(9) "Medical records" means all records relating to the history, diagnosis, treatment, or prognosis of a patient. (b) A physician may delegate to any qualified and properly trained person acting under the physician's supervision the act of administering or providing dangerous drugs in the physician's office, as ordered by the physician, that are used or required to meet the immediate needs of the physician's patients. (a) A hospital, institution, or program that is licensed by the state, is operated by the state or a political subdivision of the state, or directly or indirectly receives state financial assistance may not differentiate in regard to a person licensed under this subtitle solely on the basis of the academic medical degree held by the person. (2) the administration of medications by a physician assistant or registered nurse other than as provided by this section. (2) "Continuing threat to the public welfare" means a real danger to the health of a physician's patients or to the public from the acts or omissions of the physician caused through the physician's lack of competence, impaired status, or failure to care adequately for the physician's patients, as determined by: (B) a medical peer review committee in this state; (C) a physician licensed to practice medicine in this state or otherwise lawfully practicing medicine in this state; (D) a physician engaged in graduate medical education or training; or. 271 (S.B. Amended by Acts 2003, 78th Leg., ch. 204, Sec. 928 (S.B. September 1, 2005. The Texas Medical Practice Act governs the practice and license of physicians and certain other practitioners. 2, eff. 1, eff. 0000003245 00000 n
1, eff. and his medical practice, C Care LLC, both of Chesterfield, Missouri; Shamim Justin Badiyan, M.D., of Frisco, Texas, and Psych Care Consultants LLC, of St. Louis, Missouri, have agreed to pay a total of $525,610 to resolve False Claims Act allegations that they received illegal kickbacks in violation of the Anti-Kickback Statute in return for referring patients for . 406), Sec. HB 2454. and HB 3285, Clarification on HB 2174 regarding the 10-day opioid prescribing limit for acute pain, Key clarifications regarding opioid prescribing, Keep your patients and practice safe from opioid prescription fraud, Board Rules, Registration, Inspection Info, 1515 Hermann Drive, Houston, TX 77004-7126, HCMS contacted TxEVER regarding answers to some, The above link includes information on the, The above TMB CME link also includes information on the Texas. (a) One or more physicians licensed by the board may delegate, to one or more physician assistants or advanced practice registered nurses acting under adequate physician supervision whose practice is facility-based at a hospital or licensed long-term care facility, the administration or provision of a drug and the prescribing or ordering of a drug or device if each of the delegating physicians is: (1) the medical director or chief of medical staff of the facility in which the physician assistant or advanced practice registered nurse practices; (2) the chair of the facility's credentialing committee; (3) a department chair of a facility department in which the physician assistant or advanced practice registered nurse practices; or. 1420, Sec. 1, eff. This subtitle does not prohibit a hospital from entering into an independent contractor agreement with a physician to provide services at the hospital or at another health care facility owned or operated by the hospital and: (1) paying the physician a minimum guaranteed amount to ensure the physician's availability; (2) billing and collecting from patients the physician's professional fees; or. Acts 2019, 86th Leg., R.S., Ch. 0000002129 00000 n
(G) an attorney retained by the patient or by another person listed by this subdivision. The State's legal theory is that Texas Occupations Code sec. 157.101. This state program serves physicians affected by substance use disorders, physical illnesses and impairment, or psychiatric conditions through a recovery program. (B) discussion of patient care improvement; (3) take place at least once a month in a manner determined by the physician and the advanced practice registered nurse or physician assistant. (11) "Practice serving a medically underserved population" means: (A) a practice in a health professional shortage area; (B) a clinic designated as a rural health clinic under 42 U.S.C. (i) This section authorizes a physician to delegate the act of administering or providing a controlled substance to a nurse midwife or physician assistant but does not require physician delegation of: (1) further acts to a nurse midwife; or. (h) Construction and Interpretation. Acts 2013, 83rd Leg., R.S., Ch. 157.0513. Acts 2005, 79th Leg., Ch. Check the latest list of EHR vendors that are integrated with the PMP. The information in this section includes links to: the agency's relevant sections of statute (laws/practice acts); rules for physicians, physician assistants, acupuncturists, and other license types, including adopted rule changes by year, and ; the most recent proposed rule changes as well as information about the rulemaking process. DELEGATION OF PRESCRIBING AND ORDERING DRUGS AND DEVICES. 0000059632 00000 n
