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Although it is possible to use a prescriptive authority agreement in a hospital or long term care facility based practice, it is not required. You may continue to practice under protocols in these settings. APRNs and PAs must exercise prescriptive authority under one of these delegation mechanisms.
The answer can be more complex than you might think. As far as the law is concerned physician assistants (PAs) can prescribe medication in 48 states at this time. The exceptions are Florida and Kentucky. Florida is investigating adding it and expanding the scope of practice for both Nurse practitioners and physician assistants in an effort to reduce costs in their state.