Summary of State Laws Regarding Controlled Substances Rx Privileges
Alabama
Alaska
A PA with a valid DEA registration number may order, administer, dispense, and write a prescription for a schedule II, III, IV, or V controlled substance only with the authorization of the PA's primary collaborating physician. The authorization must be documented in the PA's current collaborative plan on file with the division.
The PA's authority to prescribe may not exceed that of the primary collaborating physician as documented in the collaborative plan on file with the division.
A PA with a valid DEA registration number may request, receive, order, or procure schedule II, III, IV, or V controlled substance supplies from a pharmaceutical distributor, warehouse, or other entity only with the authorization of the physician assistant's primary collaborating physician. If granted this authority, the PA is responsible for complying with all state and federal inventory and record keeping requirements. The authorization must be documented in the PA's current collaborative plan on file with the division. Within 10 days after the date of issue on the form, the physician assistant shall provide to the primary collaborating physician a copy of each DEA Form 222 official order form used to obtain controlled substances.
A prescription must include the: primary collaborating physician's name, primary collaborating physician's DEA registration number, PA's name, and PA's DEA registration number.
12 Alaska Administrative Code 40.450
Arizona
PA may prescribe Schedule II-V controlled medications and non-controlled medications. Rx for Schedule II or III controlled substance limited to 72 hours. Schedules II and III not refillable without written consent of physician. Schedules IV and V may not be prescribed more than 5 times in a 6-month period for an individual patient. Prescription-only drugs shall not be prescribed, dispensed or refillable for a period exceeding 1 year.
PA may apply to board for certification to prescribe Schedule II or III medications for 14-day period. Certification requires 45 hours of pharmacology or clinical management of drug therapy in 3 years preceding application or current NCCPA certification. PAs who prescribe, dispense or administer controlled medications must register with the DEA. Board notifies pharmacy board of PAs approved to prescribe and dispense. Pharmacy board notifies pharmacies.
Arizona Revised Statutes §32-2531, §32-2532
Supervising physician must obtain board approval to delegate authority to prescribe, dispense or administer Schedule II or III controlled substances to PA. Physician and PA must submit application on board forms with information, including disciplinary information, if applicable, on physician and PA. Board may order evaluation of physician and PA as allowed by statute. Application must contain statements that both physician and PA will abide by all laws that govern prescribing, and that physician accepts responsibility for PA. Board shall approve applications that show appropriate training and experience of PA for prescribing Schedule II and III medications and professional record of appropriate prescribing. PA and supervising physician must be able to communicate in person or via telecommunication while PA is providing health care services.
Arizona Regulatory Board of Physician Assistants, R4-17-301
Arkansas
Supervising physicians may delegate prescriptive authority to PAs to include prescribing, ordering and administration of Schedule III-V controlled substances, all legend drugs, and all non-controlled prescription medications and medical devices. All prescriptions and orders issued by PA shall identify supervising physician. PA’s prescriptive authority may not exceed that of supervising physician. PAs who prescribe controlled substances must register with the DEA.
Arkansas Code Annotated 17-105-108
Supervising physician may authorize PA to prescribe Schedule III-V and non-controlled medications. Such authorization must be included in board-approved protocol. Physician may only delegate prescribing authority for those medications the physician is authorized to prescribe. Prescriptions must contain name of supervising physician.
Arkansas Medical Board Regulation 24(5)
California
PA may administer or provide medication to a patient or transmit orally, or in writing on a patient’s record or in a drug order, an order to a person who may lawfully furnish the medication or medical device. Such authority may be limited by the supervising physician. Supervising physician who delegates authority to issue a drug order must adopt a practice-specific formulary and protocols that specify criteria for the use of a particular drug or device and contraindications. Formulary and quantitative limitations must be appropriate for type of practice of supervising physician. Schedule II-V medications administered, provided or for which a drug order is issued require patient-specific order from the supervising physician. Written drug order shall contain name, address and phone number of the supervising physician, and the name and license number of the physician assistant. Written drug order for controlled medications (except those orders written in a patient chart in a health facility) must include PA’s DEA registration number. Medical record of patient receiving Schedule II medication must be countersigned by supervising physician within 7 days.
Annotated Code of California, Business and Professions Chapter 7.7, §3502.1
Colorado
Physician may delegate authority to prescribe medication, including controlled substances, and dispense only such drugs as designated by the board. Such act shall be consistent with sound medical practice. Each prescription issued by PA shall have the name of the supervising physician imprinted on it.
Colorado Revised Statutes, §12-36-106(5)(a)
PA may issue prescription for any drug or controlled substance provided that each prescription is entered on the patient’s chart, each prescription contains the name, address, and telephone number of the supervising physician and the name of the PA, and the prescription is signed by the PA. PA may not prescribe controlled medication without DEA registration.
Rules and Regulations for Certification of and Practice by Physician Assistants, Sec. 3
Connecticut
PA may be delegated the authority to prescribe and administer drugs, including Schedule II-V controlled substances, in all settings. Supervising physician must co-sign the order for Schedule II or III drugs within 1 calendar day.
Chapter 370, Connecticut General Statutes, §20-12d
Delaware
Prescriptive authority for therapeutic drugs and treatments must be delegated by a supervising physician and is specific to the practice of the supervising physician. PAs may prescribe legend drugs and Schedule II-V controlled substances, parenteral medications, medical therapeutics, devices and diagnostics. PAs who are delegated the ability to prescribe controlled substances must obtain a state controlled substances number and must register with the DEA. Prescriptions must include the printed or legibly handwritten names of both the PA and the supervising physician. Controlled prescriptions may not be written for amounts to exceed a 3 month supply and non-controlled prescriptions may not exceed a 6 month supply. Supervising physician must reevaluate the continued therapeutic needs before a refill that exceeds above restrictions can be issued.
Delaware Rules and Regulations, §25.3
District of Columbia
As delegated to do so by a supervising physician, physician assistants may order, prescribe, and dispense legend drugs and controlled substances enumerated in schedules II through V in D.C. Official Code § 48-902.01 et seq. Physician assistants authorized to prescribe and/or dispense controlled substances must register with the DEA.
District of Columbia Municipal Regulations, Title 17, § 4912.5
Florida
Physician Assistants are not authorized to prescribe controlled substances.
Georgia
Supervising physician may delegate authority to prescribe Schedule III-V controlled medications and all non-controlled drugs and devices. Such authority must be contained in approved job description. Prescription must contain name, address and telephone of supervising physician. Form must be signed by the PA using the language: “This prescription authorized through (supervising physician) by (PA), PHYSICIAN’S ASSISTANT.” PA must inform patients that they have the right to see the physician prior to prescription being issued. PA may not prescribe more than 30 day supply except in chronic illnesses where a 90 day supply may be ordered. PA may authorize refills up to 6 months from date of original prescription; 12 months for oral contraceptives or other drugs or devices approved by the board. Supervising physician must personally evaluate patients receiving prescription medications every 6 months; 3 months for patients receiving controlled substances. Copy of prescription must be maintained in patient’s medical record. Supervising physician to countersign prescription or medical record entry for prescription within 7 working days.
Georgia Code Annotated, §43-34-103
Physician assistants who are prescribers of controlled medications may register with the DEA.
Georgia Code Annotated, §16-13-21(23)(D)
PA may order or select a drug, including a dangerous drug or a controlled substance, or order medical treatment or diagnostic study in any health care setting, provided (1) authority is delegated by supervising physician in accordance with job description; (2) controlled substances (Schedules III-V and oral orders for Schedule II are authorized only in an emergency) are selected from a board-approved formulary.
Rules of the Composite State Board of Medical Examiners, Chapter 360-5 Amended “Physician’s Assistants,” §360-5-.07
Hawaii
Prescriptions written by PAs must include printed, stamped, typed or hand-printed name, address, and phone number of both supervising physician and PA and shall be signed by the PA. Prescriptions for controlled substances must contain physician’s DEA number and PA’s DEA number. Medical record of controlled substance prescription must be reviewed and initialed by the supervising physician within 7 working days.
Hawaii Revised Statutes, §329-38
Supervising physician is authorized to allow PA to prescribe, dispense and administer medical devices subject to following:
Idaho
PA may issue written or oral prescriptions for legend drugs and controlled medications in Schedules II-V in accordance with board authorization and delegation of services agreement with supervising physician. Prescribing must be consistent with supervising physician’s regular prescriptive practice. PA must apply to board for prescription writing authority. Application must include documentation of pharmacology courses (at least 30 hours required), statement of frequency with which physician will review prescriptions, statement from supervising physician indicating PA’s qualifications. PA who is authorized to prescribe controlled medications must register with the DEA and Idaho Board of Pharmacy. Prescription forms must contain printed name, address and telephone number of PA and supervising physician.
IDAPA 22 Title 01 Chapter 03, Rules for the Licensure of PAs, §042
Illinois*
A supervising physician may delegate limited prescribing and dispensing authority to a PA. Authority may, but is not required to, include Schedule III-V controlled substances. PAs authorized to prescribe controlled medications are eligible to and must register for a mid-level practitioner controlled substances license under the Illinois Controlled Substances Act.
A supervising physician may delegate authority to a PA to prescribe Schedule II controlled substances, if all of the following conditions apply:
(A) No more than 5 Schedule II controlled substances by oral dosage may be delegated.
(B) Any delegation must be controlled substances that the supervising physician prescribes.
(C) Any prescription must be limited to no more than a 30-day oral dosage, with any continuation authorized only after prior approval of the supervising physician.
225 Illinois Compiled Statutes 95/7.5
Supervising physician may delegate limited prescriptive authority to PA to include prescribing and dispensing of legend drugs and Schedule III-V controlled substances. PAs who are delegated prescribers of controlled substances must obtain an Illinois mid-level practitioner controlled substances license. Supervising physician must file notice of delegation of prescriptive authority and termination of delegation with the department and must specify the authority delegated. Delegation must be appropriate to physician’s practice, within physician or alternate’s scope of practice, and within scope of PA’s training. Guidelines must be signed by physician and PA and include PA’s Illinois controlled substance license number and DEA number; copy to be maintained at each practice location. Name of supervising physician must appear on prescriptions written by PA.
Title 68: Chapter VII Department of Professional Regulation; Subchapter b: Professions and Occupations; Part 1350.55
*Authority for delegation of Schedule II controlled substances passed the Illinois legislature in 2009. Regulations required to implement this law have not yet been adopted.
Indiana
(a) Except as provided in this section, a physician assistant may prescribe, dispense, and administer drugs and medical devices or services to the extent delegated by the supervising physician.
(b) A physician assistant may not prescribe, dispense, or administer ophthalmic devices, including glasses, contact lenses, and low vision devices.
(c) As permitted by the board, a physician assistant may use or dispense only drugs prescribed or approved by the supervising physician. A physician assistant may not prescribe or dispense the
following drugs:
(1) A schedule I substance listed in IC 35-48-2-4.
(2) A schedule II substance listed in IC 35-48-2-6.
