A physician may delegate certain drug therapy management tasks to a properly qualified, trained pharmacist under adequate supervision, but the order or protocol cannot allow delegation of medical diagnosis.
Sec. 157.101. DELEGATION TO PHARMACIST. (a) In this section, "pharmacist" has the meaning assigned by Section 551.003. (b) A physician may delegate to a properly qualified and trained pharmacist acting under adequate physician supervision the performance of specific acts of drug therapy management authorized by the physician through the physician's order, standing medical order, standing delegation order, or other order or protocol as defined by board rule. (b-1) A delegation under Subsection (b) may include: (1) the implementation or modification of a patient's drug therapy under a protocol if: (A) the delegation follows a diagnosis, initial patient assessment, and drug therapy order by the physician; and (B) the pharmacist maintains a copy of the protocol for inspection until at least the seventh anniversary of the expiration date of the protocol; or (2) the authority to sign a prescription drug order for dangerous drugs for a patient if: (A) the delegation follows a diagnosis, initial patient assessment, and drug therapy order by the physician; (B) the pharmacist practices in a federally qualified health center, a hospital, a hospital-based clinic, or an academic health care institution; (C) the federally qualified health center, hospital, hospital-based clinic, or academic health care institution in which the pharmacist practices has bylaws and a medical staff policy that permit a physician to delegate to a pharmacist the management of a patient's drug therapy; (D) the pharmacist provides the name, address, and telephone number of the pharmacist and of the delegating physician on each prescription signed by the pharmacist; and (E) the pharmacist provides a copy of the protocol to the Texas State Board of Pharmacy. (c) Physician supervision is considered to be adequate for the purposes of this section if a delegating physician: (1) is responsible for the formulation or approval of the physician's order, standing medical order, standing delegation order, or other order or protocol and periodically reviews the order or protocol and the services provided to a patient under the order or protocol; (2) has established a physician-patient relationship with each patient who is provided drug therapy management by a delegated pharmacist; (3) is geographically located so as to be able to be physically present daily to provide medical care and supervision; (4) receives, as appropriate, a periodic status report on each patient, including any problem or complication encountered; and (5) is available through direct telecommunication for consultation, assistance, and direction. (d) This section does not restrict the use of a preestablished health care program or restrict a physician from authorizing the provision of patient care by use of a preestablished health care program if the patient is institutionalized and the care is to be delivered in a licensed hospital with an organized medical staff that has authorized standing delegation orders, standing medical orders, or protocols. (e) This section does not limit, expand, or change any provision of law relating to therapeutic drug substitution or administration of medication, including Section 554.004. (f) The board by rule shall establish the minimum content of a written order or protocol. The order or protocol may not permit the delegation of medical diagnosis. (g) In this section, "federally qualified health center" has the meaning assigned by 42 U.S.C. Section 1396d(l)(2)(B). Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by: Acts 2009, 81st Leg., R.S., Ch. 271 (S.B. 381), Sec. 1, eff. September 1, 2009. Acts 2019, 86th Leg., R.S., Ch. 197 (H.B. 2425), Sec. 1, eff. September 1, 2019. Acts 2019, 86th Leg., R.S., Ch. 976 (S.B. 1056), Sec. 1, eff. September 1, 2019. Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 2.144, eff. April 1, 2025.