Who Can Own A Pharmacy In Texas?

In contrast to the majority of other states, the state of Texas does not prohibit medical professionals from owning or investing in pharmacies, provided that the ownership structure adheres to one of the exceptions listed in the Texas Patient Non-Solicitation Law (Texas Occupation Code Ann.102.0003).

When physician investors enter into an investment arrangement with a pharmacy, they are required to be aware of the Federal Anti-Kickback Statute (AKS), which states that it is illegal to receive payment in exchange for referrals of patients to receive items or services that are covered by federal health care programs (including Medicare and Medicaid).42 U.S.C.

§ 1320a–7b (b). In addition, the Federal physician self-referral law, also known as the Stark law, prohibits physicians from referring patients who are covered by Medicare or Medicaid to a health care company if the physician or a member of the physician’s immediate family has a financial relationship with the company.

This prohibition applies to both Medicare and Medicaid patients.42 U.S.
Code § 1395nn.
Both the AKS and Stark include specific exemptions that may be utilized in order to structure investment agreements in a way that does not result in a breach of the rules.
It is important to note, however, that Texas and other states have been boosting their investigations into bribes and referrals as part of their intensifying focus on the scrutiny of physician investments in compounding pharmacies.

Compounding pharmacies that are suspected of illegally paying doctors to write prescriptions for their products and services, such as pain creams and DNA tests, are the focus of these new investigations. Particular attention is being paid to pharmacies that set up physician ownership arrangements for the sole purpose of remunerating physicians for referrals, which is in violation of Texas law, Stark, and the AKS.

For instance, the physician might not be a direct investor in the pharmacy that is filling the referred prescriptions; however, the physician might still receive indirect remuneration in the form of a small ownership interest in an umbrella company or a related pharmacy.
In this scenario, the physician would have a financial incentive to refer patients to the referred pharmacy.

The incidents of large-scale fraud involving federal programs, some of which are believed to be in the tens of millions of dollars, are typically the focus of the investigations conducted by federal authorities. But for schemes that are on a smaller scale (or do not involve Federal programs), Texas regulators can now rely on a new amendment to the Texas Pharmacy Act that took effect in September 2015 and allows the Texas State Board of Pharmacy to inspect a pharmacy’s “financial records” (which were previously off limits) in response to a specific complaint against the pharmacy.

This amendment to the Texas Pharmacy Act took effect in response to a bill that was introduced in the Texas legislature in September 2015 and was signed into law by Governor However, even with this new rule, it is possible that state investigators will not be able to show physician ownership.
Additionally, it is not yet clear if “financial records” include investor data because, to this day, no cases have yet been prosecuted under this new statute.

In spite of this, it is abundantly obvious that federal and state regulators are conducting intensive investigations into allegations of illicit referrals and bribes in the context of independent pharmacies. The right structuring of these kinds of agreements is loaded with regulatory landmines, which may result in hefty fines and penalties if they are not carried out in the correct manner.

What are the requirements for practicing pharmacy in Texas?

Eligibility Requirements – In order to become a licensed pharmacist in the state of Texas, you are required to satisfy all of the following eligibility requirements, which are listed below: Must be at least 18 years old and have ONE of the following requirements fulfilled: A Bachelor of Science degree in Pharmacy or a Doctor of Pharmacy degree from a college that has been approved by the Board of Pharmacy and is accredited by the ACPE; OR Full certification from the Foreign Pharmacy Graduate Equivalency Committee (FPGEC) if you have graduated from a college of pharmacy program that is located outside of the United States.

What is a class a pharmacy in Texas?

Application for a license that permits a facility based in Texas to dispense a medicine or device to the general public in accordance with a prescription drug order is known as a Community Pharmacy (Class A) License application. It’s possible that this pharmacy doesn’t do any compounding of sterile medications.

Including a pharmacy with a “locked door.” Community Pharmacy Engaged in Compounding Sterile Preparations (Class A-S): Application for a license that authorizes a facility located in Texas to dispense a drug or device to the general public in accordance with a prescription drug order and to engage in compounding sterile preparations.