(3) A schedule III, schedule IV, or schedule V drug if the drug contains oxycodone.
However, a physician assistant may prescribe one (1) dose of a drug listed in subdivision (2) or (3) for immediate administration if the patient is in an inpatient hospital post-operative setting and the physician is unavailable to make the prescription.
PA Practice Act; IC 25-27.5-5-4 ; Sec. 4
(a) Except as provided in section 4(d) of this chapter, a supervising physician may delegate authority to a physician assistant to prescribe:
(1) legend drugs, except as provided in section 4(c) of this
chapter; and
(2) medical devices (except ophthalmic devices, including glasses, contact lenses, and low vision devices).
(b) Any prescribing authority delegated to a physician assistant must be expressly delegated in writing by the physician assistant's supervising physician, including:
(1) the name of the drug or drug classification being delegated by the supervising physician; and
(2) the protocols the physician assistant shall use when prescribing the drug.
(c) A physician assistant who is delegated the authority to prescribe legend drugs or medical devices must do the following:
(1) Enter the following on each prescription form that the physician assistant uses to prescribe a legend drug or medical device:
(A) The signature of the physician assistant.
(B) The initials indicating the credentials awarded to the physician assistant by the NCCPA.
(C) The physician assistant's state license number.
(2) Comply with all applicable state and federal laws concerning prescriptions for legend drugs and medical devices.
(d) A supervising physician may delegate to a physician assistant the authority to prescribe only legend drugs and medical devices that are within the scope of practice of the licensed supervising physician or the physician designee.
(e) A physician assistant who is delegated the authority to prescribe controlled substances under subsection (a), and in accordance with the limitations specified in section 4(c) of this chapter, must do the following:
(1) Obtain an Indiana controlled substance registration and a federal Drug Enforcement Administration registration.
(2) Enter the following on each prescription form that the physician assistant uses to prescribe a controlled substance:
(A) The signature of the physician assistant.
(B) The initials indicating the credentials awarded to the physician assistant by the NCCPA.
(C) The physician assistant's state license number.
(D) The physician assistant's federal Drug Enforcement Administration (DEA) number.
(3) Comply with all applicable state and federal laws concerning prescriptions for controlled substances.
(f) A supervising physician may only delegate to a physician assistant the authority to prescribe controlled substances:
(1) that may be prescribed within the scope of practice of the licensed supervising physician or the physician designee;
(2) in an amount that does not exceed:
(A) a seven (7) day supply for treatment of a single acute episode of a condition or injury; or
(B) if a controlled substance cannot be dispensed in an amount that is small enough to meet the requirement of clause (A), the smallest dispensable amount; and
(3) in accordance with the limitations set forth in section 4(c) of this chapter.
PA Practice Act; IC 25-27.5-5-6; Sec. 6.
Iowa
Physician may delegate to a licensed PA the function of prescribing drugs, controlled substances and medical devices. Physician’s name must be used, recorded or otherwise indicated so the individual who administers or dispenses the prescription knows under whose authority the PA is prescribing. Rules shall be adopted by the PA board after consultation with the medical and pharmacy boards and after review and approval by a special rules review group. The rules shall prohibit the prescribing of Schedule II controlled substances which are listed as depressants.
Iowa Code, §147.107.5
PA may prescribe drugs and medical devices and controlled substances (except Schedule II depressants) when such authority is delegated by supervising physician. Each written prescription shall contain date; patient name and address; name, strength and quantity of drug; name and address of PA and physician; PA’s signature. Any prescription for a controlled substance shall contain PA’s DEA number.
Iowa Administrative Code 645-327.6(147)
Kansas
In order to prescribe controlled substances, PA shall register with the DEA.
Kansas Statutes Annotated, Chapter 65, Article 28A, Physician Assistant Licensure Act, §65-28a08
PA may prescribe Schedule II-V and non-scheduled drugs as authorized by drugs prescription protocol contained in the physician request form. Schedule II drugs require a written prescription, except in an emergency. Written prescription must contain physician and PA’s name, address, telephone number; be signed by PA and contain his DEA number when prescription is for a controlled drug. Prescription must indicate whether prescribing is by direct order of physician, pursuant to written protocol, or because of an emergency situation.
KAR Article 28a, §100-28a-13
Kentucky
Physician Assistants are not authorized to prescribe controlled substances.
Louisiana
PA scope of practice includes prescribing certain drugs and medical devices to extent delegated by supervising physician provided PA has completed a minimum of one year of clinical rotations during training and has practiced for a minimum of one year. PAs may prescribe legend drugs and Schedule III-V controlled medications.
Louisiana Statutes §1360.31
Licensed PA may not prescribe medication unless registration for prescriptive authority has been approved by the board.
Louisiana Administrative Code, Title 46, Chapter 15 §1505
To be registered as prescribing PA, physician assistant must have completed a minimum of one year of clinical rotations during training and one year of practice under supervising physician or two years of practice. Prescribing must be as delegated by physician. PA and physician must practice under practice guidelines or protocols that must include methods of supervision, types of medication and medical devices that PA is delegated to prescribe and a plan for emergency services and referrals. PA who prescribes controlled medications must register with DEA. PA with history of drug violations or history of drug abuse ineligible for registration for authority to prescribe controlled drugs.
Louisiana Administrative Code, Title 46, Chapter 15 §1521
Supervising physician must apply and register for ability to delegate prescriptive authority. PA must apply for registration to prescribe. Physician who delegates prescriptive authority for controlled substances to PA may not be employee or independent contractor to PA. Board may waive this restriction. Registrations renewed annually.
Louisiana Administrative Code, Title 46, Chapter 15 §1523, 1525, 1527, 1529
PA may prescribe legend drugs and Schedule III-V substances and medical devices. PA may not complete and issue prescription blanks previously signed by physician.
Louisiana Administrative Code, Title 46, Chapter 45 §4505
PA who is registered as a prescriber may issue prescriptions for medication or medical devices to patient of supervising physician. Prescribing PA may request, receive, sign for and deliver to a patient a medication sample. Prescription written by PA must include preprinted name, address, telephone number and prescriptive authority registration number of PA. If prescription is for controlled substance, must contain PA’s DEA number. PA must prescribe within education and experience, within clinical practice guidelines and within the specialty of the supervising physician. PA may not utilize controlled substances to treat non-cancer intractable pain as defined, obesity as defined, or self or family except in life-threatening emergencies. PA may not dispense or deliver controlled substance sample.
Louisiana Administrative Code, Title 46, Chapter 45 §4506
Maine
Delegated duties may include prescribing and dispensing of drugs and devices to the extent permitted by state and federal law. Includes Schedule III through V substances and all legend drugs. PA and primary supervising physician may request individual consideration for authorization to prescribe Schedule II drugs under specific individual guidelines.
CMR 02, 373, Chapter 2, Physician Assistants, §6
Maryland
Physician may delegate prescribing of Schedule II-V and non-controlled medications to PA if:
Massachusetts
PAs may prescribe or order medications in accordance with written guidelines developed by PA and supervising physician. Guidelines to address frequency of reviews, identification of supervising physician(s), types and classes of medications to be prescribed by PA, plans for prescribing medications not ordinarily in scope of practice, quantities of medications to be prescribed by PA, ordering of medications from manufacturer, review of prescribing, procedures for initiating IV solutions. Guidelines to be signed by supervising physician and PA and renewed annually. Guidelines to be available to board. All prescribing to be in compliance with state and federal laws. Prescriptions or orders for Schedule II medications shall be reviewed by supervising physician within 96 hours. PA not to prescribe Schedules II-IV for self-use. PA not to prescribe Schedule II for immediate family member except in emergency.
Board of Physician Assistant Registration §5.07 (Identical language in 243 CMR 2.08)
Michigan
Supervising physician may delegate ability to prescribe controlled substances in Schedules III-V to PA. Physician must establish written authorization that includes information on physician and PA, limitations or exceptions to delegation and effective date. Copy of authorization must be maintained in each location where delegation occurs. Yearly update required. Delegation may include Schedule II medications if supervising physician and PA practice in a health facility, patient is located within the facility, and the prescription for Schedule II medications is issued for the discharge of patient. Limited to 7 day supply. Delegating physician shall not delegate the prescription of a drug or device individually, in combination, or in succession with the intent to terminate a pregnancy.
Michigan Task Force on PAs, R338.2304
Minnesota
A supervising physician may delegate to a PA the authority to prescribe and administer legend drugs and medical devices in compliance with provisions of pharmacy act. PAs authorized to prescribe controlled substances must maintain a separate addendum to delegation form that lists all schedules and categories PA may prescribe.
Delegated prescribing authorized only for registered PAs who are currently certified by NCCPA. The agreement between the PA and supervising physician(s) must include signed statement regarding delegation or non-delegation of prescribing and administering legend drugs and medical devices. Statement must include protocol indicating classes of drugs for which physician delegates prescriptive authority. PAs authorized to prescribe controlled medications must register with DEA. Physician must review PA prescribing weekly.
Minnesota Statute Chapter 147A, §147A.09 (2), §147A.18 (1)
Mississippi
PA shall practice according to board-approved protocol agreed upon by PA and supervising physician. Protocol to include categories of pharmacologic agents which may be ordered, administered, dispensed and/or prescribed. PAs may not prescribe or dispense controlled substance or any drug having addiction-forming or sustaining liability. PA may administer controlled medications pursuant to physician order and according to physician-PA protocol.
PA must apply to board for authority to prescribe controlled substances (Schedules II-V); must complete board approved educational program prior to application. PAs must comply with physician regulations on maintenance of records, use of diet medication, use of controlled substances for chronic pain and prescription guidelines. PAs who prescribe controlled medications must register with DEA.
Regulations Governing the Practice of Physician Assistants, XXII, D
Missouri*
Montana
PAs may prescribe, dispense, and administer drugs to the extent authorized by the supervising physician and by board rules, the utilization plan, or both. May include Schedule III-V, as well as 34-day supplies of Schedule II drugs. Records must be kept and Rx must comply with relevant pharmacy board requirements. PAs must register with the DEA.
Montana Code Annotated, §37-20-404
Nebraska
PA may prescribe drugs and devices as delegated to do so by supervising physician. Delegated authority may include legend drugs and devices and Schedules II-V controlled medications. Prescription container label must have names of both physician and PA. PAs with delegated prescriptive authority for controlled medications must register with the DEA.
Revised Statutes of Nebraska, §71-1,107.30
Nevada
PA may, if authorized by the board, possess, administer, prescribe or dispense controlled substances and may possess, administer, prescribe or dispense poisons, dangerous drugs and devices in or out of the presence of his supervising physician to the extent specified in the PA’s certificate. Pharmacy law exam required.
Each PA authorized to prescribe and dispense non-controlled substances or to prescribe or dispense controlled substances must apply for a registration certificate from the board of pharmacy. The pharmacy board shall adopt regulations controlling the maximum amount, storage, security, record keeping and transportation of such drugs and devices, taking into consideration the PA’s training and experience, practice location and population, distance to the nearest hospital and physician, etc.
