The Nurse Practitioners Modernization Act will become law as part of the 2014-2015 enacted budget. The NPMA takes effect on January 1, 2015. This is a tremendous step forward that advances greater patient access to care and recognizes the important role that Nurse Practitioners play as independent, autonomous healthcare professionals in New York State.
The new law is a result of coordinated efforts with the Governor, the Senate and the Assembly, as well as the NPA leadership and volunteers. Nurse practitioners have been lobbying lawmakers for independence for nearly a decade, winning the battle with the adoption of the bill in this year's state budget. This new law removes the requirement of a written practice agreement between an experienced nurse practitioner as a condition of practice.
HIGHLIGHTS OF THE NEW LAW
Newly licensed Nurse Practitioners with less than 3,600 hours of practice continue to be subject to current requirements, including:
Maintaining a Written Practice Agreement (WPA) signed by the NP and physician
Identifying practice protocols approved by the State Education Department
For Nurse Practitioners with greater than 3600 hours of practice, regardless of the NP's specialty:
No signed written practice agreement is required
No practice protocols need to be identified
NP shall maintain collaborative relationships
Are consistent with Medicare's billing requirement about NPs and collaboration
In New York, this means:
NP communicates with licensed physician(s) as needed OR a Hospital that provides services through licensed physicians qualified to collaborate in the specialty involved and having privileges at such institution:
By phone or in writing
To exchange information (two way street)
In order provide comprehensive patient care make referrals as necessary
SED Attestation Form (To be developed prior to January 1st, 2015):
An attestation form will be maintained in the NP's files, and is NOT filed with SED. The NP attests that they hold one or more collaborative relationships (Law does not require identifying physician names/license numbers and no signatures are required
Will include a dispute resolution process
Dispute resolution process is established by NP and physician, but, if conflict, physician prevails (consistent with existing law. The NP always has the option of consulting with another physician).
The NPA intends on working with SED on the form development
NPs also to maintain evidence of such collaborative relationships:
For example, throughout the course of a patient encounter, should the NP need to consult with a physician, the NP may document the discussion in the patient record. This is one form of evidence of a collaborative relationship.
This type of record keeping is not required for all encounters, only necessary for purposes of showing compliance with requirement of "collaborative relationships," as needed.
NP to produce attestation form/collaborative relationship evidence upon SED's request:
Failure to do so is considered professional misconduct
This is consistent with midwives' statute
There will be Data Collection and a Report on the NP Profession Issued:
SED to collect data about profession and availability of NPs as part of triennial certification process
Similar to physician data collection
De-identified information posted to website
SED to issue the report to the Legislature by September 1, 2018
NPMA Effective Date:
January 1, 2015
NPMA will expire on June 30th, 2021, in order to provide opportunity to revisit, and determine further expansions
This is NOT a demonstration project.
The NPA will continue to work with all stakeholders throughout the time period to recommend enhancements as needed.