Q. Does state statute mandate that a statement about PA supervision be documented in outpatient chart notes?
|
|
- Letitia Woods
- 6 years ago
- Views:
Transcription
1 PA Supervision Q. Does state statute mandate that a statement about PA supervision be documented in outpatient chart notes? A. There is not a specific requirement for this, other than a PA must be able to identify who their supervising physician is for every patient encounter. One way to satisfy this requirement is to put the supervising physician's name in each clinic note. Some PAs use a schedule or keep track based on how they log into the EMR. I assume identifying the supervising physician in the clinic note was the recommendation at the meeting, but this is not explicitly required in Chapter Med 8. Q. Supervision of PAs in the ER Do PAs need to staff every patient seen with the emergency physician? A. No. The constant physical presence of a supervising physician is often unnecessary. The supervising physician and the physician assistant are jointly responsible for employing more intensive supervision when circumstances require direct observation or hands-on assistance from the supervising physician. LEGAL OPINION: The constant physical presence of a supervising physician is often unnecessary. The supervising physician and the physician assistant are jointly responsible for employing more intensive supervision when circumstances require direct observation or hands-on assistance from the supervising physician. The suggestion that every single visit has to be staffed with the ER doc is simply contrary to this language. The only way to reconcile the positions would be if the ER director is trying to say that every single patient who walks into the ER presents with a problem that requires direct observation and/or hands on assistance from a physician but that would be an enormous and unsupportable factual stretch. My recollection from discussions at the time is that the exception embodied in the rule requiring physician presence at times was meant to be narrow (hence the often unnecessary language) and was addressing those PA/physician relationships involving more specialized practices such as cardiovascular surgery, etc. Also, if you look at the definition of supervision in Med 8.02(6) it is clearly broad enough to encompass both direct supervision and general supervision. Again, my recollection of the discussions at the time of enactment was that the language needed to be that broad but also make clear that if there was a disagreement between a physician and a PA, that the physician s decision controlled. Hence the powers of direction and decision language. I always thought that was a bit odd that anybody felt the need to make that explicit but, in fairness, it is the only place in the rule that is that explicit. Q: My supervising MD oversees myself and two other providers. He is leaving our company, taking a new job with a different company. Our regional medical director is in Chicago and suggested he be our new supervising MD however, he does NOT have a WI medical license, only IL. I ve looked on the state board of Medicine website (drl.wi.gov) and Chapter 8 references supervising MD s, but gives no indication of whether or not the supervising MD has to be licensed in our state. 1. Do we have to have an WI state licensed MD to supervise us OR can it be any licensed physician 2. Can our current supervising MD continue to be our supervising MD even if he is not at the same company anymore (which he said he would be willing to do if we needed him to). 1
2 A. When State of Wisconsin statutes and code refer to a license they are referring to a State of Wisconsin issued license. Any physician without a State of Wisconsin issued license cannot serve as a supervising physician to a PA practicing in Wisconsin. If the physician has a valid State of Wisconsin license (or has the exemption noted below), they can serve as the supervising physician for a PA regardless if the PA and MD are employed by the same entity. Wisconsin Administrative Code; Chapter Med 8; Med 8.07 Practice. (1) Scope and limitations. In providing medical care, the entire practice of any physician assistant shall be under the supervision of one or more licensed physicians or physicians exempt from licensure requirements pursuant to s (2) (b), Stats. Wisconsin Statute; Medical Practice; Statute (5). Physician means an individual possessing the degree of doctor of medicine or doctor of osteopathy or an equivalent degree as determined by the medical examining board, and holding a license granted by the medical examining board. This subsection does not apply in s NOTE: Sub. (5) is amended eff by 2015 Wis. Act 116 to read: (5) "Physician" means an individual possessing the degree of doctor of medicine or doctor of osteopathy or an equivalent degree as determined by the medical examining board, and holding a license granted by the medical examining board. Q. Is there a Medicare rule that states PA s and residents cannot be supervised by the same physician at the same time? A (LEGAL OPINION). I know of no restriction in this regard and frankly it doesn t seem like it would make sense. One would think resident should be being trained how to work within a team approach. There are also plenty of examples to the contrary I can think of. For instance, surgical PA s regularly assist with surgeries while resident look on. This string suggests that there may be Medicare billing exceptions in certain situations. I looked at the particular rule being cited and it is so narrow that it is effectively written in manner to show people how not to run afoul of the billing strictures. I don t see this as a big issue. Q. My supervising doctor left abruptly due to a medical emergency. I currently have no supervising doctor. Can I continue to see patients? In our rural clinic, there is just me and an NP seeing patients. A. When PAs work alongside an NP, the NP s collaborating physician would be the best choice as the supervising physician. Otherwise, a supervising physician in another location needs to be identified. Q. Are PAs in WI required to have every note co-signed by a physician? A. No. There is no co-signature requirement for PAs in Wisconsin. There is no official document that specifically indicates that PA notes do not need co-signature. We can only reference Chapter Med 8 and point out that there is no co-signature requirement therein. Furthermore, there is no co-signature requirement when billing Medicare "incident to" the physician. The requirements for billing "incident to" are: Services are provided in a physician s office or physician s clinic; Physician sees Medicare patient on initial visit, establishes a diagnosis and treatment plan. PA sees patient on follow-up visit; For established Medicare patients with a new problem, the physician sees the patient first for the new problem, establishes a diagnosis and treatment plan, PA sees patient on follow-up visit 2