Medical board and supervising physician shall limit the authority of PA to prescribe controlled substances to those schedules which supervising physician is authorized to prescribe.
Nevada Revised Statutes, Chapter 630, §639.1373, §630.271
License issued by board sets forth the controlled substances, poisons, dangerous drugs or devices which PA is authorized to possess, administer, prescribe or dispense and the area in which PA may possess controlled substances.
PA must apply for registration with pharmacy board in order to dispense controlled substances and to prescribe and dispense poisons, dangerous drugs and devices. Personal appearance with supervising physician may be required. Consultant pharmacist must submit signed statement. PA must pass pharmacy law exam.
Nevada Administrative Code, §630.330, §639.272
New Hampshire
PA may prescribe, dispense and administer drugs and medical devices to the extent delegated by the supervising physician. PAs may transmit prescriptions in accordance with a delegation agreement or a patient-specific order of the supervising physician or alternate. PAs may not prescribe controlled substances unless they have registered with the DEA.
New Hampshire Code of Administrative Rules, Chapter Med 600 (612.01)
New Jersey
PAs may order or prescribe controlled medications in Schedules II-V if authorized by supervising physician and order or prescription is to:
New Jersey Revised Statutes §45:9-27.19.
New Mexico
PAs may prescribe, administer and distribute dangerous drugs other than controlled substances in Schedule I if done under direction of a supervising physician and within parameters of a board-approved formulary and board guidelines. Distribution process must comply with the state laws concerning Rx packaging, labeling and record keeping.
New Mexico Statutes Annotated, §61-6-7
PAs may prescribe only those drugs designated in the board-approved formulary (additions or deletions may be requested by the supervising physician based upon his specialty and scope of practice); may not prescribe controlled substances in Schedule I; may telephone Rx to pharmacy. PA may prescribe on Rx pads containing physician’s name, business address, phone; PA’s name, title and license number. PA must clearly designate “PA” or “PA-C” on signature line.
Medicine and Surgery Practitioners Regulations, Title 16, Chapter 10, Part16.8
New York
Prescriptions for controlled substances (Schedules III-V) must be written on official New York State forms issued to the PA. Must contain printed name, address, DEA registration number, telephone number and handwritten signature of prescribing PA. (Must also include Rx information as required above.) PAs may not write prescriptions for Schedule II controlled substances.
PA employed or extended privileges by a hospital may, if allowed under bylaws, rules and regulations of hospital, write medical orders, including those for controlled substances, for inpatients under care of supervising physician. Countersignature may be required if deemed necessary and appropriate by the supervising physician or the hospital, but in no event shall countersignature be required prior to execution of orders.
New York Code Rules and Regulations, Title 10, Subchapter M, §94.2
North Carolina
PA may prescribe, order, procure, dispense and administer drugs and devices subject to the following:
21 North Carolina Administrative Code, Subchapter 32S, Section .0109
North Dakota
A physician assistant may not prescribe medications except as delegated to do so by supervising physician. A PA may prescribe Schedule II-V controlled substances as delegated by a supervising physician. PAs who are delegated prescribers of controlled drugs must register with the DEA.
North Dakota Century Code, §43-17-02.1
Ohio
(A) Subject to divisions (B) and (C) of this section, the formulary established by rule by the state medical board listing the drugs and therapeutic devices by class and specific nomenclature that a supervising physician may include in the physician-delegated prescriptive authority granted to a physician assistant who holds a certificate to prescribe issued under this chapter may include any or all of the following drugs:
(1) Schedule III, IV, and V controlled substances;
(2) Drugs that under state or federal law may be dispensed only pursuant to a prescription by a licensed health professional authorized to prescribe drugs, as defined in section
4729.01 of the Revised Code;
(3) Any drug that is not a dangerous drug, as defined in section 4729.01 of the Revised Code.
(B) The formulary established in the board's rules shall not include, and shall specify that it does not include, the following:
(1) Any schedule II controlled substance;
(2) Any drug or device used to perform or induce an abortion.
(C) When adopting rules establishing the initial formulary, the board shall include provisions ensuring that a physician assistant who holds a certificate to prescribe issued under this chapter may be granted physician-delegated prescriptive authority for all drugs and therapeutic devices that may be prescribed on the effective date of the rules by a holder of a certificate to prescribe issued by the board of nursing, with the exception of schedule II controlled substances. To the extent permitted by division (A) of this section, the initial formulary may include additional drugs or therapeutic devices.
Ohio Revised Code § 4730.40
Notwithstanding the provisions of this chapter referring to the formulary established in rules adopted by the state medical board, all of the following apply:
(A) If the state medical board has adopted all rules necessary to issue certificates to prescribe under this chapter other than the formulary, the board shall begin issuing the certificates to prescribe, and the formulary established under Chapter 4723 of the Revised Code shall constitute the formulary of drugs and therapeutic devices that a physician may include in the physician-delegated prescriptive authority granted to a physician assistant who holds a certificate to prescribe issued under this chapter. The application of the formulary established under Chapter 4723. of the Revised Code shall cease on the effective date of the initial rules establishing a formulary under section 4730.39 of the Revised Code.
(B) During the period specified in division (A) of this section, all changes relative to the formulary established under Chapter 4723. of the Revised Code shall apply in like manner to physician-delegated prescriptive authority for physician assistants.
(C) Notwithstanding the inclusion of schedule II controlled substances in the formulary established under Chapter 4723. of the Revised Code, the formulary that applies to physician-delegated prescriptive authority for physician assistants under this section shall not include schedule II controlled substances.
Ohio Revised Code § 4730.401
(A) A certificate to prescribe issued under this chapter authorizes a physician assistant to prescribe and personally furnish drugs and therapeutic devices in the exercise of physician-delegated prescriptive authority.
(B) In exercising physician-delegated prescriptive authority, a physician assistant is subject to all of the following:
(1) The physician assistant shall exercise physician-delegated prescriptive authority only to the extent that the physician supervising the physician assistant has granted that authority.
(2) The physician assistant shall comply with all conditions placed on the physician-delegated prescriptive authority, as specified by the supervising physician who is supervising the physician assistant in the exercise of physician-delegated prescriptive authority.
(3) If the physician assistant possesses physician-delegated prescriptive authority for controlled substances, the physician assistant shall register with the federal drug enforcement administration.
Ohio Revised Code § 4730.41.
Oklahoma
A physician assistant under the direction of a supervising physician may prescribe written and oral prescriptions and orders. The physician assistant may prescribe drugs, including controlled medications in Schedules II through V pursuant to Section 2-312 of Title 63 of the Oklahoma Statutes, and medical supplies and services as delegated by the supervising physician and as approved by the State Board of Medical Licensure and Supervision after consultation with the State Board of Pharmacy on the Physician Assistant Drug Formulary.
A physician assistant may write an order for a Schedule II drug for immediate or ongoing administration on site. Prescriptions and orders for Schedule II drugs written by a physician assistant must be included on a written protocol determined by the supervising physician and approved by the medical staff committee of the facility or by direct verbal order of the supervising physician.
Oklahoma Statutes Annotated, tit. 59 §519.6
PA may issue written and oral prescriptions and other orders for drugs and medical supplies including controlled medications in Schedule III-V as delegated by supervising physician and approved by board. A physician assistant may write an order for a Schedule II drug for immediate or ongoing administration on site. Prescriptions and orders for Schedule II drugs written by a physician assistant must be included on a written protocol determined by the supervising physician and approved by the medical staff committee of the facility or by direct verbal order of the supervising physician.
Must be consistent with supervising physician’s scope of practice. PA may not prescribe medications that supervising physician may not prescribe. PA Rx must contain name of physician, printed name and license number of PA, PA signature and any other board-required information. PA may not dispense drugs but may request, receive and sign for professional samples and may distribute professional samples to patients.
PA who is recognized by board to prescribe may issue written and oral prescriptions and orders for medical supplies, services and drugs, including controlled medications in Schedule III-V as delegated by supervising physician and approved in PA drug formulary. Prescriptions for non-controlled medications may not exceed a 30 day supply with 2 refills for a new diagnosis or a 90 day supply with refills up to one year for an agent prescribed for an established diagnosis. Prescriptions for Schedule III-V controlled medications limited to 30 day supply with no refills. PAs authorized to prescribe controlled medications must register with the DEA and the Oklahoma Bureau of Narcotics and Dangerous Drugs.
Oklahoma Administrative Code, Title 435, 435:15-5-10, 435:15-11-1
Oregon
An application for Schedule II controlled substances prescriptive privileges must be submitted to the Board of Medical Examiners by the physician assistant's supervising physician and must be accompanied by the practice description of the physician assistant. The Schedule II controlled substances prescriptive privileges of a physician assistant shall be limited by the practice description approved by the board and may be restricted further by the supervising physician at any time. The supervising physician shall notify the physician assistant and the board of any additional restrictions imposed by the supervising physician, and the practice description on file with the board shall be amended to reflect the additional restrictions imposed. To be eligible for Schedule II controlled substances prescriptive privileges, a physician assistant must be certified by the National Commission on Certification of Physician Assistants and must complete all required continuing medical education coursework.
Oregon Revised Statutes, Chapter 677, 677.545(6)
PA may issue written or oral prescriptions for medications selected by supervising physician and approved by board if following conditions are met:
Rhode Island
PAs employed by physicians, HMOs or other health care delivery organizations may write prescriptions for legend drugs, Schedule II-V controlled substances, medical therapies, devices and diagnostics according to guidelines established by the employer. PAs employed by or extended medical staff privileges by a licensed hospital or other health facility may write medical orders for inpatients as delineated by the bylaws and credentialing process.
Rhode Island Code, §5-54-8
As delegated by supervising physician and according to guidelines established by physician, health maintenance organization or other health care delivery organization, PAs may prescribe legend drugs and devices and controlled substances from Schedules II-V. PAs who prescribe controlled substances must obtain state controlled substance registration number and must register with DEA.
Rules and Regulations for the Licensure of Physician Assistants, §§ 6.4 to 6.7
South Carolina
Prescriptions must be limited to drugs and devices authorized by supervising physician and set forth in written scope of practice guidelines. Prescriptions must be signed by PA and include PA’s board-assigned identification number, PA’s and physician’s name, address, and phone number preprinted on form. PA may request, receive, and sign for samples of drugs authorized in written scope of practice guidelines, except for controlled substances in Schedule II and may distribute professional samples to patients.
PA applying for controlled substance prescriptive drug authority must have completed 60 hours of education in pharmocotherapeutics, and at least 15 hours of education in controlled substances. PA and supervising physician must read and sign a document describing the management of expanded controlled substances prescriptive authority for PAs, which must be kept on file for review. PA and supervising physician shall periodically review this document and PA’s prescribing practices. Review must be documented in writing with a copy kept at each practice site.
