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“... r process is available here.
Register with Prescription Monitoring Program - Mandatory Checks Started March 1, 2020
The Texas Prescription Monitoring Program (PMP) is used to verify a practitioner’s own records and prescribing history as well as inquiring about patients. In addition, th ... ”
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Pain Management and the Prescription of Opioids
At least 2 of the 24 formal hours must involve the study of the following topics:
• best practices, alternative treatment options, and multi-modal approaches to pain management that may include physical ... ”
“... the two credits involving pain management and the prescription of opioids, or the required course in the prevention of human trafficking, as outlined on the page above. ”
“... for two credits involving pain management and the prescription of opioids, or the required course in the prevention of human trafficking, as outlined on the page above. ”
“... s the physician's name need to be included on the prescription?
Is there still a ratio for the number of APRNs or PAs to whom a physician may delegate prescriptive authority?
Is there a waiver if a physician wants to delegate prescriptive authority to more than seven full time equivalent APRNs a ... ”
“... 104 (2003) fee per registration, the $13.48 Prescription Monitoring Program (PMP) fee, and a $5 Office of Patient Protection fee for the first year, with an additional $1 charged for any subsequent year. These fees are required by statute and cannot be pro-rated. The remaining amount is requir ... ”
“... sp;PDF | Word
Chapter 170 -
Prescription of Opioid Antagonists: HTML | PDF | Word
Chapter 171 -
Interstate Medical Licensure Compact: HTML | PDF | Word
Physician Assistants
Chapt ... ”
“... signing for the receipt of pharmaceutical sample prescription medications and distributing the samples to patients in a specific practice setting where the physician assistant is authorized to prescribe pharmaceutical medications or order a drug or device, as provided by the Medical Practice Act, C ... ”
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The initial registration fee includes the $13.48 Prescription Monitoring Program (PMP) fee, and a $5 Office of Patient Protection fee for the first year, with an additional $1 charged for any subsequent year. These fees are required by statute and cannot be pro-rated. The remaining amount is requir ... ”
“... he biennial registration fee includes the $13.48 Prescription Monitoring Program (PMP) fee, $15.00 for the Physician Health Program (PHP) and a $2 Office of Patient Protection fee. These fees are required by statute. The remaining $535 is the fee required by the TMB.
These fees are explained ... ”
“... ature of the prescribing practitioner, unless the prescription is called into the pharmacy
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“... des an $80 Senate Bill 104 (2003) fee, the $13.48 Prescription Monitoring Program (PMP) fee, $11.00 for the National Practitioner Data Bank (NPDB), $15.00 for the Physician Health Program (PHP), and a $2 Office of Patient Protection fee. These fees are required by statute. The remaining $3 ... ”
“... &D premiums.
Other insurance benefits include prescription drug coverage, dental coverage for employee and eligible dependents, disability coverage for employee only, term life and accidental death and dismemberment for employee and eligible dependents, and TexFlex Health Care and Day Care Accou ... ”
“... ww.immunizetexas.com.
Medicaid Prescribers Prescription Pad Notice
As of April 1, 2008, practitioners who prescribe to Medicaid patients will be required to use tamper-resistant prescription paper when writing a prescription for any drug for Medicaid recipients.
Tamper Resistant Rx Provider N ... ”
“... ority of patients are issued on a monthly basis a prescription for opioids, benzodiazepines, barbiturates, or carisoprodol, but not including suboxone.
Please visit Chapter 172 of the Board rules for the complete regulations.
Board Rules
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Description: Rule Changes November 30, 2009
Document: ... g to Delegation of the Carrying Out or Signing of Prescription Drug, reflects changes passed during
the 81st Legislative Session under Senate Bill No. 532. Specifically, the amendments change requirements relating to primary, alternate and facility-based practice sites; the number of nurse midwive ...
Description: Rule Changes October 03, 2010
Document: ... e anesthetists (CRNAs) who only sign or carry out prescription drug orders are not required to register with the Board. The Board has determined that the clarification is necessary, based on the interpretation of Texas Occupations Code §157.0711(b-1) to not apply to CRNAs who are providing anesthesi ...
Description: Rule Changes September 27, 2007
Document: ... 181.2 Definitions; 181.3 Release of Contact Lens Prescription; and 181.6 Physician s Prescriptions: Delegation, relating to establishing that the verification of a contact lens prescription may substitute for an original signature to create a valid contact lens prescription. Chapter 191, District R ...
