Rx in Texas

[jmj11]

Okay, I don't know a lot about Texas laws for PAs (and could look it up but I'm too busy right now), however, yesterday I got this nasty letter from an insurance company's pharmacist who is at their Rx mail order in Texas. He had a copy of my Rx and said, "In Texas it is against the law for physician's assistants to write prescriptions so have your supervising physician rewrite this so we can fill it."

 

I was quite irritated.

 

# 1, I don't practice in Texas so I don't care what their rules are.

# 2, I told him to fix their "physician's assistant" (which was also printed on their form letter) immediately.

 

But really, PAs can't write prescriptions in Texas? Give me a break. It wasn't even a controlled substance.

[EMEDPA]

just checked on the aapa site- PAs can rx in texas but the MDs name must also be on your rx.

[whoRyou]

Here you go ... YES, the PAs supervising physician must delegate prescriptive authority allowing a PA to sign prescriptions for controlled substances, also called scheduled drugs, as well as Dangerous Drugs. However, PA's are limited to Schedules III - V. All prescription drugs that are not controlled substances fall into the category of "dangerous drugs." A list of controlled substances can be found at: http://www.dshs.state.tx.us/dmd/control_subst_sched.shtm . Physician assistants with prescriptive authority must have their own DPS and DEA numbers to prescribe controlled substances. In addition, physician assistants must have the name of their current delegating physician authorizing prescriptive authority on file with DPS. If a physician assistant does not notify the DPS of a new physician within 60 days of a supervision/delegation termination, the physician assistant’s DPS number will be terminated. Click here for more information. http://www.tmb.state.tx.us/professionals/physicianassist/licensed/paPrescriptiveDelegation.php

[jmj11]

Here you go ... YES, the PAs supervising physician must delegate prescriptive authority allowing a PA to sign prescriptions for controlled substances, also called scheduled drugs, as well as Dangerous Drugs. However, PA's are limited to Schedules III - V. All prescription drugs that are not controlled substances fall into the category of "dangerous drugs." A list of controlled substances can be found at: http://www.dshs.state.tx.us/dmd/control_subst_sched.shtm . Physician assistants with prescriptive authority must have their own DPS and DEA numbers to prescribe controlled substances. In addition, physician assistants must have the name of their current delegating physician authorizing prescriptive authority on file with DPS. If a physician assistant does not notify the DPS of a new physician within 60 days of a supervision/delegation termination, the physician assistant’s DPS number will be terminated. Click here for more information. http://www.tmb.state.tx.us/professionals/physicianassist/licensed/paPrescriptiveDelegation.php

 

 

My SP's name is on my Rx pad along with mine. But this letter said it had to be rewritten with my SP's sign. That's the part that doesn't make sense. It was for nadolol and sumatriptan.

[EMEDPA]

My SP's name is on my Rx pad along with mine. But this letter said it had to be rewritten with my SP's sign. That's the part that doesn't make sense. It was for nadolol and sumatriptan.

 

you aren't registered in the state of TX with their DPS # I assume...

[benm93]

I am in SC, and I will fill out of state PA and NP Rx's according to our laws (almost identical to TX) which means the SP name is on the RX, just on it somewhere, no signature needed. then we need the PA's npi/dea. As long as it is not a CII its all good.

 

I will say, I have lost count of the times I have hung up on a mail order pharmacist to avoid cussing at work, I do not know how they train them to be so annoying. Do not take mail order people as what the law is, they do as they please, and make up laws along the way. Call a random chain pharmacy in a state and ask their states policies. I do it all the time when I have someone going out of town. They will give you the real deal as far as what the pharmacy practice act really is, not medco policy.

[mdebord]

I do work in Texas. It's BS - sounds like it was someone who really didn't know what they were talking about. My mail order scripts don't require SP sig.

[jmj11]

My office manager resolved this this morning, after the patient had been without her meds for about 4 weeks. I was seeing patients but stuck my head out the door now and then to comment to the pharmacist via my office manager.

 

Office Manager (OM): The state of Texas doesn't require the SP signature, so please fill the meds.

Texas Pharmacist (TP): Well, yes it does.

OM: No it doesn't, if you think it does, send us a copy of the state law.

TP: Well, it requires the name of the SP to be on the Rx.

OM: That's different. The SP can't sign it because he works in another city, but the prescription we sent you has his name on it as required by law.

TP: Yeah, but we can't use your Rx because it is from Washington state and we have to transpose it onto our Rx which doesn't have the SP's name on it, so we can't fill it.

OM: Then put the SP's name on it, it was on our original.

TP: We can't do that, that would be illegal.

OM: You put the PAs name on it.

TP: That's different.

OM: So how does having the SP sign it, make it different.

TP: Then we can transpose to our Rx and we can put the prescribing physician's name on it.

OM: Can you fill the damn prescription or send us the actual law that says the SP must sign it? The patient has been without her meds for almost four weeks now.

 

Pause:

 

TP: Okay, we will sen the Rx to the patient by overnight Fed Ex.

[rcdavis]

My office manager resolved this this morning, after the patient had been without her meds for about 4 weeks. I was seeing patients but stuck my head out the door now and then to comment to the pharmacist via my office manager.

 

Office Manager (OM): The state of Texas doesn't require the SP signature, so please fill the meds.

Texas Pharmacist (TP): Well, yes it does.

OM: No it doesn't, if you think it does, send us a copy of the state law.

TP: Well, it requires the name of the SP to be on the Rx.

OM: That's different. The SP can't sign it because he works in another city, but the prescription we sent you has his name on it as required by law.

TP: Yeah, but we can't use your Rx because it is from Washington state and we have to transpose it onto our Rx which doesn't have the SP's name on it, so we can't fill it.

OM: Then put the SP's name on it, it was on our original.

TP: We can't do that, that would be illegal.

OM: You put the PAs name on it.

TP: That's different.

OM: So how does having the SP sign it, make it different.

TP: Then we can transpose to our Rx and we can put the prescribing physician's name on it.

OM: Can you fill the damn prescription or send us the actual law that says the SP must sign it? The patient has been without her meds for almost four weeks now.

 

Pause:

 

TP: Okay, we will sen the Rx to the patient by overnight Fed Ex.

 

I am beginning to appreciate how very good she can be at her job....

[whoRyou]

I feel sorry for the pt who had to wait for her meds. I hope she didn't/doesn't have any lingering side effects. :mad: