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Jones & Bartlett Learning
Nurse Practitioner's Business Practice And Legal Guide / Edition 5

Nurse Practitioner's Business Practice And Legal Guide / Edition 5

by Carolyn Buppert
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  • 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

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