Finding a Collaborating Physician in New Jersey
The regulatory landscape for Nurse Practitioners (NPs) is complex and evolving. However, Zivian was created to handle all the challenges of finding a collaborating physician so that you can focus on providing care. If you are an NP trying to find a collaborating physician in New Jersey, Zivian has you covered.
New Jersey requires nurse practitioners to have a collaborating physician. New Jersey’s regulatory structure is Reduced Practice Authority.
In this post, we break down state regulations and key considerations to establish a meaningful collaboration with a physician in the Garden State.
Note: State regulations and requirements are subject to change. Always check with your state medical or nursing board to confirm the most up-to-date information.
What Is the Practice Environment for NPs in New Jersey?
In which category does the state fall: NP independent practice, transition to independence, or collaboration required?
A NP must have a collaboration with a physician for prescriptive authority.
Delegation Authority and Process
Is a collaboration agreement required?
Yes, the collaboration agreement is called a “joint protocol.”
What form of agreement is required and what are the requirements for the substance of the agreement?
Contact our team to learn the required components of a New Jersey collaboration agreement.
Where must the agreement be stored?
The agreement must be maintained on the premises of every office in which the APRN practices.
Does the agreement need to be filed with the state?
There is no requirement.
Are there requirements to file the agreement after the initial filing (e.g., for updates or on a specified frequency)?
There is no requirement.
Who must sign the agreement?
The nurse practitioner and the collaborating physician must sign the agreement.
How often must the agreement be reviewed / reauthorized?
The agreement must be updated on an ongoing basis to reflect changes in the practice, office personnel, skills of the APRN, frequency of record review, and reference materials containing practice guidelines or accepted standards of practice and reviewed at least on an annual basis.
What are the qualifications for the collaborating provider (licensure, same scope, active practice in state, etc.)?
The collaborating provider must be a physician. No other requirements are specified.
What are the qualifications for the NP?
No requirements are specified.
Is an alternate collaborating physician required?
No, an alternate collaborating physician is not required.
Collaboration Requirements
Are there ratios / limits on the number of NPs that a collaborator may supervise or enter into collaboration agreements?
There is no requirement.
Is there an express requirement to review a certain number/percentage of charts?
Charts and patient records must be periodically reviewed by the collaborating physician and APRN, but no frequency is defined.
Is there a requirement to meet and, if so, how often and how?
There is no requirement.
Are there proximity requirements (e.g., between the NP / collaborator or practice site)?
There is no requirement.
Are there location-specific requirements (e.g., that collaborator must go to practice site at some frequency)?
There is no requirement.
Is remote supervision allowed / are there limitations on remote supervision?
Remote supervision not prohibited. The physician must be present or readily available through electronic communications in order for an NP to order medications.
Physician and NP Filing Requirements
Outside of filing the collab agreement, must the physician and/or NP file any separate forms (e.g., notice of delegation of prescriptive authority, notice of collaboration, notice to PDMP, etc.)?
There is no requirement.
Prescription Requirements and Controlled Substance Prescribing
What are the prescription requirements?
General details on prescription requirements are included below. However, please note that not all requirements are included. To learn the full spectrum of prescription and controlled substance prescribing requirements, contact the Zivian team.
An NP shall include the following information on each prescription blank issued:
The prescribing advanced practice nurse's full name, designation, that is, APN, address, telephone number, and certification number;
The full name, date of birth and address of the patient;
The date of issuance;
The name, strength, route and quantity of the medication prescribed;
The number of refills permitted or time limit for refills, or both;
A handwritten, original signature;
An explicit indication, by initials placed next to "do not substitute," if a specified brand name drug is to be dispensed;
The full name, title, address, telephone number, and license number of the collaborating physician;
Words, in addition to numbers, to indicate the drug quantity authorized if the prescription is for a controlled dangerous substance, for example: "ten (10) Percodan" or "five (5) Ritalin 5 mg"; and
If the prescription is for a controlled dangerous substance, the advanced practice nurse's DEA number and instructions as to the frequency of use.
