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During its recently adjourned 2016 session, the Florida Legislature passed, and the Governor signed HB 423, the Barbara Lumpkin Prescribing Act. The Act ends a lengthy battle to grant Advanced Registered Nurse Practitioners ("ARNPs") and Physician Assistants ("PAs") full prescribing privileges and responsibilities and treat patients within the full scope of their training and licensure.
ARNP’s and PAs have been seeking authority to prescribe Schedule 2 to drugs, including narcotics, for several years. They pointed out that prescribing and administering these drugs was within both the scope of their training and licensure and made full use of their skills. Only Florida’s prescribing statutes prevented these healthcare professionals from taking advantage of the full scope of their licenses. Indeed, Florida may be the last state where these ARNPs and PAs did not have that authority. Pursuant to the Act, effective July 1, 2016, ARNPs and PAs will be authorized to order and dispense controlled substances in Florida.
Under the Act, their authorization to prescribe these drugs will subject ARNPs and PAs to the same restrictions already applicable in the case of physicians who prescribe and dispense Schedule 2 drugs. As with physicians, the standard of practice will include, among other things: (i) A complete medical history and physical examination of a patient before beginning any treatment; and (ii) documentation in the patient’s medical record. In addition that patient will have to be seen at regular intervals. Consequently, it would be prudent for ARNPs, PAs and their supervising physicians to review these restrictions and requirements including, but certainly not limited to, those relating to the storage of and accounting for Schedule 2 controlled substances, and the regulations relating to pain clinics (if for no other reason than to ensure they do not fall under this scheme).
Clarifying the role of ARNPs and PAs in prescribing controlled substances is likely to have a significant impact on the delivery of healthcare in Florida. For ARNPs and PAs who practice in rural areas, where a physician may not be readily available, this authorization is likely to make it easier for them to provide appropriate and timely treatment to patients. In urban areas ARNPs and PAs are likely to take over even more of the "routine" care they already are providing in many physicians’ practices and other healthcare organizations.
Enactment of the Barbara Lumpkin Prescribing Act is likely to rise at least as many new questions as those resolved by this legislation. However, time, the adoption of new regulations, Board of Nursing and Board of Nursing Declaratory Statements and disciplinary actions, and court decisions will address and eventually resolve many of these questions. In the meantime, physicians, ARNPs, PAs, other healthcare professionals and providers, and some healthcare entrepreneurs will be well served to work with experienced health law counsel in understanding how these changes will impact their practices and businesses.
