Pharmacy Administration SIG Questions and Answers

     I have some questions about PAs and NPs that work in the MTF. Can they write controlled drug prescriptions to include Schedule II?  Do they have to comply with state law in the state that the AF base is located, does it matter that they do not have a DEA number, is their ability to write controlled drugs based on their state licensure, does the pharmacy have to validate their state licensure "scope of practice", does the credentialing process at the AF facility give them the authority to write controlled drugs?  Next question:  If the facility employs a civilian PA or NP that does not have prescriptive rights in their state of licensure, can they write prescriptions in the facility without a physician counter signature?   I am referring to prescriptions that will be filled in the facility.  Thanks.

     Regarding your question about NPs and PAs: Blue suit PAs and NPs are limited only by what the P&T committee approves as an authorized drug list (can be the same as any MD) and by what the credentialing office approves. Normally, the credentials office will consider the scope of practice for the PA and recommend accordingly. For example, when I was at the Academy, we had an Orthopedic PA who could write for virtually anything, including C-IIs, as heavy-duty pain medication fell within his scope of practice, and both credentials and P&T supported/approved it. NPs operate the same way. In short, much of this falls on credentialing to determine the scope of practice and then on P&T to determine what is an appropriate drug list based on that scope of practice. The scope of the state license doesn't really come into play once he or she becomes "federalized" and puts on the blue suit. If, on the other hand, you have a contract PA or NP working in your facility, then he or she will only be permitted to practice and prescribe within the scope of his or her state license, and may need to have orders countersigned by an MD or DO.