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. “Fee-splitting” can occur when a NP shares his or her practice income or fees with a physician who is not the PI`s employer. “Fee-splitting” also includes agreements or arrangements whereby the NP pays the assisting physician a sum of money that represents or otherwise depends on a percentage of the PI`s income or income in exchange for the services of the cooperating physician. For example, if an NP pays 20% of the PI`s professional income to the cooperating physician (who works in a separate medical practice) in exchange for the services of the cooperating physician, the NP and the physician are likely engaged in illegal “fee-splitting.” Full practical independence has long eluded the NPs of New York. The requirements for NPs in New York previously required an NP opening their own practice to enter into a written practice agreement with a physician, which was considered by many NPs only to be a continuation of a regulatory agreement. But in 2014, the Nurse Practitioner Modernization Act was passed by New York City. Although it is scheduled to expire in June 2021, it has initiated the new compromise of the less restrictive cooperative relationship between an experienced IP and one or more of the doctors mentioned above. Every nurse (NP) must enter into a written cooperation agreement with a physician to practice. Concerted practice agreements contain provisions that address the following: Questions about collaborative practice agreements and practice protocols can be forwarded to the Office of the Nursing Council by email [email protected] or by phone at 518-474-3817, ext. 120, or by fax at 518-474-3706. It is not the responsibility of the Office of the Nursing Council to interpret the laws that govern the financial relationship between NPs and cooperating physicians.
The New York State Education Act requires all registered nurses to practice in accordance with written practice protocols and a written practice agreement with a cooperating physician, unless the NP practices and has collaborative relationships as permitted by law and as further described in Section III, “Collaborative Relationships”, below. Newly certified NPs are NOT required to file Form 4NP with the New York State Department of Education (SED) “Verification of Collaboration Agreement and Practice Protocol” if the NP chooses to practice and maintain cooperative relationships in accordance with the new law. A copy of the Collaborative Practices Agreement should be kept in NP practice environments and made available to the New York State Department of Education (SED) for review. The following is a copy of a sample agreement (20 KB) that you can use as a template. Nurse practitioners (NPs) are required to practice according to written protocols that reflect the practice specialties in which the NP is certified. Protocols should also reflect current and recognized medical and nursing practice. Additional protocols in sub-specialized areas (i.e., hematology, orthopedics, dermatology) adapted to the practice of PI can be used, but do not need to be taken into account in the collaborative practice agreement. The New York State Education Act defines “collaborative relationships” as when an NP communicates by telephone, in person, in writing or electronically with a physician qualified to work in the specialty in question, or in the case of a licensed health facility, communicating with a physician who is qualified to work in a specialty and who has privileges in such a health facility, exchange information in order to ensure comprehensive care or transfer.
if need be. NPs who see patients in an outpatient clinic or clinic do not have as much independence. For example, during the first 3600 hours of practical work and the 36 months of their career, they must be directly supervised by a doctor. After that, New York NPs can be employed by doctors in their offices, with doctors ultimately remaining responsible for the overall care of the patient; or they open their own offices and see their own patients, but they still need to work with one or more doctors. .
