   under Section 157.102 that is within the pharmacist's scope of   practice in addition to a fee charged for dispensing a drug.          SECTION 7.  Section 1451.1261, Insurance Code, as added by   this Act, applies only to a health benefit plan that is delivered,   issued for delivery, or renewed on or after January 1, 2018. A plan   delivered, issued for delivery, or renewed before January 1, 2018,   is governed by the law as it existed immediately before the   effective date of this Act, and that law is continued in effect for   that purpose.          SECTION 8.  Not later than January 1, 2018, the Texas State   Board of Pharmacy and the Texas Medical Board shall adopt the rules   required under Section 157.102, Occupations Code, as added by this   Act.          SECTION 9.  (a) Except as provided by Subsection (b) of this   section, this Act takes effect January 1, 2018.          (b)  Section 8 of this Act takes effect September 1, 2017.