TITLE 22. EXAMINING BOARDS

PART 14. TEXAS OPTOMETRY BOARD

CHAPTER 277. PRACTICE AND PROCEDURE

The Texas Optometry Board proposes amendments to 22 TAC Chapter 277, §277.1 - Complaint Procedures.

The rules in the Chapter 277 were reviewed as a result of the Board's general rule review under Texas Government Code Section 2001.039. Notice of the review was published in the March 6, 2026, issue of the Texas Register (51 TexReg 1429). One comment was received regarding the Board's notice of review related to Rule 277.1. The commenter suggested 277.1(d)(3) be repealed. However, the Board disagrees with the comment as the statute related to that section does not expire until September 1, 2027.

The Board has determined that there continues to be a need for the rules in Chapter 277. The Board has also determined that changes to §277.1 as currently in effect are necessary.

In conjunction with the quadrennial review, the rule was reviewed by the Texas Regulatory Efficiency Office (TREO). These amendments incorporate many recommendations by TREO to reduce regulatory burdens; eliminate waste, fraud, and unnecessary rules; and increase transparency for Texas taxpayers.

The amendments clarify the Board's complaint process for the public and licensees by reducing the word count and simplifying the classification system. The rule repeals current (e)(3) related to options the Board has regarding the disposition of complaint as these options are found in statute and do not need to be repeated in the rule.

Government Growth Impact Statement. For the first five-year period the amendment is in effect, the Board estimates that the amendment will have no effect on government growth. The amendment does not create or eliminate a government program; does not require the creation or elimination of employee positions; does not require the increase or decrease in future legislative appropriations to this agency; does not require an increase or decrease in fees paid to the agency; does not create a new regulation; does not expand an existing regulation; does not increase or decrease the number of individuals subject to the rule's applicability; and does not positively or adversely affect the state's economy.

Small Business, Micro-Business, and Rural Community Impact Statement. Ms. McCoy has determined for the first five-year period following the amendment, there will be no adverse effect on small businesses, micro-businesses, or rural communities and the amendment does not positively or adversely impact the state's economy.

Regulatory Flexibility Analysis for Small and Micro-Businesses and Rural Communities. Ms. McCoy has determined that the amendment will have no adverse economic effect on small businesses, micro-businesses, or rural communities and does not positively or adversely impact the state's economy. Thus, the Board is not required to prepare a regulatory flexibility analysis pursuant to §2006.002 of the Government Code.

Takings Impact Assessment. Ms. McCoy has determined that there are no private real property interests affected by the amendment. Thus, the Board is not required to prepare a takings impact assessment pursuant to §2007.043 of the Government Code.

Local Employment Impact Statement. Ms. McCoy has determined that the amendment will have no impact on local employment or a local economy. Thus, the Board is not required to prepare a local employment impact statement pursuant to §2001.024 of the Government Code.

Public Benefit. Ms. McCoy has determined for the first five-year period the amendment is in effect there is no impact on the public although the updated rule provides increased clarity for stakeholders impacted by the complaint process.

Fiscal Note. Janice McCoy, Executive Director of the Board, has determined that for the first five-year period following the amendment, there will be no additional estimated cost, reduction in costs, or loss or increase in revenue to local governments.

Additionally, Ms. McCoy has determined that enforcing or administering the rules do not have foreseeable implications relating to the costs or revenues of state or local government.

Requirement for Rules Increasing Costs to Regulated Persons. The proposed amendment does not impose any new or additional costs to regulated persons, state agencies, special districts, or local governments; therefore, pursuant to §2001.0045 of the Government Code, no repeal or amendment of another rule is required to offset any increased costs. Additionally, no repeal or amendment of another rule is required because the proposed rules are necessary to protect the health, safety, and welfare of the residents of this state and because regulatory costs imposed by the Board on licensees is not expected to increase.

PUBLIC COMMENTS: Comments on the proposed amendment to the rules may be submitted electronically to: janice.mccoy@tob.texas.gov or in writing to Janice McCoy, Executive Director, Texas Optometry Board, 1801 N. Congress, Suite 9.300, Austin, Texas 78701. The deadline for furnishing comments is thirty days after publication in the Texas Register.

Statutory Authority. The Board proposes this rule pursuant to the authority found in §351.151 of the Occupations Code which vests the Board with the authority to adopt rules necessary to perform its duties and implement Chapter 351 of the Occupations Code. Additional authority related to the complaint process is found in Subchapter E of the Occupations Code (Public Interest Information and Complaint Procedures).

No other sections are affected by the amendments.

§ 277.1. Complaint Procedures.

(a) [~~Purpose. Pursuant to §351.205 of the Act, the Board is authorized to adopt rules relating to the investigation of complaints filed with the Board.~~]

[(b)] [~~Complaints.~~] Complaints shall be submitted on the official complaint form promulgated by the Board and shall include express authorization to release patient records to the Board if necessary. The Board shall protect the identity of a complainant in the investigative process to the extent possible. [~~Complaints shall contain the following information:~~]

~~[(1) the name and contact information of the complainant (and patient);]~~

~~[(2) the name and contact information of the person the complaint is filed against;]~~

~~[(3) the date, time, and place of occurrence of alleged violation of the Act or Board rules;]~~

~~[(4) the type of service (in-person or telehealth);]~~

~~[(5) the complete description of incident giving rise to the complaint; and]~~

~~[(6) the express authorization to release patient records to the Board where applicable.]~~

(b) [~~(c) Classification of Complaints. All complaints received shall be sent to the Executive Director. The Board shall determine jurisdiction and distinguish between categories of complaints as follows:~~]

[(1)] [~~Non-jurisdictional.~~] A complaint is considerednon-jurisdictional if the Board does not have any authority over the subject of the complaint. If possible, these complaints shall be referred to an agency having jurisdiction over the complaint.

[(2) Jurisdictional. A complaint is jurisdictional if it alleges conduct that, if true, would constitute a violation of the Act or Board rules. A jurisdictional complaint may require a Board investigation including but not limited to a Board member expert review and/or contractual third-party expert review. The Board shall further classify these complaints according to the schedule in subsection (d) of this section. These complaints shall be processed according to subsection (e) of this section.]

(c) [~~(d) Classification of Jurisdictional Complaints.~~] All jurisdictional complaints shall be classified in one of the following categories:

(1) Complaints of high priority. Complaints alleging conduct that potentially threatens the public health, including violations of the professional standard of care or glaucoma-related complaints. The processing of these complaints shall have priority over normal priority complaints. The Board shall evaluate complaints of high priority to determine whether an emergency temporary suspension shall be sought under §277.8 of this title. [~~This includes, but is not limited to, complaints alleging:~~]

~~[(A) professional misconduct,]~~

~~[(B) qualifications of applicants or licensees,]~~

~~[(C) unauthorized practice;]~~

~~[(D) other acts or the failure to act that potentially threatens the public health, and]~~

[(E) a violation of the professional standard of care. The processing of these complaints shall have priority over normal priority complaints. The Board shall evaluate complaints of high priority to determine whether an emergency temporary suspension shall be sought under §277.8 of this title.]

(2) Complaints of normal priority. Complaints alleging violations of the Optometry Act or Board rules that do not potentially threaten the public health. [~~This includes, but is not limited to, complaints alleging:~~]

~~[(A) advertising violations,]~~

~~[(B) violations of the Act or Board Rules resulting in economic harm, and]~~

~~[(C) violations of the Act regarding notice that do not potentially threaten the public health.]~~

(3) Glaucoma. All complaints received relating to glaucoma shall be considered high-priority and shall be investigated pursuant to the process outlined by §277.13 and §277.14 of this title.

(d) [~~(e)~~] Investigation-Enforcement Committee.

(1) [~~Makeup of Committee. The Chair shall appoint a committee to consider all jurisdictional complaints referred from Board staff. The committee shall be known as the~~] The Investigation-Enforcement Committee [~~and~~] shall be composed of Board [~~board~~] members who are licensed [~~optometrists or~~] therapeutic optometrists. To investigate individual complaints, subcommittees may be formed.

(2) [~~Authority of Committee.~~] The Committee shall have the power to make recommendations regarding resolution and disposition of specific cases such as those regarding professional competency or recommendations regarding dismissals of complaints and closure or investigations. The Committee may determine the appropriate disposition of the complaint consistent with applicable provisions of the Optometry Act, including but not limited to dismissal, further investigation, referral for remedial plan, or recommendation of formal proceedings.

(3) The Committee may issue subpoenas and subpoenas duces tecum to compel the attendance of witnesses and the production of books, records, and documents, to issue commissions to take depositions, to administer oaths and to take testimony concerning all matters within the assigned jurisdiction. In addition to subpoena power, each member of the committee may authorize the Executive Director to investigate an alleged violation.

[(3) Disposition of Complaint. During the investigation of a filed jurisdictional complaint related to professional competency, members of the Committee may determine:]

[(A) whether a violation of the Act or Board rules has occurred;]

[(B) whether to dismiss the matter and take no further action;]

[(C) whether to conduct further investigations;]

[(D) whether to forward to the Board the Committee's determination that a violation of the Act may have occurred together with a recommendation that the Board issue a remedial plan;]

[(E) whether to forward to the Board the Committee's determination that a violation of the Act may have occurred together with a recommendation that proceedings be instituted with the State Office of Administrative Hearings to consider disciplinary action, sanctions, administrative penalties, issuance of cease and desist orders, or refusal to issue a license;]

[(F) whether to forward to the Board the Committee's determination that some person, firm, or corporation may be practicing optometry without a license or otherwise violating the provisions of the Act, along with the members' recommendation that the board notify the attorney general or appropriate district attorney with accompanying request that appropriate action be taken in accordance with law; and]

[(G) whether to forward to the Executive Director the Committee's determination of findings applicable to subparagraphs (D) and (E) of this paragraph to issue a remedial plan or for assessment of administrative penalties.]

(e) [~~(f) Complaints Investigated by Staff.~~] Board staff may investigate jurisdictional complaints that do not directly relate to patient care and the investigation or disposition of which do not require expertise in optometry or therapeutic optometry. Board staff investigations and dispositions shall be conducted in accordance with procedures adopted by the Board. [During the investigation, Board staff may consult members of the Investigation-Enforcement Committee to assist with the investigation. A complaint shall be directed to the Investigation-Enforcement Committee if the Executive Director determines that the complaint should not be dismissed or settled or the Executive Director is unable to reach an agreed settlement.]

(f) [~~(g) Notification and Request for Information.~~] Once an investigation commences, Board staff shall notify the subject of the complaint and request a written response to the allegations along with patient charts and any other relevant information. The subject of the complaint shall [~~have 14 days from the receipt of the Board's request to~~] respond pursuant to §273.16 of this title. The Executive Director may extend the time period upon a showing of good cause by the subject of the complaint.

(g) [~~(h) Dismissal and Tracking of Complaints.~~] The Executive Director shall report on complaint dismissals and status at each Board meeting. [A complaint shall not be dismissed without appropriate consideration. The complainant shall be advised of complaint dismissals. A complaint dismissed by the Executive Director shall be approved by the Board at a Board Meeting. The Executive Director shall make a report at each board meeting regarding complaints to the Board.]

(h) [~~(i)~~] Basic Competence Violations.

(1) If during a review of patient records related to a patient complaint or an inspection conducted in accordance with Section 351.1575 of the Optometry Act [~~the investigation of an optometrist's or therapeutic optometrist's compliance with Section 351.353 of the Act and §279.1 or §279.3 of this title~~], the optometrist or therapeutic optometrist failed to complete all the of required findings in an initial examination at which a prescription for corrective lenses is written as required by Section 351.353 of the Optometry Act, the completed [~~investigation~~] report will be classified as a complaint [~~and forwarded by the Executive Director to the Investigation-Enforcement Committee~~].

