Applying for DEA Registration
A Helpful Guide for Kansas ARNP's
Effective April 1, 2000 Kansas law permits ARNPs to prescribe controlled
substances based on professional judgement and within the written protocol
adopted jointly with your responsible physician. The law doesn't restrict
ARNPs from prescribing any schedule of controlled substances, however,
if your responsible physician only authorizes schedules III and IV in
the protocol, or only certain named drugs within those schedules, those
limitations are imposed on the ARNP.
How to Request a DEA Application
The toll- free phone number to request a DEA Application is (888) 803-1179.
The form is "DEA Form-224". The application is ordered through the computer
and printed in Washington, DC. It takes up to ten working days to reach
you. You may have the application mailed to you using any address, however,
when completing the form, ARNPs must use a current business practice address
as the registration address.
Completing the DEA Application
The application will be scanned and so it must be filled out and completed
using black ink. Print legibly, your last name, then your first name,
then a space, then your middle initial, in the blocks provided. Enter
your social security number and the business phone number in the blocks
provided.
Question 1
Your business activity is mid-level practitioner. Check that box and
enter your professional degree. NP is readily recognized by DEA Registration
as meaning nurse practitioner. Kansas ARNP's should enter NP as their
designation.
Question 2
ARNPs should NOT mark this. This pertains to procuring Schedule II drugs
in quantity and is generally needed by pharmacists and hospitals only.
This is very tightly controlled by serial numbers, with every number accounted
for and lost or stolen books investigated promptly.
Question 3
Check only the drug schedules which you are authorized to write prescriptions
for based on your jointly adopted written protocol. IIN and IIIN are non-narcotic
scheduled drugs.
Question 4 (a)
4 a. Check the box "yes" if you currently are an ARNP recognized by the Kansas State Board of Nursing. Enter your ARNP certificate number. If you check NA, your application cannot be processed. If you check pending, keep in mind that your DEA Registration will not be issued until after your license is issued by the Board of Nursing.
For the second part of question 4 a. the answer is NA. Kansas doesn't
require a separate state controlled substance registration number, so
mark the NA box for state controlled substances number.
Question 4 (b)
ARNPs must complete this section. Mark the box or boxes that indicate the activities authorized to perform within each schedule of controlled substances. Prescribe and Administer are permitted to be performed by Kansas ARNPs, if contained within their written protocol. Definitions:
Prescribe--authorize a pharmacy to dispense to the patient;
Administer--apply, inject or give medication for immediate ingestion;
Dispense--specifically prohibited by Kansas Law-ARNPs should not mark this as it is prohibited by Kansas Law;
Procure--individually obtain controlled substances by
purchase or receipt of samples from a manufacturer or distributer. (Not
legally permitted in Kansas)
Question 4 c,d,e, and f
The four sections question the ARNP about criminal conduct and past licensure
sanctions related to controlled substances. Misrepresentation or lying
on a DEA application is cause for denial. If a DEA registration is issued
pursuant to an application on which these questions were falsely answered,
it can be revoked. To knowingly and intentionally falsify a DEA Registration
application is a criminal act. A "yes" answer to Question 4 c,d,e or f
will trigger the application to be forwarded to the Kansas City District
office where it will be reviewed by an investigator. Depending upon the
results of this investigation, your DEA registration may be delayed, issued
with mutually agreed upon restrictions or conditions or denied pursuant
to administrative action.
Question 5
There is space provided to enter a complete explanation of any "yes"
answer to Questions 4 c,d,e, and f. If the space provided is not large
enough, attach a sheet of paper to continue with the explanation(s).
Question 6
Payment may be made by check, U.S. Money order, VISA or MasterCard. Check
the box indicating your method of payment and enter all information needed.
The fee is $210 for three years of registration. Make checks payable to
the Drug Enforcement Administration.
Question 7
If you are an employee of local, county, state or federal government
operated hospital, institution or official, you may be exempt from payment
of the registration fee. The ARNP's supervising official must complete
this section and sign his/her name, indicating the governmental agency
involved, and the date. Note: If your DEA Registration is issued exempt
from the $210 fee, ARNP's may only use their DEA Registration in the course
of governmental authorized and compensated duties. If as an ARNP you also
want to engage in private practice, the ARNP must pay their own DEA Registration
fee.
