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Ordering Health Care Services
Re: Ordering Home Health |
Q: One of my Medicaid patients needed home health care for personal assistive services. Unfortunately, they said my collaborating physician had to sign the orders before my patient could receive the needed nursing care. Can't APNs sign orders for home health care?
A: No. Once again the regulations are lagging behind practice. Nurse practitioners may be primary care providers for Medicaid patients, but current Medicaid rules still require a physician referral for many health care services. This answer is also the same for Medicare patients.
The Health & Human Services Commission is responsible for writing the rules that govern the Texas Medicaid program, and 1 TAC §354.1035 (a)(1)specifies that a physician must order home health services. Although CNAP makes many requests to update Medicaid rules to be consistent with current laws on APN practice, this is one rule that cannot be changed until federal law is changed to allow NPs and CNSs to order home health for Medicare clients. Please be sure to support national efforts to change federal law. In the meantime, physicians must sign orders for any home health care services. |
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© 2006 Coalition for Nurses in Advance Practice
P.O. Box 5047; Austin • Texas 78763-5047 • 512-469-7882
www.cnaptexas.org
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