Bill Text: MS HB1170 | 2016 | Regular Session | Introduced
Bill Title: Nurse practitioners; specify practice setting in which not required to be within certain distance of physician's office.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Failed) 2016-02-23 - Died In Committee [HB1170 Detail]
Download: Mississippi-2016-HB1170-Introduced.html
MISSISSIPPI LEGISLATURE
2016 Regular Session
To: Public Health and Human Services
By: Representative Currie
House Bill 1170
AN ACT TO AMEND SECTION 73-25-35, MISSISSIPPI CODE OF 1972, TO SPECIFY THE TYPES OF SETTINGS IN WHICH CERTIFIED NURSE PRACTITIONERS MAY PRACTICE UNDER THE GENERAL SUPERVISION OF A LICENSED PHYSICIAN UNDER A COLLABORATIVE RELATIONSHIP THAT IS APPROVED BY THE STATE BOARD OF MEDICAL LICENSURE WITHOUT A REQUIREMENT TO BE A CERTAIN DISTANCE FROM THE PRIMARY OFFICE OF THE COLLABORATIVE PHYSICIAN; TO PROVIDE THAT IF A PROPOSED WRITTEN PRACTICE COLLABORATIVE AGREEMENT FOR THE PRACTICE OF A CERTIFIED NURSE PRACTITIONER WITH A LICENSED PHYSICIAN IN A MANAGED CARE SETTING FOR MEDICAID BENEFICIARIES IS DENIED BY THE BOARD OF MEDICAL LICENSURE, THE CERTIFIED NURSE PRACTITIONER SHALL HAVE THE RIGHT TO APPEAL THE DECISION DISAPPROVING THE COLLABORATIVE AGREEMENT TO THE DIVISION OF MEDICAID, AND THE DIVISION SHALL BE AUTHORIZED TO APPROVE THE COLLABORATIVE AGREEMENT FOR THE PRACTICE OF THE CERTIFIED NURSE PRACTITIONER; TO AMEND SECTION 73-15-20, MISSISSIPPI CODE OF 1972, TO CONFORM TO THE PRECEDING PROVISION; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. Section 73-25-35, Mississippi Code of 1972, is amended as follows:
73-25-35. Registered nurses
who are licensed and certified by the Mississippi Board of Nursing as nurse
practitioners * * * shall be authorized to practice
under the general supervision of a licensed physician under a collaborative
relationship as described in Section 73-15-20 that is approved by the State
Board of Medical Licensure in which patients are treated by the nurse
practitioner without a requirement to be a certain distance from the primary
office of the collaborative/consultative physician in the following settings:
(a) Emergency rooms;
(b) Intensive care units;
(c) Labor epidural services on obstetrical suites;
(d) State Department of Health services;
(e) State Department of Mental Health services and community mental health center services; and
(f) Federally funded health systems, including Federally Qualified Health Centers (FQHCs), Veterans Affairs Medical Centers (VAMCs) and Rural Health Clinics (RHC).
If a proposed written practice collaborative agreement for the practice of a certified nurse practitioner with a licensed physician in a managed care setting for Medicaid beneficiaries is denied by the State Board of Medical Licensure, the certified nurse practitioner shall have the right to appeal the decision disapproving the collaborative agreement to the Division of Medicaid within thirty (30) days of the decision of denial, and the division shall be authorized to approve the collaborative agreement for the practice of the certified nurse practitioner.
SECTION 2. Section 73-15-20, Mississippi Code of 1972, is amended as follows:
73-15-20. (1) Advanced practice registered nurses. Any nurse desiring to be certified as an advanced practice registered nurse shall apply to the board and submit proof that he or she holds a current license to practice professional nursing and that he or she meets one or more of the following requirements:
(a) Satisfactory completion of a formal post-basic educational program of at least one (1) academic year, the primary purpose of which is to prepare nurses for advanced or specialized practice.
(b) Certification by a board-approved certifying body. Such certification shall be required for initial state certification and any recertification as a registered nurse anesthetist, nurse practitioner or nurse midwife. The board may by rule provide for provisional or temporary state certification of graduate nurse practitioners for a period of time determined to be appropriate for preparing and passing the National Certification Examination. Those with provisional or temporary certifications must practice under the direct supervision of a licensed physician or a certified nurse practitioner or certified nurse midwife with at least five (5) years of experience.
(c) Graduation from a program leading to a master's or post-master's degree in a nursing clinical specialty area with preparation in specialized practitioner skills.
