np supervision inpatient cms requirements?

[nexus73]

I work in a state that allows nps to practice without physician supervision. But our hospital requires a physician supervisor, at least on paper. Current policies for psych nps don't require co-signing of notes or orders, but the supervising physician must be available or designate another physician to be available to respond if needed by the np.

Are there federal rules, or cms rules, that require a physician presence for inpatient care, or could the hospital do away with the supervision requirement?

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[comp1]

As far as I know...this is a state issue and in your particular case, it appears to be even more a hyperlocal hospital issue. I know when the VA granted NPs full independent practice rights, each hospital had to update their bylaws and SOPs. NPs can bill Medicare independently when their state allows independent practice. What you're describing seems like a sort of soft consultation availability. It's a good recognition that NPs typically have less training and experience than the average MD in a given specialty. It's always good practice to have someone available for consultation on more complicated cases. This wouldn't have anything to do with CMS.

 

[PikminOC]

Hospitals need someone to supervise them. So they have someone to throw under the bus.

And they make more money I think billing incident to physician then on their own.

 

[deleted1100659]

I work in a state that allows nps to practice without physician supervision. But our hospital requires a physician supervisor, at least on paper. Current policies for psych nps don't require co-signing of notes or orders, but the supervising physician must be available or designate another physician to be available to respond if needed by the np.

Are there federal rules, or cms rules, that require a physician presence for inpatient care, or could the hospital do away with the supervision requirement?

I would assume that its their choice and they could in theory have NPs without supervision, as its regulated by state medical boards and the rules vary by state.

I agree that, the act of being a supervisor on paper provides them with the perfect scapegoat if something goes wrong. Think about it, with no physician supervisor, who are they acting under? The hospital administration/hospital itself. It provides them more of a buffer, because now the argument becomes "well, Dr. X is their supervisor, why didn't he catch this??". Easy way to shift blame.

Though im sure they sell it as a way to improve care and make sure a higher standard of care is given, I believe its more of a way for them to further minimize liability.

 

[FlowRate]

I'd imagine it reduces insurance costs for the hospital.