NOTICE OF INTENT
Department of Health and Hospitals
Board of Medical Examiners
Physician Assistants, Licensure and Certification;
Qualifications for Registration of Prescriptive Authority (LAC 46:XLV.1521)
Notice is hereby given that pursuant to the authority of the Louisiana Medical Practice Act, R.S. 37:1261-1292 and the Louisiana Physician Assistant Practice Act, R.S. 37:1360.21-1360.38, and in accordance with the provisions of the Louisiana Administrative Procedure Act, R.S. 49:950 et seq., the Louisiana State Board of Medical Examiners (board) intends to amend its administrative rules governing the qualifications of physician assistants (PAs) for registration of prescriptive authority. The proposed amendments delete the word “unrestricted” from LAC 46:XLV.1521.A.2, as well as the wording of 46:XLV.1521.C.5, in order to remove certain criteria that may disqualify a PA from obtaining legend or controlled substance prescriptive authority which is not otherwise restricted by a board decision or order. The proposed amendments are set forth below.
Title 46
PROFESSIONAL AND OCCUPATIONAL STANDARDS
Part XLV. Medical Professions
Subpart 2. Licensure and Certification
Chapter 15. Physician Assistants
§1521. Qualifications for Physician Assistant Registration of Prescriptive Authority
A. Legend Drugs/Medical Devices. To be eligible for registration of prescriptive authority for legend drugs or medical devices, or both, a physician assistant shall:
1. …
2. possess a current license to practice as a physician assistant duly issued by the board and not be the subject of a current investigation or pending disciplinary proceeding by the board;
A.3. - B.3. …
C. A physician assistant shall be deemed ineligible for registration of authority to prescribe controlled substances who:
1. - 4. …
5. Repealed and Reserved;
C.6. - E. …
AUTHORITY NOTE: Promulgated in accordance with R.S. 37:1270(B)(6), 1360.23(D) and (F), and 1360.31(B)(8).
HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Board of Medical Examiners, LR 31:75 (January 2005), amended LR 38:
Family Impact Statement
In compliance with Act 1183 of the 1999 Regular Session of the Louisiana Legislature, the impact of the proposed amendments on the family has been considered. It is anticipated that the proposed amendments will have no impact on family, formation, stability or autonomy, as described in R.S. 49:972.
Public Comments
Interested persons may submit written data, views, arguments, information or comments on the proposed amendments to Rita Arceneaux, Confidential Executive Assistant, Louisiana State Board of Medical Examiners,630 Camp Street,New Orleans,LA70130, (504) 568-6820, Ex. 242. She is responsible for responding to inquiries. Written comments will be accepted until 4 p.m., October 19, 2012.
Public Hearing
A request pursuant to R.S. 49:953(A)(2) for a public hearing must be made in writing and received by the board within 20 days of the date of this notice.
Robert L. Marier, M.D.
Executive Director
The above changes were to the original Rule which is as follows (Proposed changes are in bold and underlined).
: §1521. Qualifications for Physician Assistant Registration of Prescriptive Authority
A. Legend Drugs/Medical Devices. To be eligible for registration of prescriptive authority for legend drugs or medical devices, or both, a physician assistant shall:
1. satisfy the licensure requirements of §1507 of this Chapter;
2. possess a current, unrestricted license to practice as a physician assistant duly issued by the board and not be the subject of a current investigation or pending disciplinary proceeding by the board;
3. have received authority to prescribe legend drugs and/or medical devices to the extent delegated by a supervising physician;
4. have completed:
a. a minimum of one year of clinical rotations during training and one year of practice under a supervising physician; or
b. a minimum of two years of practice under a supervising physician;
5. practice under supervision as specified in clinical practice guidelines or protocols that shall, at a minimum, include:
a. the methods to be employed by the supervising physician to insure supervision of the physician assistant's prescriptive authority;
b. the nature, types and classifications of medication and/or medical devices a physician assistant is authorized to utilize by the supervising physician;
c. a plan to accommodate immediate consultation by telephone or direct telecommunication with the supervising physician, or in his absence an approved locum tenens physician, to address medical emergencies, complications and other such matters;
d. a predetermined plan for emergency services, after-hours, weekend, and vacation coverage;
e. a predetermined plan for patient referrals to other physicians, emergency rooms and admission to hospitals at which the supervising physician holds privileges. Such plan shall include a statement that the physician assistant shall not seek privileges at any institution unless the supervising physician holds privileges at such institution;
f. an acknowledgment of the mutual obligations and responsibilities of the supervising physician and physician assistant to comply with all requirements of §4511 of these rules including, but not limited to, the review and countersigning of the physician assistant's written entry in the patient record of prescriptions for medication or medical devices; and
g. confirmation that the physician assistant shall not prescribe medication or medical devices if the supervising physician, or in his absence an approved locum tenens physician, is neither physically present nor available by telephone or other telecommunication device.