3 A Physician is on site, within the suite of offices, when the patient is seen by the PA; Services are within the PA s state law scope of practice; and The PA represents a direct financial expense to the physician billing (W-2 or leased employee, or independent contractor). The physician must continue to see the patient at a frequency that reflects ongoing management of the patient s care. Q. Are PAs required to list all physicians they could potentially work with on the supervising physician form with the state? A. Only one supervising MD needs to be listed on the form. Q. Can the PAs name be listed as the Primary Care Provider in the Electronic Medical Record? A. Yes. Under the ACA, PAs are recognized as PCPs. If an employer claims a PA cannot be listed as a PCP in the EMR, it should be investigated whether that is due to an EMR limitation that can be addressed. Q. Are PAs required to have a monthly site visit from their supervising physician? A. No. Visits were an old requirement that was removed from Med 8 when it was last updated. Scope of Practice Q. Can PAs sign DNR Bracelets? A (LEGAL OPINION). DNR bracelets must be signed by the physician is very poorly written and confusing. An argument could be made for a PA to be able to sign the bracelet on the physician s orders, but it could also be read to allow the physician to delegate the simples mechanics of the process (enter the conversation in the chart, act as scrivener for the doc on the order and physically place the bracelet). What leads me to my conclusion is the phrase in (2)(b)1 a do-not-resuscitate bracelet that meets the specifications established under s (1). If you look at (1), one of the specifications for the bracelet is the signature of the attending physician. I think when read in the context of (1), the confusing language of , while not given any clarity, would be interpreted to require that the physician be the one signing the bracelet. Stated another way, if a situation went bad where a responder ignored a DNR bracelet because it was signed by a PA, I would think the responder s actions completely justifiable, which in turn could cause a potentially big problem for the PA. Q. Can PAs perform DOT exams? A. PAs should not perform DOT physicals unless their supervising physician or someone in their group is certified. 3
4 Q. Can PAs perform/submit Prior-Authorizations? A (AAPA OPINION). Yes, as long as the drug is within a PA s state law scope of practice/prescribing authority to prescribe. Q. Can PAs sign Death Certificates? A (LEGAL OPINION). No. Chapter 69 controls vital records which includes death certificates and the other paperwork necessary for transporting of corpses, reporting cause of death, notifying law enforcement of suspicious deaths etc. Perhaps not surprisingly, one bit of data that must be on all those records is the date of death and the Date of Death is specifically defined by statute as the date a person is pronounced dead by a physician, coroner, deputy coroner, medical examiner, deputy medical examiner, or hospice nurse. Q. Can PAs work with Chiropractors or acupuncturists? A. No. PAs are prohibited from practicing with Chiropractors or acupuncturists. Q. Is it within the PA s scope of service that they can independently explain the risks and benefits of undergoing a procedure, or does the physician need to always co-sign the record they create explaining the risks and benefits? A. PAs can explain the risks/benefits of a procedure if this is allowed by the facility or employer. It is a delegated service performed by the PA. This falls under scope of practice in Med 8. Q. Do PAs need special certification to read and bill for reading EKGs? A. PAs do not need any certification to read EKGs. WAPA is not aware of any billing restriction with Medicare. Q. Are PAs able to apply fluoride varnishes in Wisconsin? A (LEGAL OPINION). I m actually a little concerned on this one. (Application of fluorides and other topical agents approved by the American dental association for the prevention of oral disease is an activity specifically referenced in Administrative Code covering dentistry as a practice of dental hygiene. Wis. Admin. Code sec. DE 3.02(2)(e). There may be more specifically going on with the practices at this clinic that could walk the issue back a bit, but as the question is framed, this is not an activity the WAPA should put its blessing on. Q. Can PAs perform truck driver physicals that their supervising physician is not certified to perform? A. WAPA previously sought legal counsel on this issue, and were warned against PAs performing DOT physicals if their supervising physician or someone in their group is not certified as well. It is a grey area, but that was the official opinion of counsel. 4
5 Q. Can PAs dispense sample medications? A. Yes. PAs can dispense. Chapter 961 of the Uniform Controlled Substance Act, specifically includes PAs in the definition of a practitioner. Billing Q. Can PAs bill for e-visits? A (LEGAL OPINION). Prior to the MEB s telemedicine ruling, PAs were restricted if there is no physician to reach out to within the fifteen minute rule. Q. Do PAs need special certification to read and bill for reading EKGs? A. PAs do not need any certification to read EKGs. WAPA is not aware of any billing restriction with Medicare. Q. Does a PA need to indicate to the name of the supervising physician when billing for visits? A. When PAs bill for visits, the payer does not need to know the name of the supervising physician. Employment Q. Can PAs in WI be employed by service corporations? A (LEGAL OPINION). Corporate practice of medicine (CPOM) questions are kind of tricky here as there is no clear guidance. I think the most recent thing is a 30 year old Attorney General Opinion. Unlike some other states, Wisconsin does not have a single CPOM statute but the rules are cobbled out of other rules and referred to as our COPM law. Physicians can practice through a service corporation structure and some professional partnerships. I interpret the question below to be asking if a PA can have an ownership interest in any allowable structure and my guess is that doing so would run afoul of the selfemployment restriction in Med 8. Normally, CPOM is more concerned with fee sharing than this issue. Q. I'm looking at possibly applying for an independent contractor position with Horizon Health, Inc. in the Milwaukee metro area, however, Chapter Med 8 states PAs cannot be self-employed. Does this means PAs cannot work as independent contractors in the state of WI? And if so, then why would this company advertise this type of a position? A (LEGAL OPINION). While neither I nor any of my partners who specialize in labor and employment have seen an enforcement action against PA employment as a 1099 independent contractor, nor are we aware of any Department letter providing a formal or informal blessing to such arrangements, it seems to run directly counter to the provisions of Med The law is fairly clear as to specific categories of folks who do work for a business on a regular basis. The primary categories are employees (W-2 earners), partner/owners (K-1 earners) and independent contractors (1099 earners) earners are, by definition, independent contractors for most employment and all taxable purposes. Without more information directly from the employer about the specifics of the arrangement, I have to stop short of explicitly condemning the practice, but I do think there are red flags all over this. 5
