Virginia Regulatory Town Hall

Proposed Text

highlight

Action:
Clarification of requirements for supervision
Stage: Fast-Track
 

18VAC90-40-100. Supervision and site visits.

Physicians A. In accordance with §54.1-2957.01 of the Code of Virginia, physicians who enter into a practice agreement with a nurse practitioner for prescriptive authority shall: 1. Supervise supervise and direct, at any one time, no more than four nurse practitioners with prescriptive authority.

2. Regularly B. Except as provided in subsection C of this section, physicians shall regularly practice in any location in which the licensed nurse practitioner exercises prescriptive authority.

1. A separate practice setting may not be established for the nurse practitioner. Exceptions to this requirement are as follows:

a. A separate office practice may be established for a certified nurse midwife or for a nurse practitioner employed by or under contract with local health departments, federally funded comprehensive primary care clinics, or nonprofit health care clinics or programs.

b. Physicians who do not regularly practice at the same location with the nurse practitioner and who provide supervisory services to such separate practices shall make regular site visits for consultation and direction for appropriate patient management. The site visits shall occur in accordance with the practice agreement, but no less frequently than once a quarter.

3. Conduct 2. A supervising physician shall conduct a monthly, random review of patient charts on which the nurse practitioner has entered a prescription for an approved drug or device.

C. Physicians who practice with a certified nurse midwife or with a nurse practitioner employed by or under contract with local health departments, federally funded comprehensive primary care clinics, or nonprofit health care clinics or programs shall:

1. Either regularly practice at the same location with the nurse practitioner or provide supervisory services to such separate practices by making regular site visits for consultation and direction for appropriate patient management. The site visits shall occur in accordance with the protocol, but no less frequently than once a quarter.

2. Conduct a monthly, random review of patient charts on which the nurse practitioner has entered a prescription for an approved drug or device.

Statutory Authority

§§54.1-2400 and 54.1-2957.01 of the Code of Virginia.

Historical Notes

Derived from VR495-03-1 and VR465-12-1 §3.3, eff. August 15, 1992; amended, Virginia Register Volume 13, Issue 20, eff. July 23, 1997; Volume 19, Issue 7, eff. January 15, 2003; amended, Virginia Register Volume 24, Issue 6, eff. January 11, 2008.