Nurse practitioner's business practice and legal guide / Carolyn Buppert.

Format:

Book

Author/Creator:

Buppert, Carolyn.

Language:

English

Subjects (All):

Nursing--Practice--United States.

Nursing.

Nursing--Practice.

Nurse practitioners--Legal status, laws, etc.

Nurse practitioners.

United States.

Nurse practitioners--Legal status, laws, etc--United States.

Legislation, Nursing.

Nurse Practitioners--legislation & jurisprudence.

Medical Subjects:

Legislation, Nursing.

United States.

Nurse Practitioners--legislation & jurisprudence.

Physical Description:

x, 496 pages ; 27 cm

Edition:

Second edition.

Place of Publication:

Sudbury, Mass. : Jones and Bartlett, [2004]

Summary:

Written by a nurse practitioner who is also a practicing attorney, Nurse Practitioner's Business Practice and Legal Guide, Second Edition provides the unique point of view of an author who knows what legal and business problems arise on a daily basis.

Nurse practitioners who read this book will have a solid foundation of knowledge with which they may continue their practice confidently and effectively, whether it be in developing an employment relationship, undertaking a business venture, giving testimony before the state legislature, composing a letter to an insurance company about an unpaid bill, teaching at a school of nursing, or serving as president of a state or national organization.

Contents:

A Nurse Practitioner, By Any Other Name 2

Services Provided by NPs 3

Preparation and License Requirements 5

Initials 6

Areas of Practice 6

Legal History of NPs 6

Demographics 7

NPs in Primary Care 7

NPs' Legal Authority to be Primary Care Providers 9

NP Versus PA: What's the Difference? 10

NP Versus Physician: What's the Difference? 12

NP Versus RN: What's the Difference? 14

NP Versus CNS: What's the Difference? 15

Where Do Nurse Practitioners Practice? 17

Appendix 1-A State-by-State What is a Nurse Practitioner? 18

Appendix 1-B State-by-State Titles for Nurse Practitioners 33

Chapter 2 Legal Scope of Nurse Practitioner Practice 37

Professional Association Definition of Scope of Practice 37

Statutory Versus Regulatory Scope of NP Practice 38

Physician Challenges to NPs' Scope of Practice 39

Need for Clarity of Scope of Practice 39

NP Scope of Practice Compared with RN Scope of Practice 40

NP and MD Scope of Practice Compared 43

Mandated Physician Involvement with NP Practice 44

Appendix 2-A State-by-State Law Nurse Practitioner Scope of Practice 47

Appendix 2-B State-by-State Requirement, if any, of Physician Collaboration 75

Chapter 3 State Regulation of Nurse Practitioner Practice 111

How Laws About NP Practice Evolve 111

What is Regulated? 112

Appendix 3-A Agency That Regulates Nurse Practitioners, State-by-State 114

Appendix 3-B State-by-State Nurse Practitioner Qualifications Required by Law 117

