Discuss the importance of lifelong learning for the APN. (This may be required for negotiations for continue education monies and time).
Nursing
Reimbursement Issues and RealitiesBecause much of the funding
for hospitals and much of the reimbursement for office practice
comes from Medicare, federal statutes and regulations and policies
from the Center for Medicare and Medicaid Services (CMS) have great
impact on the interest of hospitals and medical practices in having
NP providers. For example, the Social Security Act, which governs
Medicare and Medicaid, was written in 1965, before there were NPs.
The Act frequently uses the word “physician” as if there were no
other healthcare provider. Other healthcare providers have had to
get acts of Congress to be included in the laws governing Medicare.
The Act has been amended many times since the 1960s, but some
relevant portions of the Act remain that give permission to
physicians and only physicians to provide care. NPs made progress
in 1997 when an act of Congress authorized NPs to be reimbursed
directly for the care of Medicare patients (Buppert).1. Research
the reimbursement realities in your state.2. What is required to
get reimbursed by Medicare, Medicaid and private Insurances.3. How
do you apply for provider status?Page 5Marketing, Negotiating and
Developing APN roles1. Research the requirements for an independent
APN practice in your state2. Discuss what should be included in a
contract that you negotiate for a APN position.3. Note if your
state requires a collaborative or supervisory physician and what
type of agreement would be required in these cases.4. Review the
circumstances when a collaborative agreement would be required.5.
Discuss what should be included in a collaborative agreement in
your state (many times defined by your state statutes).Page
6Lifelong learning and the APN1. Discuss the importance of lifelong
learning for the APN. (This may be required for negotiations for
continue education monies and time).2. Discuss important ethical
issues that you anticipate to be a part of your APN practice.3.
Reflect on how you will apply Research to the health delivery
system you will be working within and your APN practice.
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