|(a) The validity of a prescription issued as a result
of a telemedicine medical service is determined by the same standards
that would apply to the issuance of the prescription in an in-person
(b) This rule does not limit the professional judgment,
discretion or decision-making authority of a licensed practitioner.
A licensed practitioner is expected to meet the standard of care and
demonstrate professional practice standards and judgment, consistent
with all applicable statutes and rules when issuing, dispensing, delivering,
or administering a prescription medication as a result of a telemedicine
(c) A valid prescription must be:
(1) issued for a legitimate medical purpose by a practitioner
as part of patient-practitioner relationship as set out in §111.005,
Texas Occupations Code; and
(2) meet all other applicable laws before prescribing,
dispensing, delivering or administering a dangerous drug or controlled
(d) Any prescription drug orders issued as the result
of a telemedicine medical service, are subject to all regulations,
limitations, and prohibitions set out in the federal and Texas Controlled
Substances Act, Texas Dangerous Drug Act and any other applicable
federal and state law.
(e) Limitation on Treatment of Chronic Pain. Chronic
pain is a legitimate medical condition that needs to be treated, but
must be balanced with concerns over patient safety and the public
health crisis involving overdose deaths. The Legislature has already
put into place laws regarding the treatment of pain and requirements
for registration and inspection of pain management clinics. Therefore,
the Board has determined clear legislative intent exists for the limitation
of chronic pain treatment through a telemedicine medical service.
(1) Treatment of chronic pain with scheduled drugs
through use of telemedicine medical services is prohibited, unless
otherwise allowed under federal and state law. For purposes of this
section, "chronic pain" means a state in which pain persists beyond
the usual course of an acute disease or healing of an injury. Chronic
pain may be associated with a chronic pathological process that causes
continuous or intermittent pain over months or years.
(2) Treatment of acute pain with scheduled drugs through
use of telemedicine medical services is allowed, unless otherwise
prohibited under federal and state law. For purposes of 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.