Current through Reg. 50, No. 13; March 28, 2025
(a) The APRN with full licensure and a valid
prescription authorization number shall:
(1)
order or prescribe only those drugs or devices that are:
(A) authorized by a prescriptive authority
agreement or, if practicing in a facility-based practice, authorized by either
a prescriptive authority agreement or protocols or other written authorization;
and
(B) ordered or prescribed for
patient populations within the accepted scope of professional practice for the
APRN's license; and
(2)
comply with the requirements for chart reviews specified in the prescriptive
authority agreement and periodic face to face meetings set forth in the
prescriptive authority agreement; or
(3) comply with the requirements set forth in
protocols or other written authorization if ordering or prescribing drugs or
devices under facility-based protocols or other written
authorization.
(b)
Prescription Information. The format and essential elements of a prescription
drug order shall comply with the requirements of the Texas State Board of
Pharmacy. The following information must be provided on each prescription:
(1) the patient's name and address;
(2) the name, strength, and quantity of the
drug to be dispensed;
(3)
directions to the patient regarding taking of the drug and the
dosage;
(4) the intended use of the
drug, if appropriate;
(5) the name,
address, and telephone number of the physician with whom the APRN has a
prescriptive authority agreement or facility-based protocols or other written
authorization;
(6) address and
telephone number of the site at which the prescription drug order was
issued;
(7) the date of
issuance;
(8) the number of refills
permitted;
(9) the name,
prescription authorization number, and original signature of the APRN who
authorized the prescription drug order; and
(10) the United States Drug Enforcement
Administration numbers of the APRN and the delegating physician, if the
prescription drug order is for a controlled substance.
(c) Waivers from Electronic Prescribing
Requirements.
(1) Beginning January 1, 2021,
licensee prescribers must issue prescriptions for controlled substances
electronically unless one of the circumstances specified in Tex. Health &
Safety Code §481.0755(a) applies.
(2) A licensee prescriber may request a
waiver from the electronic prescribing requirements by submitting a waiver
request to the Board that demonstrates the circumstances necessitating a waiver
from the electronic prescribing requirements, including:
(A) economic hardship, taking into account
factors including:
(i) any special
situational factors affecting either the cost of compliance or ability to
comply;
(ii) the likely impact of
compliance on profitability or viability; and
(iii) the availability of measures that would
mitigate the economic impact of compliance;
(B) technological limitations not reasonably
within the control of the licensee prescriber; and
(C) other exceptional circumstances
demonstrated in the waiver request.
(3) A waiver may be granted for a period of
one year. If circumstances that necessitated the waiver continue beyond that
time period, a licensee prescriber may re-apply to the Board for a subsequent
waiver no earlier than the 30th day prior to the expiration of the original
waiver.
(d) Generic
Substitution. The APRN shall authorize or prevent generic substitution on a
prescription in compliance with the current rules of the Texas State Board of
Pharmacy relating to generic substitution.
(e) An APRN may order or prescribe
medications for sexually transmitted diseases for partners of an established
patient, if the APRN assesses the patient and determines that the patient may
have been infected with a sexually transmitted disease. Nothing in this
subsection shall be construed to require the APRN to issue prescriptions for
partners of patients.
(f) APRNs may
order or prescribe only those medications that are FDA approved unless done
through protocol registration in a United States Institutional Review Board or
Expanded Access authorized clinical trial. "Off label" use, or prescription of
FDA-approved medications for uses other than that indicated by the FDA, is
permitted when such practices are:
(1) within
the current standard of care for treatment of the disease or condition;
and
(2) supported by evidence-based
research.
(g) The APRN
with full licensure and a valid prescriptive authorization number shall
cooperate with representatives of the Board and the Texas Medical Board during
an inspection and audit relating to the operation and implementation of a
prescriptive authority agreement.