(2) In determining the action to take [~~under subsection (e)(3), if any~~], the Investigation-Enforcement Committee or the Executive Director shall consider the seriousness of the omitted finding, the compliance history of the optometrist or therapeutic optometrist, and prior actions of the Board concerning similar complaints. [~~Omission of four or more basic competency findings requires the committee members to conduct an informal conference.~~]

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on June 15, 2026.

TRD-202602434

Janice McCoy

Executive Director

Texas Optometry Board

Earliest possible date of adoption: July 26, 2026

For further information, please call: (512) 305-8502

22 TAC §277.2

The Texas Optometry Board proposes amendments to 22 TAC Chapter 277, §277.2 - Disciplinary Proceedings.

The Board has determined that there continues to be a need for the rules in Chapter 277. The Board has also determined that changes to §277.2 as currently in effect are necessary.

The amendments clarify the Board's disciplinary proceedings process for the public and licensees by reducing word count and ensuring the Board's proceedings comply with the Administrative Procedures Act (APA). By referencing compliance with the APA, the Board does not need to amend its rule if the APA is amended by the Texas Legislature at a future date. Additionally, the rule adds a section referencing the option for Alternative Dispute Resolution as that rule is being repealed in a separate rule submission.

Additionally, Ms. McCoy has determined that enforcing or administering the rules do not have foreseeable implications relating to the costs or revenues of state or local government.

The Board proposes this rule pursuant to the authority found in §351.151 of the Occupations Code which vests the Board with the authority to adopt rules necessary to perform its duties and implement Chapter 351 of the Occupations Code. Additional authority related to the disciplinary process is found in Subchapter k of the Occupations Code (Disciplinary Procedures).

No other sections are affected by the amendments.

§ 277.2. Disciplinary Proceedings.

(a) [~~General statement.~~] In a contested case before the Board, proceedings shall be governed by the Administrative Procedure Act (APA), except as specifically provided in the Optometry Act. In any contested case, opportunity shall be afforded to all parties to respond and present evidence and argument on all issues involved. Unless precluded by law, informal disposition may be made of any contested case by any method authorized under Government Code, Section 2001.056, including but not limited to stipulation, agreed settlement, consent order, or default. [~~by stipulation, agreed settlement, consent order, default, refund of examination fees, remedial plan or dismissal.~~]

(b) The Board may seek to resolve a contested matter through any Alternative Dispute Resolution (ADR) procedure. Such procedures may include, but are not limited to, those applied to resolve matters pending at the State Office of Administrative Hearing (SOAH) and in the state's district courts.

(c) [~~(b) Informal disposition of contested case.~~] Prior to the imposition of disciplinary sanctions, remedial plan, or administrative penalties against a respondent (a licensee or a person issued a cease and desist order), the respondent shall be offered an opportunity to attend an informal conference and show compliance with all requirements of law, in accordance with the APA.

(1) The Executive Director shall designate the informal conference panel in accordance with Section 351.507 of the Optometry Act. [Informal conferences shall be attended by the Executive Director, the Board's legal counsel, the two members of the Investigation-Enforcement Committee, a public member, and other representatives of the Board as the Executive Director and legal counsel may deem necessary for the proper conduct of the conference.] The respondent and/or the authorized representative may attend the informal conference and shall be provided an opportunity to be heard. If applicable, the complainant may attend the informal conference in order to be heard on the complaint.

(2) Informal conferences shall not be deemed to be meetings of the Board and no formal record of the proceedings at the conferences shall be made or maintained. [ In any case where charges are based upon information provided by a person who filed a complaint with the Board (complainant), the complainant may attend the informal conference, and shall be provided with an opportunity to be heard. Nothing herein requires a complainant to attend an informal conference.]

(3) In making a settlement offer, the panel shall consider the Penalty Schedule in §277.6 of this title to determine the recommendation for an administrative fine or penalty. The panel also may recommend the respondent refund all or part of the examination fee paid by the complainant.

(4) The panel's proposed settlement offer shall be presented to the Board for its review. At the conclusion of its review, the Board shall approve, amend, or disapprove the settlement offer. If the respondent does not concur with the settlement or the Board disapproves the offer, the case shall be forwarded to SOAH for formal action.

(d) [~~(3)~~] Notice of the informal conference shall be served not less than 10 days prior to the date of the conference by certified or registered mail, return receipt requested, to the licensee's address of record as maintained by the Board or by electronic means to the licensee's designated electronic address of record, and shallinclude:

(1) [~~(A)~~] a statement of the legal authority, jurisdiction, and alleged conduct under which the enforcement action is based, with a reference to the particular section(s) of the statutes and rules involved;

(2) [~~(B)~~] an offer for the respondent to attend an informal conference at a specified time and place and show compliance with all requirements of law, in accordance with [~~Chapter 2001 of~~] the APA [~~Administrative Procedure Act~~];

(3) [~~(C)~~] a statement that the respondent has an opportunity for a hearing before SOAH [~~the State Office of Administrative Hearings~~] on the allegations; and

(4) [~~(D)~~] a default warning in the form prescribed by Board policy [the following statement in capital letters in 12 point boldface type: FAILURE TO RESPOND TO THE ALLEGATIONS, BY EITHER PERSONAL APPEARANCE AT THE INFORMAL CONFERENCE OR IN WRITING, WILL RESULT IN THE ALLEGATIONS BEING ADMITTED AS TRUE AND THE RECOMMENDED SANCTION MADE AT THE INFORMAL CONFERENCE BEING GRANTED BY DEFAULT. The notice shall be served by delivering a copy to the respondent or licensee in person, by courier receipted delivery, or by certified or registered mail, return receipt requested, to the licensee's last known address of record as shown by agency records, not less than 10 days prior to the date of the conference.]

(e) [~~(4)~~] The respondent shall respond by either personal appearance at the informal conference or in writing no later than the date of the informal conference. If the respondent chooses to respond in writing, the response shall address the allegations set forth in the notice. [If the respondent chooses to respond in writing, the response shall admit or deny each of the allegations. If the respondent intends to deny only a part of an allegation, the respondent shall specify so much of it is true and shall deny only the remainder. The response shall also include any other matter, whether of law or fact, upon which the respondent intends to rely for his or her defense.]

(f) If the respondent fails to respond [~~to the notice specified in this subsection,~~] the matter will be considered as a default case .

(1) The [~~and the~~] respondent will be deemed to have:

(A) admitted all the factual allegations in the notice specified in this subsection;

(B) waived the opportunity to show compliance with the law;

(D) waived the opportunity for a hearing on the allegations; and

(E) waived objection to the recommended sanctions made at the informal conference.

(2) [~~(5)~~] The [~~Investigation-Enforcement Committee may recommend that the~~] Board shall either enter a default order [~~, based upon the allegations set out in the notice specified in this subsection,~~] adopting the recommended sanctions made at the informal conference [~~. Upon consideration of the case, the Board may enter a default order under §2001.056 of the Administrative Procedure Act~~] or direct that the case be set for a hearing at SOAH [~~the State Office of Administrative Hearings~~].

[(6)] Any default judgment [~~granted under this section~~] will be entered on the basis of the factual allegations in the notice and upon proof of proper notice to the respondent's address of record [~~as specified in paragraph (3) of this subsection~~].

(3) [~~(7)~~] A motion for rehearing which requests that the Board vacate its default order under this section shall be granted if the motion presents convincing evidence that the failure to respond to the notice specified in this subsection was not intentional or the result of conscious indifference, but due to accident or mistake, provided that the respondent has a meritorious defense to the factual allegations contained in the notice specified in this subsection and the granting thereof will not result in delay or injury to the public or the Board.

~~[(8) Informal conferences shall not be deemed to be meetings of the Board and no formal record of the proceedings at the conferences shall be made or maintained.]~~

[(9) The Investigation-Enforcement Committee shall consider the Penalty Schedule in §277.6 of this title to determine the parameters of any administrative fine or penalty to recommend to the respondent and the Board. The Investigation-Enforcement Committee may recommend a settlement to the respondent that includes an agreed order to refund all or part of the examination fee paid by the complainant to the respondent. This settlement must be approved by the Board pursuant to subsection (b)(10).]

[(10) Any proposed order shall be presented to the Board for its review. At the conclusion of its review, the Board shall approve, amend, or disapprove the proposed order. Should the Board approve the proposed order, the appropriate notation shall be made in the minutes of the Board and the proposed order shall be entered as an official action of the Board. Should the Board amend the proposed order, the Executive Director shall contact the respondent to seek concurrence. If the respondent does not concur, the provisions of the next sentence shall apply. Should the Board disapprove the proposed order, the case shall be rescheduled for purposes of reaching an agreed order or in the alternative forwarded to the State Office of Administrative Hearings for formal action.]

(g) [~~(c) Formal disposition of a contested case.~~] All contested cases not resolved by informal conference shall be referred to SOAH [~~the State Office of Administrative Hearings~~]. Formal proceedings shall be conducted in accordance with the contested-case provisions of the APA and the procedural rules of SOAH.

[(1) Notice. The respondent shall be entitled to reasonable notice of not less than 10 days. Notice shall include the matters specifically required by the APA, to wit:]

[(A) a statement of the time, place, and nature of the hearing;]

[(B) a statement of the legal authority and jurisdiction under which the hearing is being held;]

[(C) a reference to the particular section of the Act and rules involved; and]

[(D) a short and plain statement of the matters asserted.]

[(2) Service of notice. The notice of hearing and a copy of the formal complaint shall be served on the respondent's last known address at least 10 days prior to the hearing. Service on the respondent shall be complete and effective if the document to be served is sent by registered or certified mail to the respondent at the address shown on the respondent's annual renewal certificate.]

[(3) Filing of documents. All pleadings and motions relating to any contested case pending before the State Office of Administrative Hearings shall be filed with the State Office of Administrative Hearings. They shall be deemed filed only when actually received.]

~~[(4) Motion for continuance. Continuances may be granted by the State Office of Administrative Hearings in accordance with procedural rules established by that agency.]~~

[(5) Transcription. Proceedings, or any part of them, must be transcribed on the written request of any party. The agency may pay the cost of the transcript or assess the cost to one or more parties.]

~~[(6) Discovery. Requests for the issuance of subpoenas, requests for depositions and for production of documents, and other discovery matters shall be governed by the APA.]~~

[(d) If, after receiving notice of hearing, a party fails to appear in person or by representative on the day and time set for hearing, the Administrative Law Judge may proceed in that party's absence and, as authorized by applicable law, may issue a proposal for decision or order against the defaulting party in which the factual allegations against that party in the notice of hearing are deemed admitted as true without the requirement of submitting additional proof.]

[(e) Any default judgment entered under this section shall be issued only upon adequate proof that proper notice was provided to the defaulting party, and such notice includes disclosure, in 12 point, bold-faced type: FAILURE TO RESPOND TO THE ALLEGATIONS, BY EITHER PERSONAL APPEARANCE AT THE INFORMAL CONFERENCE OR IN WRITING, WILL RESULT IN THE ALLEGATIONS BEING ADMITTED AS TRUE AND THE RECOMMENDED SANCTION MADE AT THE INFORMAL CONFERENCE BEING GRANTED BY DEFAULT. Proper notice may be established by proof that the Board complied with subsection (c)(1) and (2) of this section.]

[(f) This section does not preclude the agency from informally disposing of a case by default under the agency's statute or rules in the event the respondent fails to file a timely written response or other responsive pleading required by the agency's statute or rules.]

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on June 15, 2026.

TRD-202602435

Janice McCoy

Executive Director

Texas Optometry Board

Earliest possible date of adoption: July 26, 2026

For further information, please call: (512) 305-8502

22 TAC §277.3

The Texas Optometry Board proposes amendments to 22 TAC Chapter 277, §277.3 - Probation.

The Board has determined that there continues to be a need for the rules in Chapter 277. The Board has also determined that changes to §277.3 as currently in effect are necessary.

The amendment simply updates the terminology found in the rule from "practitioner" to "licensee" to clarify that the Board may offer probation to a licensee. It further clarifies that the Board "may" act without the unnecessary language related to a majority vote as a majority vote is needed for all Board actions.

Public Benefit. Ms. McCoy has determined for the first five-year period the amendment is in effect there is no impact on the public.

Additionally, Ms. McCoy has determined that enforcing or administering the rules do not have foreseeable implications relating to the costs or revenues of state or local government.

PUBLIC COMMENTS: Comments on the proposed amendment to the rule may be submitted electronically to: janice.mccoy@tob.texas.gov or in writing to Janice McCoy, Executive Director, Texas Optometry Board, 1801 N. Congress, Suite 9.300, Austin, Texas 78701. The deadline for furnishing comments is thirty days after publication in the Texas Register .

Statutory Authority. The Board proposes this rule pursuant to the authority found in §351.151 of the Occupations Code which vests the Board with the authority to adopt rules necessary to perform its duties and implement Chapter 351 of the Occupations Code. Additional authority related to the probation process is found in §351.506 of the Occupations Code.

No other sections are affected by the amendments.

§ 277.3. Probation.

(a) The Board may [~~shall have the right and may upon majority vote~~] rule that an order denying an application for license or any order canceling, suspending, or revoking any license be probated so long as the probated licensee [~~practitioner~~] conforms to such orders and rules as the Board may set out in the terms of the probation. The Board, at the time of its decision to probate the licensee [~~practitioner~~], shall set out the period of time which shall constitute the probationary period; provided, however, that the Board may at any time while the licensee [~~practitioner~~] remains on probation upon majority vote rescind the probation and enforce the Board's original action denying, suspending, or revoking such license for violation of the terms of the probation or for other good cause as the Board in its discretion may determine. To rescind the probation shall require a formal disciplinary hearing and be conducted as a contested case within the meaning of the Administrative Procedures Act [~~APA~~].

(b) The Executive Director shall maintain a chronological and alphabetical listing of licensees who have had their license canceled, suspended, or revoked, and shall monitor each consent order in respect to each license holder's specific sanction. Any noncompliance observed as a result of monitoring shall be referred to the Board.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on June 15, 2026.

TRD-202602436

Janice McCoy

Executive Director

Texas Optometry Board

Earliest possible date of adoption: July 26, 2026

For further information, please call: (512) 305-8502

22 TAC §277.4

The Texas Optometry Board proposes amendments to 22 TAC Chapter 277, §277.4 - Reinstatement.

The Board has determined that there continues to be a need for the rules in Chapter 277. The Board has also determined that changes to §277.4 as currently in effect are necessary.

The amendment simply updates the terminology found in the rule from "practitioner" to "person" to clarify that the person seeking reinstatement of a license should not be practicing. Additionally, it provides that the Board may make the decision to reinstate a license without holding a hearing at the State Office of Administrative Hearings (SOAH). Implied is that if the Board makes an adverse action, the person may appeal the decision to SOAH under the provisions of the Administrative Procedures Act.

Public Benefit. Ms. McCoy has determined for the first five-year period the amendment is in effect there is no impact on the public.

Additionally, Ms. McCoy has determined that enforcing or administering the rules do not have foreseeable implications relating to the costs or revenues of state or local government.

Statutory Authority. The Board proposes this rule pursuant to the authority found in §351.151 of the Occupations Code which vests the Board with the authority to adopt rules necessary to perform its duties and implement Chapter 351 of the Occupations Code. Additional authority related to the reinstatement process is found in §351.505 of the Occupations Code.

No other sections are affected by the amendments.

§ 277.4. Reinstatement.

(a) Any person [~~practitioner~~] whose license to practice has been revoked [~~for a period of more than one year~~] may, after the expiration of at least one year from the date that such revocation became final, apply to the Board, on forms provided by the Board, to have the revocation order withdrawn and to have the Board reinstate a license to practice optometry or therapeutic optometry. [In considering the reinstatement of a revoked license, the State Office of Administrative Hearings shall consider all factors it deems relevant, and the applicant for reinstatement of a revoked license must appear before the State Office of Administrative Hearings. After consideration of the proposal for decision, the]

(b) The Board in its discretion may:

(1) deny reinstatement of a revoked license;

(2) reinstate a revoked license and probate the licensee [~~practitioner~~] for a specified period of time under specified conditions; or

(3) authorize reinstatement of the revoked license.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on June 15, 2026.

TRD-202602437

Janice McCoy

Executive Director

Texas Optometry Board

Earliest possible date of adoption: July 26, 2026

For further information, please call: (512) 305-8502

22 TAC §277.5

The Texas Optometry Board proposes amendments to 22 TAC Chapter 277, §277.5 - Convictions.

The Board has determined that there continues to be a need for the rules in Chapter 277. The Board has also determined that changes to §277.5 as currently in effect are necessary.

The amendment removes unnecessary language which only restates statute or provides subjective commentary about the rule.

Public Benefit. Ms. McCoy has determined for the first five-year period the amendment is in effect there is no impact on the public.

Additionally, Ms. McCoy has determined that enforcing or administering the rules do not have foreseeable implications relating to the costs or revenues of state or local government.

Statutory Authority. The Board proposes this rule pursuant to the authority found in §351.151 of the Occupations Code which vests the Board with the authority to adopt rules necessary to perform its duties and implement Chapter 351 of the Occupations Code. Additional authority related to the review of convictions process is found in Chapter 53 of the Occupations Code

No other sections are affected by the amendments.

§ 277.5. Convictions.

[(a) The Act, §351.501(a)(3), and Texas Occupations Code Chapter 53, provide that the Board may suspend or revoke an existing valid license, disqualify a person from receiving a license, or deny to a person the opportunity to be examined for a license because of a person's conviction of a felony or misdemeanor, including being placed on deferred adjudication or court ordered community or mandatory supervision, with or without an adjudication of guilt, or revocation of parole, probation or court ordered supervision, if the crime directly relates to duties and responsibilities of a licensed optometrist or therapeutic optometrist.]

(a) [~~(b)~~] A licensee or applicant receiving a felony or misdemeanor criminal conviction, including deferred adjudication or court ordered community or mandatory supervision, with or without an adjudication of guilt, or revocation of parole, probation or court ordered supervision, shall report the order of conviction, deferred adjudication or court ordered community or mandatory supervision, or revocation of parole, probation, or supervision within 30 days of the date the court issued the order. This subsection does not require the reporting of a Class C Misdemeanor traffic violation. The failure of a licensee or applicant to report a conviction is deceit, dishonesty and misrepresentation in the practice of optometry and authorizes the Board to take disciplinary action under §351.501 of the Optometry Act.

(b) The licensee shall furnish any document relating to the conviction as requested by the Board.

~~[(c) The Texas Optometry Act authorizes licensees to provide health services.]~~

(c) [~~(d)~~] A person currently incarcerated because of a felony conviction or revocation of parole, probation or court ordered supervision in a felony case may not [ ~~sit for examination,~~] obtain a license under the Optometry Act [~~this act,~~] or renew a previously issued license to practice optometry or therapeutic optometry.

(d) [~~(e)~~] In considering whether a criminal conviction directly relates to the occupation of an optometrist or therapeutic optometrist, the Board shall consider the factors listed in [~~Texas~~] Occupations Code §53.022.

[(f)] [The practice of optometry and therapeutic optometry places the optometrist or therapeutic optometrist in a position of public trust. A licensee practices in an autonomous role in treating patients young and old; in prescribing, administering and safely storing dangerous drugs including controlled substances; in preparing and safeguarding confidential records and information; and in accepting client funds. Therefore the] The crimes considered by the Board to relate to the practice of optometry and therapeutic optometry include, but are not limited to:

(1) any felony or misdemeanor of which fraud, dishonesty or deceit is an essential element;

(2) any criminal violation of the Optometry Act, or other statutes regulating or pertaining to the practice or profession of optometry and therapeutic optometry;

(3) any criminal violation of statutes regulating other professions in the healing arts;

(4) any crime involving moral turpitude;

(5) murder;

(6) burglary;

(7) robbery;

(8) theft;

(9) sex offense;

(10) perjury;

(11) child molesting; and

(12) substance abuse or substance diversion.

(e) [~~(g)~~] In determining the present fitness of a person who has been convicted of a crime, the Board shall consider the factors listed in [~~Texas~~] Occupations Code §53.023.

[(h)] It shall be the responsibility of the person to furnish to the Board proof of the additional factors [~~applicant for license to secure and provide to the Board the recommendations of the prosecution, law enforcement, and correctional authorities regarding all offenses~~].

[(i) The applicant for license shall also furnish proof in such form as may be required by the Board, that the licensee maintained a record of steady employment and has supported licensee dependents and has otherwise maintained a record of good conduct and has paid all outstanding court costs, supervision fees, fines and restitution as may have been ordered in all criminal cases in which the licensee has been convicted.]

(f) [~~(j)~~] Upon suspension or revocation of a license, or denial of an application for license or examination because of the person's [~~prior~~] conviction of a crime and the relationship of the crime to the license, the Board shall notify the person in writing:

(1) of the reasons for the suspension, revocation, denial, or disqualification;

(2) of the review procedure provided by [~~Texas~~] Occupations Code §53.052; and

(3) of the earliest date that the person may appeal.

~~[(k) The Board, however, shall be under no duty to generate evidence with respect to the matters listed in Texas Occupations Code Chapter 53.]~~

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on June 15, 2026.

TRD-202602438

Janice McCoy

Executive Director

Texas Optometry Board

Earliest possible date of adoption: July 26, 2026

For further information, please call: (512) 305-8502

22 TAC §277.8

The Texas Optometry Board proposes amendments to 22 TAC Chapter 277, §277.8 - Emergency Temporary Suspension or Restriction.

The Board has determined that there continues to be a need for the rules in Chapter 277. The Board has also determined that changes to §277.8 as currently in effect are necessary.

The amendment provides the Chair of the Board has discretion when appointing the emergency committee and the appointments would not need to be approved by the full Board. Finally, the amendment allows the committee to meet by video or telephone call if necessary.

Public Benefit. Ms. McCoy has determined for the first five-year period the amendment is in effect there is no impact on the public.

Additionally, Ms. McCoy has determined that enforcing or administering the rules do not have foreseeable implications relating to the costs or revenues of state or local government.

Statutory Authority. The Board proposes this rule pursuant to the authority found in §351.151 of the Occupations Code which vests the Board with the authority to adopt rules necessary to perform its duties and implement Chapter 351 of the Occupations Code. Additional authority related to the emergency suspension process is found in §351.5015 of the Occupations Code.

No other sections are affected by the amendments.

§ 277.8. Emergency Temporary Suspension or Restriction.

