The process of obtaining a prescription in North Central Texas can be complex and confusing. To help make the process easier, this article will provide a step-by-step guide to obtaining a prescription in the region. The first step is to find a licensed dentist who is qualified to provide teledentistry services. The dentist will evaluate the indication, appropriateness, and safety considerations of each medication prescription, laboratory services, or dental laboratory services provided through the use of teledentistry in accordance with applicable law and current standards of care, including those of appropriate documentation.
The use of teledentistry by a licensed dentist carries the same professional responsibility as a prescription issued in connection with an in-person encounter. In North Carolina, a licensed dentist who prescribes any type of pain reliever or pain reliever as part of providing teledentistry services must meet all applicable requirements of the North Carolina Controlled Substances Reporting System. In Georgia and Texas, Physician Assistants (PAs) are prohibited from prescribing Schedule II drugs; however, they can prescribe Schedule III-V drugs. In addition, Arkansas and Missouri only allow PAs to prescribe the combined hydrocodone products listed on Schedule II of drugs.
Many other states have limitations on the supply that can be prescribed and dispensed. For example, the prescription of Schedule II drugs by PAs is limited to a 30-day supply in Arizona, Illinois, Montana, North Carolina, Pennsylvania, and South Dakota. Some states also restrict the ability of PAs to prescribe Schedule II drugs by requiring the approval of a supervisory physician. Some states also require PAs to complete board-approved courses on controlled substances before they are allowed to prescribe scheduled medications.
Recommendations for evaluation, treatment and consultation made in an optometric telemedicine environment, including the issuance of a prescription by electronic means, must meet the same standards of good practice as in traditional face-to-face clinical settings. Before providing treatment, including the issuance of prescriptions, the physician using telemedicine must interview the patient to collect the relevant medical history and to perform a physical examination, when medically necessary, sufficient for the diagnosis and treatment of the patient. The Texas Medical Board, the Texas Board of Nursing, the Texas Board of Physician Auxiliaries and the State of Texas Board of Pharmacy shall jointly adopt the rules that establish the determination of a valid prescription in accordance with Section 111.005. The physician shall be exempt from the requirements of subsection (b) and may issue a prescription for a controlled substance to a patient if the prescription is for the treatment of a patient's medical emergency, as defined by the rule of the Medical Examination Board, Judges and the Medical Licensing Commission. If a doctor, other than a veterinarian, prescribes a controlled substance included in schedules II, III, or IV for the treatment of pain, he will not issue more than one additional prescription that increases the dose of the controlled substance, unless he meets with the patient, in person or via telehealth, to reevaluate the treatment plan. Before providing treatment, including the issuance of prescriptions, electronically or otherwise, the licensee using telehealth to provide medical care must interview the patient to collect the appropriate medical history and perform a relevant physical examination, as defined in the standard of care, for the purpose of the visit, when clinically necessary, sufficient for the diagnosis and treatment of the patient. Recommendations for treatment and consultation made in an online environment, including the issuance of a prescription by electronic means, will be carried out with the same standards of appropriate practice as in traditional settings (in-person meeting). Before providing treatment, including the issuance of prescriptions, electronically or otherwise, the licensee using telemedicine will interview the patient to collect the appropriate medical history and perform a physical examination when medically necessary sufficient for the diagnosis and treatment of the patient. The State Board of Dental Examiners and the Texas State Board of Pharmacy will jointly develop and publish on the Internet website of each respective board the answers to frequently asked questions related to the determination of a valid prescription issued during the provision of teledentistry dental services. A controlled substance that is a prescription drug cannot be delivered, distributed or dispensed online without a valid prescription; however nothing in this subsection can be interpreted as meaning that an in-person medical evaluation alone demonstrates that a prescription has been validly issued for a legitimate medical purpose within usual course of professional practice. The prescription order is for medication listed in paragraph (d), clause () or for medication-assisted therapy for substance use disorder; and prescribing physician has completed telehealth examination of patient as defined in section 62A.
Prescriptions from Schedule II and Schedule III are not allowed except for drugs from Schedule II and Schedule III specifically authorized by board which may include but not limited to non-narcotic drugs from Schedule II and non-narcotic drugs from Schedule III. A licensee who provides dental services through teledentistry including but not limited to provision consultations and treatment recommendations issuance prescription diagnosis correction position teeth use orthodontic appliances shall provide such services accordance same standards care professional conduct when providing those services person other means. Once doctor has obtained relevant medical history performed physical examination it up doctor's judgment determine whether medically necessary obtain medical history perform physical examination subsequent encounters.
