Mississippi Administrative Code › Title 2 - Agriculture and Commerce › Part 601 - Organization of the Forestry Commission › Chapter 1 - Board of Commissioners › Rule 2-601-1.3 - Requirements for Collaborating Physicians

Current through June 25, 2024
Primary and secondary collaborating physicians must:
A. hold a current unrestricted license in the
				state of Mississippi and actively provide direct patient care at least eight
				(8) hours weekly;
B. notify the
				Board within seven (7) working days of entering into or termination of any
				collaborative agreement;
C. insure
				that the primary collaborative physician(s) name(s) is/are displayed for public
				view at the APRN's practice site; and
D. enter into a collaborative agreement with
				the APRN, which is written, signed and dated by both the APRN and physician,
				and which must:
1. remain in the practice
				site of the collaborating physician should there be a site visit by the
				Board;
2. define the scope of
				practice, including mutually agreed upon collaborative agreements and
				guidelines for the healthcare provided;
3. agree upon medication formulary to be used
				by APRN and physician in practice. The collaborative physician has the right to
				use the Mississippi Prescription Monitoring Program to review the APRN's
				controlled substance prescribing practices;
4. describe the individual and shared
				responsibilities of the APRN and physician;
5. be reviewed and updated annually by the
				physician and the APRN; and
6. set
				out a procedure for handling patient emergencies, unexpected outcomes or other
				urgent practice situations.
A physician shall not enter into a collaborative agreement
				  with an APRN whose training and practice is not compatible with that of the
				  physician (it is recognized and accepted practice that surgeons, obstetricians
				  and dentists have collaborative arrangements with CRNAs). It is recognized that
				  CRNAs commonly work in the anesthesia care team model where one
				  anesthesiologist may be collaborating with up to four CRNAs concurrently. In
				  the model, a group of anesthesiologists may collaborate with a group of CRNAs.
				  In this instance, it is acceptable to list multiple collaborators on the CRNA's
				  protocol. If the usual practice is for one anesthesiologist to collaborate with
				  more than four CRNAs concurrently, then a waiver must be requested and approved
				  by the Board. Any other arrangement must adhere to the standard rules of
				  collaboration that exists for an APRN. Unless otherwise waved, this rule
				  applies to hospital settings and surgical suites only. This same model shall
				  also apply to emergency medicine group practices.
The collaborative agreement shall not include medications the
				  physician does not use in his or her current practice and about which the
				  physician is not knowledgeable and competent.
Before entering into a collaborative agreement, a physician
				  should consider the following when determining the degree of autonomy the
				  agreement provides:
A. the physician's
				personal knowledge and ability to provide the time to the collaborative
				agreement;
B. the type of
				practice;
C. the scope of practice
				of the APRN;
D. the educational
				training and experience of the APRN;
E. the geographic location of the physician's
				practice and the practice of the APRN and their ability to consult in a manner
				that assures patient safety; and
F.
				the technology available to the physician and APRN to allow effective
				communication and consultation.
Physicians are prohibited from entering into a collaborative
				  agreement with an APRN whose practice location is greater than forty (40) miles
				  from the physician's practice site, unless a waiver is expressly granted by the
				  Board for that particular collaborative agreement. However, a collaborative
				  physician (primary or secondary) must be within 40 miles from the actively
				  practicing APRN. Collaborative agreements which have previously been granted as
				  waivers at the time of adoption of these rules will continue to be exempt from
				  this requirement.
Anytime a collaborating physician is working with an APRN who
				  is working in and/or staffing an emergency room the collaborative physician
				  (primary or secondary) must be physically present in the building or no more
				  than ten (10) minutes from the facility. An exception to this policy would be
				  Board approved telemanagement arrangements.
Anytime a collaborating physician is working with an APRN who
				  is working in and/or providing care in an acute care facility, there must be
				  evidence reflected in the patient's chart that a collaborative physician has
				  seen and examined the patient within twelve (12) hours of the APRN initially
				  seeing the patient on admission.
Physicians are prohibited from entering into primary
				  collaborative agreements with more than four (4) APRN's at any one time unless
				  a waiver is expressly granted by the Board for that particular collaborative
				  agreement. However, a physician may be in collaboration as the secondary
				  physician on four (4) additional collaborative agreements and no QA, as defined
				  under Rule 1.4, will be required for these additional APRNs. A secondary
				  physician status may be given to a physician who is collaborating with up to
				  two (2) APRNs who are working less than 20 hours per week at another clinic not
				  in the same practice as the APRN's primary place of work. A QA review will be
				  required quarterly.
The Board will consider the factors listed above, as well as
				  any other factors that the Board deems relevant, in determining whether to
				  grant a waiver. Such waivers may be granted to medical practices with multiple
				  physicians including, but not limited to, the following settings:
A. emergency rooms;
B. intensive care units;
C. labor epidural services on obstetrical
				suites
D. State Department of
				Health;
E. State Department of
				Mental Health; and
F. federally
				funded health systems (e.g. FQHCs, VAMCs);
G. community mental health centers.
Physicians shall complete a questionnaire pertaining to APRNs
				  upon initial licensure and during each annual renewal process.