[Federal Register Volume 64, Number 85 (Tuesday, May 4, 1999)]
[Proposed Rules]
[Pages 23812-23813]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-11070]


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DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 17

RIN 2900-AJ07


Medication Prescribing Authority

AGENCY: Department of Veterans Affairs.

ACTION: Proposed rule.

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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. 99-11070 Filed 5-3-99; 8:45 am]
BILLING CODE 8320-01-U