| (a) Purpose. Pursuant to Texas Occupations Code Chapter
111, and Texas Occupations Code §254.001(a), the Board is authorized
to adopt rules relating to the practice of dentistry, including teledentistry
dental services. This section establishes the standards of practice
for teledentistry.
(b) Definition. "Teledentistry dental service" is defined
in Texas Occupations Code §111.001(2-a).
(c) Prevention of Fraud and Abuse. Dentists who utilize
teledentistry dental services must adopt protocols to prevent fraud
and abuse through the use of teledentistry dental services.
(d) Complaints to the Board. Dentists who utilize teledentistry
dental services must provide notice of how patients may file a complaint
with the Board. Content and method of the notice must contain the
same information as set out in §108.3(a)(2)-(3) of this title
(relating to Consumer Information).
(e) Practice of Teledentistry.
(1) A dentist, dental hygienist, or dental assistant
who delivers teledentistry services to a patient located in Texas
must hold an active Texas license or registration issued by the Board.
(2) A dental health professional providing a dental
health care service or procedure as a teledentistry dental service:
(A) is subject to the same standard of care that would
apply to the provision of the same dental health care service or procedure
in an in-person setting as established in §108.7 of this title
(relating to Minimum Standard of Care, General);
(B) must establish a practitioner-patient relationship;
and
(C) must maintain complete and accurate dental records
as set out in §108.8 of this title (relating to Records of the
Dentist).
(3) A dentist may simultaneously delegate to and supervise
through a teledentistry dental service not more than five health professionals
who are not dentists.
(4) Adequate measures must be implemented to ensure
that patient communications, recordings and records are protected
consistent with federal and state privacy laws.
(5) Any individual may provide any photography or digital
imaging to a Texas licensed dentist or Texas licensed dental hygienist
for the sole and limited purpose of screening, assessment, or examination.
(f) Informed Consent. In addition to the informed consent
requirements in §108.7 of this title, and §108.8 of this
title, informed consent must include the following:
(1) the delegating dentist's name, Texas license number,
credentials, qualifications, contact information, and practice location
involved in the patient's care. Additionally, the name, Texas license
number, credentials, and qualifications of all dental hygienists and
dental assistants involved in the patient's care. This information
must be publicly displayed and provided in writing to the patient;
and
(2) a dentist who delegates a teledentistry dental
service must ensure that the informed consent of the patient includes
disclosure to the patient that the dentist delegated the service.
(g) Issuance of Prescriptions.
(1) The validity of a prescription issued as a result
of a teledentistry dental service is determined by the same standards
that would apply to the issuance of the prescription in an in-person
setting.
(2) 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 teledentistry
dental service.
(3) A valid prescription must be:
(A) issued for a legitimate dental purpose by a practitioner
as part of patient-practitioner relationship as set out in Texas Occupations
Code §111.005; and
(B) meet all other applicable laws and rules before
prescribing, dispensing, delivering or administering a dangerous drug
or controlled substance.
(4) Any prescription drug orders issued as the result
of a teledentistry dental 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.
(h) Limitation on Certain Prescriptions.
(1) In this subsection, the following definitions apply:
(A) "Controlled substance", "opiate", and "prescribe"
have the meanings assigned by Texas Health and Safety Code §481.002.
(B) "National holiday" means a day described by Texas
Government Code §662.003(a).
(2) When prescribing a controlled substance to a patient
as a teledentistry dental service, a dentist must not prescribe more
than is necessary to supply a patient for:
(A) if the prescription is for an opiate, a two-day
period; or
(B) if the prescription is for a controlled substance
other than an opiate, a five-day period.
(3) For each day in a period described by paragraph
(2) of this subsection that is a Saturday, Sunday, or national holiday,
the period is extended to include the next day that is not a Saturday,
Sunday, or national holiday.
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