Description: Rule Changes August 10, 2008
Document: ... 3.6, Delegation of the Carrying Out or Signing of Prescription Orders to Physician Assistants or Advance Practice Nurses, clarifies physician supervision at medically-underserved areas and alternate physician practice sites (withdrawn); §193.7, Delegated Drug Therapy Management , updates reference t ...
Description: Rule Changes June 24, 2009
Document: ... sional relationship has been established, for the prescription of drugs for a partner of a patient who may have a sexually transmitted disease. The Board has determined that the amendment to the rule addresses a serious public health issue and is intended to allow physicians to treat persons with se ...
Description: Rule Changes March 04, 1998
Document: ... a patient may request and receive a contact lens prescription and under which a physician shall provide such prescription, as mandated by the 75th Legislature through the Texas Contact Lens Prescription Act Chapter 183, Acupuncture, repeal of current 183.17 and new sections 183.17 and 183.23, to im ...
Description: Rule Changes January 09, 2005
Document: ... egarding delegation of carrying out or signing of prescription drug orders to Physician Assistants and Advanced Nurse Practitioners.
Description: Press Release January 11, 2007 (PDF File)
Document: ... Williams has also been arrested and charged with prescription fraud.
The temporary suspension hearing took place Wednesday, January 10, and the suspension was effective immediately. The length of a temporary suspension order is indefinite but it remains in effect until the board takes further acti ...
Description: Press Release January 24, 2005 (PDF File)
Document: ... ing: Dr. Elder diverted an associate's triplicate prescription pad to prescribe medications to himself and family members; he wrote false and fictitious prescriptions; and his hospital staff privileges were summarily suspended. Based on these findings, the panel found that Dr. Elder is a real danger ...
Description: Press Release February 09, 2005 (PDF File)
Document: ... der's diversion of another physician's triplicate prescription pad to prescribe medications to himself and family members; his resignation from Green Oaks Hospital while under investigation; his improper termination of a physician-patient relationship (the patient was a minor child whom he was treat ...
Description: Press Release February 10, 2009 A (PDF File)
Document: ... ation's action against Dr. Gilmore for allowing a prescription to be issued under her name to a patient she did not see. Kobs, Darcey Gus Jr., M.D., Lic. #D2565, Hattiesburg MS On February 6, 2009, the board and Dr. Kobs entered into an agreed order of voluntary surrender. The action was based on ac ...
Description: Press Release February 11, 2004 (PDF File)
Document: ... n was based on Dr. Hamilton's drug abuse and self-prescription of Phenobarbital. HOWARD, ANNETTE M, M.D., HOUSTON, TX, Lic. #J5161 On 2-6-04 the Board and Dr. Howard entered into an Agreed Order publicly reprimanding Dr. Howard, ordering her to perform 200 hours of community service, and assessing a ...
Description: Press Release February 15, 2007 A (PDF File)
Document: ... h codeine for no fewer than nine persons, using a prescription pad from a former employer. In August, 2006, Dr. Salmond received "field release citations" from Austin police for possession of drug paraphernalia, which later tested positive for traces of cocaine. He was reported missing during this t ...
Description: Press Release February 15, 2008 A (PDF File)
Document: ... nces registrations eliminating his Schedule II-IV prescription authorizations; that his practice be monitored by another physician for five years; that he pass the Medical Jurisprudence Examination; that he perform 100 hours of community service a year for five years; and prohibiting him from superv ...
Description: Press Release February 16, 2011 (PDF File)
Document: ... herself or any member of her immediate family any prescription drugs for 10 years; must take within one year and pass within three attempts the Medical Jurisprudence Examination; complete within one year five hours of CME in ethics; and pay an administrative penalty of $4,500 within 180 days. The Bo ...
“... ian or advanced practice professional issuing the prescription. For providers seeking information on how to access the PMP, please review Pharmacy Board PMP information at https://www.pharmacy.texas.gov/pmp/. ”
Is the Prescription Monitoring Program (PMP) check mandated each and every time a physician or authorized delegate prescribes one of the four scheduled drug types?
Yes. Prior to and each and every time a physician or advanced practice professional (such as a physician assistant or advanced practice registered nurse acting under a physician’s delegated authority) prescribes opioids, benzodiazepines, barbiturates, or carisoprodol, the patient’s prescribing history must be reviewed by the physician or advanced practice professional issuing the prescription. For providers seeking information on how to access the PMP, please review Pharmacy Board PMP information at https://www.pharmacy.texas.gov/pmp/.
