The Nurse Practitioner's Business Practice
and Legal Guide
by Carolyn Buppert, CRNP, JD
ISBN #: 0-8342-1185-8
List Price: $82.00
Publication Date: Jan 1999
Publisher: Aspen Publishers, Inc.
State-by-state law, with citations, on scope of practice, prescriptive authority, necessity of physician collaboration and qualifications to practice as an NP.
Advice on lobbying and public relations in order to change state laws where necessary.
Strategies to avoid malpractice and other lawsuits, with case examples.
Practical, up-to-date, business-oriented guidance on negotiating positions with practices, or starting your own practice.
And much, much more.
The first comprehensive business and legal resource written specifically for nurse practitioners.
Make no mistake about it. Laws governing NP practice are distinct from the laws governing registered nurses, physicians and physician assistants. You need legal guidance and business solutions specifically for NPs - not RNs, PAs, or physicians. The Nurse Practitioner's Business Practice and Legal Guide focuses -- specifically and in-depth -- on the legal and business issues that NPs face.
Written by a nurse practitioner who is also a practicing attorney, this book provides the unique point of view of an author who knows what legal and business problems arise on a daily basis. Buppert draws her knowledge from the law, actual legal cases, and her own personal experience in starting and operating her business, and assisting NPs in setting up their own practices.
"This book is excellent - it presents the issues facing nurse practitioners nationwide. In hopes of surviving the ever changing and competitive managed care arena, NPs could easily use this book as a staple for graduate school and continue to use it as NPs chip away at issues at the state and Federal level. I have already recommended this book to many NPs nationwide."
Margie Koehler, CRNP
American College of Nurse Practitioners
"This is the most comprehensive book that I have seen. It is also unique to see this material targeted to the nurse practitioner. This book is obviously of interest to any nurse practitioner, and to many others, because it is such a clear and comprehensive resource."
Nayna Campbell Philipsen, Esq
Expert guidance from attorney/nurse practitioner Carolyn Buppert…
Carolyn Buppert, MSN, JD, ANP is uniquely qualified to provide expert, practical business and legal guidance to NPs, prospective NPs, and those who would employ them. She currently maintains a legal practice specializing in legal and business issues in primary care. She is president of Better Life in Health Care Systems, which contracts with businesses for NP services. She also practices as an NP as Director of Student Health at St. John's College in Annapolis, MD.
Here is a complete Table of Contents
Chapter 1: What Is a Nurse Practitioner?
- Definition of Nurse Practitioner
- A Nurse Practitioner, By Any Other Name
- Services Provided by NPs
- Preparation and License Requirements
- Areas of Practice
- Legal History of NPs
- NPs in Primary Care
- NP versus PA: What's the Difference?
- NP versus Physician: What's the Difference?
- NP versus RN: What's the Difference?
- NP versus CNS: What's the Difference?
- Where do Nurse Practitioners Practice?
- Appendix: State-by-State Definitions of Nurse Practitioner
- Appendix: State-by-State Titles for NPs
Chapter 2: Legal Scope of Nurse Practitioner Practice
- Professional Association Definition of Scope of Practice
- Statutory vs. Regulatory Scope of NP Practice
- Physician Challenges to NPs' Scope of Practice
- Need for Clarity of Scope of Practice
- NP Scope of Practice Compared to RN Scope of Practice
- NP and MD Scope of Practice Compared
- Mandated Physician Involvement with NP Practice
- Appendix: State Laws Defining NPs' Scope of Practice, State by State
- Appendix: State-by-State Requirements of Physician Collaboration, If Any
Chapter 3: State Regulation of NP Practice
- How Laws about NP Practice Evolve
- What Is Regulated
- Appendix: Agency That Regulates NPs, State by State
- Appendix: Nurse Practitioner Qualifications Required by Law, State by State
Chapter 4: Federal Regulation of NP Practice
- Nursing Homes
- In Office and Hospital Lab Under CLIA
- Self-Referral by Health Care Providers, under the Stark Acts
- Prescription of Controlled substances under the DEA
- Reporting to the National Practitioner Data Bank
- Patient Confidentiality
- Discrimination in Hiring and Firing
- People with Disabilities under the ADA
- Appendix: Documentation Guidelines for Evaluation and Management Services
Chapter 5: Prescribing
- Controlled Substances
- Guidelines for Prescribing Legally
- Appendix: State-by-state law on Prescriptive Authority
Chapter 6: Hospital Privileges
- Are Hospital Privileges and Issue for NPs?
