Texas Register May 14, 2021 Volume: 46 Number: 20

Governor

46 TexReg 3218
May 14, 2021: Appointments Governor appoints Rey Ximenes, M.D., to the Texas State Board of Acupuncture Examiners

Appointments for April 28, 2021

Appointed to the Texas State Board of Acupuncture Examiners, for a term to expire January 31, 2027, Rey Ximenes, M.D. of Spicewood, Texas (replacing Jeremy D. Wiseman, M.D. of Austin, whose term expired).46 TexReg 3081
May 14, 2021: Appointments Governor reappoints two members and appoints one new member to the Texas Board of Chiropractic Examiners

Appointments for April 28, 2021

Appointed to the Texas Board of Chiropractic Examiners, for terms to expire February 1, 2027:

• Sarah T. Abraham of Sugar Land, Texas (replacing Gustabo “Gus” Ramirez of Tyler, whose term expired);
• Nicholas S. “Nick” Baucum, D.C. of Corpus Christi, Texas (Dr. Baucum is being reappointed);
• Mark R. Bronson, D.C. of Aledo, Texas (Dr. Bronson is being reappointed).

46 TexReg 3081
May 14, 2021: Appointments Governor reappoints two members and appoints one new member to the Texas Board of Medical Radiologic Technology

Appointments for April 28, 2021

Appointed to the Texas Board of Medical Radiologic Technology, for terms to expire February 1, 2027:

• Nicholas M. Beckmann, M.D. of Houston, Texas (Dr. Beckmann is being reappointed);
• Scott A. Morren of Anton, Texas (Mr. Morren is being reappointed);
• Shaila D. Parker of Garland, Texas (replacing Anthony “Tony” Jaso of San Antonio, whose term expired).

46 TexReg 3081
May 14, 2021: Appointments Governor designates Faraz A. Khan, M.D., as presiding officer of the Texas Board of Medical Radiologic Technology

Appointments for April 29, 2021

Designated as presiding officer of the Texas Board of Medical Radiologic Technology, for a term to expire at the pleasure of the Governor, Faraz A. Khan, M.D. of Houston, Texas (Dr. Khan is replacing Anthony “Tony” Jaso of San Antonio).

46 TexReg 3081
May 14, 2021: Appointments Governor appoints Raquel R. Olivier to the State Board of Veterinary Medical Examiners

Appointments for April 30, 2021

Appointed to the State Board of Veterinary Medical Examiners, for a term to expire August 26, 2023, Raquel R. Olivier of Houston, Texas (replacing Carlos R. Chacon of Austin, who resigned).

46 TexReg 3081
May 14, 2021: Appointments Governor appoints Gary L. Francis, M.D., Ph.D., to the Texas Diabetes Council

Appointments for May 3, 2021

Appointed to the Texas Diabetes Council, for a term to expire February 1, 2027, Gary L. Francis, M.D., Ph.D. of San Antonio, Texas (replacing Kathy Ann LaCivita, M.D. of San Antonio, whose term expired).

Texas Board of Nursing

May 14, 2021: Emergency Rule Amending 22 TAC §217.24 to allow the prescription of controlled substances for certain existing patients using telemedicine

PART 11. TEXAS BOARD OF NURSING

CHAPTER 217. LICENSURE, PEER ASSISTANCE AND PRACTICE

22 TAC §217.24

OVERVIEW

The Texas Board of Nursing (Board) adopts emergency amendments to §217.24(e), relating to Telemedicine Medical Service Prescriptions, pursuant to a finding of imminent peril to the public health, safety, and welfare, which requires adoption in fewer than thirty (30) days’ notice, as authorized by Tex. Gov’t. Code §2001.034.

BACKGROUND AND JUSTIFICATION

On March 13, 2020, the Governor of the State of Texas certified COVID-19 as posing an imminent threat of disaster to the public health and safety and declared a state of disaster in all counties of Texas. On March 23, 2020, the Office of the Governor granted a waiver of 22 TAC §217.24(e)(1), which prohibits an advanced practice registered nurse (APRN) from treating chronic pain with scheduled drugs through the use of telemedicine medical services, unless otherwise permitted under federal and state law. The waiver, however, expired on June 6, 2020.

