[NPInfo] question for those who have a medical director

[Lisa Meyer]

Sue,
I also practice in Michigan and, though I believe the spirit of the law is 
something closer to "collaboration" and collaborative agreements are 
required, the actual language says "supervision" in Michigan.  I do not know 
whether the language of Michigan law calls the agreements "collaborative" or 
simply calls them written agreements--do you know?  I know this seems like 
splitting hairs, but I do believe semantics are important when it comes down 
to how physicians perceive us.  Many people on this list in the past have 
suggested that it is not important how other professions perceive us, but it 
does affect how they choose to work with us or against us in the health care 
team.  Unless the MI law has changed, I believe it still uses "supervision" 
and I don't believe this word was accidentally chosen over collaboration.

Lisa

----- Original Message ----- 
From: <suernfnp at iwon.com>
To: <npinfo at nurse.net>
Sent: Wednesday, January 02, 2008 6:47 PM
Subject: RE: [NPInfo] question for those who have a medical director


>
> 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 
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