Prior Authorization Requirements For Providers Prescribing Buprenorphine-Containing Products

Prior authorization requirements are up to the discretion of the state Medicaid program or insurance company.

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Education Required for Addiction Counselor Credentialing

Ohio credentials three types of addiction counselors. A Licensed Chemical Dependency Counselor (LCDC) II must have an associate degree in any behavioral health/nursing field or any bachelor’s degree. A LCDC III must have a minimum of a bachelor’s degree in behavioral science or nursing. Both a LCDC II and and LCDC III require 180 hours of chemical dependency education. A Licensed Independent Chemical Dependency Counselor must have a master’s level degree in a behavioral science field. Regardless of educational level, individuals need 2,000 hours of experience or a supervised internship. Ohio Rev. Code Ann. §4758 and Ohio Chemical Dependency Professionals Board

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Licensed Professional Counselor Ability to Diagnose

Professional counselors provide services to individuals, groups, organizations or the general public involving the application of clinical counseling principles, methods or procedures to assist individuals in achieving more effective personal, social, educational or career development and adjustment, including the diagnosis and treatment of mental and emotional disorders. Ohio Rev. Code Ann. §4757.01

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Peer Support Specialist Certification or Credentialing Authority

The certification requirements for peer recovery supporters are established by the state’s Department of Mental Health. The comprehensive certification standards include minimum qualifications, training, continuing education and employment requirements. Ohio Admin. Code §5122-29-15.1

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Certified Nurse Midwife Practice Authority

Physician relationship required.

A nurse authorized to practice as a certified nurse midwife, in collaboration with one or more physicians, may provide the management of preventive services and those primary care services necessary to provide health care to women antepartally, intrapartally, postpartally, and gynecologically, consistent with the nurse’s education and certification, and in accordance with rules adopted by the board of nursing. No certified nurse midwife may perform version, deliver breech or face presentation, use forceps, do any obstetric operation, or treat any other abnormal condition, except in emergencies.

A CNM may, in collaboration with one or more physicians, prescribe drugs and therapeutic devices. Ohio Rev. Code Ann. §4723.43(A)

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Nurse Practitioner Practice Authority

Physician relationship required.

An NP is authorized to practice in collaboration with one or more physicians and may provide preventive and primary care services, services for acute illnesses, and evaluate and promote patient wellness within the nurse’s nursing specialty, consistent with the nurse’s education and certification, and in accordance with rules adopted by the Board of Nursing. Ohio Rev. Code Ann. §4723.43(C)

An NP may prescribe drugs and Schedule III-V controlled substances in collaboration with a physician. An NP may prescribe Schedule II controlled substances if the patient has a terminal condition, the supervising physician initially prescribed the substance and if the prescription is for an amount that does not exceed the amount necessary for the patient’s use in a single 24-hour period. Ohio Rev. Code Ann. §4723.481

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Nurse Practitioner Authority to Sign POLST Forms

Ohio does not have laws or regulations around POLST. NPs are authorized to sign do-not-resuscitate orders under the supervision of a physician. Ohio Rev. Code Ann. tit. 21 §2133.211

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Nurse Practitioner as a Primary Care Provider

NPs are recognized in state policy as primary care providers. An NP may provide preventive and primary care services, provide services for acute illnesses, and evaluate and promote patient wellness within the nurse’s nursing specialty, consistent with the nurse’s education and certification, and in accordance with rules adopted by the State Board of Nursing. Ohio Revised Code §4723.43(C)

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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. Ohio Rev. Code Ann. §4725.01

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Injectable Authority

Optometrists may use epinephrine administered by injection to individuals in emergency situations to counteract anaphylaxis or anaphylactic shock. Ohio Rev. Code Ann. §4725.01(C)(2)

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Prescription of controlled substances

Optometrists may prescribe Schedule III-V controlled substances and also Schedule II hydrocodone or hydrocodone combination medications. Ohio Rev. Code Ann. §4725.091

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Dental Hygienists with Direct Access

A dental hygienist may obtain an oral health access supervision permit and provide services through a written agreement with a dentist in a public health setting. The written agreement must state that the dentist has evaluated the dental hygienists skills and reviewed the patient’s health history. The dentist does not need to be present for care to be provided. Educational and experience requirements must be met. Ohio Rev. Code Ann. §4730.19.

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Dental Therapists

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

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Practice of Teledentistry

Ohio allows for teledentistry services delivered through live video. Ohio Rev. Code §4715.43

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Administration of COVID-19 Vaccine

Ohio has not enacted legislation allowing pharmacists to administer the COVID-19 vaccine. However, the federal PREP Act does allow pharmacists to administer the COVID-19 vaccine through the duration of the public health emergency.

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Prescription Adaptation

Ohio does not allow pharmacists to modify prescriptions.

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Prescription of Hormonal Contraceptives

Ohio does not allow pharmacists to prescribe hormonal contraceptives.

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Prescription of Tobacco Cessation Aids

A pharmacist may dispense nicotine replacement therapy to individuals who are at least 18 years old and seeking to quit using tobacco-containing products. The pharmacist must complete a course on nicotine replacement therapy that is taught by a provider that is accredited by the accreditation council for pharmacy education. Ohio Rev. Code Ann. §4729.284

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Supervision Requirements (Practice and Prescriptive Authority)

Supervision by a physician required for practice and prescriptive authority.

A license to practice as a PA issued under this chapter authorizes the holder to practice as a PA as follows: (1) The PA shall practice only under the supervision, control, and direction of a physician with whom the PA has entered into a supervision agreement under section 4730.19 of the Revised Code. (2) The PA shall practice in accordance with the supervision agreement entered into with the physician who is responsible for supervising the PA, including, if applicable, the policies of the health care facility in which the PA is practicing. OHIO REV. CODE ANN. § 4730.08

The supervising physician of a PA exercises supervision, control, and direction of the physician assistant. A PA may practice in any setting within which the supervising physician has supervision, control, and direction of the PA. OHIO REV. CODE ANN. § 4730.21(A),(C)-(F)

A PA who holds a valid prescriber number issued by the state medical board is authorized to prescribe and personally furnish drugs and therapeutic devices in the exercise of physician-delegated prescriptive authority. OHIO REV. CODE ANN. § 4730.411

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Number of PAs Supervised

Statute limits the number of PAs a physician may supervise.

A physician may enter into supervision agreements with any number of PAs, but the physician may not supervise more than five PAs at any one time. A PA may enter into supervision agreements with any number of supervising physicians. OHIO REV. CODE ANN. § 4730.21(B)

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Chart Co-Signatures

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

In establishing the quality assurance system, the supervising physician shall describe a process to be used for all of the following: (a) Routine review by the physician of selected patient record entries made by the PA and selected medical orders issued by the physician assistant. […] OHIO REV. CODE ANN. § 4730.21(F)(2)(a)

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Adaptable Proximity Requirements

Statute allows adaptable proximity.

The supervising physician shall be continuously available for direct communication with the PA by either of the following means: (a) Being physically present at the location where the PA is practicing; (b) Being readily available to the PA through some means of telecommunication and being in a location that is a distance from the location where the PA is practicing that reasonably allows the physician to assure proper care of patients. OHIO REV. CODE ANN. § 4730.21(A),(C)-(F)

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Scope of Practice Determination

Medical services performed by the PA are delegated by the supervising physician and must be part of the physician’s normal course of practice and expertise. Ohio Rev. Code §4730.20

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