|
Approval
to Practice (Approval
to Practice application)
Prescriptive Authority (DEA#, CS Schedules, Permit
to Dispense)
Reimbursement (Provider Numbers, Medicaid
'Z' Number)
Approval
to Practice
All nurse practitioners must submit an application for what
North Carolina regulations term Approval to Practice.
An application for approval to practice may be obtained from
the NC Board of Nursing (BON) (see below).
Once completed and returned to the BON, applications are reviewed
by members of the Joint Subcommittee of the BON and the NC
Medical Board. As well as approving NP applications, this
six-member group (three from nursing and three from medicine)
is responsible for promulgating new NP rules and regulations.
To find the next Joint Subcommittee meeting, contact the BON
(see below). This information and directions may also be obtained
from the NC Medical Board (see below).
The medical members of the Joint Subcommittee will review
NP applications at the meetings of the NC Medical Board. NP
applications are due into the BON office 45 days prior to
these meeting dates.
NC Board of Nursing
Phone: 919-782-3211 (Extension 252 for Approval to Practice application.)
Email: email@ncbon.com
Website: www.ncbon.org
NC Medical Board
Phone: 919-828-1212
Email: info@ncmedboard.org
Website: www.ncmedboard.org
Prescriptive
Authority
North Carolina nurse practitioners have had prescriptive authority
since NC statutes were amended to recognize NP practice in
1970. A formulary was used until 1994. At that time, the NP
rules were amended to allow drugs and devices to be prescribed
according to a drug and device agreement mutually
agreed upon by an individual NP (or group of NPs in the same
practice) and her/his primary supervising physician. This
change was intended to allow NPs to customize what drugs and
devices would be used in their particular practice setting.
NPs may also prescribe controlled drugs from Schedule II-III
for up to a 30 day supply with no refills, and from Schedule
IV and V with refills of up to one year (see link to Schedules
below). Prescribing controlled drugs requires a DEA number that can be obtained from the regional office of the Drug
Enforcement Agency located in Greensboro, NC (see below).
Dispensing drugs at your practice site requires a Permit
to Dispense from the NC Board of Pharmacy (see below).
Drug Enforcement Agency
Phone: 336-547-4219 (Call for DEA number.)
Website is for general information only: www.deadiversion.usdoj.gov
NC Board of Pharmacy
Phone: 919-942-4454
Website: www.ncbop.org
Reimbursement
North Carolina law has mandated the reimbursement of nurse
practitioners, certified nurse midwives and psychiatric-mental
health clinical nurse specialists by indemnity insurance plans
since 1994. Managed care companies were not addressed in this
legislation. In 2001, NC Session Law 1001-446, known as the Patients' Managed Care Bill of Rights, provided for
reimbursement to nurse practitioners, as advanced practice
nurses, for services given within their scope of practice.
In the case of managed care plans that require the use of
network providers, the NP must be within the network to receive
reimbursement. Upon written request of the supervising physician,
NPs, as primary care providers, are eligible for inclusion
in managed care network provider directories.
In spite of this law, NPs are still being denied access to
network or out-of-network panels by managed care companies.
If you have been denied the opportunity to apply for a managed
care company panel, please let us know by sending an email
to NCNA.
Medicare
Medicare has directly reimbursed NPs since January 1998 as
part of the Balanced Budget Act of 1997. NPs are reimbursed
at 85% of physician fee schedule for a covered service.
To obtain a Medicare Provider Number, contact Cigna
at the regional office in Tennessee (1-615-782-4509).
Cigna is the Medicare carrier for North Carolina.
Medicaid
Medicaid directly reimburses North Carolina NPs at 100% of
the physician fee schedule if they are self-employed.
To obtain a Medicaid Provider
Number, contact the NC Medicaid Provider Enrollment Section
at 919-855-4057.
To allow pharmacists to fill prescriptions for patients on
Medicaid, a 'Z' number is needed. UPIN numbers are no longer
used.
To obtain a 'Z' Number, call 919-855-4302.
Contact person is Lisa Week.
|
