Prescribers Flashcards
Broad Prescriptive Privileges
These professionals have wide authority to prescribe medications, often within their field of expertise.
Physicians (MD, DO)
Includes international equivalents (MBBS, MBChB)
Dentists
Veterinarians
Podiatrists
All within their respective scope of practice
Qualified Prescriptive Privileges:
These professionals have limited prescriptive authority, often tied to specific training or a collaborative relationship with other healthcare providers.
Physician Assistants (PAs) (under physician supervision)
Nurse Practitioners (NPs) (within specialty)
Midwives (pregnancy/childbirth-related)
Certified Optometrists (for eye conditions)
Pharmacists (CDTM agreements)
Prescriber Identification on NYS Prescriptions
All prescriptions must include the prescriber’s 6-digit NY registration number.
Physicians are exempt and use their NPI number instead.
The NPI is required for Medicaid billing.
Prescription Transmission Rules in NY
Prescription Transmission Rules: NY
Written = Electronic
Verbal = Faxed (Fax to fax only)
Faxed Rx must be signed and on the prescriber’s ONYSRx form.
Fax-backs for refills are no longer allowed.
Failover faxes (from software outages) are not valid prescriptions.
prescription samples
Any practitioner authorized to prescribe
in NYS may give prescription samples of
what they are allowed to prescribe
*It is illegal to sell samples
*No samples of controlled substances are
allowed in NYS. Federal laws allows samples of CS
*May have coupons.
Physician assitants (PAs) and Registerded specialists (RSAs): Roles and Supervision
PAs: Can prescribe and provide medical services under supervision.
RSAs: Cannot prescribe but perform services under physician supervision.
Supervision must be continuous but not require physical presence.
PAs Prescription Authority
May prescribe Schedules II-V and medical orders. Also can prescribe syringes/needles w. or w.o needles
DEA number required for controlled substances. obtaining dea# and prescribing CS are optional
Prescriptions can be written in both inpatient and outpatient settings.
Noncontrolled Prescription Requirements for PAs
Must be on an Official NY Prescription blank.
Include PA’s name, supervising physician’s name, address, and phone number.
Prescriptions do not require countersignature from the physician.
PA Signature Requirements
Imprint or stamp of supervising physician’s name.
Imprint or stamp of PA’s name.
PA signs their own name followed by P.A. or LPA and registration number.
Controlled Substance Prescriptions: PA Requirements
Written on ONYSRx.
PA must use their own DEA number (starts with M).
Can use own or supervising physician’s blanks, but must include supervising physician’s name.
Electronic Prescriptions by PAs
Must include PA’s electronic signature.
Include the name, address, and phone number of the supervising physician.
Verbal Prescriptions by PAs
Allowed for:
Noncontrolled drugs
Controlled substances (including emergency oral prescriptions for benzodiazepines)
Oral prescriptions for syringes
Inpatient Medical Orders by PAs
PAs can write medical orders (including controlled substances) if employed by the institution or granted extended privileges, and care of the physician.
Countersignature is required within 24 hours if mandated by the supervising physician or hospital policy.
Collaborative Agreements & Relationships (NPs)
NPs need a written collaborative agreement or collaborative relationship to prescribe.
3,600 hours of practice allows NPs to practice autonomously under a collaborative relationship according to the nurse practioner modernization act
NP Prescriptive Authority
Can prescribe controlled substances, anabolic steroids, and samples.
Verbal prescriptions allowed.
DEA number required for controlled substances. Starts with the letter M
NP Prescription Blanks
Must include NP’s name, designation (N.P.), certification number (F- followed by six digits), and office contact details.
Collaborating physician’s name is not required but can be included.
What is Midwifery?
Management of normal pregnancies, childbirth, and postpartum care (up to 28 days).
Primary reproductive health care for healthy women.
Requires a written collaborative agreement with a physician, including protocols.
Prescription Authority
Midwives can prescribe within the scope of midwifery practice.
Must complete midwifery education and be classified as midlevel practitioners.
DEA number is required for controlled substances (starts with “M”).
Midwife Prescription Blanks
Must include the midwife’s name, address, phone number, and certification number (F- followed by six digits).
May include the name of the collaborating physician, but it is not required.
can midwives
- prescribe birth control pills
2.prescibre cII for pain - anabolic steroids
- Give samples
- Sign a protocol for a pharmacist to immunize
yes
yes
idk?
yes
no
What is Expedited Partner Therapy (EPT)
EPT is a public health strategy that allows healthcare providers to prescribe or dispense medication for the sexual partners of individuals diagnosed with certain STIs (like chlamydia and gonorrhea) without the partner needing to see a provider.
EPT Prescription Requirements
Label must include pharmacy name/address, medication name, strength, directions, and date of delivery.
Counseling required.
EPT Legal Protections
Providers and pharmacists are protected from liability.
Informational materials for partners must be given.
Best dispensed in pre-packaged partner packs.
EPT Prescription Exemptions
No patient name, address, or age required on EPT prescriptions.
E-prescribing mandate waived until March 24, 2024.
EPT Treatment Recommendations
Counsel on ADRs, allergies, pregnancy concerns, and the importance of abstaining from sexual activity for 7 days after treatment.
Scope of Practice for Optometrists
Optometrists in New York can prescribe and use drugs for topical application to the surface of the eye.
Injections, syringes/needles, and controlled substances are not allowed in their scope of practice.
optometrists certification
The Phase 1 and Phase 2 certification system for optometrists is designed to ensure that optometrists gradually expand their scope of practice as they gain more specialized knowledge and experience, particularly in managing more complex and high-risk conditions.
New Regulations for Optometrists (October 2023)
On October 17, 2023, the New York State Board of Regents authorized optometrists to prescribe oral therapeutic agents under the new “O” privilege.
Effective October 25, 2023, optometrists must apply for the “O” privilege to prescribe these agents.
The “O” privilege is part of a hierarchical structure including the T (diagnostic) and R (therapeutic) privileges.
“ORT” Privilege Hierarchy for Optometrists
T Privilege: Allows optometrists to prescribe diagnostic agents.
R Privilege: Allows optometrists to prescribe therapeutic agents for treating conditions like glaucoma and ocular hypertension.
O Privilege: Allows optometrists to prescribe oral therapeutic agents.
Topical Agents for Optometrists with the “R” Privilege
Optometrists with the “R” privilege can prescribe:
Antibiotics/Antimicrobials
Decongestants/Antiallergenics
Non-steroidal anti-inflammatory agents
Steroidal anti-inflammatory agents
Antivirals
Hyperosmotic/Hypertonic agents
Cycloplegics
Artificial tears/Lubricants
Immunosuppressive agents (effective October 25, 2023)
Agents for Glaucoma & Ocular Hypertension (“R” Privilege)
Optometrists with the “R” privilege can prescribe:
Beta blockers
Alpha agonists
Direct-acting cholinergic agents
Prostaglandin analogs (effective October 25, 2023)
Carbonic anhydrase inhibitors (effective October 25, 2023)
Oral Therapeutic Agents (With “O” Privilege)
Optometrists with the “O” privilege can prescribe:
Antibiotics:
Amoxicillin/Clavulanate potassium
Cephalexin
Azithromycin
Sulfamethoxazole/Trimethoprim
Doxycycline
Tetracycline
Antiglaucoma agents for managing acute intraocular pressure:
Acetazolamide
Methazolamide
Antivirals for herpes zoster ophthalmicus:
Valacyclovir
Acyclovir
Optometrists’ Prescription Blanks
Prescription blanks must include:
Name, license number, office address, and telephone number.
License number format:
“U” followed by 6 digits for optometrists certified only in Phase 1.
“V” followed by 6 digits for optometrists certified in both Phase 1 and Phase 2.
