[NPInfo] question for those who have a medical director

[suernfnp at iwon.com]

Gail, this would depend on the state where you practice. Protocols are different per state. Here in Michigan, the physician collaborates with the NP. A collaborative agreement with a physician is required for Michigan nurse practitioners to receive direct Medicaid and Medicare reimbursement. Collaborative agreements, which define the relationship of NPs working with physicians to deliver health care services, need to be carefully written and should not state that a physician is delegating or supervising when not required or not appropriate. Medicaid stipulates in the most detail what a collaborative agreement must include. Medicare requires that there must be a written agreement in place. Therefore, if NPs create and implement collaborative agreements which comply with Medicaid requirements, the agreement will likely be satisfactory to other payors, including Medicare. 

Prescriptive authority may be delegated to a NP by a physician. Delegation of non-controlled substances does not require a written document. However, delegation of Schedule 2, 3, 4 & 5 drugs does require written authorization of the delegation. This authorization must be updated annually. 

We do not have a requirement in Michigan for chart review of NP work by a physician. We are not required to have specific protocols or a drug formulary in the collaborative agreement. I would not put them in unless they are required by your state NP practice act.

Here is the link to the Michigan Nurses Association site for sample collaborative agreeements regarding practice and prescription of scheduled medications, including "Recommendations for the Process to Develop a Collaborative Agreement." http://www.minurses.org/apn/apn-npfaq.shtml#collab 

Sue D in MI




 --- On Wed 01/02, GIN11153 at aol.com < GIN11153 at aol.com > wrote:
From: GIN11153 at aol.com [mailto: GIN11153 at aol.com]
To: NPInfo at nurse.net, prvpracnp at nurse.net, IndNursePrac at yahoogroups.com
Date: Wed, 2 Jan 2008 04:29:22 EST
Subject: [NPInfo] question for those who have a medical director

I think I have finally found a new medical director to replace the one who  <br>decided he couldn't take on another office. He's asking  what I would need  <br>from him besides being available to consult with the NP  and  sign off  on <br>protocols. Does any one have an established list?<br> <br>Gail<br><br><br><br>**************************************See AOL's top rated recipes <br>(http://food.aol.com/top-rated-recipes?NCID=aoltop00030000000004)<br>_______________________________________________<br>NPInfo mailing list<br>NPInfo at nurse.net<br>http://lists.nurse.net/mailman/listinfo/npinfo<br>*****************************<br>

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