Ask the expert: How independently from physicians can APPs work?
Credentialing Resource Center Connection, May 4, 2010
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Legally, this independence level varies from state to state. It is also important to note that just because a physician assistant, for example, may have prescribing authority, the hospital is not required to exercise that scope of his or her authority. Advance practice professional (APP) professional organizations are lobbying state and federal governments for greater recognition for their work and for more clinical independence. In Virginia, for example, physical therapists have the authority to see patients without physicians’ orders. In West Virginia, nurse practitioners are considered primary care practitioners within the HMO setting. In 2001, the Centers for Medicare & Medicaid Services published a rule that allowed state governors to allow certified registered nurse anesthetists (CRNAs) to administer anesthesia care to Medicare patients without physician supervision.
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