APRN Prescribing Law: A State-by-State Summary

Laura A. Stokowski, RN, MS

Disclosures

January 04, 2018

Independent Prescribing and APRNs

Independent prescribing (also called "prescriptive authority") is the ability of advanced practice registered nurses (APRNs) to prescribe, without limitation, legend (prescription) and controlled drugs, devices, adjunct health/medical services, durable medical goods, and other equipment and supplies. Independent prescribing does not require collaboration with a physician and is a key element of scope of practice for APRNs, as well as being part of the APRN Consensus Model, which seeks to achieve uniformity of state regulation of APRN practice.

Many states have made, and many are considering making, changes to existing laws that regulate scope of practice for APRNs, including independent prescribing privileges. Despite the existence of the consensus model, there are extensive disparities among the states with respect to prescriptive authority. In some states, prescriptive authority is granted at the time of APRN licensure; in others, the APRN must apply separately for these privileges. Differences exist in how much and what type of advanced pharmacology and pharmacotherapeutics education is required, and whether and how much supervision of prescribing practice must take place before independent prescriptive authority is granted. Variation in prescribing laws also include whether all, or only some, APRN roles can be granted prescriptive authority; restrictions on prescribing controlled substances or the schedules of controlled drugs included; and the requirements for collaboration with a physician.

With so much potential for change and the high level of recent activity on the legislative front, it is challenging to maintain a current, up-to-date resource with accurate information about independent prescribing laws in each state. The information in this resource was obtained from the state's statutes and regulations, state Board of Nursing websites, or direct communication from the state Boards of Nursing staff. As new laws are enacted, revisions can be sent to the Editor and this resource will be updated accordingly.

In response to the national opioid crisis, many states have adopted new rules or passed new laws or regulations related to the prescribing of opioids and pain management. In many cases, the details of these updated rules and regulations are too extensive to include in this resource. Prescribing APRNs should consult their state boards of nursing and/or state legislatures for the latest information on prescribing controlled substances. The National Council on State Boards of Nursing also has an Opioid Toolkit to address the problem of opioid overprescribing.

Other resources for state legislation governing APRN prescribing authority can be found below.

Web Resources

APRN Campaign for Consensus: Moving Toward Uniformity in State Laws

The National Council of State Boards of Nursing has an initiative to assist states in aligning their APRN regulation with the major elements of the Consensus Model for APRN Regulation, one of which is independent prescribing. A US map showing the status of implementation of the Consensus Model in each state is available.

American Association of Nurse Practitioners (AANP)

AANP: State Practice Environment is a state-by-state listing of regulatory requirements for nurse practitioners. It includes a regulatory map of the United States.

The schedule of controlled substances is available online.

To view a brief summary of nurse practitioner prescribing law in a particular state or Washington, DC, click on the state name in the following list.

Alabama

Alaska

Arizona

Arkansas

California

Colorado

Connecticut

Delaware

Florida

Georgia

Hawaii

Idaho

Illinois

Indiana

Iowa

Kansas

Kentucky

Louisiana

Maine

 

Maryland

Massachusetts

Michigan

Minnesota

Mississippi

Missouri

Montana

Nebraska

Nevada

New Hampshire

New Jersey

New Mexico

New York

North Carolina

North Dakota

Ohio

Oklahoma

Oregon

Pennsylvania

 

Rhode Island

South Carolina

South Dakota

Tennessee

Texas

Utah

Vermont

Virginia

Washington

Washington, DC

West Virginia

Wisconsin

Wyoming

American Samoa

Guam

Northern Mariana Islands

Puerto Rico

Virgin Islands

Abbreviations used in this resource:
ANP: advanced nurse practitioner APN: advanced practice nurse
APNP: advanced practice nurse prescriber APPN: advanced practice professional nurse
APRN: advanced practice registered nurse ARNP: advanced registered nurse practitioner
BNDD: Board of Narcotics and Dangerous Drugs BOM: Board of Medicine
BOME: Board of Medical Examiners BON: Board of Nursing
BOPh: Board of Pharmacy CAPA: collaborative agreement for prescriptive authority
CDS: Controlled Dangerous Substances CE: continuing education
CME: continuing medical education CNM: certified nurse-midwife
CNP: certified nurse practitioner CNS: clinical nurse specialist
CRNP: certified registered nurse practitioner  CSR: Controlled Substances Registration 
CSVF: Controlled Substance Verification Form DEA: Drug Enforcement Administration
IDFPR: Illinois Department of Financial and Professional Regulation KASPER: Kentucky All Schedule Prescription Electronic Reporting System
LNP: licensed nurse practitioner NA: nurse anesthetist
NED: Narcotics Enforcement Division NP: nurse practitioner
NPA: Nurse Practice Act NYSED: New York State Education Department
OARRS: Ohio Automated Rx Reporting System PCNS: psychiatric clinical nurse specialist
PDMP: prescription drug monitoring program PMP: prescription monitoring program
QACSC: Quality Alabama Controlled Substance Certificate RNP: registered nurse practitioner
VPMS: Vermont Prescription Monitoring System WCPA: written collaborative practice agreement

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