(a) In this section, "acute pain" means the normal,
predicted, physiological response to a stimulus such as trauma, disease,
and operative procedures. Acute pain is time limited and the term
does not include:
(1) chronic pain;
(2) pain being treated as part of cancer care;
(3) pain being treated as part of hospice or other
end-of-life care; or
(4) pain being treated as part of palliative care.
(b) For the treatment of acute pain, a podiatrist may
not:
(1) issue a prescription for an opioid in an amount
that exceeds a 10-day supply; or
(2) provide for a refill of an opioid.
(c) After January 1, 2021, all controlled substances
must be prescribed electronically except:
(1) in an emergency or in circumstances in which electronic
prescribing is not available due to temporary technological or electronic
failure, in a manner provided for by the Texas State Board of Pharmacy
rules;
(2) by a practitioner to be dispensed by a pharmacy
located outside this state, in a manner provided for by the Texas
State Board of Pharmacy rules;
(3) when the prescriber and dispenser are in the same
location or under the same license;
(4) in circumstances in which necessary elements are
not supported by the most recently implemented national data standard
that facilitates electronic prescribing;
(5) for a drug for which the United States Food and
Drug Administration requires additional information in the prescription
that is not possible with electronic prescribing;
(6) for a non-patient-specific prescription pursuant
to a standing order, approved protocol for drug therapy, collaborative
drug management, or comprehensive medication management, in response
to a public health emergency or in other circumstances in which the
practitioner may issue a non-patient-specific prescription;
(7) for a drug under a research protocol;
(8) by a practitioner who has received a waiver under
Section 481.0756 of the Texas Health and Safety Code from the requirement
to use electronic prescribing, as provided by subsections (d) - (e);
or
(9) under circumstances in which the practitioner has
the present ability to submit an electronic prescription but reasonably
determines that it would be impractical for the patient to obtain
the drugs prescribed under the electronic prescription in a timely
manner and that a delay would adversely impact the patient's medical
condition.
(d) To obtain a waiver of the requirement to use electronic
prescribing, a practitioner must submit a waiver request on a form
approved by the department. The waiver request form must document
sufficient evidence of the circumstances justifying the waiver as
outlined in subsection (e). A waiver granted by the department under
this section shall expire one year after the date of approval. A practitioner
may reapply for a subsequent waiver not earlier than the 30th day
before the date the waiver expires if the circumstances that necessitated
the waiver continue.
(e) A practitioner's waiver of electronic prescribing
request form must contain sufficient evidence of one or more of the
following that, in the judgment of the executive director, justify
the issuance of a waiver:
(1) economic hardship, including:
(A) any special situational factors affecting either
the cost of compliance or ability to comply;
(B) the likely impact of compliance on profitability
or viability; and
(C) the availability of measures that would mitigate
the economic impact of compliance;
(2) technological limitations not reasonably within
the control of the practitioner;
(3) issuance of fifty or fewer prescriptions for controlled
substances in the year immediately prior to the application for a
waiver, as documented by the Texas Prescription Monitoring Program;
or
(4) other exceptional circumstances demonstrated by
the practitioner.
(f) The department may revoke or refuse to issue a
waiver under this section if the practitioner violates any provision
of Texas Occupations Code, Chapters 51 or 202, this chapter, or any
rule or order of the executive director or commission.
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