New rules from the Michigan Board of Medicine have been filed with the state and are effective as of Dec. 6, 2016. One of the rules now permits nurse practitioners (NPs) to prescribe up to a 30-day supply of schedule two (CII) controlled substances. Previous restrictions that limited NPs to prescribing a seven-day supply of a CII upon discharge have been lifted, but only for NPs practicing under the delegated authority of a Medical Doctor (MD). Analogous rule changes from the Board of Osteopathic Medicine and Surgery (BOMS) are in the process of promulgation, but these rules have not been filed with the state and are thereby not yet effective. It is expected that the corresponding BOMS rules will be filed by the end of the year. Pharmacy Services Inc. (PSI) and Michigan Pharmacists Association (MPA) will continue to keep you apprised of changes as they occur. Any new information will be posted to the PSI website at PSI.solutions. The language of the new rule governing NP prescribing under delegated authority can be found below. If you have any questions, please contact Eric Roath, Pharm.D., MPA director of professional practice, at Eric@MichiganPharmacists.org.
Rule 338.2411 Delegation of prescribing controlled substances to nurse practitioner or nurse midwife; limitation.
Rule 111. (1) A physician may delegate the prescription of controlled substances listed in schedules 2 to 5 to a registered nurse who holds a specialty certification under section 17210 of the code, MCL 333.17210, with the exception of a nurse anesthetist, if the supervising physician establishes a written authorization that contains all of the following information:
· The name, license number, and signature of the supervising physician.
· The name, license number, and signature of the nurse practitioner or nurse midwife.
· The limitations or exceptions to the delegation.
· The effective date of the delegation.
(2) The supervising physician shall review and update a written authorization on an annual basis from the original date or the date of amendment, if amended. The supervising physician shall note the review date on the written authorization.
(3) The supervising physician shall maintain a written authorization at the supervising physician’s primary place of practice.
(4) The supervising physician shall provide a copy of the signed, written authorization to the nurse practitioner or nurse midwife.
(5) The supervising physician shall ensure that an amendment to the written authorization is in compliance with subrules (1), (2), (3), and (4) of this rule.
(6) A supervising physician shall not authorize a nurse practitioner or a nurse midwife to issue a prescription for a schedule 2 controlled substance with a quantity greater than a 30-day supply.
(7) A supervising physician shall not delegate the prescription of a drug or device individually, in combination, or in succession for a woman known to be pregnant with the intention of causing either a miscarriage or fetal death.