Prescriptive authority agreements must, at a minimum:
(1) be in writing and signed and dated by the parties
to the agreement;
(2) state the name, address, and all professional license
numbers of the parties to the agreement;
(3) state the nature of the practice, practice locations,
or practice settings;
(4) identify the types or categories of drugs or devices
that may be prescribed or the types or categories of drugs or devices
that may not be prescribed;
(5) provide a general plan for addressing consultation
and referral;
(6) provide a plan for addressing patient emergencies;
(7) state the general process for communication and
the sharing of information between the physician and physician assistant
to whom the physician has delegated prescriptive authority related
to the care and treatment of patients;
(8) if alternate physician supervision is to be utilized,
designate one or more alternate physicians who may:
(A) provide appropriate supervision on a temporary
basis in accordance with the requirements established by the prescriptive
authority agreement and the requirements of Chapter 157 of the Medical
Practice Act and Chapter 193 of this title (relating to Standing Delegation
Orders); and
(B) participate in the prescriptive authority quality
assurance and improvement plan meetings required under this section;
and
(9) describe a prescriptive authority quality assurance
and improvement plan and specify methods for documenting the implementation
of the plan that includes the following:
(A) chart review, with the number of charts to be reviewed
determined by the physician and physician assistant; and
(B) periodic meetings between the physician assistant
and the physician at a location determined by the physician and the
physician assistant.
(10) The periodic meetings described by paragraph (9)(B)
of this section must include:
(A) the sharing of information relating to patient
treatment and care, needed changes in patient care plans, and issues
relating to referrals;
(B) discussion of patient care improvement; and
(C) documentation of the periodic meetings.
(11) The periodic meetings shall take place at least
once a month in a manner determined by the physician and physician
assistant.
(12) The prescriptive authority agreement may include
other provisions agreed to by the physician and the physician assistant.
(13) If the parties to the prescriptive authority agreement
practice in a physician group practice, the physician may appoint
one or more alternate supervising physicians designated, if any, to
conduct and document the quality assurance meetings in accordance
with the requirements of Chapter 157 of the Medical Practice Act and
Chapter 193 of this title.
(14) The prescriptive authority agreement need not
describe the exact steps that a physician assistant must take with
respect to each specific condition, disease, or symptom.
(15) A physician or physician assistant who is a party
to a prescriptive authority agreement must retain a copy of the agreement
until the second anniversary of the date the agreement is terminated.
(16) A party to a prescriptive authority agreement
may not by contract waive, void, or nullify any provision of this
section or requirements for prescriptive authority agreements set
forth by Chapter 157 of the Medical Practice Act and Chapter 193 of
this title.
(17) In the event that a party to a prescriptive authority
agreement is notified that the individual has become the subject of
an investigation by the board or the Texas Medical Board, the individual
shall immediately notify the other party to the prescriptive authority
agreement.
(18) The prescriptive authority agreement and any amendments
must be reviewed at least annually, dated, and signed by the parties
to the agreement. The prescriptive authority agreement and any amendments
must be made available to the board, the Texas Board of Nursing, or
the Texas Medical Board not later than the third business day after
the date of receipt of request, if any.
(19) The prescriptive authority agreement should promote
the exercise of professional judgment by the physician assistant commensurate
with the physician assistant's education and experience and the relationship
between the physician assistant and the physician.
(20) This section shall be liberally construed to allow
the use of prescriptive authority agreements to safely and effectively
utilize the skills and services of physician assistants.
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