22 Tex. Admin. Code § 217.24 - Telemedicine Medical Service Prescriptions
(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, 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 22 Texas Administrative Code §
170.2(4)
(relating to Definitions).
(A) Telemedicine
medical services used for the treatment of chronic pain with scheduled drugs by
any means other than via audio and video two-way communication is prohibited,
unless a patient:
(i) is an established
patient of the APRN being treated for chronic pain;
(ii) is receiving a prescription that is
identical to a prescription issued at the previous visit; and
(iii) has been seen by the prescribing APRN,
physician, or other health professional as defined in Tex. Occ. Code §
111.001(1)
in the last 90 days, either:
(I) in-person;
or
(II) via telemedicine using
audio and video two-way communication.
(B) An APRN, when determining whether to
utilize telemedicine medical services for the treatment of chronic pain with
controlled substances as permitted by paragraph (1)(A) of this subsection,
shall give due consideration to factors that include, at a minimum, the date of
the patient's last in-person visit, patient co-morbidities, and occupational
related COVID risks. These are not the sole, exclusive, or exhaustive factors
an APRN should consider under this rule.
(C) If a patient is treated for chronic pain
with scheduled drugs through the use of telemedicine medical services as
permitted by paragraph (1)(A) of this subsection, the medical records must
document the exception and the reason that a telemedicine visit was conducted
instead of an in-person visit.
(2) For purposes of this rule, acute pain has
the same definition as used in 22 Texas Administrative Code §
170.2(2).
Telemedicine medical services may be used for the treatment of acute pain with
scheduled drugs, unless otherwise prohibited under federal and state
law.
Notes
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