6 While I think Anne is right as to the purpose and intent of the law, the language of the administrative rule is very clear and a facial reading prohibits this type of arrangement. I seem to even recall a very brief discussion on this during the last Med 8 revision in which we thought that was a good idea as it provides additional employment protections to PAs. The concern was that if 1099 employment were foreclosed, it might make PA usage less attractive. Not a lot of time was spent on this as no one was aware of it being an issue and the thought was that while we want maximum employability, that should not come at the expense of what PA s would lose in employment protections. There are a lot of ancillary issues that come out of this as to what constitutes supervision and supervising physicians, how workers compensation is handled, what are the professional liability insurance provisions protecting the PAs, the arrangements that constitute agency for vicarious liability purposes etc. The manner in which these things are handled, I suppose, could be influential on the question of whether their specific arrangement runs afoul of Med 8.09 but that would be walking a tightrope with the IRS and FLSA enforcement. I have to think Horizon Health would be aware of this and has sought legal advice, but they may not have; if they have, I would love to hear their thought process. I think the member would be well advised to ask Horizon if they have addressed this issues and how they have dealt with it. The member certainly does not want to take any action that could subject them to a licensing action. In this regard, I would also note for the record that DSPS has jurisdiction over the licensed professional, but not necessarily the employer. It would be unfortunate to see a member sanctioned because a prospective employer led them into a situation that violates the regulations. Licensure Q. Does Wisconsin require ongoing NCCPA certification for licensing renewals? A. Wisconsin does require ongoing NCCPA certification. If a PA license is allowed to lapse, the PA would have to go through the entire process of application again including the tests. Refer to this section from WI Admin Code: Med 8.05(1)(cm)(cm) - Proof that the applicant is currently certified by the national commission on certification of physician assistants or its successor agency. 6
ALABAMA~STATUTE. Code of Alabama et seq. DATE Enacted Alabama Board of Medical Examiners
ALABAMA~STATUTE STATUTE Code of Alabama 34-24-290 et seq DATE Enacted 1971 REGULATORY BODY PA DEFINED SCOPE OF PRACTICE PRESCRIBING/DISPENSING SUPERVISION DEFINED PAs PER PHYSICIAN APPLICATION QUALIFICATIONS
More informationRetail Clinics in Healthcare: Overcoming Complex Legal Challenges
Presenting a live 90-minute webinar with interactive Q&A Retail Clinics in Healthcare: Overcoming Complex Legal Challenges Complying With Corporate Practice of Medicine, Licensure, and Scope of Practice
More informationBe it enacted by the People of the State of Illinois,
AN ACT concerning health care. Be it enacted by the People of the State of Illinois, represented in the General Assembly: Section 5. The Department of Public Health Powers and Duties Law of the Civil Administrative
More informationNATIONAL ASSOCIATION FOR STATE CONTROLLED SUBSTANCES AUTHORITIES (NASCSA) MODEL PRESCRIPTION MONITORING PROGRAM (PMP) ACT (2016) COMMENT
1 NATIONAL ASSOCIATION FOR STATE CONTROLLED SUBSTANCES AUTHORITIES (NASCSA) MODEL PRESCRIPTION MONITORING PROGRAM (PMP) ACT (2016) SECTION 1. SHORT TITLE. This Act shall be known and may be cited as the
More informationPhysician-led health care teams. AMA Advocacy Resource Center. Resource materials to support state legislative and regulatory campaigns
ama-assn.org/go/physicianledteams AMA Advocacy Resource Center Physician-led health care teams Resource materials to support state legislative and regulatory campaigns Page 2 AMA Advocacy Resource Center
More informationLast updated on April 23, 2017 by Chris Krummey - Managing Attorney-Transactions
Physician Assistant Supervision Agreement Instructions Sheet Outlined in this document the instructions for completing the Physician Assistant Supervision Agreement and forming a supervision agreement
More information10 Legal Myths About Advance Medical Directives
ABA Commission on Legal Problems of the Elderly 10 Legal Myths About Advance Medical Directives by Charles P. Sabatino, J.D. Myth 1: Everyone should have a Living Will. Living Will, without more, is not
More informationTypes of Authorized Recipients Probation/Parole Officers or the Department of Corrections
Types of Authorized Recipients Probation/Parole Officers or the Department of Corrections Research current through May 2016. This project was supported by Grant No. G1599ONDCP03A, awarded by the Office
More informationAdvanced Practice Nurse Authority to Diagnose and Prescribe
Advanced Practice Nurse Authority to Diagnose and Prescribe Copyright protected information. Provided courtesy of the Illinois State Medical Society ADVANCED PRACTICE NURSES AUTHORITY TO DIAGNOSE AND PRESCRIBE
More informationATTACHMENT I. Outpatient Status: Solicitation of Public Comments
ATTACHMENT I The following text is a copy of the Federation of American Hospitals ( FAH ) comments in response to the solicitation of public comments on outpatient status that was contained in CMS-1589-P;
More informationSTATE OF RHODE ISLAND
======= LC01 ======= 00 -- S STATE OF RHODE ISLAND IN GENERAL ASSEMBLY JANUARY SESSION, A.D. 00 A N A C T RELATING TO HEALTH AND SAFETY Introduced By: Senators Perry, and C Levesque Date Introduced: February
More informationMARYLAND BOARD OF PHYSICIANS P.O. Box 2571 Baltimore, Maryland
MARYLAND BOARD OF PHYSICIANS P.O. Box 2571 Baltimore, Maryland 21215 www.mbp.state.md.us E-mail: mdh.mbppadispense@maryland.gov : ADDENDUM FOR PHYSICIAN ASSISTANT (PA) TO DISPENSE PRESCRIPTION DRUGS INSTRUCTIONS
More informationFAQ about Physician-Assisted Death
FAQ about Physician-Assisted Death In 1997, Oregon enacted the first and, so far, only Physician-Assisted Death law in the United States. This law (known as the Death with Dignity Act) requires the Oregon
More informationLexisNexis (TM) New Jersey Annotated Statutes
Page 1 1 of 1 DOCUMENT LexisNexis (TM) New Jersey Annotated Statutes *** This section is current through New Jersey 214th Legislature *** 2nd Annual Session (P.L. 2011 Chapter 175 and JR 8) State Constitution
More informationEnd of Life Option Act ( The Act )
End of Life Option Act ( The Act ) Susan L. Penney, JD UCSF Medical Center End of Life Option Act (previously referred to as Physician Assisted Suicide) ABX2 15 After decades of California rejecting prior
More informationTHE GENERAL ASSEMBLY OF PENNSYLVANIA SENATE BILL AN ACT
PRINTER'S NO. THE GENERAL ASSEMBLY OF PENNSYLVANIA SENATE BILL No. INTRODUCED BY LEACH AND FERLO, JUNE, REFERRED TO JUDICIARY, JUNE, Session of AN ACT 1 1 1 1 Amending Title (Decedents, Estates and Fiduciaries)
More informationPeer Review. By: David M. Glaser January 2015
Peer Review By: David M. Glaser dglaser@fredlaw.com 612.492.7143 January 2015 Past Webinars http://www.fredlaw.com/practices industries/health _care/health_law_webinars/ A link is included in your email.
