Prior Authorization Requirements For Providers Prescribing Buprenorphine-Containing Products

State law or statute prohibits or limits the use of prior authorization for buprenorphine containing products by either the state Medicaid plan or private insurance companies.

A plan may not impose prior authorization for an initial or renewal prescription for all buprenorphine products, methadone or long-acting injectable naltrexone for detoxification or maintenance treatment of SUD. N.Y. INS. LAW §§ 3216(i)(31-a)

Medicaid managed care and fee for-service may not require prior authorization for preferred and formulary forms of buprenorphine or injectable naltrexone for detoxification or maintenance treatment for opioid addiction. N.Y. SOC. SERV. LAW § 364-j(26-b); N.Y. PUB. HEALTH LAW § 273(10)

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Education Required for Addiction Counselor Credentialing

New York credentials one type of addiction counselor. A Credentialed Alcoholism and Substance Abuse Counselors requires, at minimum, a high school diploma, 350 hours of relevant education courses and 6,000 hours of experience. A higher-level degree can substitute the number of hours (i.e. a person with a bachelor’s degree needs 4,000 hours). N.Y. Mental Hygiene Law §19.07 and New York State Office of Alcoholism and Substance Abuse Services Credentialing Unit

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Licensed Professional Counselor Ability to Diagnose

Mental health counselors evaluate, assess, treat, disorders of behavior, character, development, emotion, personality or relationships by the use of verbal or behavioral methods with individuals, couples, families or groups in private practice, group, or organized settings. The use of assessment instruments and mental health counseling allows counselors to identify, evaluate and treat dysfunctions and disorders for purposes of providing appropriate mental health counseling services. In order to diagnose, a mental health counselor must have filled out an application, be licensed in the state of NY, completed the various educational and experience requirements and pay a fee. N.Y. Education Law §8402

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Peer Support Specialist Certification or Credentialing Authority

The standards for the certification of recovery peer advocates, including experience, training, and supervision requirements, are developed and administered by a third-party, non-profit certification provider.

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Certified Nurse Midwife Practice Authority

Full independent practice and prescriptive authority.

A midwife shall still have collaborative relationships with (i) a licensed physician who is board certified as an obstetrician-gynecologist by a national certifying body or (ii) a licensed physician who practices obstetrics and has obstetric privileges at a general hospital licensed under article twenty-eight of the public health law or (iii) a hospital, licensed under article twenty-eight of the public health law, that provides obstetrics through a licensed physician having obstetrical privileges at such institution, that provide for consultation, collaborative management and referral to address the health status and risks of his or her patients and that include plans for emergency medical gynecological and/or obstetrical coverage.

Licensed midwives may prescribe medications and order diagnostic tests within their scope of practice and consistent with their practice. This includes both controlled and non-controlled substances. N.Y. Education Law §6951

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Nurse Practitioner Practice Authority

Transition to independent practice and prescribing period required.

The practice of registered professional nursing by an NP, may include the diagnosis of illness and physical conditions and the performance of therapeutic and corrective measures within a specialty area of practice, in collaboration with a licensed physician qualified to collaborate in the specialty involved, provided such services are performed in accordance with a written practice agreement and written practice protocols. Prescribing must also take place in accordance with written practice protocols. After practicing for more than three thousand six hundred hours shall not be required to collaborate with a physician, a written practice agreement and written practice protocols. N.Y. Education Law §6903

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Nurse Practitioner Authority to Sign POLST Forms

NPs are authorized to sign medical orders for life-sustaining treatment forms. N.Y. Public Health Law §2994-a

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Nurse Practitioner as a Primary Care Provider

NPs are recognized in state policy as primary care providers. A primary care provider means a physician or nurse practitioner providing primary care to and management of medical and health care services of a patient. N.Y. Comp. Codes R. & Regs. tit. 18, §360-10.3

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Authority to perform ophthalmic procedures

Optometrists may only perform procedures related to foreign body removal and the examination, evaluation, diagnosis and treatment of the human eye. N.Y. Education Law §7101

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Injectable Authority

Optometrists may not administer any medication by injection. N.Y. Education Law §7101

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Prescription of controlled substances

Optometrists have no narcotic authority. N.Y. Education Law §7101

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Dental Hygienists with Direct Access

A dental hygienist can initiate care in public or private settings. A dentist must authorize procedures and be available for consultation, diagnosis and evaluation. N.Y. Education Law §6606, N.Y. Rules §61.9

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Dental Therapists

Statute does not identify dental therapists as an oral health provider.

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Practice of Teledentistry

Licensed dentists may provide teledentistry services and may be reimbursed by Medicaid. New York Public Health Law §2999-CC

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Administration of COVID-19 Vaccine

Pharmacists may administer the COVID-19 vaccine if a licensed physician has prescribed and ordered a patient to receive the vaccine. N.Y. Education Law §6527 Subd. 7

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Prescription Adaptation

New York does not allow pharmacists to modify prescriptions.

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Prescription of Hormonal Contraceptives

New York does not allow pharmacists to prescribe hormonal contraceptives.

*NY SB1043A will allow pharmacists to prescribe hormonal contraceptives beginning in November 2024*

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Prescription of Tobacco Cessation Aids

New York does not allow pharmacists to prescribe tobacco cessation aids.

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Supervision Requirements (Practice and Prescriptive Authority)

Supervision by a physician required for practice and prescriptive authority.

A PA may perform medical services, but only when under the supervision of a physician and only when such acts and duties as are assigned to him or her are within the scope of practice of such supervising physician. N.Y. EDUC. LAW § 6542

A licensed PA, in good faith and acting within his or her lawful scope of practice, and to the extent assigned by his or her supervising physician, may prescribe controlled substances as a practitioner under article thirty-three of this chapter, to patients under the care of such physician responsible for his or her supervision. N.Y. PUB. HEALTH LAW § 3702(1),(3)

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Number of PAs Supervised

Statute limits the number of PAs a physician may supervise.

No physician shall employ or supervise more than four PAs in his or her private practice. Nothing in this article shall prohibit a hospital from employing PAs provided they work under the supervision of a physician designated by the hospital and not beyond the scope of practice of such physician. The numerical limitation of subdivision three of this section shall not apply to services performed in a hospital. N.Y. EDUC. LAW § 6542 (3)-(5)

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Chart Co-Signatures

Chart co-signatures may be determined at the practice level.

A licensed PA employed or extended privileges by a hospital may, if permissible under the bylaws, rules and regulations of the hospital, write medical orders, including those for controlled substances, for inpatients under the care of the physician responsible for his or her supervision. Countersignature of such orders may be required if deemed necessary and appropriate by the supervising physician or the hospital, but in no event shall countersignature be required prior to execution. N.Y. PUB. HEALTH LAW § 3702(1)

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Adaptable Proximity Requirements

Statute allows adaptable proximity.

Supervision shall be continuous but shall not be construed as necessarily requiring the physical presence of the supervising physician at the time and place where such services are performed. N.Y. EDUC. LAW § 6542(2)

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Scope of Practice Determination

The PA may perform medical services and acts that are delegated by the supervising physician and are within the scope of practice of the physician. N.Y. Education Law §6542(1)

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