Controlled Substance Prescribing Authority Expanded to Physician Assistants, Nurse Practitioners in Florida

Physician assistants (PAs) and nurse practitioners (NPs) in Florida will soon be permitted to prescribe controlled substances under legislation signed by Governor Rick Scott.

Until now, Florida was the only US state that didn’t allow NPs to prescribe controlled substances like opioids. In the case of PAs, Kentucky is now the only state that doesn’t provide this prescribing authority.

Florida’s legislation will officially take effect on July 1, 2016, but the portion pertaining to PAs’ prescribing authority won’t become law until January 1, 2017. The reason for this delay is “it is expected to take until early 2017 for PAs to navigate procedural policies with the Drug Enforcement Administration and begin writing prescriptions for controlled medications,” the American Academy of PAs explained in a statement.

“This landmark legislation increases the availability of quality medical care by allowing PAs to better meet the needs of their patients,” stated Jeffrey A. Katz PA-C, DFAAPA, president and chair of the board of the American Academy of PAs. “Evidence clearly shows that when PAs are allowed to practice to the full extent of their education and experience, they increase access to health care services and improve outcomes, which is why PA-positive legislation is critical.”

Florida’s law does limit NP- and PA-written prescriptions for certain schedule 2 narcotics, such as morphine and oxycodone, to a 7-day supply. The legislation also requires continuing education courses on prescribing opioids.

An estimated 25,000 NPs and PAs currently practice in Florida, and the new law is expected to greatly expand access to controlled medications for the state’s growing population of elderly patients amid the increasingprimary care physician shortagein Florida.

The Association of American Medical Colleges has estimated that there will be a shortage of primary care physicians totaling anywhere between 12,500 and 31,100 in the next 10 years. Meanwhile, the US population will increase by about 30.8 million by 2025, and the number of Americans older than 65 years will increase by 46%.

The latest data from the US Census Bureau show that Florida has the fifth highest overall median age (41.6) among all US states.

Meanwhile, a recent study from the Mercatus Center at George Mason University found that prohibiting PAs and NPs from prescribing drugs to patients raises costs for Medicaid beneficiaries by about 11%—which translates to $109 in extra health care expenses per patient. Beyond expanded access and more affordable care, study author Edward J. Timmons said those results “suggest that broader scope of practice for NPs and PAs has little effect on the quality of care delivered.”

“More generally, broadening the scope of practice of nonphysician health care providers and reducing the monopoly power of physicians in the health care market is very likely to improve consumer welfare,” the study authors concluded.