When substantiated by credible evidence, the following acts,
practices, and conduct are considered to be violations of the Act.
The following shall not be considered an exhaustive or exclusive listing.
(1)Practice Inconsistent with Public Health and Welfare.
Failure to practice in an acceptable professional manner consistent
with public health and welfare within the meaning of the Act includes,
but is not limited to:
(A) - (K)(No change.)
(L)prescription of any dangerous drug or controlled
substance without first establishing a defined physician-patient [
proper professional] relationship [with the patient].
(i)A defined physician-patient [proper]
relationship must include, at a minimum [requires]:
(I)establishing that the person requesting the medication
is in fact who the person claims to be;
(II)establishing a diagnosis through the use of acceptable
medical practices, which includes documenting and performing: [
such as]
(-a-)patient history;[,]
(-b-)mental status examination;[
,]
(-c-)physical examination that must
be performed by either a face-to-face visit or in-person evaluation
as defined in §174.2(3) and (4) of this title (relating to Definitions).
The requirement for a face-to-face or in-person evaluation does not
apply to mental health services, except in cases of behavioral emergencies,
as defined by 25 TAC §415.253 (relating to Definitions);[
,] and
(-d-)appropriate diagnostic and laboratory
testing.
(III)An online questionnaire or questions
and answers exchanged through email, electronic text, or chat or
telephonic evaluation of or consultation with a patient are inadequate
to establish a defined physician-patient relationship [by
questionnaire is inadequate];
(IV)[(III)] discussing with
the patient the diagnosis and the evidence for it, the risks and benefits
of various treatment options; and
(V)[(IV)] ensuring the availability
of the licensee or coverage of the patient for appropriate follow-up
care.
(ii) - (iii)(No change.)
(M) - (O)(No change.)
(2) - (7)(No change.)
(8)For purposes of §164.051(a)(4)(C)
of the Texas Occupations Code, any use of a substance listed in Schedule
I, as established by the Commissioner of the Department of State Health
Services under Chapter 481, or as established under the Comprehensive
Drug Abuse Prevention and Control Act of 1970 (21 U.S.C. §801
et seq.) constitutes excessive use of such substance.
The agency certifies that legal counsel has
reviewed
the proposal and found it to be within the state agency's
legal authority to adopt.
Filed with the Office
of the Secretary of State on February 23, 2015
TRD-201500621 Mari Robinson, J.D.
Executive Director
Texas Medical Board
Earliest possible date of adoption: April 5, 2015
For further information, please call: (512) 305-7016
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