Section 1396d(l)(2)(B); (E) a county, state, or federal correctional facility; (a) is located in an area in which the Department of State Health Services determines there is an insufficient number of physicians providing services to eligible clients of federally, state, or locally funded health care programs; or, (b) is a practice that the Department of State Health Services determines serves a disproportionate number of clients eligible to participate in federally, state, or locally funded health care programs; and, (ii) for which the Department of State Health Services publishes notice of the department's determination in the Texas Register and provides an opportunity for public comment in the manner provided for a proposed rule under Chapter 2001, Government Code; or. (3) "Disciplinary order" means an action taken under Section 164.001, 164.053, 164.058, or 164.101. In addition, the program may be used to generate and disseminate information regarding prescription trends. November 1, 2013. September 1, 2019. 38 (H.B. The board may adopt additional methods to implement: (2) the delegation of prescriptive authority. The Texas Registeris a weekly publication from the TX Secretary of State that serves as the journal of state agency rule-making, including those involving the TMB. Acts 1999, 76th Leg., ch. 151.054. Acts 2013, 83rd Leg., R.S., Ch. Added by Acts 2017, 85th Leg., R.S., Ch. This subtitle may be cited as the Medical Practice Act. (h) This section does not authorize a physician, physician assistant, or nurse midwife to operate a retail pharmacy as defined under Subtitle J. 157.055. 157.007. A number of bills have been filed in the Texas Legislature this session that would amend the Texas Medical Practice Act, changing the requirements for physician licensure. 0000058371 00000 n
Texas Occupations Code, Chapter 157, 157.001 (a) (1) (C) states that a physician may delegate authority if the delegation, "is not in violation of any other statute." Because the practice of orthotics and prosthetics is protected by statute, the Texas Medical Practice Act prohibits a physician from delegating authority to an unlicensed . Medical Practice Act. (B) the procedures described in the surgery section of the common procedure coding system as adopted by the Health Care Financing Administration of the United States Department of Health and Human Services. (b-1) A physician may delegate the prescribing or ordering of a controlled substance listed in Schedule II as established by the commissioner of the Department of State Health Services under Chapter 481, Health and Safety Code, only: (1) in a hospital facility-based practice under Section 157.054, in accordance with policies approved by the hospital's medical staff or a committee of the hospital's medical staff as provided by the hospital bylaws to ensure patient safety, and as part of the care provided to a patient who: (A) has been admitted to the hospital for an intended length of stay of 24 hours or greater; or, (B) is receiving services in the emergency department of the hospital; or. and the Medical Practice Act, and 187.83 concerning Proceedings for Cease and . 157.005. Sept. 1, 1999. 0000000016 00000 n
(C) a public or nonprofit private medical facility or other facility that the secretary of health and human services determines has a health professional shortage, as described by 42 U.S.C. 278), Sec.
157.054. 418 (S.B. The Texas Occupations Code includes the enabling statutes and practice acts for physicians, physician assistants, acupuncturists, surgical assistants, medical radiologic technologists, medical physicists, perfusionists, and respiratory care practitioners. (c) A physician who issues a standing delegation order to a midwife under Chapter 203 is not liable in connection with an act performed under that standing delegation order if the midwife provides proof of licensure under that chapter before the order is issued. 0000047181 00000 n
Sept. 1, 1999. chapter 162. regulation of practice of medicine : chapter 163. district review committees : chapter 164. disciplinary actions and procedures : chapter 165. . 3, eff. Sept. 1, 1999. In 1931, the legislature increased the number to 12 physicians . Texas Medical Practice Act and Statutes