This license is intended for community pharmacies. Including a pharmacy with a “locked door.” Application for a license that would allow a facility based in Texas to dispense a radioactive medication or device for the purpose of administration to a final user is known as a Nuclear Pharmacy (Class B) application.

Institutional/Hospital/Ambulatory Surgery Center Pharmacy (Class C): Application for a license that authorizes a facility located in Texas in an inpatient facility including a hospital, licensed under Chapter 241 or 577, Health and Safety Code; a hospital maintained or operated by the state; a hospice inpatient facility licensed under Chapter 142, Health and Safety Code; or an ambulatory surgical center licensed under Chapter 243, Health and Safety Code.

In addition, an application for this license must be submitted by It’s possible that this pharmacy doesn’t do any compounding of sterile medications. Application for a license that authorizes a facility located in Texas in an inpatient facility including a hospital, licensed under Chapter 241 or 577, Health and Safety Code; a hospital maintained or operated by the state; a hospice inpatient facility licensed under Chapter 142, Health and Safety Code; or an ambulatory surgical center licensed under Chapter 241.

A pharmacy with a Clinic Pharmacy (Class D) license is allowed to dispense just a certain kind of medication or medical equipment when the patient has a prescription for the medication.
(such a Health Center or Planned Parenthood, for example) Non-Resident (Out of State) Pharmacy (Class E): Application for a facility located in a state other than Texas whose primary business is to dispense a prescription drug or device under a prescription drug order; and deliver the drug or device to a patient, including a patient in this state, by using the United States mail, a common carrier, or a delivery service.

This type of pharmacy is considered to be operating outside of the state of Texas. The practice of compounding sterile preparations is not permitted under the terms of this license. Non-Resident (Out of State) Pharmacy Engaged in Compounding Sterile Preparations (Class E-S): Application for a facility located in a state other than Texas whose primary business is to dispense a prescription drug or device under a prescription drug order; and deliver the drug or device to a patient, including a patient in this state, by using the United States mail, a common carrier, or a delivery service.

This application is for facilities that compound sterile preparation This license allows for the manufacture of compounded sterile preparations, which can then be delivered to customers in the state of Texas.
Freestanding Freestanding facilities that are licensed to offer emergency medical treatment to patients by the Texas Department of State Health Services in accordance with Chapter 254 of the Health and Safety Code are referred to as “Emergency Medical Care Center Pharmacy” (Class F) in this article.

Any institution that is formed for the principal purpose of processing prescription drug or medicine drug orders is required, according to the Act, to get a license as a Class G pharmacy. This applies to both central and decentralized prescription drug or medication order processing pharmacies.

A pharmacy that falls under the classification of Class G is not allowed to either keep medications in bulk or fulfill prescription drug orders. Any facility that is created for the primary purpose of providing restricted prescription distribution by a Class A pharmacy is required to obtain a license as a Class H pharmacy under the terms of the Act.

It is against the rules for a Class H pharmacy to either keep medications in large quantities or to fill prescriptions. When running a pharmacy, here are the top ten things you absolutely must be aware of (pdf) When running a pharmacy, here are the top ten things you absolutely must be aware of (video) Details Regarding a Person’s Record of Criminal Activity You will be need to download the Adobe Acrobat reader program in order to access material saved in the PDF format.

What is closed door pharmacy?

Who Can Own A Pharmacy In Texas What exactly is a drugstore with locked doors? Dropoff is able to ensure that all of a closed-door pharmacy’s deliveries arrive reliably on time, every time, by working in conjunction with the pharmacy. Long-term care institutions, such as nursing homes and assisted living facilities, are the primary customers of a particular kind of pharmacy known as a closed-door pharmacy.

They are not available to the general public, which is why they are referred to as “closed-door” meetings.
They exclusively serve patients who are currently residing in a long-term care institution, hence the general public is not permitted to access them.
They are in a position to cater to the unique requirements of these patients since they run their business in this manner.