(a) The [~~Annually, the~~] chair of the Board shall appoint [~~for approval by the Board~~] a three-member disciplinary panel ("panel") and alternate, consisting of at least one public member, for the purpose of making a determination of whether a license should be temporarily suspended or restricted [~~under Section 351.5015 of the Act~~]. The chair shall name one of the members as chair of the panel. If a member of the panel is recused, or unable to participate in the panel, the alternate Board member may serve in the member's place.

(b) The panel shall meet to receive information on a complaint indicating that a licensee's continued practice of optometry or therapeutic optometry may constitute a continuing or imminent threat to the public welfare. At the conclusion of the meeting, if the panel concludes that the licensee's continued practice would constitute a continuing or imminent threat to the public welfare, the panel may restrict or suspend the license for a temporary, stated period of time.

(c) The [~~disciplinary~~] panel may hold a meeting by telephone or video conference call if immediate action is required and convening of the panel at one location is inconvenient for any member of the disciplinary panel.

(d) The panel may suspend a license under this section without notice or a hearing on the complaint, provided the Investigation-Enforcement Committee shall meet in an informal conference as soon as practical, to determine if formal disciplinary proceedings should be initiated against the licensee. The licensee must receive notice of the conference at least 72 hours prior to the conference.

(e) Following the informal conference, the Investigation-Enforcement Committee shall take one of the following actions:

(1) Lift the temporary suspension or restriction and reinstate the license without conditions.

(2) Negotiate an agreed settlement order that will dissolve, continue or modify the suspension or restriction, or impose other sanctions as appropriate. The agreed order shall be presented to the Board at the next available Board Meeting for approval.

(3) Prepare a complaint affidavit setting out the details of the complaint and recommended sanctions, and forward the complaint affidavit to the State Office of Administrative Hearings for setting of an administrative hearing. Following the hearing, the administrative law judge will prepare a proposal for decision for adoption, in the form of an order, by the Board.

(f) The panel and the Investigation-Enforcement Committee may receive testimony and evidence in oral or written form. Written statements may be sworn or unsworn. The panel or committee members may question witnesses at the members' discretion. Evidence or information that is clearly irrelevant, unreliable, or unduly inflammatory will not be considered.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on June 15, 2026.

TRD-202602439

Janice McCoy

Executive Director

Texas Optometry Board

Earliest possible date of adoption: July 26, 2026

For further information, please call: (512) 305-8502

22 TAC §277.9

The Texas Optometry Board proposes to repeal 22 TAC Part 14 Chapter 277 Administration - Rule 277.9 - Alternative Dispute Resolution.

In 2025, the Texas Legislature created the Texas Regulatory Efficiency Office (TREO) to review state agency rules and procedures to reduce regulatory burdens; eliminate waste, fraud, and unnecessary rules; and increase transparency for Texas taxpayers. In conjunction with the TREO review, the Board is proposing the repeal of Rule 277.9.

This rule is derived from Texas Government Code Chapter 2009 which outlines the Alternative Dispute Resolution process for government agencies. In conjunction with the repeal of this rule, the Board is in the process of amending Rule 277.2-Disciplinary Proceedings to state the "Board may seek to resolve a contested matter through any Alternative Dispute Resolution (ADR) procedure. Such procedures may include, but are not limited to, those applied to resolve matters pending at the State Office of Administrative Hearing (SOAH) and in the state's district courts."

Government Growth Impact Statement. For the first five-year period after the repeal, the Board estimates that the repeal will have no effect on government growth. The repeal does not create or eliminate a government program; does not require the creation or elimination of employee positions; does not require the increase or decrease in future legislative appropriations to this agency; does not require an increase or decrease in fees paid to the agency; does not create a new regulation; does not expand an existing regulation; does not increase or decrease the number of individuals subject to the rule's applicability; and does not positively or adversely affect the state's economy.

Small Business, Micro-Business, and Rural Community Impact Statement. Ms. McCoy has determined for the first five-year period following the repeal, there will be no adverse effect on small businesses, micro-businesses, or rural communities and the repeal does not positively or adversely impact the state's economy.

Regulatory Flexibility Analysis for Small and Micro-Businesses and Rural Communities. Ms. McCoy has determined that the repeal will have no adverse economic effect on small businesses, micro-businesses, or rural communities and does not positively or adversely impact the state's economy. Thus, the Board is not required to prepare a regulatory flexibility analysis pursuant to §2006.002 of the Government Code.

Takings Impact Assessment. Ms. McCoy has determined that there are no private real property interests affected by the repeal. Thus, the Board is not required to prepare a takings impact assessment pursuant to §2007.043 of the Government Code.

Local Employment Impact Statement. Ms. McCoy has determined that the repeal will have no impact on local employment or a local economy. Thus, the Board is not required to prepare a local employment impact statement pursuant to §2001.024 of the Government Code.

Public Benefit. Ms. McCoy has determined for the first five-year period the repeal is in effect there is no impact on the public.

Fiscal Note. Janice McCoy, Executive Director of the Board, has determined that for the first five-year period following the repeal, there will be no additional estimated cost, reduction in costs, or loss or increase in revenue to local governments.

Additionally, Ms. McCoy has determined that enforcing or administering the rules do not have foreseeable implications relating to the costs or revenues of state or local government.

Requirement for Rules Increasing Costs to Regulated Persons. The proposed repeal does not impose any new or additional costs to regulated persons, state agencies, special districts, or local governments; therefore, pursuant to §2001.0045 of the Government Code, no repeal or amendment of another rule is required to offset any increased costs. Additionally, no repeal or amendment of another rule is required because the proposed rules are necessary to protect the health, safety, and welfare of the residents of this state and because regulatory costs imposed by the Board on licensees is not expected to increase.

PUBLIC COMMENTS: Comments on the proposed repeal rules may be submitted electronically to: janice.mccoy@tob.texas.gov or in writing to Janice McCoy, Executive Director, Texas Optometry Board, 1801 N. Congress, Suite 9.300, Austin, Texas 78701. The deadline for furnishing comments is thirty days after publication in the Texas Register.

Statutory Authority. The Board proposes this repeal pursuant to the authority found in §351.151 of the Occupations Code which vests the Board with the authority to adopt rules necessary to perform its duties and implement Chapter 351 of the Occupations Code.

No other sections are affected by the repeal.

§ 277.9. Alternative Dispute Resolution.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on June 15, 2026.

TRD-202602440

Janice McCoy

Executive Director

Texas Optometry Board

Earliest possible date of adoption: July 26, 2026

For further information, please call: (512) 305-8502

22 TAC §277.12

The Texas Optometry Board proposes amendments to 22 TAC Chapter 277, §277.12 - Denial Of License And Disciplinary Action By Board.

The Board has determined that there continues to be a need for the rules in Chapter 277. The Board has also determined that changes to §277.12 as currently in effect are necessary.

As currently written, the rule simply restates Texas Occupations Code §351.501 which is redundant and could be confusing for stakeholders. This proposed amendment simplifies and clarifies the Board's authority to discipline a licensee or applicant.

Additionally, based on a recent State Office of Administrative Hearing's ruling, the Board is attempting to define "wilful" by stating "An applicant or license holder is considered to have committed a wilful violation if the person intentionally disregarded the Optometry Act. Unless the person can prove he or she did not know how to review and understand the law, the Board deems every violation as intentional as each person is required to take and pass the Board's jurisprudence exam prior to licensure and to take one hour of continuing education related to professional responsibility each year once licensed."

Regulatory Flexibility Analysis for Small and Micro-Businesses and Rural Communities. Ms. McCoy has determined that the amendment will have no adverse economic effect on small businesses, micro-businesses, or rural communities and does not positively or adversely impact the state’s economy. Thus, the Board is not required to prepare a regulatory flexibility analysis pursuant to §2006.002 of the Government Code.

Additionally, Ms. McCoy has determined that enforcing or administering the rules do not have foreseeable implications relating to the costs or revenues of state or local government.

Statutory Authority. The Board proposes this rule pursuant to the authority found in §351.151 of the Occupations Code which vests the Board with the authority to adopt rules necessary to perform its duties and implement Chapter 351 of the Occupations Code. Additional authority related to the disciplinary process is found in Subchapter K of the Occupations Code (Disciplinary Procedures).

No other sections are affected by the amendments.

§ 277.12. Denial Of License And Disciplinary Action By Board.

(a) The Board may refuse to issue a license to an applicant or may discipline a license holder in accordance with Section 351.501 of the Optometry Act.

[(a) Denial of License. The Board may refuse to issue a license to an applicant, if the Board determines that:]

[(1) the applicant is guilty of fraud, deceit, dishonesty, or misrepresentation in the practice of optometry or therapeutic optometry or in seeking admission to that practice;]

[(2) the applicant is unfit or incompetent by reason of negligence;]

[(3) the applicant has been convicted of a misdemeanor involving moral turpitude or a felony;]

[(4) the applicant has developed an incapacity that prevents or could prevent the applicant from practicing optometry or therapeutic optometry with reasonable skill, competence, and safety to the public;]

[(5) the applicant has wilfully or repeatedly violated this chapter or a Board rule adopted under this chapter;]

[(6) the applicant has acted to deceive, defraud, or harm the public;]

[(7) the applicant is guilty of gross incompetence in the practice of optometry or therapeutic optometry;]

[(8) the applicant has engaged in a pattern of practice or other behavior demonstrating a wilful provision of substandard care;]

[(9) the applicant has committed an act of sexual abuse, misconduct, or exploitation with a patient or has otherwise unethically or immorally abused the doctor-patient relationship;]

[(10) the applicant has prescribed, sold, administered, distributed, or given a drug legally classified as a controlled substance or as an addictive or dangerous drug for other than an accepted diagnostic or therapeutic purpose;]

[(11) the applicant has failed to report to the Board the relocation of the applicant's office not later than the 30th day after the date of relocation, whether in or out of this state;]

[(12) the applicant's violation of a law of this state, other than Texas Occupations Code Chapter 351, or a rule of another licensing board in this state, or of a statute or rule of another state if the violation constitutes a violation of the laws of this state or a Board rule; or]

[(13) the applicant has violated the provisions of a disciplinary order or agreement issued by the Board.]

(b) Disciplinary actions include, but are not limited to, the authority to revoke or suspend a license, place on probation a license holder whose license has been suspended, impose a fine, impose a stipulation, limitation, or condition relating to continued practice, including conditioning continued practice on counseling or additional education, or reprimand a license holder.

(c) An applicant or license holder is considered to have committed a wilful violation if the person intentionally disregarded the Optometry Act. Unless the person can prove he or she did not know how to review and understand the law, the Board deems every violation as intentional as each person is required to take and pass the Board's jurisprudence exam prior to licensure and to take one hour of continuing education related to professional responsibility each year once licensed.

