Bill Text: TX HB1866 | 2019-2020 | 86th Legislature | Comm Sub
Bill Title: Relating to the prescribing of opioids for acute pain.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2019-04-17 - Committee report sent to Calendars [HB1866 Detail]
Download: Texas-2019-HB1866-Comm_Sub.html
86R23872 JSC-F | |||
By: Davis of Dallas | H.B. No. 1866 | ||
Substitute the following for H.B. No. 1866: | |||
By: Price | C.S.H.B. No. 1866 |
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relating to the prescribing of opioids for acute pain. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subchapter C, Chapter 481, Health and Safety | ||
Code, is amended by adding Section 481.07635 to read as follows: | ||
Sec. 481.07635. PRESCRIPTIONS OF OPIOIDS FOR ACUTE PAIN. | ||
(a) In this section, "acute pain" means the normal, predicted, | ||
physiological response to a stimulus such as trauma, disease, and | ||
operative procedures. Acute pain is time-limited. The term does not | ||
include: | ||
(1) chronic pain; | ||
(2) pain being treated as part of cancer care; | ||
(3) pain being treated as part of hospice or other | ||
end-of-life care; or | ||
(4) pain being treated as part of palliative care. | ||
(b) For the initial treatment of acute pain, a prescriber | ||
may not issue a prescription for an opioid in an amount that exceeds | ||
a seven-day supply. | ||
(c) Before issuing an initial opioid prescription for acute | ||
pain, a prescriber shall: | ||
(1) take and document the results of a thorough | ||
medical history, including: | ||
(A) the patient's experience with medication | ||
other than opioids and pain management approaches described by | ||
Subsection (d); and | ||
(B) any history of substance abuse; | ||
(2) conduct and document the results of a physical | ||
examination, as appropriate; | ||
(3) develop a treatment plan focused on determining | ||
the cause of the patient's pain; and | ||
(4) comply with the requirements of Section 481.0764. | ||
(d) A prescriber may refer or prescribe any of the following | ||
pain management services to a patient, based on the prescriber's | ||
clinical judgment and the availability of the treatment, when | ||
issuing an opioid prescription for acute pain: | ||
(1) physical therapies; | ||
(2) occupational therapies; | ||
(3) chiropractic treatment; | ||
(4) physical medicine and rehabilitation; or | ||
(5) osteopathic manipulation. | ||
(e) This section does not apply to: | ||
(1) patients: | ||
(A) with pain related to: | ||
(i) progressive functional neurological | ||
deficit; | ||
(ii) fracture; | ||
(iii) tumor; | ||
(iv) infection; or | ||
(v) immediate postsurgical recovery; | ||
(B) with chronic pain that, based on the | ||
prescriber's clinical judgment, is caused by a disease, illness, or | ||
injury that would not improve under the therapies and treatments | ||
described by Subsection (d); or | ||
(C) receiving: | ||
(i) treatment for cancer; | ||
(ii) emergency or trauma care; | ||
(iii) hospice care; | ||
(iv) palliative care; | ||
(v) long-term care; or | ||
(vi) treatment for substance abuse or | ||
opioid dependence; or | ||
(2) a prescriber who is a veterinarian. | ||
(f) This section does not require that all of the treatments | ||
under Subsection (d) be exhausted before the patient may receive a | ||
prescription for an opioid. | ||
(g) A dispenser is not subject to disciplinary action, civil | ||
liability, or criminal, civil, or administrative penalties for | ||
dispensing or refusing to dispense a controlled substance under an | ||
otherwise valid prescription that exceeds the limits provided by | ||
Subsection (b). | ||
SECTION 2. Section 481.003(a), Health and Safety Code, is | ||
amended to read as follows: | ||
(a) The director may adopt rules to administer and enforce | ||
this chapter, other than Sections 481.073, 481.074, 481.075, | ||
481.076, 481.0761, 481.0762, 481.0763, 481.07635, 481.0764, | ||
481.0765, and 481.0766. The board may adopt rules to administer | ||
Sections 481.073, 481.074, 481.075, 481.076, 481.0761, 481.0762, | ||
481.0763, 481.07635, 481.0764, 481.0765, and 481.0766. | ||
SECTION 3. Section 554.051(a-1), Occupations Code, is | ||
amended to read as follows: | ||
(a-1) The board may adopt rules to administer Sections | ||
481.073, 481.074, 481.075, 481.076, 481.0761, 481.0762, 481.0763, | ||
481.07635, 481.0764, 481.0765, and 481.0766, Health and Safety | ||
Code. | ||
SECTION 4. Section 565.003, Occupations Code, is amended to | ||
read as follows: | ||
Sec. 565.003. ADDITIONAL GROUNDS FOR DISCIPLINE REGARDING | ||
APPLICANT FOR OR HOLDER OF NONRESIDENT PHARMACY LICENSE. Unless | ||
compliance would violate the pharmacy or drug statutes or rules in | ||
the state in which the pharmacy is located, the board may discipline | ||
an applicant for or the holder of a nonresident pharmacy license if | ||
the board finds that the applicant or license holder has failed to | ||
comply with: | ||
(1) Section 481.073, 481.074, [ |
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481.0761, 481.0762, 481.0763, 481.07635, 481.0764, 481.0765, or | ||
481.0766, Health and Safety Code; | ||
(2) Texas substitution requirements regarding: | ||
(A) the practitioner's directions concerning | ||
generic substitution; | ||
(B) the patient's right to refuse generic | ||
substitution; or | ||
(C) notification to the patient of the patient's | ||
right to refuse substitution; | ||
(3) any board rule relating to providing drug | ||
information to the patient or the patient's agent in written form or | ||
by telephone; or | ||
(4) any board rule adopted under Section 554.051(a) | ||
and determined by the board to be applicable under Section | ||
554.051(b). | ||
SECTION 5. Section 481.07635, Health and Safety Code, as | ||
added by this Act, applies only to a prescription issued on or after | ||
the effective date of this Act. A prescription issued before the | ||
effective date of this Act is governed by the law in effect on the | ||
date the prescription is issued, and the former law is continued in | ||
effect for that purpose. | ||
SECTION 6. This Act takes effect September 1, 2019. |