Ariz. Admin. Code § 4-19-511

Current through Register Vol. 30, No. 45, November 8, 2024

Section R4-19-511 - Prescribing and Dispensing Authority; Prohibited Acts

A. The Board shall authorize an RNP, CNM, or CNS to prescribe and dispense (P&D) drugs and devices within the RNP's, CNM's, or CNS's population focus only if the RNP, CNM, or CNS does all of the following:

1. Obtains authorization by the Board to practice as an RNP, CNM, or CNS;

2. Applies for prescribing and dispensing privileges on the application for RNP, CNM, or CNS certification;

3. Submits a completed verified application on a form provided by the Board that contains all of the following information:

a. Name, address, e-mail address and home telephone number;

b. Arizona registered nurse license number, or copy of compact license;

c. RNP, CNM, or CNS population focus;

d. RNP, CNM, or CNS certification number issued by the Board; and

e. Business address and telephone number;

4. Submits evidence of a minimum of 45 contact hours of education within the three years immediately preceding the application, covering one or both of the following topics consistent with the population focus of education and certification:

a. Pharmacology, or

b. Clinical management of drug therapy, and

5. Submits the required fee.

B. An applicant who is denied P & D authority may request a hearing by filing a written request with the Board within 30 days of service of the Board's order denying the P & D authority. Board hearings shall comply with A.R.S. Title 41, Chapter 6, Article 10, and 4 A.A.C. 19, Article 6, of this Chapter.

C. An RNP, CNM, or CNS shall not prescribe or dispense drugs or devices without Board authority or in a manner inconsistent with law. The Board may impose an administrative or civil penalty for each violation, suspend the RNP's, CNM's, or CNS's P & D authority, or impose other sanctions under A.R.S. § 32-1606(C). In determining the appropriate sanction, the Board shall consider factors such as the number of violations, the severity of each violation, and the potential for or existence of patient harm.

D. In addition to acts listed under R4-19-403, for an RNP, CNM, or CNS who prescribes or dispenses a drug or device, a practice that is or might be harmful to the health of a patient or the public, includes one or more of the following:

1. Prescribing a controlled substance to oneself, a member of the RNP's, CNM's, or CNS's family or any other person with whom the RNP, CNM, or CNS has a relationship that may affect the RNP's, CNM's, or CNS's ability to use independent, objective and sound judgment when prescribing;

2. Providing any controlled substance or prescription-only drug or device for other than accepted therapeutic purposes;

3. Delegating the prescribing and dispensing of drugs or devices to any other person;

4. Prescribing for a patient that is not in the RNP's, CNM's, or CNS's population focus of education and certification except as authorized in subsection (D)(5)(d); and

5. Prescribing, dispensing, or furnishing a prescription drug or a prescription-only device to a person unless the RNP, CNM, or CNS has examined the person and established a professional relationship, except when engaging in one or more of the following:

a. Providing temporary patient care on behalf of the patient's regular treating and licensed health care professional;

b. Providing care in an emergency medical situation where immediate medical care or hospitalization is required by a person for the preservation or health, life, or limb;

c. Furnishing a prescription drug to prepare a patient for a medical examination; or

d. Prescribing antimicrobials to a person who is believed to be at substantial risk as a contact of a patient who has been examined and diagnosed with a communicable disease by the prescribing RNP, CNM, or CNS even if the contact is not in the population focus of the RNP's, CNM's, or CNS's certification.

6. Prescribing or dispensing any controlled substance or prescription-only drug or device in a manner that is inconsistent with other state or federal requirements.

E. An RNP, CNM, or CNS shall not dispense a Schedule II Controlled Substance that is an opioid, except for an opioid that is for medication assisted treatment for substance use disorders.

F. A CNS's prescribing is additionally limited according to A.R.S. § 32-1651.

G. A CRNA may apply for and obtain a prescribing-only certificate upon successful completion of all application requirements that are applicable to prescribing, as listed for other APRNs, and follow the same prescribing restrictions and administrative processes, as described in subsections (A)-(D), of this Section; and consistent with A.R.S. § 32-1634.04, and all other applicable laws.

Ariz. Admin. Code § R4-19-511

Adopted effective November 25, 1996 (Supp. 96-4). Section repealed; new Section made by final rulemaking at 11 A.A.R. 3804, effective November 12, 2005 (Supp. 05-3). Amended by final rulemaking at 19 A.A.R. 1438, effective July 6, 2013 (Supp. 13-2). Amended by final rulemaking at 23 A.A.R. 1420, effective 7/1/2017. Amended by final rulemaking at 25 A.A.R. 919, effective 6/3/2019. Amended by final rulemaking at 26 A.A.R. 3289, effective 12/2/2020.