Prescriptive Authority & Protocol Agreement 2025

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Practice authority can be defined as a nurse practitioners (NP) authority to practice with or without physician oversight. Prescriptive authority refers to a nurse practitioners authority to prescribe medications.
PAs are licensed to practice in all 50 states, the District of Columbia, all US territories, and the uniformed services. PAs are authorized to prescribe medications in all jurisdictions where they are licensed, except Puerto Rico.
Generally, prescriptive authority requires an application to the federal Drug Enforcement Agency (DEA) and adherence to all state requirements, including current and active licensing, potential supervisory or collaborative practice agreements, and any applicable continuing education and training.
Prescriptive authority is the ability of healthcare providers to prescribe specific medications, including controlled substances. Physicians of either Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) designations have the highest degree of prescriptive authority.
It is the position of AANP that NP prescriptive authority be solely regulated by state boards of nursing and in ance with the NP role, education and certification.
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Delegation of Prescriptive Authority to APRNs and PAs addresses the ability of a physician to delegate the prescribing and ordering of drugs and devices to advanced practice registered nurses (APRNs) and physician assistants (PAs). Individuals in these positions must act under adequate physician supervision.
Decreases Costs FPA avoids duplication of services and billing costs associated with outdated physician oversight of NP practice. FPA reduces unnecessary repetition of orders, office visits and care services. Protects Patient Choice FPA allows patients to see the health care provider of their choice.

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