On July 15, a new law in Kentucky took effect that expands the prescribing authority for advanced practice registered nurses (“APRNs”). Kentucky Revised Statutes 314.042 allows APRNs that have been prescribing non-scheduled legend drugs under physician supervision for four years to prescribe these drugs without physician oversight. Proponents of the law say that the change will increase access to basic health care throughout the Commonwealth. 

The signing of the bill by Governor Beshear in February ended a five-year fight over the amount of authority to be given to APRNs when prescribing medicine. The current law requires that APRNs enter into an agreement with a physician qualified in the same or similar practice as the APRN so that a doctor supervises the APRN’s prescribing practices. A previous version of the bill, which removed the physician agreement requirement entirely, passed the House last year but stalled in the Senate. The new law finds compromise by allowing APRNs that have been prescribing under an agreement for four years to prescribe non-scheduled legend drugs without such oversight.

Proponents of the change in the law cite federal health reform and the expansion of Medicaid in Kentucky as the impetus for updating the statute. They claim that the bill expands access to health care for Kentuckians living in areas with a shortage of primary care providers, as APRNs can now prescribe medication such as antibiotics, insulin and diabetes medications.

The law extends the same rights to APRNs from other states so long as they meet the requirements of the statute. Also established by the law is the Collaborative Prescribing Agreement Joint Advisory Committee. The committee will be composed of three APRNs with prescribing experience and three physicians with APRN supervisory experience and is to serve in an advisory role to the Kentucky Board of Nursing and the Kentucky Board of Medical Licensure regarding issues related to the physician-APRN agreements. While the statute increases the rights afforded to APRNs, they are still required to enter into physician oversight agreements in order to prescribe scheduled drugs to patients.

Patrick C. Walsh