2006 Code of Virginia § 54.1-2957.01 - Prescription of certain controlled substances and devices by licensed nurse practitioners

54.1-2957.01. Prescription of certain controlled substances and devices bylicensed nurse practitioners.

A. In accordance with the provisions of this section and pursuant to therequirements of Chapter 33 ( 54.1-3300 et seq.) of this title, a licensednurse practitioner, other than a certified registered nurse anesthetist,shall have the authority to prescribe controlled substances and devices asset forth in Chapter 34 ( 54.1-3400 et seq.) of this title as follows: (i)Schedules V and VI controlled substances on and after July 1, 2000; (ii)Schedules IV through VI on and after January 1, 2002; (iii) Schedules IIIthrough VI controlled substances on and after July 1, 2003; and (iv)Schedules II through VI on and after July 1, 2006. Nurse practitioners shallhave such prescriptive authority upon the provision to the Board of Medicineand the Board of Nursing of such evidence as they may jointly require thatthe nurse practitioner has entered into and is, at the time of writing aprescription, a party to a written agreement with a licensed physician whichprovides for the direction and supervision by such physician of theprescriptive practices of the nurse practitioner. Such written agreementsshall include the controlled substances the nurse practitioner is or is notauthorized to prescribe and may restrict such prescriptive authority asdeemed appropriate by the physician providing direction and supervision.

B. It shall be unlawful for a nurse practitioner to prescribe controlledsubstances or devices pursuant to this section unless such prescription isauthorized by the written agreement between the licensed nurse practitionerand the licensed physician.

C. The Board of Nursing and the Board of Medicine, in consultation with theBoard of Pharmacy, shall promulgate such regulations governing theprescriptive authority of nurse practitioners as are deemed reasonable andnecessary to ensure an appropriate standard of care for patients.

The Board of Medicine and the Board of Nursing shall be assisted in thisprocess by an advisory committee composed of two representatives of the Boardof Nursing and one nurse practitioner appointed by the Board of Nursing, andfour physicians, three of whom shall be members of the Board of Medicineappointed by the Board of Medicine. The fourth physician member shall bejointly appointed by the Boards of Medicine and Nursing. Regulationspromulgated pursuant to this section shall include, at a minimum, (i) suchrequirements as may be necessary to ensure continued nurse practitionercompetency which may include continuing education, testing, and/or any otherrequirement, and shall address the need to promote ethical practice, anappropriate standard of care, patient safety, the use of new pharmaceuticals,and appropriate communication with patients, and (ii) requirements forperiodic site visits by physicians who supervise and direct nursepractitioners who provide services at a location other than where thephysician regularly practices.

D. This section shall not limit the functions and procedures of certifiedregistered nurse anesthetists or of any nurse practitioners which areotherwise authorized by law or regulation.

E. The following restrictions shall apply to any nurse practitionerauthorized to prescribe drugs and devices pursuant to this section:

1. The nurse practitioner shall disclose to his patients the name, addressand telephone number of the supervising physician, and that he is a licensednurse practitioner.

2. Physicians, other than physicians employed by, or under contract with,local health departments, federally funded comprehensive primary careclinics, or nonprofit health care clinics or programs to provide supervisoryservices, shall not supervise and direct at any one time more than four nursepractitioners. In the case of nurse practitioners, other than certified nursemidwives, the supervising physician shall regularly practice in any locationin which the nurse practitioner exercises prescriptive authority pursuant tothis section. A separate office for the nurse practitioner shall not beestablished. In the case of certified nurse midwives, the supervisingphysician either shall regularly practice in the location in which thecertified nurse midwife practices, or in the event that the certified nursemidwife has established a separate office, the supervising physician shall berequired to make periodic site visits as required by regulations promulgatedpursuant to this section.

3. Physicians employed by, or under contract with, local health departments,federally funded comprehensive primary care clinics, or nonprofit health careclinics or programs to provide supervisory services, shall not supervise anddirect at any one time more than four nurse practitioners who provideservices on behalf of such entities. Such physicians either shall regularlypractice in such settings or shall make periodic site visits to such settingsas required by regulations promulgated pursuant to this section.

F. This section shall not prohibit a licensed nurse practitioner fromadministering controlled substances in compliance with the definition of"administer" in 54.1-3401 or from receiving and dispensing manufacturers'professional samples of controlled substances in compliance with theprovisions of this section.

G. Notwithstanding any provision of law or regulation to the contrary, anurse practitioner licensed by the Boards of Nursing and Medicine in thecategory of certified nurse midwife and holding a license for prescriptiveauthority may prescribe Schedules II through VI controlled substances withoutthe requirement for either medical direction or supervision or a writtenagreement between the licensed nurse practitioner and a licensed physicianwhile participating in a pilot program approved by the Board of Healthpursuant to 32.1-11.5.

(1991, cc. 519, 524; 1992, c. 409; 1995, c. 506; 1999, c. 745; 2000, c. 924;2005, c. 926; 2006, c. 494.)

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