The 83rd Texas Legislature passed legislation to simplify the process by which physicians supervise and delegate to Physician Assistants (PAs) and Advance Practice Registered Nurses (APRNs). This article summarizes the rules recently adopted by the Texas Medical Board (TMB) to implement SB 406 (83R). The major changes effectuated by these rules are the removal of site-based restrictions and the addition of prescriptive authority agreements, whereby physicians can more effectively engage PAs and APRNs in collaborative practice. These are very important points for the physicians taking the Texas board exam.
New Terms and Phrases. The final rules scrap the definition for Medically Underserved Area and instead define a practice serving a medically underserved population. Other defined terms and phrases shift the focus of the rules governing delegation: hospital, medication order, physician group practice, prescriptive authority agreement, device, and facility-based practice site, to highlight a few. The final rules do not change the definition for a standing delegation order, except to point out that a standing delegation order and a prescriptive authority agreement are separate and distinct as defined by the rule.
Expanded Delegation of Prescribing and Ordering Drugs and Devices. Under SB 406, physicians may now delegate the prescribing or ordering of Schedule II controlled substances in a hospital facility-based practice, consistent with hospital policy, if the patient has been admitted to the hospital for 24 hours or longer or if the patient is receiving services in the emergency department. Physicians may also delegate the prescribing of Schedule II drugs as part of a plan of care for a terminal patient receiving hospice treatment from a qualified hospice provider. Otherwise, the final rule retains the current limits on a physician’s authority to delegate the prescribing or ordering of a drug or device.
Reference:
http://www.wallerlaw.com/News-Events/Bulletins/118502/Texas-Medical-Board-Adopts-Rules-Required-by-SB-406-to-Ease-Supervision-of-PAs-and-APRNs
New Terms and Phrases. The final rules scrap the definition for Medically Underserved Area and instead define a practice serving a medically underserved population. Other defined terms and phrases shift the focus of the rules governing delegation: hospital, medication order, physician group practice, prescriptive authority agreement, device, and facility-based practice site, to highlight a few. The final rules do not change the definition for a standing delegation order, except to point out that a standing delegation order and a prescriptive authority agreement are separate and distinct as defined by the rule.
Expanded Delegation of Prescribing and Ordering Drugs and Devices. Under SB 406, physicians may now delegate the prescribing or ordering of Schedule II controlled substances in a hospital facility-based practice, consistent with hospital policy, if the patient has been admitted to the hospital for 24 hours or longer or if the patient is receiving services in the emergency department. Physicians may also delegate the prescribing of Schedule II drugs as part of a plan of care for a terminal patient receiving hospice treatment from a qualified hospice provider. Otherwise, the final rule retains the current limits on a physician’s authority to delegate the prescribing or ordering of a drug or device.
Reference:
http://www.wallerlaw.com/News-Events/Bulletins/118502/Texas-Medical-Board-Adopts-Rules-Required-by-SB-406-to-Ease-Supervision-of-PAs-and-APRNs
