|(a) The APRN with full licensure and a valid prescription
authorization number shall:
(1) order or prescribe only those drugs or devices
(A) authorized by a prescriptive authority agreement
or, if practicing in a facility-based practice, authorized by either
a prescriptive authority agreement or protocols or other written authorization;
(B) ordered or prescribed for patient populations within
the accepted scope of professional practice for the APRN's license;
(2) comply with the requirements for chart reviews
specified in the prescriptive authority agreement and periodic face
to face meetings set forth in the prescriptive authority agreement;
(3) comply with the requirements set forth in protocols
or other written authorization if ordering or prescribing drugs or
devices under facility-based protocols or other written authorization.
(b) Prescription Information. The format and essential
elements of a prescription drug order shall comply with the requirements
of the Texas State Board of Pharmacy. The following information must
be provided on each prescription:
(1) the patient's name and address;
(2) the name, strength, and quantity of the drug to
(3) directions to the patient regarding taking of the
drug and the dosage;
(4) the intended use of the drug, if appropriate;
(5) the name, address, and telephone number of the
physician with whom the APRN has a prescriptive authority agreement
or facility-based protocols or other written authorization;
(6) address and telephone number of the site at which
the prescription drug order was issued;
(7) the date of issuance;
(8) the number of refills permitted;
(9) the name, prescription authorization number, and
original signature of the APRN who authorized the prescription drug
(10) the United States Drug Enforcement Administration
numbers of the APRN and the delegating physician, if the prescription
drug order is for a controlled substance.
(c) Waivers from Electronic Prescribing Requirements.
(1) Beginning January 1, 2021, licensee prescribers
must issue prescriptions for controlled substances electronically
unless one of the circumstances specified in Tex. Health & Safety
Code §481.0755(a) applies.
(2) A licensee prescriber may request a waiver from
the electronic prescribing requirements by submitting a waiver request
to the Board that demonstrates the circumstances necessitating a waiver
from the electronic prescribing requirements, including:
(A) economic hardship, taking into account factors
(i) any special situational factors affecting either
the cost of compliance or ability to comply;
(ii) the likely impact of compliance on profitability
or viability; and
(iii) the availability of measures that would mitigate
the economic impact of compliance;
(B) technological limitations not reasonably within
the control of the licensee prescriber; and
(C) other exceptional circumstances demonstrated in
the waiver request.
(3) A waiver may be granted for a period of one year.
If circumstances that necessitated the waiver continue beyond that
time period, a licensee prescriber may re-apply to the Board for a
subsequent waiver no earlier than the 30th day prior to the expiration
of the original waiver.
(d) Generic Substitution. The APRN shall authorize
or prevent generic substitution on a prescription in compliance with
the current rules of the Texas State Board of Pharmacy relating to
(e) An APRN may order or prescribe medications for
sexually transmitted diseases for partners of an established patient,
if the APRN assesses the patient and determines that the patient may
have been infected with a sexually transmitted disease. Nothing in
this subsection shall be construed to require the APRN to issue prescriptions
for partners of patients.
(f) APRNs may order or prescribe only those medications
that are FDA approved unless done through protocol registration in
a United States Institutional Review Board or Expanded Access authorized
clinical trial. "Off label" use, or prescription of FDA-approved medications
for uses other than that indicated by the FDA, is permitted when such
(1) within the current standard of care for treatment
of the disease or condition; and
(2) supported by evidence-based research.
(g) The APRN with full licensure and a valid prescriptive
authorization number shall cooperate with representatives of the Board
and the Texas Medical Board during an inspection and audit relating
to the operation and implementation of a prescriptive authority agreement.