More information(9) Efforts to enact protections for kidney dialysis patients in California have been stymied in Sacramento by the dialysis corporations, which spent
This initiative measure is submitted to the people in accordance with the provisions of Article II, Section 8, of the California Constitution. This initiative measure amends and adds sections to the Health
More informationAdvanced Practice Nurses Authority to Diagnose and Prescribe. Excellence Through Coordinated Patient Care. Copyright protected. information.
Excellence Through Coordinated Patient Care Copyright protected information. Provided courtesy of the Illinois State Medical Society Advanced Practice Nurses Authority to Diagnose and Prescribe 12-1655-S
More informationGENERAL ASSEMBLY OF NORTH CAROLINA SESSION 2015 HOUSE DRH20205-MG-112 (03/24) Short Title: Enact Death With Dignity Act. (Public)
H GENERAL ASSEMBLY OF NORTH CAROLINA SESSION HOUSE DRH-MG-1 (0/) H.B. Apr, HOUSE PRINCIPAL CLERK D Short Title: Enact Death With Dignity Act. (Public) Sponsors: Referred to: Representatives Harrison and
More informationSENATE BILL No. 323 AMENDED IN SENATE MARCH 26, Introduced by Senator Hernandez (Principal coauthor: Assembly Member Eggman) February 23, 2015
AMENDED IN SENATE MARCH 26, 2015 SENATE BILL No. 323 Introduced by Senator Hernandez (Principal coauthor: Assembly Member Eggman) February 23, 2015 An act to amend Section 2835.7 of the Business and Professions
More informationGENERAL ASSEMBLY OF NORTH CAROLINA SESSION 2017 S 2 SENATE BILL 750* Health Care Committee Substitute Adopted 6/12/18
GENERAL ASSEMBLY OF NORTH CAROLINA SESSION 0 S SENATE BILL 0* Health Care Committee Substitute Adopted /1/ Short Title: Health-Local Confinement/Vet. Controlled Sub. (Public) Sponsors: Referred to: May,
More informationAlert. Recognition of Advance Practice Registered Nurses by Michigan Statute. msms.org. April 2017
Alert April 2017 Recognition of Advance Practice Registered Nurses by Michigan Statute By Patrick J. Haddad, JD, Kerr, Russell and Weber, PLC, MSMS Legal Counsel Public Act 499 of 2016, effective April
More information1:35. NPP April Young Medical Consulting, LLC. Non-Physician Practitioner Coding and Billing. Disclaimer
Non-Physician Practitioner Coding and Billing Jill Young - CPC, CEDC, CIMC, East Lansing, Michigan 1 Disclaimer This material is designed to offer basic information for coding and billing. The information
More informationAlert. Changes to Licensed Scope of Practice of Physician s Assistants in Michigan. msms.org. Participating Physician. Practice Agreement
Alert Changes to Licensed Scope of Practice of Physician s Assistants in Michigan By Patrick J. Haddad, JD, Kerr, Russell and Weber, PLC, MSMS Legal Counsel FEBRUARY 24, 2017 Public Act 379 of 2016, effective
More informationYour Medical Record Rights in Wisconsin
Your Medical Record Rights in Wisconsin (A Guide to Consumer Rights under HIPAA) JOY PRITTS, JD NINA L. KUDSZUS HEALTH POLICY INSTITUTE GEORGETOWN UNIVERSITY Your Medical Record Rights in Wisconsin (A
More informationNP or PA as Billing Provider
NP or PA as Billing Provider Claire Agnew, CPA MBA CHC Vice President of Financial Operations Phoenix Children s Medical Group Phoenix Children s Hospital Arizona s only children s hospital recognized
More informationDEPARTMENT OF HUMAN SERVICES AGING AND PEOPLE WITH DISABILITIES DIVISION OREGON ADMINISTRATIVE RULES CHAPTER 411 DIVISION 58
DEPARTMENT OF HUMAN SERVICES AGING AND PEOPLE WITH DISABILITIES DIVISION OREGON ADMINISTRATIVE RULES 411-058-0000 Definitions CHAPTER 411 DIVISION 58 LONG TERM CARE REFERRAL SERVICES Unless the context
More informationThe California End of Life Option Act (Patient s Request for Medical Aid-in-Dying)
Office of Origin: I. PURPOSE II. III. A. The California authorizes medical aid in dying and allows an adult patient with capacity, who has been diagnosed with a terminal disease with a life expectancy
More informationApplication of Proposals in Emergency Situations
March 27, 2018 Alex Azar Secretary Department of Health and Human Services Hubert H. Humphrey Building Room 509F 200 Independence Avenue, SW. Washington, DC 20201 Re: RIN 0945-ZA03 Re: Protecting Statutory
More informationTelehealth Legal and Compliance Issues. Nathaniel Lacktman, Anna Whites, Esq.
