Legal Update: Physician Assistants' Prescriptive Privileges
Reprinted with permission from the Minnesota Board of Medical Practice
Minnesota Board of Medical Practice Update/Summer 2002

There seems to be some confusion about what the law, Minnesota Statutes Chapter 147A.18, says about the topic of the delegation of prescriptive privileges. Here are answers to some frequently asked questions.

Q: Are all registered Physician Assistants
eligible to prescribe?

A:No. Only Physician Assistants who are currently
certified by the National Commission on Certification
of Physician Assistants or successor agency approved
by the Board are eligible.

Q: What needs to be included in the Physician/
Physician Assistant Supervisory Agreement in
terms of prescriptive privileges?

A:A statement by the Supervising Physician regarding
delegation or nondelegation of the functions of prescribing,
dispensing, and administering of legend drugs
and medical devices to the Physician Assistant. The
statement must include a protocol indicating categories
of drugs for which the Supervising Physician delegates
prescriptive, administering and dispensing authority.

Q: Are there ongoing requirements for the
Physician Assistant to be able to prescribe?

A:Yes. Physician Assistants who have been delegated
authority to prescribe must provide evidence of
currentcertification by the National Commission on
Certification of Physician Assistants. If they have
been delegated the authority to prescribe controlled
substances, they must present evidence of the certification,
possess a valid DEA certificate and pay the annual
fee (currently $135).

Q: Is the Supervising Physician required to
review the Physician Assistant’s prescribing?

A:Yes. Supervising Physicians must retrospectively
review the prescribing, dispensing, and administering of
legend (prescription) and controlled drugs and medical
devices by Physician Assistants to whom they have delegated
this authority. The review must take place at
least weekly. The process and schedule for the review
should be individualized to the Physician/Physician
Assistant team and must be outlined in the delegation
agreement.

Q: What are grounds for termination of the
delegated authority to prescribe?

A:Grounds for the immediate loss of privileges are:
a) the Physician/Physician Assistant Supervisory
Agreement is terminated;
b) the authority to prescribe, dispense, and administer
is terminated or withdrawn by the Supervising
Physician; or
c) the Physician Assistant reverts to inactive status,
loses National Commission on Certification of
Physician Assistants certification, or loses or
terminates registration status.

It is the Physician Assistant’s responsibility to notify
the Board in writing within ten days of the occurrence
of any of these circumstances.

Q: Are there other requirements and restrictions?

A:Yes. These include:
a) an Internal Protocol which lists each
category of drug or medical device, or
controlled substance which the Physician
Assistant has the delegated authority to
prescribe, dispense or administer. This
Internal Protocol must be signed, dated,
kept on file at the practice site and must
be submitted to the Board upon request.
The Supervising Physician and the
Physician Assistant may amend the
Internal Protocol within the limits of the
Delegation form. The Supervising
Physician and the Physician Assistant
must sign and date the amendments.
b) The Supervising Physician and the
Physician Assistant must review the
Delegation on an annual basis, at the time
of re-registration. The Internal Protocol
must be signed and dated by the
Supervising Physician and the Physician
Assistant after review.

Q: What needs to be included on a prescription
written by a Physician Assistant?

A:The following are required to be present:
(1) the date of issue;
(2) the name and address of the patient;
(3) the name and quantity of the drug
prescribed;
(4) directions for use; and
(5) the name, address, and telephone
number of the prescribing Physician
Assistant and of the physician serving as
supervisor.
It is this final item, “what must be contained on a
prescription,” that is generating the most confusion.
Many Physician Assistants, and their Supervising
Physician(s), don’t seem to understand that the name
(and address and phone number) of the Supervising
Physician must be included. 

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