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 under 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. The physician assistant shall have no authority to prescribe
a Schedule II controlled substance after the initial therapy of up to a 72-hour
dose, until the patient has been examined by the supervising physician and the
supervising physician has reviewed and approved the prescription of a Schedule
II controlled substance by the physician assistant for up to a 30-day supply.
(i) If the supervising physician determines
and documents that the patient is chronically ill, the physician assistant may
write a prescription for a Schedule II controlled substance for up to a 30-day
supply of the Schedule II controlled substance, only if the prescription of a
Schedule II controlled substance by the physician assistant is reviewed and
approved by the supervising physician at least every 30 days.
(ii) If the supervising physician determines
and documents that the patient is terminally ill, the physician assistant may
write a prescription for a Schedule II controlled substance for up to a 30-day
supply if the prescription of a Schedule II controlled substance by the
physician assistant is reviewed and approved by the supervising physician at
least every 120 days.
(iii) 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
printed format at the heading of the blank. The supervising physician's name
and license number must also be printed or preprinted on the
prescription.
(2) The signature of
a physician assistant must 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 or oral
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 or oral 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, directions
for use 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 at least weekly in accordance
with §
25.178 (relating to medical
records).
(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 this section and with the regulations of the Department of
Health in 28 Pa. Code §§
25.51-25.58 and 25.91-25.95
(relating to prescriptions; and labeling of drugs, devices and
cosmetics).