An APRN who prescribes medication or devices shall advise patients by a sign or pamphlets in the waiting room of the office, that a patient may request a generic drug as a substitute for a brand name drug prescribed.
Each prescription for a controlled dangerous substance shall be written on a separate New Jersey Prescription Blank.
An APRN may prescribe medications and devices in all other medically appropriate settings, subject to the following conditions:
The collaborating physician and advanced practice nurse shall address in the joint protocols whether prior consultation with the collaborating physician is required to initiate a prescription for a controlled dangerous substance;
The prescription is written in accordance with standing orders or joint protocols developed in agreement between a collaborating physician and the APRN, or pursuant to the specific direction of a physician;
The APRN writes the prescription on a New Jersey Prescription Blank pursuant to P.L.2003, c.280 (C.45:14-40 et seq.), signs the nurse’s own name to the prescription and prints the nurse’s name and certification number;
The prescription is dated and includes the name of the patient and the name, address, and telephone number of the collaborating physician;
The physician is present or readily available through electronic communications;
The charts and records of the patients treated by the advanced practice nurse are periodically reviewed by the collaborating physician and the APRN;
The joint protocols developed by the collaborating physician and the APRN are reviewed, updated, and signed at least annually by both parties; and
The APRN has completed six contact hours of continuing professional education in pharmacology related to controlled substances, including pharmacologic therapy, addiction prevention and management, and issues concerning prescription opioid drugs, including responsible prescribing practices, alternatives to opioids for managing and treating pain, and the risks and signs of opioid abuse, addiction, and diversion, in accordance with regulations adopted by the New Jersey Board of Nursing. The six contact hours shall be in addition to New Jersey Board of Nursing pharmacology education requirements for advanced practice nurses related to initial certification and recertification of an APRN as set forth in N.J.A.C. 13:37-7.2.
For more information, contact our team.
What are the requirements for controlled substance prescribing?
General details on prescription requirements are included below. However, please note that not all requirements are included. To learn the full spectrum of prescription and controlled substance prescribing requirements, contact the Zivian team.
When prescribing, dispensing, or administering controlled dangerous substances, an APRN shall:
Take a thorough medical history of the patient which reflects the nature, frequency, and severity of any pain, the patient's history of substance use or abuse, and the patient's experience with non-opioid medication and non-pharmacological pain management approaches;
Conduct a physical examination, including an assessment of physical and psychological function, and an evaluation of underlying or coexisting diseases or conditions;
Access relevant prescription monitoring information as maintained by the Prescription Monitoring Program (PMP) pursuant to N.J.S.A. 45:1-46.1 and consider that information in accordance with N.J.A.C. 13:45A-35;
Develop a treatment plan, which identifies the objectives by which treatment success is to be evaluated, such as pain relief and improved physical and psychological function, and any further diagnostic evaluations or other treatments planned, with particular attention focused on determining the cause of the patient's pain; and
Prepare a patient record that reflects the medical history, the findings on examination, any relevant PMP data, and the treatment plan, as well as:
The complete name of the controlled substance;
The dosage, strength, and quantity of the controlled substance; and
The instructions as to frequency of use.
With respect to Schedule II controlled dangerous substances, unless the prescribing of opioids is subject to limitations as set forth below, an APRN may authorize a quantity, not to exceed a 30-day supply, which shall be at the lowest effective dose as determined by the directed dosage and frequency of dosage.
More prescription and controlled substance prescribing requirements can be found via N.J.A.C. 13:37-7.9A. To learn more, contact the Zivian team.
Sources
N.J.A.C. 13:35-6.6.
N.J.A.C. 13:37-7.9
N.J.A.C. 13:37-7.9A
N.J. Stat. § 45:11-49
N.J. Stat. § 45:11-49.2