Chapter 4 Federal Regulation of the Nurse Practitioner Profession 135

Medicare 135

Medicaid 139

Nursing Homes 139

In-Office and Hospital Laboratories Under CLIA 140

Self-Referral by Health Care Providers, Under the Stark Acts 140

Prescription of Controlled Substances Under the DEA 142

Reporting to the National Practitioner Data Bank 142

Patient Confidentiality 142

Discrimination in Hiring and Firing 145

People with Disabilities Under the ADA 145

Appendix 4-A Documentation Guidelines for Evaluation and Management Services 146

Chapter 5 Prescribing 183

Controlled Substances 183

Guidelines for Prescribing Legally 186

Appendix 5-A State-by-State Law Prescriptive Authority 188

Chapter 6 Hospital Privileges 227

Are Hospital Privileges an Issue for NPs? 227

Do PCPs Need Hospital Privileges? 228

What if Health Plans Require PCPs to Have Admitting Privileges? 229

Do NPs Need Hospital Privileges for Advancement of the Profession? 229

Do Individual NPs Need Hospital Privileges? 229

Who has Hospital Privileges? 230

Does Federal Law Support Full Hospital Privileges for NPs? 232

What Does it Mean to Have Hospital Privileges? 232

Levels of Privilege 232

The Application Process 233

Expense 233

Denial of Privileges 233

Expect Change 234

Chapter 7 Negligence and Malpractice 235

What Can Happen to an NP Who is Sued? 236

Life Cycle of a Lawsuit 236

What is Malpractice? 236

Elements of Malpractice 236

Examples of Lawsuits Against NPs 238

The National Practitioner Data Bank 242

Working with Practice Guidelines 243

How to Prevent Lawsuits 244

What to do if Sued 244

Communication 244

Liability of Collaborating Physicians 244

Malpractice Insurance 246

Chapter 8 Risk Management 249

Risk of Making a Clinical Error 249

Risk of Being Sued for Malpractice When There Was No Clinical Error 252

Risk of Public Perception That the Individual NP Is a Poor-Quality Provider 253

Risk of Breaching Patient Confidentiality 253

Risk of Violating a Patient's Right to Informed Consent 255

Risk of Negligent Nondisclosure 260

Risk of Poor Quality Ratings 261

Risk of Disciplinary Action 261

Risk of Medicare Fraud 263

Business Risk Management 264

Dealing with High-Risk Patients 265

Chapter 9 Reimbursement for Nurse Practitioner Services 269

Payers 269

Medicare 269

Medicaid 273

Indemnity Insurers 273

Managed-Care Organizations 274

Direct Contracts for Health Services 279

Billing Third-Party Payers 279

Billing Self-Paying Patients 284

Appendix 9-A Credentialing Information 286

Chapter 10 The Employed Nurse Practitioner 289

What Rights Does an Employed NP Have? 289

Does an NP Need a Contract? 290

Three Difficult Clauses 291

How to Negotiate a Reasonable Agreement 296

Interviewing 303

Responsibilities of an NP Employee 303

Employer's Evaluation of the NP's Performance 304

Malpractice Insurance 304

Collaborative Practice Agreements 304

Appendix 10-A Sample Nurse Practitioner Collaborative Practice Agreement 306

Appendix 10-B Sample Employment Agreement 310

Chapter 11 Practice Ownership: Legal Business Considerations for the Nurse Practitioner Owner 321

Advantages of Practice Ownership 321

Decisions Before Starting a Practice 322

Business Planning 338

Doing Business 343

Appendix 11-A A Checklist for Setting Up a Practice 358

Appendix 11-B Independent Contractor Agreement 372

Appendix 11-C Sample Business Plan 377

Appendix 11-D Professional Services Agreement 393

Chapter 12 Lawmaking and Health Policy 399

The Legal Process 399

The Judicial System 400

Health Policy 400

Laws and Rules That Affect NPs 401

Changing Laws 401

Understanding the Big Picture 402

The Process of Changing the Law 408

Chapter 13 Promoting the Profession to the Public 417

Public Relations Steps 418

Setting the Goal 418

Developing the Plan 418

Developing the Budget 419

Working the Plan 419

The Substance of the Message 420

Supporting Data 421

Collecting Impressive Facts 423

Present Barriers to Fact Collection 424

Not-So-Impressive Facts About NPs 424

Dealing with the Downside 425

Appendix 13-A A Simple PR Plan for a State NP Organization 428

Appendix 13-B Some Talking Points for NPs 430

Appendix 13-C Sample Fact Sheets on NPs 433

Chapter 14 Standards of Care for Nurse Practitioner Practice 437

Definitions of Standard of Care 437

Who is Monitoring Standard of Care 437

How Should NPs Keep Current on Standard of Care? 446

Credentialing 446

Chapter 15 Measuring Nurse Practitioner Performance 449

Measuring Quality 449

Multiple Measures, Multiple Measurers 450

Productivity 450

Housekeeping Performance Measures 451

NCQA Measures of Clinical Performance 451

Other Measures 452

Formal Research 452

Patient Ratings 453

Peer Review 453

Utilization 453

How to Get an "A" on Performance Report Cards 454

Ensuring Compliance 454

Appendix 15-A NPs' Self-Evaluation 456

Appendix 15-B Health Maintenance Flowchart 457

Chapter 16 Resolving Ethical Dilemmas 459

Analyzing the Ethical Choices Inherent in These Situations 460

Ethical Analyses 467

Chapter 17 Strategies for NPs 469

Opportunities in a Changing Field 469

Opponents of a See-A-Nurse-First System 470

What are the Challenges for NPs Attempting to Advance the Profession? 470

Strategies to Implement Collectively 471

Ten Organizational Strategies 471.

Notes:

Includes bibliographical references and index.

ISBN:

0763733415

OCLC:

52962901