| (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
setting.
(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
medical service.
(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,
of Texas Occupations Code; and
(2) meet all other applicable laws before prescribing,
dispensing, delivering or administering a dangerous drug or controlled
substance.
(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 for Chronic Pain. For purposes of this
rule, chronic pain has the same definition as used in §170.2(4)
of this title (relating to Definitions). Telemedicine medical services
used for the treatment of chronic pain with scheduled drugs by any
means other than via audio and video two-way communication is prohibited,
unless a patient:
(A) is an established chronic pain patient of the physician
or health professional issuing the prescription;
(B) is receiving a prescription that is identical to
a prescription issued at the previous visit; and
(C) has been seen by the prescribing physician or health
professional defined under Section 111.001(1) of Texas Occupations
Code, in the last 90 days either:
(i) in-person; or
(ii) via telemedicine using audio and video two-way
communication.
(2) Treatment for Acute Pain. For purposes of this
rule, acute pain has the same definition as used in §170.2(2)
of this title. Telemedicine medical services may be used for the treatment
of acute pain with scheduled drugs, unless otherwise prohibited under
federal and state law.
|
| Source Note: The provisions of this §174.5 adopted to be effective July 4, 2004, 29 TexReg 6088; amended to be effective October 17, 2010, 35 TexReg 9085; amended to be effective June 4, 2015, 40 TexReg 3148; amended to be effective November 26, 2017, 42 TexReg 6512; amended to be effective October 7, 2021, 46 TexReg 6544 |