The adoption of emergency amendments to §217.24(e) is immediately necessary to allow APRNs to provide necessary treatment to established patients with chronic pain while mitigating the risk of exposure to COVID-19. Under the emergency amendments, the treatment of chronic pain with scheduled drugs through the use of telemedicine medical services by any means other than via audio and video two-way communication is prohibited, unless certain conditions are met. First, a patient must be an established chronic pain patient of the APRN. Second, the patient must be receiving a prescription that is identical to a prescription issued at the previous visit. Third, the patient must have been seen by the prescribing APRN or physician or health professional as defined in Tex. Occ. Code §111.001(1) in the last 90 days, either in-person or via telemedicine using audio and video two-way communication. These requirements are consistent with the rules adopted by the Texas Medical Board at 22 TAC §174.5 (relating to Issuance of Prescriptions) on an emergency basis, effective May 2, 2021, and the provisions of federal law that currently permit the use of telemedicine medical services for the prescription of controlled substances during the COVID-19 pandemic.

46 TexReg 3087

Texas Department of Insurance

May 14, 2021: Notices Division of Workers’ Compensation will conduct official rule review to consider 28 TAC, Chapters 160, 165, 166, 180

RULE REVIEW

The Texas Department of Insurance, Division of Workers’ Compensation (DWC) will review all sections in the following chapters of 28 TAC:

CHAPTER 160 (REPORTS OF INJURY AND OCCUPATIONAL DISEASE–GENERAL PROVISIONS)

CHAPTER 165 (REJECTED RISK: INJURY PREVENTION SERVICES)

CHAPTER 166 (ACCIDENT PREVENTION SERVICES)

CHAPTER 180 (MONITORING AND ENFORCEMENT)

DWC will consider whether the initial reasons for adopting these rules continue to exist and whether these rules should be repealed, readopted, or readopted with amendments.

PUBLIC COMMENT

To comment on this rule review project, submit your written comments by 5:00 p.m., central time, on June 14, 2021.

Instructions for submitting public comment are included in this week’s edition of the Texas Register (46 Tex Reg 3147). 46 TexReg 3147

Texas Medical Board

May 14, 2021: Emergency Rule Amending 22 TAC §174.5 to allow physicians to issue prescription refills for certain chronic pain patients using telemedicine during the COVID-19 pandemic

CHAPTER 174. TELEMEDICINE

SUBCHAPTER A. TELEMEDICINE

22 TAC §174.5

OVERVIEW

The Texas Medical Board (Board) adopts, on an emergency basis, amendments to 22 TAC §174.5, effective May 2, 2021 at 12:01 a.m.

The emergency amendment would allow physicians to utilize telemedicine to continue issuing previous prescription(s) for scheduled medications to established chronic pain patients, if the physician has, within the past 90 days, seen a patient in-person or via a telemedicine visit using two-way audio and video communication.

BACKGROUND AND JUSTIFICATION

On March 13, 2020, the Governor of Texas certified COVID-19 as posing an imminent threat of disaster to the public health and safety and declared a state of disaster in all counties of Texas. On March 19, 2020, the Texas Governor issued a waiver suspending the strict enforcement of §174.5(e)(2)(A) which generally prohibits the utilization of telemedicine to prescribe scheduled drugs for the treatment of chronic pain. The waiver was issued in order to protect public health and curb the spread of COVID-19 by providing patients access to schedule drugs needed to ensure on-going treatment of chronic pain and avoid potential adverse consequences associated with the abrupt cessation of pain medication. On March 1, 2021, the Board adopted, on an emergency basis, amendments to 22 TAC §174.5. Such rule is set to expire at 11:59 p.m. on May 1, 2021.

Therefore, the emergency amendment to §174.5(e) is immediately necessary to help the state’s physicians, physician assistants and other health care professionals continue to mitigate the risk of exposure to COVID-19 and provide necessary medical servicesrelated to issuance of prescriptions including controlled substances for patients. Pursuant to the Governor’s declaration of disaster issued on March 13, 2020, related to COVID-19, physicians can continue the treatment of chronic pain with scheduled drugs for established patients after having an in-person or two-way audio and video communications telemedicine medical services within the last 90 days.

46 TexReg 3086