Although closed-door pharmacies provide many of the same services as retail pharmacies, they also have several characteristics that set them apart in their own right. For instance, because they treat a greater number of customers, pharmacies that are only accessible by appointment typically have a more comprehensive selection of pharmaceuticals.

Does Texas require a pharmacy license?

Pharmacy technician applicants in Texas are required to get certification before they may register with the state Board of Pharmacy. This is one of the few states that has such a requirement. Before delegating responsibilities on the work, employers are obligated to offer new trainees and technicians with first training that takes place on the job.

Can a pharmacist prescribe in Texas?

Who is authorized to hand out prescriptions? In the state of Texas, the only people who are allowed to write prescriptions are doctors of medicine (MD or DO), dentists (DDS), podiatrists (DPM), and veterinarians (DVM). It is also possible for therapeutic optometrists to write prescriptions for specific eye drops or ointments, and if the optometrist has the appropriate credentials to practice as an optometric glaucoma specialist, the optometrist may even be able to write prescriptions for certain oral medicines.

Under the direction of a supervising physician and in accordance with a published protocol, advanced practice nurses (APN) or physician assistants (PA) may dispense prescriptions. Both advanced practice nurses and physician assistants have completed specialized training and education to enable them to diagnose and treat patients.

When the pharmacist goes to fill my prescription, why does she need more information first? Before a prescription may be filled, the law mandates that it must contain a specific amount of information. It is the responsibility of the pharmacist to ensure that the prescription has all of the necessary information.

As a result, the pharmacist or another employee of the drugstore may ask you for information that is not necessarily included on the prescription.
For instance, they may ask for your full name and/or address.
In addition, prior to filling the prescription, the pharmacist is obligated to do a screening, often known as a review, of both the prescription and your patient medication record.

In order for the pharmacist to carry out this check, also known as a drug use review (DUR), he or she will inquire about several fundamental aspects of your health, including the following: Your age or date of birth; any known allergies, previous drug reactions, chronic conditions; names of other drugs you may be routinely taking, including over-the-counter drugs such as Tylenol, aspirin, antacids, etc.; names of any supplements or any complementary or alternative medicines such as probiotics, herbs, acupuncture, etc.

your sex or gender; your age; your date of birth; any known allergies; any previous drug reactions; any chronic conditions; names of other drugs This medication record for the patient provides the pharmacist with assistance in recognizing drug-related issues, such as Drug allergies, interactions with other medications that you are taking, improper dose or duration of therapy, therapeutic duplication with other medications that are being taken, and inappropriate usage of a medication are all examples of potential adverse drug reactions.

A patient has the ability to decline providing the pharmacist with any portion or all of the aforementioned information. However, if the patient does not provide this information to the pharmacist, the patient will not be able to benefit from the screening that the pharmacist will perform to identify any possible issues that may have an impact on the patient’s health.

Please be aware that the pharmacist is obligated to preserve the confidentiality of any and all patient information.
Why does the pharmacist occasionally contact my doctor before refilling my medications, and what is the purpose of this call? If the prescribing physician has not given their permission, the pharmacist is not allowed to refill the prescription.

On the initial prescription, a physician may choose to allow no refills, one refill, many refills, or none at all. When a pharmacist attempts to refill a prescription after the patient has already used all of the refills that were permitted on the first prescription, they are required to get permission from the prescribing physician.

Even though your physician may want you to take the prescribed medication for an extended period of time, he or she may still want to monitor your drug therapy by asking the pharmacist to call at each refilling of the prescription. Calling your pharmacy a few days before you run out of your prescription will help your pharmacist and keep you from having to wait in line for your refill.

If there are no more refills available, your pharmacist will have time to inquire with your primary care physician about receiving permission to renew your prescription. It is against the law to fill prescriptions for drugs that are on Schedule II. If your doctor wants you to continue taking a Schedule II medicine after the initial prescription has been filled, he or she will need to issue you a fresh, written prescription for the medication.

