(a)The validity of a prescription issued as a result
of a telemedicine medical service is determined by the same standards
that would apply to the issuance of the prescription in an in-person
(b)This rule does not limit the professional judgment,
discretion or decision-making authority of a licensed practitioner.
A licensed practitioner is expected to meet the standard of care and
demonstrate professional practice standards and judgment, consistent
with all applicable statutes and rules when issuing, dispensing, delivering,
or administering a prescription medication as a result of a telemedicine
(c)A valid prescription must be:
(1)issued for a legitimate medical purpose by a practitioner
as part of patient-practitioner relationship as set out in §111.005,
of Texas Occupations Code; and
(2)meet all other applicable laws before prescribing,
dispensing, delivering or administering a dangerous drug or controlled
(d)Any prescription drug orders issued as the result
of a telemedicine medical service, are subject to all regulations,
limitations, and prohibitions set out in the federal and Texas Controlled
Substances Act, Texas Dangerous Drug Act and any other applicable
federal and state law.
(e)Limitation on Treatment of Chronic Pain. Chronic
pain is a legitimate medical condition that needs to be treated but
must be balanced with concerns over patient safety and the public
health crisis involving overdose deaths. The Legislature has already
put into place laws regarding the treatment of pain and requirements
for registration and inspection of pain management clinics. Therefore,
the Board has determined clear legislative intent exists for the limitation
of chronic pain treatment through a telemedicine medical service.
(1)For purposes of this rule, chronic pain has the
same definition as used in §170.2(4) of this title (relating
(2)For purposes of this rule, acute pain has the same
definition as used in §170.2(2) of this title.
(A)Treatment of chronic pain with scheduled drugs
through use of telemedicine medical services is prohibited, unless
otherwise allowed under federal and state law.
(B)Treatment of acute pain with scheduled drugs through
use of telemedicine medical services is allowed, unless otherwise
prohibited under federal and state law.
The agency certifies that legal counsel has reviewed
the adoption and found it to be a valid
exercise of the agency's legal
Filed with the Office
of the Secretary of State on November 6, 2017
Interim Executive Director
Texas Medical Board
Effective date: November 26, 2017
Proposal publication date: September 15, 2017
For further information, please call: (512) 305-7016