Verify DEA and CDS certificates

A federal Drug Enforcement Administration (DEA) certificate is required for all qualified practitioners who write prescriptions for controlled substances. Many individual states also require a practitioner to hold a Controlled Dangerous Substances (CDS) certificate in addition to a DEA certificate. Note that the terminology may vary by state, such as Controlled Substance Registration in Wyoming and Bureau of Narcotics and Dangerous Drugs in Missouri. Visit the National Association of State Controlled Substances Authorities website for detailed information on each state’s requirements at www.nascsa.org.

Organizations must verify the DEA or CDS in states where the practitioner will treat members. In many organizations, these will also be verified in other states where the applicant holds certificates. Acceptable verification sources include a copy of the certificate, the DEA or CDS agency, the National Technical Information Service, the state CDS agency, and the American Medical Association (AMA) or American Osteopathic Association (AOA) profile. An original DEA or CDS certificate can also be viewed and the verification documented in the file. States that have a pharmaceutical licensing agency may use that agency for verification as well.

There are several situations in which an applicant may not hold a DEA or CDS certificate. The specialty practiced by the applicant (e.g., pathology) may not require one, or the specialty practiced (e.g., chiropractic medicine) may not include prescribing authority. State regulations also vary as to whether advanced practice professionals, such as physician assistants and nurse practitioners, have prescribing authority (referred to as midlevel practitioners by the DEA). A practitioner may also apply to an organization while his or her DEA or CDS application is still in process. For that reason, the health plan may consider an alternative process for credentialing practitioners with a pending DEA/CDS. The organization would require that another credentialed practitioner agree in writing to write controlled substance prescriptions for members on behalf of the applicant until the DEA or CDS is granted. Once the applicant has received his or her DEA or CDS certificate, the health plan verifies it from an appropriate source and adds this information to the credentials file. This process should be documented in the organization’s policies and include any time frame limits on obtaining the DEA or CDS after credentialing is approved (e.g., six months).

Source: Managed Care Credentialing