Although the BON has sole authority to establish the qualifications and certification requirements of APNs through R&Rs, the BON and BOME regulate the collaborative practice of physicians with CRNPs and CNMs, requiring them to practice with BON- and BOME-collaborative practice agreements. Major changes to the practice act included removing collaborative agreement requirements, placing the regulation of CNMs and CNPs under the sole jurisdiction of the BON, and modernizing statutory language. Tennessee made substantive change in terminology surrounding the professional relationship between physicians and APRNs for prescriptive services, amending code sections utilizing “supervision” to “collaboration.” Designated responsibilities and relationships between physicians and APRNs were not altered through this legislation; however, changes such as this inform the public about the nature of the relationship between APRNs and physicians in individual states. A BON and BOME joint committee recommends R&R governing the collaborative relationship between physicians, CRNPs, CNMs, and the prescription of legend drugs that may be prescribed by authorized CRNPs and CNMs. Regulations require that an APRN must have a plan for patient consultation and referral, but a physician relationship is not required. BC/BS will reimburse CRNPs and CNMs in collaboration with a preferred physician provider at 70% of the physician rate.
The term collaboration does not require direct, on-site supervision by the collaborating physician. No formal collaboration agreement is required. APRNs are regulated by the Alaska BON, defined in statute, and include CNP, CNS, CNM, and CRNA roles. CRNAs practice under separate BON rules and regulations from the CNP, CNS, and CNM; however, incorporation of all APRN regulations is in process. CNSs and CRNAs are not regulated by the joint committee (BON and BOME) and are not eligible for Rx authority. CRNPs and CNMs in collaborative practice with a physician may prescribe controlled substances in Schedules III, IV, and V pursuant to the rules of the Alabama BOME Chapter 540-X-18. CRNPs and CNMs are required to complete 12 continuing medical education contact hours in advanced pharmacology and prescribing trends and 4 additional contact hours every 2 years for renewal of the Qualified Alabama Controlled Substances Certificate under current regulation for Schedule III-V controlled substance authority.
The CRNP or CNM and collaborating physician shall be present in any approved practice site a minimum of 10% of the CRNP/CNM's scheduled hours if the CRNP or CNM has less than 2 years of collaborative practice experience. CRNPs are required to hold an MSN degree and national certification upon entry into practice with a few exceptions: Initial CRNP applicants are exempt from requirement for MSN at the discretion of the BON if graduation was before 1996 in a post-BSN NP program or graduation before 1984 from a non-BSN program preparing NPs. The Arizona State Legislature grants APRNs authority, and the BON alone regulates their practice. To renew Rx authority, APRNs must complete 12 contact hours of continuing education (CE) in advanced pharmacotherapeutics, including 2 CE hours in opioid prescribing each 2-year renewal cycle. APRNs are defined as APNs in Alabama and include CNP (CRNP in statute), CNS, CNM, and CRNA roles. The CRNP or CNM who is in collaborative practice and has prescription privileges may sign for and dispense approved formulary drugs. Nothing in the law precludes admitting privileges for APRNs. Alaska does not have “any willing provider” language in current law.
The medical professional will need to indicate what physical disability you have. APRNs are further defined as RNs who, due to specialized education and experience, are certified to perform acts of medical diagnosis and prescription as well as dispense medical, therapeutic, or corrective measures under regulations adopted by the BON. CE requirements for APRNs are 30 CE units; 12 of these must be advanced pharmacotherapeutics as well as 12 hours of CE in clinical management of patients every 2 years. Authorized APRNs have independent Rx authority-including Schedules II-V controlled substances-and may apply for DEA registration. If you are wondering who is eligible for handicap placards in PA, note that you will be required to have a qualifying disability that is certified by an approved physician. The collaborating physician. CRNP or CNM must sign written protocols. The Alabama Medicaid Program enrolls and reimburses CRNPs independently pursuant to supervision rules; however, a CRNP who is employed and reimbursed by a facility that receives reimbursement from the Alabama Medicaid program for services provided by the CRNP may not enroll. CRNP SOP is defined in statute and regulation; APNs practice in accordance with national standards and functions identified by the appropriate specialty-certifying agency in congruence with Alabama law.
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