Nurse Practitioner Collaborative Agreement Template

Posted April 11th, 2021 by admin

Newly certified nurses must submit the New York State Education Department`s (SED) Form 4NP-Verification of Collaborative Agreement and Practice Protocol within 90 days of starting professional practice. The NP is not required to submit additional 4PPs with the SED. A completed 4NP form does not correspond to a common practice agreement. Form 4 NP can be downloaded from the SED website by clicking here. After the New York State Education Law 6902, a nurse (NP) diagnoses diseases and physical conditions and implements therapeutic and corrective measures in a practical specialty. This law requires the NP to practice in collaboration with a physician qualified for cooperation in the NP specialty and in accordance with a written practice agreement and written practice protocols. A „fee split“ can occur when an NP shares its income or practice expenses with a physician who is not NP`s employer. „royalty splitting,“ an agreement or agreement whereby the MNP pays the cooperating physician an amount that depends on a percentage or other part of the NP`s income or income in exchange for the benefits of the cooperating physician, or otherwise dependent on it. For example, if an NP pays 20% of the NP`s professional income to the cooperating physician (who works in a separate medical practice) in exchange for the cooperating physician`s benefits, the NP and the physician are likely to practice an illegal „tariff split.“ A copy of the cooperation agreement must be kept within the practical parameters of NP and made available to the New York State Education Department (SED) for consultation.

Here is a copy of an example of a cooperation agreement (20 KB) that you can use as a template. Many NPNs work for two or more health care providers or in an institution with patients cared for by several different physicians. The SED does not necessarily require that NP enter into several cooperation agreements in such situations. For example: any nurse (NP) must enter into a written cooperation agreement with a doctor in order to practice. Cooperation agreements include provisions that deal with cooperation agreements and practical protocols can be nursebd@nysed.gov by email or phone at 518-474-3817 ext. 120 or by fax at 518-474-3706. It is not the jurisdiction of the Office for the Interpretation of Financial Relations Laws between NPNs and cooperating physicians. Nurses (PNN) are required to practice in accordance with written protocols that reflect the department (s) of the practice in which the PNP is certified.

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