Illinois prescriptive authority

Trauma Columnist · Dec 28, 2012

Here ya go:

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Questions regarding Schedule II Prescriptive Authority

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What Schedule II drugs can I prescribe?

As an APN who has a written collaborative agreement, Schedule II and Schedule II n are allowed. Examples of Schedule II medications include but are not limited to: Acetaminophen with Oxycodone, Percocet, Codiene, Hydromorphone. Schedule II n include: Ritalin and Seconal. For a list of all Schedule drugs, please refer to the DEA website at www.usdoj.gov/dea/pubs/scheduling.html.

Can I prescribe all Schedule II medications?

You cannot prescribe schedule II medications until you have a controlled substance license that includes schedule II medications. Please see the "How can I obtain my Schedule II Illinois controlled substance license?” option below for more information. Once you have your updated license there is a limit to the number of Schedule II medications you can prescribe. In the written collaborative agreement, you and the physician will decide which medications you can prescribe. The physician must also have the capacity to prescribe the same medications you prescribe. An APN may prescribe a total of five Schedule II medications. There is a caveat to the five medications. For example, morphine counts as one drug and includes brand name derivates such as MS Contin, Roxanol and Duramorph.

Am I only able to prescribe the same original five Schedule II medications?

No, you may revise your list as often as you like however, it needs to be a drug prescribed by your collaborator or that you are privileged to order.

What do I do about patients on a Schedule II drug which is no longer on my list of 5 medications?

You may not prescribe or renew a prescription for Schedule II not included on your list of 5 medications. If you choose to continue your patient on this drug, your collaborating physician must write the prescription.

How can I obtain my Schedule II Illinois controlled substance license?

It is our recommendation that APNs do not write for Schedule II drugs in the State of Illinois until the following has been reconciled. You will need to obtain an updated Illinois controlled substance license in order to obtain your DEA number. IDFPR staff will have to create a new "Delegation of Prescription Authority" form which is required to obtain an Illinois Controlled Substance License, which is a prerequisite for obtaining a DEA number. That form will need to be revised to reflect the option of prescribing Schedule II drugs.

How do I apply for my DEA including Schedule II medications?

Refer to the IL Department of Financial and Professional Regulation (IDFPR) website for detailed information on status of prescribing Schedule II medications. www.idfpr.com

If I work in a hospital or ASTC, can I prescribe Schedule II medications for my patients?

Yes, in a hospital or ASTC, you can order schedule II medications without limits as long as your credentialing and privileging allow you to do so.

May I accept samples from a drug representative?

Yes, this has been in effect since the last NPA.

Does the physician’s name need to be on the prescription pad?

Yes. If you have a written collaborative agreement the name of the collaborating physician for that patient needs to appear on the prescription.

Do I still have prescriptive authority without a collaborative agreement?

You may have prescriptive authority delegated via the privileging process. You will be ordering medications in the hospital setting.

Can an NP keep his/her license for controlled substances and the DEA number upon leaving a collaborative agreement arrangement?

When it appears that a collaborative arrangement will be dissolved, the APN should go to the IDFPR website (www.ildpr.com) and download 2 documents: (a) Termination of Delegation of Prescriptive Authority, and (b) Delegation of Prescriptive Authority. The "Termination" form has to be signed by the soon-to-be "outgoing" collaborating physician (CP). There's a place to indicate the date that the termination will take place, so the APN should be sure to get this form signed before s/he and the CP part company. Then s/he should get the "Delegation" form signed by her/his new CP prior to prescribing under that relationship. These forms will generate a new form from IDFPR (gets mailed to the "outgoing" and "incoming" CPs) that clarifies the APN's authority related to her/his controlled substance license. The DEA doesn't need to know about a change in CPs; that's handled through the controlled substance license. However, it MIGHT need to know a change of employment--if that is the address that was submitted on the DEA application.

It should be noted that technically a DEA number isn't required for an APN to prescribe non-controlled substances, meaning that a DEA number isn't required by law if the APN doesn't prescribe controlled substances. However, Medicaid and other reimbursers seem to require a DEA number before they pay for a script, so we urge all APNs to get a DEA #, even if s/he only gets authority for Schedule V drugs (the least risky drugs), so that s/he had a # to put on her/his script. It's embarrassing for a patient to try to get a script filled just because there's no DEA #--even though it's not really required by law.

Three physicians have delegated me prescriptive authority. One will be leaving the group and moving out of state. Is there a form I send to the State of Illinois?

Yes, there is a form that will need to be submitted to:

Department of Financial and Professional Regulation

ATTN: Division of Professional Regulation

320 W Washington, 3rd Floor

Springfield, IL 62786

The form is titled "Notice of Termination of Delegated Prescriptive Authority for Controlled Substances." The form can be downloaded from the www.idfpr.com website. The form must be signed by the collaborating physician that will be terminating the agreement.

http://www.idfpr.com/dpr/apply/forms/f1883apn.pdf"

http://www.isapn.org/?page=PIRTScheduleII&hhSearchTerms=prescription

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kimberlys63 · Dec 29, 2012

I think it is more revised than this also. I don't think there is a five drug limit and we can now also do transdermal. I found these Changes at the sea site and nurse practitioner act section 65-40 Kim

Trauma Columnist · Dec 29, 2012

could be. I'm in a nephrology practice and I refer to pain clinic for anything past norco.