[(b) Disciplinary Action. The Board may revoke or suspend a license, place on probation a license holder whose license has been suspended, impose a fine, impose a stipulation, limitation, or condition relating to continued practice, including conditioning continued practice on counseling or additional education, or reprimand a license holder if the Board determines that:]

[(1) the license holder is guilty of fraud, deceit, dishonesty, or misrepresentation in the practice of optometry or therapeutic optometry or in seeking admission to that practice;]

[(2) the license holder is unfit or incompetent by reason of negligence;]

[(3) the license holder has been convicted of a misdemeanor involving moral turpitude or a felony;]

[(4) the license holder has developed an incapacity that prevents or could prevent the license holder from practicing optometry or therapeutic optometry with reasonable skill, competence, and safety to the public;]

[(5) the license holder has directly or indirectly employed, hired, procured, or induced a person to practice optometry or therapeutic optometry in this state without a license;]

[(6) the license holder has directly or indirectly aided or abetted an unlicensed person in the practice of optometry or therapeutic optometry;]

[(7) the license holder has placed the holder's license at the disposal or service of, including lending, leasing, or renting to, a person not licensed to practice optometry or therapeutic optometry in this state;]

[(8) the license holder has wilfully or repeatedly violated this chapter or a Board rule adopted under this chapter;]

[(9) the license holder has wilfully or repeatedly represented to a member of the public that the license holder is authorized or competent to cure or treat an eye disease beyond the authorization granted by this chapter;]

[(10) the license holder has had the right to practice optometry or therapeutic optometry suspended or revoked by a federal agency for a cause that the Board believes warrants that action;]

[(11) the license holder has acted to deceive, defraud, or harm the public;]

[(12) the license holder is guilty of gross incompetence in the practice of optometry or therapeutic optometry;]

[(13) the license holder has engaged in a pattern of practice or other behavior demonstrating a wilful provision of substandard care;]

[(14) the license holder has committed an act of sexual abuse, misconduct, or exploitation with a patient or has otherwise unethically or immorally abused the doctor-patient relationship;]

[(15) the license holder has prescribed, sold, administered, distributed, or given a drug legally classified as a controlled substance or as an addictive or dangerous drug for other than an accepted diagnostic or therapeutic purpose;]

[(16) the license holder has failed to report to the Board the relocation of the applicant's or license holder's office not later than the 30th day after the date of relocation, whether in or out of this state;]

[(17) the license holder has practiced or attempted to practice optometry while the license holder's license was suspended;]

[(18) the applicant's violation of a law of this state, other than Texas Occupations Code Chapter 351, or a rule of another licensing board in this state, or of a statute or rule of another state if the violation constitutes a violation of the laws of this state or a Board rule; or]

[(19) the applicant has violated the provisions of a disciplinary order or agreement issued by the Board.]

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on June 15, 2026.

TRD-202602441

Janice McCoy

Executive Director

Texas Optometry Board

Earliest possible date of adoption: July 26, 2026

For further information, please call: (512) 305-8502

PART 15. TEXAS STATE BOARD OF PHARMACY

CHAPTER 283. LICENSING REQUIREMENTS FOR PHARMACISTS

22 TAC §283.7

The Texas State Board of Pharmacy proposes amendments to §283.7, concerning Examination Requirements. The amendments, if adopted, allow an applicant for licensure by examination who has completed the three didactic years of pharmacy education to take the Texas Pharmacy Jurisprudence Examination a maximum of one time prior to graduation from a college/school of pharmacy and remove outdated examination requirements.

Daniel Carroll, Pharm.D., Executive Director/Secretary, has determined that, for the first five-year period the rules are in effect, there will be no fiscal implications for state or local government as a result of enforcing or administering the rule. Dr. Carroll has determined that, for each year of the first five-year period the rule will be in effect, the public benefit anticipated as a result of enforcing the amendments will be to streamline the pharmacist licensure process, reduce testing stress and workload, and clear and correct regulatory language. There is no anticipated adverse economic impact on large, small or micro-businesses (pharmacies), rural communities, or local or state employment. Therefore, an economic impact statement and regulatory flexibility analysis are not required.

For each year of the first five years the proposed amendments will be in effect, Dr. Carroll has determined the following:

(1) The proposed amendments do not create or eliminate a government program;

(2) Implementation of the proposed amendments does not require the creation of new employee positions or the elimination of existing employee positions;

(3) Implementation of the proposed amendments does not require an increase or decrease in the future legislative appropriations to the agency;

(4) The proposed amendments do not require an increase or decrease in fees paid to the agency;

(5) The proposed amendments do not create a new regulation;

(6) The proposed amendments do limit an existing regulation by providing more flexibility in scheduling a licensure examination;

(7) The proposed amendments do not increase or decrease the number of individuals subject to the rule's applicability; and

(8) The proposed amendments do not positively or adversely affect this state's economy.

The Board is requesting public comments on the proposed amendments and information related to the cost, benefit, or effect of the proposed amendments, including any applicable data, research, or analysis. Any information that is submitted in response to this request must include an explanation of how and why the submitted information is specific to the proposed amendments.

Written comments on the amendments may be submitted to Eamon D. Briggs, Deputy General Counsel, Texas State Board of Pharmacy, 1801 Congress Avenue, Suite 13.100, Austin, Texas 78701-1319, FAX (512) 305-8061. The deadline for comments is 30 days after publication in the Texas Register.

The amendments are proposed under §§551.002 and 554.051 of the Texas Pharmacy Act (Chapters 551 - 569, Texas Occupations Code). The Board interprets §551.002 as authorizing the agency to protect the public through the effective control and regulation of the practice of pharmacy. The Board interprets §554.051(a) as authorizing the agency to adopt rules for the proper administration and enforcement of the Act.

The statutes affected by these amendments: Texas Pharmacy Act, Chapters 551 - 569, Texas Occupations Code.

§ 283.7. Examination Requirements.

Each applicant for licensure by examination shall pass the Texas Pharmacy Jurisprudence Examination and the NAPLEX. The examination requirements shall be as follows:

(1) Prior to taking the required examination, the applicant shall:

(A) except as provided in paragraph (3) of this section, meet the educational and age requirements as set forth in §283.3 of this title (relating to Educational and Age Requirements);

(B) meet all requirements necessary in order for the Board to access the criminal history record information, including submitting fingerprint information and being responsible for all associated costs; and

(i) name;

(ii) addresses, phone numbers, date of birth, and social security number; and

(iii) any other information requested on the application.

(2) All applicants shall pass NAPLEX, which includes, at a minimum, the following subject areas:

(A) chemistry;

(B) mathematics;

(D) pharmacology; and

(E) practice of pharmacy.

(3) An applicant who has completed the three didactic years of pharmacy education (i.e., P1 through P3 years) may take the Texas Pharmacy Jurisprudence Examination a maximum of one time prior to graduation from a college/school of pharmacy [~~Effective October 1, 1979, the following requirements apply~~].

[(A) To pass NAPLEX, an applicant shall make the following grades:]

[(i) a minimum grade of 60 on chemistry, mathematics, pharmacy, and pharmacology test;]

[(ii) a minimum grade of 75 on the practice of pharmacy test; and]

[(iii) a minimum average grade of 75 on the NAPLEX.]

[(B) Should the applicant fail to achieve a minimum grade of 60 in any of the tests set out in paragraph (2)(A) - (E) of this section or fail to achieve a minimum grade of 75 in the practice of pharmacy test or fail to achieve a minimum average grade of 75 in the NAPLEX, such applicant, in order to be licensed, is required to retake all tests until such time as the minimum average grades are achieved.]

(4) The [~~Effective June 1, 1986, the~~] following examination requirements apply.

(A) To pass the NAPLEX, an applicant shall make a minimum scaled score [~~average grade~~] of 75.

(B) Should the applicant fail to achieve a minimum scaled score [~~average grade~~] of 75 in the NAPLEX, such applicant, in order to be licensed, shall retake the NAPLEX, as specified in §283.11 of this title (relating to Examination Retake Requirements) until such time as a minimum scaled score [~~average grade~~] of 75 is achieved.

(5) To pass the Texas Pharmacy Jurisprudence Examination, an applicant shall make a minimum grade of 75. Should the applicant fail to achieve a minimum grade of 75 on the Texas Pharmacy Jurisprudence Examination, such applicant, in order to be licensed, shall retake the Texas Pharmacy Jurisprudence Examination as specified in §283.11 of this title until such time as a minimum average grade of 75 is achieved.

(6) A passing grade on an examination may be used for the purpose of licensure for a period of two years from the date of passing the examination.

(7) Each applicant for licensure by examination utilizing NAPLEX scores transferred from another state shall meet the following requirements for licensure in addition to the requirements set out in paragraphs (1) - (6) of this section.

(A) The applicant shall request NABP to transfer NAPLEX scores to the board. Such request shall be in accordance with NABP policy.

(B) The applicant shall pay the fee set out in §283.9 of this title.

(8) The NAPLEX and Texas Pharmacy Jurisprudence Examination shall be administered in compliance with the Americans with Disabilities Act of 1990 (42 U.S.C. Section 12101 et seq.) and in accordance with NABP policy.

(9) The board, in accordance with NABP policy, shall provide reasonable accommodations for an applicant diagnosed as having dyslexia, as defined in §51.970, Texas Education Code. The applicant shall provide:

(A) written documentation from a licensed physician which indicates that the applicant has been diagnosed as having dyslexia; and

(B) a written request outlining the reasonable accommodations requested.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on June 9, 2026.

TRD-202602340

Daniel Carroll, Pharm.D.

Executive Director

Texas State Board of Pharmacy

Earliest possible date of adoption: July 26, 2026

For further information, please call: (512) 305-8084

CHAPTER 291. PHARMACIES

SUBCHAPTER A. ALL CLASSES OF PHARMACIES

22 TAC §291.3

The Texas State Board of Pharmacy proposes amendments to §291.3, concerning Required Notifications. The amendments, if adopted, clarify the meaning of a "fire, flood, or natural disaster" for purposes of required notification to the board, cross-reference an existing notification requirement, and update terminology in accordance with House Bill 1500.

Daniel Carroll, Pharm.D., Executive Director/Secretary, has determined that, for the first five-year period the rules are in effect, there will be no fiscal implications for state or local government as a result of enforcing or administering the rule. Dr. Carroll has determined that, for each year of the first five-year period the rule will be in effect, the public benefit anticipated as a result of enforcing the amendments will be clear and correct regulatory language that more accurately reflects the Board's requirements for the continuous operation of a pharmacy. There is no anticipated adverse economic impact on large, small or micro-businesses (pharmacies), rural communities, or local or state employment. Therefore, an economic impact statement and regulatory flexibility analysis are not required.

For each year of the first five years the proposed amendments will be in effect, Dr. Carroll has determined the following:

(1) The proposed amendments do not create or eliminate a government program;

(2) Implementation of the proposed amendments does not require the creation of new employee positions or the elimination of existing employee positions;

(3) Implementation of the proposed amendments does not require an increase or decrease in the future legislative appropriations to the agency;

(4) The proposed amendments do not require an increase or decrease in fees paid to the agency;

(5) The proposed amendments do not create a new regulation;

(6) The proposed amendments both limit and expand an existing regulation by clarifying the circumstances and required notification for a pharmacy to discontinue operations for longer than 30 days;

(7) The proposed amendments do not increase or decrease the number of individuals subject to the rule's applicability; and

(8) The proposed amendments do not positively or adversely affect this state's economy.

The statutes affected by these amendments: Texas Pharmacy Act, Chapters 551 - 569, Texas Occupations Code.

§ 291.3. Required Notifications.

(a) Change of Location.

(1) When a pharmacy changes location, the following is applicable:

(A) A new completed pharmacy application containing the information outlined in §291.1 of this title (relating to Pharmacy License Application) must be filed with the board not later than 30 days before the date of the change of location of the pharmacy;

(B) An amended license reflecting the new location of the pharmacy will be issued by the board; and

(C) A fee as specified in §291.6 of this title (relating to Pharmacy License Fees) will be charged for processing the application for change of location.

(2) At least 14 days prior to the change of location of a pharmacy that dispenses prescription drug orders, the pharmacist-in-charge shall post a sign in a conspicuous place indicating that the pharmacy is changing locations. Such sign shall be in the front of the prescription department and at all public entrance doors to the pharmacy and shall indicate the date the pharmacy is changing locations.

