Are Pre-Signed Prescriptions a Good Idea? Even Legal?

Carolyn Buppert, MSN, JD


April 11, 2018

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A nurse practitioner asks about the legality, and consequences, of issuing pre-signed prescriptions.

My employer, a physician, wants to pre-sign prescription forms so that I can refill medications while he is away. He says that he will back me up on any prescriptions I write under his signature. I have prescriptive authority but not for every class of medications. I would be very careful. Is this a problem, legally?
Response from Carolyn Buppert, MSN, JD
Healthcare attorney

It's a huge problem, for both the physician and for you. At least one physician lost his license and served time in jail for pre-signing prescriptions so that nurse practitioners at his clinic could refill medications on his days off. At that time, nurse practitioners in his state did not have full prescriptive authority. A physician assistant was sentenced to prison for filling in prescriptions that were pre-signed by his supervising physician. A nurse practitioner recently lost her license for filling in pre-signed prescription forms.

Here is the law prosecutors use:

All prescriptions for controlled substances shall be dated as of, and signed on, the day when issued and shall bear the full name and address of the patient, the drug name, strength, dosage form, quantity prescribed, directions for use and the name, address and registration number of the practitioner. [1]

So, don't ever fill in a prescription pre-signed by someone else, even if your intentions are to help patients. Your employer's offer to back you up will have no sway with either the Board of Nursing or federal prosecutors. Both you and the physician can be prosecuted. The problem of not having full prescriptive authority is resolved only by changing the law in your state.


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