There are a variety of New York and federal laws that affect financial relationships between physicians. Certain types of financial relationships between registered nurses and cooperating physicians are prohibited by the Education Act or the Malpractice Regulations (see, for . B, the Education Act § 6513, 8 NYCRR § 29.1) or other state or federal laws. If a joint practice is voluntarily terminated by one of the parties, the physician is responsible for notifying the Medical Association within 14 days. Many cooperating doctors are concerned about liability. Because if a nurse makes a mistake and is sued for professional misconduct, the doctor supervising her could also be sued. The determination is not based on the number of people. The board limits a physician to supervise a total of 360 full-time equivalent (FTE) hours per week by mid-level physicians. Mid-level practitioners include CRNPs, NCM and MAs. County and state health departments are exempt from this rule. Please contact our office if you have any further questions about this. The Council of Medical Examiners and the Nursing Council jointly approve applications for approval of collaborative practices between qualified physicians and RNPs and/or NJCs. Here we describe the specifics of cooperation agreements for nuclear power plants and the most important protective measures for doctors and ODs who wish to sponsor a nuclear power plant.

Once you have found an employee, you will need to formalize your relationship in writing with a cooperation agreement. Many state nursing offices or state professional care associations can provide model cooperation agreements. To practice medicine with full authority to assess, diagnose, treat, and prescribe medications, many states require some level of medical supervision for nurses. The level of oversight required varies from state to state, ranging from regular in-person meetings to case review quotas, prescription and protocol reviews, and may be a temporary requirement before full practice authority (three years, a certain number of clinical hours) or an ongoing requirement for state approval is met. Scope of practice laws are those passed by state governments that regulate nurse practitioners in one of three ways: How will you set minimum standards for consultation between the nurse/senior physician or support physician(s), as described in the quality assurance standards of a cooperation agreement? How and what will your documentation contain? For nurses looking for a multi-state license, or for doctors interested in working with a nurse, navigating the regulatory landscape and government oversight rules can be overwhelming. Nurses who provide virtual care should be aware that, depending on where they practice and the services they provide, they may need medical supervision to treat patients. Laws vary, so it`s important to make sure you comply with your state`s regulations. By finding a cooperating physician, establishing a cooperative agreement, and ensuring that the physician has adequate liability protection, NPs are well positioned to set up a successful virtual practice.

There is no renewal of cooperation agreements. The parties are required to notify their respective licensing bodies when an agreement is terminated. Initial application forms for cooperation agreements are available from the Nursing Council. A cooperation agreement usually includes the following information: As with most health professions, there is a lot of paperwork that comes with practicing as a nurse. NPs must obtain national certification as well as state approval to practice. In addition, an NPI number and registration documents are required for nurses to bill insurers. In some places, NPs have even more coordination, as the state`s scope of practice laws require additional documentation to meet the requirements of practice. Such a document is a cooperation agreement. In order for clinicians to access a steady stream of virtual care consultations, it is often necessary to purchase multiple government licenses.

But for NPs, the power of practice varies from state to state, with some states allowing treatment and prescribing with an independent authority and others restricting the practice of NP through mandatory medical surveillance and cooperation through so-called collaborative practice agreements. Supervisory relationships are a necessary step for nurses who want to work in virtual care across many state borders. Learn more about the Collaboration Agreement with NP Physicians and how to configure it securely and compliantly. The fee for a physician who begins a collaborative practice is $200. The scope of practice laws may, for example, prohibit nuclear power plants from prescribing controlled substances. Or these laws may require nurses to complete a certain number of hours of medical training to practice. The most common requirement in state scope of practice laws is that NPs work with a physician or practice under the supervision of a physician. The specifics of these laws vary from state to state. Restricted practice: The nurse is not allowed to participate in one or more elements of clinical practice, and medical supervision is required for patient care. Word of mouth is often one of the best ways to find a collaborative relationship. Many nurses find physician employees through employee referrals and other working relationships, post requests on social media groups, attend in-person and virtual industry events, join networking groups, and make connections via LinkedIn. Reduced practice: The nurse can provide certain services independently and must have a cooperative agreement with a physician for other elements of patient care.

NPs can refer patients to their cooperating physician if medically necessary, provided the NP does not receive anything in exchange for the referral. New York law does not require that a cooperation agreement include a payment provision. Over the past decade, the nursing workforce has more than doubled, in response to the industry`s growing focus on primary care and a growing shortage of doctors. While most NP workplaces are focused on hospitals, doctors` offices, and ambulatory care centers, the explosion of more accessible and affordable virtual care has led to significant opportunities for NPs to work in telemedicine. No cooperation agreement can effectively cover all clinical situations. Therefore, the joint practice agreement should not and should not be a substitute for the practice of professional judgment by the nurse. There are situations that affect patient care, both ordinary and unusual, that require the individual exercise of the nurse`s clinical judgment. Registered nurses are required to practice according to written protocols that reflect the areas of expertise of the practice in which the NP is certified. Protocols should also reflect current and recognized medical and nursing practice. Additional protocols in sub-specialized areas (hematology, orthopedics, dermatology) suitable for the practice of NP may be used, but should not be reflected in the cooperation agreement. While the exact requirements of a collaborative relationship vary from state to state, some level of medical involvement or surveillance is required for the NP to provide clinical care.

A copy of the cooperation agreement must be kept in np practice environments and made available to the New York State Department of Education (SED) for inspection. The following is a copy of a sample agreement (20 KB) that you can use as a template. Questions regarding cooperation agreements and practice protocols can be directed to the Nursing Council Office by email at or by calling 518-474-3817 ext. . . .