(3) Disasters, accidents, and emergencies which require the pharmacy to change location shall be immediately reported to the board. If a pharmacy changes location suddenly due to disasters, accidents, or other emergency circumstances and the pharmacist-in-charge cannot provide notification 14 days prior to the change of location, the pharmacist-in-charge shall comply with the provisions of paragraph (2) of this subsection as far in advance of the change of location as allowed by the circumstances.

(4) When a Class A-S, C-S, or E-S pharmacy changes location, the pharmacy's classification will revert to a Class A, Class C, or Class E unless or until the board or its designee has inspected the new location to ensure the pharmacy meets the requirements as specified in §291.133 of this title (relating to Pharmacies Compounding Sterile Preparations).

(5) When a Class B pharmacy changes location, the board shall inspect the pharmacy at the new location to ensure the pharmacy meets the requirements as specified in subchapter C of this title (relating to Nuclear Pharmacy (Class B)) prior to the pharmacy becoming operational.

(b) Change of Name. When a pharmacy changes its name, the following is applicable:

(1) A new completed pharmacy application containing the information outlined in §291.1 of this title (relating to Pharmacy License Application) must be filed with the board within 10 days of the change of name of the pharmacy;

(2) An amended license reflecting the new name of the pharmacy will be issued by the board; and

(3) A fee as specified in §291.6 of this title (relating to Pharmacy License Fees) will be charged for processing the application for change of name.

(1) The owner of a pharmacy shall notify the board in writing within 10 days of a change of any managing officer of a partnership or corporation which owns a pharmacy. The written notification shall include the effective date of such change, an updated sworn disclosure statement as required by §560.052(b) of the Act and as specified in §291.4 of this title (relating to Sworn Disclosure Statement), and the following information for all managing officers:

(A) name and title;

(B) home address and telephone number;

(D) a copy of social security card or other official document showing the social security number as approved by the board; and

(E) a copy of current driver's license, state issued photo identification card, or passport.

(2) For purposes of this subsection, managing officers are defined as the top four executive officers, including the corporate officer in charge of pharmacy operations, who are designated by the partnership or corporation to be jointly responsible for the legal operation of the pharmacy.

(d) Change of Ownership.

(1) When a pharmacy changes ownership, a new pharmacy application must be filed with the board following the procedures as specified in §291.1 of this title (relating to Pharmacy License Application), including, as required by §560.052(b) of the Act, the submission of a sworn disclosure statement as specified in §291.4 of this title (relating to Sworn Disclosure Statement). In addition, a copy of the purchase contract or mutual agreement between the buyer and seller must be submitted.

(2) A fee as specified in §291.6 of this title will be charged for issuance of a new license.

(e) Change of Pharmacist Employment.

(1) Change of pharmacist employed in a pharmacy. When a change in pharmacist employment occurs, the pharmacist shall report such change in writing to the board within 10 days.

(2) Change of pharmacist-in-charge of a pharmacy. The incoming pharmacist-in-charge shall be responsible for notifying the board within 10 days in writing on a form provided by the board that a change of pharmacist-in-charge has occurred. The notification shall include the following:

(A) the name and license number of the departing pharmacist-in-charge;

(B) the name and license number of the incoming pharmacist-in-charge;

(D) a statement signed by the incoming pharmacist-in-charge attesting that:

(i) an inventory, as specified in §291.17 of this title (relating to Inventory Requirements), has been conducted by the departing and incoming pharmacists-in-charge; if the inventory was not taken by both pharmacists, the statement shall provide an explanation; and

(ii) the incoming pharmacist-in-charge has read and understands the laws and rules relating to this class of pharmacy.

(f) Notification of Theft or Loss of a Controlled Substance or a Dangerous Drug.

(1) Controlled substances. For the purposes of the Act, §562.106, the theft or significant loss of any controlled substance by a pharmacy shall be reported in writing to the board immediately on discovery of such theft or loss. A pharmacy shall be in compliance with this subsection by submitting to the board a copy of the Drug Enforcement Administration (DEA) report of theft or loss of controlled substances, DEA Form 106, or by submitting a list of all controlled substances stolen or lost.

(2) Dangerous drugs. A pharmacy shall report in writing to the board immediately on discovery the theft or significant loss of any dangerous drug by submitting a list of the name and quantity of all dangerous drugs stolen or lost.

(g) Fire, Flood, or Natural [~~Other~~] Disaster. If a pharmacy experiences a fire, flood, or natural [~~other~~] disaster that may have affected the strength, purity, or labeling of drugs, medications, devices, or other materials used in the diagnosis or the treatment of injury, illness, and disease, the following requirements are applicable.

(1) Responsibilities of the pharmacist-in-charge.

(A) The pharmacist-in-charge shall be responsible for reporting the date of the fire, flood or natural [~~other~~] disaster to the board [which may affect the strength, purity, or labeling of drugs, medications, devices, or other materials used in the diagnosis or the treatment of injury, illness, and disease; such notification shall be reported to the board,] within 10 days from the date of the fire, flood, or natural disaster.

(B) The pharmacist-in-charge or designated agent shall comply with the following procedures.

(i) If controlled substances, dangerous drugs, or Drug Enforcement Administration (DEA) order forms are lost or destroyed in the disaster, the pharmacy shall:

(I) notify the DEA and the board of the loss of the controlled substances or order forms immediately upon discovery; and

(II) notify the board in writing of the loss of the dangerous drugs by submitting a list of the dangerous drugs lost.

(ii) If the extent of the loss of controlled substances or dangerous drugs is not able to be determined, the pharmacy shall:

(I) take a new, complete inventory of all remaining drugs specified in §291.17(c) of this title (relating to Inventory Requirements);

(II) submit to the DEA a statement attesting that the loss of controlled substances is indeterminable and that a new, complete inventory of all remaining controlled substances was conducted and state the date of such inventory; and

(III) submit to the board a statement attesting that the loss of controlled substances and dangerous drugs is indeterminable and that a new, complete inventory of the drugs specified in §291.17(c) of this title was conducted and state the date of such inventory.

(C) If the pharmacy changes to a new, permanent location, the pharmacist-in-charge shall comply with subsection (a) of this section.

(D) If the pharmacy moves to a temporary location, the pharmacist shall comply with subsection (a) of this section. If the pharmacy returns to the original location, the pharmacist-in-charge shall again comply with subsection (a) of this section.

(E) If the pharmacy closes due to a fire, flood, or natural [~~other~~] disaster[,] and timely notifies the board under subparagraph (A) of this paragraph, the pharmacy may [~~not~~] be closed for not longer than 90 days [~~as specified in §291.11 of this title (relating to Operation of a Pharmacy)~~].

(F) If the pharmacy discontinues business (ceases to operate as a pharmacy), the pharmacist-in-charge shall comply with §291.5 of this title (relating to Closing a Pharmacy).

(G) The pharmacist-in-charge shall maintain copies of all inventories, reports, or notifications required by this section for a period of two years.

(2) Drug stock.

(A) Any drug which has been exposed to excessive heat, smoke, moisture, or other conditions which may have caused deterioration shall not be dispensed.

(B) Any potentially adulterated or damaged drug shall only be sold, transferred, or otherwise distributed pursuant to the provisions of the Texas Food Drug and Cosmetics Act (Chapter 431, Health and Safety Code) administered by the Bureau of Food and Drug Safety of the Texas Department of State Health Services.

(h) Notification to Consumers.

(1) Pharmacy.

(A) Every licensed pharmacy shall provide notification to consumers of the name, mailing address, Internet site address, and telephone number of the board for the purpose of directing complaints concerning the practice of pharmacy to the board. Such notification shall be provided as follows.

(i) If the pharmacy serves walk-in customers, the pharmacy shall either:

(I) post in a prominent place that is in clear public view where prescription drugs are dispensed:

(-a-) a sign which notifies the consumer that complaints concerning the practice of pharmacy may be filed with the board and list the board's name, mailing address, Internet site address, telephone number, and a toll-free telephone number for filing complaints; or

(-b-) an electronic messaging system in a type size no smaller than ten-point Times Roman which notifies the consumer that complaints concerning the practice of pharmacy may be filed with the board and list the board's name, mailing address, Internet site address, telephone number, and a toll-free number for filing complaints; or

(II) provide with each dispensed prescription a written notification in a type size no smaller than ten-point Times Roman which states the following: "Complaints concerning the practice of pharmacy may be filed with the Texas State Board of Pharmacy at: (list the mailing address, Internet site address, telephone number of the board, and a toll-free telephone number for filing complaints)."

(ii) If the prescription drug order is delivered to patients at their residence or other designated location, the pharmacy shall provide with each dispensed prescription a written notification in type size no smaller than ten-point Times Roman which states the following: "Complaints concerning the practice of pharmacy may be filed with the Texas State Board of Pharmacy at: (list the mailing address, Internet site address, telephone number, and a toll-free telephone number for filing complaints)." If multiple prescriptions are delivered to the same location, only one such notice shall be required.

(iii) The provisions of this subsection do not apply to prescriptions for patients in facilities where drugs are administered to patients by a person required to do so by the laws of the state (i.e., nursing homes).

(B) A pharmacy that maintains a generally accessible site on the Internet that is located in Texas or sells or distributes drugs through this site to residents of this state shall post the following information on the pharmacy's initial home page and on the page where a sale of prescription drugs occurs.

(i) Information on the ownership of the pharmacy, to include at a minimum, the:

(I) owner's name or if the owner is a partnership or corporation, the partnership's or corporation's name and the name of the chief operating officer;

(II) owner's address;

(III) owner's telephone number; and

(IV) year the owner began operating pharmacies in the United States.

(ii) The Internet address and toll free telephone number that a consumer may use to:

(I) report medication/device problems to the pharmacy; and

(II) report business compliance problems.

(iii) Information about each pharmacy that dispenses prescriptions for this site, to include at a minimum, the:

(I) pharmacy's name, address, and telephone number;

(II) name of the pharmacist responsible for operation of the pharmacy;

(III) Texas pharmacy license number for the pharmacy and a link to the Internet site maintained by the Texas State Board of Pharmacy; and

(IV) the names of all other states in which the pharmacy is licensed, the license number in that state, and a link to the Internet site of the entity that regulates pharmacies in that state, if available.

(C) A pharmacy whose Internet site has been verified by the National Association of Boards of Pharmacy to be in compliance with the laws of this state, as well as in all other states in which the pharmacy is licensed shall be in compliance with subparagraph (B) of this paragraph.

(2) Texas State Board of Pharmacy. The [~~On or before January 1, 2005, the~~] board shall establish a pharmacy profile system as specified in §2054.2606, Government Code.

(A) The board shall make the pharmacy profiles available to the public on the agency's Internet site.

(B) A pharmacy profile shall contain at least the following information:

(i) name, address, and telephone number of the pharmacy;

(ii) pharmacy license number, licensure status, and expiration date of the license;

(iii) the class and type of the pharmacy;

(iv) ownership information for the pharmacy;

(v) names and license numbers of all pharmacists working at the pharmacy;

(vi) whether the pharmacy has had prior disciplinary action by the board;

(vii) whether the pharmacy's consumer service areas are accessible to persons with disabilities [~~disabled persons~~], as defined by law;

(viii) the type of language translating services, including translating services for persons who are deaf or hard [~~with impairment~~] of hearing, that the pharmacy provides for consumers; and

(ix) insurance information including whether the pharmacy participates in the state Medicaid program.

(C) The board shall gather this information on initial licensing and update the information in conjunction with the license renewal for the pharmacy.

