Published Apr 9, 2014
I am scheduled to see patients without a provider on the premises at a clinic where I work. Where do I find California law regarding having clinics being open without a provider on the premises - I thought it was illegal due to the fact it puts patients and facility at risk for liability, let alone the risk to myself and the one other front office staff member. That particular day I will be bringing patients back to see the psychologist via telemed (TV). I would like to find proof that it is not standard practice.
Thank you for your support, it is much appreciated.
This is what happened here, not quite the same as your situation, but thought I'd share. Former Fulton doctor, office manager charged with defrauding Medicare after he moved to Vegas | syracuse.com
CrunchRN, ADN, RN
Would you be billing medicare for services?
Well possibly, however the parient(s) will be in the office to see a Dr. of Psychology over the TV (telemed). But there will be no provider physically here if something goes wrong (heart attack, stroke, compative patient, allergic reaction, etc).
You cannot bill medicare without a provider present normally. Liability wise you shouldn't give injections/meds etc without a provider present. You can do routine nurse visit stuff though. Does the practice have an attorney (believe me they do). I would want to get an opinion from them about whether or not you can safely and legally do this without a provider on site. Also, need to make sure complying with medicare requirements and any california requirements. Talk with your practice manager so they can help figure all that out.
If people do have stroke/heart attack etc you would just call 911 and give supportive care. You are not required to have a provider physically present in the office unless you are performing certain procedures and for some billing instances. If the video provider is legally providing care that may take care of the billing issue. It is a complicated question.
Thank you for your information. It is very hard to find a clear cut answer as there are thousands of laws. I have searched the AMA, CA Medial Board, and Telemed.gov sites, even the nursing board site. It is impossible to get a definitive answer just by reading through never ending legal information that never hits on the point. Yes, I thought of talking to a lawyer, but I'm sure my employer would not appreciate me contacting their lawyer, and I did send an email to the Director of Clinics only to not get a response - I got the hint he does not want an issue over it. I do have a final step that I think I will get an answer.
I now beleive, as well, that it is okay that I see patients as long as nothing invasive is done. It could be more of a liability for the organization and less likely for me. Though my concern is not just about me, but is for everyone as a whole.
Thank you for your interest and help!!!
It is tough. I wish you the best.
Esme12, ASN, BSN, RN
Telemed TV is used frequently. I suggest contacting BON this can be tricky.
Legal Considerations for Nurses Practicing in a Telehealth Setting
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