bill letting doctors dispense drugs from their offices

The text as introduced · 1,760 words

89R12578 BEE-F

By: Pierson
H.B. No. 3878

A BILL TO BE ENTITLED

AN ACT

relating to the authority of a physician to provide and dispense and

to delegate authority to provide and dispense certain drugs.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 151.002, Occupations Code, is amended by

adding Subdivisions (3-a) and (13-a) to read as follows:

(3-a) "Dispense" has the meaning assigned by Section

551.003.

(13-a) "Provision" means the supply of one or more

unit doses of a drug, medicine, or dangerous drug.

SECTION 2. The heading to Section 157.002, Occupations

Code, is amended to read as follows:

Sec. 157.002. GENERAL DELEGATION OF ADMINISTRATION , [ AND ]

PROVISION , AND DISPENSING OF DANGEROUS DRUGS.

SECTION 3. Sections 157.002(a), (b), (e), and (g),

Occupations Code, are amended to read as follows:

(a) In this section , "administering" [ :

[ (1) "Administering" ] means the direct application of

a drug to the body of a patient by injection, inhalation, ingestion,

or any other means.

[ (2) "Provision" means the supply of one or more unit

doses of a drug, medicine, or dangerous drug. ]

(b) A physician may delegate to any qualified and properly

trained person acting under the physician's supervision the act of

administering [ or providing ] dangerous drugs in the physician's

office, as ordered by the physician, that are used or required to

meet the immediate needs of the physician's patients or the act of

providing or dispensing dangerous drugs as ordered by the physician

to the physician's patients . The administration , [ or ] provision ,

or dispensing of the dangerous drugs must be performed in

compliance with laws relating to the practice of medicine and state

and federal laws relating to those dangerous drugs.

(e) The administration , [ or ] provision , or dispensing of

the drugs may be delegated through a physician's order, a standing

medical order, a standing delegation order, or another order

defined by the board.

(g) A drug or medicine provided or dispensed under

Subsection (b) or (c) must be supplied in a suitable container

labeled in compliance with applicable drug laws. A qualified and

trained person, acting under the supervision of a physician, may

specify at the time of the provision or dispensing of the drug the

inclusion on the container of the date of the provision or

dispensing and the patient's name and address.

SECTION 4. The heading to Chapter 158, Occupations Code, is

amended to read as follows:

CHAPTER 158. AUTHORITY OF PHYSICIAN TO PROVIDE OR DISPENSE CERTAIN

DRUGS AND SUPPLIES

SECTION 5. Sections 158.001(a) and (c), Occupations Code,

are amended to read as follows:

(a) A physician licensed under this subtitle may provide

[ supply ] a patient with any drug, remedy, or clinical supply

necessary to meet the patient's immediate needs.

(c) This chapter does not prohibit a physician from

providing [ supplying ] to a patient, free of charge, a drug provided

to the physician by a drug manufacturer for an indigent

pharmaceutical program if, in the physician's opinion, it is

advantageous to the patient, in adhering to a course of treatment

prescribed by the physician, to receive the drug.

SECTION 6. Section 158.002(a), Occupations Code, is amended

to read as follows:

(a) This chapter does not prohibit a physician from

providing [ supplying ] a pharmaceutical sample to a patient free of

charge if, in the physician's opinion, it is advantageous to the

patient, in adhering to a course of treatment prescribed by the

physician, to receive the sample.

SECTION 7. The heading to Section 158.003, Occupations

Code, is amended to read as follows:

Sec. 158.003. DISPENSING OF DANGEROUS DRUGS TO CERTAIN

PATIENTS IN CERTAIN RURAL AREAS.

SECTION 8. Section 158.003, Occupations Code, is amended by

adding Subsection (a-1) to read as follows:

(a-1) This section applies only to a physician providing

care under workers' compensation insurance coverage, as defined by

Section 401.011, Labor Code.

SECTION 9. Chapter 158, Occupations Code, is amended by

adding Section 158.004 to read as follows:

Sec. 158.004. DISPENSING OF DANGEROUS DRUGS. (a) In this

section, "reimbursement for cost" means an additional charge,

separate from that imposed for the physician's professional

services, that includes the cost of a drug product and all other

actual costs to the physician incidental to providing the

dispensing service. The term does not include a separate fee

imposed for the act of dispensing a drug itself.

(b) This section does not apply to a dangerous drug produced

by compounding as defined by Section 551.003.

(c) A physician may:

(1) maintain a supply of dangerous drugs in the

physician's office to be dispensed in the course of treating the

physician's patients; and

(2) be reimbursed for the cost of dispensing those

drugs without obtaining a license under Chapter 558.

(d) A drug dispensed under this section must be:

(1) necessary for the treatment of the condition for

which the physician is treating the patient; and

(2) received by the patient at the physician's

practice location.