Consult your local pharmacist if you have any questions or concerns regarding the refilling of a prescription. I need my prescription filled, but is the pharmacist compelled to do so? A pharmacist may choose not to fill a customer’s prescription for a variety of reasons, including the following: The pharmacist believes that an excessive quantity has been prescribed; the pharmacist has reason to believe that the prescription wasn’t issued by the doctor whose name appears on the prescription; or the pharmacist has reason to believe that the prescription wasn’t issued by the doctor whose name appears on the prescription.

In the event that a pharmacist has any uncertainties regarding the clinical appropriateness or legality of a prescription, it is his or her duty to consult with the prescribing physician for more information. Before you take the drug, the pharmacist will undertake this essential and decisive examination first so that they can ensure its safety.

I need to know if a physician may offer me an open prescription or permit my current medication to be renewed forever. No.
Prescriptions are only valid for a certain amount of time according to the law.
Prescriptions often become invalid either six months or one year after the date the prescription was initially written, depending on the medication.

Even if there are still refills available on the initial prescription, the pharmacist is required to acquire permission from the prescribing physician before continuing to refill the prescription after the prescription has expired. In the event that my prescription permits for refills, is it possible for me to receive all of the refills at once? Depends.

Only the quantity of medication that is specified on the patient’s prescription can be dispensed by the pharmacist. When deciding whether or not to re-fill a prescription, the pharmacist is also required to take into account how long the medication should continue to be effective (based on the dosage instructions and the amount that was dispensed), and the prescription can only be refilled after an adequate amount of time has passed since the last time it was refilled.

In spite of this, a pharmacist is allowed to dispense up to a 90-day supply of certain medications in response to a valid prescription that calls for the initial dispensing of a smaller quantity, followed by periodic refills of the same quantity, as long as the following conditions are met: the medication in question is not a psychotropic; the patient is at least 18 years old; the prescribing doctor has not indicated on the prescription that dispensing the prescription in an initial quantity, followed by periodic refills, If my prescription was written by a physician in another state or even another country, is it possible for a local pharmacy to fulfill the order? Yes, under certain situations.

If a genuine doctor-patient relationship already exists, a prescription from a doctor licensed in another state who is not licensed in Texas can be filled in Texas even though the doctor in question is not licensed in Texas. The majority of the time, we are unable to fill prescriptions that have been written by doctors in other countries.

A Texas pharmacy may fill a prescription for a non-controlled medicine written by a physician located in Canada or Mexico if the prescription is written down and presented to the pharmacist. It is against the law in the state of Texas to fill a prescription for a restricted substance that was written by a medical practitioner in either Canada or Mexico.

Can I bring back a prescription to the pharmacy where it was filled? In all likelihood, the answer is no.
After a prescription has left the pharmacy, the pharmacist no longer has any way of knowing whether or not the product is still risk-free.
Because of this, the legislation in the state prevents the pharmacist from accepting the return of a prescription medicine, in whole or in part, and then utilizing the substance to fill another prescription.

This is done in the interest of ensuring the general public’s safety. Consider the problem in the following light: Would it be OK to you for the medicine that you buy from the pharmacy to be medication that was previously returned by another customer? Can I take my prescription with me to a different drugstore if I change my mind? It is possible for a pharmacist to hand off a prescription and any outstanding refills to a colleague working in a different drugstore, but only under specified circumstances.

However, once a prescription is moved, the original pharmacy’s copy of the prescription is rendered null and worthless, and it may no longer be renewed there.
This restriction applies even if the prescription is subsequently transferred back to the original pharmacy.
If I ask for a copy of my prescription, would the pharmacist be able to provide it to me? There is a possibility that a pharmacist will provide you with a copy of your prescription.

