Help us end the collaborative agreement requirement!!

TheOldGuy · Feb 3, 2011

I don't mean to be rude, but if you want to promote action, you need to be clear and accurate. When you refer to "House Bill", you need to specify for which state. This is not a congressional bill. Congressional bills are identified as H.R.. H.R. 282 is about federal contractors using E Verify for employment verification.

And by the way, it is "legislator" not "legislater". When it comes to political issues - especially in this area where we are claiming equivalency with the medical profession - we need to work extra hard to make sure we are presenting ourselves in the best possible way. Perception is reality. Misspellings, even on this board, make us look bad.

carachel2 · Feb 3, 2011

Won't do it. Will never do it. We don't have the education to back up the independent practice. Do we know enough to do what we do? yes. Do we know enough to be completely independent ? no. Does the public deserve to know we have someone to collaborate with ? Yes

TJFRN · Feb 3, 2011

I believe the poster is referring to FL. I believe FL is 1 of the 2 states that don't allow NP's to write prescriptions for controlled substances.

prairienp · Feb 4, 2011

Won't do it. Will never do it. We don't have the education to back up the independent practice. Do we know enough to do what we do? yes. Do we know enough to be completely independent ? no. Does the public deserve to know we have someone to collaborate with ? Yes

May I suggest you change we to I, there are many who can and do currently practice independently. Working in a rural clinic I have not "collaborated" with a MD in 2 years, in fact, over the past 2 years the MD sends his patients to me when he wont be at the site.

Trauma Columnist · Feb 4, 2011

Can you clarify what state?

Here in IL we are trying to get rid of collaborative agreements too but I'm in the minority and think this isn't needed.

lucianne · Feb 4, 2011

The original poster is referring to Kentucky and HB 282 seeks to remove the collaborative practice agreement for non-scheduled drugs, not controlled substances. Those will still require a collaborative agreement. At least in Kentucky, the essence of the collaborative agreement is that an MD promises to be available to consult with the collaborating NP should the need arise. There is no supervision, no chart or prescription review, no requirement to even contact one another. It is a pretty meaningless document and some NPs have reported that their collaborating physicians are requiring large monthly fees or percentages of gross income to essentially give permission for an NP to practice.

Trauma Columnist · Feb 4, 2011

Thanks for the info. Seems like several states have collaborative agreement issues.

buster4 · Feb 4, 2011

H.B. 282 is under review in Kentucky, I, along with many others, are wanting it to pass. It is surprising to me, but then again it shouldn't, how negative some can be toward others.

TJFRN · Feb 4, 2011

Good luck! :yeah:

Advanced Practice Columnist / Guide · Feb 4, 2011

The original poster is referring to Kentucky and HB 282 seeks to remove the collaborative practice agreement for non-scheduled drugs, not controlled substances. Those will still require a collaborative agreement. At least in Kentucky, the essence of the collaborative agreement is that an MD promises to be available to consult with the collaborating NP should the need arise. There is no supervision, no chart or prescription review, no requirement to even contact one another. It is a pretty meaningless document and some NPs have reported that their collaborating physicians are requiring large monthly fees or percentages of gross income to essentially give permission for an NP to practice.

Thanks for clarifying. However, how would this law bypass the federal requirement imposed by CMS that mandates that in order to bill Medicare and Medicaid, the NP has to have a collaborative agreement with a physician?

carachel2 · Feb 4, 2011

May I suggest you change we to I, there are many who can and do currently practice independently. Working in a rural clinic I have not "collaborated" with a MD in 2 years, in fact, over the past 2 years the MD sends his patients to me when he wont be at the site.

I never said we "can't" do it. I "could" do it but I "won't." I have seen first hand the eduation provided in medical school and then the education provided in NP school (and this is a large, well known state school program with a non-existent fail rate). And NPs who want to "play" MDs are COMPLETELY fooling themselves if think the education is even remotely comparable. We are prepared to do what we do very well, but we are not prepared to be 100% on our own. I'm just one of those who thinks you should go to medical school if you wanted it that way.

So go ahead and do it. That's fine. I just don't think you are prepared properly to do it and I'll always believe that. I would never go to an independent NP provider.