Current through Register Vol. 54, No. 44, November 2, 2024
(a)
Prescribing, dispensing and administration of drugs.
(1) The supervising physician may delegate to
the physician assistant the prescribing, dispensing and administering of drugs
and therapeutic devices.
(2) A
physician assistant may not prescribe or dispense Schedule I controlled
substances as defined by section 4 of The Controlled Substances, Drug, Device,
and Cosmetic Act (35 P. S. §
780-104).
(3) A physician assistant may prescribe a
Schedule II controlled substance for initial therapy, up to a 72-hour dose. The
physician assistant shall notify the supervising physician of the prescription
as soon as possible, but in no event longer than 24 hours from the issuance of
the prescription. A physician assistant may write a prescription for a Schedule
II controlled substance for up to a 30-day supply if it was approved by the
supervising physician for ongoing therapy. The prescription must clearly state
on its face that it is for initial or ongoing therapy.
(4) A physician assistant may only prescribe
or dispense a drug for a patient who is under the care of the physician
responsible for the supervision of the physician assistant and only in
accordance with the supervising physician's instructions and written
agreement.
(5) A physician
assistant may request, receive and sign for professional samples and may
distribute professional samples to patients.
(6) A physician assistant authorized to
prescribe or dispense, or both, controlled substances shall register with the
Drug Enforcement Administration (DEA).
(b)
Prescription blanks. The
requirements for prescription blanks are as follows:
(1) Prescription blanks must bear the license
number of the physician assistant and the name of the physician assistant in a
printed format at the heading of the blank. The supervising physician must also
be identified as required in §
16.91 (relating to identifying
information on prescriptions and orders for equipment and service).
(2) The signature of a physician assistant
shall be followed by the initials "PA-C" or similar designation to identify the
signer as a physician assistant. When appropriate, the physician assistant's
DEA registration number must appear on the prescription.
(3) The supervising physician is prohibited
from presigning prescription blanks.
(4) The physician assistant may use a
prescription blank generated by a hospital provided the information in
paragraph (1) appears on the blank.
(c)
Inappropriate
prescription. The supervising physician shall immediately advise the
patient, notify the physician assistant and, in the case of a written
prescription, advise the pharmacy if the physician assistant is prescribing or
dispensing a drug inappropriately. The supervising physician shall advise the
patient and notify the physician assistant to discontinue using the drug and,
in the case of a written prescription, notify the pharmacy to discontinue the
prescription. The order to discontinue use of the drug or prescription shall be
noted in the patient's medical record by the supervising physician.
(d)
Recordkeeping
requirements. Recordkeeping requirements are as follows:
(1) When prescribing a drug, the physician
assistant shall keep a copy of the prescription, including the number of
refills, in a ready reference file, or record the name, amount and doses of the
drug prescribed, the number of refills, the date of the prescription and the
physician assistant's name in the patient's medical records.
(2) When dispensing a drug, the physician
assistant shall record the physician assistant's name, the name of the
medication dispensed, the amount of medication dispensed, the dose of the
medication dispensed and the date dispensed in the patient's medical
records.
(3) The physician
assistant shall report, orally or in writing, to the supervising physician
within 36 hours, a drug prescribed or medication dispensed by the physician
assistant while the supervising physician was not physically present, and the
basis for each decision to prescribe or dispense in accordance with the written
agreement.
(4) The supervising
physician shall countersign the patient record within 10 days.
(5) The physician assistant and the
supervising physician shall provide immediate access to the written agreement
to anyone seeking to confirm the physician assistant's authority to prescribe
or dispense a drug. The written agreement must list the categories of drugs
which the physician assistant is not permitted to prescribe.
(e)
Compliance with
regulations relating to prescribing, administering, dispensing, packaging and
labeling of drugs. A physician assistant shall comply with
§§
16.92-16.94 (relating to prescribing,
administering and dispensing controlled substances; packaging; and labeling of
dispensed drugs) and Department of Health regulations in 28 Pa. Code
§§
25.51-25.58 (relating to
prescriptions) and regulations regarding packaging and labeling dispensed
drugs. See §
16.94 and 28 Pa. Code
§§25.91-25.95 (relating to labeling of drugs, devices and
cosmetics).
The provisions of this §18.158 issued under
sections 8, 13 and 36 of the Medical Practice Act of 1985 (63 P. S.
§§
422.8,
422.13 and
422.36).
This section cited in 49 Pa. Code §
18.122 (relating to definitions);
and 49 Pa. Code §
18.151 (relating to role of
physician assistant).
