Great News! Governor Signs Bill Authorizing Controlled Prescribing Authority for PAs

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July 16, 2009

Dear Missouri PA:
Great news! Last Friday, July 10, Governor Nixon has signed SB 296 into law. As you remember, this bill authorizes physicians to delegate to PAs Schedule III-V controlled prescriptive authority. It also clarified the law so that PAs who practice in federally designated rural health clinics do not have to apply for a waiver to the 66% supervision requirement, and extends the first-time waiver from one year to five years. A copy of this bill can be found here (the language starts on page 54).

The new law requires PAs to amend their supervision verification form that is filed with the state Board of Healing Arts to include delegated controlled prescribing authority. PAs must also provide proof of meeting the following educational and practice requirements:

• The supervising physician must determine and document the the PA having completed at least 120 hours in a 4-month period during which the PA has practiced with the supervising physician on-site prior to prescribing controlled substances when the supervising physician is not on-site. This requirement does not apply to PAs practicing federally qualified rural health clinics.
• PA must verify 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 pharmacological content in an accredited PA program satisfies this requirement;
  2. Completion of a minimum of 300 clock hours of clinical training by the supervising physician in the prescription of drugs, medicines, and therapeutic devices;
  3. Completion of a minimum of 1 year of supervised clinical practice or supervised clinical rotations. One year of clinical rotations in an accredited program which includes pharmacotherapeutics as a component of its clinical training satisfies this requirement, and proof of such training shall serve to document this experience;
  4. A PA previously licensed in a jurisdiction where PAs 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 PA has met the above requirements and provides documentation of existing federal DEA registration.

The changes to the law are effective 90 days from the date of the Missouri Legislature's adjournment this year, on August 30, 2009. However, don't print those prescription pads yet &emdash; the federal Drug Enforcement Administration (DEA) also needs to sign off on the changes to the law before PAs will be able to register with the federal DEA and state controlled substance authority. We will keep you all updated on the progress of this process.

As always, thank you for the many phone calls, letters, and personal conversations PAs and supervising physicians had with their legislators during the course of this legislative session. We are just getting started in transforming the PA laws in this state, and will continue to keep you informed about our future plans.

If you have additional questions about the new law, or anything else, please do not hesitate to contact me. Thanks again for your help this year!

Sincerely,

Paul Winter
MAPA President