Little Health Law Blog
Our healthcare and business law firm advises many medical practices on compliance matters. One question our clients often ask us is how a medical practice can properly order, administer, and/or dispense medications to its patients. When a mid-level provider (such as a nurse practitioner or physician assistant) is the practitioner on site who is prescribing and ordering, the rules are different from when a physician is on site prescribing and order. This post discusses some considerations before a mid-level provider orders, administers, or dispenses drugs to patients in Georgia. If you would like to discuss compliance considerations for your medical practice, you may contact our healthcare and business law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.
Although there is an ability for physicians to dispense to patients after notifying the medical board (Ga. R. & Regs. § 480-28), this does not extend to nurse practitioners or physician assistants. The rules allowing “practitioners” in Georgia to dispense define a practitioner as “a person licensed as a dentist, physician, podiatrist or veterinarian . . .”; the definition does not include mid-level providers. Additionally, under O.C.G.A. § 43-34-23, physicians can delegate to mid-level providers the ability to dispense dangerous drugs, but only in very specific work settings (such as a mid-level provider who works for the department of health or a non-profit organization (see O.C.G.A. 43-34-23(b)(2), (3)). If those practice settings are not relevant, then only a physician may dispense from the practice. In October 2025, the medical board also addressed the ability of nurse practitioners to bulk order testosterone for administering and/or dispensing and confirmed that nurse practitioners are “not [permitted] to order bulk drugs for office administration or practitioner dispensing.” The board reinforced that nurse protocol agreements only allow nurse practitioners to prescribe but not to order bulk drugs. Here is another statement from the medical board in December 2025:
Question: Can an NP or PA purchase or otherwise procure controlled substances (Schedule II-V) directly using their own DEA registrations for the purpose of maintaining office stock to be administered or dispensed to patients at a later date? Does such procurement and dispensing authority need to be conducted under the supervising/delegating physician’s DEA registration or under a facility DEA registration?
Response: Such practice is inappropriate and does not align with the laws of Georgia. O.C.G.A. § 43-34-25 authorizes prescriptive authority only, meaning the ability to write a patient-specific prescription that the patient can have filled in a pharmacy. This statute does not authorize midlevel/advanced practice providers to dispense drugs. In addition, this past October, the Board stated in response to a question regarding APRNs ordering bulk testosterone from 503B facilities that O.C.G.A. § 43-34-25 authorizes the delegation of prescriptive authority allowing an APRN to issue patient-specific drug orders, but not to order bulk drugs for office administration or dispensing.
In December of 2024, the Georgia medical board provided the following guidance:
O.C.G.A. § 43-34-23 only permits a physician to delegate the dispensing of dangerous drugs to a PA in very limited circumstances. If the PA is not working in one of the listed capacities, then they should not be dispensing. It is the physician’s responsibility to ensure they have reported to the Georgia Composite Medical Board that they intend to dispense from their office and that they and their PA/APRN are in full compliance with O.C.G.A. § 26-4-130, Board of Pharmacy Rule Chapter 480-28 Practitioner Dispensing of Drugs, and O.C.G.A. § 43-34-23.
If you would like to discuss compliance considerations for your medical practice, you may contact our healthcare and business law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.