While point of care dispensing is legal in almost every state, Texas has long been one of the major exceptions. According to Chapter 169 of the Texas Medical Board Rules and Chapter 158 of the Texas Occupations Code, doctors may not "provide, dispense or distribute” prescription medications directly from drugs their office or clinic, with an exception that physicians may do so to respond to a patient's acute condition where a patient requires these drugs immediately. This exception is limited to situations in which there is a patient need to access medication before she or he is able to obtain them from a pharmacy. This is limited to a maximum of three days' supply of medication. Notably, doctors and clinics are prohibited from charging patients (or their insurance) for these medications or for the service of dispensing them. Medical practitioners in some specified rural areas are exempt from these regulations because of the limited availability and accessibilities of local pharmacies.
However, this may be changing, with pressure coming from some Texas legislators, doctors' organizations, and legal challenges.
In the last session of the Texas House of Representatives, House Bills 460 and 1622 would have opened up the practice of Physician Dispensing in Texas. While neither of them passed, their introduction suggests that there is an increased appetite for point of care dispensing in Texas.
Court Challenges to Texas Doctor Dispensing Regulations
Two Texas doctors have recently filed suit against the above regulations, arguing that they are unconstitutional. This blog will be watching developments closely.