Changes Coming in Delegation of Prescriptive Authority?
Texas Medical Board staff met with the representatives of the Texas Nursing Board and the Department of Public Safety regarding prescriptive delegation for mid-level providers. They discussed the two methods that mid-level providers to prescribe scheduled drugs:
(1) The mid-level providers can obtain there own certification with the DEA and DPS. Their individual certification number must appear on their prescription pad and they are required to have a supervisor relationship with a licensed physician. This person is viewed as a “sponsor.”
(2) There must be a standing protocol for the mid-level provider to prescribe using the physician’s prescription pad for the listed symptoms and only prescribe medications that are listed in the protocol for the symptoms.
The parties meet to discuss creating a field on the Texas Medical Board’s Physician Profile that will list all of the mid-level providers under the physician’s sponsorship who have prescriptive authority.
The Texas Medical Board’s Standing Delegation Committee voted to create a sub-committee with the Physician Assistant Board and the Nursing Board to look into the guidelines for supervising physicians over PA’s and APN’s who have prescriptive authority under the physician’s supervision. Their goal is to have everyone on the same page as to what the rules are and the risks involved in prescriptive delegation.
My Take: First, physicians and mid-levels need to be sure they are in full compliance with current level and the correct paper work is in the Board denoting the supervisor relationship. Second, look for the rules to be changed in the future. If you have three boards get together, I can assure you the rules will change. Given the current regulatory climate, I suspect that rules will tighten-up. I just hope that before the Boards publish any rule changes, they talk and meet with “stake holders” in this area as any changes to mid-level prescriptive authority will have significant affect over thousands of providers. Please continue to monitor this blog for changes.