Mid-level practitioner

The term mid-level practitioner is an identifier used by the United States Drug Enforcement Administration (DEA) to monitor and control the diversion of controlled substances in the U.S. It is based on Title 21, Code of Federal Regulations, Section 1300.01(b28).

Definitions

The DEA classification of mid-level practitioner includes nurse practitioners, Certified Nurse-Midwives, Certified Registered Nurse Anesthetists, clinical nurse specialists, Doctors of Oriental Medicine, euthanasia technicians, homeopathic physicians, medical psychologists, naturopathic physicians, nursing homes, optometrists, pharmacists, and physician assistants who are licensed, registered, or otherwise permitted to dispense a controlled substance in the course of professional practice.^[1][2]

In contrast, according to the DEA, a practitioner is a physician, dentist, veterinarian, or podiatrist, who is "licensed, registered, or otherwise permitted by the United States or the jurisdiction in which he/she practices, to prescribe a controlled substance in the course of professional practice."^[3]

Non-Physician Practitioner

An Non-Physician Practitioner (NPP) in the Emergency Department is defined by Medicare as either a nurse practitioner or a physician assistant.^[4] Medicare will pay for emergency department services for specific NPPs, i.e., nurse practitioners and physician assistants, when these services meet the critical care services definition and requirements.^[5]

Controversy

The American Academy of Nurse Practitioners released a position paper in 2009 denouncing the use of the terms "mid-level provider," "physician extenders," "limited license providers," "non-physician providers," and "allied health providers" when referring to nurse practitioners.^[6] The American Academy of Nurse Practitioners prefers that nurse practitioners are referred to as "independently licensed providers," "primary-care providers," "health-care professionals," and "clinicians."^[7]

See Also

• nurse practitioners
• Certified Nurse-Midwives
• Certified Registered Nurse Anesthetists
• clinical nurse specialists
• Doctors of Oriental Medicine
• euthanasia technicians
• homeopathic physicians
• medical psychologists
• naturopathic physicians
• nursing homes
• optometrists
• pharmacists
• physician assistants

References

1. ^ http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html, U.S. Department of Justice Drug Enforcement Administration, Office of Diversion Control, Mid-Level Practitioners Authorization by State, Accessed 11 June 2011.
2. ^ http://www.deadiversion.usdoj.gov/drugreg/practioners/mlp_by_state.pdf, U.S. Department of Justice Drug Enforcement Administration, Office of Diversion Control, Mid-Level Practitioners Authorization by StateChart, Accessed 11 June 2011.
3. ^ http://www.deadiversion.usdoj.gov/pubs/manuals/pract/section5.htm, U.S. Department of Justice Drug Enforcement Administration, Office of Diversion Control, Section V – Valid Prescription Requirements, Accessed 11 June 2011.
4. ^ http://www.cms.hhs.gov/transmittals/downloads/R1776B3.pdf, Medicare Carriers Manual by the Centers for Medicare and Medicaid Services (CMS) pursuant to Transmittal 1776, implemented on October 25, 2002, Accessed 11 June 2011
5. ^ http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5993.pdf, Medicare Carriers Manual by the Centers for Medicare and Medicaid Services (CMS) pursuant to Transmittal 1548, 2008, Accessed 11 June 2011
6. ^ http://www.aanp.org/AANPCMS2/Publications/PositionStatementsPapers/MLP.htm, Use of Terms Such as Mid-Level Provider and Physician Extender, American Academy of Nurse Practitioners, 2009 (Revised 2010), Accessed 11 June 2011.
7. ^ http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2960214-6/fulltext Devi, Sharmila, US nurse practitioners push for more responsibilities, The Lancet, Volume 377, Issue 9766, Pages 625 - 626, 19 February 2011, doi:10.1016/S0140-6736(11)60214-6, Accessed 11 June 2011.