“... s are allowed in very limited circumstances). All prescription drugs that are not controlled substances fall into the category of "dangerous drugs." Physician assistants with prescriptive authority must have their own DEA numbers to prescribe controlled substances. In addition, physician assistants ... ”
Can a PA sign a prescription for controlled substances?
Yes, the PAs supervising physician must delegate prescriptive authority allowing a PA to sign prescriptions for controlled substances, also called scheduled drugs, as well as Dangerous Drugs. However, PA's are generally limited to Schedules III – V (Schedule IIs are allowed in very limited circumstances). All prescription drugs that are not controlled substances fall into the category of "dangerous drugs." Physician assistants with prescriptive authority must have their own DEA numbers to prescribe controlled substances. In addition, physician assistants must have the name of their current delegating physician authorizing prescriptive authority on file with DEA.
Please note: Under Senate Bill 195, the requirement for controlled substances registration (CSR) with the Texas Department of Public Safety (DPS) was eliminated as of September 1, 2016.
“Yes, a PA can call in a prescription to a pharmacy. However, the PA can only do so at the direction of a physician. ”
Can a PA call in a prescription to a pharmacy?
Yes, a PA can call in a prescription to a pharmacy. However, the PA can only do so at the direction of a physician.
“... rity of patients are issued on a monthly basis, a prescription for opioids, benzodiazepines, barbiturates, or carisoprodol, but not including suboxone. ”
What is a “pain management clinic”?
A pain management clinic is defined in statute and rule as a publicly or privately owned facility for which a majority of patients are issued on a monthly basis, a prescription for opioids, benzodiazepines, barbiturates, or carisoprodol, but not including suboxone.
“... atment, including surgery, with the issuance of a prescription for a majority of the patients. Note: The TMB cannot give legal advice. Please consult an attorney if you have questions regarding whether or not your clinic meets one of the exemptions listed above. However, the Board does have inspecti ... ”
Who does not need to register a pain management clinic?
Regulations regarding the registration and operation of pain management clinics do not apply to the following settings:
Note: The TMB cannot give legal advice. Please consult an attorney if you have questions regarding whether or not your clinic meets one of the exemptions listed above. However, the Board does have inspection authority, and owners of clinics that have not been properly registered can be investigated.
“... ts of which relate to the distribution of illegal prescription drugs or a controlled substance as defined by Texas Occupations Code Annotated §551.003(11) The medical director of a pain management clinic must operate the clinic in compliance with Drug Prevention and Control Act, 21 U.S.C ... ”
Who can own or operate a pain management clinic?
A pain management clinic may not operate in Texas unless the clinic is owned and operated by a medical director who: • is a physician who practices in Texas • has an unrestricted medical license • holds a certificate of registration for that pain management clinic In addition, the owner/operator of a pain management clinic, an employee of the clinic, or a person with whom a clinic contracts for services may not: • have been denied, by any jurisdiction, a license issued by the Drug Enforcement Agency or a state public safety agency under which the person may prescribe, dispense, administer, supply, or sell a controlled substance; • have held a license issued by the Drug Enforcement Agency or a state public safety agency in any jurisdiction, under which the person may prescribe, dispense, administer, supply, or sell a controlled substance, that has been restricted; or • have been subject to disciplinary action by any licensing entity for conduct that was a result of inappropriately prescribing, dispensing, administering, supplying, or selling a controlled substance A pain management clinic may not be owned wholly or partly by a person who has been convicted of, pled nolo contendere to, or received deferred adjudication for: • an offense that constitutes a felony; or • an offense that constitutes a misdemeanor, the facts of which relate to the distribution of illegal prescription drugs or a controlled substance as defined by Texas Occupations Code Annotated §551.003(11) The medical director of a pain management clinic must operate the clinic in compliance with Drug Prevention and Control Act, 21 U.S.C.A. 801 et.seq. and the Texas Controlled Substances Act, Chapter 481 of the Texas Health and Safety Code, relating to the prescribing and dispensing of controlled substances. The medical director of a pain management clinic must, on an annual basis, ensure that all personnel: • are properly licensed, if applicable, • are trained including 10 hours of continuing medical education related to pain management, and • are qualified for employment.
“... lephone number are required to be included on the prescription drug order. If the prescription is for a controlled substance, the physician’s DEA number is also required to be included on the prescription. SB 406 did not change the requirements for what needs to be included on a pr ... ”
Does the physician's name need to be included on the prescription?
