(a) Any APRN who violates the sections of this rule
or orders or prescribes in a manner that is not consistent with the
standard of care shall be subject to removal of the authority to order
or prescribe under this section and disciplinary action by the Board.
Behaviors associated with ordering and prescribing medications for
which the Board may impose disciplinary action include, but are not
limited to:
(1) ordering, prescribing, dispensing, or administering
medications or devices for other than evidenced based therapeutic
or prophylactic purposes that meet the minimum standards of care;
(2) ordering, prescribing, or dispensing medications
or devices for personal use;
(3) failing to properly assess and document the assessment
prior to ordering, prescribing, dispensing, or administering a medication
or device;
(4) selling, purchasing, trading, or offering to sell,
purchase, or trade a prescription drug sample;
(5) delegation of authority to any other person to
order, prescribe, or dispense of an order or prescription for a drug
or device; and
(6) failing to access and review the prescription monitoring
program (PMP) authorized by Chapter 481, Health and Safety Code, before
prescribing opioids, benzodiazepines, barbiturates, or carisoprodol,
unless a statutory exemption contained in that chapter has been documented.
If an APRN has made a good faith effort to comply with the requirement
and is unable to do so because of circumstances beyond the APRN's
control, documentation of this effort shall be made on the patient's
prescription or in the patient's electronic prescription record.
(b) Failure to cooperate with a representative of the
Board who conducts an onsite investigation may result in disciplinary
action. Failure to cooperate with a representative of the Board or
the Texas Medical Board who inspects and audits the practice relating
to the implementation and operation of the prescriptive authority
agreement may result in disciplinary action.
(c) The Board shall immediately notify the Texas Medical
Board and the Texas Physician Assistant Board:
(1) when an APRN licensed by the Board becomes the
subject of an investigation involving the delegation and supervision
of prescriptive authority; and
(2) upon the final disposition of an investigation
involving an APRN licensed by the Board and the delegation and supervision
of prescriptive authority.
(d) Upon receipt of notice from the Texas Medical Board
and/or the Texas Physician Assistant Board that a licensee of one
of those boards is under investigation involving the delegation and
supervision of prescriptive authority, the Board may open an investigation
against an APRN who is a party to the prescriptive authority agreement
with the licensee who is under investigation by the board that provided
the notice.
(e) The Board shall report to the United States Drug
Enforcement Administration any of the following:
(1) any significant changes in the status of the RN
license or advanced practice license; or
(2) disciplinary action impacting an APRN's ability
to authorize or issue prescription drug orders and medication orders.
(f) The practice of the APRN approved by the Board
to order and prescribe is subject to monitoring by the Board on a
periodic basis.
(g) The Board shall maintain a list of APRNs who have
been subject to a final adverse disciplinary action for an act involving
the delegation and supervision of prescriptive authority.
(h) The Board shall provide information to the public
regarding APRNs who are prohibited from entering into or practicing
under a prescriptive authority agreement.
(i) This section takes effect September 1, 2019.
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