Nurse Practitioner's Business Practice And Legal Guide / Edition 5 available in Hardcover
Nurse Practitioner's Business Practice And Legal Guide / Edition 5
- ISBN-10:
- 1284050912
- ISBN-13:
- 2901284050911
- Pub. Date:
- 05/01/2014
- Publisher:
- Jones & Bartlett Learning
Nurse Practitioner's Business Practice And Legal Guide / Edition 5
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Overview
Awarded Second Place in the 2017 AJN Book of the Year Awards in Advanced Practice Nursing!
Nurse Practitioner's Business Practice and Legal Guide, Sixth Edition is a must-have resource for every new or current nurse practitioner (NP) that explains and analyzes the legal issues relevant to nurse practitioners. Completely updated and revised, it includes a new chapter on answering frequently asked questions from NPs. In addition, it provides the latest state-by-state laws, including regulatory developments and prosecutions of nurse practitioners, and new case analyses and lessons learned from those cases.
The Sixth Edition also offers new discussions of NP competencies, how the Doctor of Nursing Practice (DNP) degree relates to NPs, the differences in primary care and acute care NPs, definitions of medical bio-ethics terminology, additional malpractice cases and the lessons to learn from them, emerging issues in health policy, guidelines around prescribing opioids and controlled drugs, clinical performance measures, electronic health records, and new opportunities for NPs under the Affordable Care Act.
What's more, it addresses emerging health law issues with analysis of key cases, including:
• Examples regarding trouble over NPs and kickbacks
• Stark Law compliance issues and related criminal cases involving nurse practitioners who are employed by hospitals
• Nurse practitioners who have encountered issues with the Health Insurance Portability and Accountability Act (HIPAA)
• An attempted work around for the Medicare requirement that a physician order home care resulting in an NP using a physician's name to order home care and then being prosecuted for identity theft
• An NP and physician who did not follow Medicare's incident-to rules and both the NP and MD were charged with health care fraud
• Criminal cases against NPs who prescribed opioids or steroids either without authorization or without appropriate evaluation and monitoring
Product Details
ISBN-13: | 2901284050911 |
---|---|
Publisher: | Jones & Bartlett Learning |
Publication date: | 05/01/2014 |
Pages: | 520 |
Product dimensions: | 7.00(w) x 10.00(h) x 1.30(d) |
About the Author
Attorney, Boulder, Colorado
Table of Contents
Preface viii
Chapter 1 What Is a Nurse Practitioner? 1
Definition of Nurse Practitioner 1
An NP, by Any Other Name 2
Services Provided by NPs 3
Preparation and License Requirements 5
Initials 5
Areas of Practice 5
Legal History of NPs 6
Demographics 7
NPs in Primary Care 7
NP Versus Physician Assistant: What Is the Difference? 8
NP Versus Physician: What Is the Difference? 10
NP Versus RN: What Is the Difference? 11
NP Versus Clincial Nurse Specialist: What Is the Difference? 12
Where Do Nurse Practitioners Practice? 14
The NP Doctorate 14
Use of the Title "Doctor" 15
Appendix 1-A State-by-St ate Definitions of Nurse Practitioner 18
Appendix 1-B State-by-State Titles for Nurse Practitioners 36
Chapter 2 Legal Nurse Practitioner Scope of Practice 39
Professional Association Definition of Scope of Practice 39
Statutory Versus Regulatory NP Scope of Practice 40
Physician Challenges to NP Scope of Practice 40
Need for Clarity of Scope of Practice 41
NP Scope of Practice Compared with Registered Nurse Scope of Practice 44
NP and Physician Scope of Practice Compared 46
Can an NP Work Outside the NP's Certification? 46
An Individual NP's Portfolio 48
Mandated Physician Involvement with NP Practice 50
Appendix 2-A Scope of Practice 55
Appendix 2-B Physician Collaboration 94
Chapter 3 State Regulation of Nurse Practitioner Practice 133
How Laws About NP Practice Evolve 133
What Is Regulated? 134
Appendix 3-A State-by-State List of Agencies That Regulate Nurse Practitioners 136
Appendix 3-B State-by-State Nurse Practitioner Qualifications Required by Law 138
Chapter 4 Federal Regulation of the Nurse Practitioner Profession 165
Medicare 166
Medicaid 168
Nursing Homes 169
In-Office and Hospital Laboratories Under the Clinical Laboratory Improvement Amendments 169
Self-Referral by Healthcare Providers Under the Stark Acts 170
Prescription of Controlled Substances Under the DEA 172
Reporting to the National Practitioner Data Bank 172
Patient Confidentiality 172
Discrimination in Hiring and Firing 174
Requirements Under the Americans with Disabilities Act 174
Appendix 4-A Documentation Guidelines for Evaluation and Management Services 175
Chapter 5 Prescribing 203
Controlled Substances 203
