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The Pediatric Forum |

Melding Fields of Care—Reply

Birt Harvey, MD
Arch Pediatr Adolesc Med. 2001;155(6):740. doi:10.1001/archpedi.155.6.739.
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Nurse practitioners play a valuable role in the care of children. They work with pediatricians in hospitals, including NICUs and pediatric ICUs, physician offices, hospital-based clinics, schools, and public health settings. By definition, NPs are registered nurses with a minimum of 9 months advanced training beyond the 2 years required for basic nursing education. Most have considerably more training, and many have a master's degree.

Dr Byrne's concern is the "Citizens' Petition," which she believes will limit the role of NPs. This petition, signed by 33 national medical and surgical specialty and subspecialty organizations—among them, the American Medical Association, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, AAP, the American Psychological Association, and the American College of Physicians—asks that HCFA implement a system to assure that NPs who bill under their own names (approximately 14% of The National Association of Pediatric Nurse Associates and Practitioners members1) are in compliance with state scope-of-practice laws and laws requiring that they work in collaboration with a physician. The Social Security Act defines collaboration as receiving medical direction and appropriate supervision. Apparently HCFA has been paying NPs who are not complying with these legal requirements.

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