B. Controlled Substances. To be eligible for registration of prescriptive authority for controlled substances a physician assistant shall:
1. satisfy the requirements of §1521.A;
2. possess a current, unrestricted permit or license to prescribe controlled substances in Louisiana duly issued by the Office of Narcotics and Dangerous Drugs, Department of Health and Hospitals, State of Louisiana or its successor, and be currently registered to prescribe controlled substances without restriction as to the schedules delegated by the supervising physician with the Drug Enforcement Administration, United States Department of Justice (DEA). A physician assistant authorized to prescribe controlled substances shall provide the board photocopies of his Louisiana permit and federal registration prior to prescribing controlled substances; and
3. not be deemed ineligible for registration for any of the causes set forth in §1521.C.
C. A physician assistant shall be deemed ineligible for registration of authority to prescribe controlled substances who:
1. has, within the five years preceding application for registration, been convicted, whether upon verdict, judgment or plea of guilty or nolo contendere of any crime constituting a felony under the laws of the United States or of any state or who has entered into a diversion program, a deferred prosecution or other agreement in lieu of the institution of criminal charges or prosecution for such crime;
2. has, within the five years preceding application for registration, been convicted, whether upon verdict, judgment or plea of guilty or nolo contendere of any crime, an element of which is the manufacture, production, possession, use, distribution, sale or exchange of any controlled substance or who has entered into a diversion program, a deferred prosecution or other agreement in lieu of the institution of criminal charges or prosecution for such crime;
3. has, within the five years preceding application for registration, habitually used or abused any medication, alcohol or other substance which can produce physiological or psychological dependence or tolerance or which acts as a central nervous system stimulant or depressant;
4. has had suspended, revoked or restricted, his narcotics controlled substance permit, license, certificate or registration (state or federal), or who has voluntarily surrendered to such state or federal authority while under investigation in lieu of the institution of disciplinary charges or action against such authority;
5. has had his professional license suspended, revoked or placed on probation or restriction in any manner by the board or by any licensing authority, or who has in the presence of an investigation agreed not to seek re-licensure, voluntarily surrendered or entered into an agreement with the board or with any licensing authority in lieu of the institution of disciplinary charges or action against such license; (Repealed and reserved)
6. has, within the five years preceding the application for registration, been denied, had suspended, revoked, restricted or relinquished staff or clinical privileges at a hospital or other health care institution following a hearing or an opportunity for hearing, as a result of professional competency or conduct or who is currently the subject of an unresolved investigation by a hospital medical staff for professional competency or conduct; or
7. has failed his most recent attempt at passage of the certification or recertification examination administered by the NCCPA and has yet to take or successfully pass such examination on a subsequent attempt.
D. The board may deny registration of prescriptive authority to an otherwise eligible physician assistant for any of the causes enumerated by R.S. 37:1360.33, or any other violation of the provisions of the Louisiana Physician Assistant Practice Act, R.S. 37:1361.21 et seq. or its rules applicable to physician assistants.
E. The burden of satisfying the board as to the eligibility of the applicant for approval of registration of prescriptive authority shall be upon the applicant. An applicant shall not be deemed to possess such qualifications unless the applicant demonstrates and evidences such qualifications in the manner prescribed by and to the satisfaction of the board.
HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Board of Medical Examiners, LR 31:75 (January 2005).
