PMID: 7033348Jan 1, 1981Paper

Nurse practitioner reimbursement

Journal of Health Politics, Policy and Law
S Wriston

Abstract

The Rural Health Clinics Act demonstrates the current trend in reimbursement of nurse practitioners: Congress intends to move slowly and continuously with mid-level practitioner reimbursement, limiting NP practice first to rural underserved areas, and reimbursing at a cost-related rate to avoid unnecessarily inflating costs. The Act's recognition of the NP as a reimbursable provider of traditional medical services, needing only indirect supervision, is important, especially with regard to the mandatory Medicaid coverage of "rural health clinic services." All states which do not explicitly prohibit NPs have been affected by this mandate, precipitating state legislative efforts to more clearly define NP scope of practice. There is still a need to clarify the ambiguity surrounding NP Medicaid reimbursement policies; Medicaid plans are frequently not well coordinated with nurse practice statutes. Altering third-party payor practices to permit reimbursement for services of nurse practitioners would alleviate some of the current restrictions on NP practice. However, medical society opposition also plays a significant role in such restriction. Antitrust courts, free of the tremendous lobbying power of medical interest groups, may be a...Continue Reading

Citations

Jan 1, 1987·Social Science & Medicine·N Campbell-Heider, D Pollock
Mar 17, 1999·Clinical Nurse Specialist CNS·L C Price, P A Minarik
Jan 1, 1992·Journal of the American Academy of Nurse Practitioners·J S Dempster
Jan 1, 1990·Journal of Professional Nursing : Official Journal of the American Association of Colleges of Nursing·C L Scott, O A Harrison
Dec 1, 1983·Law, Medicine & Health Care : a Publication of the American Society of Law & Medicine·N Baker
Jan 1, 1986·Journal of Professional Nursing : Official Journal of the American Association of Colleges of Nursing·L N Andrews

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