Request By:
Richard L. Ross, R.Ph.
Executive Director
Kentucky Board of Pharmacy
1228 U.S. 127 South
Frankfort, Kentucky 40601-4330
Opinion
Opinion By: Chris Gorman, Attorney General; Conley C. Congleton, Assistant Attorney General
Re: Your Letter to this Office Wherein You Requested an Opinion as to "whether a pharmacist may legally fill a prescription (written or oral) from a physician's assistant for continuation of medications originally prescribed by the supervising physician."
The following regulation of the Kentucky Board of Medical Licensure applies to your above-referenced request:
201 KAR 9:175. Physician assistants; certification and supervision. Section 8. Duties of Supervising Physicians. A supervising physician shall:
(2) Prohibit physician assistants from prescribing or dispensing controlled substances or other drugs; . . .
That regulation is quite clear. A physician assistant cannot prescribe controlled substances or other drugs.
As to whether a physician's assistant may authorize the refill of a prescription originally prescribed by his supervising physician, KRS 217.065 provides as follows:
Except for violations of KRS 218A.350, a drug or device shall be deemed to be misbranded: (11) If:
(b) It is a drug or device and its label (as originally packed) directs that it is to be dispensed or sold only on prescription, unless it is dispensed or sold on a prescription of an authorized practitioner and its label (as dispensed) bears the name and place of business of the dispenser or seller, the seril number and date of such prescription, and the name of such licensed practitioner. Such prescriptions shall not be refilled except on the specific authorization of the prescribing practitioner ; . . . (Emphasis added.)
That portion of KRS 217 makes it quite clear that a prescription for a drug that is to be dispensed or sold only on prescription may only be refilled on the specific authorization of the prescribing practitioner. That certainly precludes a physician's assistant from authorizing such refills. However, this Office knows of nothing which would prevent a prescribing practitioner, in his capacity as supervising physician of a physician's assistant, from having his physician's assistant communicate the prescribing practitioner's specific authorization of previously unauthorized refills to a pharmacist. If that is done, however, the written or oral communication from the physician's assistant should definitely include the statement that the authorization is specifically that of the prescribing practitioner. The pharmacist receiving such a communication must decide for himself, based upon his knowledge of the drug, the physician's assistant, the patient and the prescribing practitioner, whether any further verification is desirable with regard to whether the prescribing practitioner has actually specifically authorized the refill (s).
Therefore, it is our opinion that a pharmacist may not legally fill a prescrition (written or oral) from a physician's assistant for continuation of medications originally prescribed by the supervising physician; and a pharmacist may not legally refill a prescription of a licensed practitioner pursuant to authorization of a physician's assistant.