TX MPJE cheat sheet

Federal CSA scheduling places drugs in Schedules I-V; Schedule II has accepted medical use but high abuse potential and requires a written or e-prescription (with limited exceptions).

Federal law preempts conflicting state law only where compliance with both is impossible; a state may impose stricter controls than federal law, and Texas does so for CS records and reporting.

Texas pharmacies must be licensed by TSBP; a separate federal DEA registration is required for any entity that handles controlled substances.

Texas requires a pharmacist-in-charge (PIC) for every licensed pharmacy; the PIC is responsible for compliance with all TSBP rules.

Texas pharmacies must report dispensing of Schedule II-V controlled substances to the PMP (PMP Aware) as required by Texas Health & Safety Code; reporting is generally required by the next business day.

Texas requires a valid pharmacist-patient relationship before dispensing; prescriptions from out-of-state prescribers are generally valid if the prescriber is licensed in that state and the prescription is otherwise lawful.

Texas law requires pharmacies to maintain a written or electronic policy and procedure manual covering dispensing, counseling, and CS handling.

The Texas Pharmacy Act is codified in Tex. Occ. Code ch. 551-569; TSBP rules are in 22 Tex. Admin. Code.

Federal HIPAA and Texas Medical Records Privacy Act (ch. 181) both govern patient record confidentiality; Texas law may be more protective.

Texas pharmacist licenses renew every two years; renewal requires completion of 30 hours of continuing education per renewal period, including at least 1 hour on opioid abuse and 1 hour on Texas pharmacy law.

Texas pharmacy technician registration renews every two years; technicians must complete 20 hours of CE per renewal period, including at least 1 hour of pharmacy law.

A Texas pharmacist license expires on the last day of the pharmacist's birth month; the license must be renewed before the expiration date to avoid late fees and possible reinstatement requirements.

Texas requires fingerprint-based criminal history checks for pharmacist licensure and technician registration applicants.

A Texas pharmacy license must be renewed annually; the renewal requires disclosure of any change in ownership, location, or PIC.

A pharmacist may practice only in a licensed pharmacy (or other authorized setting) and must display the license; TSBP may inspect at any time.

Texas requires notification to TSBP within 10 days of a change of address or name for licensees.

Pharmacists must report certain arrests, convictions, and disciplinary actions to TSBP within 30 days.

A pharmacist license may be placed on inactive status; inactive licensees may not practice and must still meet CE requirements for reactivation.

A valid prescription must contain the patient name, drug name/strength/dosage form, quantity, directions, prescriber name and signature (or electronic signature), and date.

Schedule II prescriptions may not be refilled; Schedule III-V prescriptions may be refilled up to five times within six months of the issue date unless the prescriber specifies otherwise.

Texas requires a prescription to be filled within one year of the date issued unless it is a controlled substance, which has shorter limits (CS: generally 6 months for refills; Schedule II must be filled within 30 days in many contexts).

Texas requires the pharmacy to provide a written prescription label with the pharmacy name/address, prescription number, date, patient name, directions, prescriber name, drug name/strength, quantity, and expiration/BDD.

Texas requires patient counseling by a pharmacist (or intern under supervision) for new prescriptions unless the patient refuses; refusal must be documented.

Prescription records must be retained for at least two years in Texas; controlled substance records must be retained for at least two years and be readily retrievable.

Texas allows electronic prescriptions for controlled substances if they meet DEA EPCS requirements and Texas PMP check requirements.

A pharmacist may refuse to fill a prescription based on professional judgment (e.g., suspected forgery or therapeutic issue) but must document the reason and, if applicable, notify the prescriber.

Texas requires a pharmacist to check the PMP before dispensing opioids, benzodiazepines, barbiturates, or carisoprodol (with limited exceptions).

Schedule II drugs require a written or EPCS prescription; oral orders are permitted only in a bona fide emergency with follow-up written prescription within 7 days.

Texas requires a physical inventory of all controlled substances every two years (biennial inventory) and records of receipt, dispensing, and disposal.

Schedule II records must be maintained separately from other records; Schedule III-V records may be maintained separately or readily retrievable.

Texas requires reporting of controlled substance theft or significant loss to DEA and TSBP; a DEA Form 106 is used for theft/loss.

The Texas PMP must be checked before dispensing opioids, benzodiazepines, barbiturates, and carisoprodol; the check must be documented.

A prescriber may issue a Schedule II prescription for up to a 90-day supply if the prescription includes specific instructions for filling in increments (partial fills).

Partial filling of a Schedule II prescription is permitted if the pharmacist is unable to supply the full quantity; the remaining quantity must be filled within 72 hours or the prescription is void.

Texas requires a pharmacist to verify the identity of the person picking up a controlled substance prescription and to maintain a record of the pickup.

Disposal of controlled substances must comply with DEA regulations (e.g., reverse distributor, DEA Form 41) and Texas rules.

Texas pharmacists may administer immunizations to patients aged 3 and older under a standing delegation order or prescription; reporting to ImmTrac2 is required for children.

Texas pharmacists may initiate and manage drug therapy under a collaborative practice agreement (CPA) with a physician; the CPA must be in writing and define scope.

Texas pharmacists may dispense naloxone without a prescription under a standing order; pharmacists must provide education on overdose response.

Texas pharmacists may provide hormonal contraception without a prescription under a standing order (per Texas rules); pharmacists must screen for contraindications and refer as needed.

Medication therapy management (MTM) services may be provided by pharmacists; documentation and communication with the prescriber are required.

Texas requires patient counseling on new prescriptions and on any change in dose, strength, or directions; counseling may be delegated to an intern or technician only if the pharmacist is available.

Pharmacists must report adverse drug events and medication errors through internal quality assurance processes; Texas requires a continuous quality improvement program.

Texas pharmacists may administer epinephrine, glucagon, and other emergency medications under protocol; the protocol must be in writing.

TSBP may impose disciplinary actions including reprimand, suspension, probation, restriction, and license revocation for violations of the Pharmacy Act or rules.

Grounds for discipline include fraud, incompetence, unprofessional conduct, violation of CS laws, and failure to maintain required records.

Texas requires pharmacists to report to TSBP any pharmacist or technician who is impaired or who has committed a violation that poses a risk to patients.

The Texas Pharmacy Act prohibits aiding and abetting unlicensed practice; a pharmacist may not allow an unlicensed person to perform pharmacist duties.

Texas requires a pharmacist to maintain patient confidentiality and to comply with HIPAA and Texas Medical Records Privacy Act.

Texas requires pharmacies to have a continuous quality improvement (CQI) program that documents and analyzes medication errors and near misses.

A pharmacist must not dispense a prescription that the pharmacist knows or should know is forged, altered, or issued without a valid prescriber-patient relationship.

Texas requires pharmacists to complete at least 1 hour of CE on opioid abuse and 1 hour on pharmacy law each renewal period.

TSBP may issue emergency suspension of a license if continued practice poses an imminent threat to public health and safety.