Telehealth Legal and Compliance Issues Nathaniel Lacktman, Esq. @Lacktman Anna Whites, Esq. Anna Whites Law Office Attorney Advertising Prior results do not guarantee a similar outcome Models used are
More informationEPCS FREQUENTLY ASKED QUESTIONS FOR ELECTRONIC PRESCRIBING OF CONTROLLED SUBSTANCES. Revised: March 2016
FREQUENTLY ASKED QUESTIONS FOR ELECTRONIC PRESCRIBING OF CONTROLLED SUBSTANCES EPCS Revised: March 2016 NEW YORK STATE DEPARTMENT OF HEALTH Bureau of Narcotic Enforcement 1-866-811-7957 www.health.ny.gov/professionals/narcotic
More informationThe District of Columbia Death with Dignity Act (Patient Request for Medical Aid-in-Dying)
Office of Origin: I. PURPOSE II. A. authorizes medical aid in dying and allows an adult patient with capacity, who has been diagnosed with a terminal disease with a life expectancy of six months or less,
More informationINCREASE ACCESS TO PRIMARY CARE SERVICES BY ALLOWING ADVANCED PRACTICE REGISTERED NURSES TO PRESCRIBE
INCREASE ACCESS TO PRIMARY CARE SERVICES BY ALLOWING ADVANCED PRACTICE REGISTERED NURSES TO PRESCRIBE Both nationally and in Texas, advanced practice registered nurses have helped mitigate the effects
More informationPhysician Assistant Reimbursement: Hot Topics
Physician Assistant Reimbursement: Hot Topics 2 Physician Assistant reimbursement: Hot Topics James A. Kilmark, PA-C Physician Assistant in Emergency Medicine Emergency Physicians Medical Group: PA/NP
More informationFrequently Asked Questions
Frequently Asked Questions This FAQ is as complete as possible, however it is not possible to answer every question, and some categories overlap. Because of this, some questions/answers may be in a different
More information} Review recently enacted PA legislation. } Outline state PA legislative issues. } Describe federal PA issues
Marriott, Coralville, IA October 6, 2014 Ed Friedmann, PA } Review recently enacted PA legislation } Outline state PA legislative issues } Describe federal PA issues } Describe why PA input is needed in
More informationThe Wisconsin epdmp:
The Wisconsin epdmp: Frequently Asked Questions Pursuant to 2015 Wisconsin Act 266, effective April 1, 2017, Wisconsin-licensed physicians and other prescribers must review a patient s records from Wisconsin
More informationFLORIDA ~ STATUTE , and Florida Statutes
FLORIDA ~ STATUTE STATUTE DATE Enacted 1976 REGULATORY BODY PA DEFINED SCOPE OF PRACTICE PRESCRIBING/DISPENSING SUPERVISION DEFINED 458.347, 458.348 and 627.419 Florida Statutes Council on Physician Assistants;
More informationAdvanced Practice Registered Nurses (APRNs)
- 4 - Advanced Practice Registered Nurses (APRNs) - 5 - Advanced Practice Registered Nurses (APRNs) APRNs are registered nurses who have at a minimum completed graduate coursework (masters degree), passed
More informationSENATE SUBSTITUTE FOR SENATE SUBSTITUTE FOR. SENATE, No. 787 STATE OF NEW JERSEY. 213th LEGISLATURE ADOPTED NOVEMBER 24, 2008
SENATE SUBSTITUTE FOR SENATE SUBSTITUTE FOR SENATE, No. STATE OF NEW JERSEY th LEGISLATURE ADOPTED NOVEMBER, 00 Sponsored by: Senator RICHARD J. CODEY District (Essex) Senator JOHN H. ADLER District (Camden)
More informationBold blue=new language Red strikethrough=deleted language Regular text=existing language Bold Green = new changes following public hearing
Bold blue=new language Red strikethrough=deleted language Regular text=existing language Bold Green = new changes following public hearing 700.001: Definitions Delegate means an authorized support staff
More informationFAQ about the Death With Dignity Act
FAQ about the Death With Dignity Act In 1997, Oregon enacted the Death with Dignity Act which allows physicians to write prescriptions for a lethal dosage of medication to Oregonians with a terminal illness.
More informationStark, False Claims and Anti- Kickback Laws: Easy Ways to Stay Compliant with the Big Three in Healthcare
Stark, False Claims and Anti- Kickback Laws: Easy Ways to Stay Compliant with the Big Three in Healthcare In health care, we are blessed with an abundance of rules, policies, standards and laws. In Health
More informationOKLAHOMA ADMINISTRATIVE CODE TITLE 435. STATE BOARD OF MEDICAL LICENSURE AND SUPERVISION CHAPTER 15. PHYSICIAN ASSISTANTS INDEX
Updated September 1, 2016 OKLAHOMA ADMINISTRATIVE CODE TITLE 435. STATE BOARD OF MEDICAL LICENSURE AND SUPERVISION CHAPTER 15. PHYSICIAN ASSISTANTS INDEX Subchapter 1. General Provisions Subchapter 3.
More informationRE: CMS-1631-PM Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2016
September 8, 2015 Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-2333-P Mail Stop C4-26-05 7500 Security Boulevard Baltimore, MD 21244-1850 Main Office
More informationASSEMBLY BILL No. 214
AMENDED IN SENATE AUGUST, 00 AMENDED IN SENATE AUGUST, 00 AMENDED IN SENATE AUGUST, 00 AMENDED IN SENATE JULY, 00 AMENDED IN SENATE JUNE, 00 AMENDED IN SENATE JUNE, 00 AMENDED IN SENATE AUGUST 0, 00 california
More informationAre you the Ant. or the Grasshopper? 501r 4 - FAP - Learn the Requirements to stay Compliant. Shawn Gretz. Aesop Fable 10/6/2015
501r 4 - FAP - Learn the Requirements to stay Compliant shawn@americollect.com 800-838-0100 Shawn Gretz VP of Sales for Americollect and AmeriEBO I am not a lawyer, nor do I play one on TV, and I did not
More informationMaryland MOLST FAQs. Maryland MOLST Training Task Force
Maryland MOLST FAQs Maryland MOLST Training Task Force October 2017 Frequently Asked Questions About Maryland MOLST What does MOLST stand for? MOLST is an acronym that stands for Medical Orders for Life-Sustaining
More informationIllinois Compiled Statutes Civil Immunities Good Samaritan Act 745 ILCS 49/
Illinois Compiled Statutes Civil Immunities Good Samaritan Act 745 ILCS 49/ (745 ILCS 49/) (745 ILCS 49/1) Sec. 1. Short title. This Act may be cited as the Good Samaritan Act. (745 ILCS 49/2) Sec. 2.