(i) Notification of Licensees or Registrants Obtaining Controlled Substances or Dangerous Drugs by Forged Prescriptions. If a licensee or registrant obtains controlled substances or dangerous drugs from a pharmacy by means of a forged prescription, the pharmacy shall report in writing to the board immediately on discovery of such forgery. A pharmacy shall be in compliance with this subsection by submitting to the board the following:

(1) name of licensee or registrant obtaining controlled substances or dangerous drugs by forged prescription;

(2) date(s) of forged prescription(s);

(3) name(s) and amount(s) of drug(s); and

(4) copies of forged prescriptions.

(j) Notification of Disciplinary Action. For the purpose of the Act, §562.106, a pharmacy shall report in writing to the board not later than the 10th day after the date of:

(1) a final order against the pharmacy license holder by the regulatory or licensing agency of the state in which the pharmacy is located if the pharmacy is located in another state; or

(2) a final order against a pharmacist who is designated as the pharmacist-in-charge of the pharmacy by the regulatory or licensing agency of the state in which the pharmacy is located if the pharmacy is located in another state.

(k) Temporary Closing for Loss of Pharmacist-in-Charge. A pharmacy that temporarily closes for loss of a pharmacist-in-charge as provided by §291.5(d)(2) of this title shall notify the board in writing on a form provided by the board. The pharmacy shall submit the notification not later than the next business day after the date of departure of the pharmacist-in-charge.

(l) Loss of Data. As provided by §§291.34(e), 291.55(a), 291.75(c), 291.104(a), and 291.151(e) of this title (relating to Records; Records; Records; Operational Standards; Pharmacies Located in a Freestanding Emergency Medical Care Facility (Class F)), when a Class A, Class B, Class C, Class E, or Class F pharmacy experiences a significant loss of information from its data processing system, the pharmacist-in-charge shall report the loss to the board in writing within 10 days of discovery of the loss.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on June 9, 2026.

TRD-202602341

Daniel Carroll, Pharm.D.

Executive Director

Texas State Board of Pharmacy

Earliest possible date of adoption: July 26, 2026

For further information, please call: (512) 305-8084

22 TAC §291.11

The Texas State Board of Pharmacy proposes amendments to §291.11, concerning Operation of a Pharmacy. The amendments, if adopted, clarify that a pharmacy may not discontinue operating for a period of 30 days or longer unless the pharmacy has timely notified the board of a fire, flood, or natural disaster.

Daniel Carroll, Pharm.D., Executive Director/Secretary, has determined that, for the first five-year period the rules are in effect, there will be no fiscal implications for state or local government as a result of enforcing or administering the rule. Dr. Carroll has determined that, for each year of the first five-year period the rule will be in effect, the public benefit anticipated as a result of enforcing the amendments will be clear and correct regulatory language that more accurately reflects the Board's requirements for the continuous operation of a pharmacy. There is no anticipated adverse economic impact on large, small or micro-businesses (pharmacies), rural communities, or local or state employment. Therefore, an economic impact statement and regulatory flexibility analysis are not required.

For each year of the first five years the proposed amendments will be in effect, Dr. Carroll has determined the following:

(1) The proposed amendments do not create or eliminate a government program;

(2) Implementation of the proposed amendments does not require the creation of new employee positions or the elimination of existing employee positions;

(3) Implementation of the proposed amendments does not require an increase or decrease in the future legislative appropriations to the agency;

(4) The proposed amendments do not require an increase or decrease in fees paid to the agency;

(5) The proposed amendments do not create a new regulation;

(6) The proposed amendments both limit and expand an existing regulation by clarifying the circumstances and required notification for a pharmacy to discontinue operations for longer than 30 days;

(7) The proposed amendments do not increase or decrease the number of individuals subject to the rule's applicability; and

(8) The proposed amendments do not positively or adversely affect this state's economy.

The statutes affected by these amendments: Texas Pharmacy Act, Chapters 551 - 569, Texas Occupations Code.

§ 291.11. Operation of a Pharmacy.

(a) For the purposes of §565.002(a)(7) of the Texas Pharmacy Act, the following words and terms shall be defined as follows.

(1) "Failure to engage in the business described in the application for a license" means the holder of a pharmacy license has not commenced operating the pharmacy within six months of the date of issuance of the license.

(2) "Ceased to engage in the business described in the application for a license" means the holder of a pharmacy license, once it has been in operation, discontinues operating the pharmacy for a period of 30 days or longer, except as provided in paragraph (3) of this subsection [~~unless the pharmacy experiences a fire or disaster, in which case the pharmacy must comply with §291.3(g) of this title (relating to Required Notifications)~~].

(3) A pharmacy may discontinue operating for not longer than 90 days if the pharmacy experiences a fire, flood, or natural disaster that may have affected the strength, purity, or labeling of drugs, medications, devices, or other materials used in the diagnosis or the treatment of injury, illness, and disease and timely notifies the board under §291.3(g) of this title (relating to Required Notifications).

(b) For the purposes of this section, the term "operating the pharmacy" means the pharmacy shall demonstrate observable pharmacy business activity on a regular, routine basis, including a sufficient number of transactions of receiving, processing, or dispensing prescription drug orders or medication drug orders.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on June 9, 2026.

TRD-202602342

Daniel Carroll, Pharm.D.

Executive Director

Texas State Board of Pharmacy

Earliest possible date of adoption: July 26, 2026

For further information, please call: (512) 305-8084

22 TAC §291.13

The Texas State Board of Pharmacy proposes new rule §291.13, concerning Telehealth Services Provided by a Pharmacist. The new rule, if adopted, establishes the documentation and retention requirements regarding a patient's consent to treatment, data collection, and data sharing for telehealth services provided by a pharmacist, in accordance with House Bill 1700.

Daniel Carroll, Pharm.D., R.Ph., Executive Director/Secretary, has determined that, for the first five-year period the rule is in effect, there will be no fiscal implications for state or local government as a result of enforcing or administering the rule. Dr. Carroll has determined that, for each year of the first five-year period the rule will be in effect, the public benefit anticipated as a result of enforcing the rule will be to provide consistency between state law and Board rules regarding the recordkeeping and retention requirements for telehealth services provided by a pharmacist. There is no anticipated adverse economic impact on large, small or micro-businesses (pharmacies), rural communities, or local or state employment. Therefore, an economic impact statement and regulatory flexibility analysis are not required.

For each year of the first five years the proposed rule will be in effect, Dr. Carroll has determined the following:

(1) The proposed rule does not create or eliminate a government program;

(2) Implementation of the proposed rule does not require the creation of new employee positions or the elimination of existing employee positions;

(3) Implementation of the proposed rule does not require an increase or decrease in the future legislative appropriations to the agency;

(4) The proposed rule does not require an increase or decrease in fees paid to the agency;

(5) The proposed rule does create a new regulation concerning telehealth services provided by a pharmacist in order to comply with state law;

(6) The proposed rule does not limit or expand an existing regulation;

(7) The proposed rule does not increase or decrease the number of individuals subject to the rule's applicability; and

(8) The proposed rule does not positively or adversely affect this state's economy because the proposed rule would have a de minimis impact on the economy.

The Board is requesting public comments on the proposed rule and information related to the cost, benefit, or effect of the proposed rule, including any applicable data, research, or analysis. Any information that is submitted in response to this request must include an explanation of how and why the submitted information is specific to the proposed rule.

Written comments on the proposed rule may be submitted to Eamon D. Briggs, Deputy General Counsel, Texas State Board of Pharmacy, 1801 Congress Avenue, Suite 13.100, Austin, Texas 78701-1319, FAX (512) 305-8061. The deadline for comments is 30 days after publication in the Texas Register.

The new rule is proposed under §§551.002 and 554.051 of the Texas Pharmacy Act (Chapters 551 - 569, Texas Occupations Code). The Board interprets §551.002 as authorizing the agency to protect the public through the effective control and regulation of the practice of pharmacy. The Board interprets §554.051(a) as authorizing the agency to adopt rules for the proper administration and enforcement of the Act.

The statutes affected by the proposed rule: Texas Pharmacy Act, Chapters 551 - 569, Texas Occupations Code.

§ 291.13. Telehealth Services Provided by a Pharmacist.

(a) "Telehealth service" shall have the meaning defined by Texas Occupations Code §111.001(3).

(b) The requirements of subsection (c) of this section apply to a telehealth service regardless of whether the patient interaction occurs in a video or audio-only format.

(c) A pharmacist who provides a telehealth service shall ensure that the informed consent of the patient, or of another individual authorized to make health care treatment decisions for the patient, is obtained before the telehealth service is provided. The informed consent may be obtained either in writing or verbally.

(1) The informed consent shall include the patient's consent to:

(A) treatment;

(B) data collection; and

(2) The informed consent shall be documented in:

(A) the pharmacy's data processing system;

(B) an electronic logbook; or

(3) If obtained verbally, the informed consent shall be documented by recording the initials or identification code of the pharmacist or agent who obtained the consent.

(4) Documentation of informed consent shall be:

(A) kept by the pharmacy at the pharmacy's licensed location and be available, for at least two years from the date of such record, for inspection and copying by the board or its representative and to other authorized local, state, or federal law enforcement agencies; and

(B) supplied by the pharmacy within 72 hours, if requested by an authorized agent of the board. Failure to provide the records, either on site or within 72 hours, constitutes prima facie evidence of failure to keep and maintain records in violation of the Act.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on June 9, 2026.

TRD-202602343

Daniel Carroll, Pharm.D.

Executive Director

Texas State Board of Pharmacy

Earliest possible date of adoption: July 26, 2026

For further information, please call: (512) 305-8084

SUBCHAPTER C. NUCLEAR PHARMACY (CLASS B)

22 TAC §291.55

The Texas State Board of Pharmacy proposes amendments to §291.55, concerning Records. The amendments, if adopted, require the pharmacist-in-charge of a Class B pharmacy to notify the board of a significant loss of information from the pharmacy's data processing system.

Daniel Carroll, Pharm.D., Executive Director/Secretary, has determined that, for the first five-year period the rules are in effect, there will be no fiscal implications for state or local government as a result of enforcing or administering the rule. Dr. Carroll has determined that, for each year of the first five-year period the rule will be in effect, the public benefit anticipated as a result of enforcing the amendments will be improved assistance to individuals affected by data loss events and regulatory consistency across pharmacy classes. There is no anticipated adverse economic impact on large, small or micro-businesses (pharmacies), rural communities, or local or state employment. Therefore, an economic impact statement and regulatory flexibility analysis are not required.

For each year of the first five years the proposed amendments will be in effect, Dr. Carroll has determined the following:

(1) The proposed amendments do not create or eliminate a government program;

(2) Implementation of the proposed amendments does not require the creation of new employee positions or the elimination of existing employee positions;

(3) Implementation of the proposed amendments does not require an increase or decrease in the future legislative appropriations to the agency;

(4) The proposed amendments do not require an increase or decrease in fees paid to the agency;

(5) The proposed amendments do not create a new regulation;

(6) The proposed amendments do expand an existing regulation by adding a new notification requirement;

(7) The proposed amendments do not increase or decrease the number of individuals subject to the rule's applicability; and

(8) The proposed amendments do not positively or adversely affect this state's economy.

The statutes affected by these amendments: Texas Pharmacy Act, Chapters 551 - 569, Texas Occupations Code.

§ 291.55. Records.

(a) Maintenance of records.

