Medical benefits: Patient rights— Medication prescribing authority,

[Federal Register: May 4, 1999 (Volume 64, Number 85)]

[Proposed Rules]

[Page 23812-23813]

From the Federal Register Online via GPO Access [wais.access.gpo.gov]

[DOCID:fr04my99-27]

DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 17

RIN 2900-AJ07

Medication Prescribing Authority

AGENCY: Department of Veterans Affairs.

ACTION: Proposed rule.

SUMMARY: This document proposes to amend the medical regulations of the Department of Veterans Affairs (VA) regarding patient rights concerning the prescribing of medications. The current regulations were intended to ensure that patients are free of unnecessary medications, that a patient's medical record contains entries reflecting prescribed medications, that drug regimens are reviewed in a timely manner, and that medications not be used as punishment. The adoption of this proposed rule would not lessen these requirements. However, the regulations noted that medication would be administered only on the written order of a physician. Further, the regulations provided for medication review only by a physician. Today, throughout the health care industry other health care professionals are recognized as qualified and credentialed to prescribe medications and conduct medication reviews. Under these circumstances, VA proposes to update the regulations by stating that other health care professionals also are able to prescribe medications as authorized by VA and to conduct the necessary medication reviews. Further, in order to utilize technological advances, VA proposes to amend the regulations to allow for VA health care professionals to issue prescriptions by electronic means in addition to ordering prescriptions by telephone.

DATES: Comments must be received on or before July 6, 1999.

ADDRESSES: Mail or hand-deliver written comments to: Director, Office of Regulations Management (02D), Department of Veterans Affairs, 810 Vermont Avenue, NW, Room 1154, Washington, DC 20420. Comments should indicate that they are submitted in response to ``RIN 2900-AJ07.'' All written comments received will be available for public inspection at the above address, Room 1158, between the hours of 8:00 a.m. and 4:30 p.m., Monday through Friday (except holidays).

FOR FURTHER INFORMATION CONTACT: Ronald J. Gebhart, M.D., Chief Consultant, Primary and Ambulatory Care (112), Veterans Health Administration, 202-273-8550. (This is not a toll-free number.)

SUPPLEMENTARY INFORMATION:

Regulatory Flexibility Act

The Secretary of Veterans Affairs hereby certifies that adoption of the proposed rule will not have a significant economic impact on a substantial number of small entities as they are defined in the Regulatory Flexibility Act, 5 U.S.C. 601-612. This proposed rule concerns which VA health care professionals may prescribe medications. It would not have an affect on small entities and is not intended to affect the prescription of medications to veterans. Pursuant to 5 U.S.C. 605(b), this proposed rule, therefore, is exempt from the initial and final regulatory flexibility analysis requirements of Secs. 603 and 604.

Executive Order 12866

This proposed rule has been reviewed by OMB under Executive Order 12866.

Catalog of Federal Domestic Assistance

There is no Catalog of Federal Domestic Assistance number for this proposed rule.

List of Subjects in 38 CFR Part 17

Alcoholism, Claims, Dental health, Drug abuse, Foreign relations, Government contracts, Grant programs-health, Health care, Health facilities, Health professions, Medical devices, Medical research, Mental health programs, Nursing home care, Philippines, Veterans.

Approved: January 5, 1999 Togo D. West, Jr., Secretary of Veterans Affairs.

For the reasons set out in the preamble, 38 CFR part 17 is proposed to be amended as set forth below.

PART 17--MEDICAL

1. The authority citation for part 17 continues to read as follows:

   Authority: 38 USC 501, 1721, unless otherwise noted.

2. In 17.33, paragraph (e) is revised to read as follows:

   17.33 Patients' rights.

   * * * * *

   (e) Medication. Patients have a right to be free from unnecessary or excessive medication. Medication will be administered only on the order of a healthcare professional authorized by VA to prescribe medication. That individual may issue the order personally, or in the case of an emergency, by telephone or other electronic means. If made personally, the healthcare professional must issue the order in writing by placing an entry in the patient's medical record. If the order is issued by telephone or other electronic means, the person receiving the order must place an entry in the patient's medical record showing that the order was made, and it must be countersigned within 24 hours by a healthcare professional authorized by VA to prescribe medication. The

   [[Page 23813]]

   attending healthcare provider shall be responsible for all medication given or administered to a patient. The attending healthcare provider shall review the drug regimen of each patient under his or her care at least every thirty (30) days, and the administration of certain medications will be reviewed more frequently. Medication shall not be used as punishment, or for the convenience of the staff, or in quantitites which interfere with the patient's treatment program. * * * * *

   [FR Doc. 99-11070Filed5-3-99; 8:45 am]

   BILLING CODE 8320-01-U