South Carolina Code of Laws Article 7, §40-47-965
South Dakota
PA may provide medical services delegated by the supervising physician if the service is within the PA's skills, forms a component of the physician's scope of practice, and is provided with supervision including prescribing and provision of drug samples or a limited supply of labeled medications, including Schedule II controlled substances for one period of not more than thirty days, for treatment of causative factors and symptoms. Medications or sample drugs provided to patients shall be accompanied with written administration instructions and appropriate documentation shall be entered in the patient's record. Physician assistants may request, receive, and sign for professional samples of drugs provided by the manufacturer
South Dakota Code of Laws, 36-4A-26.1
PAs can prescribe non-controlled medications and administer or dispense controlled substances as delegated by their supervising physician. PAs may prescribe controlled medications but must register with the DEA and obtain State Controlled Substance Registration. Employment contract must specifically identify the controlled substance activities authorized by the Supervising physician.
From 9/24/96 Department of Health Letter
Tennessee
Supervising physician may delegate to a PA the authority to prescribe and/or issue legend drugs and controlled substances in Schedule II-V in accordance with board rules. PA who is a delegated prescriber of controlled medications must register with the DEA. Pre-printed name of supervising physician and PA must be on Rx pad. Prescribing PA shall file notice with board’s PA committee containing name of the PA and supervising physician, copy of formulary of medications PA authorized to prescribe and/or issue.
Tennessee Code Annotated, 63-19-107
Within ten (10) business days after the physician assistant has examined a patient who falls in one of the following categories, the supervising physician shall make a personal review of the historical, physical, and therapeutic data gathered by the physician assistant on that patient and shall so certify in the patient’s chart within thirty (30) days:
Texas
A physician may delegate the carrying out or signing of a prescription drug order for a controlled substance only if:
(1) the prescription is for a controlled substance listed in Schedules III, IV, or V as established by the commissioner of public;
(2) the prescription is for a period not to exceed 30 days;
(3) the refill of a prescription is authorized after consultation with the delegating physician and the consultation is noted in the patient's chart; and
(4) with regard to a prescription for a child less than two years of age, the prescription is made after consultation with the delegating physician and the consultation is noted in the patient's chart.
This section does not limit the authority of a physician to delegate the carrying out or signing of a prescription drug order involving a controlled substance under this subchapter.
Texas Occupations Code, § 157.0511
Delegated prescribing may include dangerous drugs and Schedule III-V controlled medications. Controlled substance prescriptions limited to 30 days; refill must be authorized after consultation with supervising physician. Prescription for controlled medications for child under 2 years of age requires consultation with supervising physician. The consultation must be noted in the patient’s chart.
Rules for Physician Assistants, Chapter 193 (standing delegation orders) §193.6.
Utah
PA acting in accordance with a delegation of services agreement may prescribe or administer an appropriate controlled substance if the PA holds a Utah controlled substance license and a DEA registration, the prescription or administration of the controlled substance is also within the prescriptive practice of the supervising physician and the supervising physician cosigns any medical chart record of prescription for a Schedule II or III controlled substance made by the PA.
Utah Code Annotated, 58-70a-501
Vermont
“Authorization to prescribe medication and medical devices” means the authorization for a PA to prescribe, dispense and administer drugs and medical devices to the extent delegated by the supervising physician. Prescribing and dispensing of drugs may include Schedules II through V inclusive. At not time shall prescriptive practices of the PA exceed the prescriptive practices of the supervising physician(s).
Scope of practice statement must include authorization to prescribe medication. PAs who prescribe controlled medications must register with the DEA.
Rules of the Board of Medical Practice, 13 141 001, Section II, parts 5.2 and 7.3
Virginia
A licensed physician assistant shall have the authority to prescribe Schedules II-VI controlled substances upon provision to the board of evidence that PA has entered into and is at the time of prescribing a party to a written agreement with physician or podiatrist which provides for direction and supervision of the PA’s prescriptive practices.
Code of Virginia, § 54.1-2952.1
Washington
Certified PA may issue written or oral prescriptions when approved by the commission or its designee.
(1) Written prescriptions shall include the name, address, and telephone number of the physician or medical group; the name and address of the patient and the date on which the prescription was written.
(a) The certified physician assistant shall sign such a prescription using his or her own name followed by the letters 'P.A.-C.'
(b) The written prescriptions for schedule two through five must include the physician assistant's D.E.A. registration number, or, if none, the sponsoring physician's D.E.A. registration number, followed by the letters 'P.A.-C' and the physician assistant's license number.
(2) A certified physician assistant employed or extended privileges by a hospital, nursing home or other health care institution may, if permissible under the bylaws, rules and regulations of the institution, order pharmaceutical agents for inpatients under the care of the sponsoring physician(s).
(3) The license of a certified physician assistant who issues a prescription in violation of these provisions shall be subject to revocation or suspension.
(4) Certified physician assistants may dispense medications the certified physician assistant has prescribed from office supplies. The certified physician assistant shall comply with the state laws concerning prescription labeling requirements.
Washington Administrative Code, 246-918-035
West Virginia
PAs authorized to issue prescriptions for Schedules III through V controlled substances shall write on the prescription form the Federal Drug Enforcement Administration number issued to that physician assistant. Prescriptions written for Schedule III drugs shall be limited to a seventy-two (72) hour supply and may not authorize a refill. The maximum amount of Schedule IV or Schedule V drugs shall be no more than ninety (90) dosage units or a thirty (30) day supply, whichever is less.
Prescriptions for other legend drugs shall not be prescribed or refillable for a period exceeding six (6) months.
West Virginia Legislative Rules Title II, Series 1B, §§ 14.8-14.9
Wisconsin
A PA may issue written prescription orders for drugs under supervision of licensed physician (may include Schedules II-V and non-controlled drugs). Following conditions apply:
1. Reviews and countersigns the prescription order prepared by the physician assistant, or
2. Reviews and countersigns within 72 hours the patient record prepared by the physician assistant practicing in the office of the supervising physician or at a facility or a hospital in which the supervising physician has staff privileges, or
3. Reviews by telephone or other means, as soon as practicable but within a 72- hour period, and countersigns within one week, the patient record prepared by the physician assistant who practices in an office facility other than the supervising physician's main office of a facility or hospital in which the supervising physician has staff privileges.
Wisconsin Administrative Code, Chapter Med 8.07-8.08
Wyoming
A PA may prescribe Schedule II-V and non-scheduled medications as an agent of the supervising physician.
Wyoming Statutes, 33-26-510
(a) As the agent of the supervising physician, a PA may prescribe, administer and dispense medications, including schedule II-V. Dispensing shall be limited to rural clinics in which pharmacy services are not physically available.
(b) A PA shall not prescribe schedule I.
(c) Use of pre-signed prescription pads is prohibited.
Chapter V Rules of Practice and Procedures: Physician Assistants, § 17
9/09
Alabama
(a) Upon receipt of a Qualified Alabama Controlled Substances Registration Certificate (QACSC) and a valid registration number issued by the United States Drug Enforcement Administration, an assistant to physician may prescribe, administer, authorize for administration, or dispense only those controlled substances listed in Schedules III, IV, and V of Article 2, Chapter 2, Title 20 in accordance with rules adopted by the board and any protocols, formularies, and medical regimens established by the board for regulation of a QACSC.
(b) An assistant to physician shall not utilize his or her QACSC for the purchasing, obtaining, maintaining, or ordering of any stock supply or inventory of any controlled substance in any form.
(c) An assistant to physician authorized to prescribe, administer, or dispense controlled substances in accordance with the provisions of this article shall not prescribe, administer, or dispense any controlled substance to his or her own self, spouse, child, or parent.
Code of Alabama Statutes, §20-2-63
Alaska
A PA with a valid DEA registration number may order, administer, dispense, and write a prescription for a schedule II, III, IV, or V controlled substance only with the authorization of the PA's primary collaborating physician. The authorization must be documented in the PA's current collaborative plan on file with the division.
The PA's authority to prescribe may not exceed that of the primary collaborating physician as documented in the collaborative plan on file with the division.
A PA with a valid DEA registration number may request, receive, order, or procure schedule II, III, IV, or V controlled substance supplies from a pharmaceutical distributor, warehouse, or other entity only with the authorization of the physician assistant's primary collaborating physician. If granted this authority, the PA is responsible for complying with all state and federal inventory and record keeping requirements. The authorization must be documented in the PA's current collaborative plan on file with the division. Within 10 days after the date of issue on the form, the physician assistant shall provide to the primary collaborating physician a copy of each DEA Form 222 official order form used to obtain controlled substances.
A prescription must include the: primary collaborating physician's name, primary collaborating physician's DEA registration number, PA's name, and PA's DEA registration number.
12 Alaska Administrative Code 40.450
Arizona
PA may prescribe Schedule II-V controlled medications and non-controlled medications. Rx for Schedule II or III controlled substance limited to 72 hours. Schedules II and III not refillable without written consent of physician. Schedules IV and V may not be prescribed more than 5 times in a 6-month period for an individual patient. Prescription-only drugs shall not be prescribed, dispensed or refillable for a period exceeding 1 year.
PA may apply to board for certification to prescribe Schedule II or III medications for 14-day period. Certification requires 45 hours of pharmacology or clinical management of drug therapy in 3 years preceding application or current NCCPA certification. PAs who prescribe, dispense or administer controlled medications must register with the DEA. Board notifies pharmacy board of PAs approved to prescribe and dispense. Pharmacy board notifies pharmacies.
Arizona Revised Statutes §32-2531, §32-2532
Supervising physician must obtain board approval to delegate authority to prescribe, dispense or administer Schedule II or III controlled substances to PA. Physician and PA must submit application on board forms with information, including disciplinary information, if applicable, on physician and PA. Board may order evaluation of physician and PA as allowed by statute. Application must contain statements that both physician and PA will abide by all laws that govern prescribing, and that physician accepts responsibility for PA. Board shall approve applications that show appropriate training and experience of PA for prescribing Schedule II and III medications and professional record of appropriate prescribing. PA and supervising physician must be able to communicate in person or via telecommunication while PA is providing health care services.
Arizona Regulatory Board of Physician Assistants, R4-17-301
Arkansas
Supervising physicians may delegate prescriptive authority to PAs to include prescribing, ordering and administration of Schedule III-V controlled substances, all legend drugs, and all non-controlled prescription medications and medical devices. All prescriptions and orders issued by PA shall identify supervising physician. PA’s prescriptive authority may not exceed that of supervising physician. PAs who prescribe controlled substances must register with the DEA.
Arkansas Code Annotated 17-105-108
Supervising physician may authorize PA to prescribe Schedule III-V and non-controlled medications. Such authorization must be included in board-approved protocol. Physician may only delegate prescribing authority for those medications the physician is authorized to prescribe. Prescriptions must contain name of supervising physician.
