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Kentucky Board of Nursing Issues Advisory on Nurse Practitioner Prescribing During State of Emergency, Pushes Telehealth

Following the Kentucky Board of Medical Licensure’s Advisory, the Kentucky Board of Nursing issued advisory guidance regarding prescribing practices for Nurse Practitioners.

The guidance begins with a reminder of prescribing limits per the schedule of the drug prescribed, then immediately states that APRNs may utilize telehealth when prescribing controlled substances per 201 KAR 20:520. The good faith examination required to establish the provider-patient relationship under KRS 218A.010(4) can now, under the present emergency, be accomplished via telehealth. The definition of telehealth includes interactive audio, video, or other electronic media, and, as the Board points out, telephones.

The guidance also uses the same KBML “current but temporary state of emergency” to suggest that the COVID-19 crisis may be a circumstance when it wouldn’t be appropriate to require a patient to come in prior to refilling a prescription or obtaining a new prescription for a non-refillable medication that they have been taking, so long as the standard prerequisites are met using telehealth. The history and stability of the patient should play a key role in determining the appropriateness of prescribing via telehealth and should be documented. 

Nurse Practitioners may also use telehealth with respect to medication assisted treatment for prescribing that occurs after the initial induction protocol. As for the initial induction protocol, the guidance states, “201 KAR 20:065 §3(4)(c) states that, if an in-office observed induction does not occur, the APRN shall appropriately document the circumstances in the patient record and shall implement a SAMHSA-recognized or ASAM-recognized home-based induction protocol.” Telehealth can be used to conduct the weekly or monthly visits required per 201 KAR 20:06 §3(4)(e-j) for the maintenance period following the initial induction.

Telehealth is taking center stage during the COVID-19 crisis, and for good reason. Please continue to check back for updates as we give providers new information and relay guidance during this crisis, and should you need clarification or assistance, give the healthcare attorneys at McBrayer a call today.

Lisa English Hinkle is a Member of McBrayer law. Ms. Hinkle chairs the healthcare law practice and is located in the firm’s Lexington office. Contact Ms. Hinkle at lhinkle@mcbrayerfirm.com or (859) 231-8780, ext. 1256, or reach out to any of the attorneys at McBrayer. 

Services may be performed by others.

This article does not constitute legal advice.

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