ALABAMA State Board of Medical Examiners 848 Washington Avenue ...
Qualified Alabama Controlled Substance Certificate for Certified Registered Nurse Practitioners and Certified Nurse Midwives
ALABAMA State Board of Medical Examiners 848 Washington Avenue Montgomery, Alabama 36104
George C. Smith, Jr., M.D. – Chairman Larry D. Dixon –Executive Director
Requirements for QACSC • Be a CRNP or CNM in a collaborative practice with a physician who holds a valid, unrestricted ACSC • Submit documentation for 12 Hours of CME: – Prescribing Controlled Drugs (8 Credits) http://www.masalink.org/prescribing/ – Category 1 credits in advanced pharmacology and controlled substances prescribing trends (4 Credits)
• 12 Months of Active Clinical Practice in an approved collaborative agreement. (Temporary and Provisional approval time may not be used)
QACSC Applications • Applications will be available on the board website after the September 20, 2013 board meeting. • Applications WILL NOT be accepted until October 1, 2013
• Application must include: – Completed Application (No Unanswered Questions) – Copy of CME certificates for completion of required courses.
QACSC Applications Continued – Affidavit of 12 months of Active Clinical Practice in an Approved Collaborative Agreement – Check for $110.00 – Made out to: Alabama Board of Medical Examiners – Completed Formulary Form – Covering Agreements (If Applicable)
QACSC Application (Sample) The following sample application form is just a draft and is subject to change before final release.
QACSC Formulary (Sample) The following sample formulary form is just a draft and is subject to change before final release.
QACSC Covering Physician Agreement (Sample) The following sample covering agreement form is just a draft and is subject to change before final release.
QACSC Prescribing Protocol (Sample) The following sample prescribing protocol form is just a draft and is subject to change before final release.
QACSC Renewal • QACSC Licenses have to be renewed annually • Renewal fee is $60.00 per QACSC • Must be renewed between October 1st and December 31st. • Must register with PDMP before you can renew. http://www.adph.org/PDMP/ • Must obtain a Federal DEA Certificate. http://www.deadiversion.usdoj.gov/
QACSC Renewals Continued • If you obtain a QACSC this year (Between Oct. 1st – Dec. 31st) you will have to renew before Midnight on December 31, 2013 • Renewals Online at http://www.alrenewals.org/ • Will receive Post Card in mail at the beginning of October reminding you of the renewal. • Manual forms may be printed by logging into the renewal site.
Important Things to Remember • The QACSC License is specific to one Collaborative Agreement. You must obtain one QACSC for each Collaborative Agreement (CP)
Important Things to Remember • The Covering Physicians must sign a separate covering agreement indicating they also agree to the CRNP/CNM prescribing controlled substances and the covering physicians must be coverings on the original Collaborative Practice agreement.
Important Things to Remember Continued • If the covering physicians do not sign an agreement the CRNP/CNM CANNOT prescribe when that physician is providing backup coverage • Every two years the CRNP/CNM must take a 4-hour Board Approved Pharmacology Course
Important Things to Remember Continued • If you obtain a QACSC in the 2013 Calendar year (between Oct. 1st – Dec. 31st) you will have to renew the QACSC before Midnight on December 31st • Before you can renew a QACSC you must register with PDMP and obtain a federal DEA certificate
Important Things to Remember Continued • If you have a DEA from another state it may be transferred to Alabama by address change, however, you must obtain a QACSC first and then process address change online with DEA • DEA should be ready by September 30, 2013 to process applications but you must obtain a QACSC before applying for a DEA certificate.
Important Things to Remember Continued • All QACSC licenses have to be approved by the board and the board meets once a month. • To have the QACSC approved during the October 2013 meeting the completed application, all required documents and check must be submitted by October 8, 2013.
