Nurse Practitioner's Business Practice And Legal Guide / Edition 4

Nurse Practitioner's Business Practice And Legal Guide / Edition 4

by Carolyn Buppert
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Jones & Bartlett Learning
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Nurse Practitioner's Business Practice And Legal Guide / Edition 4

Nurse Practitioner’S Business Practice And Legal Guide, Fourth Edition Lays A Solid Foundation Of Knowledge Upon Which Students Can Build 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.

Product Details

ISBN-13: 9780763799748
Publisher: Jones & Bartlett Learning
Publication date: 04/04/2011
Edition description: 4
Pages: 520
Product dimensions: 7.00(w) x 10.10(h) x 1.30(d)

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

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