Prescriptive delegation for controlled substances in texas

When it comes to prescription delegation for controlled substances in Texas, there are a number of regulations that must be followed. Failure of a licensed physician to fully comply with the Texas Medical Board’s (TMB) rules on prescriptive delegation could lead to sanctions and be costly to one’s career.
The national opioid crisis has not slowed and prescriptions for controlled substances are under heightened scrutiny by regulators and enforcement agencies. The Center for Disease Control (CDC) cites prescription opioids as one of the drivers of opioid overdose deaths. In response to the growing problem, the TMB and law enforcement agencies have been targeting doctors who prescribe pain medication. It is important for licensed medical professionals who prescribe controlled substances, particularly opioids, to understand that their licenses may come under attack. Prescriptive Delegation for Controlled Substances in Texas Licensed physicians in Texas have the ability to delegate prescriptive authority to an Advanced Practice Registered Nurse (APRN) and to a Physician Assistant (PA). Physicians who delegate prescriptive authority to APRN’s or PA’s must register with the TMB.
APRNs and PAs may prescribe Schedule II drugs, which are drugs known to have a high potential for abuse, in the following situations:

  • In a hospital facility-based practice, in accordance with policies approved by the hospital’s medical staff or a committee of the hospital’s medical staff as provided by the hospital’s bylaws to ensure patient safety and as part of care provided to a patient who:
    • Has been admitted to the hospital for an intended 24 hour stay or longer; or
    • Is receiving services in the emergency department of the hospital.
  • As part of the plan of care for the treatment of a person who has executed a written certification of a terminal illness and is receiving hospice treatment from a qualified hospice provider.

Schedule II delegation authority cannot be granted in free standing emergency departments, even if that department is affiliated with a hospital. In a free standing emergency department a physician may only delegate authority to prescribe controlled substances in Schedules III through V.
APRNs and PAs have a duty to consult with the delegating physician for prescription refills of controlled substances after the initial 90-day supply. Consultation is also required to prescribe a controlled substance to a child under two years of age. In both cases, it is necessary to document the consultation in the patient’s medical records. Hire an Experienced Medical License Defense Attorney If you have been notified of a complaint filed against you with the Texas Medical Board, BERTOLINO LLP can help. We are experienced TMB license defense attorneys and we know how to navigate the TMB’s complaint process. We are prepared to represent you at any legal hearing or proceeding regarding your professional license.
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