Important Things to Remember Continued • Prescribing Controlled Drugs Course Dates for 2014: – March 29th-30th Montgomery, AL – Renaissance – August 8th-10th Destin, FL - San Destin
– November 22nd-23rd Birmingham, AL - Wynfrey
ALABAMA State Board of Medical Examiners 848 Washington Avenue Montgomery, Alabama 36104
George C. Smith, Jr., M.D. – Chairman Larry D. Dixon –Executive Director
Requirements for QACSC • Be a CRNP or CNM in a collaborative practice with a physician who holds a valid, unrestricted ACSC • Submit documentation for 12 Hours of CME: – Prescribing Controlled Drugs (8 Credits) http://www.masalink.org/prescribing/ – Category 1 credits in advanced pharmacology and controlled substances prescribing trends (4 Credits)
• 12 Months of Active Clinical Practice in an approved collaborative agreement. (Temporary and Provisional approval time may not be used)
QACSC Applications • Applications will be available on the board website after the September 20, 2013 board meeting. • Applications WILL NOT be accepted until October 1, 2013
• Application must include: – Completed Application (No Unanswered Questions) – Copy of CME certificates for completion of required courses.
QACSC Applications Continued – Affidavit of 12 months of Active Clinical Practice in an Approved Collaborative Agreement – Check for $110.00 – Made out to: Alabama Board of Medical Examiners – Completed Formulary Form – Covering Agreements (If Applicable)
QACSC Application (Sample) The following sample application form is just a draft and is subject to change before final release.
QACSC Formulary (Sample) The following sample formulary form is just a draft and is subject to change before final release.
QACSC Covering Physician Agreement (Sample) The following sample covering agreement form is just a draft and is subject to change before final release.
QACSC Prescribing Protocol (Sample) The following sample prescribing protocol form is just a draft and is subject to change before final release.
QACSC Renewal • QACSC Licenses have to be renewed annually • Renewal fee is $60.00 per QACSC • Must be renewed between October 1st and December 31st. • Must register with PDMP before you can renew. http://www.adph.org/PDMP/ • Must obtain a Federal DEA Certificate. http://www.deadiversion.usdoj.gov/
QACSC Renewals Continued • If you obtain a QACSC this year (Between Oct. 1st – Dec. 31st) you will have to renew before Midnight on December 31, 2013 • Renewals Online at http://www.alrenewals.org/ • Will receive Post Card in mail at the beginning of October reminding you of the renewal. • Manual forms may be printed by logging into the renewal site.
Important Things to Remember • The QACSC License is specific to one Collaborative Agreement. You must obtain one QACSC for each Collaborative Agreement (CP)
Important Things to Remember • The Covering Physicians must sign a separate covering agreement indicating they also agree to the CRNP/CNM prescribing controlled substances and the covering physicians must be coverings on the original Collaborative Practice agreement.
Important Things to Remember Continued • If the covering physicians do not sign an agreement the CRNP/CNM CANNOT prescribe when that physician is providing backup coverage • Every two years the CRNP/CNM must take a 4-hour Board Approved Pharmacology Course
Important Things to Remember Continued • If you obtain a QACSC in the 2013 Calendar year (between Oct. 1st – Dec. 31st) you will have to renew the QACSC before Midnight on December 31st • Before you can renew a QACSC you must register with PDMP and obtain a federal DEA certificate
Important Things to Remember Continued • If you have a DEA from another state it may be transferred to Alabama by address change, however, you must obtain a QACSC first and then process address change online with DEA • DEA should be ready by September 30, 2013 to process applications but you must obtain a QACSC before applying for a DEA certificate.
Important Things to Remember Continued • All QACSC licenses have to be approved by the board and the board meets once a month. • To have the QACSC approved during the October 2013 meeting the completed application, all required documents and check must be submitted by October 8, 2013.
Important Things to Remember Continued • Prescribing Controlled Drugs Course Dates for 2014: – March 29th-30th Montgomery, AL – Renaissance – August 8th-10th Destin, FL - San Destin
– November 22nd-23rd Birmingham, AL - Wynfrey
