Total Health Law Blog
Our healthcare and business law firm previously published a blog post on the federal telemedicine rules. Both Federal and State rules govern the provision of telemedicine. Each state’s rules governing telemedicine are different, but the applicable laws and rules are generally found in the state medical board’s rules, insurance code, and when applicable, Medicaid rules. This post focuses specifically on Texas’s telemedicine prescribing rules. Our firm previously posted an overview of Texas’s general telemedicine rules. If you have questions about telemedicine rules or would like to discuss this blog post, you may contact our healthcare and business law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@hamillittle.com. You may also learn more about our law firm by visiting www.hamillittle.com.
Texas Rules on Prescribing Based on a Telemedicine Visit
Texas’ rules governing telemedicine are found in the Texas Administrative Code and Texas Occupational Code. Below is an overview of some requirements currently in Texas governing the practice of telemedicine.
A. General Telemedicine Prescribing Rules
Texas Administrative Code § 174.5 covers the prescribing rules. First, the “same standards that would apply to the issuance of the prescription in an in-person setting” govern “[t]he validity of a prescription issued as a result of telemedicine medical services.” Tex. Admin. Code § 174.5(a).
Prescriptions must be: “(1) issued for a legitimate medical purpose by a practitioner as part of patient-practitioner relationship as set out in §111.005, of Texas Occupations Code; and (2) meet all other applicable laws before prescribing, dispensing, delivering or administering a dangerous drug or controlled substance.” Tex. Admin. Code § 174.5(c).
B. Prescribing Dangerous Drugs or Controlled Substances
It violates the Texas act to prescribe any dangerous drug or controlled substance without first establishing a “practitioner-patient relationship.” Tex. Occ. Code. § 190.8(1)(L). As also discussed in our previous post, Chapter 111 of the Texas Occupational Code defines a “practitioner-patient relationship” in the telemedicine context as a provider who:
“(3) provides the telemedicine medical services . . . through the use of one of the following methods, as long as the practitioner complies with the follow-up requirements in Subsection (b), and the method allows the practitioner to have access to, and the practitioner uses, the relevant clinical information that would be required in accordance with the standard of care described in Section 111.007:
(A) synchronous audiovisual interaction between the practitioner and the patient in another location;
(B) asynchronous store and forward technology, including asynchronous store and forward technology in conjunction with synchronous audio interaction between the practitioner and the patient in another location, as long as the practitioner uses clinical information from:
(i) clinically relevant photographic or video images, including diagnostic images; or
(ii) the patient’s relevant clinical records, such as the relevant medical or dental history, laboratory and pathology results, and prescriptive histories; or
(C) another form of audiovisual telecommunication technology that allows the practitioner to comply with the standard of care described in Section 111.007.”
Tex. Occ. Code Section 111.005.
C. Pain Management Prohibited
Prescribing pain management treatment from a telemedicine visit is prohibited in Texas, as in many other states. Tex. Admin. Code § 174.9 states: “(6) Chronic Pain Treatment Prohibited–Treatment of chronic pain with scheduled drugs through use of telecommunications or information technology is prohibited, unless otherwise allowed under federal and state law.”
As is clear from the above, medical practices must be thoughtful before prescribing from a telemedicine visit. If you have questions about telemedicine rules or would like to discuss this blog post, you may contact our healthcare and business law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@hamillittle.com. You may also learn more about our law firm by visiting www.hamillittle.com.
*Disclaimer: Thoughts shared here do not constitute legal advice.