States Remove Barriers to PAs Prescribing Medication-Assisted Treatment

Board Actions in New Mexico and Wisconsin Increase Flexibility

March 26, 2018

PAs who are combatting the nation’s opioid epidemic will have more flexibility in two states due to favorable decisions made by their licensing boards. Both the New Mexico Medical Board and the Wisconsin Medical Examining Board recently determined that PAs who are waivered by the Drug Enforcement Administration (DEA) to prescribe buprenorphine for the treatment of opioid-use disorder (OUD) are not required to collaborate with a waivered physician. This position is consistent with federal law.

PAs became eligible under federal law to prescribe buprenorphine for medication-assisted treatment (MAT) of OUD in 2016. The new law allows PAs who complete 24 hours of approved training to apply for the DEA waiver (also called an x-waiver), which allows them to treat up to 30 patients. Waivered PAs are required to practice in collaboration with a physician who is eligible for a waiver, though the law does not require the physician to actually be waivered.

Millions of Americans in need of MAT lack access to providers who are willing or able to prescribe it. While the updated federal law was intended to increase the number of MAT providers, many states’ laws and regulations limit a PA to practicing or prescribing within their supervising or collaborating physician’s usual scope of practice, even if the PA has received additional education or training. This means PAs in these states must practice with a waivered physician even though federal law does not require the physician to be waivered. Other states lack clear language regarding whether a PA may follow the federal statute. The actions by the licensing boards in New Mexico and Wisconsin will remove the barriers and ambiguities for PAs in these states and may serve as a model for other states in need of additional MAT providers.

AAPA joined with the American Society of Addiction Medicine (ASAM) and the American Association of Nurse Practitioners (AANP) to send a letter to states supporting the position taken by New Mexico and Wisconsin.

Erika Miller is AAPA’s director of constituent organization outreach and advocacy. Contact her at [email protected].