263 CMR, § 5.06 - Prescription Practices of a Physician Assistant
(1) Any physician assistant who holds a full
license, issued by the Board pursuant to
263 CMR
3.02: Requirements for Full
Licensure, may issue written or oral prescriptions or medication
orders for a patient, provided that he or she does so in accordance with all
applicable state and federal laws and regulations including, but not limited
to, M.G.L. c. 112, § 9E; c. 94C, §§ 7, 9 and 20;
105 CMR 700.000:
Implementation of M.G.L. c. 94C; and 263 CMR
5.06(1).
(2) A physician assistant
who holds a temporary license, issued by the Board pursuant to
263 CMR 3.04:
Temporary License, may prepare a written or oral prescription
or medication order for a patient, provided that:
(a) Any such written prescription or
medication order is signed by his or her supervising physician, or by another
licensed physician who has been designated to assume temporary supervisory
responsibilities with respect to that physician assistant pursuant to
263 CMR
5.04(3)(g), prior to the
issuance of said prescription or medication order to the patient;
(b) Any such oral prescription or medication
order is approved, in writing, by his or her supervising physician, or by
another licensed physician who has been designated to assume temporary
supervisory responsibilities with respect to that physician assistant pursuant
to
263 CMR
5.04(3)(g), prior to the
issuance of that oral prescription or medication order; and
(c) All such oral or written prescriptions or
medication orders are issued in the name of the supervising physician, and are
otherwise issued in accordance with all applicable state and federal laws and
regulations, including but not limited to, M.G.L. c. 112, § 9E; c. 94C,
§§ 7, 9 and 20;
105 CMR 700.000:
Implementation of M.G.L. c. 94C; and 263 CMR
5.06(2).
(3) Any
prescription or medication order issued by a physician assistant for a Schedule
II controlled substance, as defined in
105 CMR
700.002: Schedules of Controlled
Substances, shall be reviewed by his or her supervising physician,
or by a temporary supervising physician designated pursuant to
263 CMR
5.04(3)(g), within 96 hours
after its issuance.
(4) All
physician assistants shall issue prescriptions or medication orders in
accordance with written guidelines governing the prescription of medication
which are mutually developed and agreed upon by the physician assistant and his
or her supervising physician.
(a) Such
guidelines shall address, but need not be limited to, the following issues:
1. Identification of the supervising
physician for that work setting;
2.
Frequency of medication reviews by the physician assistant and his or her
supervising physician;
3. Types and
classes of medications to be prescribed by the physician assistant;
4. The initiation and/or renewal of
prescriptions for medications which are not within the ordinary scope of
practice for the specific work setting in question, but which may be needed to
provide appropriate medical care;
5. The quantity of any medication to be
prescribed by a physician assistant, including initial dosage limits and
refills;
6. The types and
quantities of Schedule VI medications which may be ordered by the physician
assistant from a drug wholesaler, manufacturer, laboratory or distributor for
use in the practice setting in question;
7. Review of initial prescriptions or changes
in medication; and
8. Procedures
for initiating intravenous solutions.
(b) Such guidelines shall be available for
review by the Board or its designee, the Massachusetts Board of Registration in
Medicine or its designee, the Massachusetts Department of Public Health or its
designee, and such other state or federal government agencies as may be
reasonably necessary and appropriate to ensure compliance with all applicable
state or federal laws and regulations. Copies of such guidelines, however, need
not be filed with those agencies.
(c) All such guidelines must be in writing
and must be signed by both the supervising physician and the physician
assistant. Such guidelines shall be reviewed annually and dated and initialed
by both the supervising physician and the physician assistant at the time of
each such review. The physician assistant and his or her supervising physician
may alter such guidelines at any time and any such changes shall be initialed
by both parties and dated.
(5) All prescriptions or medication orders
issued by a physician assistant shall be issued in a manner which is consistent
with the scope of practice of the physician assistant, the guidelines developed
pursuant to 263 CMR 5.06(4), and accepted standards of good medical practice
for licensed physicians with respect to prescription practices.
(6) At least four hours of the continuing
medical education which a physician assistant is required to obtain pursuant to
263 CMR 3.05(3)
as a condition for license renewal shall be
in the field of pharmacology and/or pharmacokinetics.
(7) All prescriptions written by a physician
assistant shall be written in accordance with
105 CMR 721.000:
Standards for Prescription Format and Security in
Massachusetts.
(8) A
physician assistant may order only Schedule VI controlled substances from a
drug wholesaler, manufacturer, distributor or laboratory, and only in
accordance with the written guidelines developed with his or her supervising
physician pursuant to 263 CMR 5.06(4). A physician assistant may sign only for
sample Schedule VI controlled substances received by or sent to the practice
setting by a pharmaceutical representative.
(9) The use of pre-signed prescription blanks
or forms is prohibited.
(10) A
physician assistant shall not prescribe controlled substances in Schedules II,
III and IV for his or her own use. A physician assistant shall not prescribe
Schedule II controlled substances for a member of his or her immediate family,
including a parent, spouse or equivalent, child, sibling, parent-in-law,
son/daughter-in-law, brother/sister-in-law, step-parent, step-child,
step-sibling, or other relative permanently residing in the same residence as
the physician assistant.
(11) The
physician assistant and the supervising physician for that work setting shall
be jointly responsible for all prescriptions or medication orders issued by the
physician assistant in that work setting.
Notes
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