On the other hand, a reproduction of a prescription can be used for educational or research reasons alone. A duplicate prescription cannot be used to get a medication from a pharmacist for dispensing purposes. The information on a copy can be used by a pharmacist to contact your physician about obtaining a fresh prescription for you.

Can pharmacists prescribe in Texas?

Under the direction of a supervising physician and in accordance with a published protocol, advanced practice nurses (APN) or physician assistants (PA) may dispense prescriptions.
Both advanced practice nurses and physician assistants have completed specialized training and education to enable them to diagnose and treat patients.

As a result, the pharmacist or another employee of the drugstore may ask you for information that is not necessarily included on the prescription.
For instance, they may ask for your full name and/or address.
In addition, before to filling the prescription, the pharmacist is obligated to screen, or check, both the prescription and your patient medication record.

your sex or gender; your age; your date of birth; any known allergies; any previous drug reactions; any chronic conditions; names of other drugs This medication record for the patient provides the pharmacist with assistance in recognizing drug-related issues, such as Drug allergies, interactions with other medications that you are taking, improper dose or duration of therapy, therapeutic duplication with other medications that are being taken, and inappropriate usage of a medication are all examples of potential adverse drug reactions.

A patient has the ability to decline providing the pharmacist with any portion or all of the aforementioned information. However, if the patient does not provide the pharmacist with the requested information, the patient will not receive the benefit of the pharmacist’s screening for any potential concerns that may have an impact on the patient’s health.

Please be aware that the pharmacist is obligated to preserve the confidentiality of any and all patient information.
Why does the pharmacist occasionally contact my doctor before refilling my medications, and what is the purpose of this call? If the prescribing physician has not given their permission, the pharmacist is not allowed to refill the prescription.

Even though your physician may want you to take the prescribed medication for an extended period of time, he or she may still want to monitor your drug therapy by asking the pharmacist to call at each refilling of the prescription. Calling your pharmacy a few days before you run out of your prescription will help your pharmacist and keep you from having to wait in line for your refill.

Consult your local pharmacist if you have any questions or concerns regarding the refilling of a prescription. I need my prescription filled, but is the pharmacist compelled to do so? A pharmacist may choose not to fill a customer’s prescription for a variety of reasons, including the following: The pharmacist believes that an excessive quantity has been prescribed; the pharmacist has reason to believe that the prescription wasn’t issued by the doctor whose name appears on the prescription; or the pharmacist has reason to believe that the prescription wasn’t issued by the doctor whose name appears on the prescription.

I need to know if a physician may offer me an open prescription or permit my current medication to be renewed forever. No. Prescriptions are only valid for a certain amount of time according to the law. Prescriptions often become invalid either six months or one year after the date the prescription was initially written, depending on the medication.

Only the quantity of medication that is specified on the patient’s prescription can be dispensed by the pharmacist.
When deciding whether or not to re-fill a prescription, the pharmacist is also required to take into account how long the medication should continue to be effective (based on the dosage instructions and the amount that was dispensed), and the prescription can only be refilled after an adequate amount of time has passed since the last time it was refilled.

If a genuine doctor-patient relationship already exists, a prescription from a doctor licensed in another state who is not licensed in Texas can be filled in Texas even though the doctor in question is not licensed in Texas.
The majority of the time, we are unable to fill prescriptions that have been written by doctors in other countries.

Can I bring back a prescription to the pharmacy where it was filled? In all likelihood, the answer is no. After a prescription has left the pharmacy, the pharmacist no longer has any way of knowing whether or not the product is still risk-free. Because of this, the legislation in the state prevents the pharmacist from accepting the return of a prescription medicine, in whole or in part, and then utilizing the substance to fill another prescription.

However, once a prescription is moved, the original pharmacy’s copy of the prescription is rendered null and worthless, and it may no longer be renewed there.
This restriction applies even if the prescription is subsequently transferred back to the original pharmacy.
If I ask for a copy of my prescription, would the pharmacist be able to provide it to me? There is a possibility that a pharmacist will provide you with a copy of your prescription.