§ 481.074 — PRESCRIPTIONS.

Texas § 481.074

• Jurisdiction: Texas
• Code HS: Health and Safety Code

Text

Sec. 481.074. PRESCRIPTIONS. (a) A pharmacist may not:
(1) dispense or deliver a controlled substance or cause a controlled substance to be dispensed or delivered under the pharmacist's direction or supervision except under a valid prescription and in the course of professional practice;
(2) dispense a controlled substance if the pharmacist knows or should have known that the prescription was issued without a valid patient-practitioner relationship;
(3) fill a prescription that is not prepared or issued as prescribed by this chapter;
(4) permit or allow a person who is not a licensed pharmacist or pharmacist intern to dispense, distribute, or in any other manner deliver a controlled substance even if under the supervision of a pharmacist, except that after the pharmacist or pharmacist intern has fulfilled his professional and legal responsibilities, a nonpharmacist may complete the actual cash or credit transaction and delivery; or
(5) permit the delivery of a controlled substance to any person not known to the pharmacist, the pharmacist intern, or the person authorized by the pharmacist to deliver the controlled substance without first requiring identification of the person taking possession of the controlled substance, except as provided by Subsection (n).
(b) Except in an emergency as defined by board rule under Subsection (b-1) or as otherwise provided by Section 481.075 (j) or (m) or 481.0755 , a person may not dispense or administer a controlled substance without an electronic prescription that meets the requirements of and is completed by the practitioner in accordance with Section 481.075 .
(b-1) In an emergency as defined by board rule, a person may dispense or administer a controlled substance on the oral or telephonically communicated prescription of a practitioner. The person who administers or dispenses the substance shall:
(1) if the person is a prescribing practitioner or a pharmacist, promptly comply with Subsection (c); or
(2) if the person is not a prescribing practitioner or a pharmacist, promptly write the oral or telephonically communicated prescription and include in the written record of the prescription the name, address, and Federal Drug Enforcement Administration number issued for prescribing a controlled substance in this state of the prescribing practitioner, all information required to be provided by a practitioner under Section 481.075 (e)(1), and all information required to be provided by a dispensing pharmacist under Section 481.075 (e)(2).
(b-2) In an emergency described by Subsection (b-1), an agent designated in writing by a practitioner defined by Section 481.002 (39)(A) may communicate a prescription by telephone. A practitioner who designates a different agent shall designate that agent in writing and maintain the designation in the same manner in which the practitioner initially designated an agent under this subsection. On the request of a pharmacist, a practitioner shall furnish a copy of the written designation. This subsection does not relieve a practitioner or the practitioner's designated agent from the requirement of Subchapter A , Chapter 562 , Occupations Code. A practitioner is personally responsible for the actions of the designated agent in communicating a prescription to a pharmacist.
(c) Not later than the seventh day after the date a prescribing practitioner authorizes an emergency oral or telephonically communicated prescription, the prescribing practitioner shall cause an electronic prescription, completed in the manner required by Section 481.075 , to be delivered to the dispensing pharmacist at the pharmacy where the prescription was dispensed. On receipt of the electronic prescription, the pharmacist shall annotate the electronic prescription record with the original authorization and date of the emergency oral or telephonically communicated prescription.
(d) Except as specified in Subsections (e) and (f), the board, by rule and in consultation with the Texas Medical Board, shall establish the period after the date on which the prescription is issued that a person may fill a prescription for a controlled substance listed in Schedule II. A person may not refill a prescription for a substance listed in Schedule II.
(d-1) Notwithstanding Subsection (d), a prescribing practitioner may issue multiple prescriptions authorizing the patient to receive a total of up to a 90-day supply of a Schedule II controlled substance if:
(1) each separate prescription is issued for a legitimate medical purpose by a prescribing practitioner acting in the usual course of professional practice;
(2) the prescribing practitioner provides instructions on each prescription to be filled at a later date indicating the earliest date on which a pharmacy may fill each prescription;
(3) the prescribing practitioner concludes that providing the patient with multiple prescriptions in this manner does not create an undue risk of diversion or abuse; and
(4) the issuance of multiple prescriptions complies with other applicable state and federal laws.
(e) The partial filling of a prescription for a controlled substance listed in Schedule II is permissible in accordance with applicable federal law.
(f) A prescription for a Schedule II controlled substance for a patient in a long-term care facility (LTCF) or for a hospice patient with a medical diagnosis documenting a terminal illness may be filled in partial quantities to include individual dosage units. If there is any question about whether a hospice patient may be classified as having a terminal illness, the pharmacist must contact the practitioner before partially filling the prescription. Both the pharmacist and the practitioner have a corresponding responsibility to assure that the controlled substance is for a terminally ill hospice patient. The pharmacist must record the prescription in the electronic prescription record and must indicate in the electronic prescription record whether the patient is a "terminally ill hospice patient" or an "LTCF patient." A prescription that is partially filled and does not contain the notation "terminally ill hospice patient" or "LTCF patient" is considered to have been filled in violation of this chapter. For each partial filling, the dispensing pharmacist shall record in the electronic prescription record the date of the partial filling, the quantity dispensed, the remaining quantity authorized to be dispensed, and the identification of the dispensing pharmacist. Before any subsequent partial filling, the pharmacist must determine that the additional partial filling is necessary. The total quantity of Schedule II controlled substances dispensed in all partial fillings may not exceed the total quantity prescribed. Schedule II prescriptions for patients in a long-term care facility or hospice patients with a medical diagnosis documenting a terminal illness are valid for a period not to exceed 60 days following the issue date unless sooner terminated by discontinuance of the medication.
(g) A person may not dispense a controlled substance in Schedule III or IV that is a prescription drug under the Federal Food, Drug, and Cosmetic Act (21 U.S.C. Section 301 et seq.) without a prescription of a practitioner defined by Section 481.002 (39)(A) or (D), except that the practitioner may dispense the substance directly to an ultimate user. A prescription for a controlled substance listed in Schedule III or IV may not be filled or refilled later than six months after the date on which the prescription is issued and may not be refilled more than five times, unless the prescription is renewed by the practitioner. A prescription under this subsection must comply with other applicable state and federal laws.
(h) A pharmacist may dispense a controlled substance listed in Schedule III, IV, or V under a prescription issued by a practitioner defined by Section 481.002 (39)(C) only if the pharmacist determines that the prescription was issued for a valid medical purpose and in the course of professional practice. A prescription described by this subsection may not be filled or refilled later than six months after the date the prescription is issued and may not be refilled more than five times, unless the prescription is renewed by the practitioner.
(i) A person may not dispense a controlled substance listed in Schedule V and containing 200 milligrams or less of codeine, or any of its salts, per 100 milliliters or per 100 grams, or containing 100 milligrams or less of dihydrocodeine, or any of its salts, per 100 milliliters or per 100 grams, without the prescription of a practitioner defined by Section 481.002 (39)(A), except that a practitioner may dispense the substance directly to an ultimate user. A prescription issued under this subsection may not be filled or refilled later than six months after the date the prescription is issued and may not be refilled more than five times, unless the prescription is renewed by the practitioner.
(j) A practitioner or institutional practitioner may not allow a patient, on the patient's release from the hospital, to possess a controlled substance prescribed by the practitioner unless:
(1) the substance was dispensed under a medication order while the patient was admitted to the hospital;
(2) the substance is in a properly labeled container; and
(3) the patient possesses not more than a seven-day supply of the substance.
(k) A prescription for a controlled substance must show:
(1) the quantity of the substance prescribed:
(A) numerically, if the prescription is electronic; or
(B) if the prescription is communicated orally or telephonically, as transcribed by the receiving pharmacist;
(2) the date of issue;
(2-a) if the prescription is issued for a Schedule II controlled substance to be filled at a later date under Subsection (d-1), the earliest date on which a pharmacy may fill the prescription;
(3) the name, address, and date of birth or age of the patient or, if the controlled substance is prescribed for an animal, the species of the animal and the name and address of its owner;
(4) the name and strength of the controlled substance prescribed;
(5) the directions for use of the controlled substance;
(6) the intended use of the substance prescribed unless the practitioner determines the furnishing of this information is not in the best interest of the patient; and
(7) the name, address, Federal Drug Enforcement Administration number, and telephone number of the practitioner at the practitioner's usual place of business.
(l) A pharmacist may exercise his professional judgment in refilling a prescription for a controlled substance in Schedule III, IV, or V without the authorization of the prescribing practitioner provided:
(1) failure to refill the prescription might result in an interruption of a therapeutic regimen or create patient suffering;
(2) either:
(A) a natural or manmade disaster has occurred which prohibits the pharmacist from being able to contact the practitioner; or
(B) the pharmacist is unable to contact the practitioner after reasonable effort;
(3) the quantity of prescription drug dispensed does not exceed a 72-hour supply;
(4) the pharmacist informs the patient or the patient's agent at the time of dispensing that the refill is being provided without such authorization and that authorization of the practitioner is required for future refills; and
(5) the pharmacist informs the practitioner of the emergency refill at the earliest reasonable time.
(l-1) Notwithstanding Subsection (l), in the event of a natural or manmade disaster, a pharmacist may dispense not more than a 30-day supply of a prescription drug, other than a controlled substance listed in Schedule II, without the authorization of the prescribing practitioner if:
(1) failure to refill the prescription might result in an interruption of a therapeutic regimen or create patient suffering;
(2) the natural or manmade disaster prohibits the pharmacist from being able to contact the practitioner;
(3) the governor has declared a state of disaster under Chapter 418 , Government Code; and
(4) the Texas State Board of Pharmacy, through its executive director, has notified pharmacies in this state that pharmacists may dispense up to a 30-day supply of a prescription drug.
(l-2) The prescribing practitioner is not liable for an act or omission by a pharmacist in dispensing a prescription drug under Subsection (l-1).
(m) A pharmacist may permit the delivery of a controlled substance by an authorized delivery person, by a person known to the pharmacist, a pharmacist intern, or the authorized delivery person, or by mail to the person or address of the person authorized by the prescription to receive the controlled substance. If a pharmacist permits delivery of a controlled substance under this subsection, the pharmacist shall retain in the records of the pharmacy for a period of not less than two years:
(1) the name of the authorized delivery person, if delivery is made by that person;
(2) the name of the person known to the pharmacist, a pharmacist intern, or the authorized delivery person if delivery is made by that person; or
(3) the mailing address to which delivery is made, if delivery is made by mail.
(n) A pharmacist may permit the delivery of a controlled substance to a person not known to the pharmacist, a pharmacist intern, or the authorized delivery person without first requiring the identification of the person to whom the controlled substance is delivered if the pharmacist determines that an emergency exists and that the controlled substance is needed for the immediate well-being of the patient for whom the controlled substance is prescribed. If a pharmacist permits delivery of a controlled substance under this subsection, the pharmacist shall retain in the records of the pharmacy for a period of not less than two years all information relevant to the delivery known to the pharmacist, including the name, address, and date of birth or age of the person to whom the controlled substance is delivered.
(o) Repealed by Acts 2019, 86th Leg., R.S., Ch. 1105 (H.B. 2174 ), Sec. 16, eff. September 1, 2019.
(p) Repealed by Acts 2019, 86th Leg., R.S., Ch. 1105 (H.B. 2174), Sec. 16, eff. September 1, 2019.
(q) Each dispensing pharmacist shall send all required information to the board by electronic transfer or another form approved by the board not later than the next business day after the date the prescription is completely filled.

Legislative History

Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Amended by Acts 1989, 71st Leg., ch. 1100, Sec. 5.02(h), eff. Sept. 1, 1989; Acts 1991, 72nd Leg., ch. 615, Sec. 10, eff. Sept. 1, 1991; Acts 1991, 72nd Leg., ch. 761, Sec. 6, eff. Sept. 1, 1991; Acts 1993, 73rd Leg., ch. 351, Sec. 28, eff. Sept. 1, 1993; Acts 1993, 73rd Leg., ch. 789, Sec. 16, eff. Sept. 1, 1993; Acts 1997, 75th Leg., ch. 745, Sec. 12, 13, eff. Jan. 1, 1998; Acts 1999, 76th Leg., ch. 145, Sec. 2, eff. Sept. 1, 1999; Acts 2001, 77th Leg., ch. 251, Sec. 10, eff. Sept. 1, 2001; Acts 2001, 77th Leg., ch. 1254, Sec. 10, eff. Sept. 1, 2001. Amended by: Acts 2005, 79th Leg., Ch. 349 (S.B. 1188 ), Sec. 21(a), eff. September 1, 2005. Acts 2005, 79th Leg., Ch. 1345 (S.B. 410 ), Sec. 44(a), eff. June 18, 2005. Acts 2007, 80th Leg., R.S., Ch. 535 (S.B. 994 ), Sec. 1, eff. September 1, 2007. Acts 2007, 80th Leg., R.S., Ch. 567 (S.B. 1658 ), Sec. 2, eff. September 1, 2007. Acts 2007, 80th Leg., R.S., Ch. 1391 (S.B. 1879 ), Sec. 2, eff. September 1, 2007. Acts 2007, 80th Leg., R.S., Ch. 1391 (S.B. 1879 ), Sec. 2, eff. September 1, 2008. Acts 2007, 80th Leg., R.S., Ch. 1391 (S.B. 1879 ), Sec. 2. Acts 2009, 81st Leg., R.S., Ch. 774 (S.B. 904 ), Sec. 1, eff. June 19, 2009. Acts 2011, 82nd Leg., R.S., Ch. 91 (S.B. 1303 ), Sec. 12.007, eff. September 1, 2011. Acts 2011, 82nd Leg., R.S., Ch. 1228 (S.B. 594 ), Sec. 2, eff. September 1, 2011. Acts 2011, 82nd Leg., R.S., Ch. 1342 (S.B. 1273 ), Sec. 2, eff. September 1, 2011. Acts 2015, 84th Leg., R.S., Ch. 1268 (S.B. 195 ), Sec. 9, eff. September 1, 2016. Acts 2017, 85th Leg., R.S., Ch. 485 (H.B. 2561 ), Sec. 2, eff. September 1, 2017. Acts 2019, 86th Leg., R.S., Ch. 1105 (H.B. 2174 ), Sec. 4, eff. September 1, 2019. Acts 2019, 86th Leg., R.S., Ch. 1105 (H.B. 2174 ), Sec. 16, eff. September 1, 2019.