Question 8
Sign and date the DEA Registration application, taking care to legibly
print your name and title. Mail it to the: United States Department of
Justice, Drug Enforcement Administration, Central Station, P.O. Box 28083,
Washington, D.C. 20038-8083
Processing by the DEA
The volume of mail processed by the registration section of the Drug Enforcement Administration (DEA) is very large. It moves through the system according to the day it is received. Your check is processed then the application is checked for accuracy and completeness. All pertinent data is entered into DEA's computer system and is given a control number. These activities take about two weeks.
If the application is incomplete, it will be returned to the applicant for completion. If the fee is insufficient, applicants will be contacted. No processing will take place until all information is provided and the fee is paid.
Every day, the DEA registration assistant in the St. Louis office downloads pending applications. She will verify by mail with the Kansas State Board of Nursing that you have met the state requirements to obtain a federal controlled substances registration. Verification of licensure, address, drug schedules and activities are made with the nursing board for all applicants pending. These verification mailings take place approximately twice a week. It is the responsibility of the Kansas State Board of Nursing to determine whether the individual ARNP has met the requirements for controlled substance registration. The Kansas State Board of Nursing is using a form that ARNP's must complete and return to the KSBN for this process. The name of the form is the "Controlled Substance Verification Form." To obtain a copy of this form, contact the Kansas State Board of Nursing, Landon State Office Building, 900 S.W. Jackson, Suite 551-South, Topeka, Kansas 66612 (785) 296-5752, FAX (785) 296-3929, e-mail ksbn0@ink.org
From the time you mail your application, it usually takes from six to
eight weeks before you receive your DEA Registration certificate.Your
DEA number will consist of two alpha and seven numeric numbers. The first
alpha character will be an "M". The second alpha character will be the
first initial of your last name.
Other Responsibilities of ARNP's Following Issuance of a DEA
Certificate
Name Changes
If you change your name, you need to first notify the Kansas Board of
Nursing then write a letter to: Registration Assistant, Drug Enforcement
Administration, 7911 Forsyth Blvd., Suite 500, St. Louis, Missouri 63105.
Include your DEA Registration number and what change you need to make
and why. After the DEA receives this information, the Board of Nursing
will be contacted by mail to verify that the respective change has been
made with the agency as well.
Practice Location Changes
If you change practice locations, you must notify the DEA and the Kansas
State Board of Nursing. You can do this by directing a letter to the Registration
Assistant in St. Louis. The "Controlled Substance Verification Form" can
be used to report this to KSBN.You may transfer your DEA Registration
only to another state that authorizes nurse practitioners to handle controlled
substances and you may handle them only to the extent that state authorizes.
Renewal Forms
A renewal application for your DEA Registration is mailed to the address
on your DEA Certificate. It is not forward able by the post office. If
you do not inform DEA of your current practice address, you will not receive
your renewal and your registration will expire.
Administering & Prescribing Controlled Substances at Practice Location
You may only possess controlled substances for administration at the
practice location noted on your DEA Registration. If you have more than
one practice location at which you administer controlled substances, the
ARNP or responsible physician must have a DEA Registration listed for
that address. Prescribing controlled substances from anywhere within the
same state, ARNP's need only one DEA Registration for a practice address
within the state.
What is the Role of the Kansas State Board of Nursing in the ARNP's DEA Application Process?
The Drug Enforcement Agency (DEA) Registration process is between the
ARNP and the Department of Justice, DEA division. However, in order to
insure that ARNP's are complying with applicable state law, the DEA will
contact the Kansas State Board of Nursing to verify each ARNP's application.
The Kansas State Board of Nursing is using a form that ARNP's must complete
and return to the KSBN for this process. This form will permit the Board
of Nursing to verify what is needed by the DEA . The name of the form
used by the Board of Nursing is the "Controlled Substance Verification
Form." To obtain a copy of this form, contact the Kansas State Board of
Nursing, Landon State Office Building, 900 S.W. Jackson, Suite 551-South,
Topeka, Kansas 66612 (785) 296-5752, FAX (785) 296-3929, e-mail ksbn0@ink.org
Kansas ARNP and Pharmacy Act Changes
Implementing DEA Registration for ARNPs
Effective April 1, 2000
H.B. 2168 was passed during the 1999 Legislative Session and made changes
in the ARNP statutes, pharmacy act and insurance statutes that permits
ARNP's (except CRNA's) to write prescriptions for Scheduled Drugs II-V.
