Nurses/Allied Professionals

nurseNelson Hardiman represents nurses, nurse practitioners, physician assistants, dental hygienists, paramedics and other ancillary health care providers. To meet the need for improved access to healthcare, patients are increasingly encountering “practitioner extenders.” The roles and scopes of practice for these professionals are expanding and the regulatory demands are always changing. For example, On Oct. 6, 2015, California Gov. Jerry Brown signed a bill into law that changes documentation requirements for Physician Assistants in California. Senate Bill (SB) 337, adds flexibility to the patient chart co-signature requirements that will allow for a reduction in the number of charts that are required to be co-signed by a physician.

The bill creates two new alternatives to the previous 5 percent monthly chart co-signature requirement when practicing with protocols. The first option allows PAs to have a minimum of 10 cases reviewed through medical records review meetings that occur during at least 10 months of the year.  The second new option requires a review of at least 10 records per month for 10 months during the year using a combination of countersignature and the medical records review meeting documentation methods. The medical records review meetings may occur in person or by electronic communication.

The bill also reduces the state’s Schedule II chart co-signature requirement from 100 percent to 20 percent for PAs that have completed a controlled substance course as outlined in California regulations.

Along with these expanded roles and requirements, comes enhanced scrutiny by regulatory agencies, licensing boards, insurance companies, and the Centers for Medicare and Medicaid Services.  Nelson Hardiman counsels and assists nurses, nurse practitioners, physician assistants and other ancillary healthcare practitioners across a wide range of business, regulatory, and strategic challenges, including:

  • Business Transactions
    • Formation of professional corporations
    • Formation of management companies
    • Healthcare provider contracts
    • Managed care network contracts
  • Regulatory Defense
    • Medical Board and Board of Registered Nursing investigations and defense
      • Medical negligence
      • DUI and substance abuse
      • Record-keeping
    • Reimbursement audits and investigations by governmental payors
  • Compliance
    • Stark and Anti-Kickback Statute Compliance
    • Medicare and Medi-Cal compliance
    • HIPAA and state patient data privacy and security requirements
    • Scope of Practice
      • Physician supervision
      • Procedures and protocols
  • Litigation
    • Licensure defense and appeals
    • Medicare and Medi-Cal provider enrollment appeals
    • Payor and reimbursement disputes
    • Overpayment appeals
    • False Claims Act/qui tam whistle-blower litigation defense
    • Business and employment litigation
    • Medicare and Medi-Cal exclusions and suspensions