More informationPrescription Monitoring Program State Profiles - Illinois
Prescription Monitoring Program State Profiles - Illinois Research current through December 2014. This project was supported by Grant No. G1399ONDCP03A, awarded by the Office of National Drug Control Policy.
More informationPENNSYLVANIA Advance Directive Planning for Important Health Care Decisions
PENNSYLVANIA Advance Directive Planning for Important Health Care Decisions Caring Connections 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 Caring Connections, a program
More informationSUBCHAPTER 32M - APPROVAL OF NURSE PRACTITIONERS
SUBCHAPTER 32M - APPROVAL OF NURSE PRACTITIONERS 21 NCAC 32M.0101 DEFINITIONS The following definitions apply to this Subchapter: (1) "Approval to Practice" means authorization by the Medical Board and
More informationTitle 18 RCW Chapter
WA 2007 RCW 18.130.020 Definitions. Title 18 RCW Chapter 18.250 The definitions in this section apply throughout this chapter unless the context clearly requires otherwise. (1) "Board" means any of those
More informationTELEMEDICINE LAWS AND RECENT LEGISLATION IN NEARBY STATES
kslegres@klrd.ks.gov 68-West Statehouse, 300 SW 10th Ave. Topeka, Kansas 66612-1504 (785) 296-3181 FAX (785) 296-3824 http://www.kslegislature.org/klrd October 18, 2017 TELEMEDICINE LAWS AND RECENT LEGISLATION
More informationYour Medical Record Rights in Rhode Isl and
Your Medical Record Rights in Rhode Isl and (A Guide to Consumer Rights under HIPAA) JOY PRITTS, JD MARISA GUEVARA HEALTH POLICY INSTITUTE GEORGETOWN UNIVERSITY Your Medical Record Rights in Rhode Island
More informationThe Act, which amends the Small Business Act ([15 USC 654} 15 U.S.C. 654 et seq.), is intended to:
Drug-Free Workplace Act of 1998 PM:249:7651 In This Chapter SUMMARY OF PROVISIONS OVERVIEW The Drug-Free Workplace Act of 1998 was enacted as part of the Omnibus Consolidated and Emergency Supplemental
More informationCharles Oppenheim and Amy Joseph
Compliance TODAY April 2017 a publication of the health care compliance association www.hcca-info.org The mission of making Compliance an academic discipline an interview with Ryan Meade Director, Center
More informationQuick Reference Site-Specific Prescriptive Delegation Statute & Rule 5/22/2010
Quick Reference Site-Specific Prescriptive Delegation Statute & Rule 5/22/2010 Use the table below to compare requirements between the four site types. Click on the underlines to see the relevant statute
More informationIndiana. Your Medical Record Rights in. (A Guide to Consumer Rights under HIPAA)
Your Medical Record Rights in Indiana (A Guide to Consumer Rights under HIPAA) JOY PRITTS, JD NINA L. KUDSZUS HEALTH POLICY INSTITUTE GEORGETOWN UNIVERSITY Your Medical Record Rights in Indiana (A Guide
More informationSENATE, No STATE OF NEW JERSEY. 216th LEGISLATURE INTRODUCED APRIL 28, 2014
SENATE, No. STATE OF NEW JERSEY th LEGISLATURE INTRODUCED APRIL, 0 Sponsored by: Senator LORETTA WEINBERG District (Bergen) Senator JOSEPH F. VITALE District (Middlesex) Senator JAMES W. HOLZAPFEL District
More informationSTATEMENTS OF POLICY
STATEMENTS OF POLICY Title 55 PUBLIC WELFARE DEPARTMENT OF PUBLIC WELFARE [ 55 PA. CODE CH. 6000 ] Procedures for Surrogate Health Care Decision Making [41 Pa.B. 352] [Saturday, January 15, 2011] Scope
More informationADMINISTRATIVE HEARINGS COUNTY OF WAKE 15 BSW PROPOSAL FOR DECISION
STATE OF NORTH CAROLINA IN THE OFFICE OF ADMINISTRATIVE HEARINGS COUNTY OF WAKE 15 BSW 04491 NORTH CAROLINA SOCIAL WORK ) CERTIFICATION AND LICENSURE BOARD, ) Petitioner, ) ) v. ) ) STEPHANIE HELBECK CORNFIELD
More informationGENERAL ASSEMBLY OF NORTH CAROLINA SESSION 2017 SESSION LAW SENATE BILL 750
GENERAL ASSEMBLY OF NORTH CAROLINA SESSION 2017 SESSION LAW 2018-76 SENATE BILL 750 AN ACT TO ADDRESS HEALTH ISSUES IN LOCAL CONFINEMENT FACILITIES AND TO ENSURE THAT STATE PRISONS ARE FULL PARTICIPANTS
More informationA GUIDE TO HOSPICE SERVICES
A GUIDE TO HOSPICE SERVICES PURPOSE: Minnesota Rules 4664.0140, subpart 1 states: "Every individual applicant for a license, and every person who provides direct care, supervision of direct care, or management
More informationOptimal Team Practice
Optimal Team Practice Updates to AAPA s Guidelines for State Regulation of PAs Montana Academy of PAs 2018 Annual Conference June 6, 2018 Ann Davis, MS, PA-C VP, Constituent Organization Outreach and Advocacy,
More information[Second Reprint] SENATE, No. 278 STATE OF NEW JERSEY. 217th LEGISLATURE PRE-FILED FOR INTRODUCTION IN THE 2016 SESSION
[Second Reprint] SENATE, No. STATE OF NEW JERSEY th LEGISLATURE PRE-FILED FOR INTRODUCTION IN THE 0 SESSION Sponsored by: Senator JOSEPH F. VITALE District (Middlesex) SYNOPSIS Requires surgical practices
More information24 (b) "Boards" means the Board of Medicine and the Board. 27 graduated from an approved program, who is licensed to perform
CHAMBER ACTION Senate House.. 1 WD/2R. 05/02/2005 10:20 AM. 2.. 3.. 4 5 6 7 8 9 10 11 Senator Peaden moved the following amendment: 12 13 Senate Amendment (with title amendment) 14 On page 4, lines 27
More informationDIVISION OF CORPORATIONS, BUSINESS AND PROFESSIONAL LICENSING
Statutes and Regulations Nursing Home Administrators December 2010 (Centralized Statutes and Regulations not included) DEPARTMENT OF COMMERCE, COMMUNITY, AND ECONOMIC DEVELOPMENT DIVISION OF CORPORATIONS,
More information100-28a-1a. Definitions. As used in this article, each of the following terms shall have the
