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
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
 
 
  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, [or] 481.075, 481.076,
  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.
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