(a) Podiatrists shall comply with all federal and state
laws and regulations relating to the ordering and prescribing of controlled
substances in Texas, including but not limited to requirements set
forth by the United States Drug Enforcement Administration, United
States Food & Drug Administration, Texas Health & Human Services
Commission, Texas Department of Public Safety, Texas State Board of
Pharmacy, and the department.
(b) A podiatrist may not prescribe a controlled substance
except for a valid podiatric medical purpose and in the course of
podiatric practice.
(c) A podiatrist may not confer upon and may not delegate
prescriptive authority (the act of prescribing or ordering a drug
or device) to any other person.
(d) A podiatrist may designate an agent to communicate
a prescription to a pharmacist. A podiatrist who designates an agent
shall provide a pharmacist on request with a copy of the podiatrist's
written authorization for a designated agent to communicate a prescription
and shall maintain at the podiatrist's usual place of business a list
of the designated agents. The podiatrist remains personally responsible
for the actions of the designated agent who communicates a prescription
to a pharmacist.
(e) Responsible prescribing of controlled substances
requires that a podiatrist consider certain elements prior to issuing
a prescription, including, but not limited to:
(1) reviewing the patient's Schedule II, III, IV, and
V prescription drug history report by accessing the Texas State Board
of Pharmacy's - Texas Prescription Monitoring Program (PMP) database;
(2) the patient's date of birth matches with proper
identification;
(3) an initial comprehensive history and physical examination
is performed;
(4) the Schedule II prescription copy is in the chart
or record found for each prescription written; and
(5) alternative therapy (e.g. ultrasound, TENS) discussed
and prescribed for the patient.
(f) Prior to prescribing opioids, benzodiazepines,
barbiturates, or carisoprodol, a podiatrist shall review the patient's
Schedule II, III, IV, and V prescription drug history report by accessing
the Texas State Board of Pharmacy's - Texas Prescription Monitoring
Program (PMP) database. Failure to do so is grounds for disciplinary
action by the department.
(g) Prior to prescribing any controlled substance,
a podiatrist may review the patient's Schedule II, III, IV, and V
prescription drug history report by accessing the Texas State Board
of Pharmacy's - Texas Prescription Monitoring Program (PMP) database.
(h) An employee of the podiatrist acting at the direction
of the podiatrist may perform the function described in subsection
(e) and (f) so long as that employee acts in compliance with HIPAA
and only accesses information related to a particular patient of the
podiatrist.
(i) A podiatrist or an employee of a podiatrist acting
at the direction of the podiatrist may access the Texas State Board
of Pharmacy's - Texas Prescription Monitoring Program (PMP) database
to inquire about the podiatrist's own Schedule II, III, IV, and V
prescription drug activity.
(j) A podiatrist or an employee of a podiatrist acting
at the direction of the podiatrist may not access the Texas State
Board of Pharmacy's - Texas Prescription Monitoring Program (PMP)
database for reasons not directly related to a patient under their
care. Unauthorized access is grounds for disciplinary action by the
department.
(k) If a podiatrist uses an electronic medical records
management system (health information exchange) that integrates a
patient's Schedule II, III, IV, and V prescription drug history data
from the Texas State Board of Pharmacy's - Texas Prescription Monitoring
Program (PMP) database, a review of the electronic medical records
management system (health information exchange) with the integrated
data shall be deemed compliant with the review of the Texas State
Board of Pharmacy's - Texas Prescription Monitoring Program (PMP)
database as required under §481.0764(a) of the Texas Health and
Safety Code and these rules.
(l) The duty to access a patient's Schedule II, III,
IV, and V prescription drug history report through the Texas State
Board of Pharmacy's - Texas Prescription Monitoring Program (PMP)
database as described in subsection (e) does not apply in the following
circumstances: (1) it is clearly noted in the patient's medical record
that the patient has a diagnosis of cancer or is in hospice care;
or (2) the podiatrist or an employee of the podiatrist makes a good
faith attempt to access the Texas State Board of Pharmacy's - Texas
Prescription Monitoring Program (PMP) database but is unable to access
the information because of circumstances outside the control of the
podiatrist or an employee of the podiatrist and the good faith attempt
and circumstances are clearly documented in the patient's medical
record for prescribing a controlled substance.
(m) Information obtained from the Texas State Board
of Pharmacy's - Texas Prescription Monitoring Program (PMP) database
may be included in any form in the searched patient's medical record
and is subject to any applicable state or federal confidentiality,
privacy or security laws.
(n) In accordance with Texas Health and Safety Code
Chapter 483, Subchapter E., a podiatrist may prescribe an opioid antagonist
to a person at risk of experiencing an opioid-related drug overdose
or to a family member, friend, or other person in a position to assist
the person who is at risk of experiencing an opioid-related drug overdose.
A podiatrist who prescribes an opioid antagonist shall document the
basis for the prescription in the medical record of the person who
is at risk of experiencing an opioid-related drug overdose.
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