The new law is effective April 1, 2000 and the Kansas Board of promulgated
implementing regulations that also go into effect April 1. They require
ARNP's prescribing scheduled drugs to obtain a DEA certificate and number
through the DEA Registration process. The most significant changes to
the statutes and regulations appear below as reference.
Revised ARNP Statute Requiring DEA Numbers to Prescribe Scheduled Drugs
1999 Supp. K.S.A. 65-1130
(d) An advanced registered nurse practitioner may prescribe drugs pursuant to a written protocol as authorized by a responsible physician. Each written protocol shall contain a precise and detailed medical plan of care for each classification of disease or injury for which the advanced registered nurse practitioner is authorized to prescribe and shall specify all drugs which may be prescribed by the advanced registered nurse practitioner. Any written prescription order shall include the name, address and telephone number of the responsible physician. The advanced registered nurse practitioner may not dispense drugs, but may request, receive and sign for professional samples and may distribute professional samples to patients pursuant to a written protocol as authorized by a responsible physician. In order to prescribe controlled substances, the advanced registered nurse practitioner shall (1) register with the federal drug enforcement administration; and (2) notify the board of the name and address of the responsible physician or physicians. In no case shall the scope of authority of the advanced registered nurse practitioner exceed the normal and customary practice of the responsible physician. An advanced registered nurse practitioner certified in the category of registered nurse anesthetist while functioning as a registered nurse anesthetist under K.S.A. 65-1151 to 65-1164, inclusive, and amendments thereto, shall be subject to the provisions of K.S.A. 65-1151 to 65-1164, inclusive, and amendments thereto, with respect to drugs and anesthetic agents and shall not be subject to the provisions of this subsection. For the purposes of this subsection, "responsible physician" means a person licensed to practice medicine and surgery in Kansas who has accepted responsibility for the protocol and the actions of the advanced registered nurse practitioner when prescribing drugs.
(e) As used in this section, "drug" means those articles and substances
defined as drugs in K.S.A. 1998 Supp. 65-1626 and 65-4101 and amendments
thereto.
ARNP Regulation Revisions
The regulation implementing K.S.A. 65-1130, which is K.A.R. 60-11-104a
was recently revised to reflect the changes in statute. The new regulation
effective April 1, 2000 is as follows:
60-11-104a. Protocol requirements; prescription orders.
(A)Each written protocol that an advanced registered nurse practitioner is to follow when prescribing, administrating, or supplying a prescription-only drug shall meet the following requirements:
(1) Specify for each classification of disease or injury the corresponding class of drugs that the advanced registered nurse practitioner is permitted to prescribe;
(2) be maintained in either a loose-leaf notebook or a book of published protocols. The notebook or book of published protocols shall include a cover page containing the following data:
-
(A) The names, telephone numbers, and signatures of the advanced registered
nurse practitioner and a responsible physician who has authorized the
protocol: and
(B) the date on which the protocol was adopted or last reviewed: and
(3) be kept at the advanced registered nurse practitioner's principle place of practice.
(b) Each advanced registered nurse practitioner shall ensure that each protocol is reviewed by the advanced registered nurse practitioner and physician at least annually.
(c) Each prescription order in written form shall meet the following requirements:
(1) Include the name, address and telephone number of the practice location of the advanced registered nurse practitioner;
(2) include the name, address, and telephone number of the responsible physician;
(3)be signed by the advanced registered nurse practitioner with the letters A.R.N.P.;
(4) be from a class of drugs prescribed pursuant to protocol: and
(5) contain and D.E.A. registration number issued to the advanced registered nurse practitioner when a controlled substance, as defined in K.S.A. 65-4101(e) and the amendments thereto, is prescribed.
(d) Nothing in this regulation shall be construed to prohibit any registered nurse or licensed practical nurse or advanced registered nurse practitioner from conveying a prescription order orally or administrating a drug if acting under the lawful direction of a person licensed to practice either medicine and surgery or dentistry, or certified as an advanced registered nurse practitioner.
(e) When used in this regulation, terms shall be construed to have the
meanings set forth in the pharmacy act of the state of Kansas, K.S.A.
65-1626, and amendments thereto.