100-28a-1a. Definitions. As used in this article, each of the following terms shall have the meaning specified in this regulation: (a) Active practice request form means the board-provided form that each
More informationTelemedicine. Important Information. Telemedicine 5/6/2016. Lauren Prew
Telemedicine Lauren Prew Important Information This presentation is similar to any other seminar designed to provide general information on pertinent legal topics. The statements made and any materials
More informationNOTICE OF PRIVACY PRACTICES
Page 1 of 10 NOTICE OF PRIVACY PRACTICES EFFECTIVE DATE: The Notice of Privacy Practices became effective on April 14, 2003 and was amended on August 30, 2013. THIS NOTICE DESCRIBES HOW HEALTH INFORMATION
More informationRULE THE PHYSICIAN S ROLE IN PRESCRIPTIVE AUTHORITY FOR ADVANCED PRACTICE NURSES
DEPARTMENT OF REGULATORY AGENCIES Colorado Medical Board RULE 950 - THE PHYSICIAN S ROLE IN PRESCRIPTIVE AUTHORITY FOR ADVANCED PRACTICE NURSES 3 CCR 713-37 [Editor s Notes follow the text of the rules
More informationMcLennan Community College. Tele-Communicator Academy Enrollment Process
McLennan Community College Tele-Communicator Academy Enrollment Process Academy Contact Information Academy Enrollment Process APPLY TO THE TELE-COMMUNICATOR ACADEMY Dennis A. Stapleton Cheryl Brooks Academy
More informationGENERAL INFORMATION: NURSE PRACTITIONER PRACTICE
BOARD OF REGISTERED NURSING PO Box 944210, Sacramento, CA 94244-2100 P (916) 322-3350 F (916) 574-8637 www.rn.ca.gov Louise R. Bailey, MEd, RN, Executive Officer GENERAL INFORMATION: NURSE PRACTITIONER
More informationPurpose: To establish guidelines for the clinical practice of Non-Physician Medical Practitioners (NPMP).
Purpose: To establish guidelines for the clinical practice of Non-Physician Medical Practitioners (NPMP). Policy: The Central California Alliance for Health (the Alliance) requires all NPMPs to meet the
More information(7) Indicate the appropriate and explicit directions for use. (9) Not authorize any refills for schedule II controlled substances.
ACTION: Revised DATE: 07/20/2017 4:25 PM 4729-5-30 Manner of issuance of a prescription. (A) A prescription, to be valid, must be issued for a legitimate medical purpose by an individual prescriber acting
More informationCruising Through Key Legal Compliance Issues in Telemedicine
April 12, 2018 Cruising Through Key Legal Compliance Issues in Telemedicine Presented by Cal Marshall 2018 Chambliss, Bahner & Stophel, P.C. All Rights Reserved. Chambliss, Bahner & Stophel, P.C. Liberty
More informationRULES OF TENNESSEE DEPARTMENT OF LABOR AND WORKFORCE DEVELOPMENT WORKERS COMPENSATION DIVISION
RULES OF TENNESSEE DEPARTMENT OF LABOR AND WORKFORCE DEVELOPMENT WORKERS COMPENSATION DIVISION CHAPTER 0800-02-25 WORKERS COMPENSATION MEDICAL TREATMENT TABLE OF CONTENTS 0800-02-25-.01 Purpose and Scope
More informationAgency for Health Care Administration
Page 1 of 50 FED - J0000 - INITIAL COMMENTS Title INITIAL COMMENTS CFR Type Memo Tag FED - J0003 - COMPLIANCE WITH FED,STATE,& LOCAL LAWS Title COMPLIANCE WITH FED,STATE,& LOCAL LAWS CFR 491.4 Type Condition
More informationPayment for the Services of Nurse Practitioners, Physician Assistants, and Certified Nurse-Midwives
Appendix B Payment for the Services of Nurse Practitioners, Physician Assistants, and Certified Nurse-Midwives Health-care services are paid for by individuals and by third-party payers. Third-party payers
More informationDischarge Planning for Patients Hospitalized for Mental Health Treatment Interpretative Guidelines for Oregon Hospitals
Discharge Planning for Patients Hospitalized for Mental Health Treatment Interpretative Guidelines for Oregon Hospitals May 2016 1 PURPOSE This document is meant to offer interpretative guidance for Oregon
More informationVirginia. Your Medical Record Rights in. (A Guide to Consumer Rights under HIPAA)
Your Medical Record Rights in Virginia (A Guide to Consumer Rights under HIPAA) JOY PRITTS, JD NINA L. KUDSZUS HEALTH POLICY INSTITUTE GEORGETOWN UNIVERSITY Your Medical Record Rights in Virginia (A Guide
More informationEligible Professional Core Measure Frequently Asked Questions
Eligible Professional Core Measure Frequently Asked Questions CPOE for Medication Orders 1. How should an EP who orders medications infrequently calculate the measure for the CPOE objective if the EP sees
More informationAmbulatory Patient Groups Payments for Duplicate Claims and Services in Excess of Medicaid Service Limits. Medicaid Program Department of Health
New York State Office of the State Comptroller Thomas P. DiNapoli Division of State Government Accountability Ambulatory Patient Groups Payments for Duplicate Claims and Services in Excess of Medicaid
More informationChapter II OVERVIEW OF THE MEDICAL BOARD OF CALIFORNIA
Overview of the Medical Board of California 5 Chapter II OVERVIEW OF THE MEDICAL BOARD OF CALIFORNIA A. MBC Generally 2 Created in the Medical Practice Act, the Medical Board of California is a semi-autonomous
More informationA Hospital Guide to the Colorado End-of-Life Options Act Version 2.0, December 2016
A Hospital Guide to the Colorado End-of-Life Options Act Version 2.0, December 2016 For additional information, contact: Amber Burkhart Policy Analyst amber.burkhart@cha.com 720.330.6028 1 This guidance
More informationAPPROVED REGULATION OF THE BOARD OF OCCUPATIONAL THERAPY. LCB File No. R Effective May 16, 2018
APPROVED REGULATION OF THE BOARD OF OCCUPATIONAL THERAPY LCB File No. R067-17 Effective May 16, 2018 EXPLANATION Matter in italics is new; matter in brackets [omitted material] is material to be omitted.