(1) Every inventory or other record required to be kept under this section shall be:

(A) kept by the pharmacy and be available, for at least two years from the date of such inventory or record, for inspecting and copying by the board or its representative, and other authorized local, state, or federal law enforcement agencies; and

(B) supplied by the pharmacy within 72 hours, if requested by an authorized agent of the board. If the pharmacy maintains the records in an electronic format, the requested records must be provided in a mutually agreeable electronic format it specifically requested by the board or its representative. Failure to provide the records set out in this subsection, either on site or within 72 hours, constitutes prima facie evidence of failure to keep and maintain records in violation of the Act.

(2) Records of controlled substances listed in Schedules I and II shall be maintained separately from all other records of the pharmacy.

(3) Records of controlled substances, other than original prescription drug orders, listed in Schedules III - V shall be maintained separately or readily retrievable from all other records of the pharmacy. For purposes of this subsection, "readily retrievable" means that the controlled substances shall be asterisked, red-lined, or in some other manner readily identifiable apart from all other items appearing on the record.

(4) Records, except when specifically required to be maintained in original or hard copy form, may be maintained in an alternative data retention system, such as a data processing system or direct imaging system provided:

(A) the records maintained in the alternative system contain all of the information required on the manual record; and

(B) the data processing system is capable of producing a hard copy of the record upon request of the board, its representative, or other authorized local, state, or federal law enforcement or regulatory agencies.

(5) Loss of data. The pharmacist-in-charge shall report to the board in writing any significant loss of information from the pharmacy's data processing system within 10 days of discovery of the loss.

(b) Prescriptions.

(1) Professional responsibility. Pharmacists shall exercise sound professional judgment with respect to the accuracy and authenticity of any radioactive prescription drug order they dispense. If the pharmacist questions the accuracy or authenticity of a radioactive prescription drug order, he/she shall verify the order with the practitioner prior to dispensing.

(2) Oral radioactive prescription drug orders.

(A) Only a pharmacist may receive an oral prescription drug order for a controlled substance. Only an authorized nuclear pharmacist, or a pharmacist-intern or pharmacy technician under the direct supervision of an authorized nuclear pharmacist, may receive from a practitioner or a practitioner's designated agent:

(i) an oral therapeutic prescription drug order; or

(ii) an oral diagnostic prescription drug order in instances where patient specificity is required for patient safety (e.g., radiolabeled blood products, radiolabeled antibodies).

(B) A practitioner shall designate in writing the name of each agent authorized by the practitioner to communicate prescriptions orally for the practitioner. The practitioner shall maintain at the practitioner's usual place of business a list of the designated agents. The practitioner shall provide a pharmacist with a copy of the practitioner's written authorization for a specific agent on the pharmacist's request.

(C) A pharmacist may not dispense an oral radioactive prescription drug order for a dangerous drug or a controlled substance issued by a practitioner licensed in the Dominion of Canada or the United Mexican States unless the practitioner is also licensed in Texas.

(3) Radioactive prescription drug orders issued by practitioners in another state.

(A) Dangerous drug prescription orders. A pharmacist may dispense a radioactive prescription drug order for dangerous drugs issued by practitioners in a state other than Texas in the same manner as radioactive prescription drug orders for dangerous drugs issued by practitioners in Texas are dispensed.

(B) Controlled substance prescription drug orders. A pharmacist may dispense radioactive prescription drug orders for controlled substances in Schedule III, IV, or V issued by a practitioner in another state provided:

(i) the radioactive prescription drug order is written, oral, or telephonically or electronically communicated prescription as allowed by the DEA issued by a person practicing in another state and licensed by another state as a physician, dentist, veterinarian, or podiatrist, who has a current federal Drug Enforcement Administration registration number, and who may legally prescribe Schedule III, IV, or V controlled substances in such other state; and

(ii) the radioactive prescription drug order is not dispensed more than six months from the initial date of issuance.

(4) Radioactive prescription drug orders issued by practitioners in the United Mexican States or the Dominion of Canada.

(A) Controlled substance prescription drug orders. A pharmacist may not dispense a radioactive prescription drug order for a Schedule II, III, IV, or V controlled substance issued by a practitioner licensed in the Dominion of Canada or the United Mexican States.

(B) Dangerous drug prescription drug orders. A pharmacist may dispense a radioactive prescription drug order for a dangerous drug issued by a person licensed in the Dominion of Canada or the United Mexican States as a physician, dentist, veterinarian, or podiatrist provided the radioactive prescription drug order is an original written prescription.

(C) Prescription drug orders for Schedule II controlled substances. No Schedule II controlled substance may be dispensed without a written prescription drug order of a practitioner on an official prescription form as required by the Texas Controlled Substances Act, §481.075.

(5) Electronic radioactive prescription drug orders. For the purpose of this paragraph, electronic radioactive prescription drug orders shall be considered the same as oral radioactive prescription drug orders.

(A) An electronic radioactive prescription drug order may be transmitted by a practitioner or a practitioner's designated agent:

(i) directly to a pharmacy; or

(ii) through the use of a data communication device provided:

(I) the confidential prescription information is not altered during transmission; and

(II) confidential patient information is not accessed or maintained by the operator of the data communication device other than for legal purposes under federal and state law.

(B) A practitioner shall designate in writing the name of each agent authorized by the practitioner to electronically transmit prescriptions for the practitioner. The practitioner shall maintain at the practitioner's usual place of business a list of the designated agents. The practitioner shall provide a pharmacist with a copy of the practitioner's written authorization for a specific agent on the pharmacist's request.

(i) Schedule II controlled substance except as authorized in §481.075, Health and Safety Code; or

(ii) dangerous drug or controlled substance issued by a practitioner licensed in the Dominion of Canada or the United Mexican States unless the practitioner is also licensed in Texas.

(6) Original prescription drug order records.

(A) Original prescriptions shall be maintained and readily retrievable by the pharmacy and remain accessible for a period of two years from the date of filling.

(B) If an original prescription drug order is changed, such prescription order shall be invalid and of no further force and effect; if additional drugs are to be dispensed, a new prescription drug order with a new and separate number is required.

(i) in three separate files as follows:

(I) prescriptions for controlled substances listed in Schedule II;

(II) prescriptions for controlled substances listed in Schedules III - V; and

(III) prescriptions for dangerous drugs and nonprescription drugs; or

(ii) within a patient medication record system provided that original prescriptions for controlled substances are maintained separate from original prescriptions for noncontrolled substances and prescriptions for Schedule II controlled substances are maintained separate from all other original prescriptions.

(D) Original prescription records other than prescriptions for Schedule II controlled substances may be stored on microfilm, microfiche, or other system which is capable of producing a direct image of the original prescription record, e.g., a digitalized imaging system. If original prescription records are stored in a direct imaging system, the following is applicable:

(i) The original prescription records must be maintained and readily retrievable as specified in subparagraph (C) of this paragraph.

(ii) The pharmacy must provide immediate access to equipment necessary to render the records easily readable.

(7) Prescription drug order information.

(A) All original radioactive prescription drug orders shall bear:

(i) the name of the patient, if applicable at the time of the order;

(ii) the name of the institution;

(iii) the name, and if for a controlled substance, the address and DEA registration number of the practitioner;

(iv) the name of the radiopharmaceutical;

(v) the amount of radioactive material contained in millicuries (mCi), microcuries (uCi), or bequerels (Bq) and the corresponding time that applies to this activity, if different than the requested calibration date and time;

(vi) the date and time of calibration; and

(vii) the date of issuance.

(B) At the time of dispensing, a pharmacist is responsible for the addition of the following information to the original prescription:

(i) the unique identification number of the prescription drug order;

(ii) the initials or identification code of the person who compounded the sterile radiopharmaceutical and the pharmacist who checked and released the product unless maintained in a readily retrievable format;

(iii) the name, quantity, lot number, and expiration date of each product used in compounding the sterile radiopharmaceutical; and

(iv) the date of dispensing, if different from the date of issuance.

(8) Refills. A radioactive prescription drug order must be filled from an original prescription which may not be refilled.

(1) All nuclear pharmacies shall maintain a policy and procedure manual. The nuclear pharmacy policy and procedure manual is a compilation of written policy and procedure statements.

(2) A technical operations manual governing all nuclear pharmacy functions shall be prepared. It shall be continually revised to reflect changes in techniques, organizations, etc. All pharmacy personnel shall be familiar with the contents of the manual.

(3) The nuclear pharmacy policies and procedures manual shall be prepared by the pharmacist-in-charge with input from the affected personnel and from other involved staff and committees to govern procurement, preparation, distribution, storage, disposal, and control of all drugs used and the need for policies and procedures relative to procurement of multisource items, inventory, investigational drugs, and new drug applications.

(d) Other records. Other records to be maintained by a pharmacy:

(1) a permanent log of the initials or identification codes which identifies each dispensing pharmacist by name (the initials or identification codes shall be unique to ensure that each pharmacist can be identified, i.e., identical initials or identification codes shall not be used);

(2) copy 3 of DEA order forms (DEA 222) which have been properly dated, initialed, and filed, and all copies of each unaccepted or defective order form and any attached statements or other documents;

(3) a hard copy of the power of attorney to sign DEA 222 order forms (if applicable);

(4) suppliers' invoices of controlled substances; a pharmacist shall verify that the controlled drugs listed on the invoices were actually received by clearly recording his/her initials and the actual date of receipt of the controlled substances;

(5) suppliers' credit memos for controlled substances and dangerous drugs;

(6) a hard copy of inventories required by §291.17 of this title (relating to Inventory Requirements);

(7) hard copy reports of surrender or destruction of controlled substances and/or dangerous drugs to an appropriate state or federal agency;

(8) records of distribution of controlled substances and/or dangerous drugs to other pharmacies, practitioners, or registrants; and

(9) a hard copy of any notification required by the Texas Pharmacy Act or these sections, including, but not limited to, the following:

(A) reports of theft or significant loss of controlled substances to DEA and the board;

(B) notifications of a change in pharmacist-in-charge of a pharmacy; and

(C) reports of a fire or other disaster which may affect the strength, purity, or labeling of drugs, medications, devices, or other materials used in the diagnosis or treatment of injury, illness, and disease.

(e) Permission to maintain central records. Any pharmacy that uses a centralized recordkeeping system for invoices and financial data shall comply with the following procedures.

(1) Controlled substance records. Invoices and financial data for controlled substances may be maintained at a central location provided the following conditions are met.

(A) Prior to the initiation of central recordkeeping, the pharmacy submits written notification by registered or certified mail to the divisional director of DEA as required by the Code of Federal Regulations, Title 21, §1304.04(a), and submits a copy of this written notification to the board. Unless the registrant is informed by the divisional director of DEA that permission to keep central records is denied, the pharmacy may maintain central records commencing 14 days after receipt of notification by the divisional director.

(B) The pharmacy maintains a copy of the notification required in subparagraph (A) of this paragraph.

(C) The records to be maintained at the central record location shall not include executed DEA order forms, prescription drug orders, or controlled substance inventories, which shall be maintained at the pharmacy.

(2) Dangerous drug records. Invoices and financial data for dangerous drugs may be maintained at a central location.

(3) Access to records. If the records are kept on microfilm, computer media, or in any form requiring special equipment to render the records easily readable, the pharmacy shall provide access to such equipment with the records.

(4) Delivery of records. The pharmacy agrees to deliver all or any part of such records to the pharmacy location within two business days of written request of an authorized agent of the board or any other authorized official.

(5) Ownership of pharmacy records. For purposes of these sections, a pharmacy licensed under the Act is the only entity which may legally own and maintain prescription drug records.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on June 9, 2026.

TRD-202602344

Daniel Carroll, Pharm.D.

Executive Director

Texas State Board of Pharmacy

Earliest possible date of adoption: July 26, 2026

For further information, please call: (512) 305-8084