The following words and terms, when used in this chapter shall
have the following meanings unless the context indicates otherwise.
(1)Prescription--Any medication(s)
that require a prescription issued to the ultimate user as the result
of a telemedicine medical service, by:
(A)a Texas licensed physician, and if the prescription
is for a controlled substance, the physician must have a current valid
DEA registration number; or
(B)issued by a Texas licensed practitioner, acting
under the delegated authority of a Texas licensed physician, and in
accordance with the required prescriptive authority agreement or other
permissible forms of delegation as set out by Chapter 157 of the Medical
Practice Act, and, if the prescription is for a controlled substance,
the licensed practitioner must have a current, valid DEA registration.
In addition, if the prescription is for a controlled substance listed
in schedule II, the licensed practitioners may only use the official
prescription forms issued with their name, address, phone number,
and DEA numbers, and the delegating physician's name and DEA number.
(C)The use of electronic prescriptions (e-scripts)
is allowed as permitted by state and federal law.
(2)Store and forward technology--is
defined in §111.001(2) of the Texas Occupations Code.
(3)Telehealth services--is defined
in §111.001(3) of the Texas Occupations Code.
(4)Telemedicine medical services--is
defined in §111.001(4) of the Texas Occupations Code.
(5)Ultimate user--is the same definition
used in the Texas Pharmacy Act.
[(1)Distant site provider--A physician
or a physician assistant or advanced practice nurse who is supervised
by and has delegated authority from a licensed Texas physician, who
uses telemedicine to provide health care services to a patient in
Texas. Distant site providers must be licensed in Texas.]
[(2)Established medical site--A location
where a patient will present to seek medical care where there is a
patient site presenter and sufficient technology and medical equipment
to allow for an adequate physical evaluation, as appropriate for the
patient's presenting complaint. It requires establishing a defined
physician-patient relationship, as defined by §190.8(1)(L) of
this title (relating to Violation Guidelines). A patient's private
home is not considered an established medical site, except as provided
in §174.6(d) of this title (relating to Telemedicine Medical
Services Provided at an Established Medical Site). An established
medical site includes all Mental Health and Mental Retardation Centers
(MHMRs), and Community Centers, as defined by Health and Safety Code,
Chapter 534, where the patient is a resident and the medical services
provided are limited to mental health services.]
[(3)Face-to-face visit--An evaluation
performed on a patient where the provider and patient are both at
the same physical location or where the patient is at an established
medical site.]
[(4)In-person evaluation--A patient
evaluation conducted by a provider who is at the same physical location
as the location of the patient.]
[(5)Medium--Any mechanism of information
transfer including electronic means.]
[(6)Patient site location--The patient
site location is where the patient is physically located.]
[(7)Patient site presenter--The patient
site presenter is the individual at the patient site location who
introduces the patient to the distant site physician for examination
and to whom the distant site physician may delegate tasks and activities.
A patient site presenter must be:]
[(A)licensed or certified in this state to perform
health care services or a qualified mental health professional-community
services (QMHP-CS) as defined in 25 TAC §412.303(48); and]
[(B)delegated only tasks and activities within the
scope of the individual's licensure or certification.]
[(8)Person--An individual unless
otherwise expressly made applicable to a partnership, association,
or corporation.]
[(9)Physician-patient e-mail--An
interactive communication via an interactive electronic text messaging
system between a physician (or their medical staff and patients within
a professional relationship in which the physician has taken on an
explicit measure of responsibility for the patient's care.]
[(10)Telemedicine medical service--The
practice of medical care delivery, initiated by a distant site provider,
who is physically located at a site other than the site where the
patient is located, for the purposes of evaluation, diagnosis, consultation,
or treatment which requires the use of advanced telecommunications
technology that allows the distant site provider to see and hear the
patient in real time.]
[(11)Group or Institutional Setting--These
include residential treatment facilities, halfway houses, jails, juvenile
detention centers, prisons, nursing homes, group homes, rehabilitation
centers, and assisted living facilities.]
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 September 1, 2017
TRD-201703487 Mari Robinson, J.D.
Executive Director
Texas Medical Board
Earliest possible date of adoption: October 15, 2017
For further information, please call: (512) 305-7016
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