NEWS THAT AFFECTS PRACTICE

Tamper-resistant law, set forth August 17, 2007:

State Medicaid Director Letter states that prescriptions must contain at least one of the three tamper-resistant characteristics in order to be considered "tamper resistant" in the first phase of the program. For the second phase, prescriptions must contain all three characteristics.

Tamper resistant prescription characteristics:

1) one or more industry-recognized features designed to prevent unauthorized copying of a completed or blank prescription form;

2) one or more industry-recognized features designed to prevent the erasure or modification of information written on the prescription by the prescriber;

3) one or more industry-recognized features designed to prevent the use of counterfeit prescription forms.

On Saturday, September 29, 2007, President Bush signed the "Extenders Law," delaying the implementation date for all paper Medicaid prescriptions to be written on tamper-resistant paper. This established a six-month delay for the tamper-resistant prescription pad program (TRPP) for Medicaid prescriptions drugs. Georgia Medicaid will not implement the TRPP before March 2008.

For more information please visit the Centers for Medicare and Medicaid Services link: http://www.cms.hhs.gov/SMDL/downloads/SMD081707.pdf

NPI Numbers

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers. Covered health care providers and all health plans and health care clearinghouses will use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). This means that the numbers do not carry other information about healthcare providers, such as the state in which they live or their medical specialty. Beginning May 23, 2007 (May 23, 2008, for small health plans), the NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions.

If you are a health care provider who bills for services, you probably need an NPI. If you bill Medicare for services, you definitely need an NPI! Getting an NPI is easy. Getting an NPI is free. The first step is to get your NPI. If you delay applying for your NPI, you risk your cash flow and that of your health care partners as well.

Simply log onto the National Plan and Provider Enumeration System (NPPES) and apply online.

School Physicals

We really didn’t win this battle but we can now perform school/sports physicals as long as a physician signs off on the form. We will have to revisit this issue at a later date.

The GHSA (Georgia High School Association) passed some changes to their by-laws that allow Nurse Practitioners to conduct sports physicals but still require a doctor's signature. This signature can be in the form of a scripted stamp as long as identifying physician info is on the sports physical form.

Summary of the Revised By-law Changes
Georgia High School Athletic Association Bylaws:
1.41 (b) The physical exam must be conducted by a licensed medical physician or doctor of Osteopathic medicine, or a physician's assistant, or "nurse practitioner" (the new addition)
1.41 (c) The exam must be signed by a doctor, but the doctor's stamp is acceptable if it is in script, and if information appears elsewhere on the form identifying him/her as a medical doctor.
1.41 (d) The GHSA requires that member schools use the latest edition of the preparticipation physical evaluation form approved by the American Academy of Pediatrics, et al., that is found in the "GHSA Forms Notebook

Licensing Issues

In Georgia the Secretary of State handles licensing of all professionals following the guidelines as set forth by each board. Click here to apply for a license, check the status of an application, apply for a replacement license or change your address. You have 30 days to change your address with the board once you relocate, even if you stay in the state of Georgia.

Malpractice Insurance

This is an excellent article to read if you have any questions about your own personal need for malpractice insurance.
Questions and Answers on Malpractice Insurance for Nurse Practitioners
Posted 02/03/2006
Carolyn Buppert, NP, JD

NSO Nurses Service Organization: Nurse Practitioners, Nurse Practitioner Students
800-247-1500

CM&F Group, Inc.
800-221-4904

Mass Mutual

Reimbursement

Information to apply for participation in 3rd party reimbursement:

Georgia Medicaid



Alabama Medicaid Provider Enrollment
Provider Enrollment Phone Numbers: 888-223-3630 (AL, FL, GA, MS and TN)

Florida Medicaid Enrollment
Reimbursement to Georgia Providers who care for Florida Pediatric Medicaid Recipients

North Carolina Medicaid Provider Enrollment

South Carolina Medicaid Provider Enrollment

Tennessee Medicaid Provider Enrollment: 800-852-2683

Medicare Provider Enrollment

Blue Cross Blue Shield of Georgia

Blue Cross Blue Shield of Alabama

Blue Cross Blue Shield of Florida

Blue Cross Blue Shield of North Carolina

Blue Cross Blue Shield of South Carolina

Blue Cross Blue Shield of Tennessee

Blue Cross Blue Shield Federal

TRICARE Provider Enrollment

Certification

Certified Nurse Midwife:
ACNM Certification Council
If you were certified before January 1, 1996 your certificate has no expiration date and is valid for life. However, if you were certified after January 1, 1996 your certificate is valid for eight years. (866) 366-9632 or (410) 694-9424.

Nurse Practitioner/ Clinical Nurse Specialist:
ANCC
Toll Free: 800-284-2378
Recertification every 5 years. Certification for Nurse Practitioners, Clinical Nurse Specialists, other advanced practice and basic specialties.

Nurse Practitioners:
American Academy of Nurse Practitioners
Phone: 512-442-5202

Pediatric Nurse Practitioners:
Pediatric Nursing Certification Board
Toll Free: 888-641-2767
If you'd like to become a CPN® or Primary Care CPNP® using the Exam by Endorsement option, please bear in mind that this eligibility pathway closes March 31, 2008. All ANCC certified applicants wishing to be considered for this pathway must apply by this date.

Nurse Anesthetists:
Council on Certification/Recertification of Nurse Anesthetists
Phone: 847-692-7050
The Council on Certification of Nurse Anesthetists (CCNA) and the Council on Recertification of Nurse Anesthetists (COR) have formed the separately incorporated National Board on Certification and Recertification of Nurse Anesthetists ( NBCRNA ).

Free Journals and Reference Material

NPPR Nurse Practitioners’ Prescribing Reference
Toll Free: 800-436-9269
Quarterly lab pocket sized prescribing reference.

Clinician Reviews
Toll Free: 800-480-4851
Peer-Reviewed journal for NP’s and PA’s.

Clinical Advisor
Toll Free: 800-430-5450

Consultant
Toll Free: 800-280-0628
Peer-Reviewed consultations in primary care.

The American Journal for Nurse Practitioners
Phone: 609-371-5085
The official journal for nurse practitioners, peer-reviewed.

Nurse Practitioner World News
Phone: 609-371-5085
The official news publication of nurse practitioners.

JNP The Journal for Nurse Practitioners
Toll Free: 800-654-2452
The official journal of the American College of Nurse Practitioners.

Advance for Nurse Practitioners
Phone: 610-278-1400 The source for peer-reviewed clinical and professional information.

Free CEU’s

National Diabetes Education Initiative

Medscape from webmd

2006 Psychiatric Congress Online Symposium

Prescription Assistance Programs

AstraZeneca

DuraMed Pharmaceuticals, Inc.

Eli Lilly and Company

Glaxo-Smith-Kline

Johnson & Johnson

Novo Nordisk

Ortho-McNeil

Pfizer/Parke-Davis

Solvay Pharmaceuticals

Wyeth Pharmaceuticals Inc.

Needymeds.com

Discount Prescription Cards and Programs: