The Texas Medical Board (Board) proposes amendments to 22 TAC §174.5, relating to the Issuance of Prescriptions.

The amendments to §174.5(e) allow physicians to utilize telemedicine to continue issuing previous prescription(s) for scheduled medications to established chronic pain patients, if the physician has, within the past 90 days, seen a patient in-person or via a telemedicine visit using two-way audio and video communication. The amendments will consistently and conveniently provide patients access to schedule drugs needed to ensure on-going treatment of chronic pain and avoid potential adverse consequences associated with the abrupt cessation of pain medication.

Scott Freshour, General Counsel for the Texas Medical Board, has determined that, for each year of the first five years the amendments are in effect, the public benefit anticipated as a result of enforcing the proposed amendments will be to allow physicians and other health care professionals to provide necessary medical services to related to issuance of prescriptions including controlled substances for patients. The amendments eliminate the required travel to the physician or healthcare provider for an in-person visit each time the patient needs a refill for pain medication and improves the overall continuity of care for these patients, while still meeting the standard of care and complying with state and federal law.

Mr. Freshour has also determined that for the first five-year period the amendments are in effect, there will be no fiscal impact or effect on government growth as a result of enforcing the proposed amendments.

Mr. Freshour has also determined that for the first five-year period these amendments are in effect there will be no probable economic cost to individuals required to comply with these proposed amendments.

Pursuant to Texas Government Code §2006.002, the agency provides the following economic impact statement for these proposed amendments and determined that for each year of the first five years the amendments will be in effect, there will be no effect on small businesses, micro businesses, or rural communities. The agency has considered alternative methods of achieving the purpose of the proposed amendments and found none.

Pursuant to Texas Government Code §2001.024(a)(4), Mr. Freshour certifies that this proposal has been reviewed and the agency has determined that for each year of the first five years the amendments are in effect:

(1) there is no additional estimated cost to the state or to local governments expected as a result of enforcing or administering the proposed amendments;

(2) there is no estimated reduction in costs to the state or to local governments as a result of enforcing or administering the proposed amendments;

(3) there is no estimated loss or increase in revenue to the state or to local governments as a result of enforcing or administering the proposed amendments; and

(4) there is no foreseeable implication relating to cost or revenues of the state or local governments with regard to enforcing or administering the proposed amendments.

Pursuant to Texas Government Code §2001.024(a)(6) and §2001.022, the agency has determined that for each year of the first five years the amendments will be in effect, there will be no effect on local economy and local employment.

Pursuant to Government Code §2001.0221, the agency provides the following Government Growth Impact Statement for the amendments. For each year of the first five years the amendments will be in effect, Mr. Freshour has determined the following:

(1) The proposed amendments do not create or eliminate a government program.

(2) Implementation of the proposed amendments do not require the creation of new employee positions or the elimination of existing employee positions.

(3) Implementation of the proposed amendments do not require an increase or decrease in future legislative appropriations to the agency.

(4) The proposed amendments do not require an increase or decrease in fees paid to the agency.

(5) The proposed amendments do not create new regulations.

(6) The proposed amendments do not repeal existing regulations. The proposed amendments do not expand or limit an existing regulation.

(7) The proposed amendments do not increase the number of individuals subject to the rules' applicability.

(8) The proposed amendments do not positively or adversely affect this state's economy.

Comments on the proposals may be submitted to Rita Chapin, P.O. Box 2018, Austin, Texas 78768-2018, or e-mail comments to: rules.development@tmb.state.tx.us. A public hearing will be held at a later date.

The proposed amendments are proposed under the authority of Texas Occupations Code §§153.001, which provides authority for the Board to adopt rules necessary to administer and enforce the Medical Practice Act and to adopt rules necessary to regulate and license physicians.

Other statutes affected by this rule are Chapters 111 of the Texas Occupations Code.