Authorized by and implementing K.S.A. 1999 Supp. 65-1130; effective, T-60-9-12-88. Sept. 12, 1988; effective Feb. 13, 1989; amended May 7, 1990; amended Jan.3, 1995; amended Mar. 31, 2000.
For a complete copy of the Kansas Nurse Practice Act send a personal
check (or money order) for $4.50 to the Kansas Board of Nursing, Landon
State Office Building, 900 S.W. Jackson, Suite 551-South, Topeka, Kansas
66612. Specific statutes are also available on the internet by entering
the statute numbers. Internet Site is www.ink.org/public/legislative ARNP
statutes are K.S.A. 65-1130 through 65-1139.
Pharmacy Act Changes
Definitions in the Pharmacy Act (K.S.A. 1999 Supp. 65-1626) were also amended to define the term mid-level practitioner and then incorporate this term in the appropriate places of this definition section to authorize prescription writing by ARNP's and dispensing by licensed pharmacists of such prescriptions. Below are the two significant definitions that were changed and become effective April 1, 2000. There are several others that for consistency were amended to reference "mid-level practitioner" in the pharmacy act.
(cc) "Prescription order" means: (1) An order to be filled by a pharmacist for prescription medication issued and signed by a practitioner or a mid-level practitioner in the authorized course of professional practice; or (2) an order transmitted to a pharmacist through word of mouth, note, telephone or other means of communication directed by such practitioner or mid-level practitioner.
(ii) "Mid-level practitioner" means an advanced registered nurse practitioner
issued a certificate of qualification pursuant to K.S.A. 65-1131 and amendments
thereto who has authority to prescribe drugs pursuant to a written protocol
with a responsible physician under K.S.A. 65-1130 and amendments thereto
or a physician's assistant registered pursuant to K.S.A. 65-2896a and
amendments thereto who has authority to prescribe drugs pursuant to a
written protocol with a responsible physician under K.S.A. 65-2896e and
amendments thereto.
H.B. 2168 was passed by the 1999 Kansas legislature and the bill
is an engrossed bill of the 1999 Legislative Session. The entire bill
is available on the internet at www.ink.org/public/legislative under Engrossed
Bills.
Controlled Substance Prescriptions
The ARNP Perspective
By Larry Froelich, R.Ph., Board of Pharmacy
Effective April 1, 2000, prescriptions for controlled substances will
be able to be written by ARNP's (otherwise referred to as Mid-Level Practitioners).
Previous to this change, these prescriptions could only be transmitted
orally. The other change permits ARNP's to request, receive and sign for
professional samples and distribute these samples to patients pursuant
to a written protocol.
Samples
ARNPs may not accept samples for any controlled substances, since they are illegal to be sampled in Kansas by ANYONE to ANYONE. If an ARNP encounters a company doing this, please call the Board of Pharmacy (888-792-6273).
(K.A.R. 68-20-15a. A controlled substance listed in schedules II through V shall not be distributed on a gratuitous basis by a manufacturer or distributor to a practitioner, mid-level practitioner, pharmacist, or any other person.)
Coupon distribution by drug companies is permitted, provided they are not coupons intended to be preprinted prescriptions. (K.A.R. 68-20-18) Controlled substance prescriptions in schedules II through V shall not be issued on a prescription blank that is preprinted with the name of a propriety preparation or with the strength, quantity, or directions.
ARNPs may distribute samples, but not dispense. Distribute means to hand out samples at no charge to your patients. Dispense means to label and/or sell samples.
Pharmacists will be insuring that these prescriptions clearly identify
the responsible physician, since all prescription labels written by an
ARNP must contain the name of the Practitioner, and the name of the ARNP.
This can be done either by circling the physician's name or by writing
the physician's name on the prescription.
Time Lines and Refills
Written prescriptions for controlled substances are valid for a period of six months after the original date they are written. There are no quantity limitations for controlled substances. However, sometimes problems can arise when writing for more than one month's quantity because of the patients' insurance company. Additionally, if you want to write prescriptions in advance - i.e. you are using Ritalin to treat a patient and you want to write 3 months prescriptions at one office visit - write and date all of the prescriptions on the same date and put a note out to the side to the pharmacist telling them when that prescription may be filled.
Refills-C-II Prescriptions - No Refills.
C-III & C-IV - Maximum of 5 Refills within 6
months.