Arkansas Medical Board Regulation 24(5)
California
PA may administer or provide medication to a patient or transmit orally, or in writing on a patient’s record or in a drug order, an order to a person who may lawfully furnish the medication or medical device. Such authority may be limited by the supervising physician. Supervising physician who delegates authority to issue a drug order must adopt a practice-specific formulary and protocols that specify criteria for the use of a particular drug or device and contraindications. Formulary and quantitative limitations must be appropriate for type of practice of supervising physician. Schedule II-V medications administered, provided or for which a drug order is issued require patient-specific order from the supervising physician. Written drug order shall contain name, address and phone number of the supervising physician, and the name and license number of the physician assistant. Written drug order for controlled medications (except those orders written in a patient chart in a health facility) must include PA’s DEA registration number. Medical record of patient receiving Schedule II medication must be countersigned by supervising physician within 7 days.
Annotated Code of California, Business and Professions Chapter 7.7, §3502.1
Colorado
Physician may delegate authority to prescribe medication, including controlled substances, and dispense only such drugs as designated by the board. Such act shall be consistent with sound medical practice. Each prescription issued by PA shall have the name of the supervising physician imprinted on it.
Colorado Revised Statutes, §12-36-106(5)(a)
PA may issue prescription for any drug or controlled substance provided that each prescription is entered on the patient’s chart, each prescription contains the name, address, and telephone number of the supervising physician and the name of the PA, and the prescription is signed by the PA. PA may not prescribe controlled medication without DEA registration.
Rules and Regulations for Certification of and Practice by Physician Assistants, Sec. 3
Connecticut
PA may be delegated the authority to prescribe and administer drugs, including Schedule II-V controlled substances, in all settings. Supervising physician must co-sign the order for Schedule II or III drugs within 1 calendar day.
Chapter 370, Connecticut General Statutes, §20-12d
Delaware
Prescriptive authority for therapeutic drugs and treatments must be delegated by a supervising physician and is specific to the practice of the supervising physician. PAs may prescribe legend drugs and Schedule II-V controlled substances, parenteral medications, medical therapeutics, devices and diagnostics. PAs who are delegated the ability to prescribe controlled substances must obtain a state controlled substances number and must register with the DEA. Prescriptions must include the printed or legibly handwritten names of both the PA and the supervising physician. Controlled prescriptions may not be written for amounts to exceed a 3 month supply and non-controlled prescriptions may not exceed a 6 month supply. Supervising physician must reevaluate the continued therapeutic needs before a refill that exceeds above restrictions can be issued.
Delaware Rules and Regulations, §25.3
District of Columbia
As delegated to do so by a supervising physician, physician assistants may order, prescribe, and dispense legend drugs and controlled substances enumerated in schedules II through V in D.C. Official Code § 48-902.01 et seq. Physician assistants authorized to prescribe and/or dispense controlled substances must register with the DEA.
District of Columbia Municipal Regulations, Title 17, § 4912.5
Florida
Physician Assistants are not authorized to prescribe controlled substances.
Georgia
Supervising physician may delegate authority to prescribe Schedule III-V controlled medications and all non-controlled drugs and devices. Such authority must be contained in approved job description. Prescription must contain name, address and telephone of supervising physician. Form must be signed by the PA using the language: “This prescription authorized through (supervising physician) by (PA), PHYSICIAN’S ASSISTANT.” PA must inform patients that they have the right to see the physician prior to prescription being issued. PA may not prescribe more than 30 day supply except in chronic illnesses where a 90 day supply may be ordered. PA may authorize refills up to 6 months from date of original prescription; 12 months for oral contraceptives or other drugs or devices approved by the board. Supervising physician must personally evaluate patients receiving prescription medications every 6 months; 3 months for patients receiving controlled substances. Copy of prescription must be maintained in patient’s medical record. Supervising physician to countersign prescription or medical record entry for prescription within 7 working days.
Georgia Code Annotated, §43-34-103
Physician assistants who are prescribers of controlled medications may register with the DEA.
Georgia Code Annotated, §16-13-21(23)(D)
PA may order or select a drug, including a dangerous drug or a controlled substance, or order medical treatment or diagnostic study in any health care setting, provided (1) authority is delegated by supervising physician in accordance with job description; (2) controlled substances (Schedules III-V and oral orders for Schedule II are authorized only in an emergency) are selected from a board-approved formulary.
Rules of the Composite State Board of Medical Examiners, Chapter 360-5 Amended “Physician’s Assistants,” §360-5-.07
Hawaii
Prescriptions written by PAs must include printed, stamped, typed or hand-printed name, address, and phone number of both supervising physician and PA and shall be signed by the PA. Prescriptions for controlled substances must contain physician’s DEA number and PA’s DEA number. Medical record of controlled substance prescription must be reviewed and initialed by the supervising physician within 7 working days.
Hawaii Revised Statutes, §329-38
Supervising physician is authorized to allow PA to prescribe, dispense and administer medical devices subject to following:
- prescribing and dispensing may include Schedule III-V controlled medications and all legend drugs
- PA who is delegated prescriber of controlled medications must register with the DEA
- PA prescriptions must include name, address and phone number of supervising physician and PA
- PA employed by or extended privileges by hospital or extended care facility may write orders for medications Schedule II-V as allowed by facility policy
- board must notify pharmacy board at least annually of each PA who is an authorized prescriber
Idaho
PA may issue written or oral prescriptions for legend drugs and controlled medications in Schedules II-V in accordance with board authorization and delegation of services agreement with supervising physician. Prescribing must be consistent with supervising physician’s regular prescriptive practice. PA must apply to board for prescription writing authority. Application must include documentation of pharmacology courses (at least 30 hours required), statement of frequency with which physician will review prescriptions, statement from supervising physician indicating PA’s qualifications. PA who is authorized to prescribe controlled medications must register with the DEA and Idaho Board of Pharmacy. Prescription forms must contain printed name, address and telephone number of PA and supervising physician.
IDAPA 22 Title 01 Chapter 03, Rules for the Licensure of PAs, §042
Illinois*
A supervising physician may delegate limited prescribing and dispensing authority to a PA. Authority may, but is not required to, include Schedule III-V controlled substances. PAs authorized to prescribe controlled medications are eligible to and must register for a mid-level practitioner controlled substances license under the Illinois Controlled Substances Act.
A supervising physician may delegate authority to a PA to prescribe Schedule II controlled substances, if all of the following conditions apply:
(A) No more than 5 Schedule II controlled substances by oral dosage may be delegated.
(B) Any delegation must be controlled substances that the supervising physician prescribes.
(C) Any prescription must be limited to no more than a 30-day oral dosage, with any continuation authorized only after prior approval of the supervising physician.
225 Illinois Compiled Statutes 95/7.5
Supervising physician may delegate limited prescriptive authority to PA to include prescribing and dispensing of legend drugs and Schedule III-V controlled substances. PAs who are delegated prescribers of controlled substances must obtain an Illinois mid-level practitioner controlled substances license. Supervising physician must file notice of delegation of prescriptive authority and termination of delegation with the department and must specify the authority delegated. Delegation must be appropriate to physician’s practice, within physician or alternate’s scope of practice, and within scope of PA’s training. Guidelines must be signed by physician and PA and include PA’s Illinois controlled substance license number and DEA number; copy to be maintained at each practice location. Name of supervising physician must appear on prescriptions written by PA.
Title 68: Chapter VII Department of Professional Regulation; Subchapter b: Professions and Occupations; Part 1350.55
*Authority for delegation of Schedule II controlled substances passed the Illinois legislature in 2009. Regulations required to implement this law have not yet been adopted.
Indiana
(a) Except as provided in this section, a physician assistant may prescribe, dispense, and administer drugs and medical devices or services to the extent delegated by the supervising physician.
(b) A physician assistant may not prescribe, dispense, or administer ophthalmic devices, including glasses, contact lenses, and low vision devices.
(c) As permitted by the board, a physician assistant may use or dispense only drugs prescribed or approved by the supervising physician. A physician assistant may not prescribe or dispense the
following drugs:
(1) A schedule I substance listed in IC 35-48-2-4.
(2) A schedule II substance listed in IC 35-48-2-6.
(3) A schedule III, schedule IV, or schedule V drug if the drug contains oxycodone.
However, a physician assistant may prescribe one (1) dose of a drug listed in subdivision (2) or (3) for immediate administration if the patient is in an inpatient hospital post-operative setting and the physician is unavailable to make the prescription.
PA Practice Act; IC 25-27.5-5-4 ; Sec. 4
(a) Except as provided in section 4(d) of this chapter, a supervising physician may delegate authority to a physician assistant to prescribe:
(1) legend drugs, except as provided in section 4(c) of this
chapter; and
(2) medical devices (except ophthalmic devices, including glasses, contact lenses, and low vision devices).
(b) Any prescribing authority delegated to a physician assistant must be expressly delegated in writing by the physician assistant's supervising physician, including:
(1) the name of the drug or drug classification being delegated by the supervising physician; and
(2) the protocols the physician assistant shall use when prescribing the drug.
(c) A physician assistant who is delegated the authority to prescribe legend drugs or medical devices must do the following:
(1) Enter the following on each prescription form that the physician assistant uses to prescribe a legend drug or medical device:
(A) The signature of the physician assistant.
(B) The initials indicating the credentials awarded to the physician assistant by the NCCPA.
(C) The physician assistant's state license number.
(2) Comply with all applicable state and federal laws concerning prescriptions for legend drugs and medical devices.
(d) A supervising physician may delegate to a physician assistant the authority to prescribe only legend drugs and medical devices that are within the scope of practice of the licensed supervising physician or the physician designee.
(e) A physician assistant who is delegated the authority to prescribe controlled substances under subsection (a), and in accordance with the limitations specified in section 4(c) of this chapter, must do the following:
(1) Obtain an Indiana controlled substance registration and a federal Drug Enforcement Administration registration.
(2) Enter the following on each prescription form that the physician assistant uses to prescribe a controlled substance:
(A) The signature of the physician assistant.
(B) The initials indicating the credentials awarded to the physician assistant by the NCCPA.
(C) The physician assistant's state license number.
(D) The physician assistant's federal Drug Enforcement Administration (DEA) number.
(3) Comply with all applicable state and federal laws concerning prescriptions for controlled substances.
(f) A supervising physician may only delegate to a physician assistant the authority to prescribe controlled substances:
(1) that may be prescribed within the scope of practice of the licensed supervising physician or the physician designee;
(2) in an amount that does not exceed:
(A) a seven (7) day supply for treatment of a single acute episode of a condition or injury; or
(B) if a controlled substance cannot be dispensed in an amount that is small enough to meet the requirement of clause (A), the smallest dispensable amount; and
(3) in accordance with the limitations set forth in section 4(c) of this chapter.
PA Practice Act; IC 25-27.5-5-6; Sec. 6.
Iowa
Physician may delegate to a licensed PA the function of prescribing drugs, controlled substances and medical devices. Physician’s name must be used, recorded or otherwise indicated so the individual who administers or dispenses the prescription knows under whose authority the PA is prescribing. Rules shall be adopted by the PA board after consultation with the medical and pharmacy boards and after review and approval by a special rules review group. The rules shall prohibit the prescribing of Schedule II controlled substances which are listed as depressants.
