MO HB1481

Physicians may enter into written collaborative practice arrangements with registered professional nurses and advanced practice registered nurses to delegate authority to administer, dispense, or prescribe drugs and provide treatment within the nurse's scope of practice and competence.

Advanced practice registered nurses may prescribe controlled substances in Schedules III, IV, and V under collaborative arrangements, with Schedule III narcotics limited to a 120-hour supply without refill; arrangements cannot delegate authority to administer controlled substances for inducing sedation or general anesthesia.

Written collaborative practice arrangements must include contact information for both professionals, office locations, a patient disclosure statement, certifications, manner of collaboration, controlled substance prescriptive authority, review procedures, and duration; collaborating physicians must review at least 10% of charts every 14 days and 20% of controlled substance prescription charts.

Geographic proximity requirement between collaborating physician and nurse may be waived for up to 28 days per calendar year for certain rural health clinics if alternative coverage plans are included in the arrangement.

A collaborating physician may not enter into collaborative arrangements with more than three full-time equivalent advanced practice registered nurses; advanced practice registered nurses must practice with the collaborating physician continuously present for at least one month before practicing independently.