Yes, the physician’s name, address and telephone number are required to be included on the prescription drug order. If the prescription is for a controlled substance, the physician’s DEA number is also required to be included on the prescription. SB 406 did not change the requirements for what needs to be included on a prescription drug order.
“... Caution: federal law prohibits dispensing without prescription” or “Rx only” or another legend that complies with federal law. Many other states use the term “legend drugs.” ”
What is a dangerous drug? Are these legend drugs?
Texas is one of just a few states that use the term “dangerous drugs.” The Dangerous Drug Act defines a dangerous drug as a device or drug that is unsafe for self-medication and that is not included in Schedules I through V or Penalty Groups 1 through 4 of Chapter 481, Health and Safety Code (Texas Controlled Substances Act). The term includes a device or drug that bears, or is required to bear, the legend: “Caution: federal law prohibits dispensing without prescription” or “Rx only” or another legend that complies with federal law. Many other states use the term “legend drugs.”
“... nd §481.002, Health and Safety Code. A prescription is an order to dispense a drug or device to a patient for self-administration as defined by §551.003, Occupations Code. ”
What is the difference between medication orders and prescriptions?
A medication order is an order for administration of a drug or device to a patient in a hospital for administration while the patient is in the hospital or for emergency use on the patient’s release from the hospital, as defined by §551.003, Occupations Code and §481.002, Health and Safety Code. A prescription is an order to dispense a drug or device to a patient for self-administration as defined by §551.003, Occupations Code.
“... lt with the delegating physician for refills of a prescription for controlled substances after the initial 90 day supply. Consultation is also required when prescribing controlled substances for children under the age of two years. In both cases, the consultation must be documented in th ... ”
How often is physician consultation required when prescribing controlled substances?
APRNs and PAs must consult with the delegating physician for refills of a prescription for controlled substances after the initial 90 day supply. Consultation is also required when prescribing controlled substances for children under the age of two years. In both cases, the consultation must be documented in the patient’s medical record.
“... that the PMP has been checked prior to issuing a prescription. Certain electronic medical record systems, for example, may provide other ways to document that the review has been completed. ”
May I maintain a copy of the PMP history report in the patient’s medical record?
Yes. The provider may maintain a copy of the PMP history report in the patient’s medical record. There is no specific method required for documenting that the PMP has been checked prior to issuing a prescription. Certain electronic medical record systems, for example, may provide other ways to document that the review has been completed.
“Refills issued to the patient pursuant to a valid prescription and without any reauthorization from the prescriber do not require a PMP check by the prescriber. However, if a prescriber is issuing a prescription for a patient that is unchanged from a previous prescription issued to the patient ... ”
What if a prescriber is just approving a refill?
Refills issued to the patient pursuant to a valid prescription and without any reauthorization from the prescriber do not require a PMP check by the prescriber. However, if a prescriber is issuing a prescription for a patient that is unchanged from a previous prescription issued to the patient (often referred to as a refill), then this would be considered a new prescription and would require a PMP check.
“... count any relevant information prior to issuing a prescription. ”
Is only the prescriber allowed to check the PMP, or can someone else check on behalf of the physician?
A physician, their delegated midlevel provider, or any other qualified and licensed individual delegated authority to check the PMP may do so on behalf of the prescriber. Ultimately though, it is the prescriber’s responsibility to ensure that the PMP has been checked and that they have reviewed and taken into account any relevant information prior to issuing a prescription.
“... ans. If a prescribing delegate is issuing a prescription under the authority of a physician who does not have a waiver, then the prescribing delegate must issue the prescription via e-prescribing. If an individual wants to look up whether a prescribing delegate has a waver they can do so ... ”
Do delegates who have prescribing authority have to apply for their own waiver or are they covered by the supervising physician’s waiver?
If the supervising physician has a waiver, then the prescribing delegate is also covered under that waiver. So long as the prescribing delegate is prescribing under the authority of a physician who has been granted a waiver, then the prescribing delegate may use non-electronic prescribing means. If a prescribing delegate is issuing a prescription under the authority of a physician who does not have a waiver, then the prescribing delegate must issue the prescription via e-prescribing.
If an individual wants to look up whether a prescribing delegate has a waver they can do so as listed below:
For physician assistants: A PA’s waiver status will not be viewable on their TMB public profile. Each PA’s public profile has a link to their supervising physician’s profile page. The physician’s profile page will list the waiver status.
For nurse practitioners: APRN waivers are determined by the Texas Board of Nursing. Information on the waiver process for the APRNs is available on the Texas Board of Nursing Website.