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Docs: Are You Hiring PAs and NPs Illegally in Your Medical Practice?

As medical practices continue to grow, more and more physicians are finding the need to employ physician assistants (PAs) and nurse practitioners (NPs).

Hospitals are following the trend and adding non-physician providers to their staff.

The need to efficiently provide care to more patients in a day requires more than running an advertisement and hiring the person who appears to be the most personable and qualified. Many other factors need to be considered.

Be certain the rules of the specific state are followed

It is vitally important that physicians know exactly what the law is in their state regarding the job duties of PAs and NPs and how much physician supervision is required. Some states allow PAs and NPs almost unfettered freedom to evaluate, diagnose and treat patients. Others states are more rigid in what the non-physician practitioners are allowed to do without close supervision.

Another aspect of the law that physicians often overlook and that varies by state is the requirement for the physician to have a written agreement with the non-physician provider that defines specifically the job duties of the non-physician as well as how much supervision will be provided by the physician. This is often referred to as a “collaboration agreement.”

Many states require a separate agreement with each category of non-physician provider as well as mandating that copies of the agreements be filed with the state. If non-physicians are authorized to provide prescriptions to patients, proper paperwork granting this authority generally must be filed with the state, and physician oversight is required.

Complying with state law is imperative. Laws change frequently, and different laws may apply to each different type of provider. Specific state laws must be regularly checked to be sure the medical practice is in compliance. A failure to provide the proper oversight, in addition to causing problems due to not obeying the law, may also put the practice at a higher risk for malpractice lawsuits.

Billing requirements must be complied with

Different insurers may require different billing procedures for PAs and NPs. Each specialty practice is unique and has its own rules. All physicians who employ non-physician providers must be aware of the appropriate billing rules for their particular areas of practice. Depending on the service that was provided, there may be rules requiring the physician to be on site to supervise in order to comply with billing requirements.

Physicians and non-physician providers should sign binding employment agreements

No matter how well physicians and their non-physician providers relate to each other, there may come a time when the non-physician leaves the practice. If physicians have not been diligent in requiring written employment agreements with non-compete clauses and prohibitions against soliciting patients, the non-physicians may encourage patients to follow them to their new place of employment.

Physician Billing Services Case Study

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