Senate Bill No. 592 - Summary

• Repeals and replaces section 334.104, RSMo to establish new regulations for collaborative practice arrangements between physicians and nurses in Missouri.

• Allows physicians to delegate authority to registered professional nurses to administer or dispense drugs and provide treatment within the nurse's scope of practice, skill, training, and competence.

• Permits advanced practice registered nurses to administer, dispense, or prescribe controlled substances in Schedules III, IV, and V, except for sedation or general anesthesia, with Schedule III narcotic prescriptions limited to a 120-hour supply without refill.

• Requires written collaborative practice arrangements containing specific provisions including complete contact information, office locations, patient disclosure statements, certifications, controlled substance authority descriptions, and mandatory physician review of at least 10% of charts every 14 days (20% for controlled substance prescriptions).

• Limits physicians to collaborative arrangements with no more than five full-time equivalent advanced practice registered nurses; establishes that both physicians and nurses may refuse to collaborate without penalty; and exempts certified registered nurse anesthetists from requiring collaborative practice arrangements if supervised by an anesthesiologist, physician, dentist, or podiatrist.