They are entitled to receive copies, a narrative, or a summary of the records (or to have them sent to the person of their choosing). Effective June 27, 2023, this is a one-time, eight-hour training requirement for all DEA-registered practitioners on the treatment and management of patients with opioid or other substance use disorders. September 1, 2009. 1240 (H.B. 1, eff. Sec. 6, eff. Acts 2009, 81st Leg., R.S., Ch. 53, eff. (f) Subsections (b) and (c) do not authorize a physician or a person acting under the supervision of a physician to keep a pharmacy, advertised or otherwise, for the retail sale of dangerous drugs, other than as authorized under Section 158.003, without complying with the applicable laws relating to the dangerous drugs. The facility-based physician may not be prohibited from delegating the prescribing or ordering of drugs or devices under Section 157.0512 at other practice locations, including hospitals or long-term care facilities, provided that the delegation at those locations complies with all the requirements of Section 157.0512. The legislature finds that: (1) the practice of medicine is a privilege and not a natural right of individuals and as a matter of public policy it is necessary to protect the public interest through enactment of this subtitle to regulate the granting of that privilege and its subsequent use and control; and. PRESCRIPTIVE AUTHORITY AGREEMENT. Chapter 170 Prescription of Controlled Substances defines acute and chronic pain and explains the requirement to check the Texas Prescription Monitoring Program (PMP). 8, eff. (4) with regard to a prescription for a child less than two years of age, the prescription is made after consultation with the delegating physician and the consultation is noted in the patient's chart. To enroll, see the TxEVER Welcome page and click on the User Enrollment link. The Texas Prescription Monitoring Program (PMP) is used to verify a practitioner's own records and prescribing history as well as inquiring about patients. In a letter sent this week, the Texas Medical Association formally asked the state's medical regulatory agency to "swiftly act to prevent the wrongful intrusion into the practice of medicine . 4, eff. (3) limits the person's practice of medicine in this state to treating, during the period beginning on the date the team arrives in this state for the event and ending on the date the team leaves this state: (A) the members, coaches, and staff of the team; and. 157.051. 1121 (S.B. Sec. 419), Sec. 1.27, eff. Sept. 1, 2001; Acts 2003, 78th Leg., ch. Acts 1999, 76th Leg., ch. A protocol or other order shall be defined in a manner that promotes the exercise of professional judgment by the advanced practice registered nurse and physician assistant commensurate with the education and experience of that person. 406), Sec. Acts 1999, 76th Leg., ch. These cases Amended by Acts 2003, 78th Leg., ch. (2) Act--The Texas Pharmacy Act, Chapters 551 - 569, Occupations Code, as amended. Sec. (a) A program supported in whole or in part by the state or by a political subdivision of the state may not discriminate against a health care practitioner because the practitioner is a physician specializing in ophthalmology. 1, eff. (e) The disclosure panel may not prescribe materials under this section without first consulting with the Texas State Board of Medical Examiners. Acts 2017, 85th Leg., R.S., Ch. Sec. (b) Except as provided by Subsection (b-1), a physician may delegate the prescribing or ordering of a controlled substance only if: (1) the prescription is for a controlled substance listed in Schedule III, IV, or V as established by the commissioner of the Department of State Health Services under Chapter 481, Health and Safety Code; (2) the prescription, including a refill of the prescription, is for a period not to exceed 90 days; (3) with regard to the refill of a prescription, the refill is authorized after consultation with the delegating physician and the consultation is noted in the patient's chart; and. (p) The board may not adopt rules pertaining to the elements of a prescriptive authority agreement that would impose requirements in addition to the requirements under this section. About Athletic Training. Acts 2005, 79th Leg., Ch. 419), Sec. 0000057799 00000 n
Section 1395x(aa); (C) a public health clinic or a family planning clinic under contract with the Health and Human Services Commission or the Department of State Health Services; (D) a clinic designated as a federally qualified health center under 42 U.S.C. Statutes Title 3, Health Professions; Subtitle B, Physicians; Chapter 157, Authority of Physician to Delegate Certain Medical Acts; Section 157.0512, Prescriptive Authority Agreement. (3) A licensed physician is required to retain records from a forensic medical examination in accordance with Section 153.003 of the Medical Practice Act. Corporations and non-physicians are also prohibited from employing a physician to provide health care services in the . 889 (H.B. Texas Administrative Code. The Texas Medical Board is subject to Chapter 325, Government Code (Texas Sunset Act). Licensure, CME requirements, DEA, KSTAR and more
