Posted October 28, 2009
Legislation that went into effect on Sept. 1 will enable better patient access and more streamlined NP practice in Texas. SB 532, sponsored by Sen. Dan Patrick and Rep. Garnet Coleman, made the following changes to "physician alternative practices":
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The requirement for a physician to be on site 20% of the time is reduced to 10%.
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An alternative practice site may be up to 75 miles from the primary practice site, an increase from 60 miles.
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The physician-NP supervisory ratio increases from 3:1 to 4:1.
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Chart review may be done electronically from a remote location.
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NPs and PAs can now write prescriptions for controlled substances lasting up to 90 days, an increase from 30 days.
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A waiver process can be used to increase the practice ratio to 6:1, to modify or eliminate the mileage limitation, or to modify other elements of the on-site practice requirements, provided that a means for off-site collaboration and communication is still provided.
The Convenient Care Association (CCA), which represents operators of convenient care clinics, worked with the Texas Medical Association and other healthcare groups to promote this bill. Tine Hansen-Turton, executive director of the CCA, commented: "As an industry we felt that in a state such as Texas, with barriers to access and where approximately 25% of the population is uninsured, any unnecessary limitations on healthcare practice, especially for nurse practitioners, who serve a critical role, should be reexamined."
The bill is not a solution to all access issues in Texas, said Hansen-Turton, but it eases both the practical and administrative effects of current policy in Texas.
"Texas was considered one of the most costly states to operate in based on the former law, so we expect the bill will have a promising impact on the growth of existing and new clinics in the state, including employment opportunities for NPs," she added.
Four operators of convenient care clinics - MinuteClinic, RediClinic, Take Care and CHRISTUS Medical Group in Walmart - will now be better able to provide patients with the care they need.
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