(a) APRNs should access and review the prescription monitoring program (PMP) authorized by Chapter 481, Health and Safety Code, prior to prescribing any controlled substance for patients being treated for pain.     
      (b) APRNs must access and review the PMP before prescribing opioids, benzodiazepines, barbiturates, or carisoprodol unless:      
        (1) the patient has been diagnosed with cancer or the patient is receiving hospice care; and       
        (2) the APRN clearly notes on the prescription or in the electronic prescription record that the patient was diagnosed with cancer or is receiving hospice care, as applicable.       
      (c) An APRN will not be subject to disciplinary action if the APRN:      
        (1) makes a good faith attempt to access and review the PMP prior to prescribing opioids, benzodiazepines, barbiturates, or carisoprodol, but is unable to access the information because of circumstances outside the control of the APRN; and       
        (2) clearly notes on the patient's prescription or in the patient's electronic prescription record the APRN's attempt to access and review the PMP and the circumstances that prevented the APRN from being able to do so.       
      (d) Documentation that the review of the PMP occurred and rationale for prescribing a controlled substance must be included in the patient's medical record.     
      (e) This section takes effect September 1, 2019.     
     Source Note:        The provisions of this §228.2 adopted to be effective September 1, 2019, 43 TexReg 7537