(a) - (d)(No change.)
(1)Treatment of chronic pain with scheduled drugs
through use of telemedicine medical services is prohibited, unless
otherwise allowed under federal and state law. For purposes of this
section, "chronic pain" means a state in which pain persists beyond
the usual course of an acute disease or healing of an injury. Chronic
pain may be associated with a chronic pathological process that causes
continuous or intermittent pain over months or years.
(A)Notwithstanding paragraph (e)(1),
treatment of chronic pain with scheduled drugs through use of telemedicine
medical services is not prohibited by this rule if the patient is
an established chronic pain patient of the APRN and is seeking telephone
refill of an existing prescription, and the APRN determines that such
telemedicine treatment is needed due to the COVID-19 pandemic.
(B)If a patient is treated for chronic
pain with scheduled drugs through the use of telemedicine medical
services as permitted by (e)(1)(A), the medical records must document
the exception and the reason that a telemedicine visit was conducted
instead of an in-person visit.
(C)An APRN, when determining whether
to utilize telemedicine medical services for the treatment of chronic
pain with controlled substances as permitted by (e)(1)(A) above, shall
give due consideration to factors that include, at a minimum, date
of the patient's last in-person visit, patient co-morbidities, and
occupational related COVID risks. These are not the sole, exclusive,
or exhaustive factors an APRN should consider under this rule.
(D)The emergency amendment of this
rule, effective July 7, 2020, shall be in effect for only 60 days
or the duration of the time period that the Governor's disaster declaration
of March 13, 2020, in response to the COVID-19 pandemic is in effect,
whichever is shorter.
The agency certifies that legal counsel has
reviewed the emergency adoption and found it to be within the state
agency's legal authority to adopt.
Filed with the Office
of the Secretary of State on July 6, 2020
Deputy General Counsel
Texas Board of Nursing
Effective date: July 7, 2020
Expiration date: September 4, 2020
For further information, please call: (512) 305-6822