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When Can Physicians Delegate the Authority to Write Prescriptions for Controlled Substances in Texas?

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Due to the worsening problem of opioid addiction in Texas and across the country, the Texas legislature and Texas Medical Board (TMB) have enacted laws regarding when doctors can delegate their power to write prescriptions for opioids and other controlled substances. If you fail to follow these rules, you could risk the loss of your license to practice medicine and face other punishments by the TMB that could have long-term ramifications on your career.
 

What Are the Requirements for Delegation of Prescription Authority?

Doctors in Texas are permitted to delegate the authority to prescribe Schedule II drugs to an Advanced Practice Registered Nurse (APRN) or a Physician Assistant (PA). Schedule II drugs are those that have a high potential of abuse and include medications like opioids. They are allowed to prescribe these drugs in these situations:
 
Hospital-based facility. In a hospital setting, the policy must be approved by the facility’s medical staff or in the by-laws to ensure patient safety. The patient must have been admitted to the hospital for an intended stay of 24 hours or longer or be receiving care in an emergency department. However, an APRN or PA can only prescribe Schedule III through V controlled substances in a free-standing emergency department.
Hospice. If a patient has a written certificate for terminal care, an APRN or PA has authority to prescribe pain medications as part of his hospice care.
 
To delegate authority, the doctor and APRN or PA must have a written protocol, which is a written authorization delegating this authority, or a written prescriptive authority agreement signed by both parties. APRNs and PAs must consult with the doctor granting them authority to prescribe before refilling an initial 90-day supply of a controlled substance.
 
Are you a doctor in the Dallas, Fort Worth, or Mid-Cities area facing a complaint by the Texas Medical Board for violating these or other rules? Get your questions answered and the help you need to protect your license. Call our office to schedule a free consultation with attorney Walt Taylor today.
Walter L. Taylor
Employment & Medical Peer Review Lawyer helping workers, doctors, nurses, dentists and pharmacists in Texas.
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