The NPA has recently learned that a Mental Health Agency has been fined by the State of New York's Medicaid program for permitting a Nurse Practitioner to sign outpatient psychiatric treatment plans. Even though the NP is certified in the specialty of psychiatry and otherwise qualified to do so, both Federal & State Statute specify that outpatient psychiatric treatment plans require a physician signature as referenced under 42CFR 440.90(a) and 14 NYCRR Section 587.16(e)(1). In this instance, it is our understanding that the NP had been instructed by her employer to sign the treatment plans and reassured that such action was legal.

The NPA continues to make both the ACNP and AANP aware of the need to amend Federal Statute to permit qualified NPs to sign outpatient psychiatric treatment plans. In the interim, it remains important to remind members that you must be conscious of your legal scope at all times and not rely upon any employer to direct your practice. Common practices that are performed at the request of an employer may be inconsistent with statute/regulation and ultimately result in a penalty/fine or state disciplinary action as was the case here.

Should you have any questions, please feel free to contact the NPA office at 518-348-0719 or by email at info@thenpa.org.

Sincerely,

Seth Gordon
President & CEO