Missouri State Senate


SB 167 - This act repeals current provisions of law which authorizes physicians to enter into collaborative practice arrangements with advanced practice registered nurses. Under the act, doctors may delegate to a registered professional nurse or licensed practical nurse the authority to administer or dispense drugs and provide treatment within the scope of practice, skills, and training of the nurse. The act provides that each advanced practice register nurse is accountable to patients for having a written attestation for consultation, care coordination, or referral with a physician or other health care providers. Physicians may still enter into a collaborative practice agreements with certified registered nurse anesthetists.

The act repeals the requirement that certified registered nurse anesthetists who have a certificate of controlled substance prescriptive authority must also have delegated authority under a collaborative practice arrangement to prescribe certain controlled substances. The act also repeals the requirement that the name of the collaborating physician be printed on a controlled substance label when the prescription is written by an advanced practice registered nurse.

The act adds advanced practice registered nurses to the list of those who can prescribe drugs covered by MO HealthNet payments. Services of an advanced practice registered nurse are also added to the list of services qualified for MO HealthNet payments.

The act provides that the State Board of Registration for the Healing Arts shall not take certain disciplinary action against a physician for services delegated to a licensed practical nurse provided that the services are performed within the scope of practice of the registered professional nurse or licensed practical nurse and consistent with the nurse's skills and training.

The act modifies the definitions of "advanced practice registered nurse," "certified clinical nurse specialist," "certified nurse midwife," "certified nurse practitioner," "certified registered nurse anesthetist," and "licensure," as well as adds a definition for "advanced practice registered nursing."

The act repeals provisions allowing the Board of Nursing to grant certificates of controlled substance prescriptive authority to advance practice registered nurses. The act provides that all advanced practice registered nurses are authorized to provide certain services.

The act modifies the procedure and qualifications for initial licensure to practice as a registered professional nurse, licensed practical nurse, and an advanced practice registered nurse.

Under the act, the Board may cause a complaint to be filed with the Administrative Hearing Commission when the holder of a certificate of registration or authority, permit or license prescribes, administers, or dispenses a controlled substance which is nontherapeutic in nature or in the manner it was prescribed. The board may file a complaint also when the holder fails to keep accurate records of controlled substances received, prescribed, dispensed and administered, for writing false prescriptions, or when a holder prescribes, administers, or dispenses a controlled substance in violation of applicable state and federal law.

Lastly, the act provides that a registered professional nurse is permitted to authorize a pharmacist to fill a prescription on behalf of an advance practice registered nurse.

This act is similar to SB 679 (2012).