Drug Enforcement Agency Certificate (DEA) or Sate Controlled Dangerous Substances (CDS) Certificate

Question 1

Joint Commission (JC)
DEA Certificate or CDS Certificate

Answer 1

Before recommending privileges, the medical staff evaluates challenges to any licensure

Question 2

NCQA
DEA Certificate or CDS Certificate

Answer 2

CR 3 Element A Factor 2
DEA or CDS certificate must be verified in each state where the practitioner provides care to its members through one of the following:
- a copy of the DEA or CDS certificate
- Documented visual inspection of the original certificate
- Confirmation with the DEA or CDS agency
- AMA Physician Masterfile (DEA only)
- Confirmation from the state pharmaceutical licensing agency where applicable
- AOA Official Osteopathic Physician Profile Report or AOA Physician Master file
If the practitioner does not prescribe medications requiring DEA or CDS certificate, there must be a documented process to require an explanation as to why the practitioner does not prescribe medications. There must be arrangements for the practitioner’s patients who need prescriptions for medications requiring DEA or CDS certification.
If the DEA is pending, the organization must document the practitioner’s lack of DEA or CDS and obtain the name of a designated alternate prescriber who may be an individual or practice.
Time limit: must be verified prior to the decision and valid and current at the time of the credentialing decision

Question 3

ACHC Acute Care Hospital
DEA Certificate or CDS Certificate

Answer 3

Application requests information regarding actions against DEA certificate or state CDS certificate.

Question 4

DNV NIAHO for Hospitals
DEA Certificate or CDS Certificate

Answer 4

MS.6 SR.4b MS
Initial appointment to the medical staff and granting of clinical privileges shall include:
- primary source verification of current Federal Narcotics Registration Certification (DEA) number (if required)

SR 5
Primary source verify DEA at reappointment (if required)

MS.6 SR.11
Medical staff criteria for consideration of automatic suspension includes when the practitioner’s DEA certificate has been revoked, suspended or on probation for any reason

Question 5

URAC Health Plan
DEA Certificate or CDS Certificate

Answer 5

Credentialing application must include evidence of current DEA certificate or state controlled dangerous substance certificate, if applicable
The organization may either collect a copy of the DEA or CDS certificate or the certificate number.
Time limit: obtained within 180 days of the credentialing decision

Question 6

AAAHC for Ambulatory Health Care
DEA Certificate or CDS Certificate

Answer 6

If applicable, verify on an ongoing basis; at a minimum, at expiration, appointment and reappointment.
Verify from primary or secondary sources.
The application includes information about federal actions or sanctions including DEA

Question 7

Medicare Hospital COPS and Interp Guidelines
DEA Certificate or CDS Certificate

Answer 7

not specifically addressed