Iowa Code, §147.107.5
PA may prescribe drugs and medical devices and controlled substances (except Schedule II depressants) when such authority is delegated by supervising physician. Each written prescription shall contain date; patient name and address; name, strength and quantity of drug; name and address of PA and physician; PA’s signature. Any prescription for a controlled substance shall contain PA’s DEA number.
Iowa Administrative Code 645-327.6(147)
Kansas
In order to prescribe controlled substances, PA shall register with the DEA.
Kansas Statutes Annotated, Chapter 65, Article 28A, Physician Assistant Licensure Act, §65-28a08
PA may prescribe Schedule II-V and non-scheduled drugs as authorized by drugs prescription protocol contained in the physician request form. Schedule II drugs require a written prescription, except in an emergency. Written prescription must contain physician and PA’s name, address, telephone number; be signed by PA and contain his DEA number when prescription is for a controlled drug. Prescription must indicate whether prescribing is by direct order of physician, pursuant to written protocol, or because of an emergency situation.
KAR Article 28a, §100-28a-13
Kentucky
Physician Assistants are not authorized to prescribe controlled substances.
Louisiana
PA scope of practice includes prescribing certain drugs and medical devices to extent delegated by supervising physician provided PA has completed a minimum of one year of clinical rotations during training and has practiced for a minimum of one year. PAs may prescribe legend drugs and Schedule III-V controlled medications.
Louisiana Statutes §1360.31
Licensed PA may not prescribe medication unless registration for prescriptive authority has been approved by the board.
Louisiana Administrative Code, Title 46, Chapter 15 §1505
To be registered as prescribing PA, physician assistant must have completed a minimum of one year of clinical rotations during training and one year of practice under supervising physician or two years of practice. Prescribing must be as delegated by physician. PA and physician must practice under practice guidelines or protocols that must include methods of supervision, types of medication and medical devices that PA is delegated to prescribe and a plan for emergency services and referrals. PA who prescribes controlled medications must register with DEA. PA with history of drug violations or history of drug abuse ineligible for registration for authority to prescribe controlled drugs.
Louisiana Administrative Code, Title 46, Chapter 15 §1521
Supervising physician must apply and register for ability to delegate prescriptive authority. PA must apply for registration to prescribe. Physician who delegates prescriptive authority for controlled substances to PA may not be employee or independent contractor to PA. Board may waive this restriction. Registrations renewed annually.
Louisiana Administrative Code, Title 46, Chapter 15 §1523, 1525, 1527, 1529
PA may prescribe legend drugs and Schedule III-V substances and medical devices. PA may not complete and issue prescription blanks previously signed by physician.
Louisiana Administrative Code, Title 46, Chapter 45 §4505
PA who is registered as a prescriber may issue prescriptions for medication or medical devices to patient of supervising physician. Prescribing PA may request, receive, sign for and deliver to a patient a medication sample. Prescription written by PA must include preprinted name, address, telephone number and prescriptive authority registration number of PA. If prescription is for controlled substance, must contain PA’s DEA number. PA must prescribe within education and experience, within clinical practice guidelines and within the specialty of the supervising physician. PA may not utilize controlled substances to treat non-cancer intractable pain as defined, obesity as defined, or self or family except in life-threatening emergencies. PA may not dispense or deliver controlled substance sample.
Louisiana Administrative Code, Title 46, Chapter 45 §4506
Maine
Delegated duties may include prescribing and dispensing of drugs and devices to the extent permitted by state and federal law. Includes Schedule III through V substances and all legend drugs. PA and primary supervising physician may request individual consideration for authorization to prescribe Schedule II drugs under specific individual guidelines.
CMR 02, 373, Chapter 2, Physician Assistants, §6
Maryland
Physician may delegate prescribing of Schedule II-V and non-controlled medications to PA if:
- intent to delegate prescriptive authority included in delegation agreement
- PA shows evidence of certification by NCCPA within previous 2 years or completion of 8 hours of pharmacology CME within previous 2 years and bachelor’s degree or equivalent, 2 years of work experience as PA or prior approval for medication order writing
- PA attests to willingness to comply with applicable state and federal law
- prescriptions written by PA are noted in medical record and countersigned by supervising physician consistent with current standards of acceptable medical practice
- prescriptions written by PA contain PA’s name and supervising physician’s name, address and phone number
- PA who is delegated prescriber of controlled medications has a valid DEA registration and state controlled substance registration
Massachusetts
PAs may prescribe or order medications in accordance with written guidelines developed by PA and supervising physician. Guidelines to address frequency of reviews, identification of supervising physician(s), types and classes of medications to be prescribed by PA, plans for prescribing medications not ordinarily in scope of practice, quantities of medications to be prescribed by PA, ordering of medications from manufacturer, review of prescribing, procedures for initiating IV solutions. Guidelines to be signed by supervising physician and PA and renewed annually. Guidelines to be available to board. All prescribing to be in compliance with state and federal laws. Prescriptions or orders for Schedule II medications shall be reviewed by supervising physician within 96 hours. PA not to prescribe Schedules II-IV for self-use. PA not to prescribe Schedule II for immediate family member except in emergency.
Board of Physician Assistant Registration §5.07 (Identical language in 243 CMR 2.08)
Michigan
Supervising physician may delegate ability to prescribe controlled substances in Schedules III-V to PA. Physician must establish written authorization that includes information on physician and PA, limitations or exceptions to delegation and effective date. Copy of authorization must be maintained in each location where delegation occurs. Yearly update required. Delegation may include Schedule II medications if supervising physician and PA practice in a health facility, patient is located within the facility, and the prescription for Schedule II medications is issued for the discharge of patient. Limited to 7 day supply. Delegating physician shall not delegate the prescription of a drug or device individually, in combination, or in succession with the intent to terminate a pregnancy.
Michigan Task Force on PAs, R338.2304
Minnesota
A supervising physician may delegate to a PA the authority to prescribe and administer legend drugs and medical devices in compliance with provisions of pharmacy act. PAs authorized to prescribe controlled substances must maintain a separate addendum to delegation form that lists all schedules and categories PA may prescribe.
Delegated prescribing authorized only for registered PAs who are currently certified by NCCPA. The agreement between the PA and supervising physician(s) must include signed statement regarding delegation or non-delegation of prescribing and administering legend drugs and medical devices. Statement must include protocol indicating classes of drugs for which physician delegates prescriptive authority. PAs authorized to prescribe controlled medications must register with DEA. Physician must review PA prescribing weekly.
Minnesota Statute Chapter 147A, §147A.09 (2), §147A.18 (1)
Mississippi
PA shall practice according to board-approved protocol agreed upon by PA and supervising physician. Protocol to include categories of pharmacologic agents which may be ordered, administered, dispensed and/or prescribed. PAs may not prescribe or dispense controlled substance or any drug having addiction-forming or sustaining liability. PA may administer controlled medications pursuant to physician order and according to physician-PA protocol.
PA must apply to board for authority to prescribe controlled substances (Schedules II-V); must complete board approved educational program prior to application. PAs must comply with physician regulations on maintenance of records, use of diet medication, use of controlled substances for chronic pain and prescription guidelines. PAs who prescribe controlled medications must register with DEA.
Regulations Governing the Practice of Physician Assistants, XXII, D
Missouri*
1. A physician assistant with a certificate of controlled substance prescriptive authority as provided in this section may prescribe any controlled substance listed in schedule III, IV, or V of section 195.017, RSMo, when delegated the authority to prescribe controlled substances in a supervision agreement. Such authority shall be listed on the supervision verification form on file with the state board of healing arts. The supervising physician shall maintain the right to limit a specific scheduled drug or scheduled drug category that the physician assistant is permitted to prescribe. Any limitations shall be listed on the supervision form. Physician assistants shall not prescribe controlled substances for themselves or members of their families. Schedule III controlled substances shall be limited to a five-day supply without refill. Physician assistants who are authorized to prescribe controlled substances under this section shall register with the federal Drug Enforcement Administration and the state bureau of narcotics and dangerous drugs, and shall include such registration numbers on prescriptions for controlled substances.
2. The supervising physician shall be responsible to determine and document the completion of at least one hundred twenty hours in a four-month period by the physician assistant during which the physician assistant shall practice with the supervising physician on-site prior to prescribing controlled substances when the supervising physician is not on-site. Such limitation shall not apply to physician assistants of population-based public health services as defined in 20 CSR 2150-5.100 as of April 30, 2009.
3. A physician assistant shall receive a certificate of controlled substance prescriptive authority from the board of healing arts upon verification of the completion of the following educational requirements:
(1) Successful completion of an advanced pharmacology course that includes clinical training in the prescription of drugs, medicines, and therapeutic devices. A course or courses with advanced CCS HCS SB 296 44 pharmacological content in a physician assistant program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) or its predecessor agency shall satisfy such requirement;
(2) Completion of a minimum of three hundred clock hours of clinical training by the supervising physician in the prescription of drugs, medicines, and therapeutic devices;
(3) Completion of a minimum of one year of supervised clinical practice or supervised clinical rotations. One year of clinical rotations in a program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) or its predecessor agency, which includes pharmacotherapeutics as a component of its clinical training, shall satisfy such requirement. Proof of such training shall serve to document experience in the prescribing of drugs, medicines, and therapeutic devices;
(4) A physician assistant previously licensed in a jurisdiction where physician assistants are authorized to prescribe controlled substances may obtain a state bureau of narcotics and dangerous drugs registration if a supervising physician can attest that the physician assistant has met the requirements of subdivisions (1) to (3) of this subsection and provides documentation of existing federal Drug Enforcement Agency registration.
Missouri Revised Statutes, §334.747
*Regulations required to implement this law have not yet been adopted.
Montana
PAs may prescribe, dispense, and administer drugs to the extent authorized by the supervising physician and by board rules, the utilization plan, or both. May include Schedule III-V, as well as 34-day supplies of Schedule II drugs. Records must be kept and Rx must comply with relevant pharmacy board requirements. PAs must register with the DEA.
Montana Code Annotated, §37-20-404
Nebraska
PA may prescribe drugs and devices as delegated to do so by supervising physician. Delegated authority may include legend drugs and devices and Schedules II-V controlled medications. Prescription container label must have names of both physician and PA. PAs with delegated prescriptive authority for controlled medications must register with the DEA.
Revised Statutes of Nebraska, §71-1,107.30
Nevada
PA may, if authorized by the board, possess, administer, prescribe or dispense controlled substances and may possess, administer, prescribe or dispense poisons, dangerous drugs and devices in or out of the presence of his supervising physician to the extent specified in the PA’s certificate. Pharmacy law exam required.
Each PA authorized to prescribe and dispense non-controlled substances or to prescribe or dispense controlled substances must apply for a registration certificate from the board of pharmacy. The pharmacy board shall adopt regulations controlling the maximum amount, storage, security, record keeping and transportation of such drugs and devices, taking into consideration the PA’s training and experience, practice location and population, distance to the nearest hospital and physician, etc.
Medical board and supervising physician shall limit the authority of PA to prescribe controlled substances to those schedules which supervising physician is authorized to prescribe.
