Earlier this year the Texas Board of Nursing (BON) adopted significant amendments to the Board Rules. The changes are now in effect. BON licensees subject to the amendments have a duty to comply with the new mandates.
Requirement to Review the Prescription Monitoring Program
As of September 1, 2019, advanced practice registered nurses (APRNs) are required to check the Texas Prescription Monitoring Program (PMP) prior to prescribing opiates, benzodiazepines, barbiturates, or carisoprodol. 22 Tex. Admin. Code §222.8(d). The PMP collects prescription data on all Schedule II, III, IV, and V controlled substances dispensed by Texas pharmacies and be pharmacies located in other states to Texas residents Its purpose is to help control the misuse of controlled substances and compile information regarding prescription trends.
APRNs are further required to document their review of the PMP and rational for prescribing the medication in the patient's medical records. Exemptions to checking the PMP are allowed if the patient is receiving hospice care or is diagnosed with cancer. In such cases, the applicable exemption must be noted on the prescription or in the electronic prescription record. 22 Tex. Admin. Code §222.8(d)(4).
Failure to access and review the PMP before prescribing opioids, benzodiazepines, barbiturates, or carisoprodol, unless a statutory exemption has been documented, creates grounds for disciplinary action from the BON. 22 Tex. Admin. Code §222.10(a)(6).
The amended Board Rules authorize, but do not require, an APRN to access the PMP prior to prescribing any controlled substance. The mandate applies only to prescriptions for an opiate, benzodiazepine, barbiturate, or carisoprodol.
Renewal Fee Increases
License renewal fees for all Texas nurses have increased. The Board deemed these increases necessary to ensure it raises enough funds as required by the Legislature to support agency operations.
Effective September 1, 2019, renewal fees for licensed vocational nurses (LVN) and registered nurses (RN) increased by $3 each, and renewal fees for APRNs increased by $14.
The reasons for the higher increase for APRN license renewal fees is threefold:
- Fund the operations of the PMP, which is operated by the Texas Board of Pharmacy.
- Fund compliance with House Bill 2174, which provides for medical assistance reimbursement for treatment for certain substance use disorders.
- Fund Texas Online subscription fees.
APRNs Required to Identity the Licensure Credential
Texas APRNs are required to identify themselves as APRNs and identify the licensure title they are authorized to use by the Board. The amended Board Rule states: "A registered nurse who holds current licensure issued by the Board as an APRN shall, at a minimum, use the designation "APRN" and the APRN licensure title, which consists of the current role and population focus area, granted by the Board." 22 Tex. Admin. Code §221.2(b).
Under this rule, a family nurse practitioner must use both APRN and FNP. The Rules do not specify an order in which the credentials must appear. The requirement to use both licensure titles has been in effect since February of this year.
Issues with Your Texas Nursing License
If you have been notified of a complaint filed against you with the Texas Board of Nursing, BERTOLINO LLP can help. We are experienced BON license defense attorneys and we know how to navigate BON's complaint process. We are prepared to represent you at any legal hearing or proceeding regarding your professional license.
Contact us today or call (512) 717-5432 and schedule a case evaluation.
Our law firm helps professionals, like you, keep their licenses when those licenses are under attack by a state agency or board.