(C) effectively communicating with patients regarding the prescription of an opioid or other controlled substance. (7) "Medical peer review" or "professional review action" means the evaluation of medical and health care services, including evaluation of the qualifications and professional conduct of professional health care practitioners and of patient care provided by those practitioners. Acts 2013, 83rd Leg., R.S., Ch. by the Governor and confirmed by the Texas Senate. Registered Nurses and Physician Assistants . Pending publication of the current statutes, see S.B. The term includes evaluation of the: (A) merits of a complaint relating to a health care practitioner and a determination or recommendation regarding the complaint; (C) quality of the care provided by a health care practitioner; (D) report made to a medical peer review committee concerning activities under the committee's review authority; (E) report made by a medical peer review committee to another committee or to the board as permitted or required by law; and. Acts 2011, 82nd Leg., R.S., Ch. Opioid Prescription Limits for Acute Pain -, CME requirements on Human Trafficking prevention and Pain Management-Prescription of Opioids apply to license renewal period beginning with renewal on or after Sept. 1, 2020. 269 (S.B. September 1, 2005. The Texas Medical Board (TMB) is the state agency charged with keeping Texas patients safe through the licensure and regulation of Texas physicians. Acts 1999, 76th Leg., ch. 725 52
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157.0514. 1515 Hermann Drive, Houston, TX 77004-7126. It consisted of 11 physician members appointed biennially by the governor and confirmed by the senate. Sec. 388, Sec. (a) The board, the Texas Board of Nursing, and the Texas Physician Assistant Board shall jointly develop a process: (1) to exchange information regarding the names, locations, and license numbers of each physician, advanced practice registered nurse, and physician assistant who has entered into a prescriptive authority agreement; (2) by which each board shall immediately notify the other boards when a license holder of the board becomes the subject of an investigation involving the delegation and supervision of prescriptive authority, as well as the final disposition of any such investigation; (3) by which each board shall maintain and share a list of the board's license holders who have been subject to a final adverse disciplinary action for an act involving the delegation and supervision of prescriptive authority; and. 0000011854 00000 n
1.28, eff. 157.060. 1121 (S.B. Unless the physician has reason to believe the physician assistant or advanced practice registered nurse lacked the competency to perform the act, a physician is not liable for an act of a physician assistant or advanced practice registered nurse solely because the physician signed a standing medical order, a standing delegation order, or another order or protocol, or entered into a prescriptive authority agreement, authorizing the physician assistant or advanced practice registered nurse to administer, provide, prescribe, or order a drug or device. In this subchapter: (1) "Advanced practice registered nurse" has the meaning assigned to that term by Section 301.152. APPLICATION TO CERTAIN PERSONS PROVIDING NUTRITIONAL ADVICE. The following information must be provided on each prescription subject to this subchapter: (3) directions to the patient regarding the taking of the drug and the dosage; (4) the intended use of the drug, if appropriate; (5) the name, address, and telephone number of the physician; (6) the name, address, telephone number, and identification number of the registered nurse or physician assistant completing or signing the prescription drug order; Sec. Telemedicine medical services used for the treatment of chronic pain with scheduled drugs by any means other than via audio and video two-way communication is prohibited unless certain circumstances are met, as explained inChapter 174.5 Telemedicine-Issuance of Prescriptions. The deadline to satisfy the requirement is the date of a physician's next scheduled DEA registration submission, whether a renewal or an initial registration. PERFORMANCE OF DELEGATED ACT NOT PRACTICING WITHOUT MEDICAL LICENSE. Section 164.051(a)(2)(B) of the Medical Practice Act, 204.303(a)(2) of the Physician Assistant Act, and 203.351(a)(7) of the Acupuncture Act, (collectively, the "Licensing Acts") authorize the board to take disciplinary action . (k) A party to a prescriptive authority agreement may not by contract waive, void, or nullify any provision of this section or Section 157.0513. November 1, 2013. (c) This subtitle may not be construed in a manner that: (1) discriminates against a school or system of medical practice; or. For more information about the program, refer to the TXPHP website. (c) Pursuant to the physician's order and in accordance with facility policies or medical staff bylaws, the nurse anesthetist may select, obtain, and administer those drugs and apply the medical devices appropriate to accomplish the order and maintain the patient within a sound physiological status. 202, Sec. (b-1) A facility-based physician may not delegate at more than one hospital or more than two long-term care facilities under this section unless approved by the board. 157.059. 0000044149 00000 n