(2) Rulemaking. The board shall provide by rule the appropriate requirements for advanced practice registered nurses in the categories of certified registered nurse anesthetist, certified nurse midwife and advanced practice registered nurse.
(3) Collaboration. An advanced practice registered nurse shall perform those functions authorized in this section within a collaborative/consultative relationship with a dentist or physician with an unrestricted license to practice dentistry or medicine in this state and within an established protocol or practice guidelines, as appropriate, that is filed with the board upon license application, license renewal, after entering into a new collaborative/consultative relationship or making changes to the protocol or practice guidelines or practice site. The board shall review and approve the protocol to ensure compliance with applicable regulatory standards. The advanced practice registered nurse may not practice as an APRN if there is no collaborative/consultative relationship with a physician or dentist and a board-approved protocol or practice guidelines. The protocol or practice guidelines shall be subject to the provisions of Section 73-25-35.
(4) Renewal. The board shall renew a license for an advanced practice registered nurse upon receipt of the renewal application, fees and protocol or practice guidelines. The board shall adopt rules establishing procedures for license renewals. The board shall by rule prescribe continuing education requirements for advanced practice nurses not to exceed forty (40) hours biennially as a condition for renewal of a license or certificate.
(5) Reinstatement. Advanced practice registered nurses may reinstate a lapsed privilege to practice upon submitting documentation of a current active license to practice professional nursing, a reinstatement application and fee, a protocol or practice guidelines, documentation of current certification as an advanced practice nurse in a designated area of practice by a national certification organization recognized by the board and documentation of at least forty (40) hours of continuing education related to the advanced clinical practice of the nurse practitioner within the previous two-year period. The board shall adopt rules establishing the procedure for reinstatement.
(6) Changes in status. The advanced practice registered nurse shall notify the board immediately regarding changes in the collaborative/consultative relationship with a licensed physician or dentist. If changes leave the advanced practice registered nurse without a board-approved collaborative/consultative relationship with a physician or dentist, the advanced practice nurse may not practice as an advanced practice registered nurse.
(7) Practice requirements. The advanced practice registered nurse shall practice:
(a) According to standards and guidelines of the National Certification Organization.
(b) In a collaborative/consultative relationship with a licensed physician whose practice is compatible with that of the nurse practitioner. Certified registered nurse anesthetists may collaborate/consult with licensed dentists. The advanced practice nurse must be able to communicate reliably with a collaborating/consulting physician or dentist while practicing.
(c) According to a board-approved protocol or practice guidelines.
(d) Advanced practice registered nurses practicing as nurse anesthetists must practice according to board-approved practice guidelines that address pre-anesthesia preparation and evaluation; anesthesia induction, maintenance, and emergence; post-anesthesia care; peri-anesthetic and clinical support functions.
(e) Advanced practice registered nurses practicing in other specialty areas must practice according to a board-approved protocol that has been mutually agreed upon by the nurse practitioner and a Mississippi licensed physician or dentist whose practice or prescriptive authority is not limited as a result of voluntary surrender or legal/regulatory order.
(f) Each collaborative/consultative relationship shall include and implement a formal quality assurance/quality improvement program which shall be maintained on site and shall be available for inspection by representatives of the board. This quality assurance/quality improvement program must be sufficient to provide a valid evaluation of the practice and be a valid basis for change, if any.
(g) Nurse practitioners may not write prescriptions for, dispense or order the use of or administration of any schedule of controlled substances except as contained in this chapter.
(8) Prescribing controlled substances and medications. Certified nurse midwives and certified nurse practitioners may apply for controlled substance prescriptive authority after completing a board-approved educational program. Certified nurse midwives and certified nurse practitioners who have completed the program and received prescription authority from the board may prescribe Schedules II-V. The words "administer," "controlled substances" and "ultimate user," shall have the same meaning as set forth in Section 41-29-105, unless the context otherwise requires. The board shall promulgate rules governing prescribing of controlled substances, including distribution, record keeping, drug maintenance, labeling and distribution requirements and prescription guidelines for controlled substances and all medications. Prescribing any controlled substance in violation of the rules promulgated by the board shall constitute a violation of Section 73-15-29(1)(f), (k) and (l) and shall be grounds for disciplinary action. The prescribing, administering or distributing of any legend drug or other medication in violation of the rules promulgated by the board shall constitute a violation of Section 73-15-29(1)(f), (k) and (l) and shall be grounds for disciplinary action.
SECTION 3. This act shall take effect and be in force from and after July 1, 2016.
