Could a Kentucky pharmacist refill a physician’s prescription on a physician assistant’s own authorization?

Plain-English summary

Kentucky’s Board of Pharmacy asked whether a pharmacist could fill or continue medication based on a written or oral prescription from a physician assistant. The Attorney General said in 1992 that the medical-board regulation prohibited physician assistants from prescribing drugs and that KRS 217.065 required the prescribing practitioner’s specific authorization for a refill. A physician assistant could not supply an independent refill authorization. The AG drew a narrower distinction: the assistant could communicate the supervising prescriber’s own specific authorization to the pharmacist, clearly identifying it as that prescriber’s authorization. The pharmacist could decide whether further verification was desirable.

Currency note

This opinion was issued in 1992. Subsequent statutory amendments, court decisions, or later AG opinions may have changed the analysis. Treat this page as historical context, not current legal advice. Verify current law before relying on any specific rule, deadline, or remedy mentioned here.

Historical summary

Pharmacists receiving refill communications

The AG said a pharmacist could not fill a new prescription written or spoken by a physician assistant, nor refill a physician’s prescription based on the assistant’s own authorization. A message from the assistant could communicate the supervising physician’s specific approval, provided the message made that source clear. The opinion left verification of the prescriber’s actual approval to the pharmacist’s judgment based on the information available.

Supervising physicians and assistants

The medical-board regulation quoted in the opinion prohibited assistants from prescribing or dispensing drugs. KRS 217.065 reserved refill authorization to the original prescriber. The AG treated communicating that prescriber’s authorization as different from issuing the authorization oneself.

Common questions

Could a physician assistant prescribe a continuation of the supervising doctor’s medication?

The AG said no under the regulation it read in 1992; the assistant could not prescribe drugs.

Could the assistant independently approve a refill of the doctor’s prescription?

No. The opinion read KRS 217.065 to require specific authorization by the prescribing practitioner.

Could the assistant telephone the pharmacist with the doctor’s approval?

The AG said an assistant could relay the supervising prescriber’s specific authorization if the communication clearly stated that it came from the prescriber. It said the pharmacist could consider whether to verify the authorization further.

Background and statutory framework

The opinion applied then-current 201 KAR 9:175, which barred physician assistants from prescribing or dispensing drugs, and KRS 217.065, which required specific refill authorization by the prescribing practitioner. The AG separated an assistant’s prohibited independent authorization from transmission of the physician’s own decision.

Citations and references

• 201 KAR 9:175: then-current medical-board rule on physician assistants quoted by the AG.
• KRS 217.065: specific prescriber authorization required for refills in the AG’s analysis.

Source

• Landing page: https://kdla.access.preservica.com/uncategorized/IO_6611dc9e-0852-423c-9fba-aea452523edf/
• Original PDF: https://kdla.access.preservica.com/download/file/IO_6611dc9e-0852-423c-9fba-aea452523edf

Original opinion text

OAG 92-37
March 11, 1992

Richard L. Ross, R.Ph.
Executive Director
Kentucky Board of Pharmacy
1228 U.S. 127 South
Frankfort, Kentucky 40601-4330
RE: Your Letter to this Office Wherein You Requested an Opinion as to “whether a pharmacist may legally fill a prescription (written or oral) from a physician’s assistant for continuation of medications originally prescribed by the supervising physician.” Dear Mr. Ross: The following regulation of the Kentucky Board of Medical Licensure applies to your above-referenced request: 201 KAR 9:175. Physician assistants; certification and supervision. Section 8. Duties of Supervising Physicians. A supervising physician shall: (2)Prohibit physician assistants from prescribing or dispensing controlled substances or other drugs; . . . That regulation is quite clear. A physician assistant cannot prescribe controlled substances or other drugs. As to whether a physician’s assistant may authorize the refill of a prescription originally prescribed by his supervising physician, KRS 217.065 provides as follows: Except for violations of KRS 218A.350, a drug or device shall be deemed to be misbranded: (11) If: (b)

It is a drug or device and its label (as originally packed) directs that it is to be dispensed or sold only

Richard L. Ross, R.Ph.
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OAG 92-37
on prescription, unless it is dispensed or sold on prescription of an authorized practitioner and its label (as dispensed) bears the name and place of business of the dispenser or seller, the serial number and date of such prescription, and the name of such licensed practitioner. Such prescriptions shall not be refilled except on the specific authorization of the prescribing practitioner; . . . (Emphasis added.) That portion of KRS 217 makes it quite clear that a prescription for a drug that is to be dispensed or sold only on prescription may only be refilled on the specific authorization of the prescribing practitioner. That certainly precludes a physician’s assistant from authorizing such refills. However, this Office knows of nothing which would prevent a prescribing practitioner, in his capacity as supervising physician of a physician’s assistant, from having his physician’s assistant communicate the prescribing practitioner’s specific authorization of previously unauthorized refills to a pharmacist. If that is done, however, the written or oral communication from the physician’s assistant should definitely include the statement that the authorization is specifically that of the prescribing practitioner. The pharmacist receiving such a communication must decide for himself, based upon his knowledge of the drug, the physician’s assistant, the patient and the prescribing practitioner, whether any further verification is desirable with regard to whether the prescribing practitioner has actually specifically authorized the refill(s). Therefore, it is our opinion that a pharmacist may not legally fill a prescription (written or oral) from a physician’s assistant for continuation of medications originally prescribed by the supervising physician; and a pharmacist may not legally refill a prescription of a licensed practitioner pursuant to authorization of a physician’s assistant. Sincerely, CHRIS GORMAN ATTORNEY GENERAL Conley C. Congleton Assistant Attorney General (502) 564-7600 CCC:reb

Richard L. Ross, R.Ph.
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OAG 92-37