Recent changes to Michigan law have increased the prescriptive authority of certain specialty nurses. Michigan has recently created a classification for certain specialty nurses, called “advanced practice registered nurses” or “APRNs,” which are registered professional nurses with a specialty as a (i) nurse midwife; (ii) nurse practitioner; or (iii) a clinical nurse specialist. Along with this new classification comes some increased prescriptive authority
A. Prior Law
Under prior Michigan law there was not a classification for an APRN. However, Michigan law did define a “prescriber” to include a “licensed health professional acting under the delegation and using, recording, or otherwise indicating the name of the delegating licensed doctor of medicine or licensed doctor of osteopathic medicine and surgery.” This would suggest that a specialty nurse, such as a nurse practitioner (“NP”), could prescribe controlled substances under Michigan law.
The definition of prescriber did not discuss what prescriptions NPs could write. The Michigan Board of Medicine had issued rules which limited the delegating authority of physicians with regard to controlled substances. A physician could delegate to a specialty nurse, the ability to prescribe controlled substances in schedules 3 through 5 pursuant to written authorization that met the enumerated requirements. For controlled substances in schedule 2, a physician could only delegate authority to prescribe those medications if (1) the physician and NP were in a freestanding surgical outpatient facility, hospital, or hospice; (2) the patient is located within the facility; and (3) the delegation was otherwise in compliance with the rule. Furthermore, the prescription could not be for more than a 7-day period.
B. The New Statute
As of April 9, 2017, an APRN can prescribe controlled substances in schedules 2 through 5 when delegated the authority by a physician. However, a prescription issued under that requires the names and DEA registration numbers of both the APRN and the delegating physician to be “used, recorded, or otherwise indicated.” New regulations also conform with the new prescriptive authority of APRNs.
Supervising physicians and APRNs must ensure they meet both state and federal prescribing regulations. Failure to meet these regulations and inappropriate prescribing of controlled substances can result in loss of licensure, fines, felonies, and imprisonment. Chapman Law Group is dedicated to helping providers understand their legal responsibility and defend against criminal and administrative action related to prescribing.