Guidelines for Prescribing Legally 206
Appendix 5-A State-by-State Law Prescriptive Authority 208
Chapter 6 Hospital Privileges 263
Are Hospital Privileges an Issue for NPs? 263
Do PCPs Need Hospital Privileges? 263
Do NPs Need Hospital Privileges for Advancement of the Profession? 264
Do Individual NPs Need Hospital Privileges? 265
Who Has Hospital Privileges? 265
Does Federal Law Support Full Hospital Privileges for NPs? 267
What Does It Mean to Have Hospital Privileges? 267
Levels of Privilege 268
The Application Process 268
Expense 268
Denial of Privileges 268
Change on the Horizon 269
Chapter 7 Negligence and Malpracitce 271
What Can Happen to an NP Who Is Sued? 272
Life Cycle of a Lawsuit 272
What Is Malpractice? 272
Elements of Malpractice 272
Examples of Lawsuits Against NPs 274
The National Practitioner Data Bank 282
Working with Practice Guidelines 283
How to Prevent Lawsuits 283
What to Do If Sued 283
Communication 284
Liability of Collaborating Physicians 284
Malpractice Insurance 286
Chapter 8 Risk Management 289
Risk of Making a Clinical Error 289
Risk of Being Sued for Malpractice When There Was No Clinical Error 292
Risk of Public Perception That the Individual NP Is a Poor-Quality Provider 292
Risk of Breaching Patient Confidentiality 292
Risk of Violating a Patient's Right to Informed Consent 294
Risk of Negligent Nondisclosure 298
Risk of Poor-Quality Ratings 299
Risk of Disciplinary Action 299
Risk of Medicare Fraud 301
Business Risk Management 301
Dealing with High-Risk Patients 302
Risk of Being Accused of Prescribing or Dispensing Controlled Drugs Inappropriately 303
Electronic Medical Records-18 Ways to Reduce Legal Risks 304
Chapter 9 Reimbursement for Nurse Practitioners Services 311
Payers 311
Medicare 311
Medicaid 314
Indemnity Insurers 315
Direct Contracts for Health Services 319
Billing Third-Party Payers 319
Billing Self-Paying Patients 324
Conclusion 324
Appendix 9-A Credentialing Information 326
Chapter 10 The Employed Nurse Practitioner 329
What Rights Does an Employed NP Have? 329
Does an NP Need a Contract? 330
Three Difficult Clauses 331
How to Negotiate a Reasonable Agreement 335
Interviewing 340
Responsibilities of an NP Employee 341
Employer's Evaluation of the NP's Performance 341
Malpractice Insurance 341
Collaborative Practice Agreements 341
Appendix 10-A Sample Nurse Practitioner Collaborative Practice Agreement 343
Appendix 10-B Sample Employment Agreement 344
Chapter 11 Practice Ownership: Legal and Business Considerations for the Nurse Practitioner Owner 353
Advantages of Practice Ownership 353
Decisions Before Starting a Practice 354
Business Planning 368
Doing Business 372
Appendix 11-A A Checklist for Setting Up a Practice 383
Appendix 11-B Sample Independent Contractor Agreement 396
Appendix 11-C Sample NP Business Plan 400
Appendix 11-D Sample Professional Services Agreement 415
Chapter 12 Lawmaking and Health Policy 421
The Legal Process 421
The Judicial System 422
Health Policy 422
Laws and Rules That Affect NPs 423
Changing Laws 423
Understanding the Big Picture 423
The Process of Changing the Law 427
Conclusion 433
Chapter 13 Promoting the Profession to the Public 435
Public Relations Steps 435
The Substance of the Message 438
Supporting Data 438
Collecting Impressive Facts 443
Not-So-Impressive Facts About NPs 443
Dealing with the Downside 443
Appendix 13-A A Simple PR Plan for a State NP Organization 445
Appendix 13-B Tips for Promoting a Practice or an Individual NP's Expertise on Social Media 447
Appendix 13-C Some Talking Points for NPs 449
Appendix 13-D Sample Fact Sheet on NPs 451
Chapter 14 Standards of Care for Nurse Practitioner Practice 453
Who Is Monitoring the Standard of Care? 453
How Should NPs Keep Current on Standard of Care? 459
Credentialing 460
NP Competencies 460
Chapter 15 Measuring Nurse Practitioner Performance 463
Measuring Quality 463
Multiple Measures, Multiple Measurers 464
Productivity 464
Housekeeping Performance Measures 465
National Committee for Quality Assurance Measures of Clinical Performance 465
Other Measures 466
Formal Research 466
Patient Ratings 466
Peer Review 467
Utilization 467
How to Get an "A" on Performance Report Cards 467
Ensuring Compliance 468
Appendix 15-A NP Self-Evaluation 469
Appendix 15-B Health Maintenance Flowchart 470
Chapter 16 Resolving Ethical Dilemmas 471
The Basics of Biomedical Ethics 471
Examples 473
Analyzing the Ethical Choices Inherent in These Situations 473
Ethical Analyses 479
Chapter 17 Strategies for Nurse Practitioners 481
Opportunities in a Changing Field 481
Opponents of the See-a-Nurse-First System 482
Challenges for NPs Attempting to Advance the Profession 482
Strategies to Implement Collectively 483
Ten Organizational Strategies 483
Chapter 18 Frequently Asked Questions from Nurse Practioners 491
Index 499