Brief(1)
As amended by Senate Committee, H.B. 2168 authorizes advanced registered nurse practitioners and physicians' assistants to prescribe drugs and controlled substances. To accomplish this the bill amends statutes in the Kansas Nurse Practice Act, the Pharmacy Act of the State of Kansas, the Uniform Controlled Substances Act, the Food, Drug and Cosmetic Act , the Kansas Healing Arts Act, the Mental Health Technology Act, and statutes that concern the Kansas Health Insurance Association, the drug formulary maintained by Social and Rehabilitation Services, physicians' assistants, and sales tax exemptions.
H.B. 2168 amends one of the statutes in the Kansas Nurse Practice Act that currently authorizes advanced registered nurse practitioners (ARNPs) to transmit prescriptions pursuant to written protocols entered into by an ARNP and a person licensed to practice medicine and surgery. The changes in the statute allow ARNPs, pursuant to written protocols, to prescribe drugs and controlled substances and to request, receive, and distribute professional drug samples. Any prescription order written by an ARNP is to include the name, address, and telephone number of the responsible physician. The latter is defined as a person licensed to practice medicine and surgery in Kansas who has accepted responsibility for the protocol and the actions of the ARNP when the nurse is prescribing drugs. In order to prescribe controlled substances, the ARNP would be required to register with the Drug Enforcement Administration and to notify the Board of Nursing of the name and address of the physician or physicians who are acting as responsible physicians. Under the provisions of H.B. 2168, an ARNP may not dispense drugs.
One of the statutes that relates to persons whose names have been entered on a register of those eligible to act as physicians' assistants is amended by H.B. 2168. The amendments change the provisions of the statute that now allow a physician's assistant to transmit orders for prescription drugs as authorized by a written protocol, but prohibit prescribing drugs. The amendments allow a physician's assistant to prescribe drugs and controlled substances pursuant to a written protocol entered into between the physician's assistant and such person's responsible physician. The same authorizations, requirements, and restrictions relating to prescribing made applicable to prescribing by ARNPs are made applicable to physician's assistants. The physician's assistant may not dispense drugs.
An amendment to the definitions section of the Pharmacy Act of the State of Kansas adds a definition of mid-level practitioner. Mid-level practitioner, as defined by H.B. 2168, is an ARNP who has authority to prescribe drugs pursuant to a written protocol with a responsible physician under K.S.A. 65-1130 or a physician's assistant who has authority to prescribe drugs pursuant to a written protocol with a responsible physician under K.S.A. 65-2896e. The same addition is made in the definitions section of the Uniform Controlled Substances Act.
Since under existing law only persons who are included in the definition of "practitioner" are authorized to prescribe drugs and controlled substances and ARNPs and physician's assistants are not added to the definition of "practitioner" in the Pharmacy Act of the State of Kansas and the Uniform Controlled Substances Act, but rather are defined as mid-level practitioners, it is necessary to amend other statutes that reference prescribing or prescriptions to include prescribing or prescription orders written by mid-level practitioners. The Senate Committee amendments add a number of statutes to those amended by H.B. 2168 to add references to mid-level practitioners. The statutes that are amended include a criminal code statute that concerns obtaining a prescription-only drug by fraudulent means; a statute that is a part of the law that concerns the uninsurable health insurance plan; the Prevention of Assisted Suicide Act; the Food, Drug and Cosmetic Act; the section of the Kansas Healing Arts Act that relates to treatment of obesity; the Mental Health Technology Act; a statute that concerns sales tax exemptions; and a statute that concerns the Medicaid drug formulary. Additional sections of the Pharmacy Act of the State of Kansas and the Uniform Controlled Substances Act are also amended to add references to mid-level practitioners.
The Senate Committee amendments make H.B. 2168 effective from and after April 1, 2000 and publication in the statute book.
Background
H.B. 2168 was introduced at the request of the Board of Nursing whose representative supported the bill in House committee hearings as did representatives of the Kansas State Nurses Association; the Kansas Medical Society; the Kansas Association for the Medically Underserved; the Kansas Association of Osteopathic Medicine; several ARNPs; and several physicians. In the Senate Committee on Public Health and Welfare, the Committee held hearings on S.B. 193, a bill creating virtually identical amendments relating to prescribing by physician's assistants. Many of the same conferees appeared in favor of the Senate bill. The Senate Committee decided to consolidate the subject matter of the two bills into one in order to avoid amending a number of the same statutes twice. Other technical amendments were added as noted in the bill summary as a result of a statutory search relating to prescribing and prescriptions.
The change in effective date for H.B. 2168 will allow time for the respective regulatory boards to adopt appropriate regulations if any are necessary and to determine whether the amendments contained in the bill will satisfy registration requirements of the Drug Enforcement Administration.
1. *Supplemental notes are prepared by the Legislative Research Department and do not express legislative intent. The supplemental note and fiscal note for this bill may be accessed on the Internet at http://www.ink.org/public/legislative/bill_search.html