(g) A drug or medicine provided under Subsection (b) or (c) must be supplied in a suitable container labeled in compliance with applicable drug laws. (g) The controlled substance must be supplied in a suitable container that is labeled in compliance with the applicable drug laws and must include: (3) the name, address, and telephone number of the physician; (4) the name, address, and telephone number of the nurse midwife or physician assistant; and. 0000002292 00000 n
(l) In the event that a party to a prescriptive authority agreement is notified that the individual has become the subject of an investigation by the board, the Texas Board of Nursing, or the Texas Physician Assistant Board, the individual shall immediately notify the other party to the prescriptive authority agreement. 7, eff. The relevant chapters are listed below. Chapter 157 of the Act addresses physician delegation of medical acts. APPLICATION TO CERTAIN INDEPENDENT CONTRACTOR AGREEMENTS. Refreshed: 2023-07-19 151.053. 1.02, eff. 3, eff. PRESCRIBING AT FACILITY-BASED PRACTICE SITES. 418 (S.B. Imran Chishti, M.D. Notice to Patients Concerning Complaintsfor posting. September 1, 2007. Sec. GOVERNMENTAL DISCRIMINATION PROHIBITED. (2) affects the use of the principles or teachings of any church in ministering to the sick or suffering by prayer or pastoral counseling without the use of a drug or other material substance represented as medically effective. 0000004286 00000 n
Sec. State board rules and regulations, licensure, CME requirements, scams targeting TMB licensees and DEA registrants. Texas State Board of Medical Examiners Medical Records Chapter 165.1 - 165.5 165.1. APPLICATION AND CONSTRUCTION OF SUBTITLE. The term includes an advanced nurse practitioner and advanced practice nurse. Complaints & Enforcement. Sec. (a) Consent for the release of confidential information must be in writing and signed by: (1) the patient; (2) a parent or legal guardian of the patient if the patient is a minor; (3) a legal guardian of the patient if the patient has been adjudicated incapacitated to manage the patient's personal affairs; (4) an attorney ad litem . Acts 2013, 83rd Leg., R.S., Ch. Sec. September 1, 2019. Acts 2019, 86th Leg., R.S., Ch. (a) A physician's authority to delegate the prescribing or ordering of a drug or device under this subchapter is limited to: (3) controlled substances to the extent provided by Subsections (b) and (b-1). (9) Immunization--The act of inducing antibody formation, thus leading to immunity. A person is exempt from the licensing requirements of this subtitle and may engage in the practice of medicine in this state if the person: (1) is employed or designated as a team physician by a sports team visiting this state for a specific sporting event; (2) is licensed to practice medicine in the team's home state; and. %PDF-1.4
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Physician TMB Profile
1625), Sec. (g) The prescriptive authority agreement may include other provisions agreed to by the physician and advanced practice registered nurse or physician assistant. 5, eff. The Texas Prescription Monitoring Program(PMP) is under the oversight of the Texas State Board of Pharmacy and monitors Schedule II through V controlled substance prescriptions. PHYSICIAN LIABILITY FOR DELEGATED ACT. To the extent reasonably possible, the board and the board's authorized representative shall conduct any inspection or audit under this section in a manner that minimizes disruption to the delivery of patient care. (f) The authority of a physician to delegate under this section is limited to: (1) seven nurse midwives or physician assistants or their full-time equivalents; and. 2, eff. The Texas Occupations Code includes the enabling statutes and practice acts for physicians, physician assistants, acupuncturists, surgical assistants, medical radiologic technologists, medical physicists, perfusionists, and respiratory care practitioners. The Texas Medical Board (TMB) is the state agency charged with keeping Texas patients safe through the licensure and regulation of Texas physicians. 7 (S.B. Sept. 1, 1999. Added by Acts 2013, 83rd Leg., R.S., Ch. 0000053787 00000 n
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As used in this subtitle, the terms "practitioner" and "practitioner of medicine" include physicians and surgeons. Unless continued in existence as provided by that chapter, the board is abolished and this subtitle and Chapters 204, 205, 206, 601, 602, 603, and 604 expire September 1, 2031. 2426), Sec. 388, Sec. Other sections of theTexas Constitution and Statutesincludethe Health and Safety Code and Family Code. %%EOF