(e) A physician who dispenses dangerous drugs under this

section shall:

(1) comply with each labeling and packaging

requirement of Subtitle J applicable to that class of drug;

(2) oversee compliance with each recordkeeping,

storage, and maintenance requirement of Subtitle J applicable to

that class of drug;

(3) comply with patient counseling requirements under

Subtitle J;

(4) provide written information to the patient about

the drug being dispensed in accordance with Subtitle J; and

(5) verify the accuracy of each act, task, and

function performed in the preparation of the drug before delivery

of the drug to the patient, including the final check of the product

and any related requirement of Subtitle J.

(f) The board shall adopt rules as necessary to ensure that

the requirements of Subsection (e) are enforced in substantially

the same manner that the Texas State Board of Pharmacy enforces the

relevant provisions of Subtitle J applicable to Class A pharmacies

and rules adopted under that subtitle.

(g) A physician who desires to dispense dangerous drugs

under this section shall notify the Texas State Board of Pharmacy

and the board that the physician is dispensing dangerous drugs

under this section. The Texas State Board of Pharmacy and the board

shall jointly adopt a form by which a physician may provide

notification as required by this subsection.

(h) This section does not permit a physician to operate a

retail pharmacy without complying with Chapter 558.

SECTION 10. Section 551.003(31), Occupations Code, is

amended to read as follows:

(31) "Pharmacy" means a facility at which a

prescription drug or medication order is received, processed, or

dispensed under this subtitle, Chapter 481 or 483, Health and

Safety Code, or the Comprehensive Drug Abuse Prevention and Control

Act of 1970 (21 U.S.C. Section 801 et seq.). The term does not

include :

(A) a narcotic drug treatment program that is

regulated under Chapter 466, Health and Safety Code ; or

(B) a location where:

(i) a physician dispenses a dangerous drug

under Section 158.003 or 158.004; or

(ii) a person provides or dispenses a

dangerous drug under a physician's supervision in accordance with

Section 157.002(b) .

SECTION 11. Section 551.004, Occupations Code, is amended

by adding Subsection (a-1) and amending Subsection (b) to read as

follows:

(a-1) For purposes of Subsection (a)(1), "retailing of

prescription drugs" does not include the collection of a

reimbursement for cost, as defined by Section 158.003(a) or

158.004(a).

(b) This subtitle does not prevent :

(1) a practitioner from :

(A) administering a drug to a patient of the

practitioner ; or

(B) dispensing dangerous drugs under Section

158.003 or 158.004; or

(2) a person from providing or dispensing a dangerous

drug under a physician's supervision in accordance with Section

157.002(b) .

SECTION 12. Section 558.001, Occupations Code, is amended

by amending Subsection (c) and adding Subsection (d) to read as

follows:

(c) Except as provided by Subsection (d), a [ A ] person may

not dispense or distribute prescription drugs unless the person:

(1) is a pharmacist; or

(2) is otherwise authorized by this subtitle to

dispense or distribute prescription drugs.

(d) A physician or person acting under the physician's

supervision may provide or dispense dangerous drugs in accordance

with Section 157.002(b), 158.003, or 158.004.

SECTION 13. The heading to Chapter 563, Occupations Code,

is amended to read as follows:

CHAPTER 563. [ PRESCRIPTION REQUIREMENTS; ] DELEGATION OF

ADMINISTRATION , [ AND ] PROVISION , AND DISPENSING OF DANGEROUS DRUGS

SECTION 14. Sections 563.051(a) and (c), Occupations Code,

are amended to read as follows:

(a) A physician may delegate to any qualified and properly

trained person acting under the physician's supervision the act of

administering [ or providing ] dangerous drugs in the physician's

office, as ordered by the physician, that are used or required to

meet the immediate needs of the physician's patients or the act of

providing or dispensing dangerous drugs, as ordered by the

physician, to the physician's patients . The administration , [ or ]

provision , or dispensing of the dangerous drugs must be performed

in compliance with laws relating to the practice of medicine and

state and federal laws relating to those dangerous drugs.

(c) The administration , [ or ] provision , or dispensing of

the drugs may be delegated through a physician's order, a standing

medical order, a standing delegation order, or another order

defined by the Texas Medical [ State ] Board [ of Medical Examiners ].

SECTION 15. Section 563.052, Occupations Code, is amended

to read as follows:

Sec. 563.052. SUITABLE CONTAINER REQUIRED. A drug or

medicine provided or dispensed under this subchapter must be

provided or dispensed [ supplied ] in a suitable container labeled in

compliance with applicable drug laws. A qualified and trained

person, acting under the supervision of a physician, may specify at

the time of the provision or dispensing of the drug the inclusion on

the container of the date of the provision or dispensing and the

patient's name and address.

SECTION 16. The heading to Section 563.053, Occupations

Code, is amended to read as follows:

Sec. 563.053. DISPENSING OF DANGEROUS DRUGS TO CERTAIN

PATIENTS IN CERTAIN RURAL AREAS.

SECTION 17. Section 563.053, Occupations Code, is amended

by adding Subsection (a-1) to read as follows:

(a-1) This section applies only to a physician providing

care under workers' compensation insurance coverage, as defined by

Section 401.011, Labor Code.

SECTION 18. The heading to Subchapter B, Chapter 563,

Occupations Code, is repealed.

SECTION 19. This Act takes effect September 1, 2025.