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Many Texas Laws Affecting Pharmacy Take Effect Sept. 1

Friday, August 30, 2019   (1 Comments)
Posted by: Brian Sparks
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New Laws Affecting Texas Pharmacy Take Effect Sept 1, 2019

The Texas Legislature passed dozens of bills earlier this year that affect pharmacists and pharmacies. Many of those laws will take effect September 1. As a reminder, the Prescription Monitoring Program (PMP) mandate has been delayed from September 1 to March 1, 2020. Make sure you are aware of the following new laws and how they will affect your practice:

Pharmacist Prescription Signature Authority Under Collaborative Practice

House Bill 2425 allows pharmacists working in an FQHC to adjust and manage a patient’s drug therapy, including the signing of the prescription drug order, with a physician’s delegation. This practice is already allowed in hospitals, hospital-based clinics, and academic health care institutions. This will allow patients in medically underserved areas to receive expanded access to care and for pharmacists in those areas to provide more services.

Pharmacy Protection from Wholesale Invoice Audits

House Bill 1455 protects community pharmacies in Texas from overreach by PBM practices in wholesale invoice audits that attempt to unnecessarily penalize businesses for legitimate claims based on administrative technicalities. Pharmacies may now avoid said penalties that could be a financial burden.

Opioid Prescription Quantity Limit for Acute Pain

House Bill 2174 requires that, for the treatment of acute (not chronic) pain, a practitioner may not issue a prescription for an opioid in an amount that exceeds a 10-day supply, nor provide for a refill of an opioid for acute pain. Exceptions are provided for cancer care, hospice or other end-of-life care, palliative care, and opioids prescribed for the treatment of substance addiction. (Provisions of this law requiring electronic prescribing of controlled substances do not take effect until January 1, 2021.)

Initiatives to Identify, Prevent, and Respond to Opioid Addiction, Misuse, and Abuse

House Bill 3285 requires pharmacists who dispense opioids are required to have at least one hour of continuing education covering alternative or multi-modal treatment approaches to pain management. The Texas State Board of Pharmacy will adopt rules for pharmacists to establish the content of continuing education (CE). Pharmacists will also be looked to and encouraged to participate in early intervention and treatment services for persons with substance use disorders and for those at risk of developing these disorders.

Texas State Board of Pharmacy Cleanup Bill

Senate Bill 683 and House Bill 2847 update sections of the Texas Pharmacy Act and the Controlled Substance Act. These bills require pharmacies to submit a “zero” report if the pharmacy does not dispense any controlled substances during a seven-day period; authorize pharmacist interns to have access to the Prescription Monitoring Program (PMP) and authorize pharmacy technician trainees to have access to the PMP as a delegate. SB 683 also gives the Texas State Board of Pharmacy the authority to revoke the pharmacy license of a pharmacy that has ceased to operate for a period of 30 days or longer.

Sale of Dextromethorphan to Minors

House Bill 1518 prohibits the sale of dextromethorphan “over the counter” to individuals under the age of 18 years. Community pharmacies and store owners should be diligent programing any systems and educating their staff of this new law to avoid liability and civil penalties, while protecting minors from abuse of dextromethorphan. Pharmacists may dispense dextromethorphan with a valid prescription to someone less than 18 years of age.

Telepharmacy Expansion to FQHCs

Senate Bill 670 allows pharmacy owners the opportunity to partner with FQHCs to open telepharmacy locations in their facilities.

2020–21 State Budget

House Bill 1 is the 2020–21 state budget and has a price tag of $250.7 billion. The two-year budget includes $84 billion for health and human services programs. HB 1 orders roughly $900 million in cuts to Medicaid. Pharmacy will have to stay diligent and stave off any cuts to pharmacy.

Tobacco 21

Senate Bill 21 raises the legal smoking and vaping age in Texas to 21 years. Those younger than 21 who possess, use, or try to buy e-cigarettes or other tobacco products could receive a $100 fine. The bill exempts active-duty members of U.S. and state military forces who are at least 18 years old if they present a military ID card at the time of purchase.

State Hemp Production

House Bill 1325 legalizes hemp and hemp-derived extracts like CBD oil as long as they contain no more than 0.3% of tetrahydrocannabinol (THC), the psychoactive element in marijuana.

Drug-Price Transparency

House Bill 2536 requires the Health and Human Services Commissioner to establish a website that contains pricing information for prescription drugs with a wholesale acquisition cost of at least $100 for a 30-day supply. Pharmaceutical manufacturers must provide this data by January 15 each year and provide an update each time a drug increases more than 15 percent in a year, or more than 40 percent over three years. Pharmacy benefit managers (PBMs) must report to the Commissioner the aggregated rebates, fees, price protection payments and any other payments collected from pharmaceutical manufacturers that were passed to health benefit plans or enrollees at point of sale of a prescription drug or retained as revenue by the PBM.

Medicaid Medication-Assisted Treatment for Opioid Use Disorder

Senate Bill 1564 better aligns the state's Medicaid policy with federal law by providing Medicaid medical benefits reimbursement for the prescribing of buprenorphine by certain advanced practice registered nurses.

Stage Four Cancer

House Bill 1584 prohibits health plans from requiring “fail first” step therapy protocols for prescription drugs for patients with stage-four advanced, metastatic cancer.

Concealed Carry During Disaster

House Bill 1177 allows Texans without a license-to-carry to carry their firearms when their property is under a mandatory order evacuation issued during a state of disaster.


Learn More!

TPA's complete online legislative wrapup offers a full list of which bills passed, which bills failed, and which bills TPA helped to defeat. It also provides effective dates and a detailed explanation of what the legislation means for pharmacy.



Carol B. Reagan PharmD says...
Posted Saturday, August 31, 2019
Thank you for all your hard work!

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