More informationInterim Commissioner Lauren A. Smith and Members of the Public Health Council
DEVAL L. PATRICK GOVERNOR TIMOTHY P. MURRAY LIEUTENANT GOVERNOR JOHN W. POLANOWICZ SECRETARY LAUREN A. SMITH, MD, MPH INTERIM COMMISSIONER The Commonwealth of Massachusetts Executive Office of Health and
More informationKANSAS STATUTES ANNOTATED Article 35 LICENSURE OF ADULT CARE HOME ADMINISTRATORS
KANSAS STATUTES ANNOTATED Article 35 LICENSURE OF ADULT CARE HOME ADMINISTRATORS 65-3501. As used in this act, or the act of which this section is amendatory, the following words and phrases shall have
More informationSTATE OF NORTH CAROLINA
STATE OF NORTH CAROLINA INVESTIGATIVE REPORT CLEVELAND COUNTY SCHOOLS SHELBY, NORTH CAROLINA DECEMBER 2011 OFFICE OF THE STATE AUDITOR BETH A. WOOD, CPA STATE AUDITOR INVESTIGATIVE REPORT CLEVELAND COUNTY
More informationADVANCE DIRECTIVE NOTIFICATION:
ADVANCE DIRECTIVE NOTIFICATION: All patients have the right to participate in their own health care decisions and to make Advance Directives or to execute Power of Attorney that authorize others to make
More informationSTATE OF NEW JERSEY MANDATORY OVERTIME RESTRICTIONS FOR HEALTH CARE FACILITIES
STATE OF NEW JERSEY MANDATORY OVERTIME RESTRICTIONS FOR HEALTH CARE FACILITIES New Jersey Department of Labor and Workforce Development Division of Wage and Hour Compliance PO Box 389 Trenton, New Jersey
More informationOVERVIEW. Surrogate Medical Decision Making. PRESENTATION TO LeadingAge. I. Who can make decisions? II. End of life issues.
PRESENTATION TO LeadingAge Kitch Drutchas Wagner Valitutti & Sherbrook One Woodward Avenue, Suite 2400 Detroit, MI 48226 5485 313.965.7900 www.kitch.com Detroit Lansing Mt. Clemens Marquette Toledo Chicago
More information(PLEASE PRINT) Sex M F Age Birthdate Single Married Widowed Separated Divorced. Business Address Business Phone Cell Phone
(PLEASE PRINT) Emma Warner, MSW, LCSW, ACSW Tulsa, OK 74105 (918) 749-6935 Personal Information Name Address Last Name First Name Initial Home Phone Soc. Sec. # City State Zip Sex M F Age Birthdate Single
More informationAssembly Bill No. 199 Assemblywomen Woodbury and Titus. Joint Sponsor: Senator Hardy
Assembly Bill No. 199 Assemblywomen Woodbury and Titus Joint Sponsor: Senator Hardy CHAPTER... AN ACT relating to health care; authorizing a physician assistant or advanced practice registered nurse to
More informationRULES OF ALABAMA STATE BOARD OF HEALTH ALABAMA DEPARTMENT OF PUBLIC HEALTH CHAPTER FREESTANDING EMERGENCY DEPARTMENTS
RULES OF ALABAMA STATE BOARD OF HEALTH ALABAMA DEPARTMENT OF PUBLIC HEALTH CHAPTER 420-5-9 FREESTANDING EMERGENCY DEPARTMENTS EFFECTIVE August 26, 2013 STATE OF ALABAMA DEPARTMENT OF PUBLIC HEALTH MONTGOMERY,
More informationMEDICAL LICENSURE COMMISSION OF ALABAMA ADMINISTRATIVE CODE CHAPTER 545 X 6 THE PRACTICE OF MEDICINE OR OSTEOPATHY ACROSS STATE LINES
Medical Licensure Chapter 545 X 6 MEDICAL LICENSURE COMMISSION OF ALABAMA ADMINISTRATIVE CODE CHAPTER 545 X 6 THE PRACTICE OF MEDICINE OR OSTEOPATHY ACROSS STATE LINES TABLE OF CONTENTS 545 X 6.01 545
More informationMalpractice and the Ripple Effects. ByrdAdatto Biography. Malpractice Lawsuits 8/30/2018
Malpractice and the Ripple Effects Bradford E. Adatto & Michael S. Byrd Dallas, Texas & Chicago, Illinois (214) 291-3200 byrdadatto.com Blog: byrdadatto.com/banter This presentation is for educational
More informationIC Chapter 2. Licensure of Hospitals
IC 16-21-2 Chapter 2. Licensure of Hospitals IC 16-21-2-1 Application of chapter Sec. 1. (a) Except as provided in subsection (b), this chapter applies to all hospitals, ambulatory outpatient surgical
More information