APPLICATION OF SUNSET ACT. Sec. The most troubling implication of the State's legal theory, however, is that if it is accurate Texas prosecutors could conceivably bring felony charges for any violation of . (B) a freestanding clinic, center, or office of a nonprofit health organization certified by the board under Section 162.001(b) that complies with the requirements of Chapter 162. Acts 2017, 85th Leg., R.S., Ch. (2) the authority to issue an electronic prescription under Section 481.075, Health and Safety Code. (4) A physician may destroy medical records that relate to any civil, criminal or administrative proceeding only if the physician knows the proceeding has been finally resolved. Drug Therapy Management by a Pharmacist under Written Protocol of a Physician. (3) be rescinded at any time by a vote of the voting physician members of the entity's organized medical staff. Purpose. 0000009801 00000 n
Texas Department of Licensing and Regulation Athletic Trainers PO Box 12157 Austin, TX 78711 (800) 803-9202 [in state only] (512) 463-6599 LIMITATION ON BOARD RULES REGARDING DELEGATION. The CPOM is a legal doctrine which places limitations on who can practice medicine, and who can provide medical services. Acts 2009, 81st Leg., R.S., Ch. November 1, 2013. Sec. 0000053911 00000 n
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Texas Medical Board Announcements, Contact Information, Rules, and News. Acts 2017, 85th Leg., 1st C.S., Ch. (b) A physician and an advanced practice registered nurse or physician assistant are eligible to enter into or be parties to a prescriptive authority agreement only if: (1) if applicable, the Texas Board of Nursing has approved the advanced practice registered nurse's authority to prescribe or order a drug or device as authorized under this subchapter; (2) the advanced practice registered nurse or physician assistant: (A) holds an active license to practice in this state as an advanced practice registered nurse or physician assistant, as applicable, and is in good standing in this state; and, (B) is not currently prohibited by the Texas Board of Nursing or the Texas Physician Assistant Board, as applicable, from executing a prescriptive authority agreement; and. 278), Sec. (4) "Doctor of osteopathic medicine" includes a doctor of osteopathy, an osteopath, an osteopathic physician, and an osteopathic surgeon. An act delegated by a physician under this chapter must comply with other applicable laws. (j) A physician, advanced practice registered nurse, or physician assistant who is a party to a prescriptive authority agreement must retain a copy of the agreement until the second anniversary of the date the agreement is terminated. (b) The delegating physician remains responsible for the medical acts of the person performing the delegated medical acts. 2299), Sec. 151.056. (B) directly or indirectly charges money or other compensation for those services. Amended by Acts 2001, 77th Leg., ch. The hospital, institution, program, state agency, or political subdivision may adopt rules and requirements relating to qualifications for medical staff appointments, including reappointments and the termination of appointments, the delineation of clinical privileges, or the curtailment of clinical privileges of persons who are appointed to that medical staff or permitted to participate in educational programs if those rules and requirements do not differentiate solely on the basis of the academic medical degree held by the affected physician and are: (1) determined on a reasonable basis, such as the professional and ethical qualifications of the physician; (3) applied without irrelevant considerations; (4) supported by sufficient evidence; and. (d) An alternate physician may provide appropriate supervision on a temporary basis as defined and established by board rule. (c) An entity described by Subsection (a) may differentiate between physicians based on a physician's maintenance of certification if the voting physician members of the entity's organized medical staff vote to authorize the differentiation. Sec. A physician shall provide continuous supervision, but the constant physical presence of the physician is not required. (a) A physician may delegate to a qualified and properly trained person acting under the physician's supervision any medical act that a reasonable and prudent physician would find within the scope of sound medical judgment to delegate if, in the opinion of the delegating physician: (A) can be properly and safely performed by the person to whom the medical act is delegated; (B) is performed in its customary manner; and, (C) is not in violation of any other statute; and. EXEMPTIONS. 2, eff. Refreshed: 2023-06-20 (m) The prescriptive authority agreement and any amendments must be reviewed at least annually, dated, and signed by the parties to the agreement. (10) Medical Practice Act--The Texas Medical Practice Act, Subtitle B, Occupations Code, as amended. 88, Sec. 16 Also, the Texas Medical Board (TMB . Physicians and other prescribers must set up a PMP account, use it to view and monitor their patients' prescription history for info that might indicate drug abuse, illicit activity, drug diversion, or doctor shopping, and check a patient's PMP history prior to issuing a new or refill prescription for certain controlled substances.
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