By: Perry  S.B. No. 1633          (In the Senate - Filed March 9, 2017; March 22, 2017, read   first time and referred to Committee on Health & Human Services;   April 24, 2017, reported adversely, with favorable Committee   Substitute by the following vote:  Yeas 8, Nays 0; April 24, 2017,   sent to printer.)Click here to see the committee vote     COMMITTEE SUBSTITUTE FOR S.B. No. 1633 By:  Perry     A BILL TO BE ENTITLED   AN ACT     relating to the provision of pharmacy services through a   telepharmacy system; establishing a remote dispensing site   license.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 562.110, Occupations Code, is amended by   amending Subsections (a), (b), (d), (e), and (f) and adding   Subsections (g), (h), and (i) to read as follows:          (a)  In this section:                (1)  "Provider pharmacy" means a Class A pharmacy that   provides pharmacy services through a telepharmacy system at a   remote dispensing site.                (2)  "Remote dispensing site" means a location licensed   as a telepharmacy that is authorized by a provider pharmacy through   a telepharmacy system to store and dispense prescription drugs and   devices, including dangerous drugs and controlled substances.                (3)  "Telepharmacy[, "telepharmacy] system" means a   system that monitors the dispensing of prescription drugs and   provides for related drug use review and patient counseling   services by an electronic method, including the use of the   following types of technology:                      (A) [(1)]  audio and video;                      (B) [(2)]  still image capture; and                      (C) [(3)]  store and forward.          (b)  A Class A or Class C pharmacy located in this state may   provide pharmacy services, including the dispensing of drugs,   through a telepharmacy system at locations separate from [in a   facility that is not at the same location as] the Class A or Class C   pharmacy.          (d)  A telepharmacy system may be located only at:                (1)  a health care facility in this state that is   regulated by this state or the United States; or                (2)  a remote dispensing site.          (e)  The board shall adopt rules regarding the use of a   telepharmacy system under this section, including:                (1)  the types of health care facilities at which a   telepharmacy system may be located under Subsection (d)(1), which   must include the following facilities:                      (A)  a clinic designated as a rural health clinic   regulated under 42 U.S.C. Section 1395x(aa)[, as amended]; and                      (B)  a health center as defined by 42 U.S.C.   Section 254b[, as amended];                (2)  the locations eligible to be licensed as remote   dispensing sites, which must include locations in medically   underserved areas, areas with a medically underserved population,   and health professional shortage areas determined by the United   States Department of Health and Human Services;                (3)  licensing and operating requirements for remote   dispensing sites, including:                      (A)  a requirement that a remote dispensing site   license identify the provider pharmacy that will provide pharmacy   services at the remote dispensing site;                      (B)  a requirement that a provider pharmacy be   allowed to provide pharmacy services at not more than two remote   dispensing sites;                      (C)  a requirement that a pharmacist employed by a   provider pharmacy make at least monthly on-site visits to a remote   dispensing site or more frequent visits if specified by board rule;                      (D)  a requirement that each month the perpetual   inventory of controlled substances at the remote dispensing site be   reconciled to the on-hand count of those controlled substances at   the site by a pharmacist employed by the provider pharmacy;                      (E)  a requirement that a pharmacist employed by a   provider pharmacy be physically present at a remote dispensing site   when the pharmacist is providing services requiring the physical   presence of the pharmacist, including immunizations;                      (F)  a requirement that a remote dispensing site   be staffed by an on-site pharmacy technician who is under the   continuous supervision of a pharmacist employed by the provider   pharmacy;                      (G)  a requirement that all pharmacy technicians   at a remote dispensing site be counted for the purpose of   establishing the pharmacist-pharmacy technician ratio of the   provider pharmacy, which, notwithstanding Section 568.006, may not   exceed three pharmacy technicians for each pharmacist providing   supervision;                      (H)  a requirement that, before working at a   remote dispensing site, a pharmacy technician must:                            (i)  have worked at least one year at a   retail pharmacy during the three years preceding the date the   pharmacy technician begins working at the remote dispensing site;   and                            (ii)  have completed a board-approved   training program on the proper use of a telepharmacy system; and                      (I)  any additional training or practice   experience requirements for pharmacy technicians at a remote   dispensing site;                (4)  the areas that qualify under Subsection (f);                (5) [(3)]  recordkeeping requirements; and                (6) [(4)]  security requirements.          (f)  A telepharmacy system located at a health care facility   under Subsection (d)(1) may not be located in a community in which a   Class A or Class C pharmacy is located as determined by board rule.   If a Class A or Class C pharmacy is established in a community in   which a telepharmacy system has been located under this section,   the telepharmacy system may continue to operate in that community.          (g)  A telepharmacy system located at a remote dispensing   site under Subsection (d)(2) may not dispense a controlled   substance listed in Schedule II as established by the commissioner   of state health services under Chapter 481, Health and Safety Code,   and may not be located within 25 miles by road of a Class A pharmacy.          (h)  If a Class A pharmacy is established within 25 miles by   road of a remote dispensing site that is currently operating, the   remote dispensing site may continue to operate at that location.          (i)  The board by rule shall require and develop a process   for a remote dispensing site to apply for classification as a Class   A pharmacy if the average number of prescriptions dispensed each   day the remote dispensing site is open for business is more than   125, as calculated each calendar year.          SECTION 2.  The Texas State Board of Pharmacy shall adopt   rules under Section 562.110, Occupations Code, as amended by this   Act, not later than January 1, 2018.          SECTION 3.  This Act takes effect September 1, 2017.     * * * * *