Prescriptive Authority and Drug Enforcement Administration Registration

Prescriptive authority is granted under state law by the appropriate board. The board granting prescriptive authority may be the Medical Board, State Board of Pharmacy, or Nursing Board for the appropriate state licensure is being pursued. The authority to write for a controlled substance is granted at a federal level and is verified through the Drug Enforcement Administration (DEA) by the appropriate state board. Drug Enforcement Agency registration is granted at the federal level and has additional requirements/fees for the registration process.

Each state has different laws regarding the role of the Nurse Practitioner that may significantly impact the NPs’ practice. Legislative changes may occur annually, bi-annually, or during an emergency legislative meeting at the state or federal level. These legislative sessions and any subsequent changes will significantly impact your scope of practice as a Nurse Practitioner.

Remaining current regarding state law is essential. In the Week 4 Discussion, as you may recall, we introduced the recent change regarding the classification of hydrocodone-containing drugs at the federal level from a Schedule III drug to a Schedule II drug. For states that allow for Nurse Practitioners to write Schedule III-V drugs, these NPs are now unable to write for hydrocodone-containing medications, which significantly impacts their ability to provide care for their patients. However, there are states that do not grant NPs prescriptive authority and/or do not allow NPs to write for controlled substances. Over the last 55 years, Nurse Practitioners have made great strides in obtaining prescriptive authority to prescribe both non-controlled and controlled drugs.

This week students will explore the prescriptive authority application process for their state. Additionally, the DEA Registration Application process will be reviewed.

Learning Objectives

By the end of this week, students will:

Analyze appropriate prescriptive authority and DEA registration processes

Analyze safe prescribing practices

Evaluate professional strengths and weaknesses

Evaluate mastery of NP clinical skills

Learning Resources

Required Readings

Buppert, C. (2018). Nurse practitioner’s business practice and legal guide (6th ed.). Sudbury, MA: Bartlett & Jones Learning.

Chapter 5, “Prescribing” (pp. 203-207)

This chapter covers prescribing as an advanced practice nurse.

MidLevelU. (2017). Medical records: What must be included from a prescribing standpoint? Retrieved from http://midlevelu.com/blog/medical-records-what-must-be-included-prescribing-standpoint

U.S. Department of Justice (n.d.). Drug Enforcement Administration: Office of Diversion Control. Retrieved from http://https://www.dea.gov/ops/diversion.shtml

This resource guides you on a federal level to enforce safe prescribing of controlled drugs.

Optional Resources

Hagan, P. C., & Ransdell, M. (2015). “Do not fill until”…… Not a legal solution! KBN Connection, Spring(43), 8-10. Retrieved from http://kbn.ky.gov/online-forms/Documents/Spr15_0116.pdf

Discussion: Safe Prescribing

In 1915, the Drug Enforcement Administration was formed, known then as the Bureau of Internal Revenue. Recognizing the variance in state laws and the process for completing applications for prescriptive authority and DEA registration is essential to the role of the NP as a prescriber. Within the last decade, safe prescribing of opioids has also become a national concern. For this Discussion, you will focus on the process for obtaining prescriptive authority after successfully completing your program of study and passing a National Certification Exam. You also will explore safe prescribing.

To prepare:

Review your state’s process for obtaining prescriptive authority and associated fees

Review the DEA website and review the process for obtaining a DEA number and associated fees.

Review and select one of the following case studies and analyze the provider information:

Case Study One: Lori, FNP-BC, is a new graduate and has recently passed her certification exam. She has just been hired to work for a Primary Care Clinic in a small town. She will be working with one physician at one site.

Case study Two: James, FNP-BC, works with a physician who specializes in pain control. He works in several clinics in the large urban city where he practices.

Post a brief summary of your case study and an explanation of the appropriate prescriptive authority and DEA registration process needed for the case study you selected. Then, explain the safe prescribing practices that these providers should use for these settings.

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