- Do PCPs Need Hospital Privileges?
- What if Health Plans Require PCPs To Have Admitting Privileges?
- Do NPs Need Hospital Privileges for Advancement of the Profession?
- Who Has Hospital Privileges?
- Does Federal Law Support Full Hospital Privileges for NPs?
- What Does it Mean to Have Hospital Privileges?
- Levels of Privilege
- The Application Process
- Denial of Privileges
- Expect Change
Chapter 7: Negligence and Malpractice
- What Can Happen to an NP Who Is Sued?
- Life Cycle of a Lawsuit
- What Is Malpractice?
- Elements of Malpractice
- Examples of Lawsuits Against NPs
- The National Practitioner Data Bank
- Working with Practice Guidelines
- How to Prevent Lawsuits
- What To Do If Sued
- Liabilities of Collaborating Physician
- Malpractice Insurance
Chapter 8: Risk Management
- Risk of Making a Clinical Error
- Risk of Being Sued When There Was No Clinical Error
- Risk of Public Perception That the Individual NP Is a Poor-Quality Provider
- Risk of Breaching Patient Confidentiality
- Risk of Violating Patient's Right to Informed Consent
- Risk of Negligent Nondisclosure
- Risk of Poor Quality Ratings
- Risk of Disciplinary Action
- Risk of Medicare Fraud
- Business Risk Management
- Dealing with High-Risk Patients
Chapter 9: Reimbursement for NP Services
- Indemnity Insurers
- Managed-Care Organizations
- Direct Contracts for Health Services
- Billing Third-Party Payers
- Billing Self-Paying Patients
- Appendix: Credentialing Information
Chapter10: The Employed NP
- What Rights Does an Employed NP Have?
- Does an NP need a Contract?
- Three Difficult Clauses
- How to Negotiate a Reasonable Agreement
- Responsibilities of a NP Employee
- Employer's Evaluation of the NP's Performance
- Malpractice Insurance
- Collaborative Practice Agreements
- Appendix: Sample Nurse Practitioner Consultation Practice Agreement
- Appendix: Sample Employment Agreement
Chapter 11: Practice Ownership: Legal and Business Considerations for the Nurse Practitioner Owner
- Advantages of Practice Ownership
- What Is Stopping NPs?
- Decisions Before Starting a Practice
- Business Planning
- Doing Business
- Appendix: Checklist for Setting Up a Practice
- Appendix: Independent Contractor Agreement
- Appendix: Professional Services Agreement
- Appendix: Sample Business Plan
Chapter 12: Lawmaking and Health Policy
- The Legal Process
- The Judicial System
- Health Policy
- Laws and Rules Which Affect NPs
- Changing Laws
- Understanding the Big Picture
- The Process of Changing the Law
Chapter 13: Promoting the Profession to the Public
- Public Relations Steps
- Setting the Goal
- Developing the Plan
- Developing the Budget
- Working the Plan
- The Substance of the Message
- Supporting Data
- Collecting Impressive Facts
- Present Barriers to Fact Collection
- Not-So-Impressive Facts About NPs
- Dealing with the Downside
- Appendix: Some Talking Points for NPs
- Appendix: Sample Fact Sheet on NPs
Chapter 14: Standards of Care for NP Practice
- Definition of Standard of Care
- Who is Monitoring Standard of Care?
- How Should NPs Keep Current on Standard of Care?
Chapter 15: Measuring NP Performance
- Measuring Quality
- Multiple Measures, Multiple Measurers
- Housekeeping Performance Measures
- NCQA Measures of Clinical Performance
- Other Measures
- Formal Research
- Patient Ratings
- Peer Review
- How to Get an "A" on Performance Report Cards
- Ensuring Compliance
- Appendix: NPs' Self Evaluation
- HEDIS-Based Health Maintenance flowchart for Ages 18 and Over
Chapter 16: Strategies for Advancing the Profession
- Opportunities in a Changing Field
- Opponents of a See-a-Nurse-First System
- What Are the Challenges for NPs Attempting To Advance the Profession?
- Strategies To Implement Collectively
- Ten Strategies
Updated October 2, 2001
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