Nevada Revised Statutes, Chapter 630, §639.1373, §630.271
License issued by board sets forth the controlled substances, poisons, dangerous drugs or devices which PA is authorized to possess, administer, prescribe or dispense and the area in which PA may possess controlled substances.
PA must apply for registration with pharmacy board in order to dispense controlled substances and to prescribe and dispense poisons, dangerous drugs and devices. Personal appearance with supervising physician may be required. Consultant pharmacist must submit signed statement. PA must pass pharmacy law exam.
Nevada Administrative Code, §630.330, §639.272
New Hampshire
PA may prescribe, dispense and administer drugs and medical devices to the extent delegated by the supervising physician. PAs may transmit prescriptions in accordance with a delegation agreement or a patient-specific order of the supervising physician or alternate. PAs may not prescribe controlled substances unless they have registered with the DEA.
New Hampshire Code of Administrative Rules, Chapter Med 600 (612.01)
New Jersey
PAs may order or prescribe controlled medications in Schedules II-V if authorized by supervising physician and order or prescription is to:
- Continue or reissue an order or prescription of controlled drug issued by supervising physician
- Adjust dosage of an order or prescription for a controlled drug originally ordered or prescribed by physician (prior consultation with physician required)
- Initiate order or prescription for controlled drug with prior consultation with supervising physician
- Initiate order or prescription for controlled drug as part of treatment plan for patient with terminal illness
New Jersey Revised Statutes §45:9-27.19.
New Mexico
PAs may prescribe, administer and distribute dangerous drugs other than controlled substances in Schedule I if done under direction of a supervising physician and within parameters of a board-approved formulary and board guidelines. Distribution process must comply with the state laws concerning Rx packaging, labeling and record keeping.
New Mexico Statutes Annotated, §61-6-7
PAs may prescribe only those drugs designated in the board-approved formulary (additions or deletions may be requested by the supervising physician based upon his specialty and scope of practice); may not prescribe controlled substances in Schedule I; may telephone Rx to pharmacy. PA may prescribe on Rx pads containing physician’s name, business address, phone; PA’s name, title and license number. PA must clearly designate “PA” or “PA-C” on signature line.
Medicine and Surgery Practitioners Regulations, Title 16, Chapter 10, Part16.8
New York
Prescriptions for controlled substances (Schedules III-V) must be written on official New York State forms issued to the PA. Must contain printed name, address, DEA registration number, telephone number and handwritten signature of prescribing PA. (Must also include Rx information as required above.) PAs may not write prescriptions for Schedule II controlled substances.
PA employed or extended privileges by a hospital may, if allowed under bylaws, rules and regulations of hospital, write medical orders, including those for controlled substances, for inpatients under care of supervising physician. Countersignature may be required if deemed necessary and appropriate by the supervising physician or the hospital, but in no event shall countersignature be required prior to execution of orders.
New York Code Rules and Regulations, Title 10, Subchapter M, §94.2
North Carolina
PA may prescribe, order, procure, dispense and administer drugs and devices subject to the following:
- PA must have received written instructions for prescribing and a written policy for periodic review of these instructions from the supervising physician. PA and physician must acknowledge that each is familiar with laws governing prescribing and agrees to comply by incorporating them into the written prescribing instructions.
- If PA is to prescribe controlled substances, supervising physician and PA must have valid DEA registration.
- Schedules II and III for 30 day supply only.
21 North Carolina Administrative Code, Subchapter 32S, Section .0109
North Dakota
A physician assistant may not prescribe medications except as delegated to do so by supervising physician. A PA may prescribe Schedule II-V controlled substances as delegated by a supervising physician. PAs who are delegated prescribers of controlled drugs must register with the DEA.
North Dakota Century Code, §43-17-02.1
Ohio
(A) Subject to divisions (B) and (C) of this section, the formulary established by rule by the state medical board listing the drugs and therapeutic devices by class and specific nomenclature that a supervising physician may include in the physician-delegated prescriptive authority granted to a physician assistant who holds a certificate to prescribe issued under this chapter may include any or all of the following drugs:
(1) Schedule III, IV, and V controlled substances;
(2) Drugs that under state or federal law may be dispensed only pursuant to a prescription by a licensed health professional authorized to prescribe drugs, as defined in section
4729.01 of the Revised Code;
(3) Any drug that is not a dangerous drug, as defined in section 4729.01 of the Revised Code.
(B) The formulary established in the board's rules shall not include, and shall specify that it does not include, the following:
(1) Any schedule II controlled substance;
(2) Any drug or device used to perform or induce an abortion.
(C) When adopting rules establishing the initial formulary, the board shall include provisions ensuring that a physician assistant who holds a certificate to prescribe issued under this chapter may be granted physician-delegated prescriptive authority for all drugs and therapeutic devices that may be prescribed on the effective date of the rules by a holder of a certificate to prescribe issued by the board of nursing, with the exception of schedule II controlled substances. To the extent permitted by division (A) of this section, the initial formulary may include additional drugs or therapeutic devices.
Ohio Revised Code § 4730.40
Notwithstanding the provisions of this chapter referring to the formulary established in rules adopted by the state medical board, all of the following apply:
(A) If the state medical board has adopted all rules necessary to issue certificates to prescribe under this chapter other than the formulary, the board shall begin issuing the certificates to prescribe, and the formulary established under Chapter 4723 of the Revised Code shall constitute the formulary of drugs and therapeutic devices that a physician may include in the physician-delegated prescriptive authority granted to a physician assistant who holds a certificate to prescribe issued under this chapter. The application of the formulary established under Chapter 4723. of the Revised Code shall cease on the effective date of the initial rules establishing a formulary under section 4730.39 of the Revised Code.
(B) During the period specified in division (A) of this section, all changes relative to the formulary established under Chapter 4723. of the Revised Code shall apply in like manner to physician-delegated prescriptive authority for physician assistants.
(C) Notwithstanding the inclusion of schedule II controlled substances in the formulary established under Chapter 4723. of the Revised Code, the formulary that applies to physician-delegated prescriptive authority for physician assistants under this section shall not include schedule II controlled substances.
Ohio Revised Code § 4730.401
(A) A certificate to prescribe issued under this chapter authorizes a physician assistant to prescribe and personally furnish drugs and therapeutic devices in the exercise of physician-delegated prescriptive authority.
(B) In exercising physician-delegated prescriptive authority, a physician assistant is subject to all of the following:
(1) The physician assistant shall exercise physician-delegated prescriptive authority only to the extent that the physician supervising the physician assistant has granted that authority.
(2) The physician assistant shall comply with all conditions placed on the physician-delegated prescriptive authority, as specified by the supervising physician who is supervising the physician assistant in the exercise of physician-delegated prescriptive authority.
(3) If the physician assistant possesses physician-delegated prescriptive authority for controlled substances, the physician assistant shall register with the federal drug enforcement administration.
Ohio Revised Code § 4730.41.
Oklahoma
A physician assistant under the direction of a supervising physician may prescribe written and oral prescriptions and orders. The physician assistant may prescribe drugs, including controlled medications in Schedules II through V pursuant to Section 2-312 of Title 63 of the Oklahoma Statutes, and medical supplies and services as delegated by the supervising physician and as approved by the State Board of Medical Licensure and Supervision after consultation with the State Board of Pharmacy on the Physician Assistant Drug Formulary.
A physician assistant may write an order for a Schedule II drug for immediate or ongoing administration on site. Prescriptions and orders for Schedule II drugs written by a physician assistant must be included on a written protocol determined by the supervising physician and approved by the medical staff committee of the facility or by direct verbal order of the supervising physician.
Oklahoma Statutes Annotated, tit. 59 §519.6
PA may issue written and oral prescriptions and other orders for drugs and medical supplies including controlled medications in Schedule III-V as delegated by supervising physician and approved by board. A physician assistant may write an order for a Schedule II drug for immediate or ongoing administration on site. Prescriptions and orders for Schedule II drugs written by a physician assistant must be included on a written protocol determined by the supervising physician and approved by the medical staff committee of the facility or by direct verbal order of the supervising physician.
Must be consistent with supervising physician’s scope of practice. PA may not prescribe medications that supervising physician may not prescribe. PA Rx must contain name of physician, printed name and license number of PA, PA signature and any other board-required information. PA may not dispense drugs but may request, receive and sign for professional samples and may distribute professional samples to patients.
PA who is recognized by board to prescribe may issue written and oral prescriptions and orders for medical supplies, services and drugs, including controlled medications in Schedule III-V as delegated by supervising physician and approved in PA drug formulary. Prescriptions for non-controlled medications may not exceed a 30 day supply with 2 refills for a new diagnosis or a 90 day supply with refills up to one year for an agent prescribed for an established diagnosis. Prescriptions for Schedule III-V controlled medications limited to 30 day supply with no refills. PAs authorized to prescribe controlled medications must register with the DEA and the Oklahoma Bureau of Narcotics and Dangerous Drugs.
Oklahoma Administrative Code, Title 435, 435:15-5-10, 435:15-11-1
Oregon
An application for Schedule II controlled substances prescriptive privileges must be submitted to the Board of Medical Examiners by the physician assistant's supervising physician and must be accompanied by the practice description of the physician assistant. The Schedule II controlled substances prescriptive privileges of a physician assistant shall be limited by the practice description approved by the board and may be restricted further by the supervising physician at any time. The supervising physician shall notify the physician assistant and the board of any additional restrictions imposed by the supervising physician, and the practice description on file with the board shall be amended to reflect the additional restrictions imposed. To be eligible for Schedule II controlled substances prescriptive privileges, a physician assistant must be certified by the National Commission on Certification of Physician Assistants and must complete all required continuing medical education coursework.
Oregon Revised Statutes, Chapter 677, 677.545(6)
PA may issue written or oral prescriptions for medications selected by supervising physician and approved by board if following conditions are met:
- PA has met board requirements for qualification
- PA has adequate training and/or experience in pharmacology (applicant may be required to take pharmacology exam).
PA must be registered with Drug Enforcement Administration in order to issue Rx for Schedule II-V controlled substances. Applicants for Schedule II prescribing authority must be currently certified by the NCCPA. Written prescription must be on blank which includes name, office address, phone number of supervising physician and names of PA, patient, and date. PA must sign Rx, include “Physician Assistant” after name (and DEA number if for controlled substance).
Oregon Administrative Rule, §847-050-0041
Pennsylvania
The supervising physician may delegate to the physician assistant the prescribing, dispensing and administering of drugs and therapeutic devices.
PA may not prescribe or dispense Schedule I controlled substances.
PA may prescribe a Schedule II controlled substance for initial therapy, up to a 72-hour dose. The PA must notify the supervising physician of the prescription as soon as possible, but in no event longer than 24 hours from the issuance of the prescription. A PA may write a prescription for a Schedule II controlled substance for up to a 30-day supply if it was approved by the supervising physician for ongoing therapy. The prescription must clearly state on its face that it is for initial or ongoing therapy.
PA may only prescribe or dispense a drug for a patient who is under the care of the physician responsible for the supervision of the physician assistant and only in accordance with the supervising physician's instructions and written agreement.