Schedule II Emergency Situations
In an emergency situation a ARNP may give oral authorization to dispense a controlled substance listed in Schedule II provided that the quantity prescribed and dispensed is limited to the amount adequate to treat the patient during the emergency period. Within 7 days after authorizing an emergency oral prescription, the ARNP shall deliver a written prescription for the emergency quantity prescribed to the dispensing pharmacist.
K.A.R. 68-20-19. For the purposes of authorizing a prescription of any controlled substance listed in schedule II of the federal or state uniform controlled substances act, the term "emergency situation" means those situations in which the prescriber determines the following:
(A) That immediate administration of the controlled substance is necessary for proper treatment of the intended ultimate user;
(B) that no appropriate alternative treatment is available, including administration of a drug that is not a controlled substance under schedule II of the act; and
(C) that it is not reasonably possible for the prescriber to provide
a written prescription to be presented, before dispensing, to the pharmacist
dispensing the substance.
Limitations
K.A.R. 100-23-1 - Treatment of Obesity -- Amphetamines shall not be dispensed or prescribed to treat obesity.
K.S.A. 65-2837a - Restrictions -- The patient's medical
record shall adequately document and the prescription order shall indicate
in the licensee's or mid-level practitioner's own handwritting, the purpose
for which the drug is being given.
Definitions:
"Mid-level practitioner" means
An advanced registered nurse practitioner issued a certificate of qualification
pursuant to K.S.A. 65-1131 and amendments thereto who has authority to
prescribe drugs pursuant to a written protocol with a responsible physician
under K.S.A. 65-1130 and amendments thereto or a physician's assistant
registered pursuant to K.S.A. 65-2896a and amendments thereto who has
authority to prescribe drugs pursuant to a written protocol with a responsible
physician under K.S.A. 65-2896e and amendments thereto. (April 1, 2000)
"Prescription order" means:
(l) An order to be filled by a pharmacist for prescription medication issued and signed by a practitioner or mid-level practitioner in the authorized course of professional practice; or
(2) An order transmitted to a pharmacist through word of mouth, note,
telephone or other means of communication directed by such practitioner
or mid-level practitioner (April 1, 2000).
"Dispenser" means
A practitioner or pharmacist who dispenses
prescription medication.
"Dispense" means:
To deliver prescription medication to the ultimate user or research subject
by or pursuant to the lawful order of a practitioner or pursuant to the
prescription of a mid-level practitioner (April 1, 2000).
"Distribute" means
To deliver, other than by administering or dispensing, any drug.
Purpose of Issuing a Prescription
1. To be effective, a prescription for a controlled substance shall be issued for a legitimate medical purpose by an ARNP acting in the usual course of professional practice. The responsibility for the proper prescribing and dispensing of controlled substances shall rest with the prescriber, but a corresponding responsibility shall rest with the pharmacist who fills the prescription. The person filling an unlawful prescription, as well as the person issuing it, shall be subject to the penalties provided for violations of the provisions of the controlled substance act, K.S.A. 65-4101, et seq. and amendments thereto.
2. A prescription shall not be issued in order for a practitioner or mid-level practitioner to obtain controlled substances for supplying that individual or any other prescriber for the purpose of general dispensing to patients.
3. A prescription shall not be issued for the dispensing of narcotic
drugs listed in any schedule to a narcotic drug-dependent person for the
purpose of continuing dependence upon these drugs, except in the course
of conducting an authorized clinical investigation in the development
of a narcotic addict rehabilitation program.
Mechanics of Issuing a Prescription
Written prescription orders for a controlled substance must be dated
and manually signed on the day issued. These prescriptions shall:
1. bear the full name, address, and telephone number of the responsible physician (practitioner);
2. bear the ARNPs name, address, and telephone number of their practice location;
3. the name and address of the patient; and
4. the drug name, strength, dosage form, quantity prescribed, and directions for use; and
5. be written with ink, indelible pencil, or typewriter.
6. ARNPs shall manually sign a prescription in the same manner as that individual would sign a check or legal document.
7. The prescriptions may be prepared by a secretary or agent for the signature of ARNPs, but the prescriber shall be responsible if the prescription does not conform in all essential respects to the state and federal law and regulations. A corresponding liability shall rest upon the pharmacist who fills a prescription that is not prepared in the form prescribed.