Texas Register

RULE §174.5Issuance of Prescriptions
ISSUE 11/17/2017
ACTION Final/Adopted
Preamble Texas Admin Code Rule

(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 setting.

(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 medical service.

(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 substance.

(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 to Definitions).

  (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 authority.

Filed with the Office of the Secretary of State on November 6, 2017


Scott Freshour

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

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