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Updates on Prescribing Controlled Substances

Physicians and Physician Assistants (PAs) who prescribe or will be prescribing controlled substances in the State of Texas need to be aware of changes to the laws regarding prescribing and ordering these drugs.

 

ACTION ALERT – Register with Prescription Monitoring Program

Texas Prescription Monitoring Program (PMP) registration is strongly encouraged for any physician and physician assistant who is prescribing controlled substances. The PMP can be used to verify a practitioner’s own records and prescribing history as well as inquiring about patients. In addition, the program may be used to generate and disseminate information regarding prescription trends.

Please know, as required by HB 2561, the Medical Board is providing licensee contact information to the Texas State Board of Pharmacy, the agency which administers the PMP, for the purposes of pre-registering prescribers for the program. The Texas State Board of Pharmacy has begun to contact prescribers, by e-mail, with a link to register with PMP.

Click here  for more information about PMP. Registration FAQs are available here

Texas Controlled Substances Registration Numbers for Physicians and PAs

Under Senate Bill 195, the requirement for controlled substances registration (CSR) with the Texas Department of Public Safety (DPS) was eliminated on September 1, 2016. DPS has stopped accepting applications for the Texas Controlled Substances Registration under Chapter 481.061 of the Health and Safety Code. 

The DPS CSR registration process will not be replaced by another process. Physicians and PAs will continue to be required to hold registration from the U.S. Drug Enforcement Administration in order to prescribe controlled substances and to register prescriptive delegation for Physician Assistants and Advanced Practice Nurses with the Texas Medical Board.

Physician Assistants with Temporary Licenses pending Medical Board approval will still be required to file a Prescriptive Delegation Form with the Registrations Department of the Medical Board.  To request a form, please email Registrations@tmb.state.tx.us.  The DEA will verify temporary licenses with assigned delegation for registration of a DEA CSR directly with board staff.


Prescription Pad Orders

Effective September 1, 2016, the Texas Prescription Program transferred to the Texas State Board of Pharmacy (TSBP). This includes the oversight and processing of the official prescription pads for Schedule II prescription forms. The Texas Department of Public Safety no longer accepts orders for the official prescription pads; however, official prescription forms issued by the Texas Department of Public Safety prior to September 1, 2016 will be considered valid prescription forms.

For information regarding prescription pad ordering, visit the TSBP's website: http://www.pharmacy.texas.gov/rxpad/.

 

Information for Prescribers

 

Use this link for important information regarding the use and abuse of certain drugs as required by Senate Bill 144 http://www.tsbp.state.tx.us/sb144.htm

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    Effective September 1, 2008, all prescriptions for Schedule II-V controlled substances must contain the information below to be considered valid and, subsequently, filled:

    • quantity of the substance prescribed (written as both a number and as a word)
    • date of issue (cannot be postdated)
    • name, address, and date of birth or age of patient
    • name and strength of the controlled substance prescribed
    • directions for the use of the controlled substance
    • intended use of the substance prescribed unless the practitioner determines the furnishing of this information is not in the best interest of the patient
    • printed or stamped name, address, Federal Drug Enforcement Administrations (DEA) registration number, and telephone number of the practitioner’s usual place of business
    • the signature of the prescribing practitioner, unless the prescription is called into the pharmacy
    • Until September 1, 2016, the practitioner’s current and valid DPS registration number for practitioners licensed in Texas.  The DPS registration number must belong to the practitioner issuing the prescription; the prescribing practitioner may be a properly registered physician assistant or an advanced practice nurse on Schedules III-V prescriptions.

    The following information from the Texas Administrative code, Title 37, Part 1, Chapter 13, Subchapter B, Rule §13.27 is available online here.

     

    (a) A mid-level practitioner must have a delegating physician with prescriptive authority as required by the Act, §481.002(39)(D). Each physician must certify the authorizing delegation on the mid-level practitioner's application and include the physician's:

         (1) name;

         (2) Texas Medical Board license number;

         (3) DPS registration number;

         (4) signature; and

         (5) date of signature.

    (b) A physician who signs a mid-level practitioner's application as the delegating physician assumes responsibility for ensuring the mid-level practitioner practices under the laws of this state related to controlled substances prescribing activities. A physician who fails to properly monitor the mid-level practitioner's activities may be subject to disciplinary action.

    (c) A delegating physician must have an unrestricted and active DPS registration and Texas Medical Board license number.

    (d) Modification or change of delegating physician.

         (1) A change of delegating physician must be submitted in writing as required by this chapter.

         (2) A delegating physician must notify the department in writing to terminate delegation with a mid-level practitioner.

    (e) Accurate and timely internal institutional records listing the name and license number of the physician must be made available to the department within 24 hours of a request.

    (f) The physician is limited to the extent and number of mid-level practitioners the physician delegated as outlined in Texas Occupations Code, Chapter 157.