Today's Law As Amended

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SB-491 Nurse practitioners.(2013-2014)

As Amends the Law Today


 Section 2835.3 is added to the Business and Professions Code, to read:

 (a) Notwithstanding any other provision of this chapter, a nurse practitioner who holds a certification as a nurse practitioner from a national certifying body may practice under this section without physician supervision if the nurse practitioner
has practiced under the supervision of a physician for at least 4160 hours and is practicing in one of the following:
(1) A clinic, health facility, or county medical facility.
(2) An accountable care organization, as defined in Section 3022 of the federal Patient Protection and Affordable Care Act (Public Law 111-148).
(3) A group practice, including a professional medical corporation, another form of corporation controlled by physicians and surgeons, a medical partnership, a medical foundation exempt from licensure, or another lawfully organized group of physicians that delivers, furnishes, or otherwise arranges for or provides health care services.
(b) Notwithstanding any other law, in addition to any other practices authorized in statute or regulation, a nurse practitioner practicing under this section may do any of the following:
(1) Order durable medical equipment. Notwithstanding that authority, nothing in this paragraph shall operate to limit the ability of a third-party payer to require prior approval.
(2) After performance of a physical examination by the nurse practitioner, certify disability pursuant to Section 2708 of the Unemployment Insurance Code.
(3) For individuals receiving home health services or personal care services, approve, sign, modify, or add to a plan of treatment or plan of care.
(4) Assess patients, synthesize and analyze data, and apply principles of health care.
(5) Manage the physical and psychosocial health status of patients.
(6) Analyze multiple sources of data, including patient history, general behavior, and signs and symptoms of illness, identify alternative possibilities as to the nature of a health care problem, and select, implement, and evaluate appropriate treatment.
(7) Establish a diagnosis by client history, physical examination, and other criteria, consistent with this section.
(8) Order, furnish, or prescribe drugs or devices.
(9) Refer patients to physicians or other licensed health care providers as provided in subdivision (c).
(10) Delegate tasks to a medical assistant that are within the medical assistant’s scope of practice.
(11) Perform additional acts that require education and training and that are recognized by the board as proper to be performed by a nurse practitioner.
(12) Order hospice care as appropriate.
(13) Perform procedures that are necessary and consistent with the nurse practitioner’s education and training.
(c) A nurse practitioner shall refer a patient to a physician and surgeon or another licensed health care provider if a situation or condition of the patient is beyond the nurse practitioner’s education or training.
(d) A nurse practitioner practicing under this section shall maintain professional liability insurance that is appropriate for his or her practice setting.
(e) Nothing in this section shall do either of the following:
(1) Limit a nurse practitioner’s authority to practice nursing.
(2) Limit the scope of practice of a registered nurse authorized pursuant to this chapter.
(f) The board shall adopt regulations by July 1, 2015, establishing the means of documenting completion of the requirements of this section.
(g) A nurse practitioner practicing pursuant to this section shall not supplant a physician and surgeon employed by a health care facility specified in paragraph (1) of subdivision (a).
SEC. 2.
 No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.