weezianna Posted November 27, 2017 Share Posted November 27, 2017 I have been investigating possible employment with the VA's interim provider program, which is their version of a locums program. After much discussion back and forth, I was told more or less that there were few opportunities for PAs, as our practice is so restricted by DEA/state controlled substance prescribing regulations. It was stated to me that at many facilities I would have to be supervised by an MD with the SAME state license as me. This makes NO sense at all, as I have worked in one state, under a different state license, and was supervised by a physician from yet a third, different state! Is this just a blatant preference for NPs? I was told that they just "get a license as an independent" practitioner, and they have "no trouble finding assignments". This is the response that the program received from Denni Woodmansee - obviously, a PA must be licensed in a state that authorizes prescription of controlled substances and must be registered with the DEA - but: "If the PA is to prescribe controlled substances directly (order or sign the prescriptions), they must be licensed in a state that authorizes prescribing at this level and be individually registered with DEA. If the state of licensure requires that the collaborating (supervising) physician be licensed in their state, that condition must be met. If the physician and PA are not licensed in the same state, it would be acceptable for the physician to sign the prescription that is prepared by the PA. " I have not encountered this situation during any of my federal employment. Is there something here that I am ignorant of/missing? I would appreciate insights from VA PAs, please. Thank you! Link to comment Share on other sites More sharing options...
Reality Check 2 Posted November 27, 2017 Share Posted November 27, 2017 I am a VA PA of fairly short duration. First govt employment. You have to be licensed in the state you work in and the same state for physicians. Just the way it is - federal or not. Makes sense and follows federal DEA rules. I don't work with anyone at my VA that is NOT licensed in our state. Some have extra licenses in other states but MUST be licensed in our state. Look up the VHA Directive 1063 and it explains VA PAs. I honestly don't think you are being asked to do more than any other locum anywhere else. Federal Prison systems seem to operate a bit differently. My VA doesn't utilize locums except maybe in Urgent Care. NPs outnumber PAs at my VA and have the whole nursing lobby/union behind them. The pay scales are still a bit off but in the process of getting fixed for PAs. NPs likely still have to be licensed in the state they are working in as well. Link to comment Share on other sites More sharing options...
weezianna Posted November 28, 2017 Author Share Posted November 28, 2017 Thanks for your reply. Funny, when I worked in SC a few years ago they had me working under my Wisconsin license. At Indian Health, in SC I worked under my NC license. My supervising MD worked under a Nevada license. Interesting. DIrective 1063 makes no mention of supervision by a physician licensed in the same state as the PA, and my current supervisor doesn't have a license in the state that I'm working in. PAs prescribe controlled substances under VA or state regulation, whatever is more restrictive. I think that locum tenens companies would have a very difficult time filling positions at federal facilities if they had to match up a provider with an MD that had the same licensure, in the same state. They all advertise "any state license". So, it seems that things are still murky here. Perhaps some state regulations require stricter supervision, but I am not sure which ones they are. Link to comment Share on other sites More sharing options...
sks5966 Posted November 28, 2017 Share Posted November 28, 2017 I currently work at the Ann Arbor VA. Prior I was at the Philadelphia VA. I use(d) a Pennsylvania PA license at both places. I have a federal DEA but only work inpatient and do not write prescriptions. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 28, 2017 Moderator Share Posted November 28, 2017 3 minutes ago, sks5966 said: I currently work at the Ann Arbor VA. Prior I was at the Philadelphia VA. I use(d) a Pennsylvania PA license at both places. I have a federal DEA but only work inpatient and do not write prescriptions. The DEA requires state specific DEA#s for PAs. I work in 2 states and have 2 #s. Link to comment Share on other sites More sharing options...
Fernwood Posted November 29, 2017 Share Posted November 29, 2017 I am currently licensed in multiple states and have work on and off in both states over the past 20 years and my DEA number has always remained the same, it follows me state to state. I have maintained a file of all DEA certification and confirmed my original DEA license number has never changed. Texas, where I currently practice required an additional Department of Public Safety certification but has since done away with that requirement. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 29, 2017 Moderator Share Posted November 29, 2017 I didn't just make that up. PA prescribing laws vary from state to state so the DEA does, in fact, require a different certificate for each state if you work in multiple states concurrently. If you only work in one state at a time you may transfer your # from state to state if they have the same prescribing rules(for instance sch 2-5), but if you work in 2 states at the same time you need 2 numbers or if you work in 2 different states with different levels of allowed prescribing. https://www.medscape.com/viewarticle/736702 Link to comment Share on other sites More sharing options...
Cideous Posted November 30, 2017 Share Posted November 30, 2017 On 11/28/2017 at 11:57 AM, EMEDPA said: The DEA requires state specific DEA#s for PAs. I work in 2 states and have 2 #s. On 11/28/2017 at 11:57 AM, EMEDPA said: The DEA requires state specific DEA#s for PAs. I work in 2 states and have 2 #s. Really? So if I have a Texas and a California state board license, but originally got my DEA in Texas, I have to re-apply for a new DEA number for California if I practice there? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 30, 2017 Moderator Share Posted November 30, 2017 or transfer your TX # to CA. if you work in both in alternate months you need 2 #s. really. I have called them and asked specifically about my situation working concurrently in WA and OR. had a bet with an NP. I won. Link to comment Share on other sites More sharing options...
weezianna Posted December 3, 2017 Author Share Posted December 3, 2017 I can understand needing multiple DEAs if working concurrently in more than one state. However, with federal employment the exempt DEA follows you. The ability to prescribe controlled substances is dictated by federal or state regulations, whichever is more restrictive. What I have encountered is a stated policy where in some states, the supervising doc must have the same state license as the PA, even in a federal facility. So in these states, a locums NP will be hired preferentially. I guess I would have to peruse all states' laws to determine which states operate this way. Link to comment Share on other sites More sharing options...
Cideous Posted December 5, 2017 Share Posted December 5, 2017 On 11/30/2017 at 5:21 PM, EMEDPA said: or transfer your TX # to CA. if you work in both in alternate months you need 2 #s. really. I have called them and asked specifically about my situation working concurrently in WA and OR. had a bet with an NP. I won. lol holy cow that is amazingly stupid, but thank you for the info! Link to comment Share on other sites More sharing options...
Reality Check 2 Posted December 5, 2017 Share Posted December 5, 2017 17 hours ago, Cideous said: lol holy cow that is amazingly stupid, but thank you for the info! It is not stupid - if State X has restricted prescribing and State Y does not - you have to have two tracking devices to ensure prescriptions are written and filled under proper criteria. If State X and State Y are next door to each other and you work in a border area - all the more important - some patients fill drugs in other states - there HAS to be a tracking method and different numbers are about the only way. Whatever state you work in - you fall under THAT license and set of restrictions. Federal folks can set their own rules many times but my experience with the VA is that they are keeping me in line with the state I am in. Not everything is a conspiracy or money grubbing effort - some stuff has some logic behind it . Play by the rules or don't play. Link to comment Share on other sites More sharing options...
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