A physician assistant may request, receive and sign for professional samples and may distribute professional samples to patients.
A physician assistant authorized to prescribe or dispense, or both, controlled substances shall register with the Drug Enforcement Administration (DEA).
State Board of Medicine Regulations §18.158
The supervising physician may delegate to the physician assistant the prescribing, dispensing and administering of drugs and therapeutic devices.
A physician assistant may not prescribe or dispense Schedule I controlled substances as defined under section 4 of The Controlled Substances, Drug, Device and Cosmetic Act (35 P. S. § 780-104).
A physician assistant may prescribe a Schedule II controlled substance for initial therapy, up to a 72-hour dose. The physician assistant shall notify the supervising physician of the prescription as soon as possible, but in no event longer than 24 hours from the issuance of the prescription. The physician assistant shall have no authority to prescribe a Schedule II controlled substance after the initial therapy of up to a 72-hour dose, until the patient has been examined by the supervising physician and the supervising physician has reviewed and approved the prescription of a Schedule II controlled substance by the physician assistant for up to a 30-day supply.
If the supervising physician determines and documents that the patient is chronically ill, the physician assistant may write a prescription for a Schedule II controlled substance for up to a 30-day supply of the Schedule II controlled substance, only if the prescription of a Schedule II controlled substance by the physician assistant is reviewed and approved by the supervising physician at least every 30 days.
If the supervising physician determines and documents that the patient is terminally ill, the physician assistant may write a prescription for a Schedule II controlled substance for up to a 30-day supply if the prescription of a Schedule II controlled substance by the physician assistant is reviewed and approved by the supervising physician at least every 120 days.
The prescription must clearly state on its face that it is for initial or ongoing therapy.
A physician assistant may only prescribe or dispense a drug for a patient who is under the care of the physician responsible for the supervision of the physician assistant and only in accordance with the supervising physician's instructions and written agreement.
A physician assistant may request, receive and sign for professional samples and may distribute professional samples to patients.
A physician assistant authorized to prescribe or dispense, or both, controlled substances shall register with the Drug Enforcement Administration (DEA).
State Board of Osteopathic Medicine Regulations, §25.177Rhode Island
PAs employed by physicians, HMOs or other health care delivery organizations may write prescriptions for legend drugs, Schedule II-V controlled substances, medical therapies, devices and diagnostics according to guidelines established by the employer. PAs employed by or extended medical staff privileges by a licensed hospital or other health facility may write medical orders for inpatients as delineated by the bylaws and credentialing process.
Rhode Island Code, §5-54-8
As delegated by supervising physician and according to guidelines established by physician, health maintenance organization or other health care delivery organization, PAs may prescribe legend drugs and devices and controlled substances from Schedules II-V. PAs who prescribe controlled substances must obtain state controlled substance registration number and must register with DEA.
Rules and Regulations for the Licensure of Physician Assistants, §§ 6.4 to 6.7
South Carolina
Prescriptions must be limited to drugs and devices authorized by supervising physician and set forth in written scope of practice guidelines. Prescriptions must be signed by PA and include PA’s board-assigned identification number, PA’s and physician’s name, address, and phone number preprinted on form. PA may request, receive, and sign for samples of drugs authorized in written scope of practice guidelines, except for controlled substances in Schedule II and may distribute professional samples to patients.
PA applying for controlled substance prescriptive drug authority must have completed 60 hours of education in pharmocotherapeutics, and at least 15 hours of education in controlled substances. PA and supervising physician must read and sign a document describing the management of expanded controlled substances prescriptive authority for PAs, which must be kept on file for review. PA and supervising physician shall periodically review this document and PA’s prescribing practices. Review must be documented in writing with a copy kept at each practice site.
South Carolina Code of Laws Article 7, §40-47-965
South Dakota
PA may provide medical services delegated by the supervising physician if the service is within the PA's skills, forms a component of the physician's scope of practice, and is provided with supervision including prescribing and provision of drug samples or a limited supply of labeled medications, including Schedule II controlled substances for one period of not more than thirty days, for treatment of causative factors and symptoms. Medications or sample drugs provided to patients shall be accompanied with written administration instructions and appropriate documentation shall be entered in the patient's record. Physician assistants may request, receive, and sign for professional samples of drugs provided by the manufacturer
South Dakota Code of Laws, 36-4A-26.1
PAs can prescribe non-controlled medications and administer or dispense controlled substances as delegated by their supervising physician. PAs may prescribe controlled medications but must register with the DEA and obtain State Controlled Substance Registration. Employment contract must specifically identify the controlled substance activities authorized by the Supervising physician.
From 9/24/96 Department of Health Letter
Tennessee
Supervising physician may delegate to a PA the authority to prescribe and/or issue legend drugs and controlled substances in Schedule II-V in accordance with board rules. PA who is a delegated prescriber of controlled medications must register with the DEA. Pre-printed name of supervising physician and PA must be on Rx pad. Prescribing PA shall file notice with board’s PA committee containing name of the PA and supervising physician, copy of formulary of medications PA authorized to prescribe and/or issue.
Tennessee Code Annotated, 63-19-107
Within ten (10) business days after the physician assistant has examined a patient who falls in one of the following categories, the supervising physician shall make a personal review of the historical, physical, and therapeutic data gathered by the physician assistant on that patient and shall so certify in the patient’s chart within thirty (30) days:
- when medically indicated;
- when requested by the patient;
- when prescriptions written by the physician assistant fall outside the protocols;
- when prescriptions are written by a physician assistant who possesses a temporary license; and
- when a controlled drug has been prescribed.
Texas
A physician may delegate the carrying out or signing of a prescription drug order for a controlled substance only if:
(1) the prescription is for a controlled substance listed in Schedules III, IV, or V as established by the commissioner of public;
(2) the prescription is for a period not to exceed 30 days;
(3) the refill of a prescription is authorized after consultation with the delegating physician and the consultation is noted in the patient's chart; and
(4) with regard to a prescription for a child less than two years of age, the prescription is made after consultation with the delegating physician and the consultation is noted in the patient's chart.
This section does not limit the authority of a physician to delegate the carrying out or signing of a prescription drug order involving a controlled substance under this subchapter.
Texas Occupations Code, § 157.0511
Delegated prescribing may include dangerous drugs and Schedule III-V controlled medications. Controlled substance prescriptions limited to 30 days; refill must be authorized after consultation with supervising physician. Prescription for controlled medications for child under 2 years of age requires consultation with supervising physician. The consultation must be noted in the patient’s chart.
Rules for Physician Assistants, Chapter 193 (standing delegation orders) §193.6.
Utah
PA acting in accordance with a delegation of services agreement may prescribe or administer an appropriate controlled substance if the PA holds a Utah controlled substance license and a DEA registration, the prescription or administration of the controlled substance is also within the prescriptive practice of the supervising physician and the supervising physician cosigns any medical chart record of prescription for a Schedule II or III controlled substance made by the PA.
Utah Code Annotated, 58-70a-501
Vermont
“Authorization to prescribe medication and medical devices” means the authorization for a PA to prescribe, dispense and administer drugs and medical devices to the extent delegated by the supervising physician. Prescribing and dispensing of drugs may include Schedules II through V inclusive. At not time shall prescriptive practices of the PA exceed the prescriptive practices of the supervising physician(s).
Scope of practice statement must include authorization to prescribe medication. PAs who prescribe controlled medications must register with the DEA.
Rules of the Board of Medical Practice, 13 141 001, Section II, parts 5.2 and 7.3
Virginia
A licensed physician assistant shall have the authority to prescribe Schedules II-VI controlled substances upon provision to the board of evidence that PA has entered into and is at the time of prescribing a party to a written agreement with physician or podiatrist which provides for direction and supervision of the PA’s prescriptive practices.
Code of Virginia, § 54.1-2952.1
Washington
Certified PA may issue written or oral prescriptions when approved by the commission or its designee.
(1) Written prescriptions shall include the name, address, and telephone number of the physician or medical group; the name and address of the patient and the date on which the prescription was written.
(a) The certified physician assistant shall sign such a prescription using his or her own name followed by the letters 'P.A.-C.'
(b) The written prescriptions for schedule two through five must include the physician assistant's D.E.A. registration number, or, if none, the sponsoring physician's D.E.A. registration number, followed by the letters 'P.A.-C' and the physician assistant's license number.
(2) A certified physician assistant employed or extended privileges by a hospital, nursing home or other health care institution may, if permissible under the bylaws, rules and regulations of the institution, order pharmaceutical agents for inpatients under the care of the sponsoring physician(s).
(3) The license of a certified physician assistant who issues a prescription in violation of these provisions shall be subject to revocation or suspension.
(4) Certified physician assistants may dispense medications the certified physician assistant has prescribed from office supplies. The certified physician assistant shall comply with the state laws concerning prescription labeling requirements.
Washington Administrative Code, 246-918-035
West Virginia
PAs authorized to issue prescriptions for Schedules III through V controlled substances shall write on the prescription form the Federal Drug Enforcement Administration number issued to that physician assistant. Prescriptions written for Schedule III drugs shall be limited to a seventy-two (72) hour supply and may not authorize a refill. The maximum amount of Schedule IV or Schedule V drugs shall be no more than ninety (90) dosage units or a thirty (30) day supply, whichever is less.
Prescriptions for other legend drugs shall not be prescribed or refillable for a period exceeding six (6) months.
West Virginia Legislative Rules Title II, Series 1B, §§ 14.8-14.9
Wisconsin
A PA may issue written prescription orders for drugs under supervision of licensed physician (may include Schedules II-V and non-controlled drugs). Following conditions apply:
- PA prepares Rx order only in patient situations described in written guidelines (which are to be reviewed at least annually by physician and PA)
- Supervising physician and PA agree that PA is qualified to prescribe
- Physician is available for consultation
- Rx contains name, address and phone of physician, name and address of PA, plus PA signature. Must contain DEA number of physician and PA if Rx is for a controlled substance.
1. Reviews and countersigns the prescription order prepared by the physician assistant, or
2. Reviews and countersigns within 72 hours the patient record prepared by the physician assistant practicing in the office of the supervising physician or at a facility or a hospital in which the supervising physician has staff privileges, or
3. Reviews by telephone or other means, as soon as practicable but within a 72- hour period, and countersigns within one week, the patient record prepared by the physician assistant who practices in an office facility other than the supervising physician's main office of a facility or hospital in which the supervising physician has staff privileges.
Wisconsin Administrative Code, Chapter Med 8.07-8.08
Wyoming
A PA may prescribe Schedule II-V and non-scheduled medications as an agent of the supervising physician.
Wyoming Statutes, 33-26-510
(a) As the agent of the supervising physician, a PA may prescribe, administer and dispense medications, including schedule II-V. Dispensing shall be limited to rural clinics in which pharmacy services are not physically available.
(b) A PA shall not prescribe schedule I.
(c) Use of pre-signed prescription pads is prohibited.
Chapter V Rules of Practice and Procedures: Physician Assistants, § 17
9/09
