Section 4723.481 | Authority of A.P.R.N. designated as clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner to prescribe drugs and therapeutic devices.
This section establishes standards and conditions regarding the authority of an advanced practice registered nurse who is designated as a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner to prescribe and personally furnish drugs and therapeutic devices under a license issued under section 4723.42 of the Revised Code.
(A) A clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner shall not prescribe or furnish any drug or therapeutic device that is listed on the exclusionary formulary established in rules adopted under section 4723.50 of the Revised Code.
(B) The prescriptive authority of a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner shall not exceed the prescriptive authority of the collaborating physician or podiatrist, including the collaborating physician's authority to treat chronic pain with controlled substances and products containing tramadol as described in section 4731.052 of the Revised Code.
(C)(1) Except as provided in division (C)(2) or (3) of this section, a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner may prescribe to a patient a schedule II controlled substance only if all of the following are the case:
(a) The patient has a terminal condition, as defined in section 2133.01 of the Revised Code.
(b) A physician initially prescribed the substance for the patient.
(c) The prescription is for an amount that does not exceed the amount necessary for the patient's use in a single, seventy-two-hour period.
(2) The restrictions on prescriptive authority in division (C)(1) of this section do not apply if a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner issues the prescription to the patient from any of the following entities:
(a) A hospital as defined in section 3722.01 of the Revised Code;
(b) An entity owned or controlled, in whole or in part, by a hospital or by an entity that owns or controls, in whole or in part, one or more hospitals;
(c) A health care facility operated by the department of mental health and addiction services or the department of developmental disabilities;
(d) A nursing home licensed under section 3721.02 of the Revised Code or by a political subdivision certified under section 3721.09 of the Revised Code;
(e) A county home or district home operated under Chapter 5155. of the Revised Code that is certified under the medicare or medicaid program;
(f) A hospice care program, as defined in section 3712.01 of the Revised Code;
(g) A community mental health services provider, as defined in section 5122.01 of the Revised Code;
(h) An ambulatory surgical facility, as defined in section 3702.30 of the Revised Code;
(i) A freestanding birthing center, as defined in section 3701.503 of the Revised Code;
(j) A federally qualified health center, as defined in section 3701.047 of the Revised Code;
(k) A federally qualified health center look-alike, as defined in section 3701.047 of the Revised Code;
(l) A health care office or facility operated by the board of health of a city or general health district or the authority having the duties of a board of health under section 3709.05 of the Revised Code;
(m) A site where a medical practice is operated, but only if the practice is comprised of one or more physicians who also are owners of the practice; the practice is organized to provide direct patient care; and the clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner providing services at the site has a standard care arrangement and collaborates with at least one of the physician owners who practices primarily at that site;
(n) A site where a behavioral health practice is operated that does not qualify as a location otherwise described in division (C)(2) of this section, but only if the practice is organized to provide outpatient services for the treatment of mental health conditions, substance use disorders, or both, and the clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner providing services at the site of the practice has a standard care arrangement and collaborates with at least one physician who is employed by that practice;
(o) A residential care facility, as defined in section 3721.01 of the Revised Code.
(3) A clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner shall not issue to a patient a prescription for a schedule II controlled substance from a convenience care clinic even if the clinic is owned or operated by an entity specified in division (C)(2) of this section.
(D) A pharmacist who acts in good faith reliance on a prescription issued by a clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner under division (C)(2) of this section is not liable for or subject to any of the following for relying on the prescription: damages in any civil action, prosecution in any criminal proceeding, or professional disciplinary action by the state board of pharmacy under Chapter 4729. of the Revised Code.
(E) A clinical nurse specialist, certified nurse-midwife, or certified nurse practitioner shall comply with section 3719.061 of the Revised Code if the nurse prescribes for a minor, as defined in that section, an opioid analgesic, as defined in section 3719.01 of the Revised Code.
The Legislative Service Commission presents the text of this section as a composite of the section as amended by multiple acts of the General Assembly. This presentation recognizes the principle stated in R.C. 1.52(B) that amendments are to be harmonized if reasonably capable of simultaneous operation.
Last updated September 30, 2024 at 4:14 AM
Available Versions of this Section
- September 17, 2014 – House Bill 314 - 130th General Assembly [ View September 17, 2014 Version ]
- March 19, 2015 – Senate Bill 276 - 130th General Assembly [ View March 19, 2015 Version ]
- April 6, 2017 – House Bill 216 - 131st General Assembly [ View April 6, 2017 Version ]
- April 6, 2023 – Amended by House Bill 509 - 134th General Assembly [ View April 6, 2023 Version ]
- October 3, 2023 – Amended by House Bill 33 - 135th General Assembly [ View October 3, 2023 Version ]
- September 30, 2024 – Amended by House Bill 509 (GA 134), House Bill 110 (GA 134), House Bill 33 (GA 135) [ View September 30, 2024 Version ]