| (I) issued by an advanced practice registered nurse
or physician assistant provided the advanced practice registered nurse
or physician assistant is practicing in accordance with Subtitle B,
Chapter 157, Occupations Code; and
(II) for a dangerous drug and signed by a pharmacist
under delegated authority of a physician as specified in Subtitle
B, Chapter 157, Occupations Code.
(ii) Each practitioner shall designate in writing the
name of each advanced practice registered nurse or physician assistant
authorized to issue a prescription drug order pursuant to Subtitle
B, Chapter 157, Occupations Code. A list of the advanced practice
registered nurses or physician assistants designated by the practitioner
must be maintained in the practitioner's usual place of business.
On request by a pharmacist, a practitioner shall furnish the pharmacist
with a copy of the written authorization for a specific advanced practice
registered nurse or physician assistant.
(E) Prescription drug orders for Schedule II controlled
substances. No Schedule II controlled substance may be dispensed without
a written prescription drug order of a practitioner on an official
prescription form as required by the Texas Controlled Substances Act, §481.075.
(3) Oral prescription drug orders.
(A) An oral prescription drug order for a controlled
substance from a practitioner or a practitioner's designated agent
may only be received by a pharmacist or a pharmacist-intern under
the direct supervision of a pharmacist.
(B) A practitioner shall designate in writing the name
of each agent authorized by the practitioner to communicate prescriptions
orally for the practitioner. The practitioner shall maintain at the
practitioner's usual place of business a list of the designated agents.
The practitioner shall provide a pharmacist with a copy of the practitioner's
written authorization for a specific agent on the pharmacist's request.
(C) A pharmacist may not dispense an oral prescription
drug order for a dangerous drug or a controlled substance issued by
a practitioner licensed in the Dominion of Canada or the United Mexican
States unless the practitioner is also licensed in Texas.
(4) Electronic prescription drug orders.
(A) Dangerous drug prescription orders.
(i) An electronic prescription drug order for a dangerous
drug may be transmitted by a practitioner or a practitioner's designated
agent:
(I) directly to a pharmacy; or
(II) through the use of a data communication device
provided:
(-a-) the confidential prescription information is
not altered during transmission; and
(-b-) confidential patient information is not accessed
or maintained by the operator of the data communication device other
than for legal purposes under federal and state law.
(ii) A practitioner shall designate in writing the
name of each agent authorized by the practitioner to electronically
transmit prescriptions for the practitioner. The practitioner shall
maintain at the practitioner's usual place of business a list of the
designated agents. The practitioner shall provide a pharmacist with
a copy of the practitioner's written authorization for a specific
agent on the pharmacist's request.
(B) Controlled substance prescription orders. A pharmacist
may only dispense an electronic prescription drug order for a Schedule
II, III, IV, or V controlled substance in compliance with federal
and state laws and the rules of the Drug Enforcement Administration
outlined in Part 1300 of the Code of Federal Regulations.
(C) Prescriptions issued by a practitioner licensed
in the Dominion of Canada or the United Mexican States. A pharmacist
may not dispense an electronic prescription drug order for a dangerous
drug or controlled substance issued by a practitioner licensed in
the Dominion of Canada or the United Mexican States unless the practitioner
is also licensed in Texas.
(5) Facsimile (faxed) prescription drug orders.
(A) A pharmacist may dispense a prescription drug order
for a dangerous drug transmitted to the pharmacy by facsimile.
(B) A pharmacist may dispense a prescription drug order
for a Schedule III-V controlled substance transmitted to the pharmacy
by facsimile provided the prescription is manually signed by the practitioner
and not electronically signed using a system that electronically replicates
the practitioner's manual signature on the prescription drug order.
(C) A pharmacist may not dispense a facsimile prescription
drug order for a dangerous drug or controlled substance issued by
a practitioner licensed in the Dominion of Canada or the United Mexican
States unless the practitioner is also licensed in Texas.
(6) Original prescription drug order records.
(A) Original prescriptions may be dispensed only in
accordance with the prescriber's authorization as indicated on the
original prescription drug order, including clarifications to the
order given by the practitioner or the practitioner's agent and recorded
on the prescription.
(B) Notwithstanding subparagraph (A) of this paragraph,
a pharmacist may dispense a quantity less than indicated on the original
prescription drug order at the request of the patient or patient's
agent.
(C) Original prescriptions shall be maintained by the
pharmacy in numerical order and remain legible for a period of two
years from the date of filling or the date of the last refill dispensed.
(D) If an original prescription drug order is changed,
such prescription order shall be invalid and of no further force and
effect; if additional drugs are to be dispensed, a new prescription
drug order with a new and separate number is required. However, an
original prescription drug order for a dangerous drug may be changed
in accordance with paragraph (10) of this subsection relating to accelerated
refills.
(E) Original prescriptions shall be maintained in three
separate files as follows:
(i) prescriptions for controlled substances listed
in Schedule II;
(ii) prescriptions for controlled substances listed
in Schedules III-V; and
(iii) prescriptions for dangerous drugs and nonprescription
drugs.
(F) Original prescription records other than prescriptions
for Schedule II controlled substances may be stored in a system that
is capable of producing a direct image of the original prescription
record, e.g., a digitalized imaging system. If original prescription
records are stored in a direct imaging system, the following is applicable:
(i) the record of refills recorded on the original
prescription must also be stored in this system;
(ii) the original prescription records must be maintained
in numerical order and separated in three files as specified in subparagraph
(D) of this paragraph; and
(iii) the pharmacy must provide immediate access to
equipment necessary to render the records easily readable.
(7) Prescription drug order information.
(A) All original prescriptions shall bear:
(i) the name of the patient, or if such drug is for
an animal, the species of such animal and the name of the owner;
(ii) the address of the patient; provided, however,
that a prescription for a dangerous drug is not required to bear the
address of the patient if such address is readily retrievable on another
appropriate, uniformly maintained pharmacy record, such as medication
records;
(iii) the name, address and telephone number of the
practitioner at the practitioner's usual place of business, legibly
printed or stamped, and if for a controlled substance, the DEA registration
number of the practitioner;
(iv) the name and strength of the drug prescribed;
(v) the quantity prescribed numerically, and if for
a controlled substance:
(I) numerically, followed by the number written as
a word, if the prescription is written;
(II) numerically, if the prescription is electronic;
or
(III) if the prescription is communicated orally or
telephonically, as transcribed by the receiving pharmacist;
(vi) directions for use;
(vii) the intended use for the drug unless the practitioner
determines the furnishing of this information is not in the best interest
of the patient;
(viii) the date of issuance;
(ix) if a faxed prescription:
(I) a statement that indicates that the prescription
has been faxed (e.g., Faxed to); and
(II) if transmitted by a designated agent, the name
of the designated agent;
(x) if electronically transmitted:
(I) the date the prescription drug order was electronically
transmitted to the pharmacy, if different from the date of issuance
of the prescription; and
Cont'd... |
