Finding a Collaborating Physician in Pennsylvania
For nurse practitioners (NPs) aspiring to establish their practice in the Pennsylvania, finding the right collaborating physician is a pivotal step towards professional growth and success.
Pennsylvania is a Reduced Practice Authority state and a collaborating physician is required for NPs.
Navigating the process of identifying a suitable collaborating physician can be both challenging and rewarding. We’ve created a guide for identifying and establishing a compliant collaboration with a physician in the Keystone 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.
The Importance of NP-Physician Collaboration in Pennsylvania
Pennsylvania's healthcare landscape is diverse, and the choice of a collaborating physician can significantly impact a nurse practitioner's ability to provide high-quality care.
Compliant healthcare collaborations ensure a seamless integration of skills, knowledge, and experience, ultimately benefiting patients. By working together, NPs and Physicians can leverage their unique expertise to provide comprehensive and patient-centered care.
Collaborative models improve efficiency of healthcare delivery, promote better outcomes, and addresses the diverse needs of the population. In Pennsylvania, where healthcare demands are dynamic, a harmonious partnership between NPs and Physicians can be critical for navigating complex medical scenarios, promoting preventive care, and contributing to an integrated healthcare system that prioritizes patient well-being.
What Is the State Practice Environment for NPs in Pennsylvania
In which category does the state fall: NP independent practice, transition to independence, or collaboration required?
A collaboration is required. Pennsylvania is classified as a Reduced Practice Authority state.
Delegation Authority and Process
Is an agreement required?
A written and signed Prescriptive Authority Collaborative Agreement (included in NP Application for Prescriptive Authority) is required. Collaboration is required for most functions at the top of an NP’s license, but an agreement is only associated with an application for prescriptive authority.
What form of agreement is required and what are the requirements for the substance of the agreement (is use of state template required?)
The Prescriptive Authority Collaborative Agreement must include:
Identities of the NP, collaborating physician, and at least one substitute collaborating physician;
The specialty in which the NP is certified;
The categories of drugs from which the NP may prescribe or dispense;
The circumstances and how often the collaborating physician will personally see the patient; and
A specification of the amount of professional liability insurance that covers the NP.
Where must the agreement be stored?
The agreement must be kept at the primary practice location of the NP.
Does the agreement need to be filed with the state?
Yes, a copy should be filed with the Bureau of Professional and Occupational Affairs.
Are there requirements to file the agreement after the initial filing (e.g., for updates or on a specified frequency)?
The NP shall notify the Board, in writing, whenever a prescriptive authority collaborative agreement is updated or terminated, and, when appropriate, shall file the ‘‘Change of Prescriptive Authority Collaborative Agreement’’ form, the amended prescriptive authority collaborative agreement with the Board, and pay the fee associated.
To change collaborating physician, a NP must first submit a form to terminate existing Prescribing Authority Collaborative Agreement to the Board of Nursing, then file a new NP Application for Prescriptive Authority.
Who must sign the agreement?
The NP and the collaborating physician.
How often must the agreement be reviewed/reauthorized?
The Agreement must be reviewed and updated by the parties at least once every two (2) years or whenever the agreement is changed.
What are the required qualifications for the collaborating provider (licensure, same scope, active practice in state, etc.)?
The physician must be licensed in Pennsylvania.
What are the required qualifications for the NP?
See licensure requirements here: Certified Nurse Practitioner PA Licensure Requirements
Is an alternate collaborating physician required?
At least one alternate supervising physician is 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?
The supervising physician must cosign records “when necessary to document [shared] accountability” for patients seen by both providers during consultation or referral.
Is there a requirement to meet and, if so, how often and how?
No requirement.
Are there proximity requirements (e.g., between the NP/collaborator or practice site)?
No requirement.
Are there location-specific requirements (e.g., that collaborator must go to practice site at some frequency)?
No requirement.
Is remote supervision allowed/are there limitations on remote supervision?
Remote supervision is permitted, provided the supervising physician is immediately available “through direct communications or by radio, telephone or telecommunications” and the team has a predetermined plan for emergency services.
Prescription Requirements and Controlled Substance Prescribing
What are the prescription requirements?
Prescriptions issued by a NP must bear the name, title, and Pennsylvania NP certification number of the NP. When appropriate, the NP’s National Provider Identifier number must also appear on the prescription. Prescriptions may not be pre-signed.
What are the requirements for controlled substance prescribing?
There are specific requirements set forth in 49 Pa. Code § 21.284b including an initial evaluation, reevaluations, patient counseling, and recording in the medical record.
Find a Collaborating Physician with Zivian Health
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Sources
Pennsylvania Department of State: Application Forms and Information
