Nurse Practitioner and Prescription

MI NP Prescribing Laws

While many of the laws and rules when it comes to healthcare and what practitioners can do are federal in nature, the states have their say as well. Among the many examples of this are the Michigan-specific laws that exist when it comes to nurse practitioners and what they are allowed to prescribe in terms of medications, when they prescribe it, whose approval they might need and so forth. This report shall list off those requirements and what they mean to nurse practitioners practicing in Michigan. While nurse practitioner rights and responsibilities are largely the same from state to state, there are most certainly some variances as well and Michigan is no different.

Analysis

One major facet of the Michigan law comes from what is known as MAPS. This is short fo the Michgan automatic prescription system. Nurse practitioners are one of the groups of people that are subject to the rules with this program. There are a few parts to the MAPS program that affect nurse practitioners. First, there are reports generated monthly that look for "excessive" prescriptions. The word "excessive" means that a single nurse practitioner or other professional is seemingly doling out more prescriptions than they should be. Obviously, this would often point to, perhaps, nurse practitioners that are doling out controlled substances, either new prescriptions or refills, too much. It can also be a sign that fraudulent prescriptions are being given. For example, a secondary person could be impersonating a legitimate nurse practitioner. Regardless, a flat for "excessive" prescriptions is not a sign of guilt, just a red flag. The flagged nurse practitioner or doctor can compare the report issued by the state to what they hold actually happened and let the state know one way or another whether the reporting is accurate. If it is, it would obviously have to be explained and proven to be legitimate. If it is not correct, then there would obviously be further investigations as to why this is the case. There are general reporting requirements that are in place across the board and this holds true in particular for all schedule two through five medicines and drugs (LARA, 2016).

When it comes to nurse practitioners in particular, there are rules for them just like there are rules for any other professional that is getting their prescribing authority delegated from or supervised by a physician. When it comes to the rules for a nurse practitioner, they are allowed to dispense controlled and non-controlled substances that range from schedule three to five. This remains true so long as there is written authorization for that nurse practitioner to do so. When it comes to schedule two drugs, the delegating physician can only delegate this to a nurse practitioner of the prescription in question is less than seven days, such as when a patient is discharged to go recover at home. This stands in contrast to physician's assistants, or PA's. PA's are not restricted when it comes to schedule two through five drugs so long as the written authorization mentioned before remains on file. Regardless, any nurse practitioner that is prescribing medicines must be registered with the Drug Enforcement Administration (DEA) to prescribe controlled substances in the first place (LARA, 2016).

As for how the rights and duties of NP's differ in other states as compared to Michigan, there are basically three levels. Those levels are full, reduced and restricted. Michigan is in the last of those three categories. A level of "full" means that physician oversight is not needed to prescribe or treat patients. A level of "reduced" means that NP's can do diagnosis but need oversight from doctors to prescribe. A level of "restricted" means that both treatment and prescription has to be supervised. As just mentioned, NP's are subject to oversight on both in the state of Michigan. Other states with such a level of restriction include Missouri, Oklahoma, Texas and Florida. States with a medium level of restriction include Kansas, Alabama, Louisiana and Utah. States that are unrestricted include Iowa, Nebraska and Colorado (NLM, 2016).