State Overview: Arizona

State law or statute prohibits or limits the use of prior authorization for buprenorphine containing products by either the state Medicaid plan or private insurance company.

Commercial insurance plans must make at least one modality of medication-assisted treatment available without prior authorization. Medication-assisted treatment is defined (by AZ Statute) as the use of FDA-approved medications, "in combination with counseling and behavioral therapies," for patients with SUD. This statute does not apply to the state Medicaid program. Ariz. Rev. Stat. Ann. § 20-3402(B)

Arizona credentials three levels of addiction counselors. A licensed independent substance abuse counselor requires a master's degree, 24 semester hours of counseling-related coursework and 3,200 supervised contact hours. A licensed associate substance abuse counselor requires a bachelor's degree, 30 semester hours of counseling-related coursework and 3,200 supervised contact hours. A licensed substance abuse technician requires a chemical dependency associate degree and 30 semester hours of counseling-related coursework. Ariz. Rev. Stat. Ann. §32-3321 and Arizona Board of Behavioral Health Examiners.

A licensed professional counselor may facilitate human development and adjustment throughout the human life span, treat interpersonal relationship issues and nervous, mental and emotional disorders that are cognitive, affective or behavioral and manage symptoms of mental illness. LPCs may also assess, appraise, evaluate, diagnose and treat individuals, couples, families and groups through the use of psychotherapy. Ariz. Rev. Stat. Ann. §32-3251.10

Arizona's Medicaid program has established requirements and standards for the training, credentialing, and supervision of peer/recovery support specialists. These individuals use their own lived mental health or substance use experiences to provide support and services to others in recovery. Training is developed and administered by third-party certification providers.

Full independent practice and prescriptive authority.

An NM has an expanded scope of practice in providing health care services for women from adolescence to beyond menopause, including antepartum, intrapartum, postpartum, reproductive, gynecologic and primary care, for normal newborns during the first 28 days of life and for men for the treatment of sexually transmitted diseases. The NM should recognize the limits of the nurse's knowledge and experience by consulting with or referring patients to other appropriate health care professionals if a situation or condition occurs that is beyond the knowledge and experience of the nurse or if the referral will protect the health and welfare of the patient. Ariz. Rev. Stat. Ann. §32-1601(5)

An NM may independently prescribe Schedules II-V, excluding Schedule II opioids except for opioids that are for medication assisted treatment for substance use disorders. Ariz. Admin. Code. §4-19-512

Full independent practice and prescriptive authority.

The NP has an expanded scope of practice within a specialty area that includes making independent decision in solving complex patient care problems. The NP should recognize the limits of the nurse's knowledge and experience by consulting with or referring patients to other appropriate health care professionals if a situation or condition occurs that is beyond the knowledge and experience of the nurse or if the referral will protect the health and welfare of the patient. Ariz. Rev. Stat. Ann. §32-1601(23)

The Board of Nursing allows an NP to prescribe and dispense drugs and devices within the NP's Population focus (e.g., family-individual across life span, adult-gerontology primary or acute care, neonatal). An NP may also prescribe Schedules II-V controlled substances excluding opioids except for opioids that are for medication assisted treatment for substance use disorders. Ariz. Admin. Code §4-19-511 and Ariz. Admin. Code §5-19-512

NPs may sign POLST forms. They must always confirm the patient's or surrogate's wishes before signing the form. (Arizona Hospital and Healthcare Association)

NPs are recognized in state policy as primary care providers. Nurse practitioners must practice within one or more population focuses, consistent with their education and certification. Population focuses include: family-individual across the life span; adult-gerontology primary or acute care; neonatal; pediatric primary or acute care; women's health-gender related; and psychiatric-mental health. Ariz. Admin. Code §4-19-501(B)

Optometrists may only examine, diagnose and treat conditions of the visual system, including the removal of foreign bodies. Ariz. Rev. Stat. Ann. §32-1701(6)

Optometrists may only administer an epinephrine autoinjector for treatment of anaphylaxis. Ariz. Rev. Stat. Ann. §32-1706(F)

Optometrists may prescribe Schedule III-V controlled substances and also Schedule II hydrocodone or hydrocodone combination medications. Ariz. Rev. Stat. Ann. §32-1706

A dental hygienist may provide services outside the private dental office with a written affiliated practice agreement. The agreement must outline practice settings and services provided. The dental hygienist must fulfill requirements before entering into an affiliated practice relationship. A dental hygienist working at a public health agency or school may apply topical fluoride without entering into an affiliated practice relationship. Ariz. Rev. Stat. Ann. §32-1281 and Ariz. Rev. Stat. Ann. §32-1289

Dental therapists may practice under the direct supervision of a dentist or under a written collaborative practice agreement. Dental therapists may perform oral exams, perform prophylaxis, dispense and administer oral and topical non-narcotic analgesics and anti-inflammatory and antibiotic medications, administer nitrous oxide, among others. A dental therapist may work in a FQHC, community health center, non-profit dental practice, a private dental office and a health center program that has received a federal look-alike designation. Ariz. Rev. Stat. Ann. §32.1276.03

Teledentistry means the use of data transmitted through interactive audio, video or data communications for the purposes of examination, diagnosis, treatment planning, consultation and directing the delivery of treatment by dentists and dental providers. Arizona Medicaid reimburses for teledentistry. Ariz. Rev. Stat. Ann. §32-1201-24 and AHCCCS Medical Policy Manual Chapter 320-I

Arizona has not enacted legislation allowing pharmacists to administer the COVID-19 vaccine. However, the federal PREP Act allowed pharmacists to administer the COVID-19 vaccine through the duration of the public health emergency.

Arizona does not allow pharmacists to modify prescriptions.

A pharmacist may dispense a self-administered hormonal contraceptive to patients 18 years of age or older. The pharmacists must obtain a completed nationally recognized self-screening risk assessment from each patient and provide the patient with information about the contraceptive. Ariz. Rev. Stat. Ann. §32-1979.01

A pharmacist must complete a training course in the subject area of tobacco cessation drug therapy and must include instruction in specific content areas. A written protocol for tobacco cessation drug therapy must be approved by the Board of Pharmacy. Ariz. Rev. Stat. Ann. §32-18-3

Supervision or collaboration not required *effective 1/01/2024 – currently collaboration*

Asserts that a PA with at least 8,000 hours of Board-certified clinical practice is not required to practice pursuant to a supervision agreement, but must continue to collaborate, consult or refer to the appropriate health care professional as indicated by the patient's condition and by the physician assistant's education, experience and competencies.

Prescriptive authority includes Schedules II-V. Requires a PA with less than 8,000 hours of Board-certified clinical practice to work in accordance with a supervision agreement that describes the physician's scope of practice, including when prescribing. Ariz. Rev. Stat. Ann. § 32-2531(A)-(G)

Statute limits the number of PAs a physician may supervise.

A supervising physician shall not supervise more than 6 PAs who work at the same time. Ariz. Rev. Stat. Ann. § 32-2533(C)

Arizona does not currently have any provisions related to chart review or co-signatures.

Statute allows adaptable proximity.

Permits collaboration, consultation or referrals to occur through electronic means and does not require the physical presence of the appropriate health care professional at the time or place the PA provides medical services. Ariz. Rev. Stat. Ann. § 32-2531(A)-(G)

The supervising physician delegates tasks to the PA that are within the PA's skills and the physician's scope of practice. Ariz. Rev. Stat. Ann. §32-2531