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This was part of a msg I got on my vm at work just before knockoff.

I was ordering home health for a patient of mine to have a visiting nurse come and assess and treat a decubitus ulcer. The msg stated that I as an "assistant" I couldn't sign those orders....I tried calling her back but she's gone for the day.

 

So in Cali, I can write for schedule drugs but apparently not for home health...

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Is this the real law, did you follow up?

 

I haven't really looked into it but I'm going to call her Monday to have her clarify...

What's weird is I give them (the actual visiting nurses) orders over the phone all the time and I identify myself as a PA all the time, and that seems to be ok.

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I run into this ALL the time. It's a medicare rule apparently for home health that all orders be written by a physician. And there has to have been a face to face visit within the past 90 days or the upcoming 30 days. And it's not just in CA.

 

So yes, apparently you can order schedule II meds but you can't order home health.

 

 

I have no idea whether the rule is the same for NPs.

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I run into this ALL the time. It's a medicare rule apparently for home health that all orders be written by a physician. And there has to have been a face to face visit within the past 90 days or the upcoming 30 days. And it's not just in CA.

 

So yes, apparently you can order schedule II meds but you can't order home health.

 

 

I have no idea whether the rule is the same for NPs.

 

My SP had a NP before me, who I replaced. I'll ask him Monday if the last guy had the same restrictions

 

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I'm pretty sure it's a medicare rule. I ran across this a few weeks ago while my SP was out of town. So the chart sat for a week, after they returned it saying it had to be signed by the "attending physician".

 

I wondered what happened in cases where there is no on sight physician? But I guess EMR and chart reviews make that easier.

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http://www.pahpm.com/

 

[h=2]Act Now!

Advocate for PAs in Hospice Care[/h]The Medicare Hospice Care Access Act, HR 3831, was introduced to the U.S. House of Representatives by Reps. Lee Terry (R-NE) and Mike Thompson (D-CA) on January 25, 2012. HR 3831 allows for Physician Assistants to provide hospice care to Medicare Beneficiaries.

However, more supporters are needed in order to continue moving this bill forward this year. In order to secure cosponsors for HR 3831, please tell your legislator about the important role of PAs in hospice medicine! Call your legislator's district or the Washington, DC office and ask to speak to the health staff. Additionally, send an email through the Legislative Action Center. For more information and to find information for your legislator, follow the link below:

http://www.capwiz.com/aapa/issues/alert/?alertid=60807531

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I'm pretty sure it's a medicare rule. I ran across this a few weeks ago while my SP was out of town. So the chart sat for a week, after they returned it saying it had to be signed by the "attending physician".

 

I wondered what happened in cases where there is no on sight physician? But I guess EMR and chart reviews make that easier.

 

I wonder about this too since my SP is not always on site. We have EMR but the intake forms for the visiting nurses must be wet signed. I spoke to the admitting nurse and she was very apologetic and stated that it was her company's policy based on medicare guidelines. Oh well hopefully this changes soon.

 

BTW NPs cant sign them either...

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