The 2019 Texas Legislature enacted three new laws that will change the way physicians prescribe opioids.
House Bill 3284 by Rep. J.D. Sheffield, DO (R-Gatesville), delays the mandate for physicians check the state’s prescription monitoring program, known as PMP Aware, for prescriptions tied to opioids, benzodiazepines, barbiturates, and carisoprodol. The bill pushes back the requirement from Sept. 1, 2019, to March 1, 2020.
The Texas Medical Association pushed for the delay, which will give electronic health record (EHR) vendors more time to make software changes that will allow prescribers to access PMP Aware directly from their EHR. The bill requires electronic prescribing of opioids unless a waiver is granted. Electronic prescribing diminishes the chance of opioids being misused.
HB 3284 works in tandem with the Supplemental Budget Bill – Senate Bill 500, by Sen. Jane Nelson (R-Flower Mound). SB 500 provides about $6 million to the Board of Pharmacy to upgrade the PMP and to purchase user licenses for all prescribers and pharmacists to have electronic access to the PMP through their EHRs. This will save physicians who were already using that service about $50 per year in fees. SB 500 took effect when Gov. Greg Abbott signed it into law in June.
Finally, House Bill 2174 by Rep. John Zerwas, MD (R-Richmond) requires that opioid prescriptions for acute pain may not exceed 10 days and cannot include any refills. This does not include treatments for substance abuse, chronic pain, or cancer care. It also does not include any end-of-life care, like palliative care or hospice.
Likewise, the law changes some prior authorization rules on opioids. Namely, it provides that medication-assisted opioid or substance abuse disorder treatment will be approved under Medicaid without prior authorization or precertification. This will be done except when needed to minimize fraud, waste, and abuse. These provisions of HB 2174 go into effect Sept. 1.
HB 2174 also requires electronic prescribing of all controlled substances starting Jan. 1, 2021, the year in which Medicare rolls out the same requirement.
If you want to learn more about these new laws and how they will affect you, check out TMA's on-demand webinar, Texas Prescription Monitoring Program (PMP) Requirements: Who, What, When, and How. The webinar is worth 1.25 AMA PRA Category 1 CreditsTM.
More information on electronic prescribing can also be found at TMA’s online prescribing resource center, or by contacting TMA's HIT Department at (800) 880-5720 or by email.
Update: